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: adhesive attending: chief complaint: hypoxia major surgical or invasive procedure: none history of present illness: mr. is a 70y m w hx of mild ipf, renal disease, cirrhosis s/p olt seen today in clinic as follow up to discharge 2 days prior. pt is immunosuppressed with recent admission for pcp pneumonia dc'd on . now on bactrim treatment and more hypoxic on evaluation at clinic w dr. in transplant clinic. . in the ed initial vitals: 98.2 100 135/74 10 97% 4l nc. labs were significant for: lactate 2.8 k: 5.2 bicarb: 17 cr: 2.9 wbc: 6.3 hct: 31 ldh: 400. imaging showed: (chest xray) reticulonodular opacities, unchanged. lateral - interval increased opacity of lung base concerning for infection. blunting of right costophrenic angle. patient was given prednisone po 60mg, zofran (prednisone made him nauseaus) and one dose of bactrim. he also recieved one liter of fluid. pulmonary medicine was consulted in the ed. . on the floor, pt reports that he feels very sob w exertion that has worsened significantly over the last few days. symptoms began on monday after discharge when he was working in the garden without his oxygen supplement. he felt fatigued and sob. his symptoms consistently worsened since. he describes his sob as "air hungry" and "gasping for air", these symptoms resolve after 20minutes of rest with o2 administration which he has been wearing consistently (incl nighttime) since monday. he is asymptomatic at rest. denies fever/chills, cough, chest pain, pleurisy, hemoptysis, abd pain, or n/v/d. past medical history: 1. cirrhosis. nash vs autoimmune vs alcohol related. s/p olt . 2. history of spontaneous bacterial peritonitis in . 3. history of gi bleed in secondary to portal gastropathy as well as esophageal varices. 4. peripheral arterial disease status post stent to superficial femoral artery approximately 10 years ago. 5. hypertension. 6. ipf, followed by pulmonary as an outpatient. 7. ckd baseline 2.1 social history: former smoker, 20-pack-year history, quit . prior social etoh drinker, none in 5 years. no h/o ivdu or other drugs. no tattoos or piercings. retired home care and home oxygen company co-partner. married x 42 years. family history: mother d. age 51 from leukemia. father d. age 59 from gastric cancer, and he had stomach ulcers and cad. brother d. age 51 from alcohol, ? cirrhosis. sister d. age 61 from cervical and ovarian cancer. physical exam: admission physical: vs - t97.9 bp 133/81 hr81 rr 20 o2 95/4l general - well-appearing overweight man in nad, comfortable, appropriate, family at bedside heent - nc/at, perrla, eomi, sclerae anicteric, oral mucosa pink slightly dry, op clear, dentures in place neck - supple, no thyromegaly, no jvd, no carotid bruits lungs - cta bilat, b/l dry rales extending halfway up chest, no rh/wh, good air movement, resp unlabored, no accessory muscle use heart - pmi non-displaced, rrr, no mrg, nl s1-s2, no jvp abdomen - nabs, soft/nt/nd, no masses or hsm, no rebound/guarding, +transplant upper abd scar extremities - wwp, no c/c/e, 2+ peripheral pulses (radials, dps) skin - no rashes or lesions lymph - no cervical, axillary, or inguinal lad neuro - awake, a&ox3 pertinent results: admission labs: 09:40am blood wbc-6.3# rbc-3.69* hgb-10.5* hct-31.0* mcv-84 mch-28.5 mchc-33.8 rdw-14.8 plt ct-387# 09:40am blood neuts-78.9* lymphs-14.4* monos-3.3 eos-2.8 baso-0.6 09:40am blood glucose-104* urean-27* creat-2.9* na-135 k-5.2* cl-102 hco3-17* angap-21* 09:40am blood alt-22 ast-32 ld(ldh)-400* alkphos-73 totbili-0.1 06:55am blood calcium-7.6* phos-3.6 mg-1.9 09:34am blood type-art tidal v-450 peep-5 fio2-100 po2-112* pco2-46* ph-7.17* caltco2-18* base xs--11 aado2-578 req o2-92 intubat-intubated vent-controlled . -------------------- microbiology: blood cxs 11/24,11/28/12/2: neg urine cxs , , : neg sputum cxs , : neg sputum : yeast cdiff neg x 3 iv cath: neg imaging: cxr : impression: 1. increased opacity at posterior lung base, difficult to discern if the right or left lung base, concerning for acute component of an infectious process. 2. right pleural thickening versus tiny pleural effusion. . cxr : findings: in comparison with study of , there is little interval change. again there is diffuse reticulonodular changes bilaterally that could be a manifestation of pcp . in view of the enlargement of the cardiac silhouette, some element of this could reflect pulmonary vascular congestion. . cxr : there is continued progression of multifocal opacities, widespread throughout the lungs, superimposed on basal areas of fibrosis. cardiomediastinal silhouette is unchanged. no appreciable pleural effusion is noted. . ct chest w/o : impression: 1. diffuse ground-glass opacification with superimposed peribronchiolar opacities in bilateral lungs, appears worse compared to , . while non-specific, in this immunocompromised patient with known pcp pneumonia, the findings suggest worsening pcp . other considerations (although less likely)are and cmv pneumonia. 