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: history of present illness: the patient was a 59-year-old male with a history of severe bolus emphysema who presented to an outside hospital on in hypercarbic respiratory failure requiring intubation and who was subsequently found to have 100% right pneumothorax. after recurrence of the pneumothorax despite repeated tube thoracostomies, the patient was transferred to for further management, failure to wean, and concern of bronchopleural fistula. at the outside hospital the patient had also been treated for a pneumonia that was believed to have progressed despite treatment with ceftriaxone and azithromycin. the patient was subsequently placed on a regimen of ciprofloxacin and vancomycin. the patient had also been placed on a steroid taper for his chronic obstructive pulmonary disease. he had required large amounts of benzodiazepines at the outside hospital and was thought to have been experiencing alcohol withdrawal. the patient had persistent tachycardia at the outside hospital and been ruled out for myocardial infarction by enzymes. he was, however, suspected to have had some degree of demand ischemia. past medical history: 1. severe bolus chronic obstructive pulmonary disease with an fev1 of 1.12, an fvc of 2.5, and a dlco of 34% of predicted on . 2. history of bilateral pneumonia resistant to ceftriaxone and azithromycin. 3. anemia, not otherwise specified. 4. alcohol abuse with a history of withdrawal. 5. history of a negative cardiac catheterization in . 6. hypertension. 7. gastroesophageal reflux disease. 8. hiatal hernia repair. 9. basal cell carcinoma excision from nose. 10. hypercholesterolemia. allergies: motrin and calcium channel blocker. medications on admission: albuterol and atrovent nebulizers, heparin subcutaneous, zantac 50 mg p.o. t.i.d., multivitamin, ciprofloxacin 400 mg b.i.d., aspirin 325 mg p.o. q.d., vancomycin 1 g b.i.d., solu-medrol taper, lactulose, versed p.r.n., morphine sulfate, ativan, lopressor p.r.n., and nitroglycerin patch. social history: the patient lives alone. the patient had an extensive smoking history. the patient has a history of alcohol abuse with a history of withdrawal. physical examination on admission: the patient presented on a ventilator which was set at imv with a volume of 800, a rate of 12, inspired oxygen of 50%, and a pressure support of 10. the patient's pulse was 71, blood pressure 149/79, respiratory rate of 13, and oxygen saturation of 94%. generally, he was an ill-appearing middle-aged man in no apparent distress. he was ventilated and sedated. heent revealed pupils that were equally, round, and reactive to light. an orogastric tube was in place. on neck examination, the patient had no cervical lymphadenopathy. on cardiac examination, the patient had a regular rate and rhythm with a normal s1 and s2, and no murmur, rubs or gallops. on pulmonary examination, the patient had crepitus along his right chest wall with a chest tube in his right thoracic wall. coarse wheezes were heard bilaterally. on abdominal examination, the patient's belly was soft, nontender, and nondistended, with normal bowel sounds. extremity examination revealed no edema. vascular examination revealed good capillary refill. for access, the patient had a right peripherally inserted central catheter line in place. pertinent laboratory data on admission: the patient had a white blood cell count of 14.5, hematocrit of 38.8, platelets of 233. his chem-7 revealed a sodium of 138, potassium of 4.3, chloride of 96, bicarbonate of 30, bun of 21, and creatinine of 0.8, with a glucose of 127. his alt was 44, with an ast of 26, and alkaline phosphatase of 77, and a total bilirubin of 0.7. radiology/imaging: electrocardiogram revealed a normal sinus rhythm with a rate of 65, normal axis, normal channels, normal intervals. st elevations in ii, iii, and f with no q waves appreciated, and an inverted t wave in avl. when this was compared to his admission electrocardiogram at the outside hospital there appeared to be no changes. chest x-ray revealed chest tube in the right chest with a small residual right pneumothorax, left lower lobe opacity, and a question of a left pleural effusion were noted. hospital course: this patient was directly admitted to medical intensive care unit on , from the outside hospital. the patient presented febrile with an elevated