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: sob, hypoxia major surgical or invasive procedure: intubation arterial line colonoscopy egd left subclavian line tracheostomy peg tube history of present illness: 68yo man with h/o hiv/aids (last cd4 211 , vl <50 on haart), cad s/p cabg , pci rca , chf (ef >55%, diastolic dysfunction), admitted with sob and fever. he has been intubated previously for recurrent pneumonia and chf exacerbations. the patient was evaluated in the ed after noting fever of 101 at home. cxr at that time showed no change from prior, ua was negative, and other labs were essentially unremarkable, and he was discharged to home. he was evaluated by his pcp and started on azithromycin for concern of atypical pneumonia. on the morning of admission he developed a fever to 101.8 and worsening shortness of breath. he denied cough and chest pain. on presentation to the ed t 99.1, hr 61, bp 146/44, rr 24 93%ra. cxr showed new bilateral patchy opacities. he was started on azithromycin, ceftriaxone, and vancomycin. he was transferred to the micu that night with worsening tachypnea and decreasing o2 saturation on 100% nrb. oxygentation improved after diuresis with torsemide, and he was transferred back to the floor on zosyn, vancomycin, and azithromycin for treatment of pneumonia. since that time he has continued to spike fevers, today to 100.7. renal function has declined with creatinine rising 3.0 to 4.4 between and today, . on the night of he was diuresed after developing pulmonary edema with iv fluid boluses for treatment of acute renal failure, thought to be prerenal in etilogy. hospital course has been complicated by recurrent diarrhea, c. diff negative x1. * on patient desaturated to 88% on 100%nrb, rr 26, bp 120/70, hr 75. abg 7.31/41/63 on nrb. cxr showed diffuse patchy infiltrates unchanged since last cxr and small bilateral effusions. patient was alert and conversive. he was sob, denies chest pain, abdominal pain, headache, dizziness. prior to transfer to the micu he received torsemide 20mg iv x1. past medical history: 1. hiv, diagnosed in . last cd4 273, vl<50 on . patient has history of ks, cmv esophagitis. source of transmission unknown. 2. cad, s/p 2-vessel cabg in and rca stent in 10/. patent stents on last cath in 10/. 3. diastolic chf 4. history of large cell lymphoma (liver and periaortic lymph nodes) s/p 6 rounds of chemotherapy in 5. peripheral vascular disease. 6. dm type 2 7. hypertension 8. gerd 9. cri with history of hyperkalemia. baseline creatinine variable. last 0.8 in 11/. 10. lipodystrophy 11. history of tia with left hemiplegia that resolved. 12. status post anterior disc excision and fusion c7-ti in . 13. h/o resp failure requiring intubation (x7 days) with "double pna" and resp failure in in 14. probable hiv encephalopathy 15. severe arthritis involving both shoulders and cervicle spine social history: he lives with his wife in . he is a lifelong non-smoker. no etoh consumption and no history of illicit drug use. + flu shot this year. family history: sister died of cad and cva brother has h/o cad mother has h/o cad physical exam: on admission: pe: t 97.3 tm 100.7 hr 78 bp 154/45 rr 38 90% nrb gen: cachectic appearing, in moderate respiratory distress with use of accessory muscles heent: perrl, anicteric, mm dry, neck: neck supple, jvp elevated to jaw cv: rrr, no mrg, nml s1s2 resp: diffuse crackles to apices, decreased bibasilar breath sounds r>l, no egophany, rll dullness to percussion abd: +bs, soft, nt, nd ext: no edema, decreased dp's b, warm neuro: alert and oriented, cn ii-xii intact with decreased hearing b (r>l), motor and sensation intact grossly on transfer to micu: pe: t 97.3 tm 100.7 hr 78 bp 154/45 rr 38 90% nrb gen: cachectic appearing, in moderate respiratory distress with use of accessory muscles heent: perrl, anicteric, mm dry, neck: neck supple, jvp elevated to jaw cv: rrr, no mrg, nml s1s2 resp: diffuse crackles to apices, decreased bibasilar breath sounds r>l, no egophany, rll dullness to percussion abd: +bs, soft, nt, nd ext: no edema, decreased dp's b, warm neuro: alert and oriented, cn ii-xii intact with decreased hearing b (r>l), motor and sensation intact grossly pertinent results: ct chest (): diffuse ground-glass opacifications and septal thickening bilaterally. there is an associated right pleural effusion. this could be due to an element of chf. there is also more patchy airspace opacifications seen at both lung bases. * left upper ext u/s (): to eval to swelling there is flow throughout all the veins of the upper extremity. there is compressibility of the subclavian and axillary veins. compressibility of the smaller upper extremity veins is limited due to technical factors on the current exam. * echo (): the left atrium is mildly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef 70%). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the right ventricular free wall is hypertrophied. the right ventricular cavity is mildly dilated. right ventricular systolic function appears depressed. 