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: hypoxia, tachypnea major surgical or invasive procedure: intubation r chest tube history of present illness: 41 yo m with remote pmh of testicular cancer at age 4 transferred to the micu in the setting of hypoxia, tachypnea, evolving bilateral pulmonary infiltrates and acute renal failure. on arrival to the micu, he was intubated for increased work of breathing. he was transiently hypotensive peri-intubation but his blood pressure stabilized. . he states that he awoke suddenly am with 8/10 nonradiating r sided pain over his posterior lower ribs, worse with inspiration. he went to for evaluation, and was discharged with dx of muscle strain from playing wii bowling. his pain improved with the oxycodone, ibuprofen 600mg, and valium he was rx'd at the ed. the following am (day of admission), he again awoke with 8/10 pain. he took his temp as advised by the ed (although had no subj fever) and noted t 101. returned to ed, where vitals were t 100.5, 109, 114/57, 36, 92%. labs showed wbc 11, band 41, cr 2.4. received 3l ivf, ceftriaxone 1gm and azithromycin 500mg, as well as ibuprofen, percocet, valium, and toradol and was admitted to the medical floor. on the floor, he was hypoxic to the 70s on ra. he stated that he felt weak, fatigued, with poor appetite. he noted that his pain causes him to feel nauseated and shake occasionally. also c/o sob due to his pain. denies f/c/n, cough, sputum, hemoptysis, abd pain, diarrhea, dysuria, hematuria, frequency, urgency, leg pain, weakness, numbness, tingling. no sick contacts or foreign travel (only notes 2.5 hr car ride yesterday). . on ros, he notes that he has occasional night sweats (had to change his nightclothes x 2) and a pound weight loss. his wife notes that he has been more tired recently. past medical history: 1. +1 mr, +1 tr, borderline pulmonary htn 2. testicular rhabdomyosarcoma, age 4, s/p orchiectomy and ln dissection 3. thyroid nodule, age 33, s/p surgical removal 4. ?excess rib cartilage ~8th grade, s/p excision c/b pleural effusion 5. pectus excavatum 6. recently diagnosed bcc social history: lives with wife, . attorney. etoh drinks/wk (although in past has had "a couple" of drinks per day). denies tob. uses pot occasionally. was hiv neg 1.5 yrs ago with no new partners since. family history: his mother was just diagnosed w/ diabetes and htn. physical exam: admission exam: vitals: t: 99.4 axillary bp: 137/66 p: 122 r: ac 400x 14 100% fio2 and 5 of peep. o2 sat 100%. general: sleepy, oriented x 3, prior to intubation was toxic appearing, thin, tachypneic heent: sclera anicteric, mmm, oropharynx clear, seemed to have some trismus neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: admission labs: 10:47pm lactate-3.5* 10:42pm type-central ve temp-38.3 rates-14/ tidal vol-400 peep-5 o2-100 po2-61* pco2-61* ph-7.20* total co2-25 base xs--4 aado2-585 req o2-97 -assist/con intubated-intubated 10:42pm lactate-3.4* k+-5.4* 10:42pm o2 sat-84 09:47pm urine hours-random creat-135 sodium-52 09:47pm urine hours-random 09:47pm urine osmolal-564 09:47pm urine gr hold-hold 09:47pm urine bnzodzpn-neg barbitrt-neg opiates-pos cocaine-neg amphetmn-neg mthdone-neg 07:56pm glucose-185* urea n-38* creat-1.6* sodium-132* potassium-5.4* chloride-100 total co2-23 anion gap-14 07:56pm glucose-178* urea n-38* creat-1.8* sodium-132* potassium-6.5* chloride-104 total co2-16* anion gap-19 07:56pm alt(sgpt)-134* ast(sgot)-229* ld(ldh)-299* alk phos-61 amylase-55 tot bili-0.5 07:56pm alt(sgpt)-96* ast(sgot)-180* ld(ldh)-558* alk phos-46 tot bili-0.4 07:56pm lipase-19 07:56pm calcium-6.9* phosphate-4.6* magnesium-2.6 07:56pm calcium-6.5* phosphate-4.0 magnesium-2.1 07:56pm wbc-4.5# rbc-4.62 hgb-14.0 hct-39.9* mcv-87 mch-30.4 mchc-35.1* rdw-14.1 07:56pm wbc-2.1*# rbc-4.60 hgb-13.6* hct-39.4* mcv-86 mch-29.6 mchc-34.6 rdw-13.9 07:56pm plt count-247 07:56pm pt-16.7* ptt-91.8* inr(pt)-1.5* 07:56pm plt count-191 07:56pm pt-28.5* ptt-150* inr(pt)-2.9* 07:06pm type-art po2-92 pco2-38 ph-7.34* total co2-21 base xs--4 07:06pm lactate-2.3* 