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: shortness of breath major surgical or invasive procedure: intubation, tracheostomy history of present illness: 77 yo m with history of copd, small cell lung cancer (14 years ago) and adenocarcinoma of the lung resected in with no evidence of recurrence who presents with 2-3 days of cough and sob. he developed worsening cough productive of yellow and white sputum 2-3 days prior to admission with shortness of breath. he reports chest pain only when coughing and his cough has been chronic for "years". no fevers or chills at home, no increased leg edema, orthopnea, wheezing or palpitations. he does report poor appetite and weight loss over the past few days. no recent travel or immobilization, no sick contacts. his lung cancer has shown no signs of symptoms of recurrence as of . he called ems and found to be 85% on ra this morning. . vitals at presentation to the ed were: t 98.4, hr 124, bp 134/68, rr 19, o2sat 91% 4l nc. patient had cxr showing diffuse opacities and mild pulmonary edema. he received ceftriaxone and levofloxacin for presumed cap. he additionally received albuterol and ipratropium and 2l ns. labs were significant for a bicarb of 19, wbc of 11.7, and a lactate of 2.3. vitals prior to transfer to the floor were: t afebrile, hr 119, bp 125/80, rr 24, 94% on nrb. . upon arrival to the floor, patient was on a non-rebreather, alert and oriented, speaking in full sentences and not in respiratory distress. he denied chest pain or pressure. past medical history: copd (mild obstructive defect on last pfts) small cell lung cancer (14 years ago) adenocarcinoma of the lung resected in hl gerd social history: lives at home with his wife, former (40 pack-years, quit after lung ca diagnosis 14 years ago). occasional etoh use, no drug use. family history: non-contributory physical exam: vs: t 98.4, bp 111/61, hr 120, rr 18 97% on nrb gen: well-appearing elderly male in nad, sitting up in bed, alert and oriented, speaking in full sentences and in no respiratory distress on non-rebreather heent: eomi, perrla, no scleral icterus, dry oral mucosa neck: no elevated jvp, no cervical lad, supple pulm: diminished breath sounds b/l, clear to auscultation with no rales or wheezes card: tachycardic, nl s1/s2, no m/r/g abd: soft, nt/nd, bs+ ext: no edema, 1+ dp on lle, 2+ pd on rle, 1+ pts b/l skin: 1cm flesh colored nodule on l cheek neuro: awake, alert, oriented x3, 5/5 strength in ue, 4+/5 in le b/l pertinent results: admission: 07:25pm plt count-245 07:25pm neuts-93.0* lymphs-3.5* monos-2.6 eos-0.4 basos-0.5 07:25pm wbc-11.7* rbc-4.38* hgb-13.4* hct-40.3 mcv-92 mch-30.5 mchc-33.1 rdw-13.2 07:25pm albumin-3.8 07:25pm ck-mb-3 ctropnt-0.01 probnp-551 07:25pm lipase-30 07:25pm alt(sgpt)-16 ast(sgot)-26 ck(cpk)-55 alk phos-84 tot bili-0.5 07:25pm estgfr-using this 07:25pm glucose-164* urea n-28* creat-1.1 sodium-137 potassium-3.5 chloride-102 total co2-19* anion gap-20 07:57pm glucose-156* lactate-2.3* na+-138 k+-3.6 cl--102 tco2-20* 09:10pm pt-10.7 ptt-20.3* inr(pt)-0.9 . discharge: 04:15 9.1 > 8.7* / 25.8* < 386 inr 1.2* 139 | 104 | 26 < 132 3.6 | 29 | 0.8 ca 8.4 mag 2.5* phos 2.1 . micro: 7:25 pm blood culture #1. blood culture, routine (preliminary): staphylococcus, coagulase negative. of two colonial morphologies. isolated from only one set in the previous five days. sensitivities performed on request.. aerobic bottle gram stain (final ): reported to and read back by 12:30pm. gram positive cocci in clusters. anaerobic bottle gram stain (final ): gram positive cocci in pairs and clusters. . direct influenza a antigen test (final ): negative for influenza a. direct influenza b antigen test (final ): negative for influenza b. . legionella urinary antigen (final ): negative for legionella serogroup 1 antigen. . mrsa screen (final ): no mrsa isolated. . imaging: cxr portable ap upright chest radiograph obtained. there is marked emphysema with stable areas of scarring along the medial aspect of the right lung with suture material projecting over the right upper lobe. subtle nodular opacities in the lower lungs bilaterally are concerning for early pneumonia. no pleural effusion or pneumothorax is seen. cardiomediastinal silhouette appears grossly stable. the imaged osseous structures appear intact. impression: marked emphysema, stable scarring in the right lung, subtle nodular opacities in the lower lungs concerning for early pneumonia. . cxr comparison is made to previous study from . there is increased density at the right base, which is new since the previous study and suggestive of right lower lobe collapse. volume loss in the right side is also seen. there are streaky densities within the apices projecting from the mediastinum suggestive of scarring. cardiac silhouette and mediastinum are within normal limits. there are again seen some streaky densities at the left base, which may represent atelectasis or early infiltrate. impression: 1. likely right lower lobe collapse with increased density and volume loss at the right base. 2. scarring within the upper lobes bilaterally. . cxr as compared to the previous radiograph, there is a slight increase in extent of the pre-existing right and left pleural effusions. the effusion on the left is confined to the lung bases, on the right, the effusion occupies approximately one-quarter to one-third of the right hemithorax. subsequent areas of bilateral atelectasis. known right and left paramediastinal fibrosis. no newly appeared lung parenchymal changes. no evidence of pneumothorax. . cxr as compared to the previous radiograph, a pre-existing opacity at the left lung base is visually minimally more apparent. although this could be due to technical factors, aspiration cannot be excluded. the pre-existing pleural effusions are unchanged in extent. . cxr as compared to the previous radiograph, the patient has been intubated. the tip of the endotracheal tube projects 5 cm above the carina. the patient has also received a nasogastric tube, and the course of the tube is unremarkable, the tip of the tube is not visualized on the image. the pre-existing right pleural effusion has substantially decreased in extent. the small effusion on the left and the opacity at the left lung bases are unchanged. no evidence of complications, notably no pneumothorax. . echo (tte) the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal. there is moderate to severe regional left ventricular systolic dysfunction with akinesis of the mid- and distal anterior wall, septum and apex. the remaining segments contract normally (lvef = 30%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened (?#). there is no aortic valve stenosis. mild (1+) aortic regurgitation is seen. mild (1+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: moderate to severe regional left ventricular systolic dysfunction, c/w lad-territory infarction or takotsubo cardiomyopathy. mild aortic and mitral regurgitation. moderate pulmonary hypertension. compared with the report of the prior study (images unavailable for review) of , regional lv systolic dysfunction appears new. brief hospital course: 77 yo with h/o copd, small cell lung cancer (14 years ago) and adenocarcinoma of the lung admitted with pneumonia. #) respiratory distress: he completed an 8-day course of vanc and zosyn for hcap and concern for aspiration given evaluation by speech therapy. he was transferred to the micu on and intubated on arrival. a large mucous plug was removed by bronchoscpy. he was extubated and then reintubated on . trach and peg completed on . he has been tolerating trach mask for intervals spanning several hours at a time and resting on pressure support. when dyspneic, he improves with suction. #) bacteremia: ed blood cx with cons in bottles which was felt to be contiaminant. did complete a course of vanc/zosyn for hcap. #) troponin elevation patient monitored with serial cardiac enzymes upon admission. troponins were trending up. ecg with initial st depressions, then new twi in v1-v4. he remained asymptomatic throughout. possibly demand ischemia from infection and prolonged tachycardia but concerning given focal ecg changes. he was started on a heparin drip, high-dose atorvastatin, aspirin, and metoprolol. cardiac enzymes were followed and initially appeared to have peaked but trended up on hospital day #4. a cardiology consult was called and did not feel was acs. we continued high dose atorvastatin, but outpatient providers should consider lowering to home dose after one month from troponin rise (). he was also continued on a full dose aspirin and a low dose-beta blocker. #) tachycardia: hr in the 120s on admission with st depressions in v3-v6, which may be rate related and resolved on f/u ecg. patient does report a history of sinus tachycardia (pcp visits with hr 100s-120s over past 5 years) for which he does not take rate controlling agents. tachycardia improved with fluids and a low dose beta blocker was initiated as above. #) hypotension patient mentates and has good urine output even with systolic blood pressure in the 80s. #) copd: fev1 72% in with mild obstructive defect. not on home oxygen and uses combivent prn. ct chest in with significant structural evidence of emphysema and chronic bronchitis. the patient was given standing nebulizer treatments of his copd. #) lung cancer follows with dr. for small cell lung cancer in s/p r paratracheal mass resection tx with xrt and chemo, and adenocarcinoma of the lung rul wedge resected in with no evidence of recurrence on most recent ct chest in . #) transition of care - needs tsh as outpatient when acute illness has resolved - needs outpatient stress test - decrease atorvastatin medications on admission: combivent 18mcg-103 mcg (90 mcg) 2 puffs prn lovastatin 20mg daily asa 81mg daily mvi with iron discharge medications: 1. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 2. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 3. heparin (porcine) 5,000 unit/ml solution : 5000 (5000) units injection tid (3 times a day). 4. acetaminophen 650 mg/20.3 ml solution : six y (650) mg po q6h (every 6 hours) as needed for fever. 5. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler : 2-4 puffs inhalation q4h (every 4 hours) as needed for wheezing. 6. ipratropium bromide 17 mcg/actuation hfa aerosol inhaler : 4-6 puffs inhalation q4h (every 4 hours) as needed for sob. 7. atorvastatin 80 mg tablet : one (1) tablet po at bedtime. 8. aspirin 325 mg tablet : one (1) tablet po daily (daily). 9. insulin lispro 100 unit/ml solution : sliding scale subcutaneous asdir (as directed). 10. metoprolol tartrate 25 mg tablet : 0.5 tablet po bid (2 times a day). 11. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr po bid (2 times a day). 12. heparin, porcine (pf) 10 unit/ml syringe : five (5) ml intravenous prn (as needed) as needed for line flush. discharge disposition: extended care facility: - - discharge diagnosis: principal: pneumonia, chronic obstructive pulmonary disease secondary: coronarty artery disease discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: bedbound. discharge instructions: you were admitted with pneumonia and due to your copd, you required a breathing tube and then a tracheostomy. followup instructions: please schedule with pcp when discharged. department: dermatology when: monday at 1:15 pm with: , md building: sc clinical ctr campus: east best parking: garage procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances thoracentesis percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy closed [endoscopic] biopsy of bronchus removal of intraluminal foreign body from trachea and bronchus without incision diagnoses: pneumonia, organism unspecified anemia, unspecified unspecified pleural effusion congestive heart failure, unspecified personal history of malignant neoplasm of bronchus and lung obstructive chronic bronchitis with (acute) exacerbation other and unspecified hyperlipidemia acute respiratory failure other specified cardiac dysrhythmias nonspecific abnormal findings in stool contents acute systolic heart failure other acute and subacute forms of ischemic heart disease, other inhalation and ingestion of other object causing obstruction of respiratory tract or suffocation foreign body in other specified parts bronchus and lung 

Answer: The patient is high likely exposed to