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: amitriptyline / benzodiazepines / morphine / valium attending: chief complaint: dyspnea, cough, pedal edema major surgical or invasive procedure: - bronchoscopy - central venous catheter/pulmonary artery catheter placement - arterial line placement history of present illness: mr. is a 47 year-old man with hiv/aids (cd4 8, vl on ; compliant with haart; history of high-grade resistance patterns; no history of ois; diagnosed ; presumed contracted from msm contact) who presented to the emergency dept today with six days of worsening bipedal edema, exertional dyspnea, and fevers. he reports a gradual worsening of his symptoms over the past six days. his exertional dyspnea has worsened to the extent that he is dyspneic at rest. he has had frequent coughing which is mostly dry, but occasionally was producing sputum. he has been having daily fevers as high as 102, along with chills and sweats. his po intake has been decreased, but he has been forcing himself to drink fluids. he has developed worsening orthopnea (now using 7 pillows at night; usually uses 3 pillows). he has been compliant with all of his medications, including his haart and his bactrim prophylaxis. when his symptoms began, he decided to increase his bactrim use to 3 ds tabs daily. he has not had sick contacts. did receive this year's influenza vaccine and omr indicates that he received the pneumovax in . . he saw one of his pcp's colleagues earlier today and was afebrile with a bp of 94/64, hr 100, and o2 sat of 94% on room air. a cxr was interpreted (on a wet read) as showing bilateral opacities consistent with an opportunistic infection such as pneumocystis. he was referred to the emergency department for further evaluation. . on presentation to the ed, he was afebrile with a bp of 115/83, hr 115, and o2 sat (by report) in the low-90s on room air. an abg at this time was 7.53/29/63. he was noted by the triage rn to be in some respiratory distress and was placed on cpap, with improvement in his o2sat up to 100%. out of concern for pneumocystis pneumonia, he was given 400mg of iv bactrim and 60mg of prednisone. his ecg was noted to have new t-wave depressions in v2-v5, and a troponin-t was 1.67, bnp >. he was given a 325mg aspirin. since this was thought to likely be demand ischemia in the setting of an acute pulmonary process, no anticoagulation was started after discussion by the ed team with the cardiology consultant on call. he was also noted to have a worsening of his baseline anemia and was consented for a blood transfusion (but was transferred to the micu before the blood had arrived to the ed). prior to transfer to the micu, an abg on cpap 7/5 with fio2 50% was 7.48/33/247. . review of systems: notable for some mild chest discomfort while coughing (much different from the patient's history of anginal pain). he denies any weight loss, hemoptysis, visual changes, abdominal pain, diarrhea, or hematochezia. past medical history: - hiv/aids, diagnosed ; genotyping in showed high-grade nnrti resistance, suspected to have pi-resistance as well; no history of ois - two-vessel cad; inferior stemi in (totally-occluded rca, two mid-lad lesions; all of them stented); bms to rplb in (in the setting of positive stress and angina); des to mid-lad (in-stent restenosis; in the setting of worsening fatigue and exertional dyspnea) - diastolic and systolic congestive heart failure (lvef 37-50%, depending on study; no echo on the omr) - dyslipidemia - hypertriglyceridemia - hypertension - severe peripheral neuropathy, thought secondary to stavudine; on very large narcotic regimen - c5-c6 diskectomy and fusion in - emphysema - depression social history: the patient lives in with his long-term partner. has smoked ppd for the past 30 years. he does not drink alcohol and has no history of drug use including iv drug use. family history: he denies any family history of cancer or lung disease. his mother has diabetes and coronary artery disease. he reports that multiple family members have had mis at early ages. physical exam: t 96.6 bp 98/60 hr 99 rr 21 sat 100% on cpap 7/5, fio2 35% general: thin middle-aged man in breathing comfortably with cpap mask, but in substantial respiratory distress without the mask heent: op clear; no scleral icterus or conjunctival erythema neck: unable to assess jvp due to cpap mask; no cervical or clavicular lymphadenopathy chest: scattered faint expiratory wheezing with mild bibasilar rales; moderately-restricted air movement; no egophony; no dullness to percussion cardiovascular: borderline tachycardic, regular; normal s1s2; no murmurs or rubs; nondisplaced pmi abdomen: moderately distended; nontender; normal bowel sounds; no hepatosplenomegaly back: no cva tenderness extremities: 2+ pitting edema bilaterally to the lower shins; 2+ pt pulses; warm, well-perfused; no cyanosis or clubbing rectal: guaiac negative (performed in ed) skin: multiple papular lesions with central dimpling on chin, jawline and neck; no jaundice neuro: alert, oriented x3, cn 2-12 intact, 5/5 strength in both arms and legs pertinent results: viral