04:38pm d-dimer-1662* 04:38pm d-dimer-as of 03:29pm type- comments-green top 03:00pm glucose-100 urea n-41* creat-2.0* sodium-133 potassium-5.5* chloride-102 total co2-17* anion gap-20 03:00pm alt(sgpt)-64* ast(sgot)-121* ld(ldh)-312* alk phos-53 tot bili-0.4 03:29pm lactate-3.2* 03:00pm tsh-14* 03:00pm asa-neg acetmnphn-5.4 bnzodzpn-neg barbitrt-neg tricyclic-neg 12:15pm comments-green top 12:15pm lactate-2.5* k+-4.6 10:40am urine hours-random 10:40am urine color-yellow appear-clear sp -1.021 09:50am glucose-116* urea n-41* creat-2.4*# sodium-132* potassium-5.7* chloride-96 total co2-26 anion gap-16 09:50am estgfr-using this 09:50am wbc-11.0# rbc-4.85 hgb-14.0 hct-41.4 mcv-85 mch-28.9 mchc-33.9 rdw-13.8 09:50am neuts-48* bands-41* lymphs-5* monos-3 eos-0 basos-0 atyps-0 metas-3* myelos-0 09:50am hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 09:50am plt smr-normal plt count-214 11:50am urine gr hold-hold 11:50am urine color-yellow appear-clear sp -1.024 11:50am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-5.0 leuk-neg relevant imaging: torso ct with contrast: impressions: 1. new pulmonary consolidation and ground- glass opacities, left greater than right, consistent with interval development of pneumonia since . 2. unchanged moderate left, and increased large right pleural effusions, with adjacent compressive atelectasis. 3. peripheral, wedge-shaped areas of low attenuation in the spleen and kidney are concerning for infection or infarction, possibly due to embolic phenomenon. 4. anasarca with trace perihepatic and trace pelvic fluid. 5. similarly distended gallbladder compared to eight days prior, without ct evidence for cholecystitis. 6. status post right orchiectomy and retroperitoneal lymphadenectomy, with new increased axillary adenopathy. 7. small aorta, measuring 7 mm proximal to bifurcation, of uncertain etiology, although finding could relate to prior radiation therapy, if the patient has had such. 8. findings in the proximal femurs suggesting prior slipped capital femoral epiphyses with bilateral hip degenerative change. abdominal u/s : impression: 1. tiny hepatic cyst, otherwise normal appearance of the liver. 2. stable gallbladder distension, containing sludge which is becoming tumefactive. no gallbladder wall thickening or edema, pericholecystic fluid, or focal tenderness over the gallbladder during the examination is seen. no specific sign of cholecystitis. 3. large pleural effusions bilaterally. 4. echogenic appearance of the kidneys, suggestive of possible parenchymal renal disease. portable cxr : the et tube tip is 3.7 cm above the carina. the ng tube tip is in the stomach. the right internal jugular line is at the proximal right atrium. the pigtail catheter inserted in the right basal hemithorax is unchanged in position. there is no interval change in the widespread consolidations mostly involving left lung but also seen in the right lung base. the surgical clips projecting over the abdomen are unchanged. microbiology: no growth on several blood, urine, stool, lavaged samples. brief hospital course: 41 year old man with a history significant for rhabdomyosarcoma testicular cancer as a child s/p resection, chemotherapy and radiation who presented with back pain, admitted to the icu for septic shock. . # hypoxic respiratory failure: based on initial cxr, etiology seemed most consistent with multifocal pna and ards. initially pe was considered and the patient was started on heparin drip briefly, however determined to be unlikely based on septic physiology. unlikely cardiogenic pulmonary edema as initial mixed venous sat was in the 80s. however, a repeat mixed venous sat the following day was 46. a tte was done at the bedside to evaluate for cardiogenic cause of respiratory failure, and found to have a globally decreased ef, consistent with septic physiology. the patient had worsening tachypnea and hypoxia on the floor, was transferred to the icu the night of admission and was intubated within hours. the patient was treated with ards net protocol, with increased peep and decreased