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: weakness major surgical or invasive procedure: bronchoscopy intubation mechanical ventilation history of present illness: mr. is a 46 year-old male with a history of hiv who initially presented to with sob and nonbloody diarrhea and a cd4 count of 19 (pt off haart for 1.5 year). since admission he has been diagnosed with pcp (from bal treated with bactrim and steroid taper), giardia (finished flaygl with no residual diarrhea), ks with pulmonary involvement(treated with paclitaxel and high dose steroids on ), thrush, hsv type ii (lesion on left chin), and cmv pnuemonitis growing from bal, as well as cmv bacteremia (treated with gancyclovir). he also developed recurrent hep b infection and therefore was started on haart therapy despite active pcp . mr. hospital course is also notable for developing bilateral apical pneumothoraces and is s/p chest tube placement by ip. the chest tube has since been pulled and his bilateral pneumothoraces were stable by radiology report. however, also developed pneumomediastinum which was present on then dissappeared on and now present and worse on today's film. he also developed tachypnea and hypoxia and was diagnosed with hospital acquired pna and was started on vanc/zosyn on . finally, his course has also been c/b siadh. . this morning mr. for increasing oxygen requirement. per primary team, the pt has been stable on the floor with o2 sats in the high 80s to low 90s on 5 l nc during this hospitalization. this morning an ngt was placed for nutrition given pt very malnourished and he was noted to be more hypoxic. the ngt was removed and patient continued to have decreasing o2 sats. he was somnolent and transiently not oriented to place. he was placed on venturi mask and nasal canula and his sats remained in the mid to low 80s. he was tachypneic and complained of air hunger. he was pale on exam, with poor air movement but otherwise no rhonchi or rhales. patient was placed on nrb and o2 sas improved to 92%. abg at this time revealed 7.4/32/51. he was then transferred to icu. . in the icu, patient was placed on nc with nonrebreather on hi flow. his o2 sats remained 89-90% despite this and he was tachypneic to mid 30s. he was somnolent but oriented x 3. patient had no other complaints at that time. . past medical history: past medical history: hiv/aids - last cd4 19. has history of thrush and syphilis at the time of his diagnosis in . he was previously on atripla but has been off therapy for 1 1/2 years. no history of pcp . social history: . social history: lives in with an occasional roommate. works in as deputy secretary of state, travels to during week, back home during weekends. he used to smoke cigarettes socially, quit 6 months ago, alcohol 1-2 times a week. former drug user predominantly with crystal meth, including iv. msm, although not currently in a relationship, history of unprotected sex. has lived in and his whole life, traveled across us, europe in , bahamas last year. . family history: family medical history: asthma, grandparents with strokes. father had mi at ages 45 and 50. physical exam: . physical exam on icu admission vs: temp: 97 bp: 101/70 hr:91 rr: 22 o2sat 80% gen: states he is anxious yet appears somnolent, cachectic appearing, pale heent: perrl, eomi, anicteric, mmm, op without lesions, no supraclavicular or cervical lymphadenopathy, no jvd resp: shallow breaths, no rhonchi or rhales cv: rr, s1 and s2 wnl, no m/r/g abd: scaphoid abdomen, nd, +b/s, soft, nt, no masses or hepatosplenomegaly ext: no c/c/e skin: ks on scalp, hsv lesion on left chin neuro: aaox3. cn ii-xii intact. moving all limbs but decreased strength throughout . pertinent results: admission labs: 11:35am blood wbc-3.3* rbc-4.57* hgb-13.6* hct-40.9 mcv-90 mch-29.7 mchc-33.2 rdw-14.2 plt ct-731* 07:20am blood wbc-2.7* rbc-3.76* hgb-11.2* hct-33.1* mcv-88 mch-29.8 mchc-33.8 rdw-14.2 plt ct-562* 11:35am blood pt-13.1 ptt-25.7 inr(pt)-1.1 11:35am blood glucose-130* urean-14 creat-0.6 na-132* k-3.7 cl-98 hco3-23 angap-15 07:20am blood glucose-114* urean-13 creat-0.5 na-132* k-3.5 cl-102 hco3-23 angap-11 07:20am blood alt-29 ast-47* ld(ldh)-506* alkphos-105 totbili-0.1 11:35am blood calcium-8.3* phos-3.3 mg-2.0 04:26pm blood type-art