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: lidocaine / morphine attending: chief complaint: recurrent right chest wall hernia. major surgical or invasive procedure: : right thoracotomy and repair of chest wall hernia. history of present illness: mr. is a 63 year old male s/p right chest wall hernia repair with -tex mesh on who presented to the postoperative clinic in pain, with erythematous right thoractomy and drainage out the chest tube site. a ct chest revealed rupture of the -tex mesh. antibiotics were started. he returns for redo right thoractomy and repair of the hernia. past medical history: -copd -osa -diabetes ii, complicated by neuropathy -chronic sinusitis -obesity -bph -gerd -cold induced asthma -oa -allergic rhinitis -htn -ptsd -hyperlipidemia (on simvastatin) . past surgical history: the patient had previous l4-l5 microdiscectomy in . he has had multiple discectomies in the past in , , and . -status post operative fusion of his left ankle following a bimalleolar ankle fracture -cervical c3-4 spine fusion with persisting cervical cord compression and plexopathy -lumbar laminectomy for spinal stenosis. social history: he lives at home with his wife and his son . 4 adult children who live away and are all described as healthy. he does not smoke. he uses wine or beer occasionally, and 2 cups of coffee a day. he reports the use of a regular diet and sleeps 8 hours per night with nocturia interrupting his sleep every hours. family history: he has a daughter today sutures old and two sons 19 and 33 years old all of which are healthy. physical exam: vs: t: 98.6 hr: 77-95 sr bp: 108-112/60 sats: 93% ra wt: 119 kg bs 121/154/161 general: 63 year-old male in no apparent distress heent: normocephalic, mucus membranes moist card: rrr. normal s1,s2 no murmur resp: bilateral diminshed breath sounds with bibasilar crackles no wheezes gi: obese, bs+ abdomen soft non-tender/non-distended extre: warm tr edema incision: right thoracotomy site with staples, mild erythema extending downward neuro; awake, alert, oriented. walks with a walker pertinent results: wbc-6.4 rbc-3.37* hgb-10.4* hct-31.3 plt ct-467* wbc-5.4 rbc-3.14* hgb-9.8* hct-29.4 plt ct-398 wbc-5.7 rbc-3.11* hgb-9.8* hct-29.1 plt ct-344 wbc-6.0 rbc-2.93* hgb-9.1* hct-27.2 plt ct-283 wbc-9.1 rbc-3.99* hgb-12.2* hct-37.3 plt ct-401 glucose-113* urean-9 creat-0.9 na-136 k-4.7 cl-97 hco3-31 glucose-171* urean-10 creat-0.8 na-135 k-4.6 cl-95* hco3-32 glucose-129* urean-8 creat-0.8 na-137 k-4.5 cl-98 hco3-30 calcium-8.3* phos-4.2 mg-1.8 glucose-117* urean-10 creat-0.7 na-137 k-4.3 cl-103 hco3-26 glucose-129* urean-15 creat-1.0 na-131* k-4.3 cl-102 hco3-25 glucose-254* urean-16 creat-1.1 na-125* k-4.9 cl-95* hco3-24 glucose-352* urean-13 creat-0.9 na-136 k-4.7 cl-100 hco3-25 calcium-8.3* phos-3.6 mg-1.8 cxr: : surgical material is again noted along the inferolateral right chest wall. the amount of pleural fluid tracking along the right chest wall and into the medial right apex, posteriorly, appears to have increased over several days. heterogeneous opacities at the right lung base are unchanged. the left lung remains well aerated. there is no left pleural effusion or pneumothorax. the cardiomediastinal silhouette is unchanged. impression: apparent increase in right pleural fluid layering along the lateral right chest wall, and in a loculated collection at the posterior right lung apex. : moderate right pleural effusion is again seen that tracks along the lateral chest wall and the major fissure. the area of opacification at the right base remains constant. left lung is well aerated without evidence of definite effusion or consolidation. persistent cardiomegaly without evidence of vascular congestion. : overall stable right pleural effusion and atelectasis following right chest tube removal with no pneumothorax or new abnormality. : some improved aeration bilaterally without evidence of pneumothorax. continued enlargement of the cardiac silhouette with atelectatic changes at the bases. no evidence of pulmonary vascular congestion. : the large right pleural effusion may be smaller in size, or fluid may have shifted to the medial hemithorax. relatively diffuse opacity at the right lung base may represent atelectasis. there is no left-sided consolidation or pleural effusion. there is no pneumothorax. the cardiomediastinal silhouette is grossly unchanged. echocardiogram: the left atrium is mildly dilated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). the estimated cardiac index is normal (>=2.5l/min/m2). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: pulmonary artery systolic hypertension. normal biventricular cavity sizes with preserved global and regional biventricular systolic function. brief hospital course: mr. is 63 year-old male admitted following right redo thoracotomy and chest wall hernia repair. he was extubated in the operating room, and monitored in the pacu prior transfer to the floor. once transfer to the floor he was found to be hypovolemic with low urine output requiring large fluid challenges. on he was transferred to the tsicu for hypotension, which he was given more fluids. he transfer back to the floor in stable condition on . respiratory: the patient required aggressive pulmonary toilet with around the clock nebulizers. he continued with his home cpap for osa/copd at night. pulmonology followed him throughout his hospital course. on it was felt he was volume overloaded gently diuresed with good effect. he was weaned off oxygen saturating mid 90's on room air. goal oxygen saturations: 89-94%. chest tube was removed on . followed by serial chest films (see above report) cardiac: he was tachycardic in the icu which responded to lopressor. on the floor he became hypertensive and his tachycardia in low 100's persisted. an echocardiogram was done and showed normal ef with moderate pulmonary artery systolic hypertension of 45 mm hg. his home dose lisinopril of 40 mg po bid was restarted and up