tidal volumes. the patient was unable to be weaned from the ventilator despite being treated with broad spectrum antibiotics for bilateral pneumonia and volume removal with cvvh after aggressive volume resuscitation. patient underwent bronchoscopy and bal which were unrevealing to cause. as the patient became more difficult to ventilate and cxrs showed progression of bilateral infiltrates despite volume removal and antibiotics, a contrast ct scan was done which showed large bilateral pleural effusions, worse on the right than left, ground glass infiltrates and airbronchograms especially on the left. the descision was made to do a diagnostic thoracentesis. dark yellow, thick fluid with was expressed from the pleura on the right side. a chest tube was placed for continuous drainage. the fluid was found to be exudative with a large number of wbc however no organisms grew from this fluid, however it was thought to be a complicated parapneumonic fluid. the patient was unable to be weaned from the ventilator, had two episodes of cardiac arrest separated by days, and was unable to be resuscitated from the second, see below. . # shock: the patient had bandemia of 41%, fever, tachypnea, and elevated lactate on admission with evidence of a pulmonary source on cxr, however blood cultures were not drawn on admission. other sources considered were endocarditis, osteomyelitis, pancreatitis, and other intra-abdominal process, however pneumonia was thought to be the source after thorough evaluation of other possibilities. after intubation the patient experienced hypotension, requiring aggressive volume resuscitation and ultimately the use of pressors. over the course of his hospitalization, the patient required the use of pressors, at times multiple pressors, to maintain adequate blood pressure. multiple cultures were sent from sputum, blood, urine, pleural fluid, bals however all following the administration of iv antibiotics and all found to be negative. the patient was initially started on levofloxacin, vancomycin and zosyn for broad antibiotic coverage. after id consultation, the patient was started on clindamycin for possible toxin mediated process given the rapidity of the progression. the patient continued to require pressors, renal function continued to worsen, and continued to spike fevers. on at 4:30am the patient underwent a run of pulseless polymorphic ventricular tachycardia. chest compressions were started, he was shocked once and spontaneous circulation returned. at that time, his electrolytes were within normal limits. he was started on an amiodarone drip. cardiology was consulted, and thought that the arrhythmia was secondary to his metabolic derrangement. cardiology recommended continuing oral amiodarone. the patient recovered from the code and was thought to be improving. he was tolerating lasix for volume removal and eventually weaned off of pressors for intermittent periods. however, on the patient coded again, initally started as hypotension, then progressed to bradycardia and eventually pea. the patient was given atropine and vasopression. defibrillation was attempted with no return of spontaneous circulation. he was given calcium and magnesium. his bedside us did not show evidence of a pericardial effusion, his labs were unremarkable. the patient was pronounced dead after 40min of resuscitation without spontaneous return of circulation. . # acute renal failure: atn from septic shock. renal was consulted. cvvh line was placed, cvvh started. volume was removed by cvvh. renal function did not return to normal, the patient was unable to be taken off cvvh. . # transaminitis: secondary to shock liver/hepatic congestion after excluding other possible sources. hepatitis serologies were negative. abdominal us unremarkable, aside from distended gall bladder, which ir declined to drain given no other signs of cholecystitis or cholelithiasis. . # back pain: r-sided, was tender to palpation over r mid-back. per his wife he had had some intermittent scapular pain for the past 4 months. most likely this pain was the