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: iodine-iodine containing / lopressor / opioids-morphine & related / ciprofloxacin / gabapentin attending: chief complaint: hypotension, hypoxia major surgical or invasive procedure: cystoscopy history of present illness: 57 yo m non-ischemic cardiomyopathy with ef recovery to 50%, atrial flutter s/p ablation, cervical stenosis, and hematuriahere for cystoscopy. pt desat to 60s after initial lma placement, was reintubated with initiation of propofol/midazolam, and had another episode of desat to 60s for ~ 5mins, but was able to resume the procedure. during the procedure, pt was noted to appear "not well, and turning black". he became hypotensive to sbp 80s for about 20 mins, and dropped to sbp 50s for several minutes during the procedure. no definitive anaphylaxis and was premedicated with 100 mg hydrocortisone and benadryl prior to retrograde pyelogram. no contrast extravasation and has had previous ct with contrast without any issues. his hypotension responded to phenylnephrine, and was also given a total of 120 mcg epiniphrine for concerns of anaphylaxis. minimal blood loss was reported. an a-line was put in. an introp tee was performed, which showed ef 25-30% with inferior wall motion abnormalities. abg showed respiratory acidosis 7.24/54/110/26, lactate 3.2. an ekg was unchanged from his baseline. cardiology was consulted, and recommended transfer to the icu for further management. on arrival to the micu, patient's vs t 97.7, hr 81, bp 135/91 (to sbp > 200 within the hour of transfer). he was sedated and intubated for assist control ventilation. labs were significant for wbc 14, lactate 3.2, . a cxr showed l pleural effusions as demonstrate by retrocardiac opacification, otherwise unchanged compared to a previous film in . past medical history: past medical history: 1. idiopathic nonischemic cardiomyopathy : presented with aflutter and chf, ef 10%, recovered to 50%. 2. hypertension. 3. atrial flutter s/p ablation 4. allergic rhinitis. 5. hematuria. . past surgical history: 1. left knee acl repair. 2. appendectomy. 3. bilateral cataract repair 4. cystoscopy social history: married to husband , works as social worker, quit tobacco, drinks 1 alcoholic drink/day, no drug use. family history: non-contributory physical exam: admission exam: vitals: t: 98.6, bp: 134/82 mmhg supine, hr 88, rr 18 bpm, o2: 100% on 40% fio2 cmv 500/15/10. gen: intubated, sedated heent: small left subconjunctival hemorrhage. no icterus. mmm. op clear. intubated. neck: supple, no lad. jvp low. normal carotid upstroke without bruits. no thyromegaly. cv: pmi in 5th intercostal space, mid clavicular line. rrr. normal s1,s2. no murmurs, rubs, clicks, or . lungs: ctab. no wheezes, rales, or rhonchi. mechanical breath sounds. abd: nabs. soft, nt, nd. no hsm. no abdominal bruits. ext: wwp, no cce. full distal pulses bilaterally. no femoral bruits. skin: no rashes/lesions, ecchymoses. neuro: sedated. perrl. withdraws to pain. pertinent results: admission labs: 01:19pm blood wbc-14.0*# rbc-6.73* hgb-16.8 hct-53.1* mcv-79* mch-25.0* mchc-31.7 rdw-17.8* plt ct-267 01:19pm blood neuts-83.4* lymphs-12.2* monos-3.7 eos-0.3 baso-0.3 01:19pm blood glucose-118* urean-13 creat-1.1 na-136 k-5.1 cl-101 hco3-23 angap-17 01:19pm blood alt-38 ast-31 ld(ldh)-309* ck(cpk)-143 alkphos-40 totbili-0.5 01:19pm blood ck-mb-2 ctropnt-<0.01 01:19pm blood calcium-8.8 phos-2.8 mg-2.1 11:39am blood type-art po2-110* pco2-54* ph-7.28* caltco2-26 base xs--1 06:04pm blood type- temp-37.1 po2-45* pco2-51* ph-7.37 caltco2-31* base xs-2 intubat-not intuba 11:39am blood glucose-118* lactate-3.2* na-136 k-4.0 cl-99 06:04pm blood lactate-1.3 11:39am blood hgb-16.9 calchct-51 11:39am blood freeca-1.18 03:00pm urine color-yellow appear-hazy sp -1.017 03:00pm urine blood-lg nitrite-neg protein-30 glucose-neg ketone-10 bilirub-neg urobiln-neg ph-7.0 leuks-tr 03:00pm urine rbc->182* wbc-7* bacteri-few yeast-none epi-<1 03:00pm urine casthy-8* 03:00pm urine mucous-rare echo : there is mild regional left ventricular systolic dysfunction with inferior wall akinesis. the remaining segments contract normally (lvef = 40%). no masses or thrombi are seen in the left ventricle. right ventricular chamber size and free wall motion are normal. