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: indinavir / ritonavir / stavudine / lamivudine attending: chief complaint: increased cough x1 week and fevers major surgical or invasive procedure: 1.) intubated secondary to hypoxic respiratory failure. successfully extubated. 2.) lumbar puncture 3.) central line placement 4.) transfused 2 units prbc history of present illness: 38 yo male with hx of hiv/aids (diagnosed in ; had cd4=5, viral load = 100k ),disseminated , candidal esophagitis, recurrent pcp, started on haart (had been held prior lft abnormalities while on clarithromycin and ethambutol for disseminated ), who presents w/ increased dry cough x 5 days, fever, l-sided abdominal pain and ruq pain. pt noted began having fevers approximately 1 week ago associated with this worsening dry cough. day after onset of symptoms he had an outpt appointment with his primary care physician at which time they got a cxr which was normal. pt noted worsening of these symptoms throughout the week until presentation. states this is similar to the symptoms he has had in the past when he was diagnosed with pcp. note, pt had been on bactrim prophylaxis for pcp which was /ced lft abnormalities (as mentioned above). he was then started on pentamadine inh pcp prophylaxis which he recieved his first dose of 5 weeks pta - was scheduled to get his 2nd pentamadine prophylaxis the week pta but did not make appointment. pt also noted onset of l-sided abdominal pain and ruq pain day pta. he does report diarrhea, which he describes as "loose stools" approximately 5 times/day, but he has had this ever since restarting the haart therapy in . denies any blood in the stool. denies nausea. ros otherwise negative for chest pain/pressure, sick contacts, sob, dysuria, weight changes. past medical history: 1. hiv/aids, cd4 nadir 5. 2. history of recurrent pcp. 3. eczema. 4. hsv. social history: mr. was diagnosed around with hiv and has been on haart intermittently since then. he lives with his partner, , who is hiv negative, in w/ one roommate. he was recently laid off from his job in an accounting firm and is currently unemployed and w/o insurance or a way to pay for medications. a case manager is looking into his options. he has had problems w/ noncompliance w/ his meds, though he expresses the desire to start taking them again. his parents and 3 of 5 siblings live in the area, with whom he states he has a good relationship. he started smoking cigarettes 6 yrs ago and smokes 1 ppd. he has used crystal meth for 2 yr when he goes clubbing, but denies other drug use, though cocaine and ecstasy use are recorded in some records. he does not drink etoh. family history: - father mi , living - paternal grandomother- mi - maternal grandmother- dm physical exam: vitals - t 98.7, hr 78, bp 127/68, rr 20, o2 98% 2l general - awake, alert, nad heent - perrl, eomi, op clear w/out thrush/lesions, neck - no cervical lad heart - rrr +s1, s2, no m/r/g lungs - scattered rhonci at bases b/l, otherwise cta abd - tender to palpation in luq, lll, ruq - difficult to assess as patient was voluntary guarding, although no noted involuntary guarding, rebound. + bs x 4 q ext - no edema in le b/l skin - no noted rashes neuro - a+ox3 pertinent results: labs on admission: 11:49pm blood type-art po2-66* pco2-28* ph-7.47* calhco3-21 base xs--1 intubat-not intuba 02:15pm blood wbc-7.1 rbc-3.31* hgb-9.3* hct-27.4* mcv-83 mch-28.0 mchc-33.8 rdw-19.7* plt ct-220 02:15pm blood neuts-77* bands-3 lymphs-10* monos-5 eos-0 baso-0 atyps-5* metas-0 myelos-0 02:15pm blood glucose-102 urean-15 creat-0.6 na-127* k-4.1 cl-94* hco3-24 angap-13 02:15pm blood alt-19 ast-39 ld(ldh)-247 alkphos-548* amylase-33 totbili-3.7* dirbili-2.5* indbili-1.2 02:15pm blood albumin-2.5* calcium-7.8* phos-2.9 mg-2.0 on tranfer to micu: 06:43pm blood type-art po2-347* pco2-23* ph-7.17* calhco3-9* base xs--18 06:51pm blood type-art po2-132* pco2-33* ph-7.10* calhco3-11* base xs--18 07:40pm blood type- po2-61* pco2-28* ph-7.24* calhco3-13* base xs--13 07:44pm blood type-art po2-484* pco2-25* ph-7.32* calhco3-13* base xs--11 11:01pm blood type-art temp-34.4 rates-16/ tidal v-650 peep-5 fio2-50 po2-224* pco2-28* ph-7.42 calhco3-19* base xs--4 intubat-intubated vent-controlled 01:35am blood type-art temp-36.2 rates-/20 tidal v-600 peep-5 fio2-40 po2-179* pco2-29* ph-7.42 calhco3-19* base xs--3 intubat-intubated on discharge: 05:33am blood wbc-3.4* rbc-3.60* hgb-10.3*# hct-30.6* mcv-85 mch-28.8 mchc-33.9 rdw-19.2* plt ct-292 05:33am blood glucose-152* urean-16 creat-0.6 na-132* k-3.8 cl-104 hco3-20* angap-12 03:19am blood alt-27 ast-40 ck(cpk)-20* alkphos-491* totbili-1.4 05:33am blood calcium-7.9* phos-2.8 mg-2.0 micro data: urine cx - negative blood cx - ngtd blood cx - ngtd fungal blood cx - ngtd urine cx - negative csf fluid - cryptococcal ag negative, lp unimpressive, cx ngtd blood cx - ngtd fungal blood cx - ngtd cmv viral load - pending blood cx - ngtd cmv viral load ngtd imaging: cxr: no focal consolidation appreciated. questionable diffuse and symmetric haziness could relate to technique, but infection such as pcp cannot be excluded. ct thorax: 1. prominent interstitial markings in both lungs, more pronounced in the lower lobes consistent with given history of pcp . 2. free fluid in the pelvis. 