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: the patient is a 52-year-old caper verdean male with hypertension, asthma, many pack year smoking history, asbestos exposure, and positive purified protein derivative with known right apical cavitary lesion (being treated since ) who was admitted to on with a productive cough, increased shortness of breath, and bilateral neck swelling. he originally had a positive purified protein derivative in with an initial negative chest x-ray. he was started on inh. then, in , he had scant hemoptysis and weight loss. an x-ray revealed a new 5-cm mass with lucency suggestive of cavitation in the right apex with hilar retraction and fullness in the paratracheal area. he was started on quadruple drug therapy. he then had one set negative acid-fast bacillus smears in as well as culture negative, and then another negative set times three acid-fast bacillus in . he went to to visit in to . he was seen back in the clinic on , and the chest x-ray showed no change in the cavitation. then, on , the patient presented to complaining of a persistent productive cough times three months with greenish white/yellow sputum with occasional scant blood mixed in, increased shortness of breath, and increased dyspnea for two weeks, dysphagia times three months, and bilateral neck swelling times a few weeks. he also complained of chest pain with left arm radiation. he ruled out for a myocardial infarction with serial cardiac enzymes and was started on levofloxacin for "bronchitis." review of systems: on review of systems, he complained of a 50-pound to 60-pound weight loss over a two to three month period, a persistent productive cough, neck swelling, dysphagia, shortness of breath, dyspnea on exertion, nausea, and vomiting. he hospital course at was notable for ruled out for a myocardial infarction by enzymes. he then had an exercise tolerance test on the treadmill which was negative. then, several hours after his exercise treadmill test, he had increasing shortness of breath and respiratory distress with "signs of seizure activity." he was intubated with an initial arterial blood gas of 6.99, pco2 of 105, and po2 of 25. intubation was very difficult. after intubation, 150 cc of blood came out of the patient's left naris and 100 cc of bright red blood per endotracheal tube. an emergent bronchoscopy revealed distorted tracheal anatomy at the level the carina, and no visualization of the right main stem bronchus due to mass compression and clot covering the area. the trachea at that level revealed friable mucosa. brushings for cytology were sent which ultimately revealed large-cell carcinoma of the lung. of note, with labile blood pressures with a systolic blood pressure of 200/110 and was started on a nipride drip. of note, sputum culture at was positive for aspergillosis; so he was also given one dose of amphotericin. he was transferred to for a rigid bronchoscopy and stents. past medical history: 1. hypertension. 2. asthma. 3. tobacco use. 4. asbestos exposure. 5. purified protein derivative positive (see history of present illness). allergies: no known drug allergies. medications on admission: home medications included albuterol, advair diskus, rifampin, inh, combivent, and levofloxacin. medications on transfer: 1. inh 300 mg intravenously q.d. 2. rifampin 600 mg intravenously q.d. 3. ceftriaxone 1 g intravenously q.8h. 4. flagyl 500 mg intravenously q.8h. 5. decadron 10 mg intravenously q.8h. 6. atrovent 10 puffs q.i.d. 7. versed drip. 8. nipride drip. 9. ranitidine 50 mg intravenously q.8h. 10. vecuronium 4 mg to 8 mg per hour drip. 11. colace. 12. amphotericin 400 mg intravenously q.d. 13. benadryl 500 mg intravenously q.d. (premedication for amphotericin). 14. lasix 20 mg intravenously q.d. 15. lopressor 25 mg p.o. b.i.d. physical examination on presentation: physical examination revealed temperature was 101.2, heart rate was 110, blood pressure was 126/90, assist-control 600 x 20, positive end-airway pressure 10, fio2 was 50%, peak inspiratory flow 34, plateau of 23. arterial blood gas was 7.37, pco2 of 45, po2 of 97. the patient was intubated and sedated. pupils were equal, round, and reactive to light at 5 mm to 4 mm bilaterally. no lymphadenopathy. lungs with rhonchi diffusely. heart revealed tachycardic. no murmurs, rubs, or gallops. the abdomen was soft, nontender, and nondistended. normal active bowel sounds. no hepatosplenomegaly appreciated. upper extremity edema of 2+, trace lower extremity edema. neurologic examination revealed unresponsive. pertinent laboratory values on presentation: laboratories revealed white blood cell count was 17.7, hematocrit was 44, and platelets were 251. inr was 1.6. differential with 81% neutrophils, 0% bands, and 12% lymphocytes. chemistry-7 revealed sodium was 143, potassium was 4.5, chloride was 108, bicarbonate was 24, blood urea nitrogen was 19, creatinine was 0.9, and blood glucose was 162. calcium was 9.1, magnesium was 2.2, phosphorous was 3.1. lactate was 2.4. total bilirubin was 0.6, albumin was 3.7, ast was 192, alt was 166, alkaline phosphatase was 75, ldh was 360, amylase was 104, and lipase was 144. pertinent radiology/imaging: chest x-ray on revealed persistent increased opacity of the right apex with linear densities and apparent cavitary lesions, a soft tissue nodule, within this cavity, and a meniscus sign. a computed tomography at on revealed a 2.7-cm x 1.8-cm thick wall cavitary lesion within the right apex, several stellate fibrotic bands radiated from this lesion inferiorly. there was an irregular 3.5-cm x 1.5-cm lesion in the posterior portion of the right upper lobe in surround ground-glass opacity in the right upper lobe, and a 7-mm nodule in the posterior right base. no pleural effusions. no pericardial effusions. positive lymphadenopathy in the paratracheal, prevascular, precarinal, and subcarinal spaces. a exercise treadmill stress test on revealed positive chest pain. no electrocardiogram changes. hospital course by issue/system: the patient was admitted to for a rigid bronchoscopy and stents. 