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: patient recorded as having no known allergies to drugs attending: chief complaint: shortness of breath major surgical or invasive procedure: none history of present illness: mr. is a 65 yo cantonese-speaking man w/hx of stage iv nsclc dx who presented to the ed with acute onset sob yesterday with exertion. he was found to have right mainste pe with extension into apical rul, rml, and rll segemnt. a head ct was performed which showed stable brain mets. he was started on heparin. on the omed service, he was transitioned to lovenox. on admission, his hr was 110s-120s in sinus. . patient triggered on the floor for tachycardia to 150s at 9 pm on the evening of his admission with a stable blood pressure. he also had an increasing oxgyen requiring ment from 91% on ra on admission to 92% on 4lnc and ultimately to a nrb. his hr remained stable between 92 - 146/69-103. he given 1l ns and his respiratory status worsened. he was tachypneic to the 30s and unable to speak in full sentences. he denies chest pain, chest pressure, fevers, chills, cough. past medical history: past oncologic history (per medical record): - presented with sob and was found to have stage iv lung cancer with mets to the spine, sternum, ribs and basal ganglia, with pathologic fractures of t2 and t5 and malignant effusion on teh left. the primary lesion is in the left lung apex with invasion into the anterior chest wall. - thoracentesis showed adenocarcinoma with ck7 and ttf-1 positive, consistent with nsclc. bronchial biopsy confirmed this diagnosis. egfr testing reported l858r mutation in exon 21 on by . - received wbxrt and xrt of c7-t6 spine, completed . other past medical history: none social history: home: lives with wife; immigrated from 18 years ago occupation: previously worked in markets etoh: denies drugs: denies tobacco: ppd x 20 years family history: father - died of lung cancer mother - died of liver cancer physical exam: gen: elderly male, in respiratory distress, tachypneic, unable to speak in full sentences vs: afebrile, hr 140s a. fib, bp 130 cv: tachycardic, irregular rate, no murmurs, rubs, gallops pulm: increased work of breath, accessory muscle use, crackles at bases bilaterally, abd: soft, non-tender, non-distended limbs: no edema skin: no rash pertinent results: abg 7.44/24/93/19 . .. \ 12.1 / 7.7 ------ 144 .. / 36.0 \ . 125 | 95 | 12 / -------------- 104 4.5 | 16 | 0.6 \ . ca 8.3 mg 1.7 phos 3.9 . imaging: cta (prelim read): r main pe with extsn into apical rul, rml, and rll segments . head ct (prelim): no ich . cxr. . interval development of pulmonary edema with increased left pleural effusion. lower extremity ultrasound : impression: no evidence of dvt in the bilateral lower extremities. cxr : increasing parenchymal opacity is seen at the right lung diffusely, particularly in the upper lobe as well as in the left lower and mid lung zones. the pattern is most consistent with a combination of alveolar and interstitial disease. there is a left-sided pleural effusion that appears similarly to the prior study. the heart size is not changed substantially since the prior study and there is no ptx. impression: worsening airspace disease nonspecific - pneumonia, chf or ards should be considered. cxr : findings: in comparison with the study of , the monitoring and support devices remain in place. diffuse bilateral pulmonary opacifications have somewhat decreased, especially in the upper zones. these are superimposed upon known pulmonary metastases. 04:26am blood wbc-7.3 rbc-3.54* hgb-10.2* hct-31.3* mcv-88 mch-28.8 mchc-32.6 rdw-17.0* plt ct-129* 04:26am blood neuts-56 bands-26* lymphs-3* monos-1* eos-0 baso-0 atyps-1* metas-8* myelos-5* nrbc-1* 04:26am blood hypochr-1+ anisocy-1+ poiklo-1+ macrocy-normal microcy-1+ polychr-1+ ovalocy-1+ schisto-1+ burr-1+ stipple-occasional 04:26am blood pt-18.5* ptt-87.1* inr(pt)-1.7* 05:00pm blood glucose-240* urean-22* creat-1.8*# na-131* k-4.0 cl-98 hco3-18* angap-19 04:26am blood glucose-194* urean-26* creat-2.6* na-126* k-4.3 cl-92* hco3-19* angap-19 02:41pm blood glucose-85 urean-30* creat-3.0* na-127* k-4.8 cl-92* hco3-18* angap-22* 04:26am blood alt-1594* ast-2651* alkphos-268* amylase-86 totbili-0.9 02:41pm blood calcium-6.4* phos-5.5* mg-1.3* 04:26am blood cortsol-31.5* 04:26am blood digoxin-1.4 11:14am blood type- rates-34/0 tidal v-420 peep-12 fio2-90 po2-46* pco2-52* ph-7.21* caltco2-22 base xs--7 aado2-557 req o2-90 -assist/con intubat-intubated 12:03pm blood type-art temp-38.1 rates-34/0 tidal v-420 peep-12 fio2-90 po2-141* pco2-42 ph-7.24* caltco2-19* base xs--8 aado2-472 req o2-79 intubat-intubated vent-controlled 03:00pm blood type-art rates-34/ tidal v-380 peep-12 fio2-100 po2-137* pco2-44 ph-7.24* caltco2-20* base xs--8 aado2-535 req o2-89 -assist/con intubat-intubated 05:52am blood lactate-1.9 05:53am blood lactate-1.6 01:19pm blood lactate-5.2* 03:00pm blood lactate-7.0* 09:07pm urine hours-random creat-43 na-65 09:07pm urine osmolal-508 4:06 am sputum source: endotracheal. gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 3+ (5-10 per 1000x field): gram positive rod(s). 