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: bactrim / sulfa (sulfonamides) / seroquel attending: chief complaint: chest pain, doe major surgical or invasive procedure: cardiac catheterization history of present illness: 49 yo m with iddm with hx of smoking and hemoptysis who presents with 4 days of waxing and chest pain and dyspnea on exertion. he describes initial pain starting 4 days prior to admission. he desribes sharp chest pain located in the center of his chest that occurred while at rest and resolved spontaneously. he has had continued shortness of breath. then on wednesday (3 days prior to admission) he awakened in the morning with severe pressure in his chest. the pain was severe for approximately an hour and then also resolved. since then he has had on and off severe dull, very heavy chest pain. it again recurred this morning and has persisted. other qualities to the pain are that it is better with sitting up and worse with lying flat, does not radiate to the back, and somewhat worse with deep breaths and coughing. during the last few days, he has had brief periods of activity intermittent with dyspnea on exertion. however, today he was so fatigued that he was unable to let his friend into his house. also he has had a cough for approximately 2-3 days and increasing sputum. initially the sputum was lime green, but now has bloody streaks (this am with increased blood). he was febrile wednesday am to 102.3 but has not taken his temp since then. . while in the ed, he tm 99.6 103 153/90 30 94%ra. gave asa 325 p xx 1 metoprolol 5 mg x 1, heparin gtt bolus, then 1000 u/hr, versed iv x 1, plavix 600 mg x 1 past medical history: : l knee gun shot wound : l knee total arthroplasty : l knee fusion hepatitis b hepatitis c genotype 1, viral load >6 million diabetes ii (last hba1c 5.6) htn gerd ptsd bph depression former ivda obstructive sleep apnea social history: social history is significant for the presence of current tobacco use. there is no history of alcohol abuse. also has history of ivda but >8 years ago. reports being in the military and worked as a seal. lives alone but rents the apartment above him to a friend. is divorced and has two children that he has not recently seen. family history: parents died at a young age. physical exam: blood pressure was 113/67 mm hg right while seated 111/73 left arm. pulse was 79 beats/min and regular, respiratory rate was 22 breaths/min. t 98.9 02 sat 98% ra generally the patient was diaphoretic and in mild distress, and somewhat jaundiced. the patient was oriented to person, place and time. there was no xanthalesma and conjunctiva were pink with no pallor or cyanosis of the oral mucosa. the neck was supple but jvp was not seen. the were no chest wall deformities, scoliosis or kyphosis. the respirations were not labored and there were no use of accessory muscles. the lungs were clear to ascultation bilaterally with normal breath sounds and no adventitial sounds or rubs. there were no thrills, lifts or palpable s3 or s4. the heart sounds were distant revealed a normal s1 and the s2 was normal but distant. ?possible rub heard on sitting up. the abdominal aorta was not palpable. abdomen was distended with mild tenderness of the ruq with voluntary guarding. the extremities had no pallor, cyanosis, clubbing or edema. lle with multiple scars consistent with prior surgeries. liver percussed to approx 6 cm pulses: right: femoral 2+ dp 2+ pt 2+ left: femoral 2+ dp 1+ pt 1+ guaiac neg per ed pertinent results: 01:50pm blood wbc-6.5 rbc-3.47* hgb-11.1* hct-31.0* mcv-89 mch-32.1* mchc-35.9* rdw-14.2 plt ct-107* 09:06am blood wbc-3.5* rbc-3.45* hgb-10.9* hct-31.9* mcv-93 mch-31.7 mchc-34.2 rdw-14.7 plt ct-123* 01:50pm blood neuts-67.4 lymphs-25.2 monos-5.1 eos-2.0 baso-0.3 01:50pm blood pt-17.0* ptt-28.4 inr(pt)-1.6* 09:06am blood pt-18.1* ptt-74.6* inr(pt)-1.7* 01:50pm blood glucose-91 urean-15 creat-1.0 na-133 k-3.9 cl-100 hco3-24 angap-13 09:06am blood glucose-99 urean-18 creat-0.2* na-138 k-4.2 cl-104 hco3-24 angap-14 01:50pm blood alt-82* ast-66* ld(ldh)-243 ck(cpk)-115 alkphos-83 totbili-0.6 08:00pm blood ck(cpk)-92 05:20am blood ck(cpk)-60 01:50pm blood ck-mb-5 ctropnt-1.46* 08:00pm blood ck-mb-notdone ctropnt-1.30* 05:20am blood ck-mb-notdone ctropnt-1.21* 05:20am blood calcium-8.8 phos-5.1* mg-2.2 cholest-125 05:20am blood triglyc-122 hdl-27 chol/hd-4.6 ldlcalc-74 02:00pm blood lactate-1.6 01:50pm blood afp-1.1 04:39pm blood %hba1c-5.4 ........... ct of the chest without and with intravenous contrast: there is no evidence of acute aortic dissection or pulmonary embolism. large pleural or pericardial effusion is identified. there is coronary artery calcifications, otherwise, the heart and great vessels appear unremarkable. there is scattered non-pathologically enlarged mediastinal lymph adenopathy with no appreciably enlarged nodes noted within the axilla or hila. evaluation of the lung parenchyma displays diffuse increased interstitial markings extending to the periphery (kerley b lines) with scattered areas of ground-glass opacity. these findings are most consistent with interstitial edema and congestive heart failure (chf). additionally, there is a more focal area of consolidation noted along the major fissure within the right middle lobe (3:64). this may also be related to underlying chf but focal infiltrative process cannot be excluded. there is bilateral dependent atelectasis. the airways are patent to the subsegmental level. limited examination through the upper abdomen displays fatty infiltration of the liver but is otherwise unremarkable. bone windows: no suspicious blastic or lytic lesions are identified. impression: 1. no evidence of acute pulmonary embolism or aortic dissection. 