dfa- nasopharyngeal aspirate (): respiratory viral antigens not detected. . . bronchoalveolar lavage (): . bordetella bronchiseptica . cefepime-------------- r ceftazidime----------- =>16 r ceftriaxone----------- =>32 r ciprofloxacin--------- 1 s gentamicin------------ 4 s imipenem-------------- <=1 s levofloxacin---------- s meropenem------------- s piperacillin---------- <=8 s piperacillin/tazo----- <=8 s tobramycin------------ 4 s trimethoprim/sulfa---- s . legionella culture (final ): no legionella isolated. . immunoflourescent test for pneumocystis jirovecii (carinii) (final ): negative for pneumocystis jirvovecii (carinii). . fungal culture (preliminary): yeast. of two colonial morphologies. . acid fast smear (final ): no acid fast bacilli seen on concentrated smear. . . . 07:35pm blood ck-mb-28* mb indx-9.0* probnp-* 07:35pm blood ctropnt-1.67* 03:57am blood ck-mb-27* mb indx-11.2* ctropnt-1.23* 10:07am blood ck-mb-25* mb indx-10.8* ctropnt-1.06* 03:34pm blood ck-mb-26* mb indx-11.7* ctropnt-1.37* . . cxr (): cardiomediastinal contours are normal with cardiac size top normal. hazy opacity is in the hilar regions bilaterally. there are small bilateral pleural effusions. there is no pneumothorax. there is no overt chf. . ecg (): sinus tachycardia with ventricular rate 115 bpm, normal axis, normal intervals. st segment depressions in leads v2-v5, new from prior ecgs. . tte (): left ventricular cavity is enlarged. there is moderate regional left ventricular systolic dysfunction with akinesis of the distal of the anterior wall, septum and apex, and hypokinesis of the lateral wall. the remaining segments contract normally (lvef 30-35%). the right ventricular cavity is mildly dilated, with hypokinesis of the basal half of the free wall. moderate to severe (3+) mitral regurgitation is seen. an eccentric jet of moderate tricuspid regurgitation is seen. there is no pericardial effusion. . tte (): the left atrium is moderately dilated. no atrial septal defect or patent foramen ovale is seen by 2d, color doppler or saline contrast with maneuvers. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. there is severe regional left ventricular systolic dysfunction with 20-25%). no masses or thrombi are seen in the left ventricle. the right ventricular cavity is mildly dilated. there is mild global right ventricular free wall hypokinesis. no ventricular septal defect is seen. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. the mitral valve leaflets do not fully coapt. severe (4+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. brief hospital course: mr. was admitted to the micu for respiratory distress. upon arrival to the micu, he was on bipap. he was started initially on empiric high-dose bactrim and prednisone for possible pneumocystis pneumonia, as well as levofloxacin for coverage of community-acquired pathogens. a bedside tte done on the evening of admission showed possible evidence of rv strain, so he was started on a heparin infusion for possible pulmonary embolus. . on the morning following his admission, he developed worsening distress and was urgently intubated for hypoxemic respiratory failure with concurrent hypotension. he underwent bronchoscopy with bal which was negative for viral dfa and pneumocystis , his bactrim was reduced to prophylactic dose and his prednisone was discontinued. his bal culture eventually grew out bordetella bronchiseptica; this was also cultured from several subsequent sputum cultures. his fevers recurred after approximately a week of intubation, but cultures continued to grow out only b. bronchiseptica. due to the unusual nature of this pathogen, id was consulted. they contact a specialist on this pathogen and recommended switching his levofloxacin to imipenem. this was swicthed to levofloxacin and doxycycline upon discharge; he will complete 2 more weeks for a total 4 week course; he will follow up with infectious disease as an outpatient. his leukopenia was noted to be worsening prior to discharge, and this was thought to be due to the imipenem therapy; he should have a cbc rechecked within the next week as an outpatient. . at the time of his admission, he was also noted to have a positive troponin in the setting of st segment depressions in his anterolateral leads. he was on heparin (as noted above), and cardiology was consulted. their impression was that his nstemi was due to demand ischemia in the setting of his respiratory distress, tachycardia, and intermittent hypotension. due to the unclear etiology of his hypotension, acute renal failure, and respiratory failure, a swan-ganz catheter was placed, and he was noted to have elevated filling pressures (pcwp 35-38, pad 38, ci 2.9, svr 800) consistent with cardiogenic shock/acute-on-chronic systolic and diastolic chf. the impression of the micu team and cardiology was that his ischemia may have been due to recurrent in-stent restenosis of his lad stent, and the plan initially was to take him to cardiac catheterization to open up this lesion. with a furosemide drip and diuril, however, he began diuresing well (with subsequent improvement in his renal function) and thus