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: respiratory failure major surgical or invasive procedure: bronchoscopies pulmonary stent placement, right bronchus intermedius history of present illness: 72 y/o male with copd, cad s/p angioplasty in , afib and small cell lung ca who started with carboplatin/vp-16 in . he initially presented to smmc on with hypotension after accidental overdose on diltiazem. there, a cxr showed r lung white out and was transferred to for bronch given concern for mass compression of the bronchus. chest ct at showed large centrally obstructing mass with right apical pneumothorax, right middle and lower lobe opacity, pigtail was placed. patient was then bronched on with purulent drainage, stent was placed and started on vanco/zosyn for presumed post-obstructive pneumonia. patient continued to be intubated after the bronch and developed hypotension requiring pressors. patient also noted to be neutropenic thought likely and sepsis and patient with afib with rvr on a dilt gtt. patient self-extubated on and was subsequently re-intubated for hypoxia and respiratory distress. a repeat bronch was performed to open collapse. he was also started on radiation chemotherapy to shrink the tumor in his chest. past medical history: extensive small cell lung cancer copd cad social history: from . son lives with him in facility. daughter in is health care proxy. has also been close with step-son . family history: non-contributory pertinent results: 08:45pm blood wbc-10.9 rbc-4.10* hgb-12.1* hct-38.0* mcv-93 mch-29.6 mchc-31.9 rdw-15.0 plt ct-150 06:04am blood wbc-24.9* rbc-2.73* hgb-8.4* hct-25.2* mcv-92 mch-30.8 mchc-33.3 rdw-15.9* plt ct-116* 06:36pm blood neuts-93.4* lymphs-4.5* monos-0.9* eos-1.1 baso-0.2 03:12am blood neuts-71* bands-18* lymphs-2* monos-2 eos-0 baso-0 atyps-2* metas-2* myelos-3* 03:12am blood hypochr-normal anisocy-1+ poiklo-2+ macrocy-1+ microcy-1+ polychr-1+ spheroc-1+ schisto-1+ burr-occasional bite-1+ acantho-occasional 08:45pm blood pt-12.0 ptt-26.6 inr(pt)-1.0 03:27am blood pt-13.2 ptt-31.0 inr(pt)-1.1 06:04am blood pt-16.1* ptt-150* inr(pt)-1.4* 03:33am blood gran ct-50* 04:43am blood gran ct-1770* 08:45pm blood glucose-88 urean-57* creat-1.1 na-138 k-5.2* cl-107 hco3-22 angap-14 03:12am blood glucose-131* urean-39* creat-1.1 na-137 k-4.1 cl-102 hco3-28 angap-11 06:04am blood glucose-240* urean-47* creat-1.3* na-134 k-4.7 cl-98 hco3-25 angap-16 08:45pm blood alt-399* ast-464* alkphos-778* totbili-1.3 01:47pm blood alt-129* ast-118* alkphos-440* totbili-1.5 04:43am blood alt-60* ast-63* alkphos-400* totbili-0.9 03:12am blood alt-39 ast-72* ld(ldh)-530* alkphos-763* totbili-0.9 08:45pm blood probnp-1870* 01:26pm blood ctropnt-<0.01 01:47pm blood probnp-1157* 08:45pm blood calcium-7.7* phos-4.0 mg-2.5 06:04am blood calcium-7.3* phos-4.0 mg-1.9 02:05am blood osmolal-291 04:41am blood tsh-0.53 01:00pm blood cortsol-52.0* 02:05am blood cortsol-16.5 06:00am blood type-art po2-74* pco2-46* ph-7.33* caltco2-25 base xs--1 05:57pm blood type-art temp-36.7 rates-18/5 tidal v-450 peep-10 fio2-40 po2-120* pco2-36 ph-7.47* caltco2-27 base xs-3 intubat-intubated 02:35pm blood type-art temp-37.0 rates-24/0 tidal v-460 peep-15 fio2-100 po2-67* pco2-49* ph-7.37 caltco2-29 base xs-1 aado2-597 req o2-98 -assist/con intubat-intubated 10:08am blood type-art temp-36.3 rates-26/ tidal v-600 peep-15 fio2-100 po2-52* pco2-50* ph-7.33* caltco2-28 base xs-0 aado2-630 req o2-100 intubat-intubated vent-controlled 03:06pm blood glucose-83 lactate-2.4* na-133* k-4.9 cl-105 02:19pm blood lactate-1.6 05:22am blood lactate-2.6* 09:33am blood lactate-3.4* 11:58am blood lactate-2.3* radiology report ct chest w/contrast study date of 12:49 am impression: 1. occlusion of the right main bronchus from the surrounding nodular conglomerate mass, in keeping with diagnosis of lung cancer with complete collapse of the right lung and surrounding pleural effusion with pleural enhancing lesions probably metastases. minimal left pleural effusion with associated airspace opacities at the left lung base, could be interstital lung disease, basilar atelectasis, mild aspiration, however, superinfection cannot be excluded. 