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: aspirin attending: chief complaint: hemoptysis major surgical or invasive procedure: 1) broncoscopy 2) embolization of rul bronchial arteries & history of present illness: 59ym w/ hemoptysis since presented to osh. bronchoscopy x3, egd, nasopharyngeal endoscopy without evidence of source. transfered to for further evaluation. on admission, denied significant hemoptysis for ~36 hours, denied cp, sob, n/v, h/o hemoptysis, weight loss. reported chronic cough occasionally productive of normal sputum for years. reported doe since construction accident and leg injury many years ago. denied melena, hematochezia. past medical history: 1) copd 2) htn 3) dm, type 2 4) chronic pancreatitis (etoh) with known splenic vein thrombosis and h/o ugib from gastric varices 5) crush injury of r leg social history: 1ppd x48y, h/o etoh use ("cut back" 30y ago, now drinks/week), lives alone, no family except cousin family history: father died of lung cancer, mother died of "female" cancer physical exam: admission exam 96.3 66sr 158/73 18 96%ra wt 77.7kg nad, anicteric, no jvd/lad coarse b/l, regular nd, soft, nt no edema pertinent results: 06:10am blood wbc-5.5 rbc-3.54* hgb-10.8* hct-32.9* mcv-93 mch-30.5 mchc-32.9 rdw-13.5 plt ct-277 04:15am blood wbc-4.0 rbc-3.02* hgb-9.5* hct-27.6* mcv-92 mch-31.5 mchc-34.4 rdw-13.6 plt ct-209 04:45am blood hct-28.5* 11:52pm blood wbc-5.0 rbc-3.14* hgb-10.3* hct-29.6* mcv-94 mch-33.0* mchc-35.0 rdw-13.1 plt ct-172 06:10am blood plt ct-277 04:15am blood plt ct-209 07:55am blood pt-12.6 ptt-24.4 inr(pt)-1.1 11:52pm blood plt ct-172 06:10am blood glucose-148* urean-9 creat-0.7 na-138 k-4.3 cl-101 hco3-26 angap-15 04:15am blood glucose-153* urean-11 creat-0.6 na-134 k-4.6 cl-101 hco3-24 angap-14 04:45am blood glucose-184* urean-9 creat-0.7 na-133 k-4.2 cl-103 hco3-24 angap-10 11:52pm blood glucose-43* urean-11 creat-0.8 na-137 k-3.9 cl-105 hco3-26 angap-10 04:45am blood alt-19 ast-26 ld(ldh)-113 alkphos-61 totbili-0.4 06:10am blood calcium-9.0 phos-3.6 mg-1.8 04:15am blood calcium-8.7 phos-3.8 mg-1.5* 04:45am blood albumin-3.1* calcium-8.3* phos-3.6 mg-2.2 11:52pm blood calcium-8.7 phos-3.3 mg-1.4* ct chest w/o contrast 12:29 pm ct chest w/o contrast reason: please perform high resolution cutshemoptysis, localization field of view: 36 medical condition: 59 yo male with hx of onset of persistent hemoptyis, 3 bronchocopies non-diagnostic. outside ct? rul ground glasscxr ?generalzied hazy ground glass reason for this examination: please perform high resolution cutshemoptysis, localization and r/o bronchiectasis, contraindications for iv contrast: none. reason for examination: persistent hemoptysis. technique: mdct contiguous images of the chest from the thoracic inlet through the level of the adrenals were obtained without injecting of the iv contrast media. the 5 and 1.25-mm slices were reconstructed for evaluation. the heart is normal. multiple coronary calcifications are seen. no pericardial effusion is present. multiple small mediastinal lymph nodes are seen which do not meet the criteria for pathological lymph node enlargement. the aorta and pulmonary trunk are normal within the limits of this unenhanced chest ct. multiple apical pleural bullae are seen bilaterally, more prominent on the right. no pneumothorax is seen. a widespread centrilobular emphysema is seen mostly within the upper lobe, but the lower lobes are involved as well. some amount of subpleural emphysema is also present bilaterally. small blebs are seen within the lower lungs. prominent thickening of the bronchial wall is seen mostly on the right, especially within the right middle lobe. ground-glass opacity is seen within the right middle lobe with areas of air cavities within it which may represent blebs surrowneded by consolidation. some element of volume loss within the right middle lobe is also present. widespread areas of patchy ground-glass opacity are seen within the right lower lobe, right middle lobe, and of small amount in the right upper lobe. a 1-cm pulmonary nodule with indistinct spiculated borders is seen within the right middle lobe, series 102, images 143-148. in addition, multiple small tiny nodules are seen scattered bilaterally, but most prominent on the right. the images of the upper abdomen reveal multiple small calcifications within the pancreas mostly within the body and tail which represent most probably chronic pancreatitis. impression: 1. bilateral centrilobular and subpleural emphysema most prominent in the upper lung lobes. 2. ground-glass opacities most prominent in the right middle and right lower lobe and may represent infectious, inflammatory noninfectious process as well as hemorrhage. 3. an ill-defined 1-cm nodule in the right middle lobe is seen. further followup with chest ct is recommended in three months. 