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: no known allergies / adverse drug reactions attending: chief complaint: shortness of breath major surgical or invasive procedure: left mainstem stent placement by dr. history of present illness: 55 y/o male history of stage iii non-small cell lung cancer, consistent with squamous cell s/p chemotherapy and radiation treatments as well as mutliple prior bronchoscopies with dr. for tumor debulking and stent placement to the left mainstem bronchus who now presents with shortness of breath. the patient lives in , but receives his pulmonary care here in . he is in for a stent placement however, before a scheduled appointment with dr. he presented this morning with acute onset of shortness of breath and chest tightness. ems was called and found patient saturating 50% on ra with intense tachypnia. patient was placed on his home o2 of 3 l which increased his saturations to about 70%. he was transitioned to nrb with 90% saturations and transferred to ed. in ed initial vs were hr 95, bp 123/73, rr 24, satting 99% on nrb. us showed ptx on left side per ed report without evidence of tension pneumothorax. a portable cxr showed collapse of the left lung with tracheal deviation toward side of collapse. while in the er,had acute sob/tachypnea with drop in sats with nrb on to 70's% which spontaneously returned to 100%. labs were within normal limits, except for a bicarbonate of 20. patient's ip physician . was conatacted in the ed and made aware of the patient's admission. plan was for icu admission with bronchoscopy/stenting of the left mainstem later on this afternoon. on arrival to the micu, pt. was sedated with propofol, intubated, his vs were hr: 94, bp: 113/69, o2sat: 100% on 100fio2 and vetilated, rr: 18 on the vent. vent settings were tv: 600cc, rr: 18, peep: 5, fio2: 96%. review of systems: unable to assess given sedation and intubation. past medical history: nsclc htn dm hypothyroidism s/p appendectomy age 17 s/p hemorrhoidectomy s/p back surgery years ago social history: lives with his wife in . has two children occupation working as an oil refinery operator with reported chemical exposures. smoking history quit smoking pack per day since he was a teenager alcohol since diagnosis decreased from 12 pack per week family history: brother with history of melanoma physical exam: admission exam: vitals - hr: 95, bp: 123/73, rr: 24, satting 99% on nrb general: intubated, sedated heent: sclera anicteric, mmm, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: foley in place ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: defer given sedation discharge exam: vitals: t 98.1 bp 140/82 p 77 rr 18 o2 sat 96% ra gen: comfortable laying in bed in nad neck: supple no jvd appreciated chest: distant heart sound. nl s1 s2 no mummurs, rubs, or gallops lungs: rhonci b/l moving good air. no accessory muscle use abdomen: soft ntnd, bs normoactive neuro: aox3 pertinent results: imaging: cxr - pre-operative impression: near complete collapse of the left lung with leftward mediastinal shift. ct may be obtained to assess further for cause of lung collapse. cxr - post-operative 1. et tube 7.5 cm from the carina. 2. marked improvement of the aeration of the left lung with possible small left pleural effusion. no pneumothorax. cxr - et tube is 8.2 cm above the carina. a left mainstem bronchus stent is in place. since the prior radiograph, there is no significant change. small left pleural effusion is unchanged the right lung is clear. there is no focal consolidation, or pneumothorax. the bony structures are intact. cxr -findings: portable ap chest radiograph is obtained. endotracheal tube is no longer visualized. cardiomediastinal contours are stable. right lung remains clear. small left pleural effusion is again noted. left lung is better aerated. no pneumothorax. ct chest -impression: 1. unremarkable position of the new stent in the left main bronchus. 2. post-radiation changes, stable. mediastinal lymphoid tissue, unchanged. thickening of the trachea, unchanged 3. interval decrease in the size of the right lower lobe nodule, currently cavitated. admission labs: 10:07am blood wbc-8.8 rbc-4.60 hgb-13.8* hct-41.9 mcv-91 mch-30.1 mchc-33.0 rdw-13.7 plt ct-233 10:07am blood neuts-83.4* lymphs-9.4* monos-4.3 eos-2.0 baso-0.9 10:07am blood plt ct-233 10:07am blood pt-9.2* ptt-25.7 inr(pt)-0.8* 10:07am blood glucose-180* urean-16 creat-1.2 na-134 k-4.7 cl-103 hco3-20* angap-16 04:04pm blood type-art po2-236* pco2-77* ph-7.14* caltco2-28 base xs--4 07:53pm blood type-art temp-36.4 rates-/18 tidal v-540 peep-5 fio2-100 po2-283* pco2-35 ph-7.40 caltco2-22 base xs--1 aado2-391 req o2-69 -assist/con intubat-intubated 04:04pm blood glucose-173* lactate-0.3* na-136 k-4.3 cl-102 04:04pm blood hgb-12.5* calchct-38 o2 sat-99 relevent labs: 03:52am blood wbc-10.3 rbc-3.71* hgb-11.1* hct-33.3* mcv-90 mch-30.0 mchc-33.4 rdw-13.5 plt ct-194 05:30am blood hct-32.1* 03:52am blood plt ct-194 03:52am blood glucose-160* urean-15 creat-1.0 na-136 k-4.0 cl-106 hco3-21* angap-13 04:05am blood type-art temp-36.4 rates-/18 tidal v-540 peep-5 fio2-50 po2-137* pco2-35 ph-7.42 caltco2-23 base xs-0 -assist/con intubat-intubated 04:05am blood lactate-1.0 discharge labs: 06:35am blood wbc-6.0 rbc-3.59* hgb-10.9* hct-32.6* mcv-91 mch-30.3 mchc-33.4 rdw-13.9 plt ct-186 brief hospital course: 55 yo male with non-small cell lung cancer with known left main stem bronchus tumor burden presenting with acute worsening sob. #left main bronchial obstruction/hypoxia/h/o nsclc: the patient presented to with shortness of breath and hypoxia. he was subsequently found to have near total collapse of his left lung with