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: ambien / bactrim / lasix attending: chief complaint: hemoptysis major surgical or invasive procedure: bronchoscopy history of present illness: 52 year old male, sle s/p recent admission 6 weeks ago with diffuse alveolar hemorrhage re pressetns after 3days of increased weakness, bilateral les, cough with increasing hemoptysis, malaise and confusion. per wife as pt confused and giving poor history he had been increasingly weak since friday requiring walker which he had not been using, he fell twice, did not hit his head and was more confused. she also noted that he has been coughing with increasing amounts of blood in his sputum. she did not note any fevers, chills or any other chnages. patient denies any other apin, cp, pleuritic pain, has, lightheadedness, or dizziness, no dysphagia although losing weight, appetite the same. no abd pain, no bleeding from anywhere else. . in ed had sats around 88%on ra, but placed on nrb, had cxr with possible consolidation of lll vs hemorrhage and ct scan with consolidation and obstruction of lll. started on levaquin and decadron and ip consulted for bronch. past medical history: 1. fuo -began in worked up by heme/onc, rheum, and id workup over the past 8 months which has been completely unrevealing to date. of note, the patient has negative hiv yet persistently low cd4 counts (mid100s), distal esophageal thickening with egd completely normal, left iliac/hilar/mediastinal lymphadenopathy s/p left iliac ln fna bx which was nondiagnostic (exicisonal bx not attempted b/c location made it unresectable), and no abnormalities on vast rheumatological workup including /rf/anca/temporal art bx. colonoscopy, liver bx, nad bone marrow bx were all also negative. the patient has also had a vast imaging workup including head ct/mri in which showed only mild prominence of sa space over frontal lobes c/w mild frontal cortical atrophy. fevers treated with prednisone in past which has caused worsening mental status. 2. cholelithiasis 3. anemia- workup has included egd and colonoscopy as well as bone marrow biopsy all of which were negative. social history: born and grew up in , used to work as a tailor before immigrating to us in . worked as a cook in a chinese restaurant until he became ill in . never been a smoker. had significant exposure to second hand smoking at work place. drank alcohol 10 years ago. had contact with prostitute 2-3 years ago. family history: non-contributory. no fh of connective tissue or bleeding d/o. he knows nothing of the health history of family members but doesn't recall anyone in his family having similar symptoms to him. physical exam: t 103.9/ p 109 bp 126/62 rr 20 o2 89-> 94 on 4l -> 98% on nrb gen: confused, lethargic, nad perrl, mmm, anicteric, clear op cv rrr, tachy no murmurs chest ctab with consolidation of bilateral bases with e to a changes, coarse bs bilaterally abd soft distended, non tender, +bs ext no edema, warm and clammy to touch pertinent results: cxr: consolidation involving the left lower lobe and lingula with obliteration of the ap window, likely due to lymphadenopathy. small left pleural effusion. heterogeneous opacity in the right lower lobe, likely due to consolidations/atelectasis. . ctscan: extensive mediastinal and hilar lymphadenopathy with obstruction of the superior segment of the left lower lobe bronchus and narrowing of the basal left lower lobe basal segment bronchi with post-obstructive consolidation/atelectasis in the left lower lobe 2) multifocal areas of alveolar consolidation/aspiration pneumonia and left upper lobe and right lung. stable small pericardial effusion and small left pleural effusion. brief hospital course: a/p: 52 yo man with sle here with 1 week of cough, hemoptysis and fevers, and 1 month of increased weakness. . 1. hemoptysis given hx of dah with sle, will bronch to r/o significant bleeidng currently. howver with consolitation with lll bronchial collapse concern for an obstructibe endo-bronchial lesion. started on ceftriaxone/clinda/levaquin for coverage of cap/aspiration pneumonia/ and post-obstructive pneumonia. also given high dose steroids and cytoxan treatment concern for immunucompomised organisms. cont atovoqoune for now. anti-gbm negative and low suspicion for goodpastures. has had 3afb smears negative in for tuberculosis so less likely. possible malignancy given possible endobronchial lesion as well, but await bronch findings. consolidation most likey source of fevers, f/u cultures. -cont vanco/zosyn/ due to immunosuppression, recent admission with concerns for pseudomonas, aytpical, mrsa pneumonia etc. -unclear why continues to have fevers despite triple abx therapy, as well as iv steroids. await bronch results from today. -for bronch today - appreciate pulm recs. will send for g.stain, culture, pcp dfa, afb, , cytology. will attempt to have pulm bx one of ln in lung to r/o lymphoma/ca. -satting well on , titrate 02 as needed to keep sats>93% -switched steroids to dexa 4mg iv q4, will consider back to prednisone 80mg po qd per rheum. -hct 32.2 now. plts, inr nml. -hx of negative afb, low suspicion for tuberculosis at this time. will send for afb off of bronch. -bronch revealed oropharyngeal flora, negative g.stain and culture, neg pcp and afb, and normal patency of airways, with a likely diagnosis of diffuse alveolar hemorrahge, with no sign of pneumonia. -patient was discharged home on levaquin to complete a 10 day course, and all other antibiotics were stopped. -rheum and pulm recommended continuing prednisone 80mg po qd, to have follow up in outpatient clinic for consideration of additional cytoxan if pt can tolerate. - . 