4. multiple tiny nodules are spread over the right lung which may be related to the diffuse above-described process. 5. thickening of the bronchial wall and small bronchiectasis more prominent in the right perihilar region and right middle lobe. 6. chronic pancreatitis. trancatheter embolization impression: 1. selective arteriography of 2 additional right bronchial arteries (not visualised on the study of ) supplying the right upper lobe demonstrated abnormal tortuous distal vessels associated with contrast blushing. no active extravasation was demonstrated in this distribution and no spinal artery was visualized. given the current active hemoptysis, embolization of these 2 additional bronchial arteries with 300-500 micron particles was performed. hemostasis was achieved in the superior vessel and significant reduction of blood flow was achieved in the inferior vessel. 2. selective arteriography of the main right bronchial artery confirmed complete stasis of blood flow in this distribution consistent with right bronchial artery embolization on . 3. selective arteriography of the left bronchial artery demonstrated normal- appearing vessels. 4. at procedures end, there was cessation of active hemoptysis and no neurologic deficits appreciated. ct chest w/o contrast 5:16 pm ct chest w/o contrast reason: please perform high res ct scan of chest field of view: 36 medical condition: 59 year old man s/p empolization of vessels of rul reason for this examination: please perform high res ct scan of chest contraindications for iv contrast: none. indication: 59-year-old man with embolization of right upper lobe vessel. technique: contiguous axial ct images of the chest are obtained without the administration of iv contrast . comparison: chest ct dated . findings: the evaluation of pulmonary and mediastinal vasculature is somewhat limited due to lack of intravenous contrast. small mediastinal nodes are seen, however, there is no significant mediastinal or hilar lymphadenopathy. coronary artery is calcified. the heart is normal in size, and there is no evidence of pericardial or pleural effusion. in the lung window, again note is made of centrilobular emphysematous change. note is made of peribronchial thickening in right middle lobe, with patchy opacities, slightly improved compared to the prior study. again note is made of 8 mm somewhat spiculated nodule in the right middle lobe, which needs followup in three months. note is made of small cyst in the left lower lobe. the central airways are patent. in the visualized portion of the upper abdomen, calcified pancreas is seen. there is no suspicious lytic or blastic lesion in skeletal structures. impression: 1. overall unchanged appearance of the chest with emphysematous changes, peribronchial thickening in right middle lobe. 2. 8 mm nodule in the right middle lobe, which needs followup in three months. alternatively comparison with prior outside studies would determine the chronicity of this finding. 3. please note the evaluation of pulmonary and mediastinal vasculature is somewhat limited due to lack of intravenous contrast. unilat lower ext veins right 8:14 pm unilat lower ext veins right reason: rt leg swelling, eval for dvt medical condition: 59 year old man s/p angiography with right leg weakness and swelling reason for this examination: eval for dvt indication: 59-year-old male with right leg weakness and swelling. technique: grayscale and doppler ultrasound of the right lower extremity. no comparison. findings: normal flow, augmentation, compressibility are seen, in superficial femoral veins as well as in popliteal veins. no evidence of dvt. impression: no evidence of dvt. mr thoracic spine 10:21 am mr thoracic spine reason: assess for spinal infarction medical condition: 59 year old man with hx of copd, dmii, djd of spine unknown level p/w hemoptysis now with rle paralysis after pulm embolization reason for this examination: assess for spinal infarction indication: patient with copd and diabetes type 2 and degenerative disease of the spine. patient presented with hemoptysis and now with right lower extremity paralysis post-pulmonary embolization. evaluate for infarction. no prior studies are available for comparison. technique: sagittal t1, t2 and stir images of the thoracic spine were obtained, with axial t2-weighted images from approximately the t6/7 through l2/3 levels. additional sagittal t2-weighted images from c2 through the upper thoracic spine were obtained, with axial t2-weighted images of the upper thoracic spine. findings: vertebral body heights in the cervical, thoracic and lumbar spine are maintained. the spinal canal is patent. on small field of view thoracic spine sagittal t2 images, there are multiple small foci of elevated t2 signal within the spinal cord. the multiple foci are scattered over at least six levels. the axial images demonstrate the