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: patient recorded as having no known allergies to drugs attending: chief complaint: dyspnea major surgical or invasive procedure: intubation l subclavian central line swan-ganz catheter history of present illness: this is a 47 year old man with a history of htn, dm, possible nstemi but negative cardiac cath in , who presents with 2 days of increasing dyspnea. he felt well until about 2 days ago when he noticed he was feeling more short of breath, particularly when walking around his house. that night he was unable to lie down to sleep, and was awake the whole night. he normally sleeps on 1 pillow. he also noticed that his feet were more swollen than usual. he has never had symptoms like this before at any time. he does not know any of his medications, but he says he has been taking them with the exception of labetalol (which he missed "a few days" and lasix missed "1 day" - he did not take any meds this morning at all). he has been taking his insulin. . he otherwise denies f/c/ns, cough, cp, abd pain, n/v/diarrhea, constipation, dysuria. . in the ed, vs were 99.7, 115, 213/119, 16, 96% (not clear on how much o2). eventually, he was recorded as satting mid-90s on 5l nc. he was briefly tried on bipap, but did not tolerate it. he apparently did not need it, and was put back on nc o2. he was given aspirin and started on a nitro gtt. he was given lasix 80mg iv to which he put out 1200cc urine. since his bp was not yet adequately controlled, he was also given hydralazine 20mg iv. sbp ranged 150-200 in the ed. past medical history: # htn # insulin dependent dm - has had multiple admissions for dka in setting etoh use - last hgba1c 7.6 () - has peripheral neuropathy, retinopathy # cri - thought to be due to diabetic and hypertensive nephropathy # sarcoid - ct = hilar/subcarinal , nodules in parenchyma - = l eye proptosis -> ct showed l maxillary mass -> bx showed non caseating granulomas c/w sarcoid - decision was made not to begin systemic tx since pt asx # h/o chronic ruq pain - present for over 13 yrs (by records), evaluated with at least 12 abdominal/ruq ultrasounds and multiple abdominal ct's without evidence of suspicious pathology # polysubstance abuse - pt drinks regularly 2-3drinks daily; occasionally uses cocaine (last use many weeks ago) # h/o nstemi: possible nstemi during admission in , but cath later showed clean coronaries social history: lives w/ a friend, no children. used to work part time as a tire-changer, but currently out of work. denies tobacco use. denies recent etoh or cocaine use (per report daily etoh use in past, last use 6 months ago). family history: mother had diabetes, niece has diabetes. denies fh of coronary artery disease, hypertension, cancer, liver disease, or renal disease. physical exam: vs: 98.9, 117, 185/97, 23, 98% on 2l nc gen: appears comfortable, lying in bed at ~30 degree angle, no accessory muscle use. heent: l eye with conjunctival injection, r pupil reactive (unable to assess l pupil as pt not able to keep eye open long enough), mmm, op clear neck: jvp 9-10cm lungs: slight bibasilar crackles, otherwise clear heart: rrr, no m/r/g abd: +bs, soft, nt/nd extrem: 2+ edema b/l to knees pertinent results: admission labs 08:18pm ck(cpk)-147 08:18pm ck-mb-5 ctropnt-0.15* 11:21am urine color-yellow appear-clear sp -1.016 11:21am urine blood-sm nitrite-neg protein-neg glucose-1000 ketone-neg bilirubin-neg urobilngn-neg ph-6.0 leuk-neg 11:21am urine rbc-0-2 wbc-0-2 bacteria-rare yeast-none epi-0 10:55am glucose-175* urea n-33* creat-2.8* sodium-140 potassium-4.0 chloride-109* total co2-22 anion gap-13 10:55am estgfr-using this 10:55am ck(cpk)-232* 10:55am ck-mb-8 ctropnt-0.16* probnp-9158* 10:55am wbc-5.7 rbc-2.98* hgb-8.7* hct-27.7* mcv-93 mch-29.3 mchc-31.5 rdw-16.8* 10:55am neuts-63.2 lymphs-27.2 monos-6.3 eos-2.1 basos-1.1 10:55am hypochrom-1+ anisocyt-1+ macrocyt-1+ 10:55am plt count-288 10:55am pt-11.4 ptt-26.2 inr(pt)-1.0 . cxr: 1. new perihilar haziness likely due to pulmonary edema given clinical suspicion for chf. differential diagnosis includes viral and pcp pneumonia as well as lung disease due to sarcoid. 2. longstanding symmetrical bilateral hilar and mediastinal lymphadenopathy highly suggestive of sarcoidosis. . tte: the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. the estimated right atrial pressure is 11-15mmhg. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild to moderate regional left ventricular systolic dysfunction with focal hypokinesis of the basal inferior wall and entire inferolateral wall. there is normal systolic function of the remaining segments. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is a small (0.5cm) pericardial effusion. compared with the prior study (images reviewed) of , the findings are similar. . ct chest: 1. large bilateral consolidative changes within the posterior lungs. aspiration and/or pneumonia are considered. 2. large bilateral pleural effusions. 3. at least small amount of ascites, partially imaged. 4. mediastinal lymphadenopathy. 5. multiple lung nodules. 