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: codeine / sulfa (sulfonamides) attending: chief complaint: transferred for further care of hypoxic respiratory failure major surgical or invasive procedure: endotracheal intubation history of present illness: mr. is a 54 year-old male, recent ex-smoker, with a history of all ph chromosome positive on gleevec status post allo mud bmt in with subsequent complete remission, also with a history of copd and probable cad, being transferred from for further management of above issues. * he presented to on with a 4-day history of fever up to 102 at home, chills and shortness of breath. per records, he denied increased cough, but endorsed increased wheezing, and reported right-sided pleuritic chest pain, mostly posterior. + orthopnea, no pnd, no lower extremity swelling. on the night of admission, he was reportedly found by his wife in the bathtub, confused with possible slurred speech. he was brought by ems to . * at , initial vitals with bp 109/69, hr 133, rr 22, sat 93% on ra, up to 97% on 2l nc. temperature not recorded. labs were remarkable for wbc 17.5 with bands 11%, neutrophils 82%, hct 36, plt 109k. sodium 131, creatinine 2.2. ck 1502, mb 4.12, troponin 0.33. abg 7.44/28/64 on supplemental oxygen. cxr with probable rll pneumonia, and questionable effusion. he was started on ctx and azithromycin iv. while in the ed, he developed svt with hr to 190s, and was given adenosine 6 mg iv x1, and diltiazem iv bolus with subsequent return to nsr in 90s. he was subsequently placed on diltiazem drip 5mg/hour. he later became hypotensive with sbp to 70s systolic, drip was stopped, and he was given ivf boluses. his antibiotic coverage was broadened with vancomycin, levofloxacin and flagyl. his blood pressure responded to the low 100s. a ct head without contrast was also obtained in the ed, initially read as normal but an addendum made note of "acute to subacute left upper anterior corona radiata hypodensity with compression of the left lateral ventricle". he was started on heparin iv, and plan was made to proceed with a head mri, which was deferred pending rule out of a metallic foreign body. in addition to he above, subsequent labs showed drop in platelets to 71 and hematocrit to 26, inr 1.7, cardiac enzymes trending down. he was transferred for further care. past medical history: 1) pre-b-cell type all, ph+: presented w/ fatigue . found to have all 90% cellularity w/ cytogenetics ph +. immunophenotyping + for cd34, hla-dr, cd10, cd19, and dim cd4 consistent with pre-b -cell type all. ecog-e2993 protocol. -phase i : w/ daunorubicin, vincristine, prednisone,l-asparaginase, and then intrathecal methotrexate -phase ii : intrathecal methotrexate, cyclophosphamide, cytarabine and 6- mercaptopurine. -induction: gleevac -: mud allo-bmt, donor cmv +, course c/b grade ii gvhd of skin and gi tract tx w/ solumedrol 2) alcohol abuse 3) left hip synovial cyst 4) bipolar disorder 5) arthritis 6) echo: : ef 60% trivial mr 7) pfts : fvc 74% of predicted, fev1 68% of predicted, fev1/fvc ratio 92%, tlc 98% of predicted 8) hiv neg 9) several stable-appearing, tiny noncalcified pulmonary nodules seen on ct scan , benign appearing 10) emphysema 11) mild sinus mucosal disease on ct scan social history: mr. is married and has 2 sons who live at home with him in and 3 sons with his previous wife. admits to alcoholism and says that he has not had a drink since . he smoked 2-4 packs per day for 36yrs but quit in . he did recently start smoking cigarrettes again. he admits to a remote hx of polysubstance abuse including cocaine, downers, marijuana, and crystal meth but denies ivdu. works in a hardware store in . he used to work in maintenance and was exposed to metal cleaning solvents a few years ago. family history: maternal aunt w/ cancer of unknown type. brother with cardiac dx. physical exam: upon arrival to : vitals: tm 102 at osh, bp 90s/60s, hr 80s, rr 26, sat 93% on 3l nc. gen: in moderate respiratory distress. heent: acessory muscle use. dry mm. neck: jvp 3-4 cm asa. no carotid bruit. resp: right basilar dullness to percussion. bronchial breathing at right base, with egophony, whispered pectoriloquy. diffuse expiratory wheezing. cvs: rrr. normal s1, s2. no murmur appreciated. gi: bs na. abdomen soft, non-tender. no hepatosplenomegaly. ext: without edema, no calf tenderness. neuro: cn intact. strenght 4+- in all extremities, no focal abnormality. sensation to light touch intact. speech intact, good recall. normal cerebellar exam. pertinent results: from in ed : wbc 17.5, bands 11%, hct 36.1%, plt 109, mcv 103. na 131, k 3.8, cl 99, hco3 20.3, bun 30, creat 2.2, glucose 163 ast 65, alt 39, alb 3.5, alp 69, t bili 1.0. * relevant imaging data: cxr in icu: rll opacity with air bronchogram, probable right ll effusion. * ct head without