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: reason for icu transfer: initiation of xrt for nsclc, hypoxemic respiratory failure major surgical or invasive procedure: xrt bronchoscopy & biopsy history of present illness: please refer to prior admit note from , pulmonary consult note on , micu green note for full details. . briefly, 64m with h/o lung ca s/p left pneumonectomy (, unknown ca), more recently had w/u of recurrent r lung mass (unrevealing medisastinoscopy and paraceliac ln biopsy () at . . : pt presented ed on for with productive cough, low grade temps, worsening dyspnea, and tachypnea. treated with levo/clinda for post-obstructive rll pna> . : ct scan revealed r hilar cavitating mass with evidence of tree and opacities of the right lung. pt subsequently tachypnea to 30s and transfered to micu green. clinda/levo was changed to pcn to treat for actinomyces. pt subsequently called back out to floor and underwent bronch that showed near occlusion of the rul bronchus by mass and endobronchial bx and transbronchial fna performed. pt desatted to 80% and remained intubated, transfered back to the micu. . : pt placed on levophed. on underwent repeat chest ct and started on vanc/cefepime/cipro. pt given increasing doses of iv lasix and later placed on dobutamine to assist with diuresis. () micafungin, flaygl added as pcn and cipro d/c'd. () vanc d/c'd as the pt underwent a rigid/flex bronch that revealed poorly differentiated nsclc. today the patient was consulted by heme-onc where numerous options were presented to the patient (xrt, chemo). the pt initially decided against xrt, but later reversed his decision and is now being transfered to the to undergo xrt. prior to transfer the pt was hypotensive, started back on levophed and given iv bolus. . ros: congestion, sore throat, chest pain, abdominal pain, nausea, vomiting, diarrhea, constipation, brbpr, melena, hematochezia, dysuria, hematuria. past medical history: past medical & surgical history: (per admit note) # lung ca s/p left pneumonectomy - first dx s/p radiation therapy (no tissue diagnosis known) followed by thoracics (dr at - being evaluated for new right hilar mass s/p mediastinoscopy with biopsy without evidence of malignancy of note; sputum culture with actinomyces # htn # niddm2 # hl # pituitary microadenoma # testicular hypofunction # obesity # angioedema after a dental procedure with negative rast for l social history: the patient quit smoking ten years ago but has a 25 pack history. he drinks rarely. he is a retired cook. no known asbestos exposures or occupational exposures. he lives alone. no illicit drug use. family history: mother died at age 38 secondary to ovarian carcinoma. father died at age 84 secondary to "heart trouble." he had hypertension as well. the patient reports a positive history of malignancy in other family members of unknown types. the patient has four siblings, all of whom are in reasonably good health. physical exam: on arrival to vitals - t: 99.4 125/94 bp: hr: rr: 02 sat: gen: intubated, nad, responding to questions appropriately, follows commands cv: rrr lungs: scattered rhonci on right abd: soft, normal bs. nontender ext: 1+ edema neuro: a/o x 3; intubated, responding to voice . labs: see below. pertinent results: 08:20pm plt count-338 08:20pm neuts-69.9 lymphs-21.3 monos-5.9 eos-2.5 basos-0.5 08:20pm wbc-6.3 rbc-4.26* hgb-12.3* hct-38.2* mcv-90 mch-28.9 mchc-32.2 rdw-14.2 08:20pm calcium-9.0 phosphate-3.6 magnesium-1.7 08:20pm ck-mb-notdone 08:20pm ctropnt-<0.01 08:20pm ck(cpk)-77 08:20pm estgfr-using this 08:20pm glucose-70 urea n-13 creat-1.1 sodium-140 potassium-3.8 chloride-98 total co2-33* anion gap-13 08:35pm pt-14.0* ptt-33.7 inr(pt)-1.2* ct chest: 1. right lower lobe cavitary mass, with associated right hilar bulky lymphadenopathy, highly concerning for recurrent bronchogenic malignancy. either the right lower lobe mass, or multiple stations of lymphadenopathy in the mediastinum would be amenable to bronchoscopic biopsy. 2. extensive peribronchiolar tree-in- opacities, small nodular and ground-glass opacities throughout the right upper lobe, and to a lesser degree in the right middle and lower lobes. findings suggest a superimposed infectious process. infection involving the cavitary mass in the right lower lobe superior segment could also be considered, along with superinfection of a preexisting cavitary mass. 3. subtle thickening of interlobular septae in portions of the right upper lobe and superior segment right lower lobe, worrisome for lymphangitic carcinomatosis. 4. necrotic-appearing 3 cm left adrenal nodule and enlarged 1.6 cm left paraaortic node worrisome for metastatic disease. 5. secretions and debris in the left mainstem bronchial stump may be acting as a nidus for infection. cytology: right main stem mass, transbronchial needle aspirate: atypical. clusters of atypical stripped nuclei and focal necrosis in a background of reactive bronchial epithelial cells, (see note.) note: the atypical nuclei are stripped of their cytoplasm and display regular nuclear contours, vesicular chromatin and large prominent nucleoli. please also refer to the concurrent endobronchial biopsy s10-964. right mainstem bronchus, endobronchial biopsy: poorly differentiated carcinoma tte: the left atrium and right atrium are normal in cavity size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). the right ventricular cavity is moderately dilated with depressed free wall contractility. there is abnormal systolic septal motion/position consistent with right ventricular pressure overload. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets are moderately thickened. there is mild aortic valve stenosis (valve area 1.2-1.9cm2). no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is severe pulmonary artery systolic hypertension. there is no pericardial effusion : 1. no evidence of endoluminal filling defects to indicate pulmonary embolus. however, multiple areas of progressive narrowing and at least one occlusion of pulmonary arterial branches by the infiltrative right hilar mass likely contribute to the described symptoms of pulmonary arterial hypertension. 