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: levofloxacin attending: chief complaint: shortness of breath major surgical or invasive procedure: none history of present illness: 64 y/o male with htn, cad (nstemi in ), copd (fev1 20%, home o2 4l, chronic steroids; intubated x2) who complaining of acute onset shortness of breath on the day of admission. he has recently been discharged from . he states that he felt a burning sensation on both sides of his lower back (which is chronic) and he became acutely dyspneic after this happened. he reports that he usually becomes sob when he has back pain. this time, he could not catch his breath and called ems immediately. of note, the patient also complains of severe burning with urination which has been chronic x 2 years. he reports that this has been worsening in severity over the last 6 months. was on cipro in the past which helped relieve his symptoms transiently. patient is not currently sexually active (has not been for 3 years). no hematuria. no h/o kidney stones. . in the , pt was tried on bipap but did not tolerate this well. he improved with albuterol/atrovent nebs x 3 and iv solumedrol. he denies fever, chills, cough, nausea, vomiting, hematuria, diarrhea, or melena/brbpr. past medical history: 1. copd on 4 l o2 at home and s/p multiple admissions and intubations for flares-fev1/fvc 35% 2. hypertension 3. hyperlipidemia 4. cad s/p nstemi () 5. chronic low back pain l1-2 laminectomy from accident at work 6. steroid induced hyperglycemia 7. left shoulder pain for several months 8. cataract 9. gerd social history: married with six children. lives at home in with wife. retired mechanic. exposed to a lot of spray paint. former smoker. quit 25 years ago. 20 pack year history. occassional etoh quit marijuana 3 years ago. denies iv drug use. activity limited due to prior spine and current shoulder problems family history: mother with asthma and father with cancer physical exam: vitals: 96 - 100/59 - 16 - 100% on 4l gen - aa man, appears comfortable, speaking in full sentences. breathing with pursed lips. heent - anicteric sclera. mmm. neck- no jvd. no bruits. cv- rrr. faint but audible s1, s2. no mrg pulm - good air movement. + crackles at lll. scatterered expiratory wheezes. no ronchi, rales. abd - nabs, soft, non distended. mild epigastic tenderness. ext - no cyanosis, edema. warm and dry. reduced skin turgor. nails - no clubbing. no pitting/color changes/indentations neuro - aox3. cn intact, no focal motor/sensory deficits pertinent results: 12:40pm wbc-16.9* rbc-4.71 hgb-12.7* hct-39.7* mcv-84 mch-27.0 mchc-31.9 rdw-15.0 12:40pm neuts-80.3* lymphs-13.4* monos-4.9 eos-1.3 basos-0.2 12:40pm plt count-306 12:40pm glucose-73 urea n-17 creat-0.9 sodium-137 potassium-4.1 chloride-98 total co2-28 anion gap-15 12:40pm calcium-9.3 phosphate-3.7 magnesium-1.8 12:40pm pt-11.7 ptt-25.9 inr(pt)-0.9 12:40pm ck(cpk)-46 12:40pm ck-mb-notdone ctropnt-<0.01 12:40pm d-dimer-429 . chest (portable ap) 5:54 pm no significant change since the prior study. brief hospital course: . . 1) dyspnea: the patient intitially presented complaining of acute onset shortness of breath at home. this most likely represented the patient's typical copd flare, for which the patient has been admitted with several times in the past. there was no evidence of pneumonia on cxr; however, he was started on ceftriaxone and azithromycin initially. these were stopped after a short peroid of time since there was no evidence of pneumonia. a few days into his admission, the patient acutely decompensated with desats into the 80's and low blood pressure (80-90's systolic). he was transferred to the micu for a 24 hour period, at which time he received bipap and more frequent nebs. he stabilized and was transferred back to the floor. while back on the floor, he continued to have episodes of acute sob requiring frequent nebs (often q1h). with nebs, his o2 sats stabilized in the mid 90's, and he did not require further icu level of care. he was started on doxycycline for coverage of possible bronchitis. blood cultures still pending without growth to date, and sputum culture obtained was not a good sample. . 2) dysuria: mr. also complained of significant dysuria on this admission, requiring catheterization. ua was negative. he was also noted to have significant urinary retention after catheterization, suggesting significant bph. he was started on flomax and proscar this admission. his dysuria could also be due to chronic prostatitis since ua was found to be negative. he was not started on antibiotic therapy for this possibility during this admission. he should see urology as an outpatient for these issues. . 