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: tape / percocet / zyvox attending: chief complaint: trachaelbronchialmalcia major surgical or invasive procedure: : right thoracotomy and tracheoplasty with mesh, right mainstem bronchus/bronchus intermedius bronchoplasty with mesh, left mainstem bronchus bronchoplasty with mesh, and flexible bronchoscopy with aspiration. : dynamic flexible bronchoscopy. history of present illness: mr. is a 56-year-old gentleman with a history of copd who was found to have severe tracheobronchomalacia. he a placement of a tracheobronchial silicone y stent on . following this his dyspnea on exertion markedly improved. unfortunately, he did suffer a stent-related infection and this needed to be removed. we spoke at length at the utility of moving on to a surgical correction of his malacia with posterior splinting with marlex mesh. we talked about the risks of this procedure including injury to the recurrent laryngeal nerve, tracheal injury, esophageal injury, vessel, heart, or diaphragmatic injury. we talked about the risks of pneumonia or other infection as a result of this, as well as the possibility of postoperative pain from the thoracotomy. we also talked about the possibility that the cervical trachea may develop or may present with symptomatic malacia which would not be corrected by this intrathoracic procedure. finally, we discussed the possibility of improvement of the malacia without betterment of his symptoms despite the stent trial findings, if his underlying lung disease were to take precedence. mr. and his partner had a chance to ask all pertinent questions following this discussion and they wished to proceed. past medical history: # htn # tracheobronchomalacia (90-95% collapse of mid-distal trachea, b/l mainstem bronchi collapse 95%) s/p y stent placement - copd x 4 yrs, rad x 15 yrs (trigger floor wax) - recent esophageal candidiasis while on steroids - gerd w/ laryngitis - thalassemia minor - hypogonadism - osteopenia - l arm neuropathy anxiety - infrarenal aaa 3.2cm, stable ct - hx cdiff (clinical dx, flagyl x 7 days) # sleep apnea # gerd with laryngitis s/p bravo procedure (. , ct), and nissen fundoplication # thalassemia minor # hypogonadism with decreased testosterone, reliance on patch # hx hsv/shingles tx valacyclovir # osteopenia # l arm neuropathy # h/o mrsa # anxiety # s/p tracheostomy (closed ) # s/p uvulopalatoplasty, rhinoplasty, adenoidectomy, septoplasty, tonsillectomy # s/p b knee surgery # s/p b saphenous vein stripping # s/p pilonidal cyst excision social history: # professional: rn at -affiliated va # tobacco: smoked from age 16 - mid 40s, maximum 2 ppd family history: noncontributory physical exam: vs: temp 98.9, hr 104, bp 122/60, rr 18, 90% on ra general: 56 year-old male no apparent distress heent: normocephalic, mucus membranes moist neck: supple, no lymphadenopathy card: rrr resp; scattered crackles throughout r>l gi: benign extr: warm no edema incision: right thoracotomy site clean, dry, intact neuro: non-focal pertinent results: wbc-4.5 rbc-4.81 hgb-9.7* hct-31.2* plt ct-209 wbc-5.5 rbc-6.43* hgb-12.3* hct-42.4 plt ct-219 glucose-92 urean-10 creat-0.9 na-144 k-3.9 cl-106 hco3-31 glucose-115* urean-14 creat-1.3* na-144 k-4.3 cl-105 hco3-29 chest (pa & lat) the heart size is normal. mediastinal position, contour and width are unremarkable. the appearance of the lungs is stable including right mid lung scarring, left lower lobe linear opacities consistent with atelectasis and there is no change in small amount of right pleural effusion and right pleural thickening. there is a small amount of right subcutaneous emphysema. the known severe emphysema is unchanged. specimen submitted: level 7 lymph nodes. procedure date tissue received report date diagnosed by dr. /mb???????????? lymph node, level 7: one unremarkable lymph node, no malignancy identified. pathology report tissue: skin bx (penis)...1 jar. study date of report not finalized at time of discharge brief hospital course: 56m former smoker with tbm and copd who presented to on s/p y-stent removal for follow-up bronchoscopy and tracheoplasty. on mr. right thoracotomy and tracheoplasty with mesh. he tolerated the procedure well and a right chest tube was left in place. pt was extubated transferred to the surgical icu from the operating room. post-operative pain was controlled with an epidural catheter as well as a pca (split bupivacaine/dilaudid) managed by the acute pain service. pt received scheduled nebulizer treatments. on pod#2 pca and epidural were increased, and clonidine was started for improved pain control. the patients blood