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: hypotension major surgical or invasive procedure: r internal jugular central line history of present illness: 51 yo male with aids (dx , on haart, vl undetectable, cd4 90 , h/o thrush and esophagitis) admitted with back pain/flank pain and fevers. he was in hus usoh until when he went to his pcp's with r sided pleurtic chest pain. he also had a resurangence of fevers to 102 - 105 and night sweats which he had had for 13 years, then stopped 2 years prior when he started haart. cxr on showed infiltrate within the left upper lobe and an opacityl at the right heart border. he was started on levaquin at that time. then on , he went to with l calf pain. he was admitted with a dvt and multiple pes. chest ct at that time also showed multiple bilateral segments and subsegmental pulmonary emboli, consolidation vs. infarct in the posterior left upper lobe and anterior right lower lobe, multiple bilateral pulmonary nodules, and mediastinal lymphadenopathy. mds there were also concerned that he could have tuberculosis as he had weight loss, fevers, and pulm nodules. he underwent bronch on which was "normal". cytology showedd atypical flora. cultures/labs from there showed negative crypto ag, oral flora from the bronch, afb smear negative, culture pending. he was started on coumadin and heparin and a second of levofloxacin. during this stay, he had no pulmonary symptoms. . on discharge from , he noticed his right leg now was tender, where it had not been before. he then was switched to a course of doxy on my his pcp. was not doing well at home since he was having extreem pain in both his legs. the swelling in the lle diminished, but the right increased. he had no pulmonary symptoms until the afternoon on when he began to become sob. he came to the ed. . in ed, initial vitals were 103.6, hr 145, bp 78/62, rr 18, 98% -> 100% on 2l .he was complaiing of worsening sob and pleurtic right chest pain. code sepsis called, rij placed. initial cvp was 7. he was boluesd 8 l ns in the ed. of note, his o2 sat on arrival was 98% ra, then 100% 2l in the ed,94% on 4l nc on arrival to micu. he was started on dopamine and levophed. he was given 1 gram of vancomycin, 1 gram of ctx, and a ds bactrim. blood cultures and urine cultures were sent. a ct chest revealed a left upper lobe opacity, subsegmental pe's, multiple b pulm nodules. . currently, he is sob and c/o pleurtic right sided and posterior chest pain and bilateral calf pain. he has been having fevers to 102 - 105 daily with night sweats. denies large weight gain (he has had touble with weight loss since his mac). no ha. no neck pain. no nausea. no vomiting. has one loose bm daily haart. denies missing any of his medicine. quit smoking 2 eeks agi. no recent ppd. no tuberculosis contacts. rashes. no recent travel. past medical history: aids on haart c/b thrush h/o mac infection of unknown site dvt left leg- copd- bullous changes intermittent diplopia asymptomatic uti moderate cervical spondylosis with moderate spinal canal stenosis and multilevel bilateral neural foraminal narrowing seen on mr cervical spine- epidermal inclusion cyst- right thigh social history: +tobacco ( pack a day) x35 years and quit 2 weeks ago, no etoh. no illict drugs, lives alone. works part-time with caterers. family history: mother- breast cancer, stomach cancer father: cva, heart disease physical exam: wt: 62kg, 97.9 po, p123, 108/75 (dopamine 9, levophed .2), r28, 96% on 4l nc (ed 8liter in and 1500cc out) general: mild resp distress, talkitave. able to relate history well. heent: nc/at, perrla. dentures in, no thrush seen. no scleral icterus noted, mmm. neck: supple, jvp normal pulmonary: anterior reveals a three componet pulmonary rub. cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: diffusly tender with voluntary guarding. normoactive bowel sounds, no masses or organomegaly noted. extreme right cvat extremities: 1+ pitting edema bilaterally on calf. very tender gastroc. 2+ radial, dp and pt pulses b/l. neurologic: a and o x3; srength grossly normal. brief hospital course: assessment: 51 yo m with aids, recent diagnosis of pe, pulmonary nodules, fevers, and shock. his shock is most likely due to sepsis given his increasing wbc and low cvp making right heart strain from pe unlikley. . plan: # septic shock: he seems to be in distributive shock. most likely this is sepsis, given that he is immunocompromised with fevers and respiratory distress. however, adrenal insufficiency unlikely given normal stim test. given his immunocomprimised state, he has many potential sources for sepsis including bactreial, fungal, and viral. infectious disease was consulted who recommended continue treatment with caspofungin, azithromycin, imipenem-cilastin. continue antiretrovirals and bactrim ppx. unclear source at this point. so far all cultures ngtd, cryptococcus, cmv, and histo serologies negative, afb x3, pcp stain, ag, negative. pt was placed on sepsis protocol. with frequent ns fluid bolus for cvp >12 and pressors. he had episode of nsvt on arrival while on dopamine and was changed over to levophed, which he required for several days of his addmision to keep map>65. given persistent hypotension concern for neurogenic shock secondary to autonomic dysfunction, neuro consult was obtained who did not think that patient has autonomic dysfunction on initial assessement. . # respiratory distress - as above, most likely secondary to pulmonary infection complicated by pulmonary emboli. required significant oxygen supplementation initially but this was reduced by 6 days of hospitalization from nrb to 40% by facemask. . # pe/dvt: hx of dvt and pe on recent hospitalization. rl leni shows dvt this admission. given