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: 72 year old male admitted on with right iliac stent artery aneurysm with a cheif complaint of back pain and mild shortness of breath. major surgical or invasive procedure: - endovascular stent graft repair of right common iliac artery with extender stend into external iliac artery and hypogastric artery embolization. history of present illness: the pt is a 72 year old male s/p aaa orininally presented on for sob, and a cta of the a/p at that time demonstrated a rci aneurysm. pt was instructed to follow up at a later date, as this was not deemed an emergent issue. on , he presented for a cat and iv fluids for his ri. he was then discharged and told to follow up with dr. . on , the pt arrived to have his rci aneurysm endvascularly repaired. past medical history: aaa repair copd cad anemia htn cri chf chronic uti dementia depression social history: spanish speaking, lives in a nursing home, ex-smoker and alcohol user. family history: noncontributory physical exam: gen: cachectic male heent: perrla, eomi lungs: rhonchi b/l bases cardiac: rrr, no murmurs abd: peg tube site clean, slightly distended, soft, nontender ext: no c/c/e neuro: axox3 palp pt bil pertinent results: wbc-13.4* rbc-3.59* hgb-10.2* hct-32.2* mcv-90 mch-28.3 mchc-31.6 rdw-17.1* plt ct-219 neuts-75.9* lymphs-16.6* monos-5.0 eos-2.2 baso-0.3 pt-13.4* ptt-32.4 inr(pt)-1.2 glucose-156* urean-48* creat-1.2 na-140 k-4.6 cl-100 hco3-30* angap-15 calcium-10.3* phos-4.3 mg-2.1 chest (portable ap); -59 distinct procedural servic reason: locate central and r/o pneumo ap supine chest: comparison to ap upright chest of 8 hours prior. there has been interval intubation with the ett tip 5 cm above the carina. right ij line seen with its tip distal svc. no pneumothorax is identified, though limited assessment due to severe emphysema and overlying tubes. severe upper lobe bullous emphysema. there remains bibasilar opacities, which may be secondary to chronic emphysema, however, it is difficult to exclude an element of mild chf/volume overload superimposed on background emphysematous changes. no pneumonia is seen. there is a persisting left retrocardiac opacity, which is unchanged dating back to multiple prior chest x-rays. impression: 1) ett and right ij in satisfactory position; no pneumothorax identified, though limited assessment due to emphysema and overlying tubes. 2) equivocal mild chf/volume overload superimposed on background emphysema. no new pneumonia. unchanged appearance of left retrocardiac opacity. follow-up again recommended to ensure resolution is recommended. echo measurements: left atrium - long axis dimension: *4.1 cm (nl <= 4.0 cm) left atrium - four chamber length: *5.5 cm (nl <= 5.2 cm) right atrium - four chamber length: 4.8 cm (nl <= 5.0 cm) left ventricle - septal wall thickness: 1.1 cm (nl 0.6 - 1.1 cm) left ventricle - inferolateral thickness: 1.0 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 4.0 cm (nl <= 5.6 cm) left ventricle - ejection fraction: 50% to 60% (nl >=55%) aorta - valve level: 3.1 cm (nl <= 3.6 cm) aorta - ascending: *3.5 cm (nl <= 3.4 cm) aortic valve - peak velocity: 1.0 m/sec (nl <= 2.0 m/sec) mitral valve - e wave: 0.5 m/sec mitral valve - a wave: 1.0 m/sec mitral valve - e/a ratio: 0.50 mitral valve - e wave deceleration time: 252 msec tr gradient (+ ra = pasp): <= 25 mm hg (nl <= 25 mm hg) findings: left ventricle: normal lv wall thickness. normal lv cavity size. suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. overall normal lvef (>55%). no resting lvot gradient. right ventricle: normal rv chamber size and free wall motion. aortic valve: mildly thickened aortic valve leaflets (3). no as. no masses or vegetations on aortic valve. mitral valve: mildly thickened mitral valve leaflets. no mass or vegetation on mitral valve. trivial mr. lv inflow pattern c/w impaired relaxation. tricuspid valve: normal tricuspid valve leaflets with trivial tr. normal pa systolic pressure. pericardium: no pericardial effusion. general comments: suboptimal image quality - poor echo windows. conclusions: left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is probably normal. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no masses or vegetations are seen on the aortic valve. the mitral valve leaflets are mildly thickened. no mass or vegetation is seen on the mitral valve. trivial mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. compared with the findings of the prior study (tape reviewed) of , there is probably no change. impression: no valvular vegetations seen. if clinically indicated, a tee would better to exclude a small valve vegetation. cta chest w&w/o c &recons; ct 100cc non ionic contrast reason: sob procedure: ct of the chest. indication: tachycardic and tachypnic with shortness of breath. technique: multidetector noncontrast low-dose images of the chest, and contrast-enhanced images of the chest following rapid bolus administration of 100 cc of iv optiray were performed. images are reformatted in the sagittal and coronal planes. iv contrast: nonionic iv optiray contrast was used for rapid bolus administration. ct of the chest with and without contrast: there is severe emphysematous change throughout the lungs, with marked