6. multiple tubes and lines as described. . ct head: profound diffuse cerebral edema, with near complete effacement of the fourth ventricle, supracellar and basal cisterns, indicative of downward transtentorial herniation. . tte: the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. no masses or thrombi are seen in the left ventricle. overall left ventricular systolic function is low normal (lvef 50%) secondary to hypokinesis of the inferior and posterior walls. there is no ventricular septal defect. the right ventricular cavity is dilated. right ventricular systolic function is borderline normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the findings of the prior study (images reviewed) of , no major change is evident. . eeg: this eeg demonstrated a severe diffuse encephalopathy with no clear cerebral electrical activity. no clear ekg, pulse, and movement artifacts were noted throughout the recording as described above. brief hospital course: this is a 47 year old man with dm, htn, sarcoid, ckd, clean coronaries on cath in , who p/w dyspnea consistent with chf exacerbation. . he initially responded well to lasix and improved rapidly from his apparent chf exacerbation. this chf exacerbation had occurred in the setting of severe hypertension, which was initially controlled with ntg gtt. he was given his usual po medications and ntg gtt was titrated off. bp was decreased from 210/110 -> 160s/70s over the course of the night. patient was comfortable on minimal o2 by morning. tte showed ef 40-50%, no significant change from prior. bnp was elevated at 9000. ekg was unchanged from baseline, and the patient ruled out for mi. . ophthalmology was consulted due to concern for acute angle glaucoma. they recommended continued treatment with eye drops. the patient's symptoms were beginning to improve. . overnight on patient had a witnessed aspiration event, resulting on hypoxia, tachypnea, and ultimately patient tired and required intubation. it is unclear what precipitated this aspiration event. antibiotics were initially held due to no fever or wbc, likelihood of aspiration pneumonitis rather than pneumonia. following intubation, chest ct on revealed large bilateral pneumonias. . on the morning of , the patient was noted to be less responsive. he suddenly became profoundly hypotensive and ultimately had a pea arrest. he received epinephrine and atropine (as well as bicarb, cacl, etc) and regained a pulse. after the arrest he was initially dependent on 4 pressors, some of which were gradually weaned off over hours. repeat tte was initially read as unchanged, but was later noted to have rv dilatation. there was concern for rv infarction vs. pe. a swan-ganz catheter was floated which showed elevated pa pressures 59/30s and wedge 30. when the patient was stable enough, he went for a head ct which showed profound diffuse cerebral edema, with near complete effacement of the fourth ventricle, supracellar and basal cisterns, indicative of transtentorial herniation. the family (specifically sister and other family members) were updated on the patient's grave prognosis and possibility of brain death. code status was changed to dnr/dni. neurology was consulted and patient felt to have no chance of meaningful neurologic recovery, clinical evidence of brain death. eeg showed severe encephalopathy. at this point it came to light that the patient's estranged wife (separated x14 years) had legal medical decision making rights. no further aggressive treatment was indicated at this time. . ultimately, the patient had another pea arrest in the early morning of and expired. his family (including wife and sister and his pcp were notified. the wife consented to post-mortem examination. medications on admission: (per last d/c summary - patient does not know meds): -aspirin 325 mg daily -atorvastatin 80 mg daily -nifedipine 90 mg daily -labetalol 600 mg po tid -tobramycin-dexamethasone 0.3-0.1 % drops os qid -latanoprost 0.005 % drops ou hs -pantoprazole 40 mg q12h ??qd -scopolamine hbr 0.25 % drops os -dorzolamide-timolol 2-0.5 % drops os -apraclonidine 0.5 % drops os tid ?? -furosemide 40 mg po daily ?? -insulin lisp & lisp prot (75-25) 25 units qam and 25 units qpm (patient was last d/c'd on 30u , but has been taking only 25 ) discharge medications: n/a discharge disposition: expired discharge diagnosis: chf exacerbation respiratory failure, secondary to aspiration pneumonia profound hypotension, leading to pea arrest cerebral edema and transtentorial herniation, leading to cardiac arrest and death discharge condition: expired discharge instructions: n/a followup instructions: n/a procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube venous catheterization for renal dialysis diagnoses: congestive heart failure, unspecified acute kidney failure, unspecified compression of brain acute respiratory failure pneumonitis due to inhalation of food or vomitus cardiac arrest anoxic brain damage diabetes mellitus without mention of complication, type i [juvenile type], not stated as uncontrolled malignant hypertensive heart disease with heart failure 

Answer: The patient is high likely exposed to