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: hypotension, mental status changes, respiratory distress/failure major surgical or invasive procedure: r-sided femoral line r-picc tracheostomy pleurex catheter placed-l sided history of present illness: yo m with hx of hypothyroidism, afib, cad, htn, new diagnosis of ge junction lymphoma (s/p 3 months of radiation therapy with tumor size as before but now no longer candidate for radiation therapy) who presents from rehab with call0in with tachypnea, rr 40's with frequent suctioning of very thick mucous. . came from rehab with complaints of sob and doe. he got morphine 8mg po x 1 at rehab prior to transfer and subsequently developed mental status changes. on arrival, he was noted to have temp 101, bp 70/p, hr 120's, rr6, 99% on 100% nrb. he was given ivf wide open, 2mg narcan with ?positive response ( rn taking care of him with response in bp to 130s). then, he was noted to have a poor gag reflex with rr 4 and thus was intubated for airway protection (getting succinylcholine and etomidate). he was then started on versed for sedation. shortly after starting his versed, his bp was noted to be 77/45 and thus was started on peripheral levophed while attempts made to place a central line. after 20 minutes, iv infiltrated in arm and he was given phentolamine at the iv site. his bp was 67/42 and finally a r. groin line was placed. he was then started on dopamine via r. groin line and became tachycardic and was questionably was in vt and shocked 200j x 3 (no strips) and started on lidocaine and magnesium. currently on levophed at 6mcg/min and lido at 2mg/min wiht bp 92/49.he was also given 4l of ns and iv ceftriaxone, vancomycin, flagyl. . per son, he states that his father had been coughing white, yellow sputum for about a week but did not complain of sob or chest pain. he states his mental status however has been the same over the past couple of weeks and his baseline activity - does not walk. speaks in full conversations but has lapses of memory at times. . transferred to micu for further care for respiratory failure, and hypotension. past medical history: hypothyroidism, cad s/p mi , ef 45%, htn, bph, depression, high cholesterol, ge junction lymphoma, peripheral t cell lymphoma social history: moved from 10 years ago former engineer wife with alzheimer's disease lives alone, walks with cane no etoh, tobacco family history: no h/o cad physical exam: vs - t 98.3, bp 107/53, hr 62, rr 17, sats 100% on ra, wt 75.8kg vent: ac, peep 8, tv set 550/actual 618, rr set 12/actual 15, fio2 100% i/o: 210 uop since placing foley catheter gen: sedated, intubated. heent: sclera anicteric. pupils pinpoint, nonrxtive. ? lateral nystagmus on opening of his eyes. cv: rr, normal s1, s2. no m/r/g. lungs: coarse rhonchi on l anteriorly, decreased bs at l base. clear on the right. abd: soft, ntnd. quiet bs. j tube dressing c/d/i. ext: fem line on r, dsg c/d/i. no ecchymosis. 2+ pt, radial pulses bilaterally. skin: no rashes. area of infiltration on l forearm erythematous, edematous. was circled in ed, has not spread outside the boundary. neuro: withdraws all four extremities to pain. pertinent results: na 122, k 5.5, cl 89, hco3 24, bun 29, cr 0.7, glu 127, mg 1.5 ck 33, trop 0.10 wbc 11.7, hct 28.3, plt 157 (diff 89n, 1b, 1l, 9m) pt 12.5, ptt 30.9, inr 1.1 amylase 40, lipase 11, alt 25, alk phos 145 lactate 2.1 ua - 1.012, sm le, neg nitrite, neg glu, neg ketone, rbc, wbc, few bacteria, epi . brief hospital course: a/p: yo m with hx of ge junction lymphoma (s/p radiation therapy for palliation), afib, hypothyroidism who presents with pna and hypotension. 1. hypotension - likely secondary to medications given (morphine initially then versed in the setting of intubation). unlikely to be secondary to septic shock given that he was not initially hypotensive and only was hypotensive in the setting of lots of morphine and then lots of versed. however, septic shock is possible given large pna and uti. doubt cardiac etiology for hypotension. in micu continued to be hypotensive requiring pressors-levophed. not thought to be septic shock micro data was negative throughout his hospitalization. he was fluid resusitated however remained on pressors until , he was started on hydrocort/fludrocort on for adrenal insufficiency. his bp remained stable off pressors and will continue hydrocort/fludrocort for a 7 day course which will end on . . 2. mental status changes - possibilities include infection with pna and uti, new hyponatremia in the setting of free water in his tfs (more likely to be the cause), medications including lots of morphine. micu course, his mental status was difficult to guage with him being intubated and sedated. off sedation pt seemed to improve with being able to follow commands with the russian interpreter and per sons. head ct negative for masses or bleeds; multiple lacunar infarcts present. . . #. pna with large effusion - likely cause of new tachypnea. micu course-pt was intubated for resp failure found to have large malignant effusions. had a pleurex cath placed which drained >1l/day. resp status improved. pt was successfully extubated and remained stable and called out to floor. his pleurex catheter fell out and re-accumulated his l-sided effusion. he also completed a 7 day course of vanc/zosyn for nosocomial pna. on following day on the medicine floor he then developed respiratory distress, he was transferred back to the micu and reintubated. on cta found to have small r-sided pleural effusions. he was started on hep gtt for pes. on cta also found to have a deviated and narrowed trachea metastatic lymphoma surrounding