3) back pain: he continued to complain of significant back pain during this admission, consistent with his musculoskeletal pain related history of l1-2 laminectomy from an accident he had at work many years ago. this pain made him anxious and occasionally precipitated shortness of breath. it was well controlled with oxycodone prn. medications on admission: 1. albuterol sulfate 0.083 % solution sig: one (1) inh inhalation every 4-6 hours as needed for shortness of breath or wheezing. 2. albuterol 90 mcg/actuation aerosol sig: one (1) inhalation every 4-6 hours as needed for shortness of breath or wheezing. 3. sertraline hcl 50 mg tablet sig: one (1) tablet po daily (daily). 4. salmeterol xinafoate 50 mcg/dose disk with device sig: one (1) disk with device inhalation q12h (every 12 hours). 5. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 6. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily 7. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid w/meals (3 times a day with meals). 8. verapamil hcl 120 mg tablet sig: one (1) tablet po once a day. 9. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 10. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 11. azithromycin 250 mg capsule sig: one (1) capsule po q24h (every 24 hours) for 1 doses. 12. atorvastatin calcium 10 mg tablet sig: one (1) tablet po daily (daily). 13. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 14. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puffs inhalation four times a day. 15. prednisone taper discharge medications: 1. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 2. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation every 4-6 hours as needed for shortness of breath or wheezing. 3. salmeterol xinafoate 50 mcg/dose disk with device sig: one (1) disk with device inhalation q12h (every 12 hours). 4. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 5. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 6. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 7. verapamil 120 mg tablet sustained release sig: one (1) tablet sustained release po q24h (every 24 hours). 8. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. atorvastatin calcium 10 mg tablet sig: one (1) tablet po daily (daily). 10. oxycodone 5 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 11. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 12. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 13. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 14. tamsulosin 0.4 mg capsule, sust. release 24hr sig: one (1) capsule, sust. release 24hr po hs (at bedtime). :*30 capsule, sust. release 24hr(s)* refills:*0* 15. ipratropium bromide 18 mcg/actuation aerosol sig: one (1) inh inhalation twice a day. 16. medication pyridium 200 mg po tid x 3d, take after meals 17. doxycycline hyclate 100 mg capsule sig: one (1) capsule po q12h (every 12 hours) for 6 days. :*12 capsule(s)* refills:*0* 18. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). :*30 tablet(s)* refills:*2* 19. prednisone 10 mg tablet sig: as per taper tablet po once a day for 30 days: days take 60 mg;days take 50 mg;day take 40 mg;day 16-20 take 30 mg;day 21-25 take 20 mg;day 26-30 take 10 mg. :*105 tablet(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: 1) copd flare 2) coronary artery disease 3) hypertension discharge condition: stable, improved from the time of admission discharge instructions: please call your doctor or return to the er if you experience difficulty breathing, chest pain, fever, or chills. take your medications as prescribed and follow up as scheduled below. please see your pcp followup instructions: 1) urology appointment on at 10am with dr. in the building on the in the surgical specialties area. 2) pulmonary breathing tests where: pulmonary function lab, phone:, will contact you regarding appointment 4) , internal medicine where: internal medicine phone: date/time: 9:00 3) provider: /eye list or eye surgery (nb) where: or eye surgery (nb) date/time: 3:30 md, procedure: non-invasive mechanical ventilation diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux unspecified essential hypertension obstructive chronic bronchitis with (acute) exacerbation other and unspecified hyperlipidemia hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (luts) acute respiratory failure old myocardial infarction lumbago other dependence on machines, supplemental oxygen cervicalgia dysuria 

Answer: The patient is high likely exposed to