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: respiratory distress, hypoxia, intubated major surgical or invasive procedure: intubation history of present illness: 65 yo m with pmh of heavy tobacco use, copd on nightly oxygen who was found unresponsive earlier this evening. daughter is a chef for a function facility and father came to watch event. appeared ashen and unwell on arrival. found sitting on toilet after not coming out for 8 minutes, unresponisve and cyanotic. given o2 and called ems. per osh report, ems found patient sitting on toilet, hypertensive, agonal breathing and unresponsive. given albuterol, combivent. they attempted intubation the field without success. bag-masked until osh, then intubated at . intial vs sbp 210/105, hr 102, 100% on 100%/ambu. pe notable for bilateral tight wheezing. ceftriaxone, azithromycin, xopenex given. ekg sr 96 bpm, normal axis, large peaked ts v3, inverted tw ii, iii/avf, v6. initial troponin i 0.1 (indeterminate), wbc 13.6. ct brain without acute abnormality, ich or mass effect. in the last week with increased sob (prompting steroid burst) and chills. today with increased cough, hoarse voice and shortness of breath. no prior influenza or recent pneumonia vaccination. per daughter had never seen him go to the doctor until two months with 'episodes' of shortness of breath, turning purple and tripoding to breath. in our ed patient was given 2.5l ns in ed. patient was briefly on propofol but this was discontinued for hypotension; now on fentanyl/midazolam for sedation. cta with pulmonary effusions, edema but no thrombus. rij placed for progressive hypotension, but norepinephrine only started upon leaving the ed with vs 83/57. upon arrival to the micu, patient is intubated, tolerating ventilator well. past medical history: tobacco use - heavy per daughter, 1-1.5 ppd copd - o2 qhs social history: social history: (per wife & daughter) - tobacco: 1-1.5 ppd since age 17 - alcohol: none - illicits: none family history: father with dm, with resultant heart problems. mother with 'stomach problems'. parents are deceased. physical exam: admission physical exam vitals: t: 98.1 bp: 109/65 p: 61 24 / 100 on 50% general: sedated, unarouable, tolerating ventilator heent: sclera anicteric, mmm, et, og tube neck: supple lungs: diffuse wheeze anteriorly with poor air movement, no clear ronchi or localizing rales anteriorly cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, mildly distended, with bowel sounds present, no grimace to deep palpation gu: foley in place ext: warm, well perfused, 2+ pulses, no edema discharge physical exam 97.8, 133/64, 71, 19, 93/2l notable change: breathing much improved with no wheeze, quiet breath sounds throughout pertinent results: on admission: 11:54pm blood wbc-30.9* rbc-4.95 hgb-15.2 hct-45.7 mcv-93 mch-30.7 mchc-33.2 rdw-13.6 plt ct-239 11:54pm blood pt-11.3 ptt-21.0* inr(pt)-0.9 07:08am blood glucose-108* urean-20 creat-0.9 na-140 k-4.5 cl-108 hco3-28 angap-9 07:08am blood alt-123* ast-43* ck(cpk)-68 alkphos-58 totbili-0.4 07:08am blood calcium-8.0* phos-3.8 mg-1.9 03:45am blood triglyc-312* hdl-42 chol/hd-4.8 ldlcalc-99 discharge labs: 04:27am blood wbc-10.7 rbc-4.39* hgb-13.5* hct-39.4* mcv-90 mch-30.7 mchc-34.2 rdw-13.1 plt ct-155 04:27am blood glucose-144* urean-29* creat-0.9 na-137 k-4.4 cl-100 hco3-34* angap-7* 03:20am blood alt-110* ast-21 ld(ldh)-157 alkphos-51 totbili-0.9 04:27am blood calcium-9.5 phos-3.1 mg-2.4 portable tte (complete) done at 1:41:28 pm final the left atrium is elongated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction with inferior and infero-lateral akinesis (prior myocardial infarction). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened (?#). no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. cta chest w&w/o c&recons, non-coronary study date of 1:02 am 1. pulmonary edema. 2. mediastinal and hilar lymph nodes are borderlin enlarged but likely reactive. 3. right adrenal myelolipoma. 4. renal hypodensities some cysts some too small to characterize. correlation with prior imaging or renal ultrasound in 6 months is recommended for further evaluation. chest (portable ap) study date of 9:28 am as compared to the previous radiograph, the patient has been intubated. the tip of the endotracheal tube projects 5 cm above the carina. the course of the nasogastric tube is unremarkable. the tip of the tube projects over the distal part of the stomach. the lung volumes have slightly increased. the distribution and severity of the pre-described parenchymal changes is unchanged. unchanged size of the cardiac silhouette. no pneumothorax. brief hospital course: 65 yo m with h/o copd, tobacco use, found unresponsive and cyanotic while sitting on toilet after several days of progressive sob; intubated at (first attempted by ems); admitted to the icu upon arrival due to persistent hypotension and need for mechanical ventilation. # respiratory arrest. etiology uncertain but would consider copd exacerbation (worsening sob x several days with steroid burst per pcp); pna (not visualized on cxr but may be dry); cardiac ischemic event (ekg without concerning changes but no prior); pe (cta preliminary negative); aspiration (but was upright on toilet) or seizure (but reportedly worsened over several day period). intubated at ; wheezing and tight on initial exam. cta negative for pe. treated with steroid burst, antibiotics for community acquired pneumonia and nebulizer treatment (ipratroprium / albuterol). extubated and transferred to the regular medical floor on . on he had new respiratory distress requiring re-intubation. this was due to a combination of variables including mucous plugging and treatment with high flow oxygen that decreased his intrinsic respiratory drive. he underwent bronchoscopy with removal of thick mucous secretion. on he was extubated without incident. he continued on nebulizer therapy and was discharged with a planned course of antibiotics and 15 days steroid taper. he was also scheduled to see pulmonary as outpatient to continue further treatment for his copd and continued tobacco use. # hypotension: initially unclear etiology. considerations included sepsis (infectious vs cardiogenic; obstructive but no pe on cta) vs. breath stacking with ventilator / copd vs new process such as pneumothorax s/p line placement. resolved with discontinuation of propofol. # leukocytosis: be reactive vs infectious process. could also be ischemia vs seizure (low suspicion). cardiac enzymes were indicative demand ischemia. though chest imaging never developed a true infiltrate, was treated for community acquired pneumonia. # copd: unclear level of control or severity. also on daily azithromycin for last 2 months. treated for exacerbation as above. discharged with tiotroprium, advair, duonebs and pulmonary follow-up. # tobacco use: recommended stopping tobacco use and was given a nicotene patch while inpatient. # cardiac dysfunction: as noted above with some elevated troponins (peak 0.11 on ) indicative of demand ischemia. cholesterol as above. ldl < 100 but could consider addition of statin medication as outpatient to push ldl < 70. started aspirin 81 mg daily. # renal cysts: noted on ct scan, patient should have repeat ultrasound in 6 months post-discharge. # hyperglycemia: new and associated with steroid burst. discharged on insulin sliding scale with plan to discontinue once off steroids or not requiring any coverage. medications on admission: prednisone taper 60mg x 3 --> 40mg x 3 --> 20 mg x 3 days (final day ) azithromycin 500 mg daily (started in ) symbicort proair albuterol sulfate home oxygen at night clarithryomycin (a couple weeks prior was on this, felt breathing improved) discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day): discontinue if increasingly active. 2. nicotine 21 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 5. duoneb 0.5-2.5 mg/3 ml solution for nebulization sig: one (1) nebulizer inhalation every six (6) hours. 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for loose stools. 7. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation q2h (every 2 hours) as needed for wheezing. 8. lorazepam 0.5 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for anxiety. 9. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 10. levofloxacin 750 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 3 days: stop . 11. prednisone 10 mg tablet sig: tapered dosing po once a day for 15 days: 50 mg daily x 3 days, then 40 mg daily x 3 days, then 30 mg daily x 3 days, then 20 mg daily x 3 days, then 10 mg daily x 3 days then stop. 12. insulin sliding scale please check fingersticks qachs while on steroids. discontinue if not requiring insulin coverage for > 24 hours. glucose insulin dose 0-70 mg/dl proceed with hypoglycemia protocol 71-150 mg/dl 0 units 151-200 mg/dl 2 units 201-250 mg/dl 4 units 251-300 mg/dl 6 units 301-350 mg/dl 8 units 351-400 mg/dl 10 units > 400 mg/dl notify m.d. discharge disposition: extended care facility: siani discharge diagnosis: primary: copd exacerbation, reactive airway disease, tobacco use discharge condition: hemodynamically stable, afebrile, oxygen saturation 92% on 2l at rest or 3-4l with ambulation. discharge instructions: you were admitted with difficulty breathing and low oxygen levels which required ventilation through a breathing tube. you were treated with antibiotics, steroids and medications to improve your breathing. once improved, you were discharged to a rehab for further recovery. please take all medications as prescribed. please keep all outpatient appointment. followup instructions: provider: function lab phone: date/time: 8:40 am provider: ,interpret w/lab no check-in intepretation billing date/time: 9:00 am provider: . phone: date/time: 9:00 am procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube arterial catheterization arterial catheterization closed [endoscopic] biopsy of bronchus diagnoses: pneumonia, organism unspecified anemia, unspecified tobacco use disorder congestive heart failure, unspecified adrenal cortical steroids causing adverse effects in therapeutic use obstructive chronic bronchitis with (acute) exacerbation acute respiratory failure acute systolic heart failure other abnormal glucose foreign body in main bronchus benign essential hypertension other specified cystic kidney disease 

Answer: The patient is high likely exposed to