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: lorazepam attending: chief complaint: shortness of breath major surgical or invasive procedure: intubation, mechanical ventilation history of present illness: 44 yo male with history of dm1, adrenal insufficiency, hepatitis c, alpha-1-antitrypsin deficiency, copd on home o2, and h/o recent mrsa pneumonia presents from rehab for shortness of breath. at rehab, the patient was noted to be suddenly hypoxic with sats in the high 80s, somewhat lethargic, and with pinpoint pupils. he was given 1mg naloxone and he became more alert. he then became more agitated and complained of sob so sent in to the ed. per rehab facility, patient has been complaining of back pain and chest pain for the past few days. he has also been a slight nonproductive cough and wheezing. he had a cxr at rehab that was negative. he did not have any fevers. per rehab, he is full code. in the ed, initial vs were: 96.6 120 151/98 24 99% 10l non-rebreather. he was anxious, complaining of sob. he was switched to 4l nc and desatted to 70s. cxr showed questionable lul infiltrate. he was wheezing on exam, intubated. labs were notable for wbc 16, alt 97, ast 79, alk phos 204. abg post intubation was 7.34/81/436/46/13. he was given vanc, levo, cefepime for hcap. and hyrdocortisone for his adrenal insufficiency. vitals on transfer notable for bp 95/50 80s-90s fio2 40% peep of 5. . on arrival to the micu, patient intubated, sedated. . review of systems: per hpi, unable to obtain additional information as patient is intubated. past medical history: # alpha-1 antitrypsin deficiency on for 8 years (followed by dr at ); portocath for infusions -reports not receiving for one month while at rehab -denied for transplantation # copd on home o2 (3l at rest, 4l with activity) # diabetes mellitus type 1 since # adrenal insufficiency # hcv infection -dr at -never been treated -reportedly has cirrhosis on liver biopsy at -no ascites on ct # chronic back pain secondary to compression fractures # methadone therapy for chronic pain # hypogonadism # osteoporosis # polysubstance abuse history # anxiety/depression # distal fibula fracture # hypothyroidism social history: # tobacco: prior 25-pack-year smoking history. denies current use. # alcohol: prior alcohol abuse. # drugs: prior ivdu. # work: currently on disability. # residence: center. previously lived in with roommate/mother's boyfriend. family history: mother: mother with dn died in , patient unsure of cause. father: died at age 46 from throat/mouth cancer. physical exam: admission physical: vitals: t: bp: 89/63 p:99 o2: 99% general - intubated, sedated, unresponsive - sclerae anicteric, mmm neck - supple, no elevated jvp heart - rrr, nl s1-s2, no mrg lungs - diffuse bilateral rhonchi, very poor air movement abdomen - +bs, soft, diffusely tender to palpation, moderate distension, no rebound or guarding extremities - wwp, no c/c, 1+ pitting edema bilaterally, no erythema neuro - unresponsive pertinent results: admission labs: 06:40pm glucose-194* urea n-29* creat-1.0 sodium-140 potassium-4.3 chloride-97 total co2-40* anion gap-7* 06:40pm calcium-7.8* phosphate-3.1 magnesium-1.8 06:40pm %hba1c-11.2* eag-275* 06:40pm urine hours-random creat-210 sodium-10 potassium-83 chloride-less than 06:40pm wbc-6.9# rbc-3.80* hgb-12.1* hct-35.9* mcv-95 mch-31.9 mchc-33.8 rdw-13.7 06:40pm plt count-131* 11:34am lactate-1.3 11:34am freeca-1.12 discharge labs: micro: blood culture pending urine culture pending imaging: cxr : impression: 1. appropriate et tube positioning. 2. prominent cardiac contour and increased left greater than right upper lung opacification, likely representing cardiac decompensation and asymmetric edema. 3. can't exclude supervening infection in the upper lungs. consider reevaluation following treatment for pulmonary edema. improving right lower lobe consolidation. 