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: erythromycin base / doxycycline / betadine / iodine / percocet / sulfa (sulfonamides) attending: chief complaint: epistaxis/hemoptysis major surgical or invasive procedure: bronchoscopy x 2 pulmonary angiography x 2 history of present illness: 48 yo male with a distant smoking history on plavix for stents presenting with hemoptysis for two days. the patient stated that he first had symptoms two nights prior to admission when he woke from his sleep coughing blood. he went back to sleep without trouble. he had another episode of hemoptysis (walnut sized) in the shower. he went to his doctor that afternoon and noted that he had a blood clot sitting on his soft palate. the bleeding became worse on the night prior to admission. at that time, he was continuously coughing blood and drove himself to the emergency room. . in the emergency room, the patient presented with vitals of t: 98.8, hr: 107, bp: 159/84, rr: 16, o2 sat: 94%. an ng lavage revealed no blood in the stomach. there was concern for intrathoracic process such as a pulmonary embolism, though d dimer was normal. he had a chest ct which showed ground glass opacities. he was admitted to the floor for further evaluation of his hemoptysis. . the patient said that he has had blood-tinged sputum in the past related to the change of weather and dry air, but never to this extent. . no chest pain, shortness of breath, lightheadedness, dizziness, nausea, diarrhea. . +recent weight loss due to gastric banding procedure past medical history: coronoary artery disease (s/p 3 vessel cabg2006)&2 drug eluting stents hypertension hyperlipidemia hypothyroid fatty liver migraine headaches proteinuria psoriasis colitis (diagnosed as teen, asymptomatic) endoscopic lap band () umbilical hernia repair () cholecystectomy social history: smoked intermittently for 20 years (1 pack lasted 3 days), but quit smoking . +cocaine/marijuana in past last use in the 80s. +social etoh. family history: grandfather with acute myocardial infarction at 42, mother with cerebrovascular accident at 68 and atrial fibrillation. father had copd. physical exam: vitals (ed): t: 98.8, bp: 159/84, hr: 107, rr: 16, o2 sat: 94% ra vitals (on floor): t: 98.6, bp: 105/56, hr: 60, rr: 16, o2 sat: 96%ra general - vibrant male in nad. resting comfortably in bed. not actively bleeding or coughing blood heent - sclera anicteric, mmm, oropharynx clear. eomi. dried blood in mucosa. neck - supple, jvp not elevated, no lad pulm - cta bilaterally; no wheezes, rales, or rhonchi cv - rrr, normal s1/s2; no murmurs, rubs, or gallops abdomen - normoactive bowel sounds; soft, non-tender, non-distended. can feel gastric band in epigastrium ext - warm, well perfused, radial and dp pulses 2+; no clubbing, cyanosis or edema pertinent results: 11:10am blood wbc-7.2 rbc-5.08 hgb-13.2* hct-41.1 mcv-81* mch-26.1* mchc-32.2 rdw-13.7 plt ct-155 11:10pm blood neuts-55.2 lymphs-34.8 monos-4.1 eos-4.9* baso-1.1 11:10pm blood pt-12.6 ptt-22.7 inr(pt)-1.1 11:10pm blood glucose-119* urean-15 creat-0.8 na-146* k-3.6 cl-108 hco3-31 angap-11 11:10am blood d-dimer-349 06:05am blood wbc-4.7 rbc-3.90* hgb-10.3* hct-29.6* mcv-76* mch-26.4* mchc-34.8 rdw-13.9 plt ct-156 12:30pm blood hct-32.5* 05:55am blood wbc-5.1 rbc-4.03* hgb-10.5* hct-31.0* mcv-77* mch-26.0* mchc-33.7 rdw-13.9 plt ct-146* 03:44am blood glucose-59* urean-9 creat-0.6 na-143 k-3.4 cl-109* hco3-22 angap-15 11:10am blood d-dimer-349 01:39pm blood -negative 02:35pm blood hiv ab-negative anti-gbm- negative radiology report cta chest w&w/o c&recons, non-coronary study date of 4:36 am impression: 1. no evidence of pulmonary embolism. 2. multifocal areas of ground-glass opacities, particularly in the right lung, which are nonspecific, but likely reflect a multifocal pneumonia. 3. bronchial wall thickening with occlusion of several airway segments to the right upper and middle lobes, particularly in the right middle lobe, likely from mucus or with history of hemoptysis, blood. radiology report sel cath 1st order study date of 1:28 pm impression: 1. normal thoracic aortogram. 2. aortogram of a solitary intercostal bronchial trunk on the right side demonstrating no evidence for extravasation or abnormal blush. of note, this vessel did have supply to the mediastinum and other midline structures. no intervention performed. 