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: darvon / percocet / codeine / e-mycin / percodan / darvocet-n 100 / penicillins / amoxicillin / ampicillin attending: chief complaint: suprapubic pain, dysuria major surgical or invasive procedure: right lung biopsy. left lung biopsy. picc line placement. suprapubic catheter change. t9 ct guided biopsy history of present illness: mr. is a 55 yo m w/long history of autonomic dysfunction complicated by urinary retention and suprapubic catheter placement who has multiple hospitalizations for recurrent uti, most recently 2/. of note, the pt's last uti was positive for esbl klebsiella resistant to most abx except for meropenem/imipenem. pt lives in a and reports 5 days pta noted onset of shaking chills, suprapubic pain/cramping, burning in the penis/urethra, and clouding of his urine. pt also noted crusting material surrounding the catheter. he was not noted to be febrile at his . he denies abdominal pain, back pain, n/v/d. he does note intermittent chest pain x 1 wk. it is sharp, left sided and lasts seconds to minutes. it is not exertional, positional or pleuritic. pt states it is different from his mi pain. he denies sob. he does c/o productive cough over past few weeks, related to an episode 1 wk prior where he "stopped breathing, felt like i was choking." pt unable to give color of sputum. <br> pt was taken from to the ed where a ua was positive. pt was given one dose of meropenem and admitted to medicine. in the ed, a wbc was 8.5, lactate 1.2, temp was 99.4 past medical history: - autonomic dysfunction c/b urinary retention requiring indwelling foley catheter, with recurrent utis - cad: s/p mi , tx with angioplasty - diffuse interstitial pneumonitis - anemia - autoimmune hepatitis - autoimmune thyroiditis - autoimmune peripheral neuropathy - intradural t10 mass - s/p cholecystectomy - chronic pain - depression social history: pt lived with wife and 30-year-old daughter prior to prolonged hospital/ stay; disabled, but formerly a truck driver; uses wheelchair at home w/ bedside commode autonomic dysfunction; previosly smoked 1ppd x 20years, then quit for ~10 yr, restarted and now quit since ; no alcohol or ivdu. family history: father had mi at 72; sister had after vaccine physical exam: gen: a&ox3 heent: ncat, perrl, eomi, op clear, no lad cv: rrr pulm: ctab abd: soft, diffusely ttp w/o rebound or guarding. sp catheter site with mild erythema, crusting. +tenderness w/manipulation. ext: no c/c/e neuro: non-focal pertinent results: medical condition: 55 year old man with productive cough, history of ? aspiration event. reason for this examination: please eval for infiltrate history: 55-year-old male with productive cough, questionable history of aspiration event. evaluate for infiltrate. comparison is made to prior radiographs dated , , and prior ct dated . ap and lateral chest radiographs: since most recent film there appears to be interval appearance to multiple ill-defined pulmonary nodules projecting over the right and left lower hemithoraces with the largest ill-defined opacity within the left mid hemithoraces measuring approximately 3.6 x 3.9 cm. changes from previously noted interstitial lung disease appear slightly improved on current radiograph. multiple calcified granulomas and calcified pleural plaques are better appreciated on prior ct examination. no evidence of pulmonary edema or pneumothorax. cardiomediastinal silhouette and hilar contours are stable. tip of left-sided picc catheter is unchanged in appearance within the brachiocephalic confluence. impression: multiple new ill-defined pulmonary nodules with most dominant nodule projecting over the mid thorax. appearance of these nodules is suspicious for neoplastic or metastatic involvement with focal infectious or fungal etiologies felt to be less likely. recommend further evaluation with ct of the chest. ct chest w/o contrast 10:53 am ct chest w/o contrast reason: please eval for masses medical condition: 55 year old man with nodules seen on cxr, concerning for mets reason for this examination: please eval for masses contraindications for iv contrast: none. indication: evaluate nodules seen on cxr. careweb notes reveal the patient has a history of autoimmune hepatitis, thyroiditis, peripheral neuropathy, and autonomic dysfunction. technique: multidetector helical scanning of the chest was performed without iv contrast. contiguous 5- and 1.25-mm thick axial and 5-mm thick coronal images were presented for interpretation. comparison: chest x-ray and cta chest . non-contrast ct of the chest: a new 1.6-cm nodule with somewhat irregular borders is seen in the right upper lobe. also, a 4.1-cm rounded solid appearing mass (soft tissue density), also with irregular contours is seen in the left lower lobe. there are no air bronchograms in this lesion. no other concerning nodules or masses are seen. there has been progression of the patient's interstitial lung disease with interlobular septal thickening and traction bronchiectasis, predominantly at the lung