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: levofloxacin / benzodiazepines / hydantoins attending: chief complaint: sob/cough major surgical or invasive procedure: none history of present illness: mr. is a 67 year old man with h/o hiv (last cd4 182, vl 56 per report), on haart, transferred from ed with shortness of breath and cough. . the patient reports 6-8 weeks of progressively worsening shortness of breath and productive cough. he was recently hospitalized at for hyponatremia and left from rehab last week (unclear if he left ama or was discharged home). he notes that he was short of breath at the osh, but that it has gotten worse over the past week. he now gets short of breath with any movement. he stopped smoking 4 days prior to admission to sob. according to the daughter, the patient has been ill since /. he has had multiple hospitalizations (frequently leaves ama), has lost weight, decreased appetite. no fevers, chills, abdominal pain, nausea, vomiting, dysuria, headache, sore throat, congestion. . pt received the following meds at the osh ed: azithromycin 500mg iv, bactrim 250mg iv, solumedrol 125mg iv, ceftriaxone 1g iv. cxr was unchanged from prior cxr last month. . in the ed, initial vs were: t 99.5 bp 132/78 p 102 rr 18 o2sat 98% 4lnc. bp was noted to drift down to sbp 90s, so the patient was given 2lns. cxr showed bilateral patchy interstitial opacification of the lower lobes. vitals on transfer: p 92 bp 101/68 rr 18 o2sat 100%4lnc. . on the floor, the patient reported feeling improved. breathing seemed less strenuous. however, given concern for hypotension, hypoxia, and possible decompensation overnight, he was transferred to the micu for further monitoring. . in the micu, the patient remains comfortable on nasal cannula. sob had improved and bp stabilized in the 120s-130s. he was called out to the medical floor sunday morning. the patient continued to remain hemodynamically stable with improving oxygen requirements to 3l nc this am. in the hour prior to transfer the patient had a rapid increase in work of breathing. although his saturations held in the low 90s he was increasing tachypneic and tachycardic. per nursing he was slightly disoriented, however eating without signs of aspiration. he was intubated on the floor with 60mcg of prpofol and 20 of succ. given gradual decline in respiratory function (6-8 weeks), this appears to be a more chronic process that is acutely worsened by evolving pna within the lll and gnr in sputum. there seems to be underlying lung obstructive pathology that was not previously identified(probable copd). pt continued to receive meropenem for gnr identified on bal cx; pt's respiratory status continued to decline. family decided that given severe underlying disease and poor prognosis in regard to returning to desired quality of life, pt was to be extubated and placed on cmo with dni/dnr. pt expired shortly after extubation. past medical history: hiv, diagnosed in , on haart, last known cd4 count 182, vl 56 htn hld pna: hospitalized in for 4.5 months, intubated, s/p lobectomy ?hep c ?copd social history: lives with son, daughter, and grandchildren. recently discharged from rehab. - tobacco: 50 pack year smoking history - alcohol: none - illicits: none . family history: nc physical exam: in icu: vitals: t 97 p 99 bp 122/55 rr 28 o2sat 96% 2lnc general: alert, oriented x2, no acute distress, extremely cachectic heent: dry mm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: wheezing and rhonchorous breath sounds throughout all lung fields cv: mildly tachycardic, s1s2, no m/r/g abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: 01:50pm pt-11.9 ptt-19.5* inr(pt)-1.0 01:50pm plt count-207 01:50pm neuts-92.2* lymphs-5.8* monos-1.4* eos-0.1 basos-0.6 01:50pm wbc-10.3 rbc-3.37* hgb-11.9* hct-34.9* mcv-104* mch-35.3* mchc-34.0 rdw-19.8* 01:50pm vit b12-383 folate-8.2 01:50pm albumin-3.7 01:50pm alt(sgpt)-14 ast(sgot)-11 ld(ldh)-160 alk phos-129 tot bili-0.2 01:50pm estgfr-using this 01:50pm glucose-176* urea n-24* creat-1.0 sodium-138 potassium-3.3 chloride-106 total co2-22 anion gap-13 11:09pm plt smr-normal plt count-188 11:09pm hypochrom-1+ anisocyt-2+ poikilocy-normal macrocyt-3+ microcyt-normal polychrom-normal 11:09pm neuts-90* bands-0 lymphs-6* monos-3 eos-1 basos-0 atyps-0 metas-0 myelos-0 11:09pm wbc-9.5 rbc-3.47* hgb-12.1* hct-36.1* mcv-104* mch-34.8* mchc-33.4 rdw-18.2* - cxr: impression: patchy areas of predominantly interstitial opacification overlying the lower lobes, chronicity indeterminate. chronic interstitial lung disease favored, but diffiuclt to exclude superimposed atypical acute process. recommend correlation with prior outside imaging when clinically available. biapical fibrosis incidentally noted. 