2. innumerous enlarged lymph nodes in the mediastinum and hila bilaterally concerning for metastatic deposits. 3. no pe or dissection of the thoracic aorta. 4. innumerous liver lesions consistent with metastasis. radiology report chest (portable ap) study date of 9:50 am impression: 1. moderate right apical pneumothorax, as communicated to dr. by telephone. 2. large centrally obstructing mass with epicenter in right hilum. 3. right mid and lower lung opacities, which may be due to post-obstructive atelectasis/pneumonitis, but reexpansion pulmonary edema is also possible in setting of recent thoracentesis. radiology report ct head w/ & w/o contrast study date of 8:45 am impression: no evidence of intracranial metastatic disease. mri is more sensitive for small metastatic lesions. aerosolized secretions in the left sphenoid sinus could indicate acute sinusitis. radiology report ct chest w/o contrast study date of 8:45 am impression: 1. patient status post right bronchus intermedius stent placement. improved aeration of the right lung. opacities in right upper lobe likely a combination of post-obstructive changes or metastatic disease. 2. interval development of small-to-moderate right-sided pneumothorax. 3. no significant change in extensive metastatic disease including nodal conglomerate within the mediastinum and bilateral hilar regions, encasing the right main stem bronchus. 4. extensive pleural plaques and pleural nodularity along with multiple lung nodules and liver lesions concerning for metastatic disease, unchanged. 5. interval decrease in bilateral pleural effusions. no change in bilateral basilar airspace opacities. radiology report chest (portable ap) study date of 12:45 am impression: ap chest compared to : some of bibasilar opacification is due to persistent pulmonary edema, but the more severe abnormality on the left is pneumonia or pulmonary hemorrhage progressed since , accompanied by small to moderate left pleural effusion, has not appreciably changed. although heart size is normal, mediastinal vascular engorgement suggests volume overload. right bronchial stent noted. et tube in standard placement. nasogastric tube passes into the stomach and out of view. no pneumothorax. brief hospital course: mr. was a 72 year old male with copd, cad initially presented to an outside hospital on with hypotension secondary to a diltiazem overdose, noted to have post-obstructive pna and transferred to on for bronch and stent placement. he was then noted to have a pneumothorax requiring chest tube placement, then was transferred from the surgical icu to the medical icu for initiation of radiation therapy in the setting of continued hypoxic respiratory failure and hypotension requiring pressors. # hypoxic respiratory failure: patient was initially intubated for bronchoscopy and stent placement into his right bronchus intermedius/right mainstem to help alleviate obstruction from tumor burden. after the procedure, he was not able to be weaned due to complicated status of lungs. in addition to his underlying copd and post-obstructive pna secondary to lung tumor burden, his initial course was also complicated by a pnx. a chest tube was placed on the right side, which was to remain there for as long as patient would need mechanical ventilation. the patient had self-extubated once early during his hospitalization and required re-intubation for hypoxia and work of breathing. he had multiple bronchoscopies throughout hospitalization to evaluate for worsening respiratory status. he was started on empiric broad spectrum antibiotics for post-obstructive pneumonia and transferred to the micu. he received radiation therapy to his chest to help shrink the pulmonary tumor and help prevent post-obstructive atelectasis. xrt has the potential to cause increased edema in the lungs, for which the team monitored. after re-intubation, the patient was maintained mostly on assist control ventilation. he was not able to tolerate trials of pressure support, which had resulted in increased agitation, exacerbation of his rapid afib and subsequent hypotension. after two weeks of intubation, the patient's respiratory status began to acutely decline further. his children and step-children came to the decision to make him cmo and extubate. the patient was extubated and taken off pressors and expired very soon afterwards. . #hypotension: mr. hypotension was secondary to sepsis from his complicated pneumonia. additionally, when he had afib with rapid rvr, his blood pressure would drop further. his blood pressure was supported by norepinephrine for much of his icu stay. . #pancytopenia: his pancytopenia was secondary to the chemotherapy he had received for metastatic small cell lung cancer within a week before hospitalization. the patient was initially neutropenic but recovered his blood counts within a couple of weeks. his blood counts were briefly supported with neupogen in addition to prbc and platelet transfusions. while neutropenic, he was especially susceptible to infection, which likely contributed to the severity of his pneumonia. . #transaminitis: the patient's elevated lfts were thought to be secondary to his chemotherapy regimen and trended down slowly with time. he likely had a baseline lft elevation due to his known liver metastases. . #afib: patient had a history of afib, for which he took sotalol and diltiazem at home. these medicines were continued for the majority of his icu stay. when the patient became agitated, his ventricular rate would rapidly rise into the 140s and contribute to hemodynamic instability. because the patient also had a pressor requirement to maintain his blood pressure, the sotalol was discontinued, while the diltiazem was continued at more frequent dosing. he was not anticoagulated during his stay due to his initial pancytopenia. . #small cell lung ca: the patient had extensive small cell lung cancer with known lung metastases and was status post a recent round of chemotherapy. head ct with and without contrast showed no metastases. per oncology team, the patient would have had a reasonable expectation for extending life by up to 5-6 months if he were able to continue chemotherapy, but he was very unlikely to be able to be ready for another round of chemotherapy (considering that his platelet count had not yet recovered, he was still intubated, and he was still requiring pressors). in addition, if this past round of chemotherapy had caused such significant complication for the patient, he would have been likely to develop further complications with another round even if he could have recovered this time. he received 5 doses of palliative radiation therapy to his chest to try to reduce the size of the tumor during his hospitalization. medications on admission: sotalol 80bid cardizem 108 q day flovent proventil pravastatin dilt sr 100 daily lisinopril 30 daily metoprolol 50 daily aspirin 81 daily discharge medications: none. discharge disposition: expired discharge diagnosis: expired discharge condition: expired discharge instructions: none. followup instructions: none. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube thoracentesis other bronchoscopy arterial catheterization other intubation of respiratory tract other incision of pleura other incision of pleura transfusion of packed cells injection or infusion of cancer chemotherapeutic substance transfusion of platelets other radiotherapeutic procedure bronchial dilation diagnoses: pneumonia, organism unspecified hyperpotassemia coronary atherosclerosis of native coronary artery malignant neoplasm of liver, secondary unspecified essential hypertension unspecified septicemia severe sepsis chronic airway obstruction, not elsewhere classified atrial fibrillation atrial flutter pulmonary collapse other and unspecified hyperlipidemia acute respiratory failure septic shock old myocardial infarction other diseases of trachea and bronchus malignant neoplasm of main bronchus interstitial emphysema malignant pleural effusion 

Answer: The patient is high likely exposed to