bases. previously seen diffuse ground- glass opacities have resolved. multiple tiny calcified granulomas are again noted reflecting prior granulomatous disease. the bronchi are patent to the subsegmental level. coronary calcifications are noted. otherwise, the heart, pericardium, and great vessels are unremarkable. no pathologically enlarged axillary, hilar, or mediastinal lymph nodes. left picc terminates in the left brachiocephalic vein. this exam is not optimized for subdiaphragmatic evaluation. the hypoattenuating lesion in the left lobe of the liver as well as bilateral renal cysts are unchanged. bone windows reveal a 7-mm sclerotic lesion in the medial clavicle, unchanged from , and likely a bone island. no other suspicious lytic or sclerotic lesions. impression: 1. 4.4-cm solid left lower lobe mass and 1.5-cm right upper lobe nodule are new compared to ct from . the differential diagnosis for these lesions is very broad and includes infections (fungal infection or nocardia), inflammatory conditions (cryptogenic organizing pneumonia), vasculitis (particularly as this patient has a history of autoimmune disorders), and neoplasm (synchronous primary carcinoma, metastasis, or pulmonary lymphoma). if the patient does not have a clinical findings of infection, a pet/ct may be helpful. 2. mild progression of fibrotic component of chronic interstitial lung disease. patient/test information: indication: endocarditis. height: (in) 66 weight (lb): 142 bsa (m2): 1.73 m2 bp (mm hg): 80/42 hr (bpm): 53 status: inpatient date/time: at 10:00 test: tte (complete) doppler: full doppler and color doppler contrast: none tape number: 2007w013-1:42 test location: west echo lab technical quality: adequate referring doctor: dr. measurements: left atrium - long axis dimension: 3.9 cm (nl <= 4.0 cm) left atrium - four chamber length: *5.4 cm (nl <= 5.2 cm) right atrium - four chamber length: *5.1 cm (nl <= 5.0 cm) left ventricle - septal wall thickness: 1.1 cm (nl 0.6 - 1.1 cm) left ventricle - inferolateral thickness: 0.9 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 5.1 cm (nl <= 5.6 cm) left ventricle - systolic dimension: 3.2 cm left ventricle - fractional shortening: 0.37 (nl >= 0.29) left ventricle - ejection fraction: >= 55% (nl >=55%) aorta - valve level: 3.6 cm (nl <= 3.6 cm) aorta - ascending: 3.2 cm (nl <= 3.4 cm) aorta - arch: 2.9 cm (nl <= 3.0 cm) aortic valve - peak velocity: 1.1 m/sec (nl <= 2.0 m/sec) mitral valve - e wave: 0.7 m/sec mitral valve - a wave: 0.6 m/sec mitral valve - e/a ratio: 1.17 mitral valve - e wave deceleration time: 224 msec tr gradient (+ ra = pasp): 23 mm hg (nl <= 25 mm hg) interpretation: findings: this study was compared to the prior study of . left atrium: elongated la. right atrium/interatrial septum: mildly dilated ra. left ventricle: normal lv wall thickness, cavity size, and systolic function (lvef>55%). normal regional lv systolic function. no resting lvot gradient. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. aortic valve: mildly thickened aortic valve leaflets (3). no as. no masses or vegetations on aortic valve. mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. no mvp. no mass or vegetation on mitral valve. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. no mass or vegetation on tricuspid valve. normal pa systolic pressure. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. no vegetation/mass on pulmonic valve. pericardium: no pericardial effusion. conclusions: the left atrium is elongated. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). regional left ventricular wall motion is normal. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no masses or vegetations are seen on the aortic valve. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. no mass or vegetation is seen on the mitral valve. mild (1+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. no vegetation/mass is seen on the pulmonic valve. there is no pericardial effusion. impression: no echocardiographic evidence of endocarditis. compared with the prior study (images reviewed) of , the findings are generally similar. the asd is not visualized on the current study. cta chest w&w/o c&recons, non-coronary 12:38 pm cta chest w&w/o c&recons, non- reason: please eval for pe, and please eval for evolving lll mass. contrast: optiray medical condition: 55 year old man with nodules seen on cxr, concerning for mets, mass evolving over weekend, ? now close enough to bronch? also, new o2 requirement over weekend, pulmonology concerned re: pe. reason for this examination: please eval for pe, and please eval for evolving lll mass. contraindications for iv contrast: none. clinical history: 55-year-old male with lung masses. new o2 requirement over weekend. evaluate for pulmonary embolus. comparison: . technique: non-contrast and contrast-enhanced multidetector ct acquired axial images of the chest. multiplanar reformatted images were obtained. ct of the chest: the previously identified nodule within the right upper lobe and mass within the left