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: past medical history: 2. hiv, last cd4 count , was 151 with a viral load of 423. 3. history of anus squamous cell carcinoma, status post chemotherapy and radiation therapy. 4. chronic obstructive pulmonary disease. 5. mitral valve replacement in , with a porcine valve. echocardiogram in , showed some mitral regurgitation, 6. peripheral neuropathy. 7. mediastinal seminoma in , that was treated with radiation and chemotherapy. 8. testicular hypofunction. 9. hypothyroidism. 10. depression. 11. atrial flutter. history of present illness: the patient had increased shortness of breath over more than the week. he was seen in dr. office on , for hemoptysis that was half blood and half sputum. initially, the chest x-ray may have shown left pneumonia for which he was treated with ten days of levofloxacin 250 mg per day. the patient says that during the course of antibiotics he had decreased hemoptysis. ct on , showed no evidence of pulmonary embolus but did show increased pulmonary nodules with a ground glass appearance. the patient denied any chest pain but did feel that he had increased pulsations in the neck over the last few days. review of systems: he has positive constipation since radiation therapy for his anal cancer. he also complains of pain in his legs and scrotal area from lymphedema post radiation therapy for his cancer that has lasted over the last two months. he has not obtained good pain control. he denies any fever, chills, sweats, diarrhea or dysuria. medications on admission: 1. stavudine 30 mg twice a day. 2. lamivudine 150 mg twice a day. 3. abacavir 300 mg twice a day. 4. advair 250 mcg twice a day. 5. aquaphor/hydrocortisone 2.5% cream once daily. 6. cyanocobalamin 1000 mcg/ml q.month. 7. dapsone 100 mg once daily. 8. delatestryl 200 mg/ml, administered as 1 cc q2weeks. 9. digoxin 0.125 mg once daily. 10. furosemide 40 mg once daily. 11. lac-hydrin 12% skin cream twice a day., 12. levofloxacin 250 mg p.o. once daily. 13. ativan 2 mg q.h.s. p.r.n. 14. marinol 2.5 mg twice a day. 15. mepron 750 mg/5 cc given as 5 cc twice a day. 16 mycelex 10 mg four times a day p.r.n. for thrush. 17. potassium 40 meq once daily. 18. proventil 90 mcg two tablets q4hours p.r.n. 19. selenium sulfide 2.5% once daily times seven days. 20. triamcinolone acetamide once daily. 21. ultrase mt 18-59-18-59 one tablet three times a day. 22. unithroid 100 mcg once daily. 23. wellbutrin sr 100 mg once daily. 24. dilaudid 2 mg q4hours p.r.n. 25. duragesic 25 mcg per hour q72hours. allergies: the patient had no known drug allergies. social history: alcohol occasionally and now less than one pack per day of cigarettes. he smokes marijuana every day. family history: mother died of an inner ear cancer. father had diabetes mellitus, coronary artery disease and brother has alcohol abuse. physical examination: on examination, the patient was afebrile at 98.4, blood pressure 106/72, respiratory rate 28, pulse 120. initially on presentation, he was only saturating at 83% in room air. after giving him three liters nasal cannula, he saturated to 92%. head, eyes, ears, nose and throat examination - he had moist mucous membranes. jugular venous pressure to the angle of the jaw. his skin had woody lymphedema, left leg greater than the right with positive scrotal edema. he has no kaposi lesions. respiratory- he had good air entry bilaterally but he had bilateral fine crackles at the bases and some bronchial breath sounds at the right upper lobe. cardiovascular examination - harsh iii/vi systolic ejection murmur at the base and left sternal border. the abdomen has positive bowel sounds, nontender, nondistended, no organomegaly. his extremities showed nonpitting edema. laboratory data: white blood cell count 8,7, platelet count 157,000. electrolytes were essentially unremarkable. neutrophils 75%. ct of the chest on , showed multiple pulmonary nodules, associated ground glass opacities, new lung nodules at the bases compared to , minor scarring at the right apex. no evidence of pulmonary embolus. hospital course: the patient was put on respiratory precautions for his increasing shortness of breath with hemoptysis. he was ruled out for tuberculosis and multiple induced sputum and bronchoalveolar lavage from his bronchoscopy sent for cytology and bacterial and fungal viral infection. essentially, his bronchoalveolar lavage had negative cytology for malignant cells. his cryptococcal antigen was negative. three sets of acid fast bacilli and cultures were negative. coccidiodes was still pending to date. his still antigen is negative. his sputum culture only grew sparse growth of yeast. fungal cultures were negative. legionella was negative. pcp was tested for and was negative. nocardia negative. urine culture times two negative. blood cultures and fungal cultures no growth to date. the patient obtained a transthoracic echocardiogram which showed an ejection fraction of 50% and akinesis of the apex and paradoxical motion of the interventricular septum. he had some right ventricular hypertrophy with mild to moderate aortic regurgitation, moderate to severe tricuspid regurgitation and at least some mild pulmonary hypertension. because all his laboratories were essentially negative for an infectious disease workup, the patient was scheduled for a vats procedure and a transesophageal echocardiogram while under general anesthesia. the patient went for the vats procedure on , and failed extubation with pco2 in the 90s. the patient was reintubated and transferred from te post anesthesia care unit to the sicu on neo-synephrine and pressure support of . the neo-synephrine was discontinued after twelve hours and the patient was successfully extubated. his last arterial blood gas on , was ph 7.35/57/85. the patient's vats had demonstrated metastatic squamous cell carcinoma. the transesophageal echocardiogram demonstrated an ejection fraction of greater than 55%, left atrial dilatation, 2+ aortic regurgitation, no mitral regurgitation, 2+ tricuspid regurgitation and no pericardial effusion, and a prosthetic mitral valve. dr. spoke with the patient about his diagnosis of metastatic squamous cell carcinoma to the lung. it was agreed with the patient that he would be discharged with hospice care and no further intervention was to be pursued. the patient was discontinued on all his antiretroviral treatments and was only continued on pain control management anxiety control medications and his antidepressant medication as well as supplemental oxygen. condition on discharge: fair. discharge status: the patient is dnr/dni. medications on discharge: 1. fentanyl patch 50 mcg/hour q72hours. 2. marinol 2 to 5 mg p.o. twice a day. 3. ativan 1 to 2 mg p.o. q4-8hours p.r.n. 4. wellbutrin sr 100 mg p.o. once daily. 5. proventil 90 mcg two puffs q4hours p.r.n. for cough. 6. home supplemental oxygen to titrate to comfort. 7. dilaudid 2 to 4 mg p.o. q2-4hours p.r.n. 8. neurontin 300 mg p.o. three times a day. the patient is to be admitted to hospice/palliative care at . discharge diagnoses: 1. metastatic squamous cell carcinoma to the lung. 2. aids. 3. hepatitis c. 4. chronic obstructive pulmonary disease. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnostic ultrasound of heart insertion of endotracheal tube other lavage of bronchus and trachea open biopsy of lung diagnoses: pneumonia, organism unspecified congestive heart failure, unspecified human immunodeficiency virus [hiv] disease secondary malignant neoplasm of lung heart valve replaced by transplant acute hepatitis c without mention of hepatic coma personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus edema 

Answer: The patient is high likely exposed to