1. pulmonary issues: the patient was initially kept on assist-control; however, on the morning of , he self-extubated, and intubation with prolonged arterial blood gas empty time was 2.23, pco2 was 54, po2 was 127. he was reintubated due to inadequate sedation resulting in self-extubation with a difficult airway. a computed tomography tracheostomy was performed for planning of rigid bronchoscopy with stents; which revealed a large speculated mass in the right upper lobe with cavitations and extensions to pleural surface, hilar lymphadenopathy. masses posterior to right carina and main stem bronchi, and two necrotic lymph nodes in right upper and mediastinal left supraclavicular, two bibasilar atelectasis with scarring containing nodular components, and three scattered tiny nodules in the lunch parenchyma. a flexible bronchoscopy was performed which revealed possible communication between the right upper lobe lesion and trachea, severe narrowing of the right main stem bronchus. bronchial washings were sent. first staging computed tomography was obtained which showed no hemorrhage, and no enhancing lesions, and normal /white differentiation. a computed tomography of the abdomen showed no metastases. because of concern over infection control, given that the patient traveled to since the last time he ruled out for tuberculosis, acid-fast bacillus times three were obtained; which were negative. the patient underwent a rigid bronchoscopy with stents on which revealed large amounts of paratracheal edema. stents were placed times two in the trachea and right main stem bronchus. it was felt that he was unlikely an extubation candidate given severe paratracheal edema without tracheostomy placed. ultimately, a tracheostomy was placed on , and the patient remained ventilated. 2. infectious disease issues: the differential diagnosis for the right upper lobe cavitary mass included malignancy alone, tuberculosis, and aspergillosis. tuberculosis was unlikely given the negative acid-fast bacillus smears and negative cultures; however, that he was always on anti-tuberculosis medications during this time complicated matters as well as recent travel to . therefore, in conjunction with infection control, it was decided that the patient should be ruled out with acid-fast bacillus smears times three. he was initially continued on inh and rifampin therapy per outpatient medications (he had already received quadruple therapy times 10 weeks and was to continue double therapy with inh and rifampin to complete a 6-month course). due to the rising ast and alt and low likelihood for tuberculosis given negative acid-fast bacillus smears, his inh and rifampin were discontinued. the patient was initially placed on levofloxacin and flagyl for postobstructive pneumonia; however, he continued to spike fevers and was changed to ambisome on due to aspergillus growing out of bronchial washings from sample taken here at as well as a computed tomography cavitary lesion highly suspicious for aspergilloma. the patient also with heavy amounts of sinus discharge, which were negative for aspergillosis. he was continued on ambisome per infectious disease recommendations and continued to spike temperatures to 103.8. he was started on vancomycin and zosyn. 3. hematology/oncology issues: an oncology consultation was obtained. the patient likely with stage iii-b large-cell carcinoma of the lung given bilateral subcarinal lymph node involvement. a radiology/oncology consultation was obtained, and the plan was to begin radiation therapy. therefore, the patient had to be transferred to the intensive care unit for daily radiation therapy. 4. cardiovascular system: the patient continued with hypotension which responded to fluids. a cardiac echocardiogram was performed which revealed findings consistent with infiltrative cardiomyopathy. however, no further workup was done at this time. a cosyntropin stimulation test was performed which revealed no evidence of renal insufficiency. , 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 percutaneous [endoscopic] gastrostomy [peg] other intubation of respiratory tract temporary tracheostomy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus other operations on trachea bronchoscopy through artificial stoma other radiotherapeutic procedure endoscopic excision or destruction of lesion or tissue of bronchus bronchial dilation diagnoses: pneumonia, organism unspecified acute kidney failure, unspecified acute and chronic respiratory failure hypotension, unspecified compression of vein malignant neoplasm of other parts of bronchus or lung secondary malignant neoplasm of lung aspergillosis 

Answer: The patient is high likely exposed to