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: penicillins attending: chief complaint: hypoxic hypercarbic respiratory failure major surgical or invasive procedure: intubation femoral line placement history of present illness: this is a 78 year old man with pmh significant for chf, adrenal insufficiency who is s/p total knee replacement who presents post intubation in the ed for respiratory failure. he was recently admitted to the for right tkr. his postop course was complicated by hypoxic hypercarbic respiratory failure. he was intubated post procedure, then extubated the following day. he was diuresed with lasix and then discharged to rehab on . today he was found to be hypoxic so he was transferred to . he was hypoxic, and a cta of the chest was performed which was negative. he was also noted to have a dilated right pupil. he received 1g vancomycin, 500 mg levofloxacin, and 10 mg decadron. his family refused intubation and he was transferred to ed. on transfer he became apneic and unresponsive. . in the ed, he was found to have a fixed and dilated right pupil and was in respiratory distress. his o2 sat was 100% on nrb. his initial abg was 7.32/73/293. he was intubated. right ij was attempted with ultrasound by the wire could not be passed, so an emergent right femoral line was placed. he was transferred to the icu. . on initial presentation to the icu he was intubated and unarousable, but became awake and denied pain or discomfort. past medical history: addison's disease psoriasis hypercholesterolemia djd: right tkr ; previous left tkr in peripheral vascular disease copd possible osa possible chf (ef >55% no wma) alcohol abuse delerium/sundowning diabetes mellitus, diet controlled bph previous le vascular bypass at , intubated 5 weeks a fib with rvr on single recent ekg social history: (per previous notes) lives in and on . he has been retired for several years. he used to work on the waterfront and has probably about 25- or 30-pack- year smoking history. however, he has not smoked for several years. he does drink a fair amount of alcoholic beverages, mostly beer. family history: nc physical exam: v: t98.9 bp 99/58 p89 r600x14 p5 60% vent: ac 600x14 60% p5 gen: intubated but awake, responsive to commands heent: right pupil 4->3mm, left pupil 2->1.5mm. eomi. op with ett. neck: right neck with subcutaneous hematoma from ij attempt, jvp not seen resp: cracles right base, occasional wheezes cv: rrr nl s1s2 no mgr abd: soft, nt, protuberant, with bowel sounds ext: peripheral vascular disease. r femoral in place. l knee with scar, right knee with staples and c/d/i bandage and no erythema. neuro: intubated, but responsive. moves all 4 extremities to command. babinski up right, equivocal left. pertinent results: 5:54p added @ 0019 136 95 7 agap=10 ------------< 80 4.4 35 0.2 estgfr: >75 (click for details) ck: 40 mb: notdone trop-t: <0.01 comments: ctropnt: ctropnt > 0.10 ng/ml suggests acute mi serum asa, etoh, acetmnphn, benzo, barb, tricyc negative tsh:0.95 free-t4:1.2 other blood chemistry: probnp: 379 comments: probnp: reference values vary with age, sex, and renal function;at 35% prevalence, ntprobnp values; < 450 have 99% neg pred value; >1000 have 78% pos pred value;see online lab manual for more detailed information 93 12.5 \ 11.3 / 340 / 33.7 \ n:94.7 band:0 l:3.1 m:1.9 e:0.1 bas:0.1 05:59pm blood type-art po2-293* pco2-73* ph-7.32* caltco2-39* base xs-8 09:31pm blood type-art po2-99 pco2-57* ph-7.43 caltco2-39* base xs-10 06:38am blood type-mix po2-41* pco2-80* ph-7.34* caltco2-45* base xs-12 06:35pm blood lactate-1.1 chest (portable ap) 8:38 pm chest (portable ap) reason: eval ett placement medical condition: 78 m intubated s/p ett advancement, pulled at tube reason for this examination: eval ett placement examination: ap chest. indication: et tube placement. single ap view of the chest is obtained on at approximately 20:33 hours. the patient remains intubated with the tip of the et tube approximately 5 cm above the carina. appearances of the lung field is essentially unchanged in the three-hour interval since the prior examination with lower lung volumes and patchy subsegmental atelectasis at both bases. no large pneumothorax is identified. head ct without contrast: the evaluation is somewhat limited due to motion. however, there is no acute intracranial hemorrhage. there is no mass effect or shift of normally midline structures. there is small right choroid fissure cyst or dilated perivascular space as seen on the prior study from . mucosal thickening in the maxillary sinuses are noted. there is air- fluid level in the nasopharynx. impression: limited study due to motion, however, no acute intracranial hemorrhage. fluid in the nasopharynx. blood culture aerobic bottle-pending; anaerobic bottle-pending inpatient blood culture aerobic bottle-pending; anaerobic bottle-pending inpatient brief hospital course: #) respiratory failure. unclear etiology in retrospect. ddx includes pneumonia/aspiration, atelectasis, copd exacerbation, chf, and medication effect. unlikely chf as ef 