03:05am blood wbc-7.6 rbc-2.35* hgb-8.3* hct-25.0* mcv-107* mch-35.4* mchc-33.2 rdw-18.2* plt ct-188 11:09pm blood wbc-9.5 lymph-6* abs -570 cd3%-89 abs cd3-507* cd4%-9 abs cd4-53* cd8%-77 abs cd8-440 cd4/cd8-0.1* 03:05am blood glucose-112* urean-21* creat-0.8 na-139 k-3.6 cl-103 hco3-27 angap-13 02:57am blood type-art temp-37.2 rates-22/ tidal v-450 peep-5 fio2-50 o2 flow-8.6 po2-86 pco2-48* ph-7.43 caltco2-33* base xs-6 intubat-intubated vent-controlled sputum gram stain-final; respiratory culture-final {acinetobacter baumannii complex} inpatient brief hospital course: mr. is a 67 year old man with h/o hiv on haart (last cd4 182, vl 56), htn, who presents with 6-8 week h/o progressively worsening shortness of breath. . #. hypoxic respiratory failure: given gradual decline in respiratory function (6-8 weeks), this appears to be a more chronic process that is acutely worsened by evolving pna within the lll and gnr in sputum. there seems to be underlying lung obstructive pathology that has not been identified yet (probable copd). had planned for extubation but depends on outcome of family meeting. - family states that patient would not desire to be trached; per family not to be reintubated. per family, will extubate today with cmo -> expired shortly after extubation. - reiterate with family that extubation is unlikely to be successful. - attempting psv prior to extubation. - sedation: wean sedation; change from drip to bolus of fentanyl - continue zyprexa 2.5 . # acidosis: possible proximal rta with elevated cl and suboptimal increase in bicarb; proximal rta most likely secondary to anti retrovirals. resolving with a bicarbonate level approx. 30 - combivir once a day started instead of tenofavir to avoid rta - trend lactate, cr - renal/id recs. . #. hiv: pt was diagnosed in . last cd4 182, vl 56, as per osh records. pt reports being adherent with current regimen of kaletra and truvada. however, per daugther the patients mental status has been deteriorating and med compliance could be an issue. - await the result of hla typing. - serum toxo serology sent (pending) and started bactrim ds qday; if negative, change bactrim every other day - continue combivir . #. anemia: pt with macrocytic anemia. appears at baseline. b12, folate normal, likely hiv meds. hct continues to trend down. - monitor hct -transfuse < 21 . # cachexia: likely aids. - ng tube feeds -started reglan . # copd: continue inh steroids. continue mdi . # fen: ivf bolus prn, replete electrolytes, regular diet # prophylaxis: subcutaneous heparin # access: peripherals # communication: patient, daughter # code: full (discussed with patient) # disposition: icu pending clinical improvement medications on admission: kaletra 2tabs po q12h truvada 1tab po qam albuterol 2puffs inh q4h / nebs qid tiotropium 1cap daily advair 500/50 1puff omeprazole 20mg po daily gemfibrozil 600mg po bid sodium chloride 1g po bid clorazepate 7.5mg po tid nature's tears prn discharge medications: none discharge disposition: expired discharge diagnosis: pna, copd, aids discharge condition: expired discharge instructions: n/a followup instructions: n/a procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization closed [endoscopic] biopsy of bronchus diagnoses: pneumonia due to other gram-negative bacteria tobacco use disorder unspecified essential hypertension unspecified protein-calorie malnutrition chronic airway obstruction, not elsewhere classified human immunodeficiency virus [hiv] disease other and unspecified hyperlipidemia acute and chronic respiratory failure antiviral drugs causing adverse effects in therapeutic use do not resuscitate status other specified disorders resulting from impaired renal function unspecified deficiency anemia 

Answer: The patient is high likely exposed to