contrast: initially read as normal, then addendum: "fluid densities in both middle ear cavities consistent with low grade om. no mastoiditis. low density area in left anterior upper corona radiata with compression of the anterior left lateral ventricles. no midline shift, no parenchymal hemorrhage. impression: ischemic infarction involving upper anterior left with associated compression of the left lateral ventricle characteristic of acute or possibly subacute event. * cxr 0100: pathy rll airspace disease. addendum with moderate-sized pleural effusion. * cxr 1100: right pleural effusion, appears loculated. airspace disease in rll, most consistent with atelectasis. probable copd. * echo : normal lv/rv size and function. normal atria. trace mr. /as. normal pv. no pericardial effusion. * legionella urinary antigen (final ): presumptive positive for legionella serogroup 1 antigen. * : mri/a head: t2 hyperintensity involving the left frontal white matter suggestive of old infarction. no abnormal enhancing lesions are seen within the brain. t2 hyperintensity within the mastoid sinuses suggestive of mastoiditis of uncertain chronicity. unremarkable circle of . . : echo: compared with the findings of the prior study (images reviewed) of , there is an improvement in lv function brief hospital course: in brief, the patient is a 54 year-old male with aml in remission status post allo-bmt, copd on chronic prednisone therapy, and probable cad, who presented with hypoxemic respiratory failure. . 1) hypoxemic respiratory failure: the patient developed hypoxic respiratory failure thought secondary to severe pneumonia with exacerbation of copd. at he was found to have a rll pneumonia. he was started on ceftriaxone and azitrhomycin for community acquired pneumonia and steroids for copd exacerbation. after he developed hypotension, his antibiotics were broadened to levofloxacin/metronidazole/vancomycin. these antibiotics were continued at the time of transfer to . after the legionella urine antigen resulted positive, his antbiotics were tailored appropriately. following transfer, he did develop respiratory distress and was intubated. his chest xray was concerning for cavitary lesion so sputum culture and afb samples were sent; these were negative. he underwent a bronchoscopy while intubated that revealed normal airways. he was successfully extubated after his agitation on the vent was managed. upon transfer to the bmt unit, his rr was 20 and o2 sat 99% on 50% face mask. he remained afebrile on the bmt floor and his oxygen requirements were steadily reduced. by time of discharge, he had normal oxygenation on room air. his steroids were tapered down and he was discharged on 7.5 mg of prednisone daily. . 2) delta mental status: the patient initially presented with reportedly slurred speech and had a head ct that was intially concerning for an infarct. he was started on heparin drip. an repeat head ct performed following transfer to was concerning for an infectious process and he was treated with vancomycin/zosyn. a follow-up mri revealed no evidence of abscess formation, so the antibiotics for this indication were discontinued. a neurology consult was obtained and thought the brain lesion was more consistent with an old stroke however in the abscence of confirmatory prior imaging this diagnosis could not be proved definitely. the patient was more agitated since extubation/off sedation. this was likely a delirium in the setting of prolonged effects of sedating medications (both from intubation), and infection in the setting of organic brain disease. the patient required 1:1 supervision after extubation. his mental status gradually cleared. by time of discharge he was alert and oriented and able to appropriately discuss his medical care. he was discharged to follow-up with neurology and to have a repeat mri to assess for stability of the brain lesion. . 3) labile blood pressure: following extubation the patient had labile blood pressure. initially he had sbps to the 190s off of sedation. he was treated with prn beta blockers. after transfer, his blood pressure was 90/60 but was asymptomatic from it. the hypotension was thought secondary to adrenal insufficieny however, he underwent -stim test with an post-stim change of ~13 units. he continued on a mild dose of predinsone. there was no evidence of infection and an tte prior to discharge showed notable improvement from the intial study. . 3) acute on chronic rf: on hospital day 2 he developed acute on chronic renal failure and a nongap acidosis so he was started on bicarb ivfs. his baseline creatinine was 1.2-1.6. there was no significant finding in the urine sediment. his creatinine slowly improved, however, his creatinine improvement stalled and upon discharge was 2.5 he received supplemental free water to correct hypernatremia. he will follow-up with nephrology upon discharge and to have his serum chemistries checked at the 7 clinic. . 