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: chest pain, tachycardia, pleural effusion major surgical or invasive procedure: thoracentesis, right-sided chest tube placement vats procedure history of present illness: briefly, mr. is a 72 yo man with esrd on hd, dm2, htn, pvd, diastolic dysfunction and cmml who initially presented with chest pain and sob while at outpt hd. he ruled out for mi. his initial cxr demonstrated evidence of a new r pleural effusion. ct scan demonstrated a r-sided pleural effusion and 2 new pulmonary nodules. past medical history: 1. esrd on hd, began dialysis . av graft placed in lue on . congenital absence of one kidney. gets hd mwf in /--followed by dr. . on , underwent attempted thrombectomy, left upper arm av graft. ligation of left upper arm av graft and placement of right femoral quinton catheter. 2. htn 3. hypercholesterolemia 4. dm, type 2 5. diastolic chf, ef >55% 6. copd 7. h/o gi bleeding 8. unilateral kidney 9. s/p cataract surgery h/o gastric lipoma, 11. pvd, s/p angioplasty. 12. h/o vre uti 13. restless legs syndrome 14. cmml - diagnosed 6 months ago, pt of dr. . diagnosed by bone marrow biopsy, did not have any symptoms. not being treated. 15. excision of lue avg, infected social history: lives with 1 daughter. 120 py hx, quit 20 years ago. no etoh. no drug use. pt was in the army from -79 and did have significan pesticide exposure. family history: m: died at 64 of mi; dm f: died at 41 of mi aunts maternal and paternal with dm. physical exam: vitals: t: 98.6 bp: 120/55 p: 107 r: 20 sao2: 94%ra general: chronically ill-appearing, awake, alert, nad, pleasant, appropriate, cooperative heent: ncat, eomi, no scleral icterus neck: supple, no significant jvd pulmonary: decreased bs on r, upper airway wheeze, no rales cardiac: distant heart sounds, no significant murmurs abdomen: soft, nt, nd, normoactive bowel sounds, no masses or organomegaly noted extremities: no edema pertinent results: 09:10pm ck(cpk)-30* 09:10pm ck-mb-notdone ctropnt-0.07* 09:10pm wbc-11.0 rbc-3.95* hgb-11.4* hct-35.1* mcv-89 mch-28.8 mchc-32.5 rdw-17.3* 12:12pm lactate-2.3* 12:12pm lactate-2.3* 10:28am glucose-169* urea n-34* creat-7.1*# sodium-142 potassium-3.9 chloride-100 total co2-26 anion gap-20 10:28am estgfr-using this 10:28am ck(cpk)-36* 10:28am ctropnt-0.07* 10:28am ck-mb-5 probnp-greater th 10:28am calcium-9.4 phosphate-3.0 magnesium-1.8 10:28am wbc-16.6*# rbc-4.50* hgb-13.0* hct-39.9* mcv-89 mch-28.9 mchc-32.6 rdw-17.3* 10:28am neuts-64.5 lymphs-15.5* monos-17.8* eos-1.8 basos-0.4 10:28am plt count-106* 10:28am pt-13.1 ptt-28.0 inr(pt)-1.1 imaging -cxr-right basilar pleural effusion with consolidation which could reflect atelectasis or pneumonia. . -chest ct-1. two new pulmonary nodules within the right lung. given patient's high- risk status of emphysema, a ct chest in 3 months after drainage of right pleural effusion is recommended for further evaluation. 2. cholelithiasis. probable distal cbd stones in which ercp would be both confirmatory and theraputic. 3. three-vessel coronary artery calcification. prominent left axillary lymph node. 4. right-sided pleural thickening presumably associated with old rib fractures. . cytology pleural fluid-pleural fluid: negative for malignant cells. mesothelial cells, histiocytes, and lymphocytes. . ct chest 5/19-1. persistent moderate-to-large right-sided pleural effusion. 2. persistent pulmonary nodules within the right lung. followup ct within three months is recommended. 3. cholelithiasis, unchanged. 4. three vessel coronary artery calcification. 5. left axillary and pretracheal lymph node which is enlarged. 6. stable old rib fractures, some of which demonstrate nonunion . cta 5/21-1. there is significant interval increase in the multi-loculated right pleural effusion with almost complete atelectasis of the right lower lobe and to a lesser extent of the right upper lobe as described above. 2. no pulmonary embolism or aortic dissection. there is extensive coronary atherosclerosis noted. . echo -the left atrium is normal in size. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. compared with the prior study (images reviewed) of , the findings are similar. brief hospital course: a/p: 72m with esrd on hd, htn, dm2, pad, cmml, diastolic dysfunction presented with pleural effusion. decompensated in setting of svt during dialysis, now resolved. . on the day of admission, while at hd, the pt became very tachycardic (svt to the 150s, ? atrial flutter) and had associated chest pain radiating to the jaw and diaphroesis. his tachycardia converted back to sinus rhythm. . he underwent thoracentesis . results were consistent with an exudative pleural effusion. repeat chest ct demonstrated persistent pleural effusion, and a cta on the day of transfer to the icu demonstrated significant interval increase in pleural effusion with almost complete atelectasis of the rll. . upon transfer to the icu, the pt did not have any complaints other than some mild wheezing. he denied chest or jaw pain, shortness of breath, diaphroesis or nausea. . #pleural effusion: was found to be exudative by light's criteria. ddx included pe, tuberculosis, malignancy, parapneumonic effusion, hemothorax. there was no evidence of pe on cta. he had a significant travel history, but reports a negative ppd in the past. this, coupled with the lack of cavitary lesion(s) on ct, makes tuberculosis unlikely. there was no pneumonic infiltrate, no fever and no white count to suggest an underlying pneumonia. his hct has been stable, although the fluid did reaccumulate so fast that a hemothorax a complication of the initial thoracentesis. given his significant smoking hx, malignancy is high on the differential. exactly why the effusion reaccumulated so quickly is unclear, although it does suggest a possible hemothorax. ip performed thoracentesis with chest tube placement and obtained 1.5l of red/blood-like fluid he was then taken to the or one day later for vats. while in the icu he became hypotensive to 70's requiring 3l of ivf and also was noticed to have a hct to 24 for which he was transfused 2 units prbcs. he was started on vanc/zosyn for broad coverage but this was discontinued after his bp stabilized and there was no evidence of infection. in addition cxr showed possible recumulation of fluid in the r.lung field. his vitals stabilized and he was transferred to the medical floor where he remained on 2l nc. he had his chest tube removed without inciddent and a follow up cxr did not show reaccumulation. wet read on his pathology from vats showed reactive histiocytosis, fibrinous changes, no evidence of cmml involvement or pulmonary/mesothelial malignancy. . #hypotension-pt was hypotensive to 70's one night in icu after hd and after or procedures. etiology likely secondary to hypovolemia. other possibilities included infection/sepsis and/or med effect from or. he was temporarily on broad spectrum antibiotics but they were discontinued after his cultures were negative. he was given midodrine prior to hd and did well. he continued to be normotensive for the duration of his hospitalization. . #atrial flutter: pt had chest discomfort, jaw pain when hd began, hr increased to svt at 150s (likely atrial flutter). svt broke spontaneously, and pt's sxs improved with sl nitro and morphine. blood pressure was stable throughout. that his sxs appear to correlate with his atrial flutter would suggest demand ischemia. there are no ischemic changes on ekg, and his cardiac enzymes are at his baseline. a primary coronary process such as plaque rupture is unlikely, and i suspect that his sxs were related to his rate. . #nsvt-pt had a 40 beat run of nsvt, asymptomatic, hemodynamically stable. ekg was done with no ischemic changes. his lytes were closely monitored and aggressively repleted. he had an echo to look for wall motion abnormalities, which showed an ef of >55%, no new wall motion abnormalities. this dc summary will be faxed to his pcp and will need to have cards follow up . # esrd: has not been able to undergo adequate hd sessions due to atypical cp and then hypotension recently. he started receiving midodrine prior to hd and tolerated hd well. he was continued nephrocaps, sevelamer, calcium acetate -needs one unit of prbcs and iron studies as per renal on day of discharge . # dm2: he was continued nph at reduced dose (10 qhs) and sliding scale. . # cmml: not active, unlikely to cause pleural effusion . # rls: continued ropinirole 0.25 . # fen/lytes: diabetic, cardiac, renal diet replete lytes prn . # prophylaxis: heparin sc 5000 tid, on home ppi, bowel reg . # code status: full code ********* on day of discharge pt's wbc 16, had been fluctuating during hospitalization, possibly due to cmml. . . medications on admission: fosinopril 20 daily metoprolol succinate 25 qhs aspirin 81 daily albuterol 4-6x/day prn tiotropium daily nephrocaps daily calcium acetate 1334 tid with meals sevelamer 1600 tid with meals insulin nph 15u qhs omeprazole 40 daily ropinirole 0.25 docusate twice daily vitamin e 400 daily discharge medications: 1. fosinopril 20 mg tablet sig: one (1) tablet po once a day. 2. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. ropinirole 0.25 mg tablet sig: one (1) tablet po bid (2 times a day). 5. insulin nph human recomb 100 unit/ml cartridge sig: fifteen (15) units subcutaneous at bedtime. 6. vitamin e 400 unit capsule sig: one (1) capsule po daily (daily). 7. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). 8. levalbuterol hcl 0.63 mg/3 ml solution for nebulization sig: one (1) ml inhalation q4hrs () as needed for dyspnea, wheezing. 9. humalog 100 unit/ml cartridge sig: as per sliding scale units subcutaneous qachs. 10. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day). 11. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 12. morphine 2 mg/ml syringe sig: 1-2 mg injection q4h (every 4 hours) as needed for pain. 13. ropinirole 0.25 mg tablet sig: one (1) tablet po bid (2 times a day). 14. ondansetron hcl (pf) 4 mg/2 ml solution sig: two (2) mg injection q8h (every 8 hours) as needed for n/v. 15. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: adhesive patch, medicateds topical daily (daily) as needed for prn hip pain. 16. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 17. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 18. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 19. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 20. vitamin e 400 unit capsule sig: one (1) capsule po daily (daily). 21. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 22. acetaminophen 500 mg tablet sig: two (2) tablet po tid (3 times a day). 23. sevelamer hcl 800 mg tablet sig: two (2) tablet po tid w/meals (3 times a day with meals). discharge disposition: extended care facility: northeast - discharge diagnosis: exudative pleural effusion hemothorax status post vats end stage renal disease on hemodialysis hypertension diabetes mellitus, type ii diastolic congestive heart failure, ef>55% restless leg syndrome chronic monomyelocytic leukemia discharge condition: stable, afebrile, o2 sat 97% 2l discharge instructions: you were admitted to the hospital for chest pain and shortness of breath. you were found to have a fluid collection at your right lung base. while you were hospitalized you had a thoracentesis, a procedure to remoce some of that fluid from your lungs for therapeutic relief and diagnosis. you had repeat shortness of breath, had a chest tube placed which found bloody fluid. you were transferred to the medical icu and had a vats. your pathology is pending at the time of discharge although preliminarily it does not appear that the tissue obtained from the vats was malignant. you had a temporary run of an irregular heart rhythm (nsvt). your ekg was unchanged and you had an echo that showed good heart function. . continue taking your medications as prescribed. . please seek medical attention if you have any chest pain, shortness of breath, dizzyness, coughing or any other concerning symptoms. . please follow up as outlined below. followup instructions: provider: , md phone: date/time: 1:20 provider: , md phone: date/time: 4:00 md procedure: insertion of intercostal catheter for drainage hemodialysis thoracentesis other incision of pleura transfusion of packed cells thoracoscopic drainage of pleural cavity thoracoscopic pleural biopsy thoracoscopic decortication of lung diagnoses: end stage renal disease tobacco use disorder congestive heart failure, unspecified iron deficiency anemia secondary to blood loss (chronic) chronic airway obstruction, not elsewhere classified peripheral vascular disease, unspecified atrial flutter pulmonary collapse hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified cardiac dysrhythmias other and unspecified angina pectoris chronic diastolic heart failure chronic myeloid leukemia, without mention of having achieved remission restless legs syndrome (rls) renal agenesis and dysgenesis 

Answer: The patient is high likely exposed to