2. diffuse increased intersitial markings with scattered ground-glass opacities are most consistent with findings of interstitial edema and chf. additionally, a more focal area of consolidation is noted within the right middle lobe which may represent a superimposed infectious process. no large pleural effusions are identified. 3. fatty infiltration of the liver. .... tte: conclusions: the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is severely depressed (ejection fraction 30 percent) secondary to severe hypokinesis of the anterior septum and anterior free wall, with extensive apical akinesis and focal apical dyskinesis (no definite apical thrombus seen). there is no ventricular septal defect. right ventricular chamber size is normal. there is focal hypokinesis of the apical free wall of the right ventricle. 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. moderate (2+) mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. compared with the findings of the prior study (images reviewed) of , intercurrent extensive anterior myocardial infarction is evident. ..... cardiac catherization: comments: 1. selective coronary angiography of this right dominant system revealed single vessel disease. there was a cloacal lmca which was free of critical stenoses. the lad was totally occluded just distal to s1 and filled distally via left-to-left and right-to-left collaterals. the lcx was diffusely diseased throughout with an aneurysmal segment in the mid-vessel and 30-40% stenoses in the om1 and om2 branches. the rca was also diffusely diseased with an aneurysmal mid-segment and plaquing up to 40%. 2. limited resting hemodynamics revealed severely elevated left heart filling pressures with an lvedp of 30mmhg. the opening aortic pressure was 119/75mmhg. 3. left ventriculography was deferred. final diagnosis: 1. one vessel coronary artery disease. 2. severe diastolic left ventricular dysfunction. .... myocardial viability test: interpretation: following injection of of thallium chloride while the patient was at rest, static spect images were obtained and analyzed 20 minutes post-injection. the patient returned 24 hours later and spect images were again obtained. the left ventricular cavity size is enlarged. 20 minute images reveal defects in the distal anterior wall, apex, and septum. 24 hour images reveal improved uptake in the septum. defects in the distal anterior wall and apex appear unchanged. impression: multiple defects in the distal anterior wall, apex, and septum with evidence of viable myocardium in the septum. brief hospital course: assessment and plan, as reviewed and discussed in multidisciplinary rounds 49 yo man with history of dm, hep c, htn and hypercholesterolemia admitted with chest pain and large anterior stemi. . 1)stemi: patient presented with symptoms and clinical syndrome consistent for a completing stemi. description of symptoms starting approx 4 days prior to presentation and lack of ck elevation supported that the myocardial damage was done several days prior to admission. echocardiogram showed severely decreased anterior wall motion. cardiac catherization done at the end of the hospitalization showed occluded lad with some collateral flow but no intervention was performed (given concern for both viability of the myocardium, compliance with plavix and fear of steal flow to a potentially non-viable area from a viable one). given that he had severe decreased anterior motion he will need chronic anticoagulation given high risk for apical thrombus. he is likely a candidate for an icd placement but this will need to be discussed as an outpatient. for futher evaluation of the myocardium, a nuclear viability test was done that shows an area of viability in the septum. patient was discharged prior to these results. for secondary prevention and treatment of mi, he was started/continued on aspirin lisinopril, metoprolol, and lipitor 80mg he was discharged with instructions to follow up with the for management of his inr. . 2) pleuritic chest pain/pericarditis: throughout the hospitalization the patient had pleuric chest pain. this was thought to be most likely caused by pericarditis after the myocardial infarction. he was treated with pain medications but nsaids were avoided. pe was ruled out with a cta. . 