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: dyspnea major surgical or invasive procedure: none history of present illness: 62 yo m w/ longstanding history of copd p/w respiratory distress today from rehab. per ed notes and family, pt c/o increased sob x 4d, worse today, w/ cough productive of yellow/green sputum. he is on vanc/meropenem to complete a 4 week course due to end on . . pt has had recent long course of hospitalizations beginning in with pna; no pathogen was identified and he received an empiric 4 week course of levofloxacin, after which he improved to his baseline and returned to work. . in late he relapsed with cough and shortness of breath; he was admitted . sputum cultures including routine cx, legionella cx, pcp staining were again not diagnostic and he was treated with empiric vanc/zosyn for 4 weeks. . on admission in , from a ct scan demonstrated a large lul bulla with fluid level, left lingular pneumonia and l pleural effusion. sputum cultures failed to identify pathogen. he was initiated on a steroid taper and empiric vanc/meropenem, and his clinical status improved. after several days his wbc count rose to 21k and repeat imaging demonstrating new rll aspiration pneumonia. discussion was held re interventional procedure to tap l chest and/or to have ct surgery perform bullectomy, though it was felt at the time that the risks of these procedures outweighed the benefits. conservative management with antibiotics was planned. . he had a repeat ct which showed slightly decreased fluid in the lul bulla. he was just seen in clinic and no change was made to his course of abx. . in the ed it was thought he had a copd flare vs. pna. he was not given further abx or steroids, but was given a combivent neb. he was also given ativan, after which time he became somnolent but in the ed was recorded as "resting comfortably". on arrival to the , he was unarousable; his abg was 7.03/156/68. he was intubated, and became responsive within an hour. past medical history: 1) copd: severe (fev1=20% pred), requires home o2 (3-5l nc) 2) necrotizing pna (pantoea species): c/b ptx/empyema requiring chest tube 3) tuberculosis (age 17): treated with 2 meds 4) cholelithiasis social history: 1) tobacco: 45 pk-years, quit 5 years ago 2) rare etoh 3) formerly worked in accounting family history: father died from lung ca. mother dies from mi. physical exam: pe: vs: t 96.5 ax, bp 165/64, p 91, rr 23, o2 90% ra gen: intubated, mouthing words, moving all extremities spontaneously heent: perrl, mmm neck: supple cv: rrr nl s1 s2 no m/r/g pulm: bilat rales extr: 1+ periph edema neuro: arousable to painful stimuli, moves all extremities pertinent results: 01:25pm pt-12.9 ptt-24.9 inr(pt)-1.1 01:25pm plt count-681* 01:25pm neuts-85.1* lymphs-7.9* monos-3.7 eos-3.1 basos-0.3 01:25pm wbc-10.6 rbc-3.25* hgb-9.2* hct-28.5* mcv-88 mch-28.2 mchc-32.1 rdw-14.9 01:25pm lactate-1.1 01:25pm ck-mb-2 ctropnt-<0.01 01:25pm glucose-118* urea n-7 creat-0.3* sodium-140 potassium-4.3 chloride-94* total co2-41* anion gap-9 10:35pm lactate-1.8 10:35pm type-art temp-37.2 po2-68* pco2-156* ph-7.03* total co2-44* base xs-4 intubated-not intuba 10:50pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-50 bilirubin-neg urobilngn-neg ph-5.0 leuk-neg brief hospital course: 62 yo m w/ severe copd and necrotizing pna/empyema in lul bulla on several months of abx since p/w respiratory failure. brief hospital course as follows: . 1) hypercarbic respiratory failure: very elevated pco2 initially, likely acute on chronic from somnolence ativan, nonrebreather o2 in ed, as he is a co2 retainer. last (6:30am on ) was 7.37/69/96. goal o2 sats were in low 90%s, pco2 50-60 to help drive down alveolar ventilation needed for extubation. extubated per patient and family's expressed wishes and per patient and family. . 2) pna: difficult to clear infected organisms from loculated bulla. likely had anaerobes which are not well grown from routine suptum culture. not able to drain fluid as any needle introduction will give ptx and track through pleural space. stopped abx as pt . . 3) copd: probably contributed to hypoxia. . 4) anemia: last hct was 29.8 (was 35.1 on ) . 5) ue edema: improved but presumed to be secondary to aggressive fluid recuscitation. monitored edema/chest exam and gave lasix as appropriate before becoming . . on , pt and family expressed wish to extubate patient and make him . patient expired in the late afternoon on . medications on admission: vanc 1g q 12h, meropenem 500 mg iv q8h, pantoprazole, advair, albuterol, tiotropium, bisacodyl discharge medications: none discharge disposition: expired discharge diagnosis: n/a discharge condition: expired discharge instructions: none followup instructions: none procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances diagnoses: pneumonia, organism unspecified anemia of other chronic disease hyposmolality and/or hyponatremia anxiety state, unspecified acute and chronic respiratory failure hypotension, unspecified emphysematous bleb personal history of tuberculosis abdominal pain, right upper quadrant 

Answer: The patient is high likely exposed to