4. severe emphysema, basal predominant, in keeping with known alpha-1 antitrypsin deficiency. cxr : impression: 1. heterogeneous opacities in the upper lungs, left greater than right, not significantly changed since exam. retrocardiac opacity is new since prior. above findings may represent asymmetric pulmonary edema or multifocal infection 2. moderate emphysema with basal predominance, compatible with patient's given history of alpha-1 antitrypsin deficiency. cxr : compared with at 2:22 a.m., multiple lines and tubes have been removed. a left subclavian indwelling catheter tip is unchanged, overlying the svc/ra junction. otherwise, no significant change is detected. again seen is hyperinflation and parenchymal scarring. relative lucency at both apices is stable and may reflect bullous change. brief hospital course: 1. hypoxic hypercarbic respiratory failure: most likely multifactorial in etiology with possible contribution from anxiety, respiratory depression from narcotics and possible aspiration. patient with alpha 1 antitrypsin deficiency and severe copd in 3-4l o2 at baseline. he was recently admitted for a pneumonia 1 month ago and has completed a course of ceftriaxone and azithromycin. cxr on admission shows a possible lul opacity and he had an elevated wbc count of 16 though no fever. he was intubated in the ed and started on broad-spectrum antibiotics with vanc, cefepime and levofloxacin, which were discontinued on day 2 due to low suspicion for true infection. patient was extubated on day 2 and was satting well on nc. oxygen was weaned on the medicine floor and patient was satting well on ra 2. diabetes mellitus type i: poorly-controlled with most recent a1c 11.9, and resent, with result of 11.2 . he was maintained on outpatient lantus 35 units daily and insulin ss. 3. le edema: on bumex for diuresis. was treated with 80mg iv lasix x2 and then restarted on home bumex with good effect. he currently does not appear significantly volume overloaded. he needs outpatient follow up for his cirrhosis. 4. cirrhosis (hcv and a1at): hep c has not been treated. he has not followed up with liver in a while. he was recently discharged on lactulose and bumex and instructed to follow up with liver as outpatient 5. adrenal insufficiency: he was given hydrocortisone in the ed. continued on prednisone taper down to home dose of 10mg daily 6. hypothyroidism: originally placed on iv levothyroxine while intubate and switched to po home levothyroxine. 7. chronic back pain: placed on fentanyl while in the icu. switched to home dose methadone and oral morphine when extubated. on transfer to floor, morphine was held for oversedation with adequate control with home methadone 8. anxiety / depression: restarted clonazepam and home mirtazapine goals of care: though previous d/c summaries state pt is dnr/dni, code status was clarified with family who confirm he is full code. palliative care followed him during this hospital stay. medications on admission: 1. clotrimazole 1 % cream sig: one (1) appl topical (2 times a day). 2. pravastatin 20 mg tablet sig: one (1) tablet po at bedtime. 3. insulin glargine 100 unit/ml solution sig: thirty five (35) units subcutaneous once a day. 4. gabapentin 600 mg tablet sig: one (1) tablet po three times a day. 5. methadone 40 mg tablet, soluble sig: one (1) tablet, soluble po at bedtime. 6. methadone 10 mg tablet sig: two (2) tablet po tid (3 times a day). 7. oxycodone 15 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for breakthrough pain. 8. bumetanide 2 mg tablet sig: one (1) tablet po daily (daily). 9. fluticasone-salmeterol 500-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 10. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q2h (every 2 hours) as needed for dyspnea, wheeze. 11. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po bid (2 times a day) as needed for constipation. 12. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 13. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 14. ergocalciferol (vitamin d2) 50,000 unit capsule sig: one (1) capsule po once a week. 15. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 16. clonazepam 1 mg tablet sig: one (1) tablet po bid (2 times a day). 17. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day). 18. polyethylene glycol 3350 17 gram/dose powder sig: one (1) capful po once a day. 19. multivitamin tablet sig: one (1) tablet po daily (daily). 20. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 21. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation. 22. fleet enema 19-7 gram/118 ml enema sig: one (1) enema rectal daily (daily) as needed for constipation. 23. prednisone 20 mg tablet sig: two (2) tablet po daily (daily). 24. mirtazapine 30 mg tablet sig: two (2) tablet po hs (at bedtime). 25. levothyroxine 150 mcg capsule sig: one (1) capsule po daily (daily): for total dose of 163mg daily. 