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: allergies: influenza virus vaccine attending: chief complaint: hypoxia/hypercarbia major surgical or invasive procedure: intubation history of present illness: 55 y/o m with dm, significant smoking history, etoh abuse,htn who was initially transferred from an osh to on s/p intubation for respiratory failure. prior to his initial admission, pt had been having viral uri symptoms. he reported that the day prior to admission to the osh, he had been in a mva. despite the fact that some of his medical records mention possbily passing out at the wheel, on our careful history he clearly denies this and states that he remembers the entire accident, suffered no loc, and was in fact directing traffic following the accident. the next day as he was getting ready for work, he found himself very sleepy to the point that he was drifting off to sleep sitting in his room. he went to his pcp, was hypoxic there and admitted to osh where he was found to be cyanotic, hypercarbic (abg on arrival 7.28/85/59), hypoxic, and was initially placed on bipap but later had to be intubated. of note, intubation was very difficult and was only successful after 4th attempt. pt was transferred to micu for further management. past medical history: 1) htn 2) dm 3) hyperchol 4) previously intubated several ago in icu for unclear reasons and per girlfriend, was difficult intubation social history: lives alone, has been dating girlfriend for 16 , no children. retired from army. quit smoking 6 ago, previously 3ppdx 25 . drinks 4-5 drinks each sat night but none during week, but used to be heavy drinker. no ivda. family history: father died of mi in 60s, mother died of cancer of unknown type. physical exam: vs: 98.3---bp=104/60---hr=78----rr=16----o2=90-93% 5lnc gen: disheveled, in nad heent: ncat. perrl. eomi. anicteric. op clear with mmm. neck: no jvd, lad. lungs: cta b/l with decr bs at bases b/l cv: rrr, nml s1s2, no mrg abd: mod obese, soft, nt, nd, nabs ext: no edema, no cyanosis, no clubbing. dp pulses 2+ b/l. left radial a-line. neuro: no tremor. a&ox3 pertinent results: 05:10am blood wbc-5.3 rbc-4.21* hgb-13.5* hct-41.6 mcv-99* mch-32.0 mchc-32.4 rdw-13.3 plt ct-267 05:05am blood wbc-5.5 rbc-4.35* hgb-14.2 hct-43.5 mcv-100* mch-32.7* mchc-32.7 rdw-13.3 plt ct-292 04:30am blood wbc-6.8 rbc-4.38* hgb-14.4 hct-43.9 mcv-100* mch-32.8* mchc-32.7 rdw-14.8 plt ct-192 07:20pm blood wbc-7.1 rbc-4.69 hgb-15.5 hct-48.7 mcv-104* mch-33.0* mchc-31.8 rdw-14.6 plt ct-198 02:40am blood neuts-67.3 lymphs-19.2 monos-9.3 eos-3.9 baso-0.2 07:25am blood neuts-70.5* lymphs-17.8* monos-7.6 eos-3.2 baso-0.8 07:20pm blood neuts-80.6* lymphs-13.0* monos-5.7 eos-0.6 baso-0.1 05:10am blood plt ct-267 05:05am blood plt ct-292 04:30am blood pt-12.4 ptt-21.9* inr(pt)-1.1 04:30am blood plt ct-192 07:20pm blood plt ct-198 05:10am blood glucose-107* urean-11 creat-0.6 na-139 k-3.8 cl-97 hco3-33* angap-13 05:05am blood glucose-106* urean-15 creat-0.6 na-141 k-3.8 cl-97 hco3-33* angap-15 02:33am blood glucose-87 urean-17 creat-0.6 na-140 k-3.7 cl-95* hco3-34* angap-15 04:30am blood glucose-93 urean-16 creat-0.7 na-139 k-3.6 cl-100 hco3-27 angap-16 07:20pm blood glucose-170* urean-17 creat-0.8 na-137 k-5.2* cl-97 hco3-33* angap-12 04:15am blood alt-33 ast-22 alkphos-56 totbili-0.4 03:40am blood alt-61* ast-37 alkphos-57 totbili-0.3 01:00pm blood alt-13 ast-15 ld(ldh)-198 alkphos-46 amylase-30 totbili-0.9 07:20pm blood alt-17 ast-21 ck(cpk)-127 alkphos-50 amylase-38 totbili-0.9 03:19am blood lipase-10 07:20pm blood lipase-27 04:37am blood ck-mb-2 ctropnt-<0.01 01:00pm blood probnp-295* 07:20pm blood ck-mb-3 ctropnt-<0.01 05:10am blood calcium-9.2 phos-4.5 mg-2.0 05:05am blood calcium-9.0 phos-4.0 mg-2.0 04:37am blood calcium-8.2* phos-5.1*# mg-2.4 01:00pm blood albumin-3.1* calcium-8.5 phos-1.8* mg-1.6 02:59pm blood %hba1c-7.4* -done -done 02:40am blood tsh-1.6 04:37am blood free t4-1.3 02:40am blood asa-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 06:13am blood type-art po2-74* pco2-59* ph-7.37 calhco3-35* base xs-6 12:10am blood po2-150* pco2-39 ph-7.49* calhco3-31* base xs-6 06:13am blood lactate-0.9 05:02am blood freeca-1.28 cta chest w&w/o c &recons 7:53 pm cta chest w&w/o c &recons; ct 150cc nonionic contrast reason: assess for pe, nature of lung mass field of view: 40 contrast: medical condition: 55 year old man with ? lung mass, resp failure reason for this examination: assess for pe, nature of lung mass contraindications for iv contrast: none. indication: 55-year-old man with respiratory failure, question lung mass. technique: mdct was used to obtain contiguous axial images from the lung bases to the thoracic inlet before and after administration of iv contrast. multiplanar reformats were also obtained. no prior studies are available for comparison. ct chest before and after iv contrast: there is atelectasis of both lower lobes. small amount of air is seen in a vessel in the anterior aspect of the lower neck, probably iatrogenic. a single enlarged hilar lymph node is seen on the left measuring 14 x 19 mm. other smaller lymph nodes are also identified in the mediastinum and hila, however, none of them are pathologically enlarged. there is an ng tube coursing below the diaphragm; the patient is intubated into the right mainstem bronchus. the superior most aspect of the abdomen is remarkable for free fluid seen around the spleen and a smaller amount around the superior most aspect of the liver. ct angiography of the chest: there is no pericardial effusion. no pulmonary embolism is identified. the aorta is normal in caliber, without evidence of dissection. bone windows show no suspicious sclerotic or lytic lesions. impression: 1. right mainstem bronchus intubation. this was discussed with dr. at 10:15 pm, . 2. bilateral lower lobe atelectasis/consolidation. bilateral small pleural effusions, right greater than left. 3. no evidence of pulmonary embolism or definite pulmonary mass. 4. intraabdominal free fluid. echo study date of measurements: left ventricle - ejection fraction: 70% (nl >=55%) tr gradient (+ ra = pasp): 21 mm hg (nl <= 25 mm hg) interpretation: findings: right atrium/interatrial septum: no asd or pfo by 2d, color doppler or saline contrast with maneuvers. left ventricle: normal lv wall thickness, cavity size, and systolic function (lvef>55%). general comments: contrast study was performed with 3 iv injections of 8 ccs of agitated normal saline, at rest, with cough and post-valsalva maneuver. conclusions: no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). spinal fluid analysis wbc, csf 1 #/ul clear and colorless performed at west stat lab rbc, csf 1* #/ul 0 - 0 performed at west stat lab polys 5 % 43 cell differential performed at west stat lab lymphs 42 % monocytes 53 % total protein, csf 46* mg/dl 15 - 45 performed at west stat lab glucose, csf 94 mg/dl performed at west time taken not noted log-in date/time: 1:03 pm sputum source: endotracheal. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. no microorganisms seen. respiratory culture (final ): no growth. legionella culture (final ): no legionella isolated. rapid plasma reagin test (final ): nonreactive. reference range: non-reactive. direct influenza a antigen test (final ): negative for influenza a viral antigen. direct influenza b antigen test (final ): negative for influenza b viral antigen. brief hospital course: 55 y/o man transferred to this hospital for hypercarbic/hypoxic respiratory failure. he was initially started on broad spectrum antibiotics for presumed community acquired pneumonia. cta demonstrated no pulmonary embolus and showed small bilateral pleural effusions with bibasilar atelectasis vs. consolidation. he was empirically tx with