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: lithium / klonopin attending: chief complaint: respiratory failure pneumonia lung mass major surgical or invasive procedure: rigid bronch with palliative stenting of l main stem bronchus () bronchoscopy central line placement intubation history of present illness: mr is a 48 yo man c hx of nsclc stage iii a s/p carboplatin and xrt on and s/p lul lobectomy on . postop course complicated by actinic esophagitis (s/p peg tube placemnt and tracheostomy). . pt last ct scan scan c lul small mass suspicious for recurrent ca. pt admitted on to osh for fever, leukocytosis and worsening hypoxia. ct of chest showed new large paratracheal mediastinal mass c small pleural effusion. pt was started on ceftriaxone + levofloxacin. pt had no improvement with worsening fever, hypotension, sepsis, hypoxemia and with deteriorating renal function. he was intubated and started on hemodialysis. atb treatment was switched to vancomycin, meropenem, fluconazole. also started on po vanc for questionable c diff. . mrsa of sputum grew mrsa . blood cx , urine cx (-). tee (-) for ie. tip culture (-) . he was admitted to surgery on . bronchoscopy was done which showed completely occluded l main stem bronchi. pathology confirmed presence of nscll. the initial plan was to take to or for debridement. however, considering pt's poor prognosis it was decided to put a palliative stent. this was done today. per verbal report of ip fellow, there was a erythematous and easy bleeding bronchial mucosa, without significant pus coming from l main stem. pt is trensferred to micu to continue management. . . . past medical history: 1. stage 3 lung cancer as well as a separate stage 1 lesion, status post incomplete round of -taxol and is currently undergoing radiation therapy. 2. interstitial nephritis secondary to lithium toxicity. his chronic renal failure is currently stable. 3. hypertension. 4. history of seizures on clozaril. 5. question of hypothyroidism. 6. head injury in with a loss of consciousness. past psychiatric history: the patient has had multiple past inpatient admissions beginning during his senior year of high school. his last hospitalization was at 4 prior to being transferred to the medical service for hypotension. outside records indicate that prior to that the most recent hospitalization was at the for one and a half months from to of this year. he has one past suicide attempt by wrist cutting in and said that this was because his father died. outside records indicate that he also had a suicide attempt by jumping off a bridge in the remote past (?). he has been on a variety of antipsychotic and mood-stabilizing agents in the past and has had at least two sessions of electroconvulsive therapy. he did extremely well on clozaril between and until it had to be stopped because of seizures. substance abuse history: records indicate that pt has a history of drug abuse including heroin but pt has refused to talk about it further. pt has a tobacco history and reports that prior to admission he smoked one to four cigarettes per day. social history: he has mother and brother who live together with whom he has close contacts. the patient reports that his father died of a amyotrophic lateral sclerosis in . currently he is unemployed. he did complete some college, his closest supports are his family and staff members at his group home. family history: maternal grandfather with alcohol abuse, he denies a family history of mental illness or suicide. family history otherwise non-contrbutory. physical exam: t max 100.4 t c 99.8 hr 117 bp 105/58 rr 20 spo2 100 % abg 7.36/34/152/20 mv ac tv 450 rr 12 peep 5 fi02 30 % i/o 5241/1605 net 4 d -233 gen : intubated , sedated heent: et tube in place, ng tube chest: r subclaviban, r chest c chest tube in place decreased bs on the r cv: rrr no m/g/r abdomennt, nd ext: edematous, r femoral line . pertinent results: 08:17pm wbc-21.3*# rbc-3.17* hgb-10.4* hct-30.7* mcv-97 mch-32.9* mchc-34.0 rdw-17.2* 08:17pm plt count-206 08:17pm pt-13.8* ptt-24.8 inr(pt)-1.2* 08:17pm glucose-87 urea n-60* creat-2.8* sodium-131* potassium-4.0 chloride-95* total co2-25 anion gap-15 08:17pm calcium-10.4* phosphate-5.1*# magnesium-2.1 08:28pm freeca-1.53* 08:28pm lactate-1.5 08:28pm type-art po2-111* pco2-47* ph-7.41 total co2-31* base xs-4 . sputum cx: respiratory culture (final ): oropharyngeal flora absent. stenotrophomonas (xanthomonas) maltophilia. sparse growth. identification and sensitivities performed on culture # 204-4647o . . cxr: there is probably a small right anterior pneumothorax manifested as deepening of the right lateral pleural sulcus, despite right apical pleural drain. there is no pleural effusion. tip of a dual channel right subclavian line projects over the svc. obscuration of the right hilus by a region of likely radiation fibrosis, and distortion of the left hilus and aortopulmonic window with left apical pleural thickening, partially calcified are all chronic findings. leftward mediastinal shift is more pronounced today. et tube is in standard placement and nasogastric tube is coiled in the upper stomach. subsequent assessment of pneumothorax is better achieved with upright radiographs and supine study, likely s1. . ct chest: the patient is status post left upper lobectomy. a dialysis catheter recently placed in an outside hospital is responsibe for the small right pneumothorax which persists despite a right pleural tube. a new, partially enhancing, 7 x 4 cm left paratracheal mediastinal mass with central hypodensity is likely necrotic tumor (unless the patient has had recent mediastinoscopy or transbronchial procedure, in which case some components could be hemorrhage; it has too much internal tissue structure for an abscess). the mass obliterate fat planes around the aortic arch, left lateral trachea and right main pulmonary artery and subsumes previously enlarged paratracheal nodes as it extends along the left side of the trachea from the undersurface of the arch of the aorta to the superior margin of the left main bronchus which is markedly irregular, more likely due to invasion by the