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: dayquil cough attending: chief complaint: dyspnea major surgical or invasive procedure: tracheostomy percutaneous endoscopic gastrotomy tube placement flexible bronchoscopy and therapeutic aspiration of secretion endotracheal intubation and extubation arterial line placement and removal history of present illness: 77 yo m with a h/o copd (fev1 22%, 3l baseline oxygen) htn, dl, afib who presents with suddent onset acute dyspnea this am. patient was eating breakfast, coughed up sputum and then took some cough syrum, and felt unrelenting sob. although patient was denying this, patient's wife says that he was feeling tired and short of breath x 2 weeks. patient tried some nebs at home, but this didnt help. family called ems and they found patient to have a sat 80% on ra. he received 2 nebs enroute and felt better. he denies fevers, chills, chest pain. reports unchanged chronic cough, and unchanged chronic back pain. . on arrival patient triggered for sat 99% on 3l. exam otherwise notable for tight breath sounds bilaterally, and noticeable using accessory muscles. received combivent neb, solumedrol 125 mg, and azithro 500 mg po x1. cxr and cta chest were unremarkable except for chronic changes. was doing well on 3l, but felt more tired so he was transitioned to bipap. ekg with rad, rbbb (new since . patient was growing more uncomfortable on bipap, so he took it off for about 30 minutes, but still sounded tight, so he was placed back on bipap 10/5 with fio2 50%. patient had increased wob, and did not tolerate bipap so was intubated and started on propafol prior to transfer. on propafol, patient dropped his bp to 84/65 so he was changed to versed, and he was detached from the vent in case of contribution of auto-peep. 1 l of ns was hung, and bp improved to sbp 100s. . in the icu, patient is intubated and sedated. . review of systems: unable to obtain past medical history: # emphysema # afib vs mfat (? on coumadin) # s/p lul lobectomy in and pleurodesis/wedge resection in (in ) # s/p spontaneous ptx x 2 # prostate cancer # nephrolitiasis social history: former history of heavy tobacco use, quit over 1 year ago. denies recreational drug use or alcohol use. lives with wife. originally from , then moved to , and finally to the us in . he is a former business in the grocery industry. family history: nc physical exam: : vitals: t: 97.7 bp: 95/49 p: 70 r: 18 o2: 100% tv 400 rr 14 peep 5 fio2 50% general: intubated, sedated heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: foley with clear urine ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema changes at discharge: now has trach and peg, tolerated trach mask with sats in 90s pertinent results: 08:15am blood wbc-10.0 rbc-4.32* hgb-13.4* hct-40.4 mcv-94 mch-31.0 mchc-33.1 rdw-12.9 plt ct-275 02:53am blood wbc-11.1* rbc-3.60* hgb-11.1* hct-34.1* mcv-95 mch-30.9 mchc-32.6 rdw-13.6 plt ct-224 08:15am blood neuts-90.9* lymphs-5.6* monos-2.8 eos-0.2 baso-0.4 01:25am blood neuts-92.1* lymphs-3.2* monos-4.2 eos-0.5 baso-0.1 12:34pm blood pt-12.6 ptt-28.2 inr(pt)-1.1 08:28am blood pt-12.7 ptt-33.8 inr(pt)-1.1 08:15am blood glucose-256* urean-22* creat-0.7 na-140 k-4.0 cl-96 hco3-34* angap-14 02:53am blood glucose-142* urean-23* creat-0.6 na-141 k-4.0 cl-97 hco3-38* angap-10 04:30pm blood ck-mb-5 ctropnt-<0.01 08:15am blood ctropnt-<0.01 05:42am blood type-art po2-141* pco2-65* ph-7.36 caltco2-38* base xs-8 11:42am blood type-art temp-37.3 rates-/17 peep-5 o2 flow-35 po2-211* pco2-57* ph-7.42 caltco2-38* base xs-10 intubat-intubated vent-spontaneou cxr there is no evidence of pneumothorax. unchanged appearance of the lung parenchyma, with massive signs of overinflation, right basal scarring, bilateral apical scarring and bullous disease, and signs of massive pulmonary emphysema. small cardiac silhouette. no evidence of pleural effusions. brief hospital course: 77m with severe copd on home o2 admitted with copd exacerbation requiring intubation, course complicated by labile blood pressures and failure to extubate x2, now s/p trach and peg. . respiratory failure: patient was admitted to icu after being intubated for respiratory failure. he was started on iv steroids and transitioned to prednisone with plan for slow taper, dose at 20mg daily at time of discharge. albuterol and ipratropium inhalers given standing. extubation was attempted twice but pt. failed agitation, hemodynamic instability. family discussion was held and decision