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. impression: mild regional left ventricular systolic dysfunction, c/w cad. mild mitral regurgitation. technically-limited study. compared with the report of the prior study (images unavailable for review) of , definite regional wall motion abnormalities are now seen, anatomically-consistent with sequelae of cad. cxr : findings: ap single view of the chest has been obtained with patient in semi-upright position. the patient is moderately rotated to the right, apparently intubated and the tube seen to terminate in the trachea some 4 cm above the level of the carina. no pneumothorax can be seen. the patient is poorly ventilated at the time of the image exposure with very high positioned diaphragms and low volume. with the exception of a small plate atelectasis on the left base and some prominent mediastinal structures on the right side, no abnormalities are seen. the lateral pleural sinuses are free and no pneumothorax is identified in the apical area. the next preceding chest examination available in our records is dated and at that time normal chest findings were present. brief hospital course: 57 year old male with non-ischemic cardiomyopathy (ef 50%), atrial flutter s/p ablation, cervical stenosis, and hematuria who presents with hypotension and hypoxia during elective cystoscopy. or course: pt was initially scheduled for outpatient cystoscopy. lma was placed, and despite easy ventillation and good etco2, pt desaturated. lma was removed and mask ventillation failed to improved spo2. pt was then intubated with normalization of vs, and procedure progressed. during the procedure, pt became hypotensive, but did respond to several epinephrine boluses. tee in or showed depressed ef, so pt remained intubated and was transferred to the icu for further management. active issues: # hypotension: the cause of poor ventilation and hypotension was unclear. may have had a reaction to the anesthetic drugs used and had also received hydrocortisone and benadryl. a anaphylactic reaction is unlikely. he was already intubated for hypoxia (see below), and his blood pressure responded to administration of phenylephrine and epinephrine. an emergent tee showed inferior wall hypokinesis ef 25%. ekg showed left axis deviation and no new ischemic changes. he was given iv fluids and was transferred to the icu. in the icu labs were significant for elevated wbc 14, lactate 3.2, abg 7.28/54/110, and negative cardiac enzymes. cxr showed a left retrocardiac opacity concerning for consolidation / atelectasis / infiltrate. there was concern for septic shock given hypotension, elevated wbc, and lll infiltrate, however this was considered less likely as he remained afebrile, his lactate normalized, and his bp corrected quickly without antimicrobials or pressors. he was observed overnight, and his cardiac enzymes were negative x 3. a repeat tte showed persistent inferior wall hypokinesis, however showed an improved ef to 40%. he was treated with po predisone 40mg for 3 days given the concern for delayed anaphylactic reaction. his blood and urine cultures were negative at the time of discharge. # hypoxia: he has a history of osa, and his desaturation occurred durng lma placement / intubation in the setting of his known osa. cxr showed left lower lobe opacity concerning for effusion / consolidation / atelectasis, or aspiration pneumonitis. his hypoxia resolved with treatment of his hypotension, and he had minimal oxygen requirements after extubation. his osa is currently untreated, as he does not respond well to bipap at night. there was low suspicion for pe given that the patient is not tachycardic and does not have any oxygen requirements. a repeat cxr showed resolution of the lll retrocardiac infiltrate. he was treated with incentive spirometer. at the time of discharge, he did not have any oxygen