3. normal right bronchial arteriogram demonstrating supply to the right lower lobe. radiology report 3ed order /brachiocephalic study date of 2:17 am impression: selective right internal mammary, right subclavian and two right bronchial arteriograms were obtained. no evidence of extravasation, blush, or aneurysms could be noticed. all bronchial arteries and branches presented with very small caliber. no embolization was attempted via the right bronchial intercostal trunk due to supply of midline arteries, likely directed towards the spine. bronchoscopy impression: hemoptysis which was related on a previous procedure to the posterior segment of the right upper lobe, status post 2 angiograms by interventional radiology with no embolization performed and status post repeat flexible bronchoscopy today with a large blood clot in the right upper lobe bronchus. plan: we will continue to monitor the patient for the time being while off plavix and continue to follow along with thoracic surgery for the possible need of right upper lobe lobectomy if the bleeding recurs. pulmonary report spirometry, lung volumes, dlco study date of 3:05 pm spirometry 3:05 pm pre drug post drug actual pred %pred actual %pred %chg fvc 5.56 4.11 135 fev1 3.77 3.13 120 mmf 2.54 3.38 75 fev1/fvc 68 76 89 lung volumes 3:05 pm pre drug post drug actual pred %pred actual %pred tlc 7.73 5.90 131 frc 3.47 3.23 107 rv 2.12 1.79 118 vc 5.74 4.11 140 ic 4.27 2.67 160 erv 1.35 1.44 94 rv/tlc 27 30 90 he mix time 1.75 dlco 3:05 pm actual pred %pred dsb 27.86 27.55 101 va(sb) 7.53 5.90 128 hb 10.30 dsb(hb) 32.65 27.55 118 dl/va 4.33 4.67 93 brief hospital course: #hemoptysis: the patient presented with hemoptysis and had an episode of epistaxis while in the er. a ct of the chest revealed non-specific multi-focal ground glass opacities, particularly in the right lung, and bronchial wall thickening with occlusion of several airway segments to the right upper and middle lobes. the patient was observed in the icu because of the large volume hemoptysis. he underwent a bronchoscopy by interventional pulmonology, but they were unable to visualize the source of the bleeding because of the large amount of blood in the right upper lobe. he underwent ir angiography, but they were not able to visualize the vessel because it was not actively bleeding. the patient was transferred to the general medical floor post-procedure where he continued to have small volume hemoptysis. interventional radiology repeated the angiography but was unable to embolize an artery because there was no active bleed. the patient underwent a second bronchoscopy on , where a clot was found to be nearly occluding the right upper lobe; the clot was not removed for concern of re-activating the original bleed. , ancas, anti-gbm ab, hiv ab, and ppd were negative. his plavix was held since admission, and his hematocrit remained stable in the low 30s after an initial drop from hct 42 in the ed. the patient did not require any blood transfusions. he did get one unit of platelets transfused, per surgical recommendations, to provide him with more functional platelets in the setting of recent plavix use. the patient was seen and evaluated by dr. of thoracic surgery who felt that the risk of right upper lobectomy was higher than the risk of significant re-bleeding at this time. no tumors or cavitary lesions were noted on the ct scan from admission. the patient will follow up with dr. as an outpatient in two weeks after re-imaging by ct. . #coronary artery disease: the patient is s/p 3 vessel cabg in and 2 drug eluting stents placed in . his plavix was discontinued because his stents were placed about four years ago. upon discharge, he was started on aspirin 81mg every other day, per recommendation of his outpatient cardiologist. the patient was continued on his home dose of simvastatin. . #hypertension: his blood pressure medication was held in the inpatient setting in order to more effectively monitor his hemodynamic status. his home dose of valsartan was restarted upon discharge from the hospital. . #emphysematous changes in lungs: emphysematous changes were noted in the patient's lungs on chest ct. the patient does have a 20-30 pack-year smoking history, though he quit smoking one month ago. he did have pulmonary function testing done prior to discharge to make sure he could tolerate a lobectomy. . . . the patient was continued on him home medications for thyroid hormone replacement and psoriasis. medications on admission: diovan 80 mg daily plavix 75 mg daily chantix 0.5 mg mvt daily simvastatin 20 mg daily lunesta 1 tab qhs synthroid 200 mcg daily dovonex 0.005% topical cream discharge medications: 1. levothyroxine 100 mcg tablet sig: two (2) tablet po daily (daily). 