likely coumadin failure ivc filter was placed. pt was started on heparin initially and then changed over to lovenox 1mcg/kg . am with rue swelling as well, with dvt. heme onc consulted, started on heparin as developing dvts through lovenox. - given recurrent dvt and ?pulmonary nodules and enlarged lymphnode concern for malignancy in setting of hypercoguble state high. - currently morphine prn. . #. hemoptysis - likely secondary to underlying pulmonary processes. consider bronchoscopy only if this worsens (currently stable). . #polyuria - unclear etiology. continues to urinate to the point of hypotension despite ivf being stopped. have neprogenic di ambisome. also not be able to concentrate urine to excrete all the salt he has gotten on the sepsis portocol causing an solute diuresis. gave dose of ddavp to see if can concentrate urine. ambisome switched to caspofungin. - renal was consulted given concern for di. they did not think that the pt has diabetes insipidus given that the patient has had normal uosm and una. more likely, this is consistent with a solute diuresis from the large amounts of fluid the patient has received during this hospitalization. it is unclear whether he is intravascularly depleted or overloaded, and his weight is up approx 6kg. if he is making appropriate urine to previous ivf administration, would expect his urine now to more accurately match his input. with restriction on ns ivf, pt's urine output has improved. . # infection - unclear etiology most likely source of infectionis pulmonary, but differential in this immunocompromised patient is very broad. id following. so far all cultures ngtd, cryptococcus, cmv, and histo serologies negative - on retrovirals, azithro/bactrim - imipenem dc'd- continuing with vanco . ## neuro - pt with c/o diplopia this morning which is new. also with nystagmus on exam concerning for brainstem process. - per discussion with neuro attg, given pt's likely hypercoaguble state need to rule out stroke. - mri/mra -small l cerebellar stroke, w/ sluggish basilar artery flow, cta also showed no thrombus but decreased basilar artery flow. per neuro ordered tte w/ bubble, no asd or pfo - daily ct showed no change (needs daily ctx7 day to assess no hemorrhagic development . #hemoptysis - likel secodary to pe and pna. stable in amount and frequency. is small amounts at this time. if decompensates of hemoptysis progresses beyond tsp amounts will need bronchoscopy and possible surgical consult. . ## neuro - pt with c/o diplopia this morning which is new. also with nystagmus on exam concerning for brainstem process. - per discussion with neuro attg, given pt's likely hypercoaguble state need to rule out stroke. - mri/mra to eval for stroke. . # aids: initially held haart therapy. restarted on . #. pulm nodules - concern for malignancy given fevers, lad. o/w infection as above. with lul mass, discuss timing of biopsy as differential includes lymphoma vs lung neoplasm, will need to discuss holding anticoagulation. . ppx: ppi, no pneumoboots, lovenox, increase bowel regimen given constipation, no bowel movement since admission per pt fen: po diet as resp status stable access: rij, r art line, piv communication: sister dispo: icu until hd stable # code status: full, discussed extensively with paitent and hcp, , his sister. is very nervous about intubation, but agrees that he may benefit from it in the short term. # dispo: icu for now given hypotension. # contact: , sister ... the patient had a prolonged intensive care unit stay. he developed further progressive thromboses. an ivc filter was placed to prevent further pulmonary emboli. he developed ischemic bowel with thrombosis of celiac and mesenteric arteries. after extensive discussion with patient and his sister , the patient was made care and comfort measures only. he was treated with iv morphine and expired peacefully on . medications on admission: truvada reyataz 150' norvir 100' bactrim ds' azithromycin twice weekly ambien prn doxycycline 100 mg since vicodin 5/725 prn for leg pain discharge medications: none discharge disposition: expired discharge diagnosis: acquired immune deficiency syndrome adenocarcinoma of lung pulmonary emboli mesenteric ischemia discharge condition: deceased discharge instructions: remains released to funeral home followup instructions: none procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified diagnostic ultrasound of heart insertion of endotracheal tube interruption of the vena cava thoracentesis arterial catheterization biopsy of lymphatic structure transfusion of packed cells injection or infusion of cancer chemotherapeutic substance diagnoses: pneumonia, organism unspecified abnormal coagulation profile other pulmonary insufficiency, not elsewhere classified unspecified septicemia severe sepsis chronic airway obstruction, not elsewhere classified other chronic pulmonary heart diseases human immunodeficiency virus [hiv] disease nausea with vomiting other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure septic shock pressure ulcer, other site other complications due to other vascular device, implant, and graft antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use malignant neoplasm of other parts of bronchus or lung hematemesis embolism and thrombosis of other specified artery accidents occurring in residential institution other pulmonary embolism and infarction vascular disorders of kidney acute venous embolism and thrombosis of unspecified deep vessels of lower extremity hepatic infarction cerebral thrombosis with cerebral infarction secondary and unspecified malignant neoplasm of lymph nodes of multiple sites polyuria disseminated due to other mycobacteria 

Answer: The patient is high likely exposed to