4) copd: the patient had a long smoking history prior to undergoing bmt. he did resume smoking approximately 2 weeks prior to discharge. he received atrovent and albuterol during this hospital stay along with increased dose of steroids. he was discharged on 7.5 mg of prednisone daily with plans to ultimately resume his home dose of 5 mg daily. . 5) thrombocytopenia: on presentation to his platelet count was >100,000. he was started on heparin for the potential stroke and 13 hours later had a platelet count of 71,000. the heparin was stopped. after transfer, his platelets continued to trend down reaching a nadir of 31,000. hit antibody was negative. anti-platelet agents were held. his platelet count gradually recovered reaching 73,000 prior to discharge. the most likely cause of his thrombocytopenia was a combination on non-immune heparin induced thrombocytopenia and sepsis induced marrow suppression. if his platelet count does not recover appropriately after discharge, a bone marrow biopsy would be considered. * 6) anemia: the patient has a baseline chronic anemia that may be secondary to gleevec. he developed no evidence of acute blood loss except for some trace guaiac positive stools. his hct was supported with occasional transfusions and was stable prior to discharge. * 7) cardiac arrhythmia: the patient developed svt while in . this was broken with diltiazem gtt. he remained in sinus rhymth will on the bmt floor. * 8) all in remission: the patient had no evidence of relapsed all on peripheral blood samples. with concern for the thrombocytopenia that developed in the hospital, a bone marrow biopsy will be considered as an outpatient if his platelets do not recover appropriately. upon discharge he was re-started on the gleevec. * 9) fen: following a successful swallowing evaluation after his mental status cleared his diet was advanced as tolerated. his hypernatremia was managed with free water boluses and his electrolytes were repleted as needed. . 10) ppx: pneumoboots, ppi, bowel regimen prn. pt consult recommended that the patient receive home pt services. . 11)access: piv, picc . 12) code: full. . 13) dispo: discharged to home with home pt services with followup in hematology clinic, neurology clinic, and nephrology clinic. medications on admission: prednisone 5 mg po qod advair 250/50 1 inh spiriva albuterol inhaler prn fluconazole 200 mg po qd gleevec 400 mg po qd klonopin 0.5 mg po qd to discharge medications: 1. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 7 days. disp:*7 tablet(s)* refills:*0* 2. gleevec 400 mg tablet sig: one (1) tablet po once a day. 3. prednisone 2.5 mg tablet sig: three (3) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 4. fluconazole 200 mg tablet sig: one (1) tablet po q24h (every 24 hours). 5. albuterol 90 mcg/actuation aerosol sig: inhalation every 4-6 hours as needed for shortness of breath or wheezing. 6. klonopin 0.5 mg tablet sig: one (1) tablet po once a day. 7. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). discharge disposition: home with service facility: vna discharge diagnosis: primary: legionella pneumonia acute renal failure . secondary: delerium leukemia s/p bone marrow transplant discharge condition: good. ambulating with walker. afebrile. vital signs stable. tolerating oral medications and nutrition. discharge instructions: you have been evaluated and treated for pneumonia, acute renal failure and delerium all of which were improved by time of discharge. . please attend your follow-up appointments as scheduled. you should have the mri before your neurology appointment. . if you experience any concerning symptom particularly fevers to > 100.5f, worsening cough or shortness of breath, please call dr. office at . . please return to the 7 clinic on friday at 10am be seen and to have your blood drawn. . you need to schedule a follow-up appointment in clinic with drs. and please call to be seen within one month. followup instructions: you have the following appointments scheduled for you: 1) hematology/ clinic: with dr. on at 11:30am 2) neurology: with drs. and within one month - see phone number above. 3) mri of brain: please call to confirm 4) nephrology: with dr. on at 4pm 5) 7 clinic: at 10am procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances other bronchoscopy diagnoses: thrombocytopenia, unspecified acute kidney failure, unspecified obstructive chronic bronchitis with (acute) exacerbation chronic kidney disease, unspecified peripheral stem cells replaced by transplant acute respiratory failure hyperosmolality and/or hypernatremia pneumonia due to legionnaires' disease acute lymphoid leukemia, in remission 

Answer: The patient is high likely exposed to