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. there is severe pulmonary artery systolic hypertension. there is no pericardial effusion. . renal u/s : no evidence of hydronephrosis. normal renal ultrasound. . egd : friability and erythema in the first part of the duodenum compatible with duodenitis. erosions in the second part of the duodenum . gi bleeding study : no evidence of intra-abdominal extravasation of tracer to indicate a gi bleed. however, lateral delayed images show abnormal tracer uptake within the region of the rectum. the rectal area could be further evaluated by direct inspection. . egd : stricture of the distal bulb blood in the fundus mucosa suggestive of barrett's esophagus otherwise normal egd to mid-jejunum . colonoscopy : there was no blood in the colon or terminal ileum. otherwise normal colonoscopy to terminal ileum . video swallow : aspiration and penetration of thin and nectar-thickened liquids. please refer to speech pathologist report for further evaluation. brief hospital course: 67 yo man with hiv/aids, cad s/p cabg, htn, dm2 admitted with fever and shortness of breath, transferred to micu with hypoxic respiratory failure requiring intubation. #) hypoxic resp failure requiring intubation. trach placed on . pt initially with multifocal pna and likely fluid overload (pcwp of 27). he received 10 days of azithromycin for atypical pna coverage and 21 days of vanco/zosyn. 1st bronch did not reveal a great deal of sputum in his airways thus assumed initial pna had resolved. he was then placed on a lasix gtt for aggressive diuresis. he was thought to have right heart failure secondary to pulm htn (cvp of 13, pa pressure of 69/28). his swan was d/c'ed on . an echo done on revealed an ef of 70%, normal e/a ratio, moderate pa htn and rv hypokinesis. his lasix gtt was eventually d/c'ed on for acute on chronic renal failure. a 2nd bronch was performed on to evaluate a rll opacitiy; bal gram stain revealed 1+ gpc but negative culture, negative pcp/afb cultures, positive yeast. a third bronch done on ; bal w/o wbc's, gram stain negative, cultures ng. a sputum cx on revealed op flora and yeast. he was treated with 3 days of caspofungin for yeast in his sputum, urine, and on his skin. yeast was then noted to be . he then developed ards (increased vd/vt ratio with decreased compliance) which subsequently resolved. he was able to be weaned off ventilator support; he tolerated a trach mask for 4 days prior to discharge. his trach was changed to a 6 portex cuffless nonfenestrated trach prior to discharge with plan to decanulate at rehab. #) gi bleed: melena and hct drop to 18 on . egd on revealed duodenitis and duodenal erosions without active bleeding. a bleeding scan revealed abnormal tracer uptake within the region of the rectum. he received 5 units of prbcs on , with hct rise to 32.2. c-scope on revealed no bleeding source, a repeat enteroscopy showed clot in fundus and stricture in duodenal bulb. no further workup was performed. he received intermittent transfusions from . his gi bleed did not recur and his hct remained stable throughtout the remainder of his hospital course. #) acute on chronic renal failure (basline cr 1.6-1.9). etiology thought to be secondary to atn from gi bleed superimposed on cri secondary to htn and dm. haart regimen was not thought to be the cause of acute failure. his creat again increased after aggressive diuresis (no casts on urine sediment at that time). his creatinine improved to 1.5 after lasix gtt d/c'ed and fluid goals changed to even. his daily fluid goal was even prior to discharge. he was given lasix prn. of note his home regimen includes lasix 40 mg daily. #) hiv: last cd4 count pre-hospitalization >300, 211 during illness. on bactrim prophylaxis. haart initially held secondary to inability to pass ngt/ogt/dob-hoff. restarted on . received haart meds intermittently until , but then held as per id as pt had to be npo for various gi and pulm procedures. haart meds again restarted on . hiv genotype ordered. viral load noted to be <50 on . #) hypernatremia. new on , presumed secondary to aggressive diuresis with lasix. he was continued on free water boluses (250 cc q 6 hrs). hypernatremia resolved on . #) htn. bp well controlled during hospital stay. he was maintained on his outpatient regimen of metoprolol, hydralazine, and amlodipine. #) dm type 2: he was on an insulin drip from - for tighter blood sugar control. prior to discharge his blood sugars were well controlled on an increased dose of nph (27 units ) and a regular insulin sliding scale. #) mid back pain; etiology likely musculoskeletal secondary to prolonged bedrest. pain was well controlled with tylenol and morphine prn. he was discharged on prn oxycodone. he was seen by pt and ot during his stay. #) psych. he developed a delirium thought to be secondary to his prolonged icu stay. it resolved prior to discharge. he was continued on olanzipine and paroxetine. #) cad s/p cabg - continued on b-b. asa and restarted after gi bleed resolved. he is not on an acei likely secondary to h/o hyperkalemia. unclear why his is not on a statin. lft's noted to be