po2-63* pco2-31* ph-7.46* caltco2-23 base xs-0 04:26pm blood o2 sat-91 04:26pm blood freeca-1.11* legionella urinary antigen (final ): negative for legionella serogroup 1 antigen. microsporidia stain (final ): no microsporidium seen. cyclospora stain (final ): no cyclospora seen. fecal culture (final ): no salmonella or shigella found. campylobacter culture (final ): no campylobacter found. ova + parasites (final ): this test does not reliably detect cryptosporidium,cyclospora or microsporidium.. giardia lamblia. cysts and trophozoites. cryptosporidium/giardia (dfa) (final ): no cryptosporidium seen. giardia lamblia seen. clostridium difficile toxin a & b test (final ): feces negative for c.difficile toxin a & b by eia. (reference range-negative). kaposi's sarcoma - skin, right scalp (a): dermal vascular proliferation consistent with kaposi's sarcoma, extending to the specimen margins (see note). ct torso: impression: 1. diffuse ground-glass pulmonary infiltration, favoring the central lungs with a reticular pattern that suggests an acute-on-chronic infection consistent with pneumocystis jiroveci pneumonia. these findings are not characteristic of mycoplasma avium intracellulare infection. 2. wedge-shaped hypodensity within the left kidney. this is most characteristic of a renal infarct; however, differential diagnosis includes focal pyelonephritis and correlation with urinalysis is suggested. 3. no appreciable lymphadenopathy. cxr : findings: as compared to the previous radiograph, the pre-described parenchymal opacities at both lung bases and in the periphery of the left hilus are unchanged in severity and distribution. there is no evidence of pneumothorax. no newly occurred focal parenchymal opacities. normal size of the cardiac silhouette. : findings: there are ill-defined patchy opacities in the lung bases bilaterally, right greater than left. there is no pneumothorax or pleural effusion. the cardiomediastinal silhouette is unremarkable. impression: ill-defined patchy bibasilar opacities, concerning for infectious process. given clinical context, pneumocystis pneumonia not excluded. on icu admission: labs: abg 7.40/32/51 freeca:1.06 lactate:1.7 . 124 95 14 ------------<53 5.2 19 0.4 . ca: 7.1 mg: 1.6 p: 3.4 alt: 56 ap: 241 tbili: 0.2 ast: 108 mcv 88 11.1 1.9>----< 98 31.8 n:92 band:0 l:4 m:4 e:0 bas:0 . . ekg: . imaging: cxr wet read right picc tip in the mid svc. new since tiny right apical ptx and bilateral pneuomediastinum, but these findings similar to cxr. bilateral lung opacities, worse on the left, unchanged since . . cxr impression: ap chest compared to through : there is no pneumothorax since following removal of the right pigtail pleural drain. a very small right pleural effusion is little larger. severe heterogeneous opacification of much of the left lung and right lower lung has progressed over the past three days, consistent with worsening infection, including pneumocystis. heart is not enlarged. pleural effusions are small, if any. no pneumothorax. . cxr impression: portable upright ap chest radiograph compared with multiple prior studies, most recent dated . a right-sided pigtail chest drain is in situ. no appreciable pneumothorax is seen: there is moderate subcutaneous emphysema, improved compared to the prior study. multifocal bilateral mid to lower zone consolidation is increased on the left side compared to the prior study, concerning for infection. . echo the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). there is no ventricular septal defect. 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 leaflets are elongated. mild bileaflet leaflet mitral valve prolapse is suggested. mild (1+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. . ct impression: 1. diffuse ground-glass pulmonary infiltration, favoring the central lungs with a reticular pattern that suggests an acute-on-chronic infection consistent with pneumocystis jiroveci pneumonia. these findings are not characteristic of mycoplasma avium intracellulare infection. 2. wedge-shaped hypodensity within the left kidney. this is most characteristic of a renal infarct; however, differential diagnosis includes focal pyelonephritis and correlation with urinalysis is suggested. 