26. levothyroxine 13 mcg capsule sig: one (1) capsule po once a day: for total daily dose of 163mg. 27. testosterone cypionate 200 mg/ml oil sig: two (2) ml intramuscular every week (). 28. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 29. insulin aspart 100 unit/ml solution sig: as directed units subcutaneous four times a day: per sliding scale. discharge medications: 1. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day). 2. pravastatin 20 mg tablet sig: one (1) tablet po hs (at bedtime). 3. insulin glargine 100 unit/ml cartridge sig: thirty five (35) units subcutaneous once a day. 4. clonazepam 1 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for anxiety. 5. gabapentin 600 mg tablet sig: one (1) tablet po three times a day. 6. methadone 10 mg tablet sig: four (4) tablet po (once a day (at bedtime)) as needed for pain. 7. methadone 10 mg tablet sig: two (2) tablet po tid (3 times a day) as needed for pain. 8. bumetanide 2 mg tablet sig: one (1) tablet po daily (daily). 9. fluticasone-salmeterol 500-50 mcg/dose disk with device sig: one (1) inhalation twice a day. 10. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q2h (every 2 hours) as needed for wheezing. 11. bisacodyl 5 mg tablet sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 12. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po twice a day. 13. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po once a day. 14. ergocalciferol (vitamin d2) 50,000 unit capsule sig: one (1) capsule po once a week. 15. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 16. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po daily (daily). 17. multivitamin tablet sig: one (1) tablet po daily (daily). 18. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 19. magnesium hydroxide 400 mg/5 ml suspension sig: one (1) po every six (6) hours as needed for constipation. 20. fleet enema 19-7 gram/118 ml enema sig: one (1) rectal once a day as needed for constipation. 21. mirtazapine 30 mg tablet sig: two (2) tablet po at bedtime. 22. insulin aspart 100 unit/ml solution sig: as directed subcutaneous per ss. 23. levothyroxine 150 mcg capsule sig: one (1) capsule po once a day. 24. levothyroxine 13 mcg capsule sig: one (1) capsule po once a day. 25. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 26. testosterone cypionate 200 mg/ml oil sig: two (2) ml intramuscular once a week. 27. prednisone 10 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: livingcenter - heathwood - discharge diagnosis: hypoxic respiratory failure antitrypsin 1 alpha deficiency copd anxiety back pain constipation dm type i discharge condition: activity status: ambulatory - independent. mental status: clear and coherent. level of consciousness: alert and interactive. discharge instructions: dear mr. , you were admitted to the for respiratory distress. you became very confused and had a low oxygen saturation which required intubation and mechanical ventilation. you were originally admitted to the intensive care unit, but as your symptoms improved you were able to be transferred to the medicine floor. your respiratory symptoms resolved and you were able to come off supplemental oxygen completely . we have made the following changes to your medications: # change prendisone to 10mg daily by mouth # stop oxycodone, continue methadone as needed for pain please continue all of your other medications as previously prescribed followup instructions: name: , location: /east address: , e/cc-6, , phone: **please discuss with the staff at the facility the need for a follow up appointment with your pcp when you are ready for discharge.** **as of the new phone number to will be .** name: , location: center for chest disease at address: , , phone: appointment: at 11:30am procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube arterial catheterization diagnoses: other chronic pain unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified unspecified viral hepatitis c without hepatic coma personal history of tobacco use depressive disorder, not elsewhere classified opioid type dependence, continuous anxiety state, unspecified acute respiratory failure long-term (current) use of insulin osteoporosis, unspecified glucocorticoid deficiency diabetes mellitus without mention of complication, type i [juvenile type], not stated as uncontrolled other testicular hypofunction other dependence on machines, supplemental oxygen alpha-1-antitrypsin deficiency 

Answer: The patient is high likely exposed to