was made to proceed with tracheostomy and peg. procedure was uncomplicated and he was transitioned to trach mask which he has tolerated well. trach settings should continue to be weaned. . labile blood pressures: pt's bp ranged from 80 to 200 systolic during this . diltiazem was titrated up and down and final dose was diltiazem 45mg q6h with good effect. sbp mostly in the 100s-140s at time of discharge. home losartan restarted. . delirium: patient was noted to be delirious during hospitalization, particularly on hospital days 10 and 11. he responded well to haloperidol and did not appear delirious at time of discharge, was cooperative and pleasant. discharged with small dose of prn haloperidol as 1mg po dose oversedated him. qtc wnl. . # atrial fibrillation: patient was in sinus during this with one very brief period of af with rvr to the 130s which quickly converted to sr on its own. no antiocoagulation, see above for rate control with diltiazem. . # code status: patient was made dnr during this after family meeting. proxy is daughter (). . transitional issues: -continue prednisone taper, 20mg x2 days to start am, then 10mg x3 days, then 5mg x3 days, then stop -wean trach requirements as tolerated -monitor bps and adjust diltiazem prn medications on : diltiazem er 240 mg hctz 12.5 mg daily tamsulosin 0.4 mg daily losartan 100 mg daily duonebs qid prn combivent 2 puff q6h discharge medications: 1. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day). 2. trazodone 50 mg tablet : one (1) tablet po hs (at bedtime) as needed for insomnia. 3. diltiazem hcl 30 mg tablet : 1.5 tablets po q6h (every 6 hours). 4. haloperidol 0.5 mg tablet : 0.5 tablet po tid (3 times a day) as needed for agitation. 5. prednisone 20 mg tablet : one (1) tablet po once a day for 2 days. 6. prednisone 10 mg tablet : one (1) tablet po once a day for 3 days: to start . 7. prednisone 5 mg tablet : one (1) tablet po once a day for 3 days: to start . 8. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 9. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day): hold for loose stools. 10. chlorhexidine gluconate 0.12 % mouthwash : fifteen (15) ml mucous membrane (2 times a day). 11. losartan 100 mg tablet : one (1) tablet po once a day. 12. tamsulosin 0.4 mg capsule, ext release 24 hr : one (1) capsule, ext release 24 hr po daily (daily). 13. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 14. acetaminophen 325 mg tablet : 1-2 tablets po q6h (every 6 hours) as needed for pain, fever. 15. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler : 2-4 puffs inhalation q4h (every 4 hours). 16. ipratropium bromide 17 mcg/actuation hfa aerosol inhaler : 4-10 puffs inhalation q4h (every 4 hours). discharge disposition: extended care facility: - discharge diagnosis: copd exacerbation atrial fibrillation discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were admitted to the hospital with respiratory failure requiring a breathing tube. you had difficulty breathing on your own and eventually got a trach in your neck to help you breathe and a tube in your stomach to feed you. once your breathing stabilized, you were transferred to rehab for continued management. . the following changes were made to your medications: stopped diltiazem er 240 mg started diltiazem 45mg qid started lansoprazole daily started docusate , senna started bisacodyl daily as needed started haloperidol prn tid started trazodone as needed for sleep started chlorhexidine started prednisone 20mg daily for 2 days, then 10mg daily for 3 days, then 5mg for 3 days, then stop stopped hydrochlorothiazide followup instructions: department: radiology when: tuesday at 10:15 am with: cat scan building: campus: east best parking: garage department: pulmonary function lab when: tuesday at 10:40 am with: pulmonary function lab building: campus: east best parking: garage department: pft when: tuesday at 11:00 am md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy diagnoses: pneumonia, organism unspecified other iatrogenic hypotension anemia, unspecified coronary atherosclerosis of native coronary artery atrial fibrillation obstructive chronic bronchitis with (acute) exacerbation personal history of tobacco use other and unspecified hyperlipidemia acute respiratory failure malignant neoplasm of prostate do not resuscitate status hyperosmolality and/or hypernatremia delirium due to conditions classified elsewhere benign essential hypertension 

Answer: The patient is high likely exposed to