lower lobe is unchanged compared to recent ct from . there are again interstitial abnormalities as evidenced by interlobular septal thickening and traction bronchiectasis, predominantly at the lung bases, the extent of which is not changed from , . multiple tiny calcified granulomas are again noted reflecting prior granulomatous disease. the airways are patent to the subsegmental level. coronary calcifications are noted within the lad. otherwise the heart and great vessels are unremarkable. there is no pericardial or pleural effusion. there is mild pleural thickening with calcified pleural plaques. no pulmonary embolus or thoracic aortic dissection is appreciated. the previously seen left pic line has been removed. small mediastinal lymph nodes are seen which do not meet ct criteria for pathologic enlargement. osseous structures demonstrate no suspicious lytic or sclerotic lesions. a bone island is seen within the right clavicle, slightly increased in size from , however, unchanged from . the visualized upper abdomen demonstrates hypodensities within the liver. the smaller hypodenisity in the left lobe of the liver (series 3,image 86) is not worrisome, however, the subtle hypoenhancing lesion in the right lobe of the liver, better seen on prior ct from is concerning and should be further evaluated with ultrasound. impression: 1. no evidence of pulmonary embolus. 2. compared to the prior ct from five days ago, there is no significant change in chronic interstitial lung disease or pulmonary mass/nodule. again, the diagnostic consideration for the mass/nodule are very broad and includes infections, inflammatory and neoplasm. these lesions are ammenable to biopsy if clinically warrented. 3. subtle hypoenhancing lesion in the right lobe of the liver, better seen on preious ct from and recommend ultrasound for better characterization. fna, lung, left lower lobe mass, cell block: h&e stain shows alveolar spaces lined by atypical mucinous epithelium with intra-alveolar and background mucin, suspicious for a well-differentiated adenocarcinoma, bronchioloalveolar type. see also cytology report c07-10734l. note: slides reviewed with dr. , with concurrence. rul biopsy: suspicious for well-differentiated adenocarcinoma with features suggestive of bronchioalveolar type. t9 bx: poorly-differentiated metastatic carcinoma brief hospital course: unfortunately the patient did not survive this hospitalization. after an egd that revealed food in the esophagus the patient likely aspirated which precipitated a pea arrest. a code blue was called and per the wishes of the family the patient was aggressively resuscitated for 1.5 hours. despite the teams best efforts the patient suffered irrepairable anoxic brain injury as revealed by an extremely limited physical exam and the findings on eeg. per the family's wishes the patient was aggressively treated for approximately one week without improvement in his neurological status. ultimately it became clear that the patient was entirely dependent on the ventilator. the family then decided to withdraw the ventilator which resulted in the rapid passing of the patient. other issues addressed during this hospitalization were recurrent uti, autonomic neuropathy, initial diagnosis of non-small cell lung cancer, anti-phospholipid syndrome, and bactermia. medications on admission: --levothyroxine 50 mcg po daily --midodrine 20 mg po at 6 am, 20 mg at noon, 10 mg at 2 pm, 10 mg at 5pm --trazodone 150 mg po hs --requip 0.5 mg po hs --demerol 50 mg po prn pain discharge disposition: extended care discharge diagnosis: lung cancer discharge condition: deceased discharge instructions: none followup instructions: none procedure: venous catheterization, not elsewhere classified 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 laryngoscopy and other tracheoscopy esophagogastroduodenoscopy [egd] with closed biopsy closed [percutaneous] [needle] biopsy of lung closed [percutaneous] [needle] biopsy of lung biopsy of bone, other bones infusion of vasopressor agent diagnoses: coronary atherosclerosis of native coronary artery malignant neoplasm of liver, secondary urinary tract infection, site not specified acquired coagulation factor deficiency sepsis constipation, unspecified acute and chronic respiratory failure cardiac arrest anoxic brain damage old myocardial infarction infection and inflammatory reaction due to other vascular device, implant, and graft urinary catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure malignant neoplasm of lower lobe, bronchus or lung secondary malignant neoplasm of bone and bone marrow staphylococcal septicemia, unspecified other and unspecified mycoses chronic pain syndrome candidal esophagitis infection and inflammatory reaction due to other genitourinary device, implant, and graft neurogenic bladder nos unspecified disorder of autonomic nervous system chronic lymphocytic thyroiditis other and unspecified nonspecific immunological findings other voice and resonance disorders 

Answer: The patient is high likely exposed to