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: hypoxic respiratory failure major surgical or invasive procedure: intubation, esophageal baloon history of present illness: hpi: pt is a 58 y/o f with htn, dm2, hypercholesterolemia who presented to an osh with increasing sob and cxr/chest ct infiltrates felt to respresent an ild, was transferred to floor for further work-up, underwent vats 1 day prior to micu admission, and developed hypoxemia and respiratory distress on the night of admission, prompting micu transfer and intubation. apparently she first began developing sx one month prior to presenting to the osh with increasing sob, attributed at first to a pneumonia that did not respond to antibiotics. her sx worsened and her doctor got a chest ct with diffuse bilateral interstitial and ground glass opacities. at osh, was ruled-out for mi, negative stress test, echo with decreased e/a ratio, cta without pe. she was transferred to and underwent vats one night prior to micu transfer, with the chest tube removed the day of transfer. overnight, she was seen by the nightfloat for hypoxia and tachypnea, transferred to the micu, and intubated. . past medical history: 1.)htn 2.)dm2 3.)hypercholesterolemia 4.)hypothyroidism social history: sochx: married. lives with her husband and children. works as a manager for an outside vendor at company. quit smoking 20 years ago, had smoked 1ppd x 10 years. no hx etoh or drug abuse. family history: fhx: mother had mi in her 70's - now with a pacemaker, also currently being treated for lymphoma. father has died, but had lupus and had cabg at age 70. brother had an mi and cabg at age 55. physical exam: pe: t 97.8, bp 96/50, hr 88, rr 20, spo2 97% vent- a/c vt 400/rr 16/peep 10/fio2 1.00 gen- anxious-appearing female, looks age, mod distress cv- rrr, s1s2, no m/r/g pul- moves air well, clear anteriorly, velcro rales way both lung fields abd- soft, nd, nabs extrm- no cyanosis/edema, warm/dry nails- no clubbing, painted neuro- sedated, intubated, perrl pertinent results: data: . non contrast ct chest impression: diffuse lung disease with a basal predominance. the differential diagnosis include nsip, uip, or cop. the less likely differentials are chronic hypersensitivity pneumonitis, sarcoidosis and drug related lung disease. if the patient is immunocompromised, atypical infection such as pcp could be possibility. 2) mediastinal lymphadenopathy. 3) innumerable small sub cm axillary lymph nodes and a 10 mm right prepectoral enlarged node.clinical correlation recommended. . bronch : showed no dah and had no complications. . vats data (): right middle lobe, wedge biopsy: a. acute and organizing interstitial pneumonitis with features of bronchiolitis obliterans/organizing pneumonitis (boop). b. intraparenchymal lymph node. right lower lobe biopsy: a. acute and organizing interstitial pneumonitis with features of bronchiolitis obliterans/organizing pneumonitis (boop). b. subpleural fibrosis and pleural adhesions. note: stains for bacteria and fungi are negative. . other lab data: + (1:80), -anca, neg anti gbm. . ct scan of chest there are multiple subcentimeter right and left paratracheal, prevascular, precarinal, and subcarinal lymph nodes measuring up to 7 mm in diameter that do not individually meet criteria for pathologic enlargement. there are no pathologically enlarged axillary lymph nodes. there is a tiny left pleural effusion, decreased in size from the previous examination. in comparison with the examination of , there is mild increase in consolidative opacity within the airspaces at the lung bases bilaterally and within the superior segment of the left lower lobe. there is additional increase in air space consolidation at the lung apices bilaterally, with patchy foci of dense consolidation at the right lung apex and in left perihilar and apical location. the distribution and extent of patchy geographic ground-glass opacity throughout the remainder of the lungs is probably not significantly changed in the interval. sutures are again seen at the right lung base. there is no pneumothorax. limited images of the liver, spleen, adrenal glands, upper poles of the kidneys, appear unremarkable. there is a small amount of dependent density within the gallbladder suggestive of small stones or milk of calcium. bone windows: bone windows demonstrate multiple right-sided rib deformities consistent with old healed fractures. no suspicious lytic or sclerotic osseous lesions are identified. impression: 1. interval progression of bilateral airspace consolidation, most prominent at the lung bases and within the superior segment of the left lower lobe, and additionally involving the lung apices and central perihilar regions. the geographic patchy ground glass opacity appears approximately unchanged in distribution. 2. decrease in size of small left pleural effusion. 3. probable gallstones or milk of calcium. brief hospital course: aa/p: 58 y/o f with htn, dm2 and newly diagnosed ild 1 day s/p transferred to micu and intubated for hypoxic respiratory failure. extubated and improved for 5 days, then required reintubation and remains intubated with increasing o2 requirements with a diagnosis of pcp (by bal) superimposed on her boop diagnosis. . 