2. sle: -for now will cont steroids and atuvoqoune, although in light of infection, will follow closely. -cont fosamax/calcium/vitamin d and ppi prophylaxis. -rheumatology consulted - appreciate recs. c3 low, c4 nml. -consider switching iv dex back to prednisone 80mg po qd per rheum recs. - normal, no evidence of pericarditis/pericardial effusion seen. -bronch results showed likely dah c/w sle disease, continued on pred 80mg po qd, to be discharged with ? additional cytoxan as outpatient. 3. generalized weakness: patient describes a generalized weakness in his extremities that has gradually progressed over the past month to the point that he uses a walker for ambulation. strength appears moderately intact to exam, although patient with difficulty/fatigue while standing or walking during exam. no localizing symptoms on neuro exam. ddx includes steroid myopathy vs polymyositis vs deconditioning. -ck 31, which makes myositis very unlikely. neuro exam nonfocal and strength fairly well preserved on exam; do not suspect spinal cord involvement at this time. steroid myopathy vs. generalized deconditioning is favored at this time. -pt to continue to have outpatient pt. . 4. myocarditis currently stable, with no c/o of cp at this time. trop neg x1 set today. ct chest showed small pericardial effusion, no clincal sign of tamponade present on exam. pt did have 20 beat run of nsvt earlier today of unknown etiology. - report with normal ef 60%, mild symmetric lvh, physiologic/trivial pericardial effusion seen. no rv collapse. no wall motion abnormalities. unchanged from 07/. . 5. nsvt patient with 20 beat run of polymorphic nsvt while in . trop, ekg normal when completed. lytes checked and were normal. resolved spontaneously, patient completely asymptomatic at the time. patient with no hx of any cardiac disease. had additional 10 and 9 beat runs of nsvt last night - completely asymptomatic. -troponins normal. normal as above. -ep consulted - will follow up on recs. -cont metoprolol to 37.5mg po bid, k>4, mg>2, and considering cardiac mri to r/o inflammation/myocarditis leading to nsvt. -outpatient follow up with cardiology. . 6. fen -clears diet for now. replete lytes to k>4, mg>2. . 7. ppx -ca/vitd/fosamax/ppi, pneumoboots as concern for hemorrhage . 8. dispo: full code. confirmed with pt and pt today with interpreter . 9. contact: daughter (, ( medications on admission: calcium/vit d fosamz 70 qwk lipitor 10 qd florinef 0.1 daily prolisec 20 qd lopressor 25 lisinopril 5 daily prednisone 80 qd atovaquine 750 zofran discharge medications: 1. atovaquone 750 mg/5 ml suspension sig: five (5) ml po bid (2 times a day). disp:*300 ml* refills:*0* 2. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. atorvastatin calcium 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 4. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 6 days. disp:*6 tablet(s)* refills:*0* 5. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day). disp:*90 tablet(s)* refills:*0* 6. prednisone 20 mg tablet sig: four (4) tablet po daily (daily). disp:*120 tablet(s)* refills:*0* 7. prilosec 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. disp:*30 capsule, delayed release(e.c.)(s)* refills:*0* 8. fosamax 70 mg tablet sig: one (1) tablet po once a week. disp:*4 tablet(s)* refills:*0* 9. calcium 500 mg tablet sig: one (1) tablet po three times a day. disp:*90 tablet(s)* refills:*0* 10. vitamin d 400 unit capsule sig: one (1) capsule po once a day. disp:*30 capsule(s)* refills:*0* discharge disposition: home with service facility: family & services discharge diagnosis: diffuse alveolar hemorrhage nonsustained ventricular tachycardia . sle anemia discharge condition: stable. afebrile x48 hours. able to ambulate as previous. discharge instructions: 1. please follow up with dr. this week. call her office at ( to schedule an appointment. . 2. take your medications as below. . 3. if develop worsening cough with blood, difficulty breathing, chest pain, lightheadedness or dizziness, please call dr. or return to the nearest er. followup instructions: provider: , md where: lm phone: date/time: 8:30 . provider: , md where: lm phone: date/time: 11:30 md, procedure: closed endoscopic biopsy of lung diagnoses: pneumonia, organism unspecified systemic lupus erythematosus paroxysmal ventricular tachycardia lung involvement in systemic sclerosis 

Answer: The patient is high likely exposed to