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: hemoptysis major surgical or invasive procedure: 1. bbronchoscopy - endoluminal laser therapy 2. bronchial artery embolization history of present illness: 63m with h/o copd and t4n2 iiib nsclc diagnosed in s/p 4 cycles of carboplatin and taxol and 8000gy radiation (6600 cgy between - and 1400 cgy from - ) who presented to the on with hemoptysis. his first episode of hemoptysis resulted in admission to which was notable for tx to micu and flexible bronchoscopy with limited visualization due to clot; he received palliative radiation as above. after this he was breifly hospitalized for "walking pna" and received a course of antibiotics (he thinks augmentin) and did well until when he began coughing up bright red blood ( teaspoons, then 150cc later in day). he felt well and denied other symptoms. he continues to cough up some clotted blood. he was transferred to the for bronchoscopy with intraluminal laser therapy as he can no longer receive xrt to central or left side of his chest. past medical history: 1. t4n2 iiib nsclc dx'd in as above 2. copd, intubated x2 for exacerbations, fev1 = 1.24 (36%) in ; 1l home oxygen at night 3. gerd 4. anemia 5. tachycardia social history: lives alone in . occasional etoh. former 1.5 ppd smoker, quit . denies ivdu, denies exposures. family history: non contributory. physical exam: vitals t afebrile bp 121/86 p 114 rr 20 o2sat 96% ra gen: pleasant, middle aged man, in nad, speaking in full sentences on ra heent: perrl, eomi, mmm, adentulous, op clear cv: tachycardic, regular, no mrg lungs: decreased bs on l abd: soft, ntnd, +bs ext: w/wp, no edema neuro: aox3, cn 2-12 grossly intact, strength 5/5, sensation grossly intact pertinent results: from : : normal flora chest ct (): soft tissue mass abutting the hilum is not significantly changed. improved aeration of left lower lobe bronchus. persistent lll atelectasis. diffuse centrilobular emphysema, numerous nodular denisities throughout the left upper lobe unchanged. large left pleural effusion, unchanged. leftward shift of mediastinum. large pericardial effusion. subcentimeter mediastinal lymph nodes. left renal cysts. ] ekg (): sinus tachy (112), avl and v2 inversions; no old ekgs for comparison ------------ pertinent studies in hospital: : left bronchial artery embolization. procedure: the risks and benefits of the procedure were explained to the patient, and written informed consent was obtained. a pre-procedure time out was performed. the patient was placed supine on the angiography table, and the skin of the right groin was prepped and draped in standard sterile fashion. local anesthesia was achieved via injection of 5 cc of 1% lidocaine. using fluoroscopic guidance, the right common femoral artery was accessed using a 19 gauge single wall puncture needle. a .035 wire was then advanced into the abdominal aorta. the needle was removed, and a 5 french sheath placed over the wire. a 5 french pigtail catheter was advanced over the wire to the level of the aortic arch. at this point, aortography was performed. this demonstrated the left common carotid artery to be arising from the right innominate artery, a common variant (bovine arch). a right bronchial artery was visualized exiting from the thoracic aorta, with multiple collaterals traversing the mediastinum and terminating in abnormal appearing vessels within the left aspect of the mediastinum, consistent with tumor vasculature. in addition, there were several tiny collateral vessels supplying the left chest wall and lungs as well as possible tumor mass via the left subclavian artery and intyernam mammary artery. at this point, the pigtail catheter was exchanged for a mickeeson catheter. this catheter was maneuvered into position with the tip terminating in the right bronchial artery. a selective arteriogram of the right bronchial artery was performed, further demonstrating the collateralization extending to the left bronchial arterial supply, and terminating in tumor vasculature. a decision was made to pursue this vessel for embolization. a fasttracker catheter was selected and advanced superselectivel into a second order bronchial of the right bronchial artery. selective arteriography showed the collateral stem directed inferiorly and supplying predominantly the left bed of the bronchial artery. the catheterposition was beyond the take-off of a small trunk to the right upper lung vessels. additional arteriography with the catheter tip further advanced into the inferior trunk again demonstrated contrast opacification of the tumor vessels from this location. it was determined that this would be a suitable location for the performance of embolization. embolization was performed via injection of 500 to 700 micrometer embospheres to the end point of arterial stasis. following the performance of embolization, the catheter was repositioned to the left subclavian artery and selective arteriography performed. this demonstrated several small, tortuous, collateral vessels which appeared to provide some minor supply to the tumor mass, however also refilled pulmonary arttery radicles and therefore embolization of these vessels was not deemed desirable at this time. also due to the tiny size of these collateral vessels as well as the possible pulmonary territory that they supply, a decision was made to forego embolization of these small collaterals and if bleeding should not be controlled they may hypertrophy in the future . the catheter was removed. the sheath was removed and pressure held until hemostasis was achieved, approximately 25 minutes. the patient tolerated the procedure well, with no complications evident at the time of the procedure. contrast: 100 cc of optiray. impression: 1. right bronchial arterial trunk supplying the left bronchial arterial territory, possibly secondary to scarring due to radiation therapy. no evidence of active extravasation of contrast to suggest active hemorrhage during the examination. 