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: shortness of breath and chest pain for two days major surgical or invasive procedure: thoracentesis and chest tube placement video-assisted thorascopic surgery history of present illness: 68 year-old m with h/o a fibb on coumadin, copd, htn, dm2, and extensive tobacco hx who presented to an osh with progressive sob and pleuritic chest pain x 2 days and was found to have a large left-sided pleural effusion with compressive atelectasis. he received zosyn 4.5mg iv x 1, 2 units of ffp and vitamin k for a supratherapuetic inr and was transferred to . . in the ed his vitals were t 98.4 hr 120 bp 133/81 rr 24 o2 sat 94%. he had a leukocytosis of 34, left shift with 6 bands, and inr of 2.5. he received additional ffp & ddavp and was transferred to the icu. interventional pulmonology was consulted, performed a thoracentesis, placed a pigtail drain, which drained 1.2 l of turbid yellow fluid (procedure stopped worsening sob and pain). the patient's respiratory status worsened (abg 7.28/50/96), required nrb, weaned to 60% facemask. it was thought this could be secondary to re-expansion of a diseased lung or pulmonary edema. he was started on vanco and zosyn. his uop dropped and he became hotn, which resolved with fluids. vanc was discontinued. patient improved and was transferred to the floor, requiring 4l o2 on nc. . currently, he reports continued shortness of breath and pain with deep inspiration. he has had an intentional 25 lbs weight loss over the last 2 months. he has had sob for over a year, which he attributed to his smoking history. it is worse on exertion, would be huffing after one flight of stairs, denies orthopnyea, pnd, or leg swelling. he is followed by a cardiologist and has had 2 stress tests in the past, results unknown per patient. . he also has chronic back and b/l knee pain. he denies f/c/sweats, sick contacts, cough, sore throat, abdominal pain, n/v/d/c, no dysuria, frequency, no ha, numbness or tingling, seizures, no rash, no lumps or bumps, + easy brusising coumadin. past medical history: copd afib on coumadin - new in the past 3 months htn hld dm-ii social history: tobacco: 50 pack years, quit 1 year ago. smoked 1ppd x 50 years. alcohol: quit 34 years ago. prior heavy alcohol use with scotch and whiskey. lives with wife. has 1 daughter and a grandaughter. retired line foreman for an electric company now works as a parking attendent for a boat company to . denies exposure to asbestos. denies exposure to tubercluosis, prisons, homeless shelters, or exotic travel. family history: son died due to wpw (his wife also had this). denies other cardiac or pulmonary diseases. denies family history of rheumatoid arthritis or lupus. physical exam: vs: t: 98.2 hr: 89 afib bp: 103/62 sats: 95% ra at rest 90 w/activity wt: bs 141 general: 68 year-old male in no apparent distress heent: normocephalic, mucus membranes moist neck: supple no lymphadenopathy card: irregular resp: decrease breath sounds lll otherwise clear gi: obese, benign extr: warm 3+ edema incision: left thoracotomy site clean, dry, intact, margins well approximated neuro: aa&o mae pertinent results: wbc-15.4* rbc-3.35* hgb-9.9* hct-30.3 plt ct-389 wbc-18.8* rbc-3.09* hgb-9.0* hct-28.2 plt ct-366 wbc-30.6* rbc-3.65* hgb-10.9* hct-33.0 plt ct-519 wbc-34.2* rbc-3.81* hgb-11.5* hct-34.1 plt ct-491 inr(pt)-1.6* inr(pt)-1.4* inr(pt)-1.4* inr(pt)-1.2* inr(pt)-1.3* urean-21* creat-1.2 na-137 k-3.9 cl-96 glucose-178* urean-22* creat-1.1 na-137 k-4.0 cl-97 hco3-33 glucose-177* urean-19 creat-0.9 na-135 k-3.9 cl-98 hco3-33 glucose-244* urean-59* creat-2.3* na-133 k-4.0 cl-101 hco3-20 calcium-8.1* phos-3.6 mg-2.0 micro: pleural and tissue cultures from or no growth blood cultures x 2 no growth urine no growth cxr: : interval removal of left chest tubes. persistence of left hemidiaphragm elevation along with moderate left pleural effusion and left lower lobe atelectasis : the left chest tubes apparently have been placed on waterseal. no evidence of pneumothorax. the degree of opacification at the left base appears to have decreased somewhat. : left-sided pleural effusion and left lower lobe consolidation remain unchanged. opacities throughout the right lung seen on ct scan are below the resolution of the plain film. otherwise, the cardiomediastinal silhouette, the hilar silhouette, and pleural surfaces remain unchanged. there is no pneumothorax. cct: : 1. partial drainage of multiloculated left effusion, with incomplete lung re-expansion and hydropneumothorax. cannot exclude some superimposed consolidation in partially aerated left lower lobe. 2. new patchy ground glass opacities in right upper and middle lobes could reflect infectious or inflammatory process, or subpleural atelectatic change. 3. severe calcific atherosclerosis and trace pericardial effusion. renal ultrasound: the right kidney is 10.8 cm in length. the left kidney is 10.9 cm in length. cortical widths arem aintained. echotexturesare within normal limits. no hydronephrosis, renal stone, or mass lesion identified. a foley catheter balloon is identified in an incompletely distended bladder. impression: normal echotexture and size of bilateral kidneys with no hydronephrosis or stone identified. foley in bladder. brief hospital course: mr. is a 68yo m w/hx of afib on coumadin, dm2, copd who presents with respiratory distress found to have a large left sided pleural effusion. . #pleural effusion: his elevated inr was reversed with ffp, vitamin k, ddavp and he underwent diagnostic and therapeutic thoracentesis with pigtail placement by interventional pulmonology. initial pleural fluid studies (ph 6.5, low glucose) suggested a complicated infectious process versus malignancy. repeat imaging after effusion drainage did not show an obvious mass. he was started on broad spectrum antibiotics and then transition to levaquin and completed a 2 week course. all of the cultures to date have no growth. thoracic surgery was consulted and he underwent left thoracoscopy converted to left thoracotomy, decortication of lung