3. apparent thickening of the sigmoid bowel wall. this could be secondary to under distension. however, inflammatory/infectious process can give similar appearance. c-spine study: no fracture identified ruq u/s: normal son appearance of the liver. there is no biliary dilatation as clinically questioned. there is mild dilatation of the common duct, which is likely secondary to the patient's status of cholecystectomy. dilated splenic vein raises possibility of portal hypertension mri head: mild age inappropriate prominence of sulci and ventricles and subtle increased periventricular hyperintensities could be secondary to hiv encephalopathy. there is no enhancing lesion or acute infarct seen. brief hospital course: the patient is a 38yo man with hiv/aids (last cd4 count = 5 and last viral load = 100k in when off of haart, currently back on haart), history of recurrent pcp infections, not on pcp prophylaxis on admission who presented with increased cough and fevers x 5 days. was febrile on admission to 101-102, with cxr on admission c/w pcp infection, had abg with pao2 = 66 also c/w pcp. was started on bactrim and 40 mg prednisone given pao2. on night of admission, pt was found down and seizing at the bedside and code was initiated for hypoxic respiratory failure and patient was intubated and transferred to icu. pt's seizure was thought to be secondary hypoxia in the setting of the pt's likely pcp infection coupled with ambulation off of oxygen. pt. was admitted to the micu on s/p respiratory failure and seizure. bp was low initially in the micu, requiring pressors and concerning for sepsis vs secondary to medications used for intubation. therefore he was initially started on vancomycin and zosyn which were subsequently d/ced after no further signs of infection, and was maintained throughout micu stay on bactrim and steroids. he received an lp in the micu that was notable for no wbcs or rbcs. micu course significant for cxr which showing diffuse haziness with no consolidation, ct showing prominent interstial markings in lungs, free fluid in the pelvis and thickening of the sigmoid wall (?concerning for infectious colitis), c-spine was negative for fractures. blood cultures, fungal blood cultures, cryptococcal antigen (in serum and csf), cmv viral load were all sent and were negative or no growth to date on discharge. pt was quickly weaned off levophed and extubated, and returned to regular medicine floor. on medicine floor, patient maintained on bactrim and steroids. oxygenation was measured at > 96% on ra. prior to discharge, patient had ambulatory oxygenation which was > 96%. patient was discharged with instructions to complete 21 day course of bactrim and prednisone taper (40mg x 5 days, 40mg qd x 5 days, 20mg qd x 5 days) and with instructions to follow up with dr. in clinic. in terms of the abdominal ct that demonstrated ? sigmoiditis, pt had complained of abdominal pain on admission with ruq u/s that ruled out any biliary process, and abdominal pain quickly resolved on admission, without complaints of worsening diarrhea from baseline. therefore no further work up was performed as an inpatient with plans to address as an outpatient as needed. pt was also anemic on admission, with hct = 27, dropping to 25 during hospital course. etiologies thought to include marrow suppression vs. anemia of chronic disease. pt was transufed 2 units of packed red blood cells with appropriate bump of hct and was discharged with hct = 30.6. patient also with hyponatremia to 127 on admission (baseline na = 133-138). as patient appeared euvolemic on exam, this was thought secondary to siadh likely to pcp . hyponatremia resolved during hospitalization and treatment of pcp and patient was discharged with na = 132. in terms of pt's hiv/aids, maintained on haart therapy throughout hospital course, lfts monitored and showed elevated t. bili and alk phos (c/w immune reconstitution syndrome per dr. but flat transaminases. of note, pt with mri prior to discharge which showed some changes that could be c/w hiv encephalopathy. patient was agitated prior to d/c, but at baseline per previous caregivers. remained alert and oriented x 3 without mental status changes throughout hospital course. medications on admission: clarithromycin 500mg ethambutol 500mg qd kaletra 3 tabs zerit 30mg truvada 1tab qd amphotericin b swish and swallow folic acid 1mg qd cyanocobalamin 100mcg qd discharge medications: 1. clarithromycin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 2. lopinavir-ritonavir 133.3-33.3 mg capsule sig: three (3) cap po bid (2 times a day). 3. stavudine 30 mg capsule sig: one (1) capsule po q12h (every 12 hours). 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 5. cyanocobalamin 100 mcg tablet sig: 0.5 tablet po daily (daily). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. ethambutol 400 mg tablet sig: one (1) tablet po daily (daily). 8. ethambutol 100 mg tablet sig: one (1) tablet po once a day. 9. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: two (2) tablet po tid (3 times a day) for 21 days: complete 21 day course, through (began course on ). disp:*qs tablet(s)* refills:*0* 10. amphotericin b 100 mg/ml suspension sig: twenty (20) mg po qid (4 times a day): 5 ml wash, 4 times/day. 11. prednisone 20 mg tablet sig: two (2) tablet po see other instructions for 21 days: 40mg 40mg qd 20mg qd . disp:*qs tablet(s)* refills:*0* 12. truvada 200-300 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: 1.) pcp 2.) hypoxic respiratory failure discharge condition: stable. patient oxygenating well on room air at rest. ambulating oxygenation is good. on bactrim and prednisone. discharge instructions: 1.) please contact physician if increased cough, shortness of breath, fevers > 100.4, change in mental status, any other questions or concerns 2.) please take medications as directed 3.) please follow up with appointments as instructed followup instructions: 1.) provider: , md where: phone: date/time: 1:30 2.) provider: , m.d. where: center phone: date/time: 9:00 md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung insertion of endotracheal tube diagnoses: other convulsions human immunodeficiency virus [hiv] disease acute respiratory failure pneumocystosis other disorders of neurohypophysis 

Answer: The patient is high likely exposed to