antibitoics. however he remained afebrile without leukocytosis. he was diuresed due to concern for possible heart failure; however, bedside transthoracic echo showed a preserved lv systolic function. repeat echo was performed with bubble study and this showed no evidence of shunt. serial abg confirmed that he was a co2 retainer with co2's ranging from 50's-80's. he reported no history of sleep apnea and stated his girlfriend has never noted symptoms either. he does have a hx of smoking but this does not appear to explain the degree of co2 retention. he was also noted to be delerious after weaned off benzos quickly. controlled with prn ativan. there was also a question of delirium associated with hypercarbia, however there was no clear trend between his co2 levels and his mental status. his episodes of confusion and agitation improved off benzo's and his co2 was better controlled on nightly bipap settings at 12/6. given his persistent hypoxia and hypercarbia, a pulmonary consult was obtained. he received pfts including dlco, also requested inspiratory force measurements. these results will be followed up in pulmonary clinic. he feels well on l nc and is able to ambulate without desatting. he is to continue on nightly bipap. medications on admission: on transfer 1) hiss 2) lasix 20 mg iv this am 3) simvastatin 10 mg qhs 4) protonix 40 mg po daily 5) metoprolol 37.5 po tid 6) ceftriaxone 1 gm iv, last dose today 7) valsartan 80 mg daily 8) albuterol 4 puffs ih q6h 9) hep sc tid 10) atrovent nebs ih q6h 11) valium 10 mg po prn ciwa discharge medications: 1. albuterol 90 mcg/actuation aerosol sig: two (2) puff inhalation every 4-6 hours. disp:*1 mdi* refills:*2* 2. atrovent 18 mcg/actuation aerosol sig: two (2) puffs inhalation every 4-6 hours. disp:*1 mdi* refills:*2* 3. valsartan 80 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 4. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). disp:*qs for 1 month cap(s)* refills:*2* 5. beclomethasone diprop monohyd 0.042 % aerosol, spray sig: one (1) spray nasal (2 times a day). disp:*qs for 1 month * refills:*2* 6. aspirin 81 mg tablet sig: one (1) tablet po once a day. 7. metformin 500 mg tablet sig: one (1) tablet po twice a day. 8. avandia 4 mg tablet sig: one (1) tablet po once a day. 9. atenolol 25 mg tablet sig: one (1) tablet po once a day. 10. simvastatin 10 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: , discharge diagnosis: primary: hypercarbic/hypoxic respirtory failure secondary: hypertension diabetes hypercholesterolemia discharge condition: stable discharge instructions: you have been diagnosed with hypoventilation, you will need close follow up with pulmonology, they will call you for an appointment next week. you also have a sleep study scheduled. be sure to follow up as directed. home oxygen and bipap have been arranged for you, continue to use this until directed otherwise by your doctor. return to the emergency department or call your doctor if you have shortness of breath, chest pain, episodes of fainting, high fevers or any other concerns. followup instructions: you have a sleep study scheduled for monday night the , come at 9:30 pm, you will be released in the morning, call with any questions or concerns follow up with pulmonology next week, the pulmonology clinic is arranging your appointment you will be called regarding an appointment next week. call with any questions or concerns. md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung enteral infusion of concentrated nutritional substances non-invasive mechanical ventilation arterial catheterization diagnoses: obstructive sleep apnea (adult)(pediatric) pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute respiratory failure obesity, unspecified diastolic heart failure, unspecified disorders of diaphragm other alteration of consciousness 

Answer: The patient is high likely exposed to