on . he was transferred to the sicu intubated and on pressors. he weaned off the pressors, successfully extubated on . he transfer to the floor in stable condition. chest tubes anterior, posterior and basilar were to water-seal. the posterior was remove on . the anterior on and the basilar on once the pleural cultures were negative. chest films: serial chest films were done which showed pleural thickening on the left, elevation of the left hemidiaphragm and the appearance of the left basal and right lower lobe atelectasis. respiratory; with aggressive pulmonary toilet, neb, chest pt, diuresis and ambulation he titrated off oxygen with saturations of 93%. . #acute on chronic renal failure: his creatinine was 3.5 on admission with clinical history, exam, and labs (fena 0.3) suggestive of pre-renal etiology. renal ultrasound did not demonstrate obstruction or hydronephrosis to suggest post--renal etiology. medications were renal dosed and nephrotoxic agents were held. he was given intravenous fluids and his creatinine improved. on he was volume overload and given iv lasix with good response. he continue on lasix while hospitalized and discharged on 40 mg po. he had 3+ lower extremity. ace wraps were applied. his cardiologist was notified and he will follow his volume status as an outpatient. . #atrial fibrillation: he was continued on diltiazem for rate control 70-80's. digoxin was held in the setting of acute renal failure, then restarted upon resolution. his coumadin was held and anticoagulation initially reversed in order for the pigtail catheter to be placed. thereafter he was started on a heparin drip, which was discontinued prior to vats. anticoagulation (warfarin) was restarted on his home dose of 5 mg. on he was given 7.5 mg coumadin for inr 1.4. and for inr 1.6. he will continue on his home dose of 5 mg and follow-up with his cardiologist on monday. . #htn: initially his home antihypertensives were held. hctz was re-started for bp control. his blood pressure 89-110 and would not tolerate ace at this time. . #dm2: his oral hyperglycemic medications were held. he was started on an insulin sliding scale. on his po hyperglycemic meds were restarted. his blood sugars range were 150-170. . #depression: he was continued on wellbutrin. . #copd: he was continued on symbicort and spiriva. disposition: he was followed by physical therapy. his ambulation improved. he was discharged to home with his family and vna. he will follow-up with his cardiologist on monday for warfarin management and volume status. he will follow-up with dr. in 2 weeks for chest ct with contrast. medications on admission: wellbutrin sr 150 mg tab oral hydrochlorothiazide 25 mg tab oral po daily actoplus met 15 mg-850 mg tab oral po qhs lipitor 40 mg tab oral po daily diovan 80 mg tab oral po daily hydralazine 25 mg tab oral po bid warfarin 5 mg tab oral digoxin 125 mcg tab oral po daily cardizem la 420 mg 24 hr tab oral po daily symbicort 80 mcg-4.5 mcg/actuation inhalation spiriva with handihaler 18 mcg inh discharge medications: 1. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 2. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 3. bupropion hcl 150 mg tablet sustained release sig: one (1) tablet sustained release po qam (once a day (in the morning)). 4. valsartan 40 mg tablet sig: two (2) tablet po daily (daily). 5. warfarin 5 mg tablet sig: one (1) tablet po once daily at 4 pm. 6. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*30 tablet(s)* refills:*0* 8. levofloxacin 750 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 9. lasix 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 10. diltiazem hcl 420 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). 11. pioglitazone 15 mg tablet sig: one (1) tablet po bid (2 times a day). 12. metformin 850 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 13. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 14. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 15. colace 100 mg capsule sig: one (1) capsule po twice a day. disp:*60 capsule(s)* refills:*2* 16. potassium chloride 10 meq capsule, sustained release sig: one (1) capsule, sustained release po once a day: take with lasix. disp:*30 capsule, sustained release(s)* refills:*2* 17. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*70 tablet(s)* refills:*0* 18. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* discharge disposition: home with service facility: vna assoc. of discharge diagnosis: pneumonia with left pleural effusion copd atrial fibrillation on coumadin hypertension dm-ii discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: call dr, office if you experience: -fever > 101 or chills -increased shortness of breath, cough or chest pain -incision develops drainage -chest tube site cover sites with a bandaid until healed -you may shower. no tub bathing or swimming until incision healed -continue fingerstick blood sugars. -daily weights. call you cardiologist if you have pound weight gain. -ace wraps both lower extemities during the day. off at night keep legs ambulated while sitting. -take warfarin 7.5 mg then 5 mg sat & sun. follow-up with dr. on monday followup instructions: follow-up with dr. 4:00pm on the clincal center cat scan phone: date/time: 10:15 radiology clinical center. nothing to eat or drink 3 hours before test coumadin follow-up with your cardiologist dr. on monday. follow-up with your pcp . within the next 2 weeks procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours fiber-optic bronchoscopy thoracentesis decortication of lung closed [endoscopic] biopsy of bronchus diagnoses: pneumonia, organism unspecified acidosis anemia, unspecified unspecified pleural effusion diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation personal history of tobacco use depressive disorder, not elsewhere classified chronic kidney disease, unspecified pulmonary collapse long-term (current) use of anticoagulants thoracoscopic surgical procedure converted to open procedure leukocytosis, unspecified 

Answer: The patient is high likely exposed to