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: sob major surgical or invasive procedure: bronchoscopy endotracheal intubation/extubation trach placement peg picc placement history of present illness: 44m with hiv (most recent cd4 9) and emphysema p/w acute on chronic dyspnea (on 4 l nc at home), ble edema present with increasing sob. history is obtained this his mother and a phone conversation with his pcp. the past week the patient has had increasing sob and cough. per his mother he was functioning despite the syptoms until the day prior to admission when he became extreely sob and felt "like he was having an asthma attck." his mother said that he felt he had to call the ambulance because his breathing had become too labored. he has been increasingly using his inhalers over the past week with little improvment in his symptoms. he saw his pcp 5 days pta at which time he was started on levofloxacin and bactrim for possible pna and fluconazole for thrush. per his mother, he has been taking all of his medications. . his pcp encouraged him to present to the days ago given his worsening anasarca and sob, but patient was resistant at first. per the pcp, has been working with him at home to attempt to get him to be more compliant with medications and he was improving somewhat until this past week when he became more sob and edmatous. . in the ed, t 98.6 bp 144/103 hr 130 rr 40 o2 sat 97 % on 2 l nc. he began breathing with rates in the 40s. abg was 7.32/52/89 and he was intubated for increased work of breathing. he was given morphine 4 mg iv x1, ativan 1 mg iv x1, ceftriaxone 1 g iv x1, azithromycin 500 mg po x1, bactrim ds po x1, solumedrol 125 mg iv x1, dilaudid 1 mg iv, propofol for sedation and was tranferred to the . past medical history: 1. hiv/aids 2. asthma 3. dysthymia 4. gastritis 5. recent admission with esophageal candidiasis social history: per omr/pcp, lives with his mother. is not currently employed. he currently smokes less than one pack per day down from 2.5 packs per day at his highest. occasional etoh, marijuana, and cocaine. he is wheelchair bound. . family history: mother and father who is still alive without medical problems. 5 siblings who are all healthy. physical exam: vitals: t 97.1 bp 120/75 o2 sat 99% on ac 500/18/. breathing over at 21 general: intubated, fighting the vent, shaking head responding to questions heent: et tube in place cv: tachycardic, rr, nl s1, s2 lungs: rhonchorous b/l, diffus wheezes abdomen: hypoactive bs, soft, mildly distended extremities: 3+ pitting edema to thighs skin: no rashes neuro: agitated on vent but following commands pertinent results: admission ekg: sinus tachy, rate 103, nl axis, nl intervals, no st-t wave changes . imaging: . cxr: bilateral patchy opacities (prelim) . cta chest: in comparison to the prior study, there is interval progression of parenchymal abnormalities consistent with an opportunistic infection in this patient with known hiv. there are ill-defined patchy and tree-in- opacities predominantly in the left lower lobe, lingula and right middle lobe with additional diffuse ground-glass opacities involving the entire lungs. there is no mediastinal, hilar, or axillary lymphadenopathy. airways are patent. heart and great vessels remain normal. no clinically significant pe is seen. there are several equivocal filling defects in the second-order branches of the lower lobes (3:66 and 3:59). images through the upper abdomen do not reveal acute findings impression: 1. findings consistent with interval progression of primary infection, likely with opportunistic agents in this patient with hiv. 2. no evidence of clinically significant pe. equivocal partial filling defects in several second-order branches of the left lower lobes bilaterally. . le u/s: no dvt . tte: the left atrium is normal in size. the estimated right atrial pressure is 0-5mmhg. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). regional left ventricular wall motion is normal. tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). 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. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. . : bal rbc: 0 polys: 86 lymphs: 2 monos: 10 eos: 1 macro: 1 . admission labs: 9.1 12.7 >---< 577 30.4 . 