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: service: medicine history of present illness: this is a 27-year-old obese mans with a history of asthma and recent episodes of pneumonia who presents with two weeks of productive cough, diaphoresis, and fatigue. the patient has asthma since childhood characterized by daily albuterol and flovent, prior hospitalization x5 (last hospitalization 14 years ago), no intubations, peak flow of 400, and dyspnea on one-block exertion, and cold weather. patient was in his usual state of health until one month prior to admission when he developed sharp right sided chest pain on inspiration and cough productive of yellow sputum. he was seen in the emergency department and found to have a right middle lobe infiltrate on chest x-ray. the patient was discharged with a diagnosis of pneumonia with asthma exacerbation, given a five day course of azithromycin. after completion of this treatment, his cough resolved and radiography demonstrated clearance of the opacity, though he reports "feeling only slightly better." over the next two weeks, he reported worsening productive cough with hemoptysis, intermittent fevers (unmeasured), and chills. he presented to the emergency department one week prior to admission with these symptoms and was given another five day course of azithromycin after chest x-ray was read as negative. a ppd was also planted, which was read negative in clinic four days later. since completion of the azithromycin, patient has noticed increased dyspnea on exertion and worsening of his cough, which is productive for yellow sputum with no blood. on the morning of admission, his mother found him to have worsened cough with heavy diaphoresis and brought him into the emergency department. a multi-system review is notable for intermittent fevers, chills, fatigue, and wheezes. he is compliant with his medications, the only recent change being a decrease of gabapentin from 400 mg qid to 400 mg . past medical history: 1. asthma. 2. hypertension. 3. gastroesophageal reflux disease. 4. bipolar disease. 5. thalassemia trait. allergies: 1. ct dye reaction being anaphylaxis. 2. the patient also notes adverse reactions to guaifenesin and cephalexin. medications: 1. albuterol 90 mcg 1-2 puffs ih . 2. fluticasone 44 mcg two puffs ih . 3. clonazepam 1 mg po q day. 4. gabapentin 400 mg po bid. 5. paroxetine 40 mg po q day. 6. topiramate 100 mg po bid. 7. omeprazole 20 mg po q day. 8. propanolol 80 mg po tid. family history: positive for pancreatic cancer in his father, who died when the patient was 4 years old and three uncles. liver cancer in his grandfather. family history of obesity and type 2 diabetes in maternal grandmother and maternal aunts/uncles: thalassemia traits in paternal side. social history: patient currently lives at home alone. he works as a substance abuse counselor for middle-aged woman. the patient is involved with a single male partner who has hcv, and reports condom use for all sexual encounters. he reports no recent travel outside of , and no sick contacts. smoking: no smoking for the past two months; less than five pack year smoking history. alcohol: no current alcohol use or past history of abuse. substance: no history of recreational or iv drug use. review of systems: as above. in addition, the patient notes no chest pain, no palpitations, no paroxysmal nocturnal dyspnea/orthopnea, no nausea, vomiting, diarrhea, no dysuria/hematuria. physical examination: the patient's vital signs are temperature of 99.3, blood pressure of 130/88 supine, pulse of 104, respiratory rate of 22, and an oxygen saturation of 83% on room air which improved to 91% on 2 liters nasal cannula, and nebulizers x1. in general, the patient is a young obese ill-appearing man who seems sleepy and diaphoretic. integument: cold, dry; no rashes or ulcerations, normal pigmentation, no jaundice. heent: his head is normocephalic, atraumatic, without scalp lesions; eyes: pupils are equal, round, and reactive to light and accommodation. extraocular movements are intact. mucous membranes moist. ears - no tenderness or discharge; nose - no erythema, obstruction, discharge, no sinus tenderness; throat - no lesions or ulcerations; normal tonsils, uvula, palate, oropharynx not injected. neck: supple; thyroid normal in size without palpable masses or nodules. lymph nodes: no palpable cervical or ancillary nodes. chest: percussion difficult to assess secondary to obesity, localized wheezes right greater than left, decreased breath sounds at the bases bilaterally left greater than right, and no crackles noted on inspiration or expiration. cardiovascularly, no jugular venous