wnl's. #) fen: pt with ngt; tube feeds at goal throughout most of hospital course. a video swallow evaluation was performed; it was determined that mr could take his po meds however will not likely maintain caloric intake without tube feeds. peg placed at bedside by gi on . #) ppx: sc heparin, ppi. elevate hob. bactrim qod. #) access: swan ganz (pulled on ), left a line pulled , right picc placed - pulled prior to discharge. medications on admission: medications on admission: abacavir sulfate 300mg--one twice a day bactrim 200-40mg/5--20 ml crixivan 333mg--3 three times a day epivir 150mg--one twice a day hydralazine hcl 100 mg tid insulin sliding scale klonopin 0.25mg--one at bedtime lopressor 50mg--one twice a day neurontin 400/800/800 nevirapine 200mg--one tablet by mouth twice a day zantac 150mg norvasc 5mg--2 every day paxil 20mg--one tablet every day peridex 1.2mg/ml--swish and spit twice a day as needed 75mg--1qd torsemide 60 mg zyprexa 5mg--one at bedtime * meds on transfer from floor to icu: abacavir 300mg amlodipine 10mg daily azithromycin 500mg iv q24hr zosyn 2.25mg iv q8hr vancomycin 1000mg iv q48hr ativan prn oxycodone 5mg prn 75mg daily hydralazine 100mg tid indinavir 1000mg tid insulin 20units nph +riss lamivudine 100mg daily metoprolol 50mg tid nevirapine 200mg olanzapine 5mg qhs paroxetine 20mg daily ranitidine 150mg daily bactrim 20ml qod triamcinolone tp asa 81mg daily discharge medications: 1. paroxetine hcl 20 mg tablet sig: one (1) tablet po daily (daily). 2. epoetin alfa 2,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-friday). 3. chlorhexidine gluconate 0.12 % liquid sig: five (5) ml mucous membrane (2 times a day). 4. heparin sodium (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day). 5. nevirapine 200 mg tablet sig: one (1) tablet po bid (2 times a day). 6. indinavir 200 mg capsule sig: five (5) capsule po three times a day. 7. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 8. clonazepam 0.5 mg tablet sig: one (1) tablet po bid (2 times a day). 9. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 10. oxycodone 5 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 11. gabapentin 400 mg capsule sig: two (2) capsule po q afternoon and pm (). 12. gabapentin 400 mg capsule sig: one (1) capsule po q am (). 13. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 14. hydralazine 50 mg tablet sig: two (2) tablet po three times a day. 15. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 16. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 17. acetaminophen 500 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 18. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po qhs (once a day (at bedtime)). 19. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 20. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed. 21. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: puffs inhalation q6h (every 6 hours). 22. bactrim 400-80 mg tablet sig: one (1) tablet po every other day. 23. abacavir 300 mg tablet sig: one (1) tablet po twice a day. 24. epivir 150 mg tablet sig: one (1) tablet po once a day. 25. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for sob, wheezing. 26. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: puffs inhalation q4h (every 4 hours) as needed. 27. nph insulin 27 units in the morning and evening. 28. regular insulin sliding scale please refer to insulin sliding scale. 29. lasix 40 mg tablet sig: one (1) tablet po once a day as needed for signs and symptoms of fluid overload: pt has been doing well with a daily fluid goal of even please give lasix based on clinical exam. normal regimen includes 40 mg daily. . discharge disposition: extended care facility: cape & islands discharge diagnosis: pneumonia chf exacerbation ards gi bleed s/p intubation, tracheostomy, and peg discharge condition: fair discharge instructions: please call your primary care physician or return to the hospital if you experience worsening shortness of breath, chest pain, cough, fever, or have any other concerns. followup instructions: you have the following appointment scheduled: 1. provider: , m.d. where: cardiac services phone: date/time: 11:00 2. provider: , m.d. where: lm disease phone: date/time: 1:30 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] arterial catheterization temporary tracheostomy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus colonoscopy pulmonary artery wedge monitoring transfusion of packed cells diagnoses: pneumonia, organism unspecified acidosis anemia, unspecified acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified unspecified protein-calorie malnutrition candidiasis of other urogenital sites other chronic pulmonary heart diseases human immunodeficiency virus [hiv] disease mononeuritis of lower limb, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure pressure ulcer, lower back hyperosmolality and/or hypernatremia diastolic heart failure, unspecified diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled duodenitis, with hemorrhage other obstruction of duodenum 

Answer: The patient is high likely exposed to