titrated his metoprolol to 37.5 mg po tid, with good effect. gi: he had normal bowel movements and remained on proton pump inhibitors. renal: he was hyponatremic with sodium of 126, which improved with normal saline to 137. renal function remained within normal range. the foley was removed on once the epidural was removed, and he voided well thereafter. he was diuresed for volume overload on once and started daily on , with positive response in overall clinical status. endocrine: his blood sugar range varied 100-400. was consulted and adjusted his insulin to maintain adequate glucose control. pain: epidural bupivacaine and morphine pca was initially used for pain control. the was transition ed to ms contin and lidocaine patch for good pain control. his pain improved on the epidural and pca were stopped. he continued with ms contin and morphine immediate release for breakthrough pain. id: incision with staples mild erythema extending downward. he remained afebrile wbc within normal range. a 10 day course augmentin 875 was started for possible cellulitis in a patient with gortex mesh. during admission, pt noted tooth pain and subsequently received panorex which did reveal abscess and pt was cleared by dental consultation service. disposition: he was seen by physical therapy who recommended short term rehab. he was discharged to in () on and will follow-up with dr. as an outpatient. medications on admission: nph 55 units qhs novolog 27 units before dinner glipizide 2.5 mg in am and 7.5 mg in pm buspirone 10 mg per last d/c summary: lisinopril 40 mg oxybutynin chloride 2.5 mg tid paroxetine hcl 50 mg daily simvastatin 20 mg daily aspirin 81 mg daily omeprazole 40 mg daily cyanocobalamin (vitamin b-12) 100 mcg daily albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puffs inhalation every 4-6 hours as needed for shortness of breath or wheezing. fluticasone-salmeterol 250-50 mcg/dose 1 puff pregabalin 25 mg tid prednisone 10 mg tablets, dose pack sig: dose pack, see instructions tablets, dose pack po once a day for 6 days: take 4 tablets a day for 2 days, 2 tablets a day for 2 days, 1 tablets a day for 2 days then stop. azithromycin 250 mg for 4 day discharge medications: 1. oxybutynin chloride 5 mg tablet sig: 0.5 tablet po tid (3 times a day). 2. pregabalin 25 mg capsule sig: one (1) capsule po tid (3 times a day). 3. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 4. buspirone 10 mg tablet sig: one (1) tablet po bid (2 times a day). 5. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 6. morphine 30 mg tablet sustained release sig: one (1) tablet sustained release po q12h (every 12 hours). 7. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 8. senna 8.6 mg tablet sig: two (2) tablet po hs (at bedtime). 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 10. polyethylene glycol 3350 17 gram/dose powder sig: one (1) packet po daily (daily). 11. paroxetine hcl 25 mg tablet sustained release 24 hr sig: two (2) tablet sustained release 24 hr po daily (daily). 12. morphine 15 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for breakthrough pain. 13. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 14. lasix 20 mg tablet sig: one (1) tablet po once a day: for a week then reevaluate volume status. you should have electrolytes checked on lasix and replaced as necessary. 15. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day): if immobile in rehab. 16. lisinopril 20 mg tablet sig: two (2) tablet po bid (2 times a day). 17. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po q 8h (every 8 hours). 18. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 19. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 20. amoxicillin-pot clavulanate 875-125 mg tablet sig: one (1) tablet po bid (2 times a day) for 10 days. 21. humalog sliding scale 71-100 mg/dl 5 units 5 units 5 units 0 units 101-150 mg/dl 5 units 5 units 5 units 0 units 151-200 mg/dl 7 units 7 units 7 units 0 units 201-250 mg/dl 9 units 9 units 9 units 2 units 251-300 mg/dl 11 units 11 units 11 units 4 units 301-350 mg/dl 13 units 13 units 13 units 6 units 351-400 mg/dl 15 units 15 units 15 units 8 units 22. insulin glargine 100 unit/ml solution sig: twenty (20) units subcutaneous at bedtime. discharge disposition: extended care facility: discharge diagnosis: -copd -osa -diabetes ii, complicated by neuropathy -chronic sinusitis -obesity -bph -gerd -cold induced asthma -oa -allergic rhinitis -htn -ptsd -hyperlipidemia (on simvastatin discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: call dr. office if you experience: -fevers > 101 or chills -incision develops drainage or increased redness -shortness or breath or cough staples will be removed on your follow-up visit. you may shower. no tub bathing or swimming until all incisions healed antibiotics: augmentin 875 mg for 10 days. followup instructions: follow-up with dr. 1:00pm on 9 chest x-ray radiology 30 minutes before your appointment provider: , md phone: date/time: 3:30 followup with your dentist if your right back gum lesions to do disappear. you had a panorex in the hospital showing this area was not absessed. procedure: reopening of recent thoracotomy site other repair of chest wall diagnoses: acidosis obstructive sleep apnea (adult)(pediatric) esophageal reflux other postoperative infection cellulitis and abscess of trunk congestive heart failure, unspecified unspecified essential hypertension acute on chronic diastolic heart failure diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) other and unspecified hyperlipidemia long-term (current) use of insulin other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation mechanical complication due to other implant and internal device, not elsewhere classified other diseases of lung, not elsewhere classified obesity, unspecified chronic obstructive asthma, unspecified hypovolemia unspecified sinusitis (chronic) posttraumatic stress disorder 

Answer: The patient is high likely exposed to