135 103 16 -------------< 153 4.8 23 0.5 ca: 8.3 mg: 2.0 p: 2.6 . discharge labs: 04:42am blood wbc-5.4 rbc-2.71* hgb-9.1* hct-27.2* mcv-101* mch-33.7* mchc-33.5 rdw-19.2* plt ct-391 04:42am blood pt-11.8 ptt-38.0* inr(pt)-1.0 04:42am blood glucose-74 urean-12 creat-0.5 na-133 k-4.4 cl-102 hco3-24 angap-11 04:42am blood calcium-8.2* phos-2.1* mg-2.0 brief hospital course: 44 yo male with hiv/aids, copd, anasarca p/w sob, intubated and admitted to icu, likely secondary to copd exacerbation. hospital course by problem: . # hypoxic respiratory failure: believed to be most likely copd exacerbation possibly secondary to underlying infection. respiratory mechanics showed increased airway resistence. he was therefore treated with solumedrol as well as albuterol and atrovent. monteleukast was also added for persistent elevated airway resistence. there was never any culture data guiding treatment of possible infection despite potential of a lll infiltrate on cxr which never cleared over the course of admission. patient completed a course of azithromycin as well as ceftriaxone for community acquired pneumonia. he also completed a course of bactrim for potential pcp despite negative bal as he had received treatment prior to admission. patient self extubated numerous times, each time requiring reintubation for increased work of breathing and respiratory distress. for this, he required increasing levels of sedation. he was started on around the clock haldol in an attempt to decrease his sedation requirements without success. he was eventually weaned off of the ventilator but failed extubation after 36 hours believed most likely secondary to respiratory muscle weakness. nifs throughout admission were in the low 20s. patient went for trach and peg and received both without incident. he did extremely well following the procedure and sedation was once again weaned. . # hiv/aids: most recent cd4 9. has h/o gastritis, , and toxoplasmosis infections. he was continued on his home haart regimen without incident. . # hyponatremia: patient developed hyponatremia believed to be most likely secondary to increased free water with tube feeds and antibiotics. there was no evidence of siadh on urine examination. free water with tube feeds were stopped and antibiotics were placed in normal saline with resolution of hyponatremia. . # anasarca: likely in setting of malnutrition (last albumin 2.4) and hiv. echo showed normal ef. was aggressively diuresed and was >5l negative at the end of his admission with resolution of anasarca. he received tube feeds throughout admission and repeat albumin was 2.6. . # diarrhea: chronic, but patient w/ large volume output. c diff negative x 3. has been negative this admission. potentially secondary to haart therapy. he was started on imodium. . # h/o gatritis: no current evidence of gastritis. patient without complaint. he was continued on valganciclovir throughout admission as well as h2 blocker. stools were guaiac negative. . # anemia: no clear bleeding source. hct low on admission. likely marrow suppression from hiv/haart therapy. received 1 unit prbc transfusion on admission. following transfusion, hct remained stable throughout admission. . # ? small pe: the were 2 subsegmental filling defects on cta. however, clinical suspicion was low. lenis were negative. no further work up was persued given other reasons for tachycardia and hypoxia which resolved with appropriate treatment as above. . # fen: continued on tube feeds. peptamen vhp full strength; starting rate: 10 ml/hr; advance rate by 10 ml q6-8h. goal rate: 55 ml/hr . # ppx: sc heparin, h2 blocker in place of ppi while on haart . # code: full . # access: l picc, piv medications on admission: (per pcp) bactrim ds (started 5 days ago) levofloxacin 500 mg po qd (day 5) lasix 60 mg po bid fluconazole 100 mg po qd azithromycin 1200 mg po q wk (mac ppx) abacavir 600 po daily atazanavir 300 mg po daily ritonavir 100 mg po daily tenofovir disoproxil fumarate 300 mg po daily lamivudine 300 mg po daily valganciclovir 900 mg po q 24h salmeterol 50 mcg/dose disk inh ipratropium bromide 0.02 % solution : one (1) inhalation q6h (every 6 hours). albuterol sulfate 0.083 % solution : one (1) inhalation q6h (every 6 hours) as