3) hypertension: blood pressure control was managed with titration of the lisinopril and metoprolol with the decrease of lisinopril to 5 mg to keep the bp in the low-normal range. . 4) rhythm: remained in normal sinus, continued metoprolol 5) pump: with systolic and diastolic dysfunction. initially presented with what appeared to be fluid overload as a result of his mi. patient diuresed a large amount without diuretics. will need outpatinet echo and possible icd placement in approx 3 weeks (40 days post mi) . 6) hemoptysis: initially presented in the setting of pleuritic chest pain and thus was concerning for pe. however this was ruled out. it seemed to be decreasing as he got further treatment for his community acquired pneumonia, but had not completely resolved. thought likely secondary to tracheobronchitis. cta did not show any concerning lesions. . 7) fever- febrile at home cause was likely with bronchitis/pneumonia. have also been in the setting of either infarction or pericarditis. treated with 7 days of levofloxacin. afebrile while inpatient. . 8) hepatitis c: appears to have poor follow up but does have documented high viral load with poor serotype. viral load was 792,000 iu/ml. lfts at baseline. decreased liver span and possible cirrhosis given elevated inr at baseline. will need outpatient follow up. . 9) hypertension: initially hypotensive, stopped clonidine, transitioned to toprol xl. . 10) dm: currently well controlled. hba1c 5.4. will give home dose of lantus unless npo (then will give 1/2 dose) and follow with sliding scale qid . 11) history of osteomyelitis: not active issue, will treat pain. medications on admission: - doxepin 300 mg bedtime - clonidine 0.3 - clonazepam 1 mg b.i.d. - methadone 180 mg once daily x 8 years ( clinic- ) - lantus 18 units bedtime - oxycontin 60 mg b.i.d. - promethazine 150 mg bedtime - protonix 40 mg b.i.d. - lisinopril 40 mg daily. - aspirin 81 mg - bowel meds discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. atorvastatin 40 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 3. 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* 4. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. coumadin 5 mg tablet sig: one (1) tablet po at bedtime. disp:*30 tablet(s)* refills:*2* 6. oxycodone 20 mg tablet sustained release 12 hr sig: three (3) tablet sustained release 12 hr po q12h (every 12 hours). 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 8. doxepin 25 mg capsule sig: twelve (12) capsule po hs (at bedtime). 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 10. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: take tablets every 5 minutes for chest pain. if you take more than 2, call ems. disp:*30 tablet, sublingual(s)* refills:*0* 11. clonazepam 1 mg tablet sig: one (1) tablet po bid (2 times a day). 12. promethazine 25 mg tablet sig: six (6) tablet po hs (at bedtime) as needed. 13. insulin glargine 100 unit/ml cartridge sig: eighteen (18) units subcutaneous at bedtime: and resume your normal sliding scale. 14. methadone 40 mg tablet, soluble sig: four (4) tablet, soluble po once a day: total dose 180mg daily. 15. methadone 10 mg tablet sig: two (2) tablet po once a day: total dose 180mg daily. 16. outpatient lab work please check inr on (fingerstick) and fax results to discharge disposition: home with service facility: homecare discharge diagnosis: primary: 1. st elevation myocardial infarction secondary: 1. leg/chest pain discharge condition: stable to be discharged to home discharge instructions: you had a myocardial infarction. it is very important that you take all of your medications to prevent a new heart attack or congestive heart failure. you were started on coumadin (warfarin) which is a blood thinner. this medication requires twice weekly monitoring of blood levels. this will be followed by the in the building. you were also started on aspirin which also thins the blood, atorvastatin (lipitor) for high cholesterol, toprol xl and lisinopril for high blood pressure. if you have chest pain, shortness of breath, sensations of heart pounding, sweating, nausea, vomiting, or feel similar to prior to this admission, please come back to the emergency department. followup instructions: please follow up with dr. on at 2:20 pm in the . call if you need to reschedule this appointment. . please follow up with dr. on as previously scheduled: provider: , md phone: date/time: 1:30 . will call you to arrange follow up with them so they may monitor your coumadin levels. additionally a nurse will come to your house to check your inr starting tomorrow. procedure: coronary arteriography using two catheters left heart cardiac catheterization diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery unspecified essential hypertension chronic hepatitis c without mention of hepatic coma diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled postmyocardial infarction syndrome 

Answer: The patient is high likely exposed to