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: pegj occlusion and respiratory failure major surgical or invasive procedure: none history of present illness: 40 yo m with ipf, s/p double lung tx , h/o recurrent pneumonia, chronic rejection and obliterative bronchiolitis, polymiositis, recent hospitalization for acute on chronic resp failure and multilobar pneumonia requiring chest tubes and pej placement by ir (discharged on ) presenting from radius rehab for pegj occlusion. he was transported from rehab to ed using bag ventilation and was found to be lethargic and disoriented upon arrival to the ed. . in the ed his vitals were temp 101, hr 117, bp 210/105, rr 33, o2sat 89-95% and his abg was 7.0/180/386. he was then placed on a ventilator in the ed and a repeat abg was 7.24/89/71/40. his pej was repositioned by surgery in the ed without difficulty and is ready to use. he was brought to the micu for resolution of his respiratory distress. a repeat abg in the micu was 7.24/94/70. his ventilator settings are tv300 rr20 peep8 fio2 40. it appears that he is now at his baseline with regards to his abg. . in the micu his mental status is much improved. he is alert and oriented with no other complaints. he denies any fever, chills, nausea, vomiting, chest pain, or shortness of breath. he does not feel disoriented or that his breathing is impaired. he feels hungry. past medical history: chronic resp failure/ vent dependent since chronic bronchitis status post bilateral lung tranplant in idiopathic pulmonary fibrosis complicated by chronic rejection and frequent aspiration pneumonia idiopathic pulmonary fibrosis since status post tracheostomy placement in esophageal dysmotility gerd htn paroxysmal atrial fibrillation hyperlipidemia dm ii sacral decubitus ulcer now healed severe anxiety depression anemia of chronic disease pancreatitis chronic renal insufficiency social history: lives at rehab, wife is supportive. has two sons. drinking, smoking, drug use. family history: nc physical exam: gen: well developed, well nourished, trach ventilation in tact heent: nc, at, mmm, perrl, eomi cv: rrr nl s1, s2 lungs: coarse insp and expir breath sounds, no focal area of consolidation, no wheezing abd: soft nt nd + bs, pej tube site c/d/i ext: 2+ pulses in all four, nl sensation, able to move all 4 extremities with 4/5 strength. neuro: alert, oriented x 3, cn 2-12 intact pertinent results: 12:16pm type-art rates-/24 tidal vol-350 o2-100 po2-386* pco2-180* ph-7.00* total co2-48* base xs-6 aado2-162 req o2-36 -assist/con intubated-intubated 03:28pm type-art po2-71* pco2-89* ph-7.24* total co2-40* base xs-7 -assist/con 06:41pm type-art temp-37.6 rates-20/ tidal vol-300 peep-8 o2-40 po2-70* pco2-94* ph-7.24* total co2-42* base xs-8 -assist/con intubated-intubated 10:13pm lactate-0.8 10:13pm type-art po2-88 pco2-72* ph-7.29* total co2-36* base xs-4 10:19pm calcium-7.6* phosphate-2.5* magnesium-1.5* 10:19pm ck-mb-notdone ctropnt-<0.01 10:19pm ck(cpk)-26* 10:19pm glucose-137* urea n-31* creat-1.1 sodium-147* potassium-4.6 chloride-113* total co2-29 anion gap-10 brief hospital course: 40 yo male vent dependent with pegj occlusion requiring transfer to the ed for eval by gen surgery and en route developing respiratory distress with hypercarbia and acidosis. . # severe respiratory acidosis: in the ed his abg showed a ph of 7.0 with a co2 of 180. on his recent admission, his co2 was found to be as high as 200 and it seems that his baseline abg is 7.2's/70's/100. his repeat abg's while on the ventilator at his normal settings in the ed and in the micu have returned to his normal baseline; otherwise, continued vent settings and nebs from rehab. . # infection: in ed patient was found to have temp of 101 with wbc of 30; afebrile and wbc decreasing on admission to the micu. on discharge from previous hospitalization() wbc was 9 in the setting of being in respiratory distress. at rehab was on meropenem, bactrim and flagyl. cxr in ed showed patchy opacity within the right base appears slightly more prominent when compared to prior radiographs and may be related to underlying fluid overload; however, superimposed infectious process cannot be excluded. cxr showed a question of worsening pneumonia; u/a was negative; blood culture and sputum culture were ngtd; lft, amylase, lipase normal; continued bactrim, flagyl, meropenem plan for 1 more week to complete course. . # pegj repositioning: main reason for transfer to was for repositioning/ occlusion of his pej. currently working well-maintained on tube feeds. . # altered mental status overnight: probable multiple