requirements. # leukocytosis: most likely stress response to or procedure and hypotension, vs aspiration pneumonitis. patient has been afebrile, his lactate was downtrending, and his vitals were stable. bl and urine cultures were sent. cxr showed a left retrocardiac opacity consistent with effusion / consolidation / atelectasis. he was monitored closely and his wbc at the time of discharge was 10.3. # s/p cystoscopy: he received an elective cystoscopy for hematuria. there was no evidence of active bleeding on cystoscopy, and his hct was elevated at 53.1. inactive issues: follow-up issues: - please follow-up on the patient's blood and urine cultures from . these were pending at the time of discharge. he also has tryptase level pending from . - he was discharged with carvedilol 3.125mg . please check his blood pressure, as he now takes carvedilol in addition to losartan 50mg daily. - he should follow up with a cardiologist, and should receive a stress mibi as outpatient. - consider nighttime home o2 therapy for his osa, as he does not tolerate bipap. he reports sleeping well in the hospital with 2l nasal cannula. medications on admission: 1. fluticasone propionate nasal 2 spry nu frequency is unknown 2. losartan potassium 50 mg po daily 3. zolpidem tartrate 10 mg po hs 4. tamsulosin 0.4 mg po hs 5. melatonin *nf* unknown oral qd 6. nortriptyline 50 mg po hs discharge medications: 1. tamsulosin 0.4 mg po hs 2. zolpidem tartrate 10 mg po hs 3. aspirin 81 mg po daily rx *adult low dose aspirin 81 mg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*0 4. carvedilol 3.125 mg po bid please hold for sbp < 100 or hr < 60 rx *carvedilol 3.125 mg 1 tablet(s) by mouth twice a day disp #*60 tablet refills:*0 5. prednisone 40 mg po daily duration: 1 days rx *prednisone 20 mg 2 tablet(s) by mouth once per day disp #*2 tablet refills:*0 6. losartan potassium 50 mg po daily 7. fluticasone propionate nasal 2 spry nu daily 8. melatonin *nf* 0 units oral qd 9. nortriptyline 50 mg po hs discharge disposition: home discharge diagnosis: primary diagnosis: hypotension secondary diagnosis: chf discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , it was a pleasure caring for you at the . you were admitted for a cyscoscopy. during the procedure, your blood pressure was low and you were transferred to the intensive care unit for testing and monitoring. we performed an ultrasound of your heart, which showed that your heart does not pump normally. you did not have a heart attack during this admission. we have arranged for you to follow up with one of the heart failure specialists here at . you will need to have a special type of stress test to further evaluate your heart as an outpatient. we will communicate this to your new cardiologist. you will also need to follow up with your urologist. thank you for allowing us to participate in your care. we made some changes to your medications, which the nurse will review with your at the time of discharge. followup instructions: department: primary care name: dr. when: monday at 11:50 am location: associates of health address: , 2nd fl, , phone: department: cardiac services when: tuesday at 1 pm with: , md building: sc clinical ctr campus: east best parking: garage department: surgical specialties when: monday at 4:30 pm with: , md building: campus: east best parking: garage procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnostic ultrasound of heart retrograde pyelogram other transurethral excision or destruction of lesion or tissue of bladder diagnoses: other primary cardiomyopathies acidosis other iatrogenic hypotension obstructive sleep apnea (adult)(pediatric) congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified other chronic pulmonary heart diseases hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) chronic kidney disease, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure chronic systolic heart failure hypoxemia accidents occurring in residential institution hematuria, unspecified acute respiratory failure following trauma and surgery 

Answer: The patient is high likely exposed to