1) hypoxic respiratory failure -- chest x-ray, discussed with radiology, had appearance of progressive disease. final results of vats consistent with organizing interstitial pneumonitis with features of boop. she progressed on antibiotics in the past, had no fever/wbc, all making an overlying infectious process seem unlikely at the time. pt had fairly normal echo at the osh, making failure also seem to be an unlikely candidate. pt was on high dose solumedrol during this time. pts repiratory function improved, and she was extubted on . she remained on high flow mask until but was very anxious with occasional desats and ct chest on showed worsening bilateral infiltrates. bal was done and she was paralyzed with cisatracurium at 0.16mg/kg/hr and an esopageal baloon was placed and she was reintubated on aprv and then pc ventillation. bal micro data grew pcp pneumonia and iv bactrim was started. the question remains whether this was in the setting of high dose steroids (only short course prior to diagnosis) or due to an underlying immunocompromised condition. id was consulted after several days of continued inability to wean with high loading pressures (>30). several fungal studies were negative as were autoimmune serologies except for which was positive (rf negative). steroids were dosed at 60mg iv bid starting . on , she was reintubated over a guidewire for cuff leak. for the next several days, all attempts to wean ventillation were unsuccessful. the patient remained fluid overloaded and daily i/o goals were net negative. she received fluids with antibiotics, etc. that made this difficult to attain and lasix drip was used intermittently. in addition, the patient has an underlying anxiety disorder and required increasing amounts of sedation of both fentanyl and versed. as soon as sedation began to wean, bp was >185 systolic with apparant distress. several times, during daily sedation weans, we asked the pt to report on any pain. she responded with head nods or shakes appropriately to questions and denied any pain or other known sources of what could have been contributing to her elevated bp. she did admit to being anxious. starting around , discussions about trach began with the family. per ip, given her high peep requirement on ac (>10), a surgical should be considered as well. between , she required occasional increased in fio2 requirement and on the morning of , on 100% fio2 and peep of 12, o2 sats were in the mid 80's after one desat to the mid 70s. bronch revealed no plugging. given high fio2, no bal was performed. secretions have been bloody at times, but no visible trauma on bal. in addition, occasional blood in ng residuals had persisted since , but negative ng lavages. at this time, discussions with the family re: this turn for the worse began. on , md. is on pc with an fio2 of 100%, peep 18, pip 33, rr 20, map 22. her cxrs for the past few days have been significantly worse. we started vancomycin and meropenam on for coag + staph aureus in the sputum from ( pending) and worsening cxrs. ct done yesterday was consistent with worsening infiltrates. . 2) pcp : pts repiratory function took a turn for the worse several days ago requiring re-intubation due to pcp pna determined to have pcp pna on bal. - iv bactrim q8 dosing for pcp pna in setting of steroids. . 3) anxiety and sedation: underlying anxiety disorder. there is a clear relationship between elevated bp and anxiety. sedation resolves both issues for now. sedation switched a few times during the admission from fentanyl/versed to propofol. most recently, this is being done on . . 4) dm -- ins gtt. . 5) anemia - hct stable in mid 20's. had anemia of chronic dz per data this admission. . 6) hyponatremia- persists. changed bactrim to be loaded in ns instead of d5 (>1l daily fluid) on with some improvement. had ranged 128-134. . 7) gut immobilization/fen- for several weeks, the patient has had high rediduals with tube feeding. she has had enemas qid with lactulose as well as a full complement of po bowel medications and iv erythromycin (due to residuals on po). tpn was commenced on . see hyponatremia above. repleating other lytes as necessary. she had a contraction alkalosis with hypochloridia due to diuresis as well. . 8) ppx -- sc heparin, pneumoboots, ppi . 9) access -- r subclavian (placed ), peripherals, a line (placed ) . 10) comm -- with husband and pcp(dr. . 11) code -- full . 12) disp -- on , due to a family meeting where the fact that the patient had previously expressed no desire to be in a long term ventillated state was revealed, she was made cmo and died quickly after she was extubated. morphine was titrated to comfort. the family was present for the extubation. medications on admission: levothyroxine 100mcg qd glyburide 5mg glucophage 500mg asa 325 qd cozaar 50mg qd (per pt, on diovan?) ?detrol la (per patient. not per doctor) ?lipitor 10mg qd (per doctor. not per patient) recent levaquin discharge disposition: expired discharge diagnosis: expired discharge condition: expired discharge instructions: expired followup instructions: expired procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances non-invasive mechanical ventilation arterial catheterization closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus open biopsy of lung injection of anesthetic into peripheral nerve for analgesia proctostomy other nonoperative respiratory measurements diagnoses: anemia of other chronic disease pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia unspecified acquired hypothyroidism constipation, unspecified anxiety state, unspecified acute and chronic respiratory failure pneumocystosis postinflammatory pulmonary fibrosis methicillin susceptible pneumonia due to staphylococcus aureus other specified alveolar and parietoalveolar pneumonopathies 

Answer: The patient is high likely exposed to