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: history of present illness: this is a 70 year old male with a history of hyperthyroidism for 30 years (not operated), and hypertension who was drunk and fell at 1 a.m. on , and then found to be hemiparetic and aphasic in the morning. he was brought to the hospital by his wife. past medical history: 1. hyperparathyroidism for which the patient has refused surgery times 30 years. 2. hypertension. 3. hypercalcemia. 4. osteoporosis. 5. chronic renal insufficiency. medications on admission: 1. fosamax 35 mg q. week. 2. amlodipine 10 mg q. day. allergies: no known drug allergies. hospital course: the patient was initially alert; he had right hemiparesis and garbled speech with a blood pressure of 220/140, but then had altered mental status and was intubated in the emergency room for airway protection. a head ct scan was done which showed a 2 mm left thalamic bleed and blood in the third and fourth ventricles, but no midline shift or edema. the patient was admitted to the neurosurgical intensive care unit for frequent neurological checks, ventricular drain placement, mechanical ventilation and blood pressure control. an external ventricular drain was placed in the lateral ventricle and the cerebrospinal fluid drained. 1. neurological system: the patient presented with a right hemiplegia, aphasia, with ct scan evidence of a large 2 cm left thalamic bleed with blood in the lateral and third and fourth ventricles. his mental status deteriorated in the emergency room and he was intubated for airway protection. he had an external ventricular drain placed which was draining as well as being transfused. the ventricular drain was clamped on and then removed on , after the ct scan of the head showed no acute changes. the patient remained stable neurologically. on , the patient was noted to be less attentive and moving his left side less than before and a repeat ct scan of the head was done which showed resolving thalamic bleed and decreased amounts of blood in the ventricles and unchanged size of the ventricles. the patient became more responsive later in the day and continued to have alternating periods of alertness and less responsiveness for the rest of his stay. 2. respiratory system: the patient did well over the next day and was extubated but had to be re-intubated when he had an episode of hemoptysis. he was again extubated on the but had to be re-intubated for airway protection as his mental status deteriorated. he then underwent a percutaneous tracheostomy on the and was weaned off the ventilator and then transferred to the floor and was found to have respiratory distress and transferred back to the intensive care unit and mechanically ventilated. a chest x-ray showed collapse of the left lung and a bronchoscopy was done which showed a large plug in the left main bronchus which was removed. bronchoscopy was repeated later in the day and again large plug was removed. the left lung improved and the patient was weaned off the ventilator and was put on a tracheostomy mask on 40% oxygen on . the patient needs hourly suctioning, aggressive physiotherapy and around-the-clock nebulizers. 3. cardiovascular: the patient had severe hypertension on arrival to the hospital and blood pressure was controlled with hydralazine and amlodipine. on , the patient had a cardiac echocardiogram, findings of which are left atrial elongation, right atrial elongation, left ventricular symmetric hypertrophy with a cavity size normal, left ventricular systolic function was hyperdynamic, greater than 75%, severe left ventricular outflow tract obstruction around 90 mm of mercury, right ventricular chamber size and free wall motion normal. aortic root moderately dilated. ascending aorta mildly dilated. no significant aortic stenosis or aortic regurgitation, significant diastolic mitral regurgitation and mild systolic mitral regurgitation, tricuspid regurgitation cannot be quantified. no vegetations seen (cannot be excluded). lopressor was started and amlodipine dose increased, and the hydralazine discontinued. cardiology service was consulted and they recommended to continue the same management. 4. infectious disease: the patient was put on oxicillin for prophylaxis during the period he had an external ventricular drain placed, that is from until . the patient had continued temperature spikes and thick yellow secretions and levofloxacin was started on , but the patient continued to have thick yellow secretions with increased white counts and temperature spikes and the levofloxacin was changed to vancomycin on . there were no positive blood, urine, cerebrospinal fluid or sputum cultures. a picc line was placed for antibiotics infusion in the left antecubital vein on . the patient continued to have low grade temperatures and spiked a temperature of 102.0 f., on . he was pan-cultured and his urinalysis showed 10 to 100,000 gram negative rods and his vancomycin was changed to levofloxacin. he responded to the antibiotic with decrease in white count, decrease in temperature and the levofloxacin is to be continued for seven days more. doppler ultrasound of the lower extremities was done which showed no evidence of deep venous thrombosis. 5. endocrine: the patient had raised serum calcium levels on admission and he was diuresed with normal saline, lasix and free water for repleting water losses. he was restarted on fosamax 35 mg q. week, his outpatient dose, and endocrine was consulted. they recommended a dose of fosamax 70 mg every week and a dose of pamidronate at 60 mg intravenous, which was given on . he had 25 hydroxy vitamin d levels and coma panel levels done which are still pending and an ultrasound of his parathyroids to rule out parathyroid adenoma. 6. gastroenterology: the patient was started on tube feeds on , and as extubation trial failed, a peg tube was placed on , and the patient was given tube feeds through the peg tube. nepro 1/2 strength with 50 mg of promod at 80 ml per hour. 7. renal: the patient was diuresed with normal saline and lasix and has had his electrolytes replaced. his creatinine level decreased from 2.0 at the time of admission to 1.3 at the time of discharge. a renal ultrasound done to evaluate for nephrocalcinosis showed evidence of multiple cysts in both kidneys with a large cyst in the left kidney with some irregularity of pole and calcification, with no other evidence of nephrolithiasis or nephrocalcinosis, no clear evidence of renal artery stenosis. discharge diagnoses: 1. hyperparathyroidism with hypercalcemia. 2. osteoporosis. 3. hypertension. 4. chronic renal insufficiency. 5. concentric hypertrophic obstructive cardiomyopathy. 6. left thalamic bleed with right hemiplegia. 7. left lower lobe pneumonia. 8. status post tracheostomy, peg and left picc line. discharge medications: 1. amlodipine 7.5 mg twice a day per ng tube. hold for systolic blood pressures less than 130. 2. lopressor 25 mg three times a day per ng tube; hold for systolic blood pressure less than 120. 3. fosamax 70 mg per week per ng tube. 4. prevacid 30 mg q. day per ng tube. 5. levofloxacin 500 mg p.o. q. day for four more days. 6. nepro half-strength with 50 mg promod at 80 ml per hour. 7. heparin 5000 units subcutaneously twice a day. 8. albuterol two puffs q. six hours. 9. zoloft 25 mg q. day. 10. beconase one puff each nostril twice a day. discharge instructions: 1. frequent pt/eps. 2. oxygen by tracheostomy mask 0.35 fio2. 3. multi-podus boots. 4. venodyne. 5. physiotherapy. 6. follow-up -weekly calcium levels in the rehabilitation. 7. endocrinology follow-up with dr. at the . 8. intermittent pamidronate as per dr. . 9. work-up for pheochromocytoma/parathyroid adenoma. condition at discharge: stable. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances other bronchoscopy intravascular imaging of intrathoracic vessels arterial catheterization temporary tracheostomy percutaneous (endoscopic) jejunostomy [pej] diagnoses: pneumonia, organism unspecified obstructive hydrocephalus unspecified essential hypertension other pulmonary insufficiency, not elsewhere classified intracerebral hemorrhage pulmonary collapse hypercalcemia 

Answer: The patient is high likely exposed to