needed. budesonide 0.25 mg/2 ml solution for nebulization : one (1) inhalation twice a day. (rest per previous d/c summary) mirtazapine 30 mg po hs clonazepam 0.5 mg po qhs dapsone 100 mg po daily thiamine hcl 100 mg tablet po daily folic acid 1 mg po daily hexavitamin po daily docusate sodium 100 mg po bid senna 8.6 mg po bid as needed. nystatin 100,000 unit/ml suspension : five (5) ml po qid megestrol 40 mg/ml suspension po bid cyanocobalamin 1000mcg po daily oxycodone-acetaminophen 5-325 mg/5 ml solution : five (5) ml po q4-6h (every 4 to 6 hours) as needed. calcium carbonate 500 mg tablet, chewable : one (1) tablet, chewable po qid (4 times a day) as needed. simethicone 80 mg tablet, chewable : one (1) tablet, chewable po four times a day as needed for bloating. discharge medications: 1. trimethoprim-sulfamethoxazole 160-800 mg tablet : one (1) tablet po once a day. 2. abacavir 300 mg tablet : two (2) tablet po qd (). 3. tenofovir disoproxil fumarate 300 mg tablet : one (1) tablet po daily (daily). 4. lamivudine 150 mg tablet : two (2) tablet po daily (daily). 5. valganciclovir 450 mg tablet : two (2) tablet po daily (daily). 6. acetaminophen 325 mg tablet : 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 7. heparin (porcine) 5,000 unit/ml solution : one (1) inj injection tid (3 times a day). 8. senna 8.8 mg/5 ml syrup : one (1) tablet po bid (2 times a day). 9. montelukast 10 mg tablet : one (1) tablet po daily (daily). 10. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day) as needed for constipation. 11. albuterol 90 mcg/actuation aerosol : six (6) puff inhalation q4h (every 4 hours). 12. ipratropium bromide 17 mcg/actuation aerosol : six (6) puff inhalation q4h (every 4 hours). 13. budesonide 0.25 mg/2 ml solution for nebulization : two (2) ml inhalation (). 14. simethicone 80 mg tablet, chewable : one (1) tablet, chewable po qid (4 times a day) as needed. 15. loperamide 2 mg capsule : one (1) capsule po qid (4 times a day) as needed for diarrhea. 16. ipratropium bromide 0.02 % solution : one (1) neb inhalation q6h (every 6 hours) as needed. 17. fentanyl 75 mcg/hr patch 72hr : one (1) patch 72hr transdermal q72h (every 72 hours). 18. hexavitamin tablet : one (1) cap po daily (daily). 19. lopinavir-ritonavir 200-50 mg tablet : one (1) tablet po bid (2 times a day). 20. azithromycin 600 mg tablet : two (2) tablet po qweek (). 21. fluconazole 100 mg tablet : one (1) tablet po q24h (every 24 hours). 22. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 23. furosemide 20 mg tablet : 0.5 tablet po daily (daily). 24. oxycodone 5 mg tablet : one (1) tablet po q4-6h (every 4 to 6 hours) as needed for pain. 25. potassium & sodium phosphates mg packet : one (1) packet po three times a day for 1 days. 26. heparin lock flush (porcine) 100 unit/ml syringe : two (2) ml intravenous daily (daily): 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. 27. insulin regular human 100 unit/ml solution : one (1) inj injection asdir (as directed): see attached sliding scale. discharge disposition: extended care facility: discharge diagnosis: primary: - hypoxemic respiratory failure - hiv/aids - hyponatremia - chronic lbp - anasarca secondary: - diarrhea - h/o gastritis - anemia - poor nutrition discharge condition: fair discharge instructions: you were admitted with a copd exacerbation. you required intubation to assist with your breathing. you tolerated this well. we also placed a feeding tube to assist with your nutrition. . please contact your pcp or the emergency department if you experience worsening shortness of breath, chest pain, fevers, chills, or abdominal pain. . please take your medications as instructed. followup instructions: please see your pcp, . , on at 11am. provider: , m.d. phone: date/time: 3:30 provider: , m.d. phone: date/time: 1:45 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 other bronchoscopy percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy diagnoses: anemia, unspecified acute kidney failure, unspecified unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia obstructive chronic bronchitis with (acute) exacerbation human immunodeficiency virus [hiv] disease acute respiratory failure 

Answer: The patient is high likely exposed to