2. stable appearance of background interstitial lung disease predominantly basilar. brief hospital course: mr. is a 70y m w hx of mild ipf, renal disease, cirrhosis s/p olt , recently admitted for hypoxia dx'd w pcp pneumonia seen today in clinic with complaint worsening hypoxia and sob since discharge. sx could be related to worsening pcp pneumonia or secondary pneumonia as suggested on pa/lateral film. . .# hypoxia: pneumonia (secondary bac infec/hcap v. worsening pcp less likely unless not compliant) v. complication from pneumonia - empyema, v. pe v. ipf exacerbation. secondary infection most concerning giving evolving retrocardiac opacity. relative leukocytosis w left shift. ct chest showed worsening ground glass opacities and suggestive of worsening pcp pna on background of chronic ipf. he was started empirically on broad abx coverage vanco, levofloxacin and cefepime. he recieved 60mg prednisone in ed and then started on 40mg po bid for pcp . pt has been afebrile. expectorated sputum xxx. avoid macrolides for intxn w tacrolimus/sirolimus. admission o2 requirement 95% on 4l (increased from 2l at time of discharge) and noted to be increasing o2 requirement overnight, on 6l via facemask on hd1. pulmonary medicine consulted. id consulted and increased o2 requirement thought to be inflammatory rxn to pcp in setting of chronic lung disease. he was cont'd on bactrim 3 tabs tid for pcp pna treatment. given increasing o2 requirement and hypoxia to high 70s w mild exertion pt was transferred to micu for observation. . #. electrolyte disturbance: admission lytes showed ag metabolic acidosis likely lactate (2.8), ?infection. abg showed respiratory alkalosis on admission o2 likely compensation. afebrile. he was given 1l ns in ed and continued on maintenance ivf on the floor. . # acute on chronic renal failure: cr 2.9 from baseline 2.1. creatinine trended to below baseline during prior stay - unclear etiology. would expect up 10-20% increase in creatinine artificially to bactrim, however current level exceeds normal adjustment. proteinuria and sm hyaline casts on admission urine - possibly dehydration. . # dm: continued on home humalog iss. . #.hl: continued on home pravastatin. . #.htn: continued on home amlodipine, metoprolol dosage. ---------- micu course . #resp failure: patient was initially maintained on facemask requiring large volumes of o2. patient tolerated this for the first two days of icu stay, but gradually became increasingly hypoxic and was intubated on . hypoxia continued to worsen and patient soon satisfied criteria for ards. was switched to ardsnet vent strategy, and required heavy sedation to avoid dissynchrony with the ventilator. patient ultimately required peeps of 12 with minute volumes of 17 liters and 60-60% o2 to maintain adequate oxygen concentration. he was unable to be weaned off ventilator. #pjp/pna: patient had previous pjp immunofluorescence from prior admission, with diffuse infiltrates visible on cxr and ggos on chest ct. patient maintained initially on bactrim as well as steroids and then changed to pentamidine d/t arf. patient was also maintained on broad coverage for hcap,cap,atypicals. patient continued to spike fevers and given high risk of infection, id recommended micafungin. #pancytopenia: patient with initial hct drop in icu that quickly stabilized, as well as thrombocytopenia and gradually progressing leukopenia reaching near-neutropenic levels. etiology of this was not known, though abx change from cefepime to meropenem was followed by stabilization/recovery of leuk counts. #renal failure: arf upon admission to unit, urine showed bactrim crystals and arf thought to be obstruction. bactrim was dced in favor of pentamidine, and renal fxn quickly recovered. #transaminitis: ruq u/s showed no concerning pathology, perturbation thought potentially pentamidine. . the patient expired on medications on admission: home oxygen oxygen 2liters continuous alendronate 35 mg tablet q weekly amlodipine 10 mg qdaily insulin ss metoprolol succinate 75 mg tablet sr pravastatin 20 mg qdaily prednisone 5 mg qdaily calcium 600 + d(3) 600-400 mg-unit . sirolimus 1 mg tablet sig:po daily sulfamethoxazole-trimethoprim ds 3 tabs tid: guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h cough discharge medications: n/a discharge disposition: expired discharge diagnosis: n/a discharge condition: n/a discharge instructions: n/a followup instructions: n/a md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances closed [endoscopic] biopsy of bronchus diagnoses: hyperpotassemia alcoholic cirrhosis of liver acute kidney failure, unspecified other and unspecified alcohol dependence, in remission chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified acute respiratory failure other shock without mention of trauma pneumocystosis postinflammatory pulmonary fibrosis diarrhea esophageal varices in diseases classified elsewhere, without mention of bleeding liver replaced by transplant sulfonamides causing adverse effects in therapeutic use mixed acid-base balance disorder other specified aplastic anemias urinary obstruction, not elsewhere classified 

Answer: The patient is high likely exposed to