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: history of present illness: mr. is a 23-year-old male with a past medical history significant for admission to from to for bilateral pulmonary emboli status post tpa administration. during this admission, he was also found to have a patent foramen ovale on echocardiography. the patient was discharged to home on lovenox and coumadin. patient received a hypercoagulable state work up during this admission which was notable for an anticardiolipin antibodies and a heterozygosity for a prothrombin gene mutation. patient presents to the emergency department with hemoptysis. after discharge from first hospital admission, the patient continued to improve until one day prior to admission when he noted cough productive of mild amounts, he estimated a half a cup of bright red blood with some accompanying dark clots. patient denies any feeling of lightheadedness, dizziness or weakness. patient denies any fever, chills, cough or shortness of breath. has occasional cough. denies runny nose, sore throat. denies melena, edema, bright red blood per rectum. patient was admitted for observation. past medical history: 1. significant for right upper extremity basilar vein superficial thrombophlebitis. 2. chronic lower extremity swelling which was diagnosed as chronic compartment syndrome. 3. patent foramen ovale, prothrombin gene mutation. 4. anticardiolipin antibodies. allergies: patient denies any known drug allergies. medications: 1. tylenol p.r.n. 2. coumadin 10 mg q. day. 3. lovenox 100 mg b.i.d. subcutaneous. family history: no history of hypercoagulable or bleeding states. social history: patient is a student, lacrosse player. denies tobacco. occasional etoh. denies any ivda. patient denies risk factors for tuberculosis. physical examination: on admission temperature of 98.4 f, pulse 77, blood pressure 138/80, respirations 20 and saturating at 95% on room air. in general this was a thin caucasian male sitting at the foot of the bed in no apparent distress. head, eyes, ears, nose and throat: pupils equal, round and reactive to light. extraocular movements intact. anicteric sclerae. moist mucous membranes. no oropharyngeal lesions were appreciated. patient's nares were only significant for a small spot of old blood on the right nares. lungs were clear to auscultation bilaterally. heart was regular rate and rhythm, s1, s2, no murmurs, rubs, or gallops. abdomen was soft, nontender, nondistended without masses. normoactive bowel sounds. extremities: no clubbing or cyanosis. left lower extremity was slightly larger than right lower extremity. laboratory: white count of 5.2, hematocrit of 40.7, platelets of 302. sodium of 140, potassium of 4, chloride of 100, bicarbonate of 23, bun of 19, creatinine of 0.9, glucose of 103, calcium 9.7, magnesium 1.8, phosphate 4.0. pt 16.3, ptt 41.9, inr of 1.8. patient received a chest x-ray which was normal without focal consolidation or pleural effusion. hospital course: secondary concern that the origin of bleeding was from patient's nares with questionable epistaxis. patient's nose was packed in the emergency department. ent consult was obtained and found no evidence on fiberoptic examination of any recent bleeding in patient's nose. consult was able to induce bloody sputum on prompting without any evidence of nasal bleeding thus suggesting pulmonary source. shortly after admission, the patient experienced recurrently hemoptysis, approximately 500 cc. intervention pulmonary consult was obtained and patient was transferred to medical icu for closure observation. ct scan of the patient's chest was obtained to evaluate for possible recurrent pulmonary emboli. ct scan showed interval stable 2 mm nodule left lung apex, notable for interval appearance of patchy areas of ground-glass opacifications in the right lower lobe and additional patches of ground-glass opacification in the right middle lobe. no pleural effusions. these abnormalities were concerning for pulmonary hemorrhage in addition to pneumonia, filling defects within the bronchi of the right middle and right lower lobe were also appreciated. the patient continued to have episodes of hemoptysis. ct scan with contrast was repeated. the scan showed significant recanalization of the left pulmonary arterial system with extensive retraction revascularization of previously noted pulmonary emboli. the residual filling defects within the segmental branches of the left lower and left middle lobe vessels were appreciated. consolidation was on the right low and right middle, no lobe was appreciated. no lymphadenopathy, no effusion. scan again concerning for pneumonic consolidation versus area of infarct secondary to difficulty of reversal lovenox at which time patient was started on heparin. on , patient underwent flexible and rigid bronchoscopy which showed a large blood clot obstruction right lower lobe bronchus which after suctioning revealed a small polypoid lesion at the take off the right lower lobe bronchus with a stream of pulsatile blood emanating from it. intervention pulmonary team used argon plasma coagulation to coagulate the lesion which was successful without further bleeding. the patient tolerated the procedure well. the patient also received bronchial arteriogram which showed take off at the right bronchial artery at the level of t4, t5 which showed a bronchial artery to lower right pulmonary artery shunt. concern was raised given patient's history of the right lower lobe pulmonary embolus, embolization of this right bronchial artery to right pulmonary artery fistula could possible result in infarction of the patient's right lower lobe. thoracic surgery consult was then obtained. discussion with medical team, thoracic surgery team and family was then held discussing options of: 1) coil embolization with possible consequence of right lower lobe infarction, 2) a right lower lobe lobectomy or 3) a conservative approach of gentle anticoagulation with the hopes of continuing and low dose thrombolysis would promote natural closure of fistula. in the setting of elevated right sided pressures in the setting of patient's pulmonary emboli, embolization and lobectomy were felt to possibly impose significant risk to patient at this time. thus in consultation with thoracic surgery and family, a conservative approach was decided upon, though ct surgery had initially recommended right lower lobe lobectomy with subsequent anticoagulation for the patient. both patient and family did not want to pursue this option so consensus was made for low dose anticoagulation. the patient was then started on lovenox with protamine at bed side. the patient continued to do well on lovenox. serial hematocrits showed no drop in patient's hematocrit status post argon beam therapy. the patient was transferred to the floor where he continued to improve. hematocrit remained stable. consultation with hematology and interventional pulmonary service felt that the patient would benefit from three weeks of lovenox prior to transition to coumadin secondary to greater ease of reversal of lovenox than coumadin. at the time of discharge, the patient was given a lovenox injection instructions. the patient was clearly instructed to lay on right side in the event of any bleeding and to present to the emergency department immediately. the patient is instructed to follow a diet low in vitamin k. the patient is scheduled for a follow up appointment with hematology / oncology on with dr. . the patient is instructed to follow up with primary care physician within two weeks. condition on discharge: at the time of discharge, the patient is stable and improved. discharge medications: lovenox 100 b.i.d. subcutaneous. , m.d. dictated by: medquist36 procedure: arteriography of pulmonary arteries control of epistaxis by anterior nasal packing endoscopic excision or destruction of lesion or tissue of bronchus diagnoses: ostium secundum type atrial septal defect other pulmonary embolism and infarction rupture of artery arteriovenous fistula of pulmonary vessels 

Answer: The patient is high likely exposed to