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: patient recorded as having no known allergies to drugs attending: chief complaint: headache x 2 days major surgical or invasive procedure: bronschoscopy and biopsy history of present illness: patient is a 50 yo f with pmhx significant for current tobacco use, hypothyroidism, hyperlipidemia, hx cva who presented to osh this morning complaining of severe headache. the patient reports that the headache woke her from sleep at 1 am on the day prior to presentation. she describes it as bitemporal, radiating to the back of her head, throbbing and associated with nausea, sensitivity to light and sound. no aura, blurry vision or other neurologic symptoms. she does have a history of migraine headaches, for which she takes excedrine migraine once every few months - describes this headache as significantly different, and the "worst headache of her life." she remained at home for one day without any relief. she also experienced fever to 101 and shaking chills at home last night prior to presentation at , as well as right-sided pleuritic chest pain. she denies any sob, cough, or sick contacts. on arrival to osh, initial vitals were t 98.1, bp 113/71, hr 111, 96% on ra. she had ct head, which was unremarkable, and lp which was normal. cxr showed a rul pna and she became progressively more hypotensive, with a nadir at 62/35 around 1300. she received 3 l ivf, ctx 2 grams iv, azithromycin 500 mg po, morphine 4 mg iv x 2 , dilaudid iv (total of 4 mg iv), reglan 10 iv, and zofran 4 iv x2 and and bp improved to 90s/30s. she was transferred to as there were no icu beds available at the osh - en route she reportedly received another 1l ns (although not documented). . in the ed, initial vs were: t 97.7 p 93 bp 78/p r 18 o2 sat 98% on 4l nc, pain 4/10 intensity. cxr showed a rul pneumonia, labs were significant for wbc 24 with a left shift (88% pmns, 5% bands), hct 34, lactate of 1.6. she was given levofloxacin 750 mg iv, acetaminophin 1gm po, toradol 30 mg iv and 500cc ns. blood and urine cultures were sent, and she was admitted to the micu service for further management. . on arrival to the micu, patient reported improvement in her headache, with intensity down to 5/10. she denied sob, chest pain, cough, abd pain or other new complaints. did report feeling thirsty and hungry. . review of systems: (+) per hpi. also reports recent 50 lb intentional weight loss, accomplished through weight watchers. (-) denies cough, shortness of breath, or wheezing. denies palpitations, or weakness. denies vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: -hypothyroidism -hyperlipidemia -hx of cva in - affect l optic nerve, has some residual left peripheral vision loss -osa - was on cpap at home, but discontinued use after significant recent weight loss -migraines, typically monthly - s/p hysterectomy - s/p l kidney removal 5-6 years ago (reports it was removed b/c of a benign tumor) - remote hx of left knee surgery (in high school) social history: lives at home with husband of 30 years. had been unemployed for 14 months, and then recently started a new job. has smoked since the age of 18 - at least 30 pack years. currently smokes ppd. etoh drinks most friday and saturday nights. no increase in etoh use lately. denies illicit drug use. family history: father with lung and bone cancer, died age 57. mother with breast ca diagnosed in her 40s. no family history of mi or cva. physical exam: vs: 97.8, bp: 132/74, p: 86, rr: 20, 97% on ra gen: well-nourished, well-appearing female heent: mmm, clear oropharynx, no lad cv: rrr, no m/r/g pulm: decreased breath sounds over right upper lobe, clear at bases and over left side abd: soft, non-tender, non-distended, bs+, ext: warm, well-perfused, radial, dp, pt pulses 2+ bilaterally pertinent results: 06:00am blood wbc-11.4* rbc-3.69* hgb-12.1 hct-34.4* mcv-93 mch-32.9* mchc-35.2* rdw-14.0 plt ct-284 06:28am blood wbc-15.7* rbc-3.41* hgb-11.3* hct-33.3* mcv-98 mch-33.1* mchc-33.9 rdw-13.9 plt ct-294 05:00am blood wbc-19.7* rbc-3.05* hgb-10.0* hct-29.7* mcv-97 mch-32.8* mchc-33.7 rdw-13.9 plt ct-259 06:00pm blood wbc-24.3* rbc-3.45* hgb-11.4* hct-34.2* mcv-99* mch-33.2* mchc-33.5 rdw-13.8 plt ct-277 06:00pm blood neuts-88* bands-5 lymphs-3* monos-4 eos-0 baso-0 atyps-0 metas-0 myelos-0 06:00pm blood pt-14.5* ptt-29.3 inr(pt)-1.3* 06:28am blood pt-11.8 ptt-24.2 inr(pt)-1.0 06:00am blood glucose-114* urean-3* creat-0.7 na-139 k-3.6 cl-106 hco3-25 angap-12 06:28am blood glucose-83 urean-11 creat-0.9 na-142 k-4.2 cl-111* hco3-23 angap-12 05:00am blood glucose-90 urean-16 creat-0.9 na-138 k-3.7 cl-111* hco3-20* angap-11 06:00pm blood glucose-90 urean-18 creat-1.0 na-137 k-4.7 cl-108 hco3-19* angap-15 06:00pm blood alt-15 ast-17 alkphos-87 totbili-0.2 06:00pm blood lipase-13 05:00am blood ctropnt-<0.01 06:00pm blood ctropnt-<0.01 06:00am blood calcium-8.4 phos-4.4 mg-1.6 06:28am blood calcium-8.6 phos-3.0 mg-2.0 05:00am blood calcium-7.8* phos-2.8 mg-1.8 06:00pm blood calcium-7.3* phos-3.8 mg-1.7 06:13pm blood lactate-1.6 cxr: : findings: portable ap upright view of the chest is obtained. there is dense consolidation in the right upper lobe with air bronchograms again noted, which could represent right upper lobe pneumonia. although, followup to resolution is advised as an underlying malignancy cannot be excluded at this time. the left lung remains clear. no pleural effusion is seen. clips in the upper abdomen are noted. heart size remains normal. impression: right upper lobe consolidation with air bronchograms, most likely representing pneumonia, although followup to resolution is advised to exclude underlying malignancy. ct abdomen : impression: 1. probable right upper lobe/right suprahilar mass with postobstructive pneumonia. right sided mediastinal and right hilar lymphadenopathy and contralateral mediastinal nodal enlargement. if this is a mass such as from malignancy, this is probable t3 n3 m0. however this may represent dense right upper lobe consolidation from infection, but less likely. 2. homogenous enlargement of the left adrenal gland may relate to a nephrectomy as no focal adrenal lesion is shown. 3. possible right first rib invasion, this can be confirmed with a pet-ct or limited mri of the chest wall, if clinically appropriate. result communicated by telephone to dr medical resident, at 3.44 pm . cytology: -transbronchial fna of 3 lymph nodes: negative for malignant cells. -bronchial washings: negative for malignant cells -unable to biopsy dominant mass via bronchoscopy brief hospital course: 50 yo f tobacco user with hx of stroke, hyperlipidemia and hypotension who presents with rul pneumonia and hypotension concerning for septic shock. # hypotension/sepsis: differential included sepsis, medication effect, hypovolemia. the patient was stablizied with fluid boluses. a cxr showed a consolidation in the rul more consistent with a mass than infiltrate. she was initially started on ceftriaxone and levofloxacin to cover for community acquired pneumonia. she was continued on levofloxacin alone for a 14 day total course. # rul opacity - a ct chest was obtained which was consistent with a pancoast tumor of the right lung with mediastinal nodes on the opposite mediastinum. the pulmonary team performed a bronchoscopy with endoscopic ultrasound. they were unable to biopsy the dominant mass. fnas were obtained from 3 lymph nodes and bronchial alveolar lavage was also performed. the cytology results were negative for malignant cells. patient will follow-up with her primary care physician regarding further of this mass, including possible ir-guided transthoracic biopsy. patient wanted to follow-up at hospital which is a cancer institute affliate. # headache - unclear etiology, possibly initially a migraine ha that may have been complicated by post-lp, positional component. resolved with pain medication. #anxiety: patient appropriately anxious regarding her diagnosis of a lung mass. patient received lorazepam 1 mg po qhs while hospitalized. she was given a prescription for ambien. she will follow up with outpatient social work. # tobacco use: patient with current history of tobacco use, ~30 pack year history. she was given nicotine patch 14 mg daily and nicotine gum 2 mg po q4h prn nicotine craving and was given nicotine replacement prescriptions. #hx of cva: residual left side peripheral vision loss. continued on asa 325 mg po qday. #hypothyroidism: continued on levothyroxine. #hyperlipidemia: continued on simvastatin and eztimibe. medications on admission: -levothyroxane 137 mcg daily -zetia 10 mg daily -simvastatin 5 mg daily -asa 325 mg daily -excedrine migraine prn -claritin prn allergies -zofarax prn cold sores discharge medications: 1. levothyroxine 137 mcg capsule sig: one (1) capsule po daily (daily). 2. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 3. simvastatin 10 mg tablet sig: 0.5 tablet po daily (daily). 4. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 5. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). disp:*14 patch 24 hr(s)* refills:*0* 6. levofloxacin 750 mg tablet sig: one (1) tablet po once a day for 10 days. disp:*10 tablet(s)* refills:*0* 7. claritin oral 8. zovirax topical 9. fioricet 50-325-40 mg tablet sig: one (1) tablet po every four (4) hours as needed for headache. disp:*10 tablet(s)* refills:*0* 10. tylenol 325 mg tablet sig: 1-2 tablets po three times a day as needed for pain. disp:*30 tablet(s)* refills:*0* 11. cepacol sore throat 15-2 mg lozenge sig: one (1) lozenge mucous membrane four times a day as needed for sore throat. disp:*30 lozenges* refills:*0* 12. ambien 10 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia for 10 days. disp:*10 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: pneumonia lung mass discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: 1. pneumonia: you were admitted to the hospital with high fevers, headache and chest pain. you were found to have a pneumonia. your infection caused your blood pressure to become low. you were given intravenous fluids to bring up your blood pressure. you were given antibiotics to treat your infection. you will continue to take antibiotics. the instructions for this are: -levofloxacin 750 mg once a day until 2. lung mass: we found a mass in your lung on your chest x-ray. we got a ct scan to further evaluate the mass. we also performed a brochoscopy to obtain a biopsy of the mass. the results of the biopsy are not available yet. you will review these results with your primary care physician. were given a cd with the images from your ct scan. your pcp will set up follow-up care with oncology at hospital which is an affiliate of cancer institute 3. the following changes were made to your medications: -added levofloxacin 750 mg once a day until -added nicotine patch- apply daily -added nicotine gum as needed for nicotine cravings -added fioricet as needed for headache -added ambien as needed for sleep followup instructions: name: , l. location: tri-river family health center address: , , phone: **dr. office will contact you to schedule an appointment. if you dont hear by wednesday, , please call the number above. dr. office will assist you in setting up a follow-up appointment at hospital. procedure: closed [endoscopic] biopsy of bronchus biopsy of lymphatic structure diagnoses: pneumonia, organism unspecified obstructive sleep apnea (adult)(pediatric) tobacco use disorder unspecified acquired hypothyroidism other and unspecified hyperlipidemia anxiety state, unspecified other late effects of cerebrovascular disease other diseases of lung, not elsewhere classified enlargement of lymph nodes migraine, unspecified, without mention of intractable migraine without mention of status migrainosus 

Answer: The patient is high likely exposed to