trachea and compromising airway. pt remained intubated airway protection. on he had 2nd pleurex cath placed and connected to suction with continual drainage. he was also trached on surgically without complications. pleurex cath remained to suction, respiratory status improved. on started trial on trach collar, however pt tired and was put back on vent. no complications post trach or pluerex cath. . #. uti - will also be treated with abx as above. f/u cultures. completed 7 day course of abx. no further uti throughout micu course. . #.rhythm - hx of afib. unclear if he really had vt. he more likely had rapid afib with dopamine wiht underlying lbbb which made it look like vt. unclear as no strips. in micu developed af w/rvr was started on dilt gtt with success. pt converted to nsr. however he went back into af was initially put on bb without success. he was then loaded with amiodorone for 1 day but was poorly rate controlled. he was switched to dilt drip which had good effect and converted to nsr. he was switched to po dilt and remained in nsr throughout micu course. ce remained neg x3. . 6. hyponatremia - unclear if from lots of free water from tube feeds. ?hypovolemic hyponatremia. got 4l ns in ed. recheck na level now. in micu hyponatremia not an issue. . 7. hyperkalemia - hemolyzed. also received succinylcholine in ed. no peaked t-waves on ekg. throughout micu course, no hyperkalemia. . 8. hypothyroidism - continued levothyroxine. . #. lymphoma of ge junction - dr. ,oncologist notified. has been getting palliative chemo but is no longer candidate for further radiation.per oncologist and micu team, multiple conversations had with family informing them of pt's extremely poor prognosis. per oncologist, pt has days to weeks left given poor prognosis, metastatic lymphoma now encasing carotids/major vessels in neck as well as affecting/deviating trachea. family hospice/palliative care, however family refused palliative care services on multiple occasion. documentation in chart. . #. hypercalcemia: lymphoma, continuing ivf- received pamidronate on . #. fen- per nutrition consult tf per peg at goal. . # access-r picc placed . . #. dnr/intubatable. . #. contact - son hcp h, cell . # dispo: screened for chronic rehab, bed available on . medications on admission: asa levothyroxine 200mcg daily peptobismol tylenol nexium mso4 4mg q2hr prn duonebs pantop dilt 60mg qd metop xl 25 daily isocal hn tube feeds 75cc/hr w/200cc water q4hr discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 2. docusate sodium 150 mg/15 ml liquid sig: one (1) po bid (2 times a day). 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. levothyroxine 100 mcg tablet sig: two (2) tablet po daily (daily). 5. ipratropium bromide 17 mcg/actuation aerosol sig: six (6) puff inhalation q4-6h (every 4 to 6 hours) as needed. 6. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day) as needed. 7. albuterol 90 mcg/actuation aerosol sig: six (6) puff inhalation q4-6h (every 4 to 6 hours) as needed. 8. fludrocortisone 0.1 mg tablet sig: one (1) tablet po daily (daily) for 2 days. 9. hydrocortisone sod succinate 100 mg/2 ml recon soln sig: one (1) recon soln injection q6h (every 6 hours) for 2 days. 10. diltiazem hcl 60 mg tablet sig: one (1) tablet po qid (4 times a day). 11. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed) for 2 days. 12. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift 13. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift 14. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift 15. heparin (porcine) in d5w 100 unit/ml parenteral solution sig: one (1) intravenous asdir (as directed): continue hep gtt until inr 2.0 while transition to coumadin. 16. pantoprazole 40 mg recon soln sig: one (1) recon soln intravenous q24h (every 24 hours). 17. midazolam 1 mg/ml solution sig: one (1) injection q4h (every 4 hours) as needed. 18. fentanyl citrate (pf) 0.05 mg/ml solution sig: one (1) injection q4h (every 4 hours) as needed. 19. heparin flush cvl (100 units/ml) 1 ml iv daily:prn 10ml ns followed by 1ml of 100 units/ml heparin (100 units heparin) each lumen qd and prn. inspect site every shift. pls hold hep gtt at 4am on for picc placement in am. discharge disposition: extended care facility: for the aged - discharge diagnosis: -ge junction t cell lymphoma -metastatic mediastinal t cell lymphoma with extensive lymphoma encasing carotids and deviating trachea -malignant pleural effusions -r sided small pulmonary embolisms -atrial fibrilation discharge condition: stable discharge instructions: pls continue pleurex cath to suction, may cap when output less than 200cc per day. . trach collar as tolerated. . followup instructions: none procedure: insertion of intercostal catheter for drainage insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis arterial catheterization temporary tracheostomy closed [endoscopic] biopsy of bronchus bronchoscopy through artificial stoma transfusion of packed cells replacement of tube or enterostomy device of small intestine diagnoses: pneumonia, organism unspecified hyperpotassemia coronary atherosclerosis of native coronary artery urinary tract infection, site not specified unspecified essential hypertension hyposmolality and/or hyponatremia unspecified acquired hypothyroidism atrial fibrillation depressive disorder, not elsewhere classified other opiates and related narcotics causing adverse effects in therapeutic use acute respiratory failure hypotension, unspecified old myocardial infarction hypercalcemia mycosis fungoides, intrathoracic lymph nodes mycosis fungoides, intra-abdominal lymph nodes 

Answer: The patient is high likely exposed to