distention, pmi palpable; normal s1, s2 without murmurs, rubs, or gallops. abdomen: obese, normoactive bowel sounds, soft, nontender, nondistended; liver palpable five cm down the midclavicular line. no guarding, no rebound. extremities: no clubbing, cyanosis, or edema; pedal pulses 2+ bilaterally. neurological: cns grossly intact. alert and oriented times three. studies: laboratory results are significant for a white blood cell count of 13.4 with 48 neutrophils, 14 bands, 23 lymphocytes, 9 monocytes, 4 eosinophils, and 2 basophils; a hematocrit of 41.3, and a platelet count of 594. his chemistries were notable for a sodium of 143, a potassium of 4.5, chloride of 100, a bicarb of 30, bun 9, and creatinine 0.7, alt elevated at 91, and ast at 44. an electrocardiogram demonstrated normal sinus rhythm at 100 beats per minute with normal intervals and normal axis; there were nonspecific t-wave inversions in lead v1. a chest x-ray in the emergency department showed interval development of a patchy opacity at the left lung base and a small left sided effusion. hospital course: 1. pulmonary - the patient was admitted and empirically treated for community acquired pneumonia with levofloxacin 500 mg q day and q6 nebulizers for questioned component of asthma. a sputum culture demonstrated betalactimase negative hemophilus influenza. on the second day of admission, he was found to be increasingly somnolent and less responsive. an arterial blood gas showed hypercarbia with a ph of 7.25, pco2 of 87, and a po2 of 79. the patient was then transferred to the unit secondary to decreased respiratory drive, where he was intubated later that evening after developing acute respiratory failure. he was extubated two days later after his breathing stabilized and then transferred back to our service on 4 liters of oxygen. in the unit, he was also started on high dose iv steroids and then switched to oral prednisone for taper. his examination on readmission to the service was improved with decreased fatigue, decreased diaphoresis, and a improved chest x-ray notable for decreased wheezing. over the next two days, his symptoms continued improving with continued steroid taper q6 naps and levofloxacin therapy. he was then weaned off of the oxygen and had o2 saturations of 93-95% on room air prior to discharge. during the hospitalization, he had a negative lower extremity noninvasive study that did not show any deep venous thromboses, a lung scan that showed low probability for pulmonary embolism and an echocardiogram that demonstrated normal left ventricular function with no valvular abnormalities or pericardial effusion. on discharge, he will follow up with pulmonary clinic, pulmonary function tests laboratories, and sleep laboratory as an outpatient. 2. hypertension: in the setting of acute respiratory failure and established history of asthma, inderal was discontinued after hospital day #2. his blood pressure was well controlled on lasix 40 mg po q day while in the hospital, and then he was also given diltiazem 30 mg po qid for rate control. on the last day of admission, he required potassium supplementation, in the setting of a potassium down to 3.3. 3. endocrine: the patient was found to have a suppressed tsh in the hospital. a free t4, total t4, and t3 were ordered for followup as an outpatient. the patient also had high fasting glucose levels while in the hospital, and hba1c was obtained for followup as well. discharge condition: good. discharge placement: home. discharge diagnoses: 1. acute respiratory failure. 2. community acquired pneumonia. 3. hypertension. 4. impaired fasting glucose. 5. suppressed tsh. discharge medications: 1. albuterol inhaler. 2. flovent inhaler. 3. neurontin 400 mg po bid. 4. paxil 40 mg po q day. 5. protonix 48 mg po q day. 6. topamax 100 mg po bid. 7. lasix 40 mg po q day. 8. levofloxacin 500 mg q day. 9. prednisone 30 mg po q day taper over the next eight days. 10. diltiazem 60 mg po qid. 11. ipratropium bromide inhaler. 12. potassium chloride 40 meq po bid. as discussed above, the patient will follow up with dr. , his primary care physician on wednesday. in addition, he will be seen for long-term evaluation and therapy in the pulmonary clinic. in addition, he will follow up in pft laboratory and sleep laboratory for further evaluation. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: pneumonia, organism unspecified esophageal reflux unspecified essential hypertension acute respiratory failure morbid obesity bipolar i disorder, most recent episode (or current) unspecified asthma, unspecified type, with (acute) exacerbation 

Answer: The patient is high likely exposed to