Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: history of present illness: the patient is a 63-year-old female with a past medical history of chronic obstructive pulmonary disease (status post medical intensive care unit admission and intubation - discharged on ) who was readmitted to the medical intensive care unit on with hypercarbic respiratory failure. the patient called emergency medical service on the day of admission secondary to complaints of shortness of breath and decreased mental status. she was subsequent intubated in the field. on arrival in the emergency department, the patient was bradycardic and progressed to pulseless electrical activity. she received atropine, epinephrine, and transcutaneous pacing. she subsequently resumed a pulsed and became tachycardic to the 190s. the patient received a cardioversion with a subsequent heart rate of 110 to 120; although, she was not noted to be hypotensive while tachycardic. an echocardiogram was performed at the bedside and revealed no effusions or evidence of right heart strain. the patient was started on levofloxacin on secondary to yellow sputum as well as concern for aspiration pneumonia in the setting of her field intubation. the patient was extubated on . of note, the patient was recently discharged after intubation and medical intensive care unit course on . she was sent home on a slow prednisone taper; however, she continued to actively smoke at home. upon questioning, the patient was unsure of prior prednisone taper dose or if she was even taking the steroids that were prescribed. at the time of transfer to the floor the patient reported her breathing was better than baseline and denied any fevers, chills, chest pain, nausea, vomiting, abdominal pain, or a change in bowel or bladder habits, diarrhea, or constipation. past medical history: 1. chronic obstructive pulmonary disease; fev1 equals 0.46 (26% of predicted), fvc equals 1.28, fev1:fvc ratio equals 49%. the patient is on 2 liters nasal cannula at home. 2. diastolic congestive heart failure (with left ventricular ejection fraction of greater than 55% and no wall motion abnormalities) 3. hypertension. 4. ethanol; history of withdrawal. 5. right pneumothorax in (status post bleb resection and pleurodesis). 6. status post total hip replacement bilaterally. 7. positive tobacco history. allergies: no known drug allergies. medications on admission: (home medications included) 1. prednisone taper. 2. thiamine. 3. folate. 4. multivitamin. 5. diltiazem 120 mg by mouth three times per day. the patient is unsure which inhaler she is currently using. physical examination on transfer: temperature current was 97.8 degrees fahrenheit, temperature maximum was 98.4 degrees fahrenheit, her heart rate was 97, her blood pressure was 131/52, her respiratory rate was 18, and her oxygen saturation was 94% on 2 liters nasal cannula. in general, the patient was cantankerous, comfortable, and in no acute distress. head, eyes, ears, nose, and throat examination revealed the oropharynx was clear. the mucous membranes were dry. neck revealed the patient with internal jugular triple lumen in place. cardiovascular examination revealed a respiratory rate. no murmurs. lungs had decreased breath sounds throughout. there was a prolonged expiratory phase. no wheezes. the abdominal examination revealed there were positive bowel sounds. the abdomen was soft, nontender, and nondistended. extremity examination revealed no edema. neurologic examination revealed the patient was alert and oriented times three. pertinent laboratory values on transfer: white blood cell count was 6.1, her hematocrit was 31.3, and her platelets were 169. chemistry-7 revealed her sodium was 140, potassium was 3.6, chloride was 95, bicarbonate was 37, blood urea nitrogen was 38, creatinine was 1.2, and her blood glucose was 125. arterial blood gas was 216/7.2/42/59/58. arterial blood gas on admission was 7.26/75/455 (on ac 550/12/5/0.9). urine culture on revealed no growth. blood culture on revealed coagulase-negative staphylococcus. sputum culture on revealed gram stain with 1+ oropharyngeal flora. culture revealed sparse oropharyngeal flora. pertinent radiology/imaging: a chest x-ray on revealed massive collapse and consolidation of left lower lobe. a healing fracture of right sixth and seventh ribs posteriorly. lower extremity doppler studies on revealed no evidence of deep venous thrombosis. concise summary of hospital course by issue/system: the patient is a 63-year-old female with severe chronic obstructive pulmonary disease including multiple recent intubations admitted with yet another chronic obstructive pulmonary disease exacerbation/hypercarbic respiratory failure in the setting of noncompliance with prior steroid taper regimen and continued tobacco use. 1. chronic obstructive pulmonary disease issues: the patient was extubated on . currently feeling better than her baseline at home. she remained on albuterol and atrovent inhalers. the patient needs a slow prednisone taper over several weeks. goal peripheral oxygen saturations of 90% to 92% (she is on 2 liters nasal cannula at home at baseline). continue nicotine patch and smoking cessation. 2. right lower lobe collapse versus consolidation issues: the patient is on a course of levofloxacin for seven days. continue on incentive spirometry and pulmonary toilet. 3. chest pain issues: the patient was complaining of reproducible chest pain. she had negative cardiac enzymes, and no electrocardiogram changes. the patient was noted to have rib fractures on her chest x-ray. her pain was responsive to nonsteroidal antiinflammatory drugs. 4. gastrointestinal issues: report of heme-positive emesis on admission. the patient's hematocrit was stable throughout her stay. question trauma related to intubation as the etiology of heme-positive emesis. the patient had no further episodes of emesis throughout her stay. the patient is currently on a proton pump inhibitor every day dosing. 5. hypertension issues: the patient's blood pressure was well controlled on her diltiazem. 6. history of ethanol withdrawal issues: the patient remained without signs or symptoms of withdrawal throughout her stay and did not require any benzodiazepine use. 7. code status issues: the patient remained a full code. condition at discharge: the patient was in stable condition; ambulating with physical therapy, saturating greater than or equal to 92% on 2 liters nasal cannula. discharge disposition: the patient was to be discharged to an acute renal failure. discharge diagnoses: 1. chronic obstructive pulmonary disease exacerbation. 2. diastolic congestive heart failure. 3. hypertension. 4. tobacco abuse. 5. pneumonia. medications on discharge: 1. multivitamin one tablet by mouth every day. 2. thiamine 100 mg by mouth once per day. 3. folic acid 1 mg by mouth once per day. 4. albuterol/ipratropium inhaler 6 puffs inhaled q.6h. 5. heparin 5000 units subcutaneously q.8h. 6. albuterol 4 puffs inhaled q.2h. as needed. 7. tylenol by mouth as needed. 8. nicotine 14-mg/24 hour patch one patch once per day. 9. pantoprazole 40 mg by mouth once per day. 10. aspirin 81 mg by mouth once per day. 11. diltiazem 120 mg by mouth three times per day. 12. levofloxacin 500 mg by mouth once per day (for three days; to be completed on ). 13. prednisone 40 mg by mouth once per day for seven days and then 20 mg by mouth once per day for seven days and then 10 mg by mouth once per day for seven days. 14. ibuprofen 400 mg by mouth q.6h. as needed. discharge instructions/followup: the patient was instructed to contact her primary care physician (dr. to schedule appropriate followup. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: tobacco use disorder congestive heart failure, unspecified unspecified essential hypertension obstructive chronic bronchitis with (acute) exacerbation acute respiratory failure pneumonitis due to inhalation of food or vomitus personal history of noncompliance with medical treatment, presenting hazards to health chronic diastolic heart failure closed fracture of multiple ribs, unspecified 

Answer: The patient is high likely exposed to