1+ (<1 per 1000x field): gram positive cocci. in pairs and clusters. 1+ (<1 per 1000x field): gram negative rod(s). 1+ (<1 per 1000x field): gram positive cocci. in pairs and chains. respiratory culture (preliminary): results pending. brief hospital course: mr. is a 65 yo m w/hx of stage iv nsclc admitted with large right mainstem bronchus pe complicated by new onset atrial fibrillation with rvr and respiratory distress. 1. respiratory distress/ards. patient is known to have large pe and was anticoagulated with lovenox. on arrival to the icu, patient was in a. fib with rvr to 150s. cxr demonstrated pulmonary edema likely secondary to fluids and rapid ventricular rate. abg demonstrated respiratory alkalosis and hypoxia with pao2 of 93 on nrb. additionally, mr. was noted on chest ct to have worsening interstitial disease secondary to malignancy progression. he was initially diuresed with lasix, rate controlled with diltiazem and treated with bipap, his status worsened and he required intubation. subsequent cxrs were consistent with ards. ventilator setting were titrated to ardsnet protocol low tidal volume ventilation. he had significant dyssynchrony, and was subsequently paralyzed. his hypoxia and acidemia gradually improved. 2. tachycardia. the patient initially in atrial fibrillation with rvr and was started on a diltiazem drip with resolution of his rvr. it was thought that his new onset atrial fibrillation was likely secondary to respiratory distress from known pulmonary processes. he was switched to po digoxin and converted to sinus rhythm. as his respiratory status deteriorated, he intermittently converted back to atrial fibrillation with rates in the 150s. this improved once he was mechanically ventilated 3. pulmonary embolism. patient presented with large right pulmonary artery pe. he was started on anticoagulation with enoxaparin. bilateral le ultrasounds were performed, to see if patient warranted consideration of ivc filter placement, but were negative for dvt. an tte was done on to check for heart strain and revealed: mild symmetric left ventricular hypertrophy lvef: >55%. trivial mr, trace aortic regurg, and mild pulmonary artery systolic hypertension. no pericardial effusion. he was switched from enoxaparin to weight based iv heparin drip. 4. septic shock. once intubated, patient developed hypotension with bp 80/60. he was bolused ns iv initially with a good response. over the course of the following 24 hours, he required pressor support, initially with phenylephrine, then with additionally vasopressin, and norepinephrine titrated to a map of 60. mixed venous oxygen saturation was high, consistent with sepsis. he was started empirically on vancomycin, cefepime and levofloxacin. ivf boluses were continued. once a map of 60 could not be maintained with maximal doses of 3 pressors, dopamine was added. the patient subsequently converted to atrial fibrillation with rvr with rates into the 150s and dopamine was stopped. his rhythm returned to sinus and his rate decreased to 110. 4. nsclc. patient nsclc with primary left apical lesion and mets to the spine, sternum, ribs and basal ganglia. patient was treated for pain with long acting morphine. 5. goals of care. on admission patient was full code. as his clinical status deteriorated with ards and septic shock, a goals of care discussion was had with the family and social work. given his persistent hypotension and respiratory failure, it was considered highly unlikely that the patient would survive this hospitalization with maximal medical treatment, and nearly impossible that he could return to his prior level of functionality if he did survive. per discussion with family, he was initially made dnr, and subsequently made comfort measures only. he was extubated, and treatment was directed toward patient comfort. patient expired at 12:30 am on . medications on admission: home medications (from bottles brought in from family): morphine 15mg po 1 tab po q4h prn pain ms contin 15mg po bid omeprazole 40mg po qday acetaminophen prn coalce 100mg po daily vitamin d 50,000units po weekly dexamethasone 2mg "as directed" fluconazole 150mg daily for 2 weeks starting . transfer meds: furosemide 20 mg iv once diltiazem 5-15 mg/hr iv infusion hr < 120 omeprazole 40 mg po daily morphine sulfate ir 15 mg po/ng q4h:prn pain senna 1 tab po/ng :prn constipation docusate sodium 100 mg po bid morphine sr (ms contin) 15 mg po q12h enoxaparin sodium 60 mg sc q12h discharge disposition: expired discharge diagnosis: acute respiratory distress syndrome septic shock pulmonary embolism discharge condition: expired discharge instructions: expired followup instructions: expired procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube diagnoses: tobacco use disorder unspecified septicemia severe sepsis atrial fibrillation acute respiratory failure secondary malignant neoplasm of brain and spinal cord septic shock malignant neoplasm of other parts of bronchus or lung other disorders of neurohypophysis other pulmonary embolism and infarction secondary malignant neoplasm of bone and bone marrow pathologic fracture of vertebrae malignant pleural effusion 

Answer: The patient is high likely exposed to