pressure was low via arterial line with systolic pressures in the 70's and 80's. the pts urine output was also decreased during this time for which he was bolused with crystalloid and transfused with hespan. diltiazem was held and narcotics were reduced with good effect of sbp in the 120's and return of appropriate urine output by the morning of pod#3. on pod#3 the chest tube was removed and the patient was transferred from the icu to the surgical floor. pt continued to improve with scheduled nebulizer treatments, and was ambulating and tolerating a regular diet. o2 was weaned as tolerated but still required to maintain saturations >90%. pts home medications were restarted including his home dose of diltiazem which he tolerated well. on pod#5 dermatology was consulted for a lesion on the patients penis which was not improving with antifungal cream. a biopsy of the lesion was taken by dermatology, of which the pathology was pending at the time of discharge. on pod#6 pt was weaned off of oxygen and maintained saturations above 90% with ambulation. pt was discharged home on pod#7 off of supplemental oxygen, tolerating a regular diet, and ambulating without assistance. medications on admission: duloxetine 40mg daily, fluticasone-salmeterol 500-50 mcg/disk , montelukast 10mg daily, clonazepam 0.5mg , gabapentin 100mg tid, pantoprazole 40mg daily, guaifenesin 1200mg , albuterol sulfate 2.5mg/3ml q4hprn, acetylcysteine 20% tid, ipratropium bromide 0.02% q4h, mvi, testim 1% tp daily, cymalta 40mg daily, discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 3. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 4. trazodone 50 mg tablet sig: three (3) tablet po hs (at bedtime). 5. clonazepam 0.5 mg tablet sig: 1-2 tablets po bid (2 times a day). 6. ibuprofen 600 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. gabapentin 300 mg capsule sig: one (1) capsule po q8h (every 8 hours). disp:*90 capsule(s)* refills:*1* 8. hydromorphone 4 mg tablet sig: 1 or 1 tablet po q3h (every 3 hours) as needed. disp:*100 tablet(s)* refills:*0* 9. guaifenesin 600 mg tablet sustained release sig: one (1) tablet sustained release po bid (). 10. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 11. albuterol sulfate 2.5 mg/3 ml solution for nebulization sig: three (3) ml inhalation q4h (every 4 hours). 12. acetylcysteine 20 % (200 mg/ml) solution sig: three (3) ml miscellaneous q4h (every 4 hours). 13. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 14. diltiazem hcl 180 mg capsule, sustained release sig: two (2) capsule, sustained release po daily (daily). 15. valacyclovir 500 mg tablet sig: one (1) tablet po daily (). 16. duloxetine 30 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 17. calcium carbonate 500 mg (1,250 mg) tablet sig: two (2) tablet po bid (2 times a day). 18. clotrimazole 10 mg troche sig: one (1) troche mucous membrane qid (4 times a day). disp:*120 troche(s)* refills:*1* 19. testim 50 mg/5 gram (1 %) gel sig: one (1) transdermal daily (). 20. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day). disp:*300 ml(s)* refills:*1* 21. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). discharge disposition: home with service facility: vna services, inc discharge diagnosis: tbm, copd, rad x 15 yrs, gerd w/ laryngitis, thalassemia minor, hypogonadism, osteopenia, l arm neuropathy, mrsa, anxiety, infrarenal aaa 3.2cm stable ct , osa discharge condition: good discharge instructions: call dr. office if experience: -fever > 101 or chills -increased shortness of breath, or cough -difficulty swallowing, nausea, vomiting -incision develops drainage or increased redness you may shower: no tub bathing or swimming for 6 weeks no driving while taking narcotics: take stool softners with narcotics. wear your oxygen 2 liters continuously followup instructions: follow-up with dr. on 10:00am in the chest disease center building one. please arrive 45 minutes prior to you appointment and report to the radiology for a chest xray. procedure: fiber-optic bronchoscopy closed [endoscopic] biopsy of bronchus other repair and plastic operations on trachea other repair and plastic operations on bronchus biopsy of penis diagnoses: esophageal reflux unspecified essential hypertension chronic airway obstruction, not elsewhere classified anxiety state, unspecified unspecified sleep apnea abdominal aneurysm without mention of rupture other thalassemia disorder of bone and cartilage, unspecified other diseases of trachea and bronchus other testicular hypofunction mononeuritis of upper limb, unspecified other inflammatory disorders of penis 

Answer: The patient is high likely exposed to