55% and no wma seen on recent echo at , but bnp normal. possible component of copd with smoking history, unknown fev1. pe ruled out by cta. cxr relatively clear wihtout infiltrate. likley baseline pco2 in the 60's given high bicarb and only mild acidosis with pco2 70's. also may have contribution by seroquel. pt was extubated the morning after admission and respiratory status remained stable thereafter. he was treated empirically for nosicomial pneumonia with vanc/levo/flagyl and intially given iv steroids, which were quickly changed to his usual steroid dose. he received albuterol/atrovent nebs standing. a swallow study can be considered to fully rule out silent aspiration though was not clinically aspirating and tolerating a normal diet. he should have a repeat cxr on and all antibiotics discontinued if there is no infiltrate. he should also have outpatient sleep study and pft's considered. #) dilated right pupil - his initially dilated pupil became more responsive throughout his course. his tox was negative. neuro evaluated and initially wanted mri of the brain, but it improved gradually and the rest of his neuro exam was normal, so it was felt most likely to be due to atrovent in the eye. mri was no longer indicated. #) s/p right tkr . surgeon was dr. . coumadin was initially held, but then restarted and should be continued for 3 weeks post surgery goal . he should follow up with his surgeon for staple removal approx day 14 postop and pt should follow. #) addison's disease - received 10 mg decadron at , then 125 iv solumedrol q8h for 2 doses. changed back to home regimen of 30mg qam and 10mg qpm. bp stable. #) type 2 diabetes - diet-controlled at home. received insulin ss while on higher dose steroids #) peripheral vascular disease - restarted low dose aspirin and statin prior to discharge #) nail onchomycosis - discontined lamisil as lft's elevated. pcp to consider restarting after rehabilitation. #) fen - resumed regular diet after extubation #) code - full per family/patient #) communication - hcp daughter h c medications on admission: aspirin 81 mg p.o. daily prednisone 30 mg p.o. q.a.m./10 mg p.o.q.p.m. multivitamin 1 p.o. daily lovastatin 20 mg p.o. q.h.s. lamisil 250 mg p.o. daily coumadin 2 mg p.o. daily x 3 weeks seroquel 25 mg p.o. q.h.s. lasix 20 mg p.o. daily. discharge medications: 1. ipratropium bromide 0.02 % solution sig: one (1) inhalation inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 2. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation every 4-6 hours as needed for shortness of breath or wheezing. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. insulin lispro (human) 100 unit/ml solution sig: qs units subcutaneous asdir (as directed): sliding scale. 5. prednisone 10 mg tablet sig: three (3) tablet po q am (). 6. prednisone 10 mg tablet sig: one (1) tablet po q pm (). 7. trazodone 50 mg tablet sig: 0.25 tablet po once mr1 (once and may repeat 1 time) as needed for insomnia. 8. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 9. warfarin 2 mg tablet sig: one (1) tablet po hs (at bedtime): goal inr . continue for at least 3 weeks postop; consider long term anitcoagulation for postop a fib. 10. vancomycin in dextrose 1 g/200 ml piggyback sig: one (1) gram intravenous q 12h (every 12 hours) for 4 days: dc if cxr clear on , otherwise continue 4 days (7 day total course). 11. levofloxacin 750 mg tablet sig: one (1) tablet po once a day for 2 days: dc if cxr shows no infiltrate on , otherwise continue 3 days. . 12. lovastatin 20 mg tablet sig: one (1) tablet po once a day. 13. lasix 20 mg tablet sig: one (1) tablet po once a day: for history of chf - may discontinue if appears dehydrated. discharge disposition: extended care facility: - discharge diagnosis: primary: hypoxic hypercapnic respiratory failure mydriasis likley secondary to opthalmic atrovent secondary: addison's disease psoriasis hypercholesterolemia djd: right tkr ; previous left tkr in peripheral vascular disease copd possible osa possible chf (ef >55% no wma) alcohol abuse delerium/sundowning diabetes mellitus, diet controlled bph previous le vascular bypass at , intubated 5 weeks a fib with rvr on previous ekg discharge condition: stable, breathing comfortably discharge instructions: you were admitted for respiratory distress and a dilated pupil. your breathing problem improved and the breathing tube was removed without any events. please call your physician or return to the emergency room if you notice worsening shortness of breath, chest discomfort, or any other concerning symptoms. you are being discharged to ne in . please follow the instructions below. followup instructions: with your pcp , 1-2 weeks after discharge from rehab. with your surgeon dr. for staple removal within 1 week. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube diagnoses: pure hypercholesterolemia congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified acute respiratory failure knee joint replacement mydriasis (persistent), not due to mydriatics 

Answer: The patient is high likely exposed to