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: no known allergies / adverse drug reactions attending: chief complaint: left shoulder pain dyspnea on exertion major surgical or invasive procedure: bronchoscopy history of present illness: mr. is a 70m with hx of metastatic prostate cancer with known metastases to the lung and thoracic/lumbar spine with progression on multiple lines of prior therapy who presents with left shoulder pain. patient reports that he was attempting to elevate himself from his wheelchair on the day of admission when he felt a "" in his l shoulder. he developed worsening pain in this region and an obvious deformity over his clavicle. the patient also endorses worsening shortness of breath with exertion over the past 2-3 days. he states that previously he was able to walk throughout his home without significant breathing difficulty, though has not been able to do so recently. he is short of breath with telephone conversations and minimal movement. he denies any associated cough, sputum production, fevers/chills, chest pain, palpitations. he does endorse increased leg swelling and lbs weight gain. with respect to his end-stage prostate cancer, the patient recently discontinued treatment with xl184 ( clinical trial) on due to extreme fatigue. he has remained transfusion dependent, receiving 2u prbcs on a weekly basis over the past two weeks. most recently, patient received 2 units of prbcs for hct 21.9 on . recent oncology notes document a recent improvement in energy level since discontinuing xl184, attributed to participation with physical therapy, transfusions, and an increased dose of steroids (dexamethasone 4 mg ). the patient is aware of his end-stage status, and has expressed interest in hospice care per heme-onc notes. in the ed inital vitals were, 97.8 78 95/58 18 88% ra. cxr revealed evidence of multifocal pna vs interstitial edema (prelim report). x-ray of his clavicle revealed a fracture. labs were significant for lactate 2.5, hct 17.8, plt 20, and inr 1.2. he was given vancomycin x 1 and piperacillin/tazobactam x 1. vs on transfer were: 77 104/57 27 100% on 4 liters. he was transferred with 18g piv x 2. on arrival to the micu, vs: afebrile 85 101/60 19 92%4l nc. he has no acute complaints. review of systems: (+) per hpi (-) denies fever, chills, night sweats. denies headache, sinus tenderness, rhinorrhea or congestion. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: hypercholesterolemia metastatic prostate ca hypothyroidism hx of diverticulosis . psh: prostatectomy, l cataract, l knee arthroscopy . onc hx:(as per recent d/c summary) - prostate biopsy which demonstrated with prostate cancer demonstrated in cores, 3+3 - prostatectomy was performed with surgical pathology revealing a pattern of 3+4 was noted, one left pelvic lymph node was removed, without malignancy identified. the seminal vesicles were without malignancy. margins were negative, and perineural invasion was noted. - psa 0.2 - psa 0.6 - psa 6.8 - ct demonstrated pulmonary nodules within the visualized lung bases, new from . - vats resection of nodule - pathology from demonstrated metastatic adenocarcinoma, consistent with metastasis from a prostatic origin based on immunostains that demonstrated tumor being positive for psa and cytokeratin cocktail. they were negative for cytokeratin 7, 20, psap and ttf-1 with satisfactory controls. - started lupron therapy - casodex added to lupron - rising psa, started on khad trial - ketoconazole stopped - started des - bronchoscopy with endobronchial ultrasound-guided transbronchial needle aspiration of station 7 and 4r and biopsies of mucosal irregularity at carina and proximal left main. - positive for malignant cells, immunoreactive for psa, psap and keratin ae1/ae3, cam 5.2 - taxotere x 3 cycles - cabazitaxel x 3 cycles - abiraterone - cycle 4 taxotere - clinical trial of xl-184 ( protocol 09-432). - withdrew from clinical trial xl-184 fatigue social history: the patient is married with a 11 year old daughter, is semi-retired, works in finance, has hx of tobacco use (20 pack years, but quit 20 yrs ago), drinks a per night, denies illicits. family history: his mother had a history of hypertension, she died at the age of 88, father with a history of ulcer, and prostate cancer, though he refused treatment. mr. reports his father died of old age at the age of 97. he denies any known history of cancer in the family otherwise. physical exam: admission exam: vitals: afebrile 85 101/60 19 92%4l nc. general: alert, oriented, no acute distress, speaks in word phrases heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp 8 cm lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: regular rate and rhythm, normal s1 + s2, no m/r/g abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: left arm in sling, bony deformity