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: cc: major surgical or invasive procedure: left upper bronchial artery embolization flexible bronchoscopy x 4 left subclavian central line history of present illness: hpi: patient is a 55yo gentleman with pulmonary thromboembolic disease who is on chronic anticoagulation who presents with hemoptysis in the setting of a supertherapeutic inr to 3.3. patient has a h/o massive pe, s/p ivc filter as well as chronic thrmobotic events. he has pulmonary htn and rv failure secondary to the thrombotic events. he started coughing blood 2 days prior to admission. he reports that it got worse on day of admission and was 1/2-1cup full in total. of note he also has a left upper lobe cavitarious lesion, suspcious for aspergilloma noted on pet in . he reported sweats and blurry vision and recent diarrhea. he denies pain, chest pain, sob, blood in his stools, change in urinary habits. . in the ed his vs were hr 100s, bp 112/70, 97% on 8lnc. he had a cta which showed new ground glass opacities surrounding the cavitary lesion. his labs were significant for inr of 3.3. he was seen by his primary pulmonologist () and angio and consented for possible intervention. he received 4 bags ffp and sent to the icu for management. on admission, impression was for supratherapeutic inr leading to bleed into cavitary lung lesion. patient received a further 2 bags of ffp with improvement in his inr to 2.2. hematorcrit was stable during his stay. sarted on voriconazole and ceftazidime (later stopped ceftaz) for treatment of pneumonia/lung lesion. patient was deemed stable for transfer to the floor, w/ plan for bronchoscopy +/- ablation by pulmonary/angio. past medical history: b/l pe w/ saddle embolism in . s/p icu admission and thrombolysis at that time. had ivc filter placed, maintained w/ goal inr since that time. pulmonary hypertension secondary to pulmonary thrombolic disease rv dysfunction lul cavitary lesion -> ? aspergilloma social history: social hx: lives with fiance. no children. custodian at middle school. 1.5 ppd x 20yrs. social etoh 3drinks/day. family history: no family h/o cancer or clotting/bleeding disorders. physical exam: pe: vs: t99.6 hr 115, bp 120/80 rr 22 99% on ra general: middle aged man in nad, speaks easily and comfortably heent: ncat, perrl, eomi, op clear chest: decreased bs bilaterally left worse than right, no crackles cardiac: tachy, rv heave, no m/r/g abd: +bs, soft, ntnd, no pulsatile mass noted ext: 2+ pulses, no edema, no clubbing. pertinent results: 01:25pm blood wbc-4.7 rbc-4.56* hgb-14.7 hct-44.4 mcv-98 mch-32.3* mchc-33.1 rdw-15.4 plt ct-195 11:45pm blood wbc-8.5# rbc-3.86* hgb-12.8* hct-36.7* mcv-95 mch-33.1* mchc-34.8 rdw-15.8* plt ct-137* 01:25pm blood neuts-55.7 lymphs-33.6 monos-6.1 eos-3.4 baso-1.2 01:25pm blood pt-31.1* ptt-34.8 inr(pt)-3.3* 01:25pm blood glucose-98 urean-13 creat-1.1 na-133 k-9.0* cl-100 hco3-21* angap-21* 11:45pm blood alt-21 ast-26 ld(ldh)-225 alkphos-282* totbili-1.4 11:45pm blood albumin-4.4 calcium-9.5 phos-2.5* mg-1.9 04:38am blood type-art temp-35.7 tidal v-500 peep-5 fio2-50 po2-71* pco2-45 ph-7.37 caltco2-27 base xs-0 -assist/con intubat-intubated 06:06pm blood lactate-2.1* . . cta chest () impression: 1. chronic calcified pulmonary embolism involving the distal left main pulmonary artery with filling defects within the upper lobe and lower lobe segmental branches. marked enlargement of the pulmonary arterial tree, likely related to underlying pulmonary hypertension. 2. left upper lobe cavitary lesion containing low-attenuation material with "air cresent" appearance which may indicate saprophytic colonization, ie. mycetoma ("aspergilloma"). this may relate to the surrounding patchy ground- glass opacity in the left upper lobe worrisome for alveolar hemorrhage from a bronchial arterial source, in this context. 3. stable left lower lobe pleural-based mass. 4. stable ground-glass opacities in the right lung, likely related to altered "mosaic perfusion" from chronic pulmonary emboli history. 5. small pericardial effusion. enlarged right heart, likely related to chronic pe history. . . pulmonary arteriogram / embolization note impression: 1. left bronchial arteriogram demonstrates vascular cavitary lesion in the left upper lobe, with apparent communication of the left bronchial artery with a branch of the left pulmonary artery. 2. successful left bronchial artery embolization with embosphere particles until stasis was achieved. 3. the case was discussed with dr. the attending of the medical team involved in the care of the patient prior to embolization and a possibility of infarction of a portion of the lung due to communication with the branch of the pulmonary artery and proximal partially occlusive chronic thrombus in the pulmonary artery was also discussed and the decision was made to go ahead with embolization as the risk of bleeding was very high. . . cardiac echo () conclusions: the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is unusually small. regional and global left ventricular wall motion are normal. (lvef>55%). no masses or thrombi are seen in the left ventricle. the right ventricular free wall is hypertrophied. the right ventricular cavity is markedly dilated with severe global free wall hypokinesis. there is abnormal septal motion/position consistent with right ventricular pressure/volume overload. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the tricuspid valve leaflets are mildly thickened. there is severe pulmonary artery systolic hypertension. the end-diastolic pulmonic regurgitation velocity is increased suggesting pulmonary artery diastolic hypertension. the main pulmonary artery is markedly dilated. there is a small to moderate sized circumferential pericardial effusion without evidence for hemodynamic compromise. echocardiographic signs of tamponade may be absent in the presence of elevated right sided pressures. compared with the prior study (images reviewed) of , the pericardial effusion is larger and the estimated pulmonary artery systolic pressure is much higher. right venticul cavity size and free wall motion are similar. . chest x-ray () comparison: . the endotracheal tube, nasogastric tube and the left subclavian central line are unchanged in position. cardiomegaly and marked enlargement of pulmonary arteries is unchanged. there has been no significant interval change in diffuse patchy consolidations throughout the right hemithorax as well as patchy consolidations in the left upper lobe which may represent pulmonary hemorrhage versus pneumonia/aspiration. a small left pleural effusion is unchanged. there is no pneumothorax. no other significant interval changes are noted. impression: no significant interval change in bilateral patchy consolidation and small left pleural effusion . brief hospital course: micu course: patient was admitted to micu on for observation due to concerning history of chronic pulmonary emboli and new onset hemoptysis. he was observed for two days in the micu during which he was stable and did not require any interventions. he was transfered to the floor on where he began having hemoptysis once again and had to be transfered to the micu for stabilization. a right mainstem intubation was attempted by anesthesia in an attempt to tamponade left lung, but this was not possible due to a very low carina. emergent bedside bronchoscopy was performed where ballon tamponade of the entire left lung was achieved. patient was taken to or on by interventional radionlogy, who was able to embolize blood supply to myecetoma, the known source of bleeding. during the procedure, it was determined that possibly due to the chronic emboli, bronchial and pulmonary circuits had coalesced and dual blood supply did not exist. due to the life threatening hemorrhage into his lung however, it was decided to risk left upper lobe ischemia and arterial supply was embolized. patient remained intubated and had several bedside flexible bronchoscopies to evacuate endobronchial thrombi with good improvement in gas exchange. inr remained elevated and was reversed with ffp with a goal below 2.0 in order to minimize residual low grade bleeding present. patient however remained dependant on mechanical ventilation and began to develop hypotension. sputum cultures isolated enterobacter and staph species and wide spectrum antibiotics were added in addition to pre-existing empiric coverage. . patient continued to have increasing o2 requirements and began to experience profound hypotension. pressors were initiated on and he was quickly maximized on levophed, vasopressin and neosynephrine with very limited results. a short trial of inhaled nitric oxide was also attempted for known severe pulmonary hypertension, with no clinically apparent results. family was contact regarding severity of his clinical situation and came in overnight. after condition continued to deteriorate and hypotension persisted in spite of above measures, family decided to pursue comfort care measures only. patient deteriorated within minutes of discontinuation of pressors and was pronounced dead at 5:40am of . . medications on admission: coumadin 7.5 3xweek, 5mg 4xweek, qmo inr checks hctz 12.5 qam nifedical xl 30mg qam protonix 40mg qam spiriva 1 cap qam revatio 20 tid (not taking - no insurance approval) discharge medications: not applicable discharge disposition: expired discharge diagnosis: patient deceased discharge condition: patient deceased discharge instructions: patient deceased followup instructions: patient deceased procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube fiber-optic bronchoscopy fiber-optic bronchoscopy fiber-optic bronchoscopy fiber-optic bronchoscopy other endovascular procedures on other vessels diagnoses: acute kidney failure, unspecified other chronic pulmonary heart diseases acute respiratory failure hypotension, unspecified long-term (current) use of anticoagulants personal history of venous thrombosis and embolism other and unspecified coagulation defects aspergillosis 

Answer: The patient is high likely exposed to