sedating medications- resolved o/n; nl ekg, trop, electrolytes, abg; discussed with patient in am of hd1 when alert and he says that he feels back to baseline. . #anxiety and depression: continued seroquel, clonazepam, morphine prn . # lung transplant: continued cellcept, tacrolimus, nebs . # dm type ii: tightened iss, max glucose 220 . # htn: continue hctz, metoprolol . fen: pej in place, tf at 50/ hr, replete lytes . ppx: sc heparin, pneumoboots, ppi . access: right picc, left piv medications on admission: lansoprazole 30 mg tablet po daily ipratropium bromide trimethoprim-sulfamethoxazole 40-200 po daily mycophenolate mofetil 1000 mg tabletbid (2 times a day). atorvastatin 10 mg po daily citalopram 40 mg tablet po daily albuterol bisacodyl 10 mg tablet po daily flagyl 500 tid clonazepam 0.5 mg po qhs quetiapine 50 mg tablet po bid prednisone 20 mg po daily docusate sodium 100 mg po bid senna zolpidem 5 mg po hs metoprolol tartrate 100 mg po tid hydrochlorothiazide 25 mg po daily morphine sulfate 2-6 mg iv q3-4h:prn abdominal pain insulin sliding scale tacrolimus 5 mg capsule : one (1) capsule po bid (2 times a day): in total should receive tacrolmius 9 mg . tacrolimus 1 mg capsule : four (4) capsule po twice a day: in total should receive tarolimus 9 mg . discharge medications: 1. morphine sulfate 2 mg iv q4h:prn pain 2. metronidazole (flagyl) 500 mg iv q8h 3. heparin flush picc (100 units/ml) 2 ml iv daily:prn 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. 4. insulin regular human 100 unit/ml solution : one (1) injection asdir (as directed). 5. albuterol 90 mcg/actuation aerosol : six (6) puff inhalation q4h (every 4 hours) as needed. 6. ipratropium bromide 17 mcg/actuation aerosol : six (6) puff inhalation q4h (every 4 hours) as needed. 7. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 8. trimethoprim-sulfamethoxazole 80-400 mg tablet : one (1) tablet po daily (daily). 9. mycophenolate mofetil 500 mg tablet : two (2) tablet po bid (2 times a day). 10. atorvastatin 10 mg tablet : one (1) tablet po daily (daily). 11. citalopram 20 mg tablet : two (2) tablet po daily (daily). 12. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 13. clonazepam 0.5 mg tablet : one (1) tablet po qhs (once a day (at bedtime)). 14. quetiapine 25 mg tablet : two (2) tablet po bid (2 times a day). 15. prednisone 20 mg tablet : one (1) tablet po daily (daily). 16. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 17. zolpidem 5 mg tablet : one (1) tablet po hs (at bedtime). 18. metoprolol tartrate 50 mg tablet : two (2) tablet po tid (3 times a day). 19. hydrochlorothiazide 25 mg tablet : one (1) tablet po daily (daily). 20. tacrolimus 1 mg capsule : nine (9) capsule po bid (2 times a day). 21. heparin (porcine) 5,000 unit/ml solution : one (1) injection tid (3 times a day). 22. acetaminophen 160 mg/5 ml solution : one (1) po q4-6h (every 4 to 6 hours) as needed. 23. meropenem 500 mg recon soln : one (1) intravenous every six (6) hours for 7 days. discharge disposition: extended care facility: hospital discharge diagnosis: blocked feeding tube respiratory distress/ pneumonia discharge condition: stable and improving discharge instructions: you will be discharged back to the rehab facility today. your pegj tube was fixed in the emergency department and you were kept overnight in the icu to monitor your respiratory status on the ventilatory. you seem to be at your baseline and will be sent home today. you continue to have a pneumonia seen on chest xray and you should continue all three antibiotics that you were recently prescribed on discharge on . if your breathing should worsening, develop a fever, chills, nausea, vomiting, headache, chest pain, abdominal swelling or pain, you should call your pmd or return to the ed immediately. additionally, if you require transport by ambulance in the future, you should request to be on a ventilator. followup instructions: follow up with your pmd at rehab to continue to monitor your pneumonia. you should follow up with the lung specialists at center for chest disease. division of thoracic surgery , phone: ( procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: esophageal reflux diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified dysthymic disorder other and unspecified hyperlipidemia acute and chronic respiratory failure tracheostomy status lung involvement in other diseases classified elsewhere attention to other artificial opening of digestive tract unspecified chronic bronchitis complications of transplanted lung polymyositis 

Answer: The patient is high likely exposed to