elevated t2 signal to be located within the central matter of the spinal cord. there is bulging of the t12-l1 disk, with mild encroachment on the spinal cord. the intervertebral disc spaces are normal, were well visualized in the central portion of the thoracic spine. no other paraspinal pathology is identified. conclusion: multiple foci of elevated t2 signal within the matter of the spinal cord most likely representing foci of infarction. brief hospital course: pt is a 59 yo man w/ pmh of copd, dm, htn admitted to osh with hemoptysis ~100-200cc/da. at osh recieved 3 negative bronch, egd and nasopharyngeal egd. pt was transfered to for further management on the thoracics service . on workup of hemoptysis pt was noted to have spiculated 9mm rml lesion and 1.5mm infrahilar node on ct. 2 days ago interventional pulmonology performed a bronch which showed no endobronchial lesions but active bleeding in posterior segment of rul. embolization was then performed by ir on to r bronchointercostal trunk. he continued to have hemoptysis and underwent repeat embolization by ir. pt was transfered out of the micu as his hemoptysis had seemed to decrease over the last day s/p embolization. on the floor the patient was discovered to have new rle weakness, a mri was performed which showed spinal cord infacrt the patient was seen by neuro who recommend pt, physical therapy saw pt in hospital and cleared pt for home with home pt. pts hematocrits remained stable after transfer to the floor and hemoptysis resolved. pt was discharged on his home regimen of medications plus a bowel regimen. medications on admission: nph 13bid protonix 40qd fentanyl patch 50q48 colace 100bid pancrease 4 caps tid enalapril 5bid restroil 30qhs ativan 0.5q8 prn augmentin 500bid discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 3. fentanyl 50 mcg/hr patch 72hr sig: one (1) transdermal every seventy-two (72) hours. 4. axid 150 mg capsule sig: one (1) capsule po twice a day. 5. amylase-lipase-protease 20,000-4,500- 25,000 unit capsule, delayed release(e.c.) sig: four (4) cap po tid w/meals (3 times a day with meals). 6. lorazepam 0.5 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed. 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 8. temazepam 15 mg capsule sig: two (2) capsule po hs (at bedtime) as needed. 9. enalapril maleate 5 mg tablet sig: 1.5 tablets po daily (daily). 10. insulin nph human recomb 100 unit/ml suspension sig: 13 units subcutaneous at bedtime. 11. humalog 100 unit/ml solution sig: as per sliding scale subcutaneous with finger stick glucose checks. discharge disposition: home with service facility: vna of southeastern mass. discharge diagnosis: primary: hemoptysis, status post embolization right spinal cord infarct secondary: diabetes hypertension copd chronic pancreatits history of right lower extremity crush injury discharge condition: stable discharge instructions: you have been diagnosed with bleeding from your right upper lung, your bleeding is now stable status post embolization by interventional radiology. on workup for your bleeding a mass was found in your right middle lung. this will need follow up with a high resolution ct scan 1 month from discharge, you primary care doctor has been contact and will help you arrange this close to where you live. also while you were in the hospital your spinal cord loss some blood flow leading to right leg weakness. continue to use a walker to ambulate and do not drive until cleared by a physical therapist. physical therapy has been arranged to work with you at home. continue to take medications as prescribed. return to the emergency room or call your doctor if you develop increasing cough, increasing blood in your sputum, shortness of breath, chest pain, abdominal pain, episodes of fainting, new weakness or sensory changes or any other concerns. be sure to follow up as directed. followup instructions: follow up with your primary care doctor, you have an appointment on at 3:45pm with dr. , call ( with questions or concerns. you will need follow up with a pulmonologist and a neurologist, speak with your primary care doctor about arranging follow up appointments with physicians near your home. you will need a follow up cat scan of your chest in 1 month to monitor your lung nodule. md, procedure: other lavage of bronchus and trachea other endovascular procedures on other vessels other endovascular procedures on other vessels arteriography of pulmonary arteries arteriography of pulmonary arteries transfusion of packed cells diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified other nervous system complications long-term (current) use of insulin chronic pancreatitis vascular myelopathies degeneration of intervertebral disc, site unspecified late effect of crushing late effects of other transport accident 

Answer: The patient is high likely exposed to