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: hypoxia major surgical or invasive procedure: none history of present illness: 62 yo m with pmhx of cad s/p cabg, tracheomalacia, chf, htn underwent op bronchoscopy with bal today for tracheomalacia evaluation , and developed progressive chills, neck stiffness, shortness of breath later in the day while at radiology for a routine scheduled ct scan for tracheomalacia (no contrast). his vs were stable except for hypoxia of 89% on a nrb, he was administered 1 amp d50 and transferred to the ed. . in ed, initial vs t99 hr 95 165/53 26 95% on 15l probnp: 2864, lactate 2.1 given, albuterol levo, flagyl, and vanco, lasix with 800cc output. was 97.1. 73 154/77 97% on 4l on admission request to icu. . of note, he has recently had 2 episodes of pna in and , which required inpatient therapy at with antibiotics but no intubation. he has been on 6 weeks of antibiotics most recently for pna with productive cough, initially with levaquin, then 2 cycles of amoxicillin, although records suggest bactrim, finished yesterday. he has also noted increased doe over the past few weeks, also associated with increased swelling in the legs bilaterally, and wt gain of 20lbs since , no clear affirmation of dietary indiscretion. this required increasing use of his baseline 2l oxygen at night with cpap to use during the day. . micu course: : admitted, resumed diet, goal i/o even, started steroids, call out echo, start prednisone 40 qday x 5days . abx: started on levo, flagyl, vanc vanco stopped . ros: no ha, blurry vision, chest pain, palpitations, nausea vomitting, + cough 6 weeks with greenish sputum, + sob, no diarrhea constipation, no dysuria, frequency, no abd pain, + chills, no photophobia, mild neck stiffness, no rash past medical history: pmhx: cad s/p cabg emphysema 2l home o2 dm htn hypothyroidism gout social history: married retired, lives with wife, was a state worker retired in 95, has chemical exposure in airplane, rubber factory. social drinker, + smoking quit 30 yrs ago, although with 60+ pk=yr history, no illicit drugs family history: mother died 75, father died 58 from stroke physical exam: vs 99 110/60 72 24 96%4l gen: nad, obese, speaking in full sentences heent: perrl, eomi, op clear, dry mm, thick neck, elevated jvp 10cm cv : distant hs, no mrg chest: coarse bs throughout, exp wheezes, mild crackles at bases abd: +bs obese, nt/nd, ext: no c/c/ 2+ pitting edema to knees skin: no rashes, lesions neuro: aaox3, cnii-cnxii intact, no focal deficits, motor throughout pertinent results: patient/test information: indication: h/o cardiac surgery. left ventricular function. shortness of breath. height: (in) 65 weight (lb): 375 bsa (m2): 2.59 m2 bp (mm hg): 145/67 hr (bpm): 65 status: outpatient date/time: at 09:50 test: tte (complete) doppler: full doppler and color doppler contrast: none tape number: 2007e002-0:34 test location: east echo lab technical quality: suboptimal referring doctor: dr. measurements: left atrium - long axis dimension: *5.9 cm (nl <= 4.0 cm) left atrium - four chamber length: *6.4 cm (nl <= 5.2 cm) right atrium - four chamber length: *6.1 cm (nl <= 5.0 cm) left ventricle - septal wall thickness: *2.0 cm (nl 0.6 - 1.1 cm) left ventricle - inferolateral thickness: *1.5 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: *6.1 cm (nl <= 5.6 cm) left ventricle - ejection fraction: 40% to 45% (nl >=55%) aorta - valve level: *3.8 cm (nl <= 3.6 cm) aorta - ascending: *3.6 cm (nl <= 3.4 cm) aortic valve - peak velocity: 1.6 m/sec (nl <= 2.0 m/sec) mitral valve - e wave: 1.1 m/sec mitral valve - a wave: 0.9 m/sec mitral valve - e/a ratio: 1.22 mitral valve - e wave deceleration time: 177 msec tr gradient (+ ra = pasp): *>= 37 mm hg (nl <= 25 mm hg) interpretation: findings: left atrium: moderate la enlargement. right atrium/interatrial septum: moderately dilated ra. left ventricle: severe symmetric lvh. mildly depressed lvef. tdi e/e' >15, suggesting pcwp>18mmhg. lv wall motion: regional lv wall motion abnormalities include: basal inferolateral - akinetic; mid inferolateral - akinetic; right ventricle: normal rv chamber size and free wall motion. aorta: mildly dilated aortic sinus. mildly dilated ascending aorta. aortic valve: mildly thickened aortic valve leaflets. no as. no ar. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. trivial mr. tricuspid valve: normal tricuspid valve leaflets. mild tr. moderate pa systolic hypertension. pulmonic valve/pulmonary artery: pulmonic valve not well seen. pericardium: no pericardial effusion. no echocardiographic signs of tamponade. general comments: suboptimal image quality - poor apical views. conclusions: the left atrium is moderately dilated. the right atrium is moderately dilated. there is severe symmetric left ventricular hypertrophy. overall left ventricular systolic function is mildly depressed with thinned and akinetic inferolateral wall. tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). right ventricular chamber size and free wall motion are normal. there may be right ventricular hypertrophy. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is at least moderate pulmonary hypertension. there is a partially echo dense pericardial region (particularly posterior to the left ventricle) consistent with a small somewhat organized pericardial effusion . there is no echocardiographic evidence of tamponade. final report ct trachea, comparison: ct trachea . indication: tracheobronchomalacia. multidetector ct of the chest was performed using the ct trachea protocol, which includes a standard-dose end inspiratory ct of the chest followed by -dose dynamic expiratory ct of the chest to assess for tracheomalacia. at end inspiration, there is no evidence of fixed tracheal or bronchial stenosis, and there are no suspicious endoluminal lesions. during dynamic expiration, there is severe diffuse tracheobronchomalacia, involving the entirety of the intrathoracic trachea and extending into the main, proximal lobar, and segmental bronchi. there is near-complete collapse at the level of the trachea, main bronchi, and lower lobe subsegmental bronchi. multifocal air trapping is present, a finding that frequently accompanies tracheobronchomalacia. as compared to the previous scan, the degree of airway malacia is similar, but the prior scan did not evaluate the distal airways due to differences in images acquisition. within the lungs, there are new multifocal areas of consolidation and ground glass attenuation, which involve all lobes of both lungs and are accompanied by peribronchiolar nodular opacities. however, the dependent portions of the lower lobes and the right middle lobe are most severely affected. previously reported poorly defined opacity adjacent to the right hemidiaphragm is difficult to compare due to coexisting adjacent new areas of consolidation. previously present scattered peribronchiolar opacities are difficult to compare due to the new diffuse areas of abnormality, but some of these have resolved in the interval. within the imaged portion of the neck, a small air collection lateral to the airway in the region of the thyroid cartilage was present previously but incompletely imaged due to differences in acquisition areas between the two studies. this is possibly due to asymmetric left piriform sinus, but an extraluminal air collection is not excluded on this limited exam. mediastinal lymph nodes have slightly increased in size, including a right paratracheal node, now measuring 11 mm and previously measuring 8 mm as well as additional lymph nodes in multiple nodal stations. these are probably reactive in the setting of presumed diffuse pulmonary infection. main pulmonary artery remains enlarged. diffuse coronary artery calcifications are present in this patient status post prior coronary bypass surgery, and focal pericardial calcifications along the right heart border are again demonstrated. no pericardial or pleural effusion is seen. in the imaged portion of the upper abdomen, the adrenal glands are normal. nonspecific stranding is present in the mesentery and in the perinephric regions. note is made of previous cholecystectomy procedure. degenerative changes are present in the spine, and post-sternotomy changes are noted. finally, bilateral mild gynecomastia is present. multiplanar and 3d images: these images confirm diffuse severe tracheobronchomalacia. impression: 1. diffuse severe tracheobronchomalacia. 2. new multifocal areas of consolidation, ground glass opacity, and peribronchiolar nodules, which may be due to either a diffuse infectious pneumonia or a massive aspiration event. these findings were communicated to dr. by telephone , while the patient was still on the ct scanner. 3. small air collection in upper left cervical region, possibly due to asymmetric appearance of left pyriform sinus. correlation with bronchoscopic findings recommended to exclude a small contained laceration injury which is less likely. brief hospital course: 1. multifocal aspiration pneumonia: in the setting of bronchoscopy, intially covered with broad spectrum antibiotics, but when bal returned without specific organisms, he was transition to augmentin with continued clincal improvement. will complete outpatient therapy. . 2. acute exacerbation of copd: treated with brief course of steroids, continued inhalors, and improved. steroids discontinued at discharge, but will give patient a prescription in case of relapse - instructed him to contact pcp if this occurs. . 3. acute renal failure: consistent with pre-renal azotemia secondary to diuresis. given systolic heart failure and nephrotic range proteinuria, would benefit from initiation of ace inhibitor at outpatient follow-up. . 4. systolic heart failure: patient was changed to toprol xl, continued on aspirin and plavix, and started on simvistatin for secondary prevention. recommend lipid testing and goal ldl < 100. . 5. iron deficiency anemia: patient with normocytic anemia, tsat < 10% and ferritin < 100 in the setting of acute inflammation. empiric iron replacement started and recommend outpatient gastroenterology consultation to rule out occult gi blood loss. 6. diabetes mellitus type ii: uncontrolled secondary to steroids, expect that it will normalize on oral hypoglycemics as an outpatient. medications on admission: doxazosin mesylate 2mg qhs advair 500/50 spiriva 18mcg qd levoxyl ? prilosec 20mg qd torsemide 40mg qd colchicine 1.2 mg qd glipizide 10mg qam, 5mg qpm atenolol 12.5 plavix 75 qd singulair 10mg qd discharge disposition: home discharge diagnosis: primary: 1. multifocal aspiration pneumonia. 2. acute exacerbation of copd. 3. acute renal failure. 4. chronic kidney disease with nephrotic range proteinuria. 4. iron deficiency anemia secondary: 1. emphysema. 2. tracheobronchomalacia. 3. cad s/p imi and cabg. 4. systolic heart failure. 5. diabetes mellitus type ii. 6. hypothyroidism. 7. gout. 8. obesity. 9. hypertension. 10. hyperlipidemia. discharge condition: good discharge instructions: - ppi for gerd followup instructions: 1. interventional pulmonary for stent for trachiomalacia 2. outpatient gi evaluation for iron defiency. procedure: venous catheterization, not elsewhere classified diagnoses: congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified unspecified septicemia severe sepsis unspecified acquired hypothyroidism gout, unspecified obstructive chronic bronchitis with (acute) exacerbation aortocoronary bypass status acute and chronic respiratory failure pneumonitis due to inhalation of food or vomitus chronic systolic heart failure iron deficiency anemia, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled other diseases of trachea and bronchus 

Answer: The patient is high likely exposed to