plans for a cardiac cath were deferred. his heparin drip was discontinued. he was kept on aspirin and clopidogrel, and his beta blocker was titrated upwards to help maximize any tachycardia-induced demand ischemia. his blood pressure was not able to tolerate even a low dose of ace-inhibitor. he should follow up with his cardiologist for further risk stratification (elective cath vs. stress test). . as his multifactorial (cardiogenic shock, emphysema, b. bronchisepticum pneumonia) respiratory failure slowly resolved, his ventilator settings were gradually weaned down. he was extubated on . post-extubated, he was in moderate respiratory distress with increasing alkalosis, presumably from acute "flash" pulmonary edema. he was diuresed and put on a nitroglycerin with gradual improvement in his respiratory status. following extubation, he was restarted on narcotics for his longstanding peripheral neuropathy. . regarding his hiv/aids, he was continued on his outpatient haart regimen throughout. he was continued on bactrim prophylaxis (briefly on treatment-dose bactrim, as above) and fluconazole. azithromycin was added for prophylaxis. given his persistent treatment failure, hiv genotyping was sent and should be followed up as an outpatient. medications on admission: oxycontin 120mg four times daily oxycodone 5-10 mg tid prn abacavir 300mg indinavir 800mg q8h lamivudine 300mg daily bactrim ds 1 tab daily fluconazole 100mg daily aspirin 325mg daily clopidogrel 75mg daily toprol xl 100mg daily pravastatin 40mg daily fenofibrate 48mg daily fluoxetine 40mg daily advair 1 puff albuterol mdi prn discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. indinavir 400 mg capsule sig: two (2) capsule po q8h (every 8 hours). 3. abacavir 300 mg tablet sig: one (1) tablet po bid (2 times a day). 4. lamivudine 150 mg tablet sig: two (2) tablet po daily (daily). 5. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po daily (daily). 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 7. fluconazole 200 mg tablet sig: 0.5 tablet po q24h (every 24 hours). 8. pravastatin 10 mg tablet sig: four (4) tablet po daily (daily). 9. fluoxetine 20 mg capsule sig: two (2) capsule po daily (daily). 10. oxycodone 5 mg tablet sig: four (4) tablet po q6h (every 6 hours) as needed. 11. oxycodone 40 mg tablet sustained release 12 hr sig: two (2) tablet sustained release 12 hr po q6h (every 6 hours). 12. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 13. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 14 days. disp:*14 tablet(s)* refills:*0* 14. doxycycline hyclate 100 mg capsule sig: one (1) capsule po q12h (every 12 hours) for 14 days. disp:*28 capsule(s)* refills:*0* 15. azithromycin 250 mg capsule sig: one (1) capsule po q24h (every 24 hours). disp:*30 capsule(s)* refills:*2* 16. albuterol 90 mcg/actuation aerosol sig: two (2) puff inhalation q6h (every 6 hours) as needed. 17. ipratropium bromide 17 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 18. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). disp:*30 tablet sustained release 24 hr(s)* refills:*2* discharge disposition: home discharge diagnosis: primary : bordetella bronchisepticans pneumonia pulmonary edema systolic chf nstemi secondary: hiv/aids peripheral neuropathy cad htn copd discharge condition: stable, ambulating, oxygenation stable on room air discharge instructions: please continue all medications as prescribed. you will need to complete the course of levofloxacin and doxycycline over the next two weeks. other new medications include lasix, a reduced dose of toprol (50 mg daily), and azithromycin for prophylaxis. please see dr. in the next week to follow-up on your recent hospitalization. you also need to see your cardiologist in the next 1-2 weeks to determine if a repeat stress test is needed versus a repeat cardiac catheterization. if you have any symptoms of fevers, chills, difficulty breathing, chest pain, or any other concerning symptoms, please contact your pcp . followup instructions: please see your pcp 1 week for follow-up care. please see your cardiologist in weeks. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more diagnostic ultrasound of heart insertion of endotracheal tube arterial catheterization closed [endoscopic] biopsy of bronchus pulmonary artery wedge monitoring diagnoses: subendocardial infarction, initial episode of care anemia, unspecified coronary atherosclerosis of native coronary artery mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified unspecified septicemia severe sepsis obstructive chronic bronchitis with (acute) exacerbation human immunodeficiency virus [hiv] disease opioid type dependence, continuous acute respiratory failure alkalosis antiviral drugs causing adverse effects in therapeutic use cardiogenic shock septic shock accidents occurring in other specified places surgical or other procedure not carried out because of contraindication acute on chronic combined systolic and diastolic heart failure polyneuropathy due to drugs pneumonia in whooping cough whooping cough due to other specified organism 

Answer: The patient is high likely exposed to