mediastinal shift towards the collapsed lung on chest x-ray. the patient has a known tumor in left mainstem region. he has had 3 previous bronchial stents for left main bronchial obstruction and hypoxia . he was intubated on admission and admitted to the micu. he underwent bronchoscopy by interventional pulmonary who placed a metal stent in his left mainstem bronchus. a repeat chest xray immediately following the procedure showed reinflation of the upper lobe but persistant collapse in the lower lobe. he was extubated on post operative day one without respiratory distress, satting well on 50% face tent mask. he was transferred to the general medical floors on hospital day 2. his supplemental o2 was weaned and he was ultimately satting well on room air at discharge. the patient was noted to have desaturations into the 80s on ambulatory pulse ox, but remained asymptomatic with no shortness of breath during these episodes. final cxr prior to discharge showed better aeration of the left lung. per interventional pulmonary he will need to have an official 6 min walk test and be evaluated for pulmonary rehab when he returns home to . he will have outpatient pulmonary follow up with dr. of , on . # presumed post obstructive pneumonia- during the bronchoscopy the patient was noted to have several thick mucous plugs, and per interventional pulmonary was started on levofloxacin for presumptive post-obstructive pneumonia. his bal cultures grew oxacillin sensitive staph aureus which was also sensitive to levofloxacin. he received one dose of iv vancomycin while the sensitivities from the culture were pending. he also received one dose of iv nafcilin. he was ultimately sent home on po levofloxacin and will have a 7 day course of antibiotics, ending 3 days after discharge. #anemia, nos: during his stay in the micu the patient was noted to have a drop in hematocrit from 41.9 pre-operatively to 32.1 post-op day 1. he received 3.5 liters of normal saline during his micu stay and the drop was thought to possibly be dilution versus peri-procedural bleeding. the patient maintained good urine output with no signs of end organ damage such chest pain or decreased urine output and no obvious sign of bleeding were noted. his baseline hct appears to be around 35. his hemoglobin and hematocrit remained stable throughout the hospital course and were 10.9/32.6 on discharge. #diabetes, type 2, controlled no complications: this is a chronic stable issue. he is on metformin and actos at home. while in the hospital he was placed on a insulin sliding scale. #hld: this is a chronic stable issue. at home he is on atorvastatin 40mg and trilipix 135mg. he was continued on the atorvastatin in the hospital. his trilipix was held, as it is not on formulary, but the patient who told to continue both medications at discharge. #htn: this is a chronic stable issue. he is onolmesartan-hctz. these medications were held as the patient's blood pressures were stable but on the low side at sbp between 100-120. on discharge his bp was 140/70 and it was recommended to the patient to resume his home bp medications. #hypothyroid: this is a chronic stable issue. he was continued on synthroid 200mcg each day transitional issues: - will need to follow up with pcp to get an offical 6 minute walk test and evaluation for pulmonary rehab - will establish outpatient pulmonary follow up with dr. of , on . medications on admission: preadmission medications listed are correct and complete. information was obtained from patientfamily/caregiver. 1. pioglitazone 30 mg po daily 2. levothyroxine sodium 200 mcg po daily 3. fenofibrate *nf* 135 mg oral qd 4. atorvastatin 40 mg po daily 5. metformin (glucophage) 850 mg po bid 6. symbicort *nf* (budesonide-formoterol) 160-4.5 mcg/actuation inhalation 7. albuterol inhaler puff ih q6h:prn sob 8. benicar hct *nf* (olmesartan-hydrochlorothiazide) 20-12.5 mg oral qd discharge medications: 1. albuterol inhaler puff ih q6h:prn sob 2. atorvastatin 40 mg po daily 3. levothyroxine sodium 200 mcg po daily 4. levofloxacin 750 mg po daily day 1 rx *levofloxacin 750 mg 1 tablet(s) by mouth daily disp #*3 tablet refills:*0 5. benicar hct *nf* (olmesartan-hydrochlorothiazide) 20-12.5 mg oral qd 6. fenofibrate *nf* 135 mg oral qd 7. metformin (glucophage) 850 mg po bid 8. pioglitazone 30 mg po daily 9. symbicort *nf* (budesonide-formoterol) 160-4.5 mcg/actuation inhalation discharge disposition: home discharge diagnosis: left main bronchus obstruction discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , it was a pleasure participating in your care at . you were admitted to the hospital because you were having difficutly breathing. you were found to have near total collapse of your left lung due to an obstruction of one of the main airways. you had a bronschopy to relieve the obstruction. you were also found to have a pneumonia and were started on antibiotics to treat the infection. followup instructions: pcp . appt: @11:00 am phone number: . , -please make sure to get 6 min walk test and evaluate for pulmonary rehab division: pulmonary with: dr. when: 7:30am phone: where: 6th ave south, fax: . procedure: endoscopic excision or destruction of lesion or tissue of bronchus bronchial dilation diagnoses: anemia, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism personal history of tobacco use pulmonary collapse other and unspecified hyperlipidemia acute respiratory failure other emphysema methicillin susceptible pneumonia due to staphylococcus aureus chronic and other pulmonary manifestations due to radiation late effect of radiation malignant neoplasm of main bronchus other pneumothorax 

Answer: The patient is high likely exposed to