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: this is a 49 year old male with a history of severe pulmonary hypertension on flolan, scleroderma with crest variety, transferred to the medical intensive care unit for hypotension, blood pressure 68/5 and worsening hypoxia. the patient states that for the last week he has had increasing shortness of breath and cough with yellow sputum and rare blood streaks. the patient improved with three days of azithromycin and reportedly was compliant with medications and diet. the patient went from walking around the apartment to being only able to ambulate for a few feet. the patient was admitted to the medicine floor. in the emergency room, the patient had a saturation of 100% on four liters and received empiric levaquin, lasix 40 to 80, bumex, spironolactone, diltiazem. the patient continued on levaquin in-house. a pulmonary and hypertension doctor and recommended intravenous antibiotics, gentle diuresis and decreasing the flolan rate to 23. the congestive heart failure service was also who agreed with the plan. earlier on the day prior to transfer, the patient had an episode of increasing respiratory rate to the 40s and tachypnea, shortness of breath, and decrease in his systolic blood pressure to the 90s on 100% non-rebreather, which improved his respiratory rate to 30. ativan and lasix were given. the patient now had an increasing oxygen requirement and desaturating to 71 to 80 on six liters and blood pressure of 78/48 with respiratory rate in the 30s. on nonrebreather, the patient had a saturation to 90%. the patient originally slightly lightheaded but resolved after 250 cc normal bolus with a gas of 7.47, 37, and 118 on 100% non-rebreather. the patient currently reports intermittent shortness of breath worse with exertion, nausea and left axillary pain. the patient denies recent fevers, chills, night sweats, head trauma, head congestion, sick contacts, sore throat, chest pain, left arm pain, abdominal pain, bloody stool. the patient has baseline three pillow orthopnea and now feels that he could not lay back more than head around 60 degrees due to his dyspnea. the patient also says baseline systolic blood pressure is 110. past medical history: 1. scleroderma of the crest variety. 2. severe pulmonary hypertension on flolan and home o2 of approximately four liters. as noted, flolan was increased from 23 to 25 as an outpatient two days prior to admission and he has been on it for one year. 3. bilateral pleural effusions status post thoracentesis in that was non-malignant. 4. congestive heart failure with diastolic dysfunction. 5. hypertension. 6. gastroesophageal reflux disease. 7. history of staphylococcus aureus bacteremia. 8. history of low potassium and low calcium. 9. history of chest wall cellulitis. allergies: morphine, percocet, codeine, causing itchiness and rash and viagra causing headaches. medications on admission: 1. diltiazem 120 xr q. p.m. 2. lisinopril 2.5 q. day, discontinued on . 3. fluoxetine 20 mg p.o. q. day. 4. coumadin 1 mg p.o. q. day. 5. flolan 25 nanograms per kg per minute to 23 nanograms per kg per minute. 6. protonix. 7. digoxin 0.125 p.o. q. day. 8. spironolactone 25 p.o. q. day. 9. potassium chloride. 10. metolazone 2.5 mg q. monday. 11. bumetanide 4 mg p.o. twice a day. 12. levaquin 500 mg q. 24. 13. ativan p.r.n. 14. tylenol p.r.n. 15. imodium p.r.n. 16. ambien p.r.n. 17. albuterol p.r.n. 18. zofran p.r.n. social history: lives alone in an apartment where his sister lives above. the patient denies tobacco history or alcohol history. physical examination: temperature 98.1 f.; blood pressure 72/53 with a map of 57; heart rate of 105; oxygen saturation 98% on seven liters nasal cannula. in general, the patient appropriately answered questions but is in very mild respiratory distress. heent: pupils equally round and reactive to light. extraocular muscles are intact. mucous membranes were moist. neck with jugular venous pressure approximately 11 cm; no lymphadenopathy. cardiovascular: regular rate and rhythm, tachycardia, no murmurs, rubs or gallops. possible s4. lungs: right greater than left crackles approximately half way on the right base. left axilla tender to palpation with reproducible pain. abdomen: hickman line on the right chest dry with dressings; clean, dry and intact. positive abdominal bowel sounds. mild tenderness in the epigastrium; otherwise soft without masses. extremities are warm; no lower extremity edema. tight skin of skin and fingers, and question toes. pink nodules on the shin. laboratory: data is ck of 37, troponin less than 0.1, white blood cell count of 9.0, hematocrit 30.0, platelets 194, zero bands. inr is 1.2, potassium 3.5, creatinine 1.7. lactate 1.2 with a gas of 7.47, 37, 118, on 100% non-rebreather. ekg is sinus tachycardia to 102, low voltage, poor r wave progression. chest x-ray with small right effusion, right interstitial opacity greater than left. right heart catheterization on , revealed an ra-pressure of 86, rv of 67/8, pa of 67/22; a wedge pressure of 11, cardiac output of 5.7 and 3.1 for the index and a pvr 421. an echocardiogram is ejection fraction of greater than 60%, left atrium mildly dilated, left ventricular cavity wall, right ventricle moderately dilated, moderate global rv free wall hypokinesis. abnormal septal motion consistent with rv volume overload. trace aortic regurgitation, trace mitral regurgitation, one plus tricuspid regurgitation, moderate pericardial effusion, no signs of tamponade. brief right atrium collapse. pulmonary function tests on , fvc of 51% of predicted, 2.32; fev1 2.06, 61% of predicted; fev1 to fvc ratio is 89 or 119% of predicted. cytology from a tap in , cytology is negative for malignant cells. hospital course: 1. hypotension: the patient was likely hypotensive after significant diuresis prior to the day of admission and worsening volume status. initially concern for septic shock, however, the patient was afebrile and did not have any blood cultures. the patient's systolic blood pressure and symptoms of dizziness responded to a small bolus, making hypovolemia the more likely etiology. other etiologies included cardiac and distributive shock, however, the patient subsequently underwent placement of a swan-ganz catheter placement for evaluation of his cardiac function, which was placed on , which subsequently revealed elevated pa pressures with a systolic in the 90s and a wedge pressure of 14. it was unlikely thought that this patient was in congestive heart failure but was likely thought to have progressing of his pulmonary hypertension. 