2. calcipotriene 0.005 % cream sig: one (1) appl topical (2 times a day). 3. simvastatin 10 mg tablet sig: two (2) tablet po hs (at bedtime). 4. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime). 5. benzonatate 100 mg capsule sig: one (1) capsule po every twelve (12) hours as needed for cough. disp:*30 capsule(s)* refills:*0* 6. diovan 80 mg tablet sig: one (1) tablet po once a day. 7. multivitamin oral 8. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po every other day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* discharge disposition: home discharge diagnosis: primary hemoptysis secondary coronary artery disease status post bypass hypothyroidism contact dermatitis discharge condition: stable, patient ambulating, on room air. tolerating pos. discharge instructions: you were admitted to the hospital because you were coughing blood. because of the large volume of blood you initially coughed up, you were monitored in the intensive care unit then transferred to the general medical floor when stable. as you know, you were found to have a a blood clot in the right upper lobe of your lung, which was likely the site of your bleeding. duirng your hospitalization, you had two bronchoscopies to visualize the lung and two procedures by intervential radiology to attempt to find the source of your bleeding. emphysema changes were seen as well in your lungs on ct from your history of smoking. you also had pulmonary function testing (pfts) done to test your lung function in case you may need surgery on your lungs. please follow up with your primary care physician regarding the pulmonary function tests and the emphysematous changes in your lungs. as discussed with dr. , you will be discharged from the hospital in stable condition. the risks of surgical removal of your right upper lung lobe were thought to be greater than the risk of significant re-bleeding at this time. you will follow up with dr. in 2 weeks for re-imaging of your chest. the following changes were made to your medications: - please stop taking plavix. you no longer need to take it for your coronary stents. - please decrease the dose and frequency of your aspirin to a baby aspirin 81mg other day. please seek medical attention if you cough up more blood, have lightheadedness or dizziness, or develop any symptoms that are concerning to you. followup instructions: appointment #1 md: dr. specialty: pcp date and time: monday, at 1:30pm location: healthcare - , ,, , phone number: appointment#2 md: dr. specialty: thoracic surgery --> please call dr. office ( and make the appointment for 2 weeks from now for repeat chest imaging. md, dmd procedure: other bronchoscopy other bronchoscopy arteriography of other intrathoracic vessels arteriography of pulmonary arteries diagnoses: obstructive sleep apnea (adult)(pediatric) esophageal reflux diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism gout, unspecified aortocoronary bypass status personal history of tobacco use percutaneous transluminal coronary angioplasty status pure hyperglyceridemia other acquired absence of organ old myocardial infarction other emphysema iron deficiency anemia, unspecified other psoriasis migraine, unspecified, without mention of intractable migraine without mention of status migrainosus other chronic nonalcoholic liver disease internal hemorrhoids without mention of complication bariatric surgery status other agents affecting blood constituents causing adverse effects in therapeutic use rosacea contact dermatitis and other eczema due to detergents contact dermatitis and other eczema due to other specified agents 

Answer: The patient is high likely exposed to