mediastinal mass than retained secretions. the left upper lobe brochial stump is clear. in addiation to change around the left hilum there is new soft tissue opacity around the left lower lobe and subsegmental bronchi which could be the remnants of pneumonia or tumor recurrence in the lung. bronchocentric nodules in both lower lobes may represent infection or aspiration. a small left pleural effusion, with attenuation value of 27hu is likely an exudate. peribronchial thickening is noted along the right upper lobe bronchus may also have been radiation-induced. there is no right hilar adenopathy. diffuse esophageal wall thickening could be secondary to esophagitis, but adjacent to the mass infiltration by tumor is also very likely. in the imaged upper abdomen, the liver, spleen and adrenals are unremarkable. hypodense cysts are noted in both kidneys and the right kidney though incompletely imaged appears atrophic. there are no bone findings suspicious for malignancy. impression: 1. new, large necrotic mediastinal mass, neoplasm unless proved otherwise. 2. new peribronchial soft tissue, left hilus, either local tumor recurrence or pneumonia. 3. bronchocentric nodules in the lower lobes could be secondary to aspiration and/or infection. 4. right pneumothorax with chest tube in place. 5. esophageal wall thickening, suspicious for tumor invasion, and possible diffuse esophagitis. . : left mainstem tumor, biopsy: invasive squamous cell carcinoma, moderately differentiated. cxr: single portable chest radiograph demonstrates an endotracheal tube with its tip at the clavicular heads, changed in position when compared to . the patient is again seen to be status post left upper lobe resection. left main stem bronchus stent is similar in appearance. right-sided chest tube is unchanged. probable small right apical pneumothorax persist. prominence of the right hila is again unchanged. there is a nasogastric tube, which is coiled in the stomach. impression: interval advance of endotracheal tube with its tip now at the clavicular heads. status post left upper lobe resection with residual left-sided hydropneumothorax, unchanged. right-sided chest tube and tiny right apical pneumothorax, unchanged. . cxr: history: stent repositioning. single portable chest radiograph demonstrates interval expansion of the previously identified left main stem bronchus stent. there is persistent opacification of the left hemithorax. patient is again noted to be status post left upper lobe lobectomy. shift of the trachea from the midline to the left remains similar in appearance. right hilar contour is unchanged. right lung is clear. endotracheal tube is noted with its tip at the clavicular heads. nasogastric tube is present with its tip in the stomach. right-sided chest tube is unchanged. there is persistent small right-sided pneumothorax. right subclavian central venous catheter is again seen with its tip in the svc. impression: interval reexpansion of left main stem bronchus stent. otherwise, no significant interval change. brief hospital course: the patient was intially admitted to thoracic surgery for surgical resection of recurrent cancer obstructing the left main stem bronchus. however, given his poor prognosis, a palliative stent was placed by interventional pulmonary. the patient was continued on vancomycin (until to finish 14 days course) and zosyn for post-obstructive pneumonia that was started at outside hospital. per infectious disease recommendations, bactrim was also started for stenotrophomonas grown from sputum culture, and zosyn was disconinued on . the pneumothorax which developed at the osh central venous access attempt was managed with a chest tube and avoidance of peep on the ventilator. . after the palliative stent placement, the patient was weaned off ventilator and extubated on , however, on the following night, the patient developed respiratory distress, was tachypneic at 40-50s, and was reintubated. cxr at that time showed worsened collapse of the left lower lobe from the obstruction, and the patient was empirically restarted on zosyn to for post-obstructive pneumonia and the stent was repositioned on . on , a family meeting was held regarding his poor prognosis from his obstructive lung cancer, and family decided to make the patient dnr/dni and switch the goals of care to comfort. subsequently after this decision, all aggressive measures were discontinued and the patient was placed on morphine for comfort. the patient expired on approximately at 04:09 am. medications on admission: zosyn 2.25 q 12 vanc per levels cipro 400 iv qd lt4 25 mcg qd metoprolol 5 iv qd asa 325 phenytoin 100 iv q 8 valproic acid 750 albuterol nebs propofol drip procrit 8000 tid dilaudid 0.5 -2 mg q 4 h prn discharge medications: none discharge disposition: expired discharge diagnosis: repiratory failure post-obstructive pneumonia left main bronchus obstruction from lung cancer non-small cell lung carcinoma acute renal failure discharge condition: expired discharge instructions: none followup instructions: none procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube fiber-optic bronchoscopy other intubation of respiratory tract laryngoscopy and other tracheoscopy closed [endoscopic] biopsy of bronchus other operations on trachea other operations on trachea bronchial dilation local excision or destruction of lesion or tissue of trachea replacement of laryngeal or tracheal stent diagnoses: pneumonia, organism unspecified acute kidney failure, unspecified unspecified acquired hypothyroidism other convulsions unspecified schizophrenia, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure pneumonitis due to inhalation of food or vomitus mechanical complication due to other implant and internal device, not elsewhere classified malignant neoplasm of other parts of bronchus or lung accidents occurring in residential institution other psychotropic agents causing adverse effects in therapeutic use nephritis and nephropathy, not specified as acute or chronic, with unspecified pathological lesion in kidney opioid type dependence, in remission 

Answer: The patient is high likely exposed to