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: horse blood extract attending: chief complaint: sob major surgical or invasive procedure: none history of present illness: 80 yo m with pmh significant for esrd on hd, cad s/p cabg x 3 copd.patient discharged 2 weeks ago from after he had a l subclavian stent placed. he presented to ed today from where he c/o of cough , sob weakness, fatigue and low grade fever x 1 week. he was diagnosed with influenza a 1 week ago. . in ed he was found to be very tachypneic rr 35 % and spo2 100% on a nrb mask. cxr with hyperinflated lung and interstitial infiltrates. patient had a cta of chest to rule out pe after which ,while he was back in the ed, he developed an episode of svt. patient's bp remained stable. vbgs : 7.09/89/95/26 .he was given 1 lt ns, levaquin , flagyl ,lasix 80 mg , solumedrol 125 mg and bronchodilators. he was intubated and transferred to micu. renal was consulted for emergent hemodyalisis. they considered there was no indication due to patient's abnormal heart rhythm. cardiology -was consulted , no indication for revascularization. recommended treating respiratory acidosis. past medical history: esrd htn nephrosclerosis on hd cad s/p cabg x 3 in pvd s/p mult revasculazations in and . chf (ef 50%) hypercholesterolemia carotid artery stenosis s/p l cea copd h/o prostate ca on lupron (psa undetectable) restless leg syndrome depression legally blind macular degeneration r inguinal hernia social history: he is a former smoker one-half pack per day for 30 years quit 22 years ago. he has former alcohol abuse, quit in . he is a former elementary and high school teacher. denies etoh.retired middle school teacher.functional status . he uses a rolling walker at baseline. family history: mom dm father prostate ca sister breast ca physical exam: t 98.5 (102.5 ax in ed) bp 105/56 hr 72 ac tv 500 rr 20 peep 5 fio2 0.6 abgs 7.27/45/186/22 gen - elderly, chronically ill, pale appearing male in nad, skin - diffuse ecchymosis in abdomen and forearms heent - tube @ 23 cm sclerae anicteric, slightly dry mm, op clear, lad, neck ,supple cv - rrr, +s1/s2, ii/vi systolic murmur over lsb and apex lungs - limited by poor inspiratory effort, decreased bs b/l, bilateral wheezing abd - soft, nt, slightly distended, normoactive bs ext - no le edema, dp pulses not appreciated but feet warm to touch, has r forearm fistula neuro - not tested, sedated. pertinent results: ekgs : -upon arrival : sinus rhythm, rbbb. -during episode of svt: left axis deviation, wide complex tachycardia, small p waves in dii -post svt : rbbb . -cxr: hyperinflated lungs , bilateral interstitial infiltrates. cta chest: . impression: 1. no evidence of pulmonary embolism. 2. new nodular opacities in the right lower lobe and right upper lobe with resolution of the left upper lobe opacity previously seen. the rapidity of these changes are more suggestive of an infectious or inflammatory process. however, continued followup to ensure resolution is recommended. 3. increased density and reticulated appearance to the vertebral bodies, likely related to renal osteodystrophy. 4. cardiomegaly and coronary artery disease and more diffuse atherosclerosis brief hospital course: #respiratory failure: most likely respiratory failure is pneumonia in the setting of a patient with a very poor lung function, as determined by previous pfts and current cxr. additional v/q mismatch is likely related to a pna considering he has fever, cough , secretions and a 2 opacities in rml and rll ,c/w multifocal pna. was extubated soon after intubation and has been weaning off of o2. -s/p course of azithro for possible legionella (legionella ag negative) and continuing on zosyn for gn's and vanco for gm positives (and enterococcus in urine). . #respiratory acidosis: patient's abgs c/w acute respiratory acidosis, probably related to copd with probably with ?hypoventilation?, muscular fatigue due to hypoxemia? phs improved after patient intubated and then remained fine after extubation. . #pna: patient has fever, elevated wbc, infiltrate on ct. etiology unclear. -sputum studies, urine legionella ag negative. dfa for influenza a and b negative. -covering with zosyn (to cover pseudomonas considering patient has bronchieactasis on ct and comes from rehab), zithromax for legionella x 5 days (completed ). vanco considering he has hx of influenza infection, could have staph pna. -blood cultures neg --remained afebrile through . white count elevated but otherwise no significant signs of infection, most likely due to steroids. white count stabilized at discharge, minimal o2 requirement. . #copd: patient has histoty of severe copd. was initially given solumedrol 80 tid which is being tapered. switched to prednisone and tapered to zero at discharge. -continue nebs -taper steroids quickly . #svt: patient had episode of svt in ed. ekg in micu has remained within nsr. per cardiology, no signs of ischemia. -continue following ekg. -added metoprolol . #cp pt c/o one episode of cp on am with some rate related st changes, relieved with bb, morphine and slntg, enzymes negative x 3. no recurrence. . #borderline bp: patients bp has remained systolic 105- 110s unclear baseline. bp prior to intubation with systolic near 130-150s. lactate elevated on admission. most likely related to hypoperfusion -initially held bp meds - now restarting with strict holding parameters. . #cad: - patient on asa, plavix, statin. bb added back and going back up to home dose slowly. - troponins were flat. . #esrd: pt makes very little urine. hd scheduled for mon, wed, fri. -continue phoslo and give epo during dyalisis -follow vanc levels in dialysis. . #lung nodule: seems to have improved per new ct. -follow up after pna has resolved. . #coagulopathy: patient has elevated ptt and pt. d dimer elevated but no evidence of dic. . #code status: discussed with wife extensively who states pt is definitely dnr/dni now even though this had been reversed for the intubation earlier on this admission. wife is hcp and states pt has been declining lately and they are prepared if he declines further to make him cmo. medications on admission: plavix 75 mg qd asa 325 mg qd metoprolol 37.5 mg tid ntg 0.3 mg sl prn lipitor 40 mg qd fluticasone 50 mcg qd albuterol nebulizer q 6 h combivent inhaler ipatropium inhaler citalopram 40 mg qd tamsulosin/flomax 0.4 qd stool softeners discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 5. calcium acetate 667 mg capsule sig: two (2) capsule po tid (3 times a day). 6. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 7. albuterol sulfate 0.083 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). discharge disposition: extended care facility: - discharge diagnosis: pneumonia discharge condition: good discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet. wigh yourself. you were treated in the hospital for pneumonia which resolved. you are to return to the rehab facility and resume all your other medications. follow all instructions. return to the hospital for any chest pain or shortness of breath. followup instructions: follow up with your doctor in the next two weeks. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis diagnoses: pneumonia, organism unspecified acidosis end stage renal disease coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified aortocoronary bypass status peripheral vascular disease, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure 

Answer: The patient is high likely exposed to