bullous formation in the upper lobes as well as anteriorly towards the lung bases. no pulmonary embolism is identified. there are no areas of consolidation. there are no pleural effusions. there is a focal 1.2 cm opacity seen in the periphery of the lingula, not seen on prior study of . the aorta is markedly tortuous, and is seen to have mass effect on the left atrium as before, which might compromise venous return. there is mild dilatation of both main pulmonary arteries indicative of pulmonary hypertension. the right pulmonary artery measures 2.5 cm, and the left 2.2 cm. there is no pneumothorax. no pericardial effusion. within the imaged portions of the upper abdomen, no abnormalities are identified. bone windows show no suspicious lesions. some secretions are noted within the trachea and right main stem bronchus. multiplanar reformatted images: images reformatted in the sagittal and coronal planes show no evidence of pulmonary embolism. no aortic aneurysm or dissection identified. impression: 1. no pulmonary embolism identified. 2. severe emphysema with marked bullous changes particularly at the upper lobes and in the lower thorax anteriorly. 3. focal 1.2 cm opacity in the periphery of the left lingula, not seen previously. while this may represent atelectasis or an inflammatory opacity, short-term followup in one to two months is recommended to ensure stability or resolution. sputum site: endotracheal source: endotracheal. gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gram positive rod(s). 4+ (>10 per 1000x field): gram negative rod(s). respiratory culture (final ): moderate growth oropharyngeal flora. pseudomonas aeruginosa. moderate growth. sensitivities: mic expressed in mcg/ml _________________________________________________________ pseudomonas aeruginosa | cefepime-------------- 8 s ceftazidime----------- 16 i ciprofloxacin--------- 2 i gentamicin------------ <=1 s imipenem-------------- 2 s meropenem-------------<=0.25 s piperacillin---------- r piperacillin/tazo----- 16 s tobramycin------------ <=1 s acid fast smear (final ): no acid fast bacilli seen on direct smear. no acid fast bacilli seen on concentrated smear. brief hospital course: the patient was admitted on pcp followed patient while in hospital the patient is an elderly male who underwent treatment of a ruptured aortic aneurysm at an outside hospital. he recovered, but was left with a greater than 6 cm right common iliac artery aneurysm. although the aneurysm was very large and the iliac artery proximal and distal was very tortuous, there appeared to be a suitable proximal and distal cuff zone for endovascular repair. pt pre-op'd cleared for surgery. pt underwent a endovascular stent graft repair of right common iliac artery aneurysm. extender stent graft into external iliac artery and embolization of right hypogastric artery.he tolerated the procedure well. there were no complications. he was transfered to the pacu in stable condition. pt remained in pacu overnight. he was extubated this day. he was also diuresed post procedure. pt had to reintubated for failed extubation. pt has a history of 02 dependent copd / aspiration pna. when extubated pt dropped his o2 sats and had labored breathing. - pt transfered to sicu. pt cri/chf remained stable. pt on cpap/ps. recieved inhalers. tube feeds through peg, foley remained, hct stable, ssi, lines remained in place. pt experienced low grade temps. yellow secretions. required no bp control. pt experienced low grade temps. pt pan cx'd. found to have increase wbc. pt given zosyn for pna. also pt started on vancomycin for pos blood cx. pt weaned to bipap. while in the sicu pt problem was the inability extubate. he recieve antibiotics for pna. he experienced some minor dementia. this was thought to be due sun downing. pt also reqiured a variety of iv medications for bp support steroids were started for copd flare. pt extubated - pt transfered to the vicu in stable condition. zosyn was dc'd / vancomycin dc'd. steroids were tapered cvl dc'd. pt still required some diuresis. - foley pt wbc remained elevated. a ct scan was obtained. this was negative. pt transfered to medicine for on going leukocytosis. medications on admission: fs jevity tylenol 325' lipitor asa lopressor 6.25'' protonix sq heparin discharge disposition: extended care facility: - discharge diagnosis: right common iliac artery aneurysm cri chf pna discharge condition: stable discharge instructions: follow-up with dr in two weeks. please call . procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances injection or infusion of other therapeutic or prophylactic substance arteriography of other intra-abdominal arteries other endovascular procedures on other vessels diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension obstructive chronic bronchitis with (acute) exacerbation depressive disorder, not elsewhere classified other persistent mental disorders due to conditions classified elsewhere constipation, unspecified hypotension, unspecified pneumonia due to pseudomonas unspecified disorder of kidney and ureter delirium due to conditions classified elsewhere aneurysm of iliac artery gastrostomy status personal history of other specified urinary system disorders 

Answer: The patient is high likely exposed to