2.interval development of multiple foci of consolidation and peribronchiolar opacities in the right middle and upper lobe concerning for progressive multifocal pneumonia. findings were called to dr. . 3. mild-to-moderate right pleural effusion. 4. diffuse adenopathy and infiltrative mass involving the right middle and upper lobe with progressive obstruction of the bronchi and pulmonary vasculature. 5. changes of left pneumonectomy. 6. enhancing nodule with central hypodensity adjacent to or within the left adrenal gland is consistent with either metastatic involvement of lymph node or adrenal gland. pathology: right bronchus intermedius mass (for frozen section), endobronchial biopsy (a): poorly differentiated carcinoma. right bronchus intermedius mass, endobronchial biopsy (b): poorly differentiated carcinoma. cardiac cath: 1. no significant coronary artery disease. 2. no central pulmonary embolism. 3. moderate pulmonary arterial hypertension. 4. elevated right-sided filling pressures. tte: left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 70%). the right ventricular free wall is hypertrophied. the right ventricular cavity is dilated with severe global free wall hypokinesis. there is no mitral valve prolapse. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the findings of the prior study (images reviewed) of , the findings are similar. brief hospital course: 64 yo male with h/o lung ca s/p left pneumonectomy, dm2, htn, admitted for fever, dyspnea and productive cough. experienced hypoxic respiratory failure during bronchoscopy, requiring intubation. he was found to have partial occlusion of rul bronchus, and biopsy of lung revealed nsclc. a stent was placed in his bronchus intermidius. he was eventually extubated. he was treated with antibiotics for post-obstructive pneumonia, and also received xrt for his lung ca. he transiently required vasopressors for hypotension, believed to be vagal response during intubation and, later, xrt. he developed chest pain with ekg findings concerning for myocardial ischemia. cardiac catheterization revealed no coronary lesions. pain was further managed with morphine. the patient was seen by palliative care, and goals of care were shifted towards comfort measures. he was discharged to a long-term facility for hospice care. medications on admission: cabergoline 0.25mg twice a week lipitor 10mg daily viagra prn metoprolol sr 200mg daily lisinopril 40mg daily glyburide 5mg daily discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 2. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed for cough . 3. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) nebs inhalation q2h (every 2 hours) as needed for sob. 4. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 5. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily prn () as needed for pain: leave on for 12 hours, then take off for 12 hours. 6. docusate sodium 50 mg/5 ml liquid sig: ten (10) ml po daily (daily). 7. ipratropium bromide 17 mcg/actuation aerosol sig: six (6) puff inhalation q4h (every 4 hours). 8. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 4-8 puffs inhalation q4h (every 4 hours). 9. morphine 15 mg tablet sustained release sig: tablet sustained releases po q4h (every 4 hours) as needed for pain. 10. scopolamine base 1.5 mg patch 72 hr sig: one (1) patch 72 hr transdermal every 3 days (every 3 days). discharge disposition: extended care facility: - discharge diagnosis: primary: hypoxic respiratory failure secondary: pericarditis acute kidney injury diabetes mellitus discharge condition: comfortable. mental status:clear and coherent level of consciousness:alert and interactive activity status:out of bed with assistance to chair or wheelchair discharge instructions: mr. , you were admitted to the hospital for fever, shortness of breath and sputum production. you had chest pain and underwent cardiac catheterization; your chest pain was ultimately believed to be due to inflammation of the lining around your heart. you required mechanical ventilation for a period of time, but you were eventually able to breathe on your own. our palliative care specialists met with you to discuss further goals of care. medications not directed at comfort (e.g. shots for insulin and blood thinners) were discontinued. you are being discharged to a hospice facility where you can be made maximally comfortable. your further medication regimens will be specifically geared towards your comfort. followup instructions: n/a md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more combined right and left heart cardiac catheterization coronary arteriography using two catheters insertion of endotracheal tube other intubation of respiratory tract closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed endoscopic biopsy of lung arteriography of pulmonary arteries other radiotherapeutic procedure endoscopic excision or destruction of lesion or tissue of bronchus diagnoses: pneumonia, organism unspecified other iatrogenic hypotension acute kidney failure with lesion of tubular necrosis unspecified pleural effusion unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation other chronic pulmonary heart diseases other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure malignant neoplasm of other parts of bronchus or lung other diseases of lung, not elsewhere classified hypoxemia obesity, unspecified accidents occurring in residential institution urinary complications, not elsewhere classified radiological procedure and radiotherapy as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure benign neoplasm of pituitary gland and craniopharyngeal duct 

Answer: The patient is high likely exposed to