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: augmentin / tetracycline / adhesive tape wp / latex / iodine / demerol attending: chief complaint: dyspnea major surgical or invasive procedure: mechanical ventillation and extubation central line placement and removal history of present illness: 51 y/o m with hx of dm, asthma, depression and ckd who presents today with respiratory distress. starting three days prior to admission, he was noting a very dry cough and having some shortness of breath. was nauseated but no vomiting. also have some mild diarrhea. he was having increasing wheezing and using his albuterol inhaler at home. also noted fevers, chillls and sweats and had a fever up to 104 at home. he was trying to keep himself out of the hospital to make it a doctors on the day after admission. some of his family also had respiratory symptoms. he has had asthma exaccerbations before, but has never needed to be intubated. he recently has a hernia repair. in the ed, his initial vitals were 100.4, 90s on ra; rr 50, 98% nrb. he was treated with levofloxacin and cipro. he was given continuous nebs and iv steroids for asthma exaccerbation. he was transferred to the icu on a face mask. on arrival, he is feeling slightly better than when he first presented. he cannot speak in full sentences and is using his accessory muscle to breath. he is tachypneic and uncomfortable and visibly diaphoretic drenching his gown. he complains of ruq pain that started with these current respiratory symptoms. his hernia repair was on his l side. he denies chest pain, dizziness, nausea, dysuria. past medical history: 1. depression 2. non-hodkins lymphoma (angioimmunoblastic -> rx w/ steroids and fludarabine x 8 cycles; in remission) 3. asthma (pf ~ 550) 4. chronic renal insufficiency (baseline ~ 1.4) 5. etoh abuse 6. tobacco abuse 7. osteoarthritis 8. copd 9. elective hernia repair social history: married with 2 sons. currently on disability. previous 60pk/yr smoker and etoh abuser but since quit. previously worked in laundry servies at a hotel. family history: sister w/ diabetes and suicide. mother w/ mi, dm, and cirrhosis. physical exam: exam on admission to micu: general appearance: well nourished, overweight / obese, anxious, diaphoretic eyes / conjunctiva: perrl head, ears, nose, throat: normocephalic lymphatic: cervical wnl, supraclavicular wnl cardiovascular: (s1: normal), (s2: normal) peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (expansion: paradoxical), (breath sounds: crackles : , wheezes : , rhonchorous: ) abdominal: soft, bowel sounds present. exam on transfer to the medicine floor: vitals: t: 98.4, bp 102/85, hr 67, rr 18, 97% on 2l. fsbg 120. weight 86.7kg general: pleasant, well appearing, in nad, hands with mild tremor heent: normocephalic, atraumatic. no conjunctival pallor. no scleral icterus. perrla/eomi. mmm. op clear. neck supple, no lad, no thyromegaly. cardiac: regular rhythm, normal rate. normal s1, s2. no murmurs, rubs or . lungs: ctab, good air movement biaterally. abdomen: nabs. soft, nt, nd. no hsm extremities: no edema or calf pain, 2+ dorsalis pedis/ posterior tibial pulses. skin: no rashes/lesions, ecchymoses. neuro: a&ox3. appropriate. cn 2-12 grossly intact. preserved sensation throughout. deltoid, 4-/5 triceps, biceps, 4+/5 wrist extensors. ip, 4+/5 hamstring and quardriceps, df, pf and te. 2+ reflexes, equal bl. couldn't assess coordination because patient does not have the strength to move fingers between nose and examiner's finger, and does not have the strength to do heel-to-shin. moderate hand tremor. gait assessment deferred psych: listens and responds to questions appropriately, pleasant pertinent results: admission labs: 06:25pm wbc-5.8 rbc-5.27 hgb-14.5 hct-42.8 mcv-81* mch-27.5 mchc-33.9 rdw-15.3 06:25pm neuts-84.7* lymphs-12.9* monos-1.5* eos-0.3 basos-0.7 06:25pm pt-14.7* ptt-34.5 inr(pt)-1.3* 06:25pm alt(sgpt)-48* ast(sgot)-134* alk phos-64 tot bili-0.3 06:25pm lipase-152* 06:25pm glucose-150* urea n-36* creat-2.7* sodium-128* potassium-3.8 chloride-94* total co2-20* anion gap-18 06:44pm lactate-1.6 k+-3.5 discharge labs: wbc 5.4 hct 35.3 platelet 253 pt 14.4 ptt 32.7 inr 1.2 creatinine 1.1 alt 88 ast 27 ldh 212 ck 166 ap 59 tbili 0.5 micro: influenza a/b dfa (): positive for influenza a viral antigen. . bronchial washings (): klebsiella pneumoniae | ampicillin/sulbactam-- 4 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s fungal culture (preliminary): no fungus isolated. . sputum culture ( and ): klebsiella pneumoniae. sensitivies as above. . blood culture (): neg blood culture (, ): ngtd . urine culture (, , ): neg urine culture (): neg . c. diff (): neg . studies: ruq us (): 1. echogenic liver consistent with fatty infiltration. other forms of liver disease and more advanced liver disease including significant hepatic fibrosis/cirrhosis cannot be excluded on this study. 2. cholelithiasis with no sign of cholecystitis. 3. persistent right hydronephrosis. cxr (): chronic blunting of the right costophrenic angle presumably due to scarring and/or chronic effusion. no acute pulmonary process. cxr (): the patient remains intubated. a right internal central jugular venous catheter terminates at the cavoatrial junction. a nasogastric tube again courses towards the stomach, although its distal course is not well characterized. the cardiac and mediastinal contours are unchanged. the lung volumes are slightly increased, but in spite of increased lung volumes, left perihilar and lower lobe opacities seem somewhat more prominent, suggestive of worsening atelectasis or pneumonia. much or all of the left lower lobe is probably involved. the presence of a coexisting right perihilar opacity may be due to co-existing pulmonary vascular congestion. cxr (): 1. interval increase of left upper lobe opacity 2. interval improvement of the left lower lobe opacity 3. stable mild pulmonary edema. cxr (): as compared to the previous examination, the monitoring and support devices are unchanged. the pre-existing predominantly left parenchymal opacities have clearly decreased in extent. the size of the cardiac silhouette is unchanged. no newly appeared focal parenchymal opacities suggesting pneumonia. cxr (): as compared to the previous radiograph, the endotracheal tube and the nasogastric tube has been removed. the right-sided central venous access line is unchanged. slight increase in extent of a pre-existing right basal and retrocardiac opacity. no other parenchymal opacities. unchanged size of the cardiac silhouette. tte (): the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy with normal cavity size. regional left ventricular wall motion is normal. left ventricular systolic function is hyperdynamic (ef>75%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are structurally normal. no mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. indeterminate pulmonary artery systolic pressures. compared with the report of the prior study (images unavailable for review) of , left ventricular hypertrophy is now identified. brief hospital course: 51 y/o m with hx of asthma, ckd, dm, who presented with respiratory distress. # acute respiratory distress syndrome: on arrival to micu, he appeared to be in respiratory distress, as he was his accessory muscle to breath, was tachypneic and uncomfortable and visibly diaphoretic drenching his gown. he was intubated shortly after micu admission. the patient was found to be h1n1 positive and also developed a severe asthma exacerbation. his chest x-ray was initially normal, but developed bilateral pulmonary infiltrates during his icu admission. he was treated with high-dose osaltamavir for 10 days, continuous albuterol nebs, and solumedrol followed by steroid taper. he was initially very hard to ventilate and had difficulty with sedation and was tried on versed, fentanyl, propofol, and dilaudid. fentanyl was stopped for concern of frozen chest and propofol was limited by elevated triglycerides. he was paralysed on and a cvl was placed. he was maintained on intermittant paralytics until . he was extubated on . his cvl was removed the same day. on the day of discharge, patient was off oxygen, satting well on room air. # ventilator-associated pneumonia: on , he spiked fever to 101.2 and was started on cefepime/vanc. he developed erythematous rash on face after cefepime and during vancomycin infusion. antibiotic was changed to meropenem on . sputum grew out klebsiella pneumoniae. he was treated with meropenem for 8 days ( to ). on the day of discharge on , patient was afebrile, satting well on room air. his lung exam was clear to auscultation bilaterally. # acute on chronic renal failure: patient was admitted with acute on chronic renal failure, with fena 0.47. his sodium was initially 128, which improved with hydration. after aggressive rehydration his creatinine improved. following the peak of his ards, he was diuresed with lasix 20 mg until euvolemic. he did not require lasix after transfer to the floor. cr on discharge was 1.1. ruq us showed persistent right hydronephrosis, which could be related to his chronic renal insufficiency. he should have continued outpatient followup on this right hydronephrosis. # right upper quadrant pain: he had ruq pain on admission, and an ultrasound showed echogenic liver consistent with fatty infiltration, but other forms of liver disease and more advanced liver disease including significant hepatic fibrosis/cirrhosis cannot be excluded on this study. he had elevated lfts as well, which were stable during this hospital stay. this was possibly related to influenza. he should have follow up to confirm resolution of these abnormalities. # diabetes: at home his blood sugars were well controlled on glyburide. however, in the micu, his blood sugars were poorly controlled on high-dose steroids. he required an insulin drip on . following cessation of iv steroids, he was weaned back to an insulin sliding scale. his glucose was well-controlled after he was transferred to medicine floor. he was discharged home on glyburide. # hypertension: patient was normotensive on admission, but became hypertensive while not tolerating vent and as home bp meds were held. around the time of extubation, he required a labetalol drip for sytolics in the 200s. he was well controlled on his home regimen prior to discharge. # steroid-associated myopathy: patient developed marked muscle weakness in micu in the setting of paralytics and high dose steroids. his ck peaked at 6958 on , which trended down steadily as the dose of steroid was tapered down. on the day of discharge, his ck was within normal range, and he had regained most of his strength. he was evaluated by physical therapy and was cleared for discharge home with home pt. patient finished his steroid taper on the last day of this hospital stay. # depression: outpatient amitriptyline and sertraline were continued. # prophylaxis: sq hep, ompeprazole, bowel reg prn # fen: regular diet per s&s. # access: pivs # communication: with patient, daughter hcp # code: full, confirmed medications on admission: albuterol mdi amitriptyline 50 qhs zyrtec 10 mg daily diltiazem 180 mg er daily advair 500-50mcg 1 puff glyburide 1.25 mg daily lisinopril 30 mg daily lorazepam 0.5 mg daily omeprazole 20 mg daily sertraline 200 mg daily zafirlukast 20 mg daily asa 81 mg daily discharge medications: 1. sertraline 50 mg tablet sig: four (4) tablet po daily (daily). 2. lisinopril 10 mg tablet sig: three (3) tablet po daily (daily). 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 4. amitriptyline 25 mg tablet sig: two (2) tablet po hs (at bedtime). 5. diltiazem hcl 180 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 6. fluticasone-salmeterol 500-50 mcg/dose disk with device sig: one (1) puff inhalation (2 times a day). 7. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: one (1) puff inhalation once a day as needed for shortness of breath or wheezing. 8. zyrtec 10 mg tablet sig: one (1) tablet po once a day. 9. glyburide 1.25 mg tablet sig: one (1) tablet po once a day. 10. aspirin 81 mg tablet sig: one (1) tablet po once a day. 11. zafirlukast 20 mg tablet sig: one (1) tablet po once a day. 12. lorazepam 0.5 mg tablet sig: one (1) tablet po once a day as needed for anxiety. discharge disposition: home with service facility: nightingale nursing discharge diagnosis: primary diagnoses: h1n1 pneumonia ventilator-associated bacterial pneumonia secondary diagnoses: type ii diabetes copd asthma hypertension gerd depression discharge condition: stable, afebrile, satting well on room air, regaining strength, ambulating well with assistance discharge instructions: it was a pleasure to be involved in your care, mr. . you were admitted to because of respiratory distress. you were found to have h1n1 flu virus, and you had to be intubated in the intensive care unit. you were also found to have bacterial pneumonia, for which you were treated with antibiotics. you were extubated on , and since then you have been recovering rapidly. on discharge, you did not require oxygen, and your lung exam sounds clear. you developed significant weakness while you were in the intensive care unit because of the medications you received. you have been working with physical therapy daily, and are regaining your strength nicely. the physical therapist cleared you to go home with visiting nurse service. you were found to have slightly elevated liver function test enzymes during this hospital stay. please follow up with your primary care doctor on this. ultrasound of the abdomen also showed that your right kidney has some distention from urine (called "hydronephrosis"), please follow up with your primary care doctor on this as well. please note that your medications have not been changed. you have finished the antibiotic course. please follow up with your primary care doctor below. followup instructions: we have made an for you to see your primary care doctor, dr. , on monday, at 10:00am. please call if you have any questions. 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: hyperpotassemia other iatrogenic hypotension friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site adrenal cortical steroids causing adverse effects in therapeutic use diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hyposmolality and/or hyponatremia personal history of tobacco use 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 acute respiratory failure osteoarthrosis, unspecified whether generalized or localized, site unspecified calculus of gallbladder without mention of cholecystitis, without mention of obstruction other acute pain chronic obstructive asthma with (acute) exacerbation toxic myopathy ventilator associated pneumonia other chronic nonalcoholic liver disease hypertensive chronic kidney disease, benign, with chronic kidney disease stage i through stage iv, or unspecified nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] other sedatives and hypnotics causing adverse effects in therapeutic use alcohol abuse, in remission other named variants of lymphosarcoma and reticulosarcoma, unspecified site, extranodal and solid organ sites other, mixed, or unspecified drug abuse, in remission 

Answer: The patient is high likely exposed to