2. successful embolization with 500 to 700 micron embospheres of the left bronchial artery via the right bronchial arterial trunk. 3. tiny collaterals from the left internal mammary and subclavian artery to the left chest wall and lung. there is some scant supply to the tumor but also connection with the pulmonary artery radicles and therefore no embolization of these branches was done at this time. echo measurements: left ventricle - ejection fraction: 70% to 80% (nl >=55%) tr gradient (+ ra = pasp): *>= 60 mm hg (nl <= 25 mm hg) interpretation: left atrium: normal la size. right atrium/interatrial septum: normal ra size. left ventricle: normal lv wall thickness. small lv cavity. hyperdynamic lvef. no resting lvot gradient. right ventricle: rv hypertrophy. dilated rv cavity. rv function depressed. aorta: normal aortic root diameter. focal calcifications in aortic root. mitral valve: mildly thickened mitral valve leaflets. tricuspid valve: severe pa systolic hypertension. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. normal main pa. no doppler evidence for pda pericardium: moderate pericardial effusion. effusion circumferential. no rv diastolic collapse. brief ra diastolic collapse. echocardiographic signs of tamponade may be absent in the presence of elevated right sided pressures. conclusions: the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity is small. left ventricular systolic function is hyperdynamic (ef 70-80%). the right ventricular free wall is hypertrophied. the right ventricular cavity is dilated. right ventricular systolic function appears depressed. the mitral valve leaflets are mildly thickened. there is severe pulmonary artery systolic hypertension. there is a moderate sized pericardial effusion. the effusion appears circumferential. no right ventricular diastolic collapse is seen. there is brief right atrial diastolic invagination. echocardiographic signs of tamponade may be absent in the presence of elevated right sided pressures. brief hospital course: mr. was admitted to the medicine floor for bronchoscopy and possible endoluminal laser therapy as he has had maximal xrt to the chest. 1. respiratory: he was having small amounts of hemoptysis on admission. he had a bronchoscopy on that showed bleeding from the left lower lobe and no endobronchial lesion. there is no indication for endobronchial therapy for his lung cancer. he underwent left bronchial artery embolization by interventional radiology. the patient coughed up 1 cup of clots/blood post-procudure but was hemodynamically stable. he was planned for discharge on but early that morning, he desaturated on the floor and became tachycardic. his abg was 7.18/70/261. he was transferred to the micu and intubated for hypercarbic respiratory failure. the etiology of his respiratory failure was felt to be mucous plugging vs blood. his ekg showed tachycardia, query mat vs afib. he was started on a diltiazem drip and oral diltiazem with good response. the diltiazem drip was weaned and he was stable on oral diltiazem and metoprolol. he underwent a bronchoscopy on that showed obstruction of the left lower lobe by old bloody secretions, 50% narrowing of superior lll secondary to extrinsic compression, extrinsic compression of the lingular segment, patent left lower lobe bronchus. he was started on levofloxacin for possible post obstruction pneumonia. he was weaned from the ventilator on . nsclc: no indication for endolumenal therapy. options need to be discussed with oncologist. 2. cardiac: he has a history of atrial fibrillation and developed multifocal atrial tachycardia on . he was started on a diltiazem drip and oral diltiazem with good response. the diltiazem drip was weaned and he was stable on oral diltiazem and metoprolol. on day of discharge he was back in sinus rhythm. he was maintained on diltiazem and metoprolol. he had a echo that showed a pericardial effusion, but no evidence of tamponade. this may be a malignant pericardial effusion and showed be followed with repeat echos. he did not have a pulsus paradoxus while he was here. 3. gerd: he was continued on lansoprazole. 4. anemia: his hematocrit remained stable in the low 30's. 5. commmunication: his niece is his hcp, and can be reached at: 7a-1p (w) - anytime (cell) - 1:30pm onward (home) 6. his code status was full. the patient was transferred at the vawx for further care. medications on admission: fluticasone inh albuterol inh q6h salmeterol inh codeine q4h prn robitussin with codeine q4-6h prn ppi zosyn discharge medications: 1. heparin sodium (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 2. lansoprazole 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 3. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 4. albuterol 90 mcg/actuation aerosol sig: 2-4 puffs inhalation q4h (every 4 hours) as needed. 5. diltiazem hcl 30 mg tablet sig: one (1) tablet po qid (4 times a day). 6. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed): per sliding scale. 7. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 14 days. last doses on . 8. metoprolol succinate 25 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po bid (2 times a day). discharge disposition: extended care facility: discharge diagnosis: non small lung cancer t4n2 iiib s/p chemotherapy, radiation s/p left bronchial artery embolization copd (fev1 1.24 in ) intubations x2 gerd anemia tachycardia discharge condition: stable discharge instructions: please take all medications as prescribed followup instructions: please follow up with your oncologist and pulmonologist. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube arteriography of other intrathoracic vessels other surgical occlusion of vessels, thoracic vessels endoscopic excision or destruction of lesion or tissue of bronchus diagnoses: esophageal reflux atrial fibrillation other specified cardiac dysrhythmias malignant neoplasm of lower lobe, bronchus or lung 

Answer: The patient is high likely exposed to