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: this is a 55-year-old man with a history of metastatic left tonsillar cancer status post resection, chemotherapy, radiation and tracheostomy placement, who presents with chest pain, productive sputum and fever. the patient states that, two to three days prior to admission, he felt weak and fatigued. he has a chronic cough at baseline, but notices that it has been increasingly productive over the past several days. he states that sputum is pinkish in color. he has not had any documented fevers. he denies any chills or sweats. in the emergency department, he was found to be febrile at 100.8. chest x-ray demonstrated bibasilar nodular opacities and new right middle lobe collapse. cta demonstrated no pulmonary embolism, but did demonstrate right middle lobe nodular opacity with surrounding ground-glass and impaction of airways with partial collapse of the right middle lobe. several other nodular opacities were noted. a small left effusion and subcarinal and hilar adenopathy was also noted. the patient was admitted for pneumonia. past medical history: 1. metastatic left tonsillar squamous cell carcinoma, originally diagnosed back in . the patient had left tonsillar fullness and left neck mass and underwent tonsillectomy in by dr. of ent. he started on chemotherapy with taxotere, cisplatin and 5-fu in . his diagnosis included stage iv and iii squamous cell carcinoma. he underwent left modified radical neck dissection in following several round of chemotherapy. on , the patient underwent neurosurgery for a c6 metastatic vertebral tumor. he had a c6 vertebrectomy, c5 to c7 anterior cervical arthrodesis and fusion, and c5 to c7 anterior cervical instrumentation performed by dr. . on , the patient demonstrated bilateral vocal cord paralysis and airway obstruction. he received a #6 shiley cuffless fenestrated tracheotomy tube by dr. of ent. 2. orthopaedic problem in right knee with metal plate allergies: no known drug allergies. medications: 1. lactulose 30 cc once daily 2. morphine elixir 15 mg every six hours 3. diazepam 30 mg every six hours social history: the patient is approximately a 120 pack year smoker, but quit approximately ten years ago. he has a history of heavy alcohol abuse in the past, but no longer drinks. he has a history of nasal cocaine use, but has no history of intravenous drug use. the patient is a homosexual man, but has never engaged in anal intercourse. he has had one partner who passed away from hiv. he has had many occupations, including art student, bartender, and landlord. family history: father died in his 80s of a cerebrovascular accident. his father also had prostate cancer, but had not received treatment. he had a brother who died at age 12 of leukemia. physical examination: vitals: temperature 100.8, blood pressure 112/74, pulse 110, respiratory rate 20, oxygen saturation 100% on room air. general: cachectic male in no acute distress, who is alert and oriented x 3, and speaks through a trach. head, eyes, ears, nose and throat: pupils equal, round and reactive to light and accommodation, extraocular movements intact, trach in place, mucous membranes moist. lungs: positive rhonchi, upper airway noise, otherwise clear. cardiovascular: tachycardic, but no murmurs, gallops or rubs. abdomen: soft, nontender, nondistended. lower extremities: no cyanosis, clubbing or edema. laboratory data: white blood cells 7.9, hematocrit 27.5, hemoglobin 8.8. neutrophils 82, bands 8, platelets 358. hospital course: 1. pneumonia: during the hospital course, the patient was initially noted to have increased secretions and increasing oxygen requirements. he also had worsening chest x-ray and increasing size of left pleural effusion. ultrasound revealed this pleural effusion was loculated, and the patient went for ultrasound-guided drainage by radiology. the patient had been on levaquin and clindamycin intravenously prior to the tap. the tap revealed 11,450 white blood cells, ldh of 3695, glucose of 4. gram stain was negative. cytology was suggestive of metastatic disease, although this could not be confirmed. given the low glucose and ldh, concern was raised over possible empyema. interventional pulmonology was consulted, and they placed a chest tube. fluid was drained, but this was felt to be a parapneumonic effusion. the chest tube had good output and drained over 300 cc of yellow fluid. the patient's chest x-ray improved gradually with this. the patient's oxygen requirement remained fairly stable, but did slightly decrease. the patient appears to have copious secretions. on hospital day nine, the patient required transfer to the medical intensive care unit for more frequent suctioning. the patient returned to the floor on hospital day ten. on hospital day 12, the patient underwent bronchoscopy for question of tracheal stenosis. this revealed no signs of tracheal stenosis, but did reveal edema of the false vocal cords, copious secretions, and mild granulation tissue around the trach. on hospital day 14, the patient had his chest tube discontinued by cardiothoracic surgery. follow-up chest x-ray revealed mild left-sided effusion. of note, the patient also had his tracheotomy changed twice during this admission. first he had it changed to a cuffed shiley due to concern over the patient's large secretions. due to patient preference and wish to speak, this was changed back to his non-cuffed fenestrated trach prior to his discharge. the patient started to have slightly decreased secretions and decreased oxygen requirements. the patient did undergo a substantial improvement. given his need for frequent suctioning and respiratory needs, he was felt to need rehabilitation. 2. hematology: the patient came in anemic at 27.5. due to the patient's shortness of breath, it was felt he may benefit from transfusion. his hematocrit slowly trended down to 23, and the patient was transfused two units of packed red blood cells on hospital day eight. the patient's hematocrit increased to about 31, where it remained stable. this was felt to be likely due to an anemia of chronic disease. the patient was on epogen and iron. 3. oncology: the patient is seen by dr. and dr. of oncology. the patient had been receiving outpatient chemotherapy with taxol and carboplatin for palliative chemotherapy. these were held during his admission. the patient may need to renew these as an outpatient. 4. gastrointestinal: the patient has had a gastrostomy tube placed in . he had this fixed prior to his most recent admission. during his admission, he had some leaking from the tube, and the patient went down to interventional radiology, who changed the external tubing with good relief of his leaking gastrostomy tube. 5. pain: the patient initially came in on morphine elixir. the patient had this dose slowly titrated up. when the patient received his chest tube, he required increasing pain medications and received a dilaudid patient-controlled analgesia with good relief. once the chest tube was discontinued, the patient was able to transition back to morphine elixir, although at a higher dose. discharge status: the patient is to be discharged to rehabilitation, where he will be able to maintain his functional status and receiving suctioning. discharge condition: stable. discharge diagnosis: 1. pneumonia, likely post-obstructive 2. metastatic left tonsillar squamous cell carcinoma 3. status post left thoracentesis 4. status post left chest tube placement 5. status post bronchoscopy 6. left chest wall pain 7. gastrostomy tube repair 8. anemia of chronic disease status post two units of packed red blood cells transfusion discharge medications: 1. lactulose 30 ml by mouth once daily 2. tylenol 325 to 650 mg by mouth every four to six hours as needed 3. diazepam 5 to 10 mg by mouth every six hours 4. epoetin alfa 14,000 units subcutaneously weekly 5. guaifenesin 10 ml by mouth every four hours 6. ranitidine 150 mg by mouth twice a day 7. levofloxacin 500 mg by mouth once daily 8. clindamycin 450 mg by mouth every six hours 9. morphine sulfate oral solution 30 mg by mouth every four hours for pain , m.d. dictated by: medquist36 procedure: insertion of intercostal catheter for drainage enteral infusion of concentrated nutritional substances thoracentesis closed [endoscopic] biopsy of bronchus replacement of gastrostomy tube diagnoses: anemia, unspecified unspecified pleural effusion pneumonitis due to inhalation of food or vomitus secondary malignant neoplasm of bone and bone marrow mechanical complication of gastrostomy attention to tracheostomy personal history of malignant neoplasm of other sites 

Answer: The patient is high likely exposed to