3. no appreciable lymphadenopathy. brief hospital course: mr. was a 46 year-old male with a history of hiv who initially presented to with sob and nonbloody diarrhea and a cd4 count of 19 (pt off haart for 1.5 year). he underwent bal with diagnosis of pjp and cmv pneumonitis which were treated with bactrim and steroid taper and gancyclovir. ks with pulmonary involvement was treated with paclitaxel and high dose steroids. in addition he recieved treatment for giardia, thrush, hsv type ii skin lesion and hospital aquired pneumonia. he also developed recurrent hep b infection and was therefore started on haart therapy. his hospital course was complicated by bilateral apical pneumothoraxes and pneumomediastinum. his pneumothoraxes were treated by chest tube which was removed after bilateral pneumothoraces were stable by radiology report. unfortunately mr. developed increasing oxygen requirement and mental status change which required his transfer to the icu. in the icu he was intubated for hypoxic respiratory failure, mechanically ventilated and a right chest tube was placed to prevent tension pneumothorax in the setting of known pneumothorax and positive pressure ventilation. mr. icu course was complicated by septic shock, renal failure, non resolving right bronchopleural fistula, pancytopenia and ards. our attempts to wean off oxygen and pressors were to no avail. given his multi-organ failure, his profound immune supression and his poor underlying nutritional status it was felt that he no longer had realistic chance of recovery. on hospital day 29 after discussion with his family and hcp and in keeping with their wishes mr. goals of care were changed to focus on comfort measures. he was extubated in the pm and expired shortly thereafter with his mother and sister at his bedside. death was pronounced on 15th febuary at 06:10 pm. the cheif cause of death was acquired immune deficiency syndrome, the immediate cause of death was respiratory failure. medications on admission: medications: home: none - previously on atripla . on transfer to icu: sulfameth/trimethoprim ds 2 tab po/ng tid (day 1 = ) vancomycin 1000 mg iv q 24h (d1 ) piperacillin-tazobactam 2.25 g iv q6h (d1 ) raltegravir 400 mg po bid emtricitabine-tenofovir (truvada) 1 tab po daily ganciclovir 220 mg iv q12h nystatin oral suspension 5 ml po qid:prn thrush azithromycin 1200 mg po/ng qmon () cepacol (menthol) 1 loz po prn cough prednisone 40 mg po/ng daily (started ordered for 4 days) oxycodone (immediate release) 5 mg po/ng q6h:prn pain acetaminophen 325-650 mg po/ng q6h:prn pain, fever ipratropium bromide neb 1 neb ih q4h:prn sob albuterol 0.083% neb soln 1 neb ih q6h:prn sob/wheeze potassium chloride replacement (oncology) iv sliding scale multivitamins 1 tab po/ng daily magnesium sulfate replacement (oncology) potassium phosphate replacement (oncology) iv sliding scale order docusate sodium 100 mg po bid:prn constipation senna 1 tab po/ng :prn constipation guaifenesin ml po/ng q6h:prn cough heparin 5000 unit sc tid order date: @ 1603 32. . allergies: nkda discharge medications: na discharge disposition: expired discharge diagnosis: na discharge condition: na discharge instructions: na followup instructions: na procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus other incision of pleura other incision of pleura closed biopsy of skin and subcutaneous tissue injection or infusion of cancer chemotherapeutic substance diagnoses: pneumonia, organism unspecified hyperpotassemia acute kidney failure, unspecified unspecified septicemia unspecified protein-calorie malnutrition severe sepsis candidiasis of mouth human immunodeficiency virus [hiv] disease acute respiratory failure pneumocystosis septic shock antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use paralytic ileus pressure ulcer, lower back hypoxemia other disorders of neurohypophysis chronic viral hepatitis b without mention of hepatic coma without mention of hepatitis delta cytomegaloviral disease hepatitis, unspecified herpes simplex without mention of complication pneumonia in cytomegalic inclusion disease pressure ulcer, stage iii spontaneous tension pneumothorax interstitial emphysema conjunctivitis, unspecified kaposi's sarcoma, skin kaposi's sarcoma, lung giardiasis 

Answer: The patient is high likely exposed to