over left clavicle, neurovascularly intact distally, 1+ le edema b/l discharge exam: expired pertinent results: admission labs: 11:00pm blood wbc-7.1 rbc-2.06* hgb-6.0* hct-17.8* mcv-87 mch-29.2 mchc-33.7 rdw-20.8* plt ct-20* 11:00pm blood neuts-57 bands-3 lymphs-25 monos-8 eos-1 baso-0 atyps-0 metas-3* myelos-3* nrbc-18* 11:00pm blood pt-12.6* ptt-23.5* inr(pt)-1.2* 08:19am blood fibrino-391# 11:00pm blood glucose-116* urean-40* creat-0.9 na-138 k-4.5 cl-103 hco3-23 angap-17 08:19am blood ld(ldh)-2456* 11:00pm blood probnp-1001* 07:43pm blood calcium-8.0* phos-3.8 mg-2.1 08:19am blood hapto-<5* 12:42am blood lactate-2.5* 07:05am blood lactate-0.9 07:05am blood type-art po2-64* pco2-32* ph-7.49* caltco2-25 base xs-1 intubat-not intuba comment-nasal microbiology: viral swab bronch culture blood culture imaging: cxr : 1. displaced left clavicular fracture, as described above. no pneumothorax. 2. mild interstitial pulmonary edema. l. clavicle xray : impression: displaced distal left clavicular fracture in patient with diffuse osteoblastic metastases. no evidence of pneumothorax. ct chest w/ contrast : impression: as compared to the previous ct examination from , there are newly appeared bilateral multifocal diffuse parenchymal opacities. the morphology of these opacities suggests multifocal pneumonia. the morphology is neither typical for pulmonary edema nor for metastatic disease. no pleural effusions. no other relevant change as compared to the previous examination with regard to size and distribution of visible lymph nodes and the appearance of the heart and the large mediastinal vessels. diffuse metastatic bone disease that is, overall, stable, with the exception of a newly evident displaced left clavicular fracture. brief hospital course: mr. is a 70 y/o m with hx of metastatic prostate cancer with known mets to the lung and extensive involvement of his thoracic and lumbar spine who presents with left clavicle fracture and hypoxemia. # hypoxemia/multifocal pneumona: cxr showed diffuse bilateral infiltrates. patient was treated for potential infectious pneumonia. bronchoscopy showed evidence of diffuse alveolar hemorrhage. patient was placed on high dose steroids which did not improve respiratory status. it was determined that there were no further interventions that would help patient, and focus should be on comfort. patient was placed on morphine drip to help with dyspnea. he expired at 20:45 on . # left clavicle fracture: likely pathologic fracture in setting of osseus involvement of disease. no evidence of neurovascular compromise distal to fracture. arm maintained in appropriate sling device. pain control with oxycontin + oxycodone home dose. # anemia/thrombocytopenia: due to dic as patient with diffuse alveolar hemorrhage. transfused for hematocrit <21 and platelets <50. when patient's breathing became significantly worse, he was made comfortable and blood draws/transfusions were discontinued. # metastatic prostate cancer: end-stage metastatic disease with bone marrow involvement. recently discontinued clinical trial. # goals of care discussion: patient intially full code on admission. family meeting held at bedside with patient, his wife , oncology attending dr. and oncology fellow on regarding goals of care. decision was made by patient, mr. to change his code status from full to dnr/dni with request for no heroic efforts to be made in the setting of cardio/pulmonary distress. palliative care consulted to help with pain and dyspnea control. when patient's breathing became too severe, he was started on morphine drip and made comfort measures only through discussion with his wife, hcp. # hypothyroidism: continued home dose levothyroxine until patient made comfort measures only. patient expired at 20:45 on . medications on admission: dexamethasone - 4 mg tablet (8 am, noon) leuprolide - 7.5 mg syringe - monthly levothyroxine - 100 mcg daily lorazepam - 0.5-1 mg q8h prn insomnia, anxiety omeprazole - 40 mg daily oxycodone - 5-10 mg q3hr prn pain oxycontin - 10 mg q 8hr aspirin - 81 mg daily ibuprofen discharge medications: expired discharge disposition: expired discharge diagnosis: expired discharge condition: expired discharge instructions: expired followup instructions: expired md procedure: closed [endoscopic] biopsy of bronchus diagnoses: pneumonia, organism unspecified pure hypercholesterolemia unspecified acquired hypothyroidism personal history of tobacco use defibrination syndrome malignant neoplasm of prostate encounter for palliative care do not resuscitate status secondary malignant neoplasm of lung secondary malignant neoplasm of bone and bone marrow personal history of antineoplastic chemotherapy anemia in neoplastic disease other respiratory abnormalities pathologic fracture of other specified site 

Answer: The patient is high likely exposed to