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: history of present illness: the patient is a 47-year-old female with human immunodeficiency virus with a cd4 nadir of 150 and a cd4 count of 443 and a viral load of less than 50 in , as well as history of intravenous drug use, chronic obstructive pulmonary disease and bipolar disorder who presented on to an outside hospital with several weeks of cough, was treated for primary care physician without response and transferred to for further evaluation and treatment. the patient had presented with several weeks of increased cough, green sputum, low grade fever, low back pain, weakness, bilateral hand swelling and non bloody diarrhea. the patient had bilateral crackles on exam at the outside hospital with a white blood cell count of 10.5. the patient was treated for pneumocystis carinii pneumonia, despite having a cd4 count greater than 200 and being on bactrim prophylaxis. the patient's course was complicated by acute renal failure, thought to be secondary to a combination of ace inhibitor and nsaids. the patient was treated with bactrim, prednisone, intravenous fluids and levaquin. a ct scan was done at the outside hospital which revealed severe diffuse bilateral fibrosis with honeycombing, no lymphadenopathy and no effusion. echocardiogram was performed which revealed ejection fraction of 45% to 50%, concentric left ventricular hypertrophy by atrial enlargement and pulmonary artery pressures in the 50s. cocaine was positive on the admission toxicology screen. the patient was bronchoscoped in early at the outside hospital revealing rare white blood cells and rare gram positive cocci with negative stains for fungi acid fast bacteria and pcp. was concern for cocaine associated boop. the patient also ruled in for a non q-wave myocardial infarction. her course was complicated by atrial fibrillation with rapid ventricular response. over the course of the few days prior to transfer, the patient developed increasing o2 requirement and was intubated. she was finally transferred to . past medical history: 1. human immunodeficiency virus complicated by cryptococcal meningitis, spinal abscess, thrush, esophagitis. the patient had most recent labs in with a viral load of less than 50 and a cd4 count of 443. 2. myocarditis 3. cervical cancer, status post total abdominal hysterectomy/bilateral salpingo-oophorectomy 4. recurrent pneumonia 5. gastroesophageal reflux disease 6. hypertension 7. bipolar disorder 8. chronic obstructive pulmonary disease 9. history of duodenal tumor 10. history of ruptured ectopic medications from outside hospital: 1. levofloxacin 500 mg po q day 2. bactrim double strength 3. dyazide 1 po q day 4. diflucan 200 mg po q day 5. celexa 30 mg po q day 6. prevacid 30 mg po q day 7. zocor 20 mg po q day 8. sustiva 600 mg q hs 9. guaifenesin 1 mg po q hs 10. premarin 0.25 mg po q day 11. neurontin 300 mg po tid 12. remeron 20 mg po q hs 13. prednisone 40 mg po bid 14. atenolol 100 mg po q day 15. norvasc 10 mg po q day 16. klonopin 0.5 mg po tid 17. combivir allergies: penicillin social history: the patient works as a community health educator. she lives alone. she has one daughter. mother lives in the area. the patient smoked one pack per day for 17 years. the patient has a history of alcohol and polysubstance abuse. the patient uses heroin and cocaine. family history: breast cancer, congestive heart failure, father with history of pulmonary fibrosis. physical examination: vital signs: the patient had a blood pressure of 90/44, pulse of 51 and oxygen saturation of 95%. the patient was on ventilatory support with pressure support of 20, peep of 5 and fio2 of 100%. the patient had a respiratory rate of 20. general: the patient was intubated, sedated and in no apparent distress. head, ears, eyes, nose and throat: pupils equal, round and reactive to light. extraocular movements intact. oropharynx clear. neck: supple with no lymphadenopathy. cardiovascular: regular bradycardia, normal s1, s2 and a 1/6 systolic murmur at the left lower sternal border and patient had jugular venous distention to 8 cm. pulmonary: bilateral inspiratory rales. abdomen: belly that was soft, nontender and nondistended with normal bowel sounds and no hepatosplenomegaly. extremities: no edema. neurologic: withdrawal to pain, moving all four extremities and 3+ deep tendon reflexes with downgoing plantar reflexes. skin: no rash. there was presence of needle tracks on the forearms. imaging: chest x-ray revealed diffuse bilateral nodular interstitial infiltrates. chest ct from the outside hospital revealed diffuse bilateral interstitial infiltrates with slightly geographic distribution, mild honeycombing. these were most prominent at the bases. pertinent laboratory findings: the patient had arterial blood gases with a ph of 7.35, pco2 of 35 and p02 of 110 on 100% fio2. the patient's white blood cell count was 7.9 with a hematocrit of 3.4 and platelets of 132. the patient's sodium was 138 with a potassium of 5.2, chloride of 110, bicarbonate of 20, bun of 71, creatinine of 1.6 and glucose of 94. albumin was 2.5. calcium 8.1, magnesium 2.1, ck 55 and troponin 4.6. the patient had an ldh of 665. summary of hospital course: on , the patient underwent open lung biopsy which revealed pathology consistent with boop. the patient was continued on ventilatory support, given steroid therapy and nebulizer treatments, as well as antibiotics. the patient continued to have atrial fibrillation with rapid ventricular response. the patient's course was complicated by thrombocytopenia and anemia. the patient was taken off heparin prophylaxis and zantac. low extremity ultrasounds were negative and a hit antibody was negative. on , electrophysiology was consulted and they recommended starting the patient on a heparin infusion as well as sotalol 80 mg po tid and lopressor. on the 21st, the patient was found to have low grade dic based on labs. on , the patient had a febrile episode with hypotension. the patient had atrial fibrillation with rapid ventricular response and was cardioverted. there was question of ventilator associated pneumonia and the patient was started on clindamycin. on , the patient was gradually weaned to pressure support ventilation. steroids and sedation were gradually weaned. on the , the patient underwent peg placement and tracheostomy. she experienced marked agitation which was thought to be secondary to withdrawal from tapering of the patient's sedation. the patient's sedation was tapered more slowly and a head ct was done which revealed no signs of intracranial hemorrhage or mass effect. the patient's mental status gradually improved. the patient was eventually weaned off of mechanical ventilation and converted to trach mask. neurology was contact regarding the patient's mental status and they felt that the picture was most consistent with benzodiazepine withdrawal. infectious disease was also contact in order to facilitate on the patient's human immunodeficiency virus care, as she moved to the outpatient setting. the patient was continued on bactrim with fluconazole. the patient had daily qtcs monitored secondary to occasional administration of haldol with the patient being on sotalol. case management and social work followed the patient in hospital. the patient had culture results with no growth at the time of this dictation. vitamin b12, tsh and cortisol were normal during the hospitalization. discharge condition: stable the remainder of this dictation will be dictated as the hospital course continues. , n. m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances temporary tracheostomy percutaneous [endoscopic] gastrojejunostomy open biopsy of lung diagnoses: subendocardial infarction, initial episode of care chronic airway obstruction, not elsewhere classified atrial fibrillation human immunodeficiency virus [hiv] disease acute respiratory failure defibrination syndrome cocaine abuse, continuous opioid abuse, continuous other specified alveolar and parietoalveolar pneumonopathies 

Answer: The patient is high likely exposed to