white count with an oxygen saturation of 94% on the above vent settings with coarse rhonchorous breath sounds, right chest wall crepitus, and a chest x-ray significant for right pneumothorax. cardiothoracic surgery was consulted and replaced the patient's chest tube. the patient completed his steroid taper and was placed on an antibiotic regimen of levofloxacin, gentamicin, and vancomycin. flagyl was subsequently added for anaerobic coverage after an episode of succulent nasogastric aspirate. a kub performed revealed no obstruction. the patient continued to spike fevers, and his regimen was changed to ceftazidime, vancomycin, and flagyl to cover possible ventilator associated pneumonia. the patient had transient episodes of hypotension unresponsive fluid boluses, requiring short intervals on pressors. the patient eventually defervesced for 48 hours. a repeat chest ct revealed severe bolus disease with a large left bola under tension and bilateral pneumonia. on , the patient had an arterial blood gas that revealed hypoxemia. peep 5 mmhg was added with modest improvement in the pao2. on , the patient spiked a temperature to 100.9. the patient was pan cultured with no growth on any cultures. he was diuresed with modest improvement in oxygenation. by , all of his access lines had been changed. the patient continued to spike temperatures to 101 to 102. stool studies were negative including studies for clostridium difficile toxin. on , the patient had a tracheostomy placed, and on , the patient underwent a peg-j placement by interventional radiology. on , the patient continued to be hypoxemic. the concern at that point was for right-to-left shunt secondary to the patient's bilateral pneumonia or pulmonary embolus. a ct angiogram revealed a large left pulmonary embolism, and the patient's chest tube in an intraparenchymal location. the chest tube was pulled by cardiothoracic surgery, and the patient was started on a continuous heparin infusion. an echocardiogram was performed to evaluate right ventricular function but was severely limited by the patient's bolus disease. on , the patient became markedly hypoxemic with an emergent ct that revealed 50% recurrent pneumothorax on the right. cardiothoracic surgery placed a right chest tube with resolution of the pneumothorax. however, the patient required paralysis in order to achieve cooperation with the ventilator. that evening, the patient became markedly hypotensive requiring neo-synephrine support. an electrocardiogram and chest x-ray done at that time were unremarkable. a family meeting was held the next day, and the patient was made do not resuscitate. the patient was eventually weaned off pressors. the patient remained hypercarbic and relatively hypoxemic. the patient was eventually placed on pressure control ventilation, and his i to e ratio was altered to improve oxygenation. the patient's driving pressure and peep were also increased. on , the patient completed a 10-day course of antibiotics and all were discontinued. the patient was re-cultured. by , all of his access lines had been relocated for a second time. his foley was changed. on , the patient became markedly acidotic, hypercarbic, and hypoxemic. his ventilatory settings were adjusted. a conversation was held with the patient's daughter who expressed her desire to have the patient designated comfort measures only. multiple attempts to contact the rest of the patient's family had been unsuccessful. ultimately, on , at 8:27 p.m, the patient expired. condition at discharge: expired. discharge status: the patient expired on , at 8:27 p.m. discharge diagnoses: 1. hypoxemic hypercarbic respiratory failure secondary to severe bolus emphysema. 2. recurrent right pneumothorax. 3. pulmonary embolism. 4. bilateral pneumonia. 5. anemia. 6. history of alcohol abuse. 7. hypertension. 8. gastroesophageal reflux disease 9. hypercholesterolemia. , m.d. dictated by: medquist36 procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances other bronchoscopy percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy diagnoses: pneumonia, organism unspecified anemia, unspecified esophageal reflux pure hypercholesterolemia other pulmonary insufficiency, not elsewhere classified obstructive chronic bronchitis with (acute) exacerbation other pulmonary embolism and infarction emphysematous bleb 

Answer: The patient is high likely exposed to