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: history of present illness: the patient is a 54 year old male with a history of chronic obstructive pulmonary disease, asthma, obstructive sleep apnea, question idiopathic pulmonary fibrosis and severe tracheobronchial malacia, status post stents to the distal trachea and right main stem bronchus in . he developed the sudden onset of dyspnea and wheezing two days prior to admission. the patient initially presented to hospital where he was found to be respiratory distress with significant bronchospasm, tachycardia and tachypnea. a chest x-ray showed the stents to be in place and did not show any evidence of pneumonia. cardiac enzymes were negative per report. the patient was transferred to on bipap and with around the clock nebulizers. an arterial blood gas prior to transfer was 7.42, 43, 97, on bipap. per report, the patient was anasarcic with significant lower extremity edema. no workup for pulmonary embolus was undertaken. the patient was intubated prior to transfer on a propofol drip. on arrival, the patient was intubated and sedated. additional history obtained through his wife was significant for marked improvement in his respiratory status status post stent placement. prior to the stent being placed, the patient was dyspneic with minor exertion including getting dressed. after stent placement, he was able to ambulate and climb stairs without significant dyspnea. past medical history: 1. status post appendectomy. 1. status post tonsillectomy. 1. status post septoplasty. 1. history of hand tremor. 1. obstructive sleep apnea on home bipap. 1. hypercholesterolemia. 1. hypertension. 1. gastroesophageal reflux disease. 1. tracheobronchomalacia. 1. asthma / chronic obstructive pulmonary disease. 1. steroid induced diabetes mellitus. 1. question idiopathic pulmonary fibrosis. 1. anxiety. 1. question coronary artery disease. social history: the patient lives with his wife and is a retired plumber. he is a former smoker and quit 12 years ago. the family denies any alcohol history or any drug abuse. family history: significant for a father who had "black lung" and was on home oxygen. medications: medications upon transfer were: 1. albuterol / atrovent nebulizers. 2. solu-medrol 80 mg intravenously q eight hours. 3. prevacid 30 mg q day. 4. singulair 10 mg q day. 5. zoloft 50 mg q day. 6. lipitor 10 mg q day. 7. levofloxacin 500 mg q day. 8. glyburide 20 mg q day. 9. lasix 20 mg q day. 10. tussionex 5 cc three times a day. 11. flonase. 12. morphine sulfate. 13. nitroglycerine paste. 14. humalog sliding scale. 15. lovenox 30 mg subcutaneously twice a day. 16. ativan. 17. advair, one puff twice a day. allergies: no known drug allergies. physical examination: on admission, temperature 97.0 f.; blood pressure 143/84; respiratory rate 14; saturation of 100 percent on ac with a tidal volume of 700 and rate of 14, peep of 5 and fio2 of 1.0. on these settings he was put on tidal volumes of 600. in general he was an ill appearing overweight male in no acute distress, sedated and intubated. heent examination: pupils equal, round and reactive to light. mucous membranes moist. cardiac examination: regular rate and rhythm with no murmurs, rubs or gallops. normal s1 and s2. pulmonary examination: clear to auscultation bilaterally posteriorly. abdomen was soft, distended, with normoactive bowel sounds, nontender to palpation. extremities with two plus bilateral lower extremity edema up to the knee. neurological examination: unable to assess secondary to sedation. laboratory data: from the outside hospital, cbc revealed a white blood cell count of 10.2 with a hematocrit of 43 and platelet count of 293. chem-7 revealed a sodium of 137, potassium of 4.0, chloride was 95; bicarbonate 29, bun 15, creatinine 0.13 and serum glucose was 220. calcium was 9.0 and magnesium was 1.8. ck was 230 with an mb fraction of 12.1 and troponin t of 0.0. ekg showed normal sinus rhythm at 92 with a normal axis and normal intervals. there were no st changes, t wave inversions or q waves. chest x-ray showed increased right atrial contour with a dilated pulmonary artery, right greater than left. et tube was well placed. there was no evidence of congestive heart failure or pneumonia. hospital course by problem: 1. respiratory distress: the patient underwent bronchoscopy with bal on the morning following admission. copious secretions were suctioned including an obstructing plug at the left main stem bronchus. initially, it was felt that mucous plugging was the cause of the patient's respiratory decline, however, the patient continued to have a high fio2 requirement despite aggressive suctioning. the patient was continued on levofloxacin which was begun at an outside hospital for possible tracheobronchitis. his initial bal was negative for any organisms. he was also treated for a chronic obstructive pulmonary disease exacerbation with intravenous steroids, mdis and high dose guaifenesin. the patient was initially on pressure control ventilation and was eventually able to be weaned to pressure support. with weaning of his sedation, he was able to tolerate a spontaneous breathing trial and on , he was successfully extubated. of note, he did continue to have significant wheezing peri extubation. discussions will be forthcoming with the interventional pulmonary team as well as with thoracic surgery regarding possible tracheal reconstruction, however, at this time, he will continue to have the stents in place. 1. hypertension: the patient had no prior history of high blood pressure, however, he was noted to have elevated blood pressures during his intensive care unit course. an echocardiogram was obtained, however, due to the patient's body habitus, poor windows were obtained. nevertheless, there was no evidence of systolic dysfunction. he was started on hydrochlorothiazide and captopril for control of his blood pressure with good response. 1. diabetes mellitus: the patient had elevated blood sugars throughout his intensive care unit course which was felt to be in part due to high dose steroids. for the initial portion of his admission, he was maintained on an insulin drip. on , he was transitioned to lantus and a regular insulin sliding scale. 1. gastroesophageal reflux disease: the patient was maintained on a twice a day proton pump inhibitor. 1. tachycardia / chest pain: per report, the patient had complaint of chest pain prior to his transfer to . of note, he did have an outpatient stress test prior to this admission which showed an equivocal reversible wall motion abnormality. he was ruled out for myocardial infarction on presentation with negative cardiac enzymes times three. an ekg was checked and it did not show any evidence of ischemia. as stated above, he was started on anti-hypertensives and echocardiogram was obtained. 1. fluid, electrolytes and nutrition: the patient was on tube feeds while he was intubated. he tolerated these well. 1. sedation: the patient was initially very agitated and dyssynchronous with the ventilator. he required high doses of propofol and versed to achieve adequate sedation. he was eventually weaned off of both with the addition of scheduled haldol. at the time of this dictation, he is off both propofol and haldol and receiving scheduled doses of haldol and ativan. the remainder of this dictation will be completed by the next house officer to assume the patient's care. that portion of the dictation will include his discharge diagnoses, medications and discharge plan. , md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances non-invasive mechanical ventilation arterial catheterization other intubation of respiratory tract other intubation of respiratory tract closed [endoscopic] biopsy of bronchus diagnoses: esophageal reflux diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled candidiasis of mouth acute respiratory failure postinflammatory pulmonary fibrosis mechanical complication due to other implant and internal device, not elsewhere classified chronic obstructive asthma with (acute) exacerbation 

Answer: The patient is high likely exposed to