2. hypoxia: the patient also presented with worsening hypoxia. differential included worsening progressive disease of severe pulmonary hypertension as well as pneumonia from a chest x-ray which showed right opacity for which the patient was treated with a course of levaquin. other etiologies included a pulmonary embolism; lenis were performed which were negative and concern for an in situ pulmonary embolism was high given the patient's current medical condition. the patient was subsequently treated with a heparin drip; however, this was complicated by a decrease in his platelets and thrombocytopenia. heparin was stopped in favor of argrotaban and a hit antibody was sent which is pending at this time. the patient's course was subsequently complicated by episode of worsening hemoptysis, at which point anti-coagulation was discontinued given the patient's risk for bleeding and an inr of 1.8. other etiologies for his hypoxia included possible congestive heart failure and volume overload given his volume resuscitation, however, his swan numbers did not reveal any evidence of this. the congestive heart failure team was involved in the care of this patient and recommended no diuresis at this time. other etiologies included interstitial lung disease due to scleroderma. the patient's rheumatologist, dr. , was regarding management of this patient and recommended a course of solu-medrol times three days for interstitial disease and the patient received those doses which transitioned to p.o. prednisone after the course. however, despite these aggressive measures, the patient continued to be hypoxic. dr. , the patient's primary pulmonologist was involved in the care of this patient. the patient's flolan was subsequently increased while measuring his cardiac output index and subsequently he was found to have a tolerable dose at 31, limited by symptoms. the patient's viagra was also started at around the clock dosing of q. four hours with subsequently improvement of his pulmonary pressures, however, the patient continued to have worsening hypoxia to the point where on , the patient was subsequently intubated after worsening respiratory status despite maximal noninvasive or positive pressure ventilation with cpap. the patient was intubated using etomidate and had significant complications with hypotension upon intubation given the hypotensive effects of sedatives. the patient was subsequently transitioned to propofol as a sedative and vented on a/c. this was also complicated by rising pa pressures and decreased systemic hypotension likely due to septal deviation of the right ventricular free wall into the left ventricle, decreasing the left ventricular outflow. the patient subsequently required the addition of levophed as a pressor to improve systemic cardiac output as well as maintaining renal perfusion and preventing shock. at the time of the dictation, the patient was still currently intubated and ventilated on a/c. 3. acute renal failure: the patient presented with an elevated creatinine on the day of admission which was likely thought to be due to hyperperfusion and prerenal azotemia with improvement of his cardiac output. the patient's creatinine improved to 1.3 at the time of this dictation. the goal was to maintain a map of greater than 65% while on levophed to improve renal perfusion. 4. anemia: the patient had a stable hematocrit, however, had an episode of acute bleed and hemoptysis which dropped his hematocrit to 26. the patient was transfused two units of packed red blood cells initially with improvement of his hematocrit. when the patient was initially admitted, the patient was thought to subsequently benefit from the pressure of blood and this was initially given, however, the patient subsequently had some worsening shortness of breath with the second transfusion and was likely discontinued. 5. hematologic: the patient had an episode of thrombocytopenia thought to be due to and related to heparin infusion. hit antibodies were sent and are still pending at this time. 6. prophylaxis: the patient was maintained on pneumoboots and protonix for gi prophylaxis. no anti-coagulation was given due to his thrombocytopenia. 7. psychiatric: the patient has a significant anxiety component which worsened his shortness of breath. the patient was initially sedated using ativan which improved some of his tachypnea. once intubated, the patient was subsequently sedated using propofol and versed. 8. access: the patient had a left swan placed for the management of his hypotension and pulmonary artery hypertension. 9. code status: full. the patient is to be maintained as a full code. the remainder of the hospital course and discharge information will be dictated by the next team covering for this patient. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances insertion of endotracheal tube other bronchoscopy non-invasive mechanical ventilation transfusion of packed cells injection or infusion of nesiritide diagnoses: pneumonia, organism unspecified congestive heart failure, unspecified other pulmonary insufficiency, not elsewhere classified primary pulmonary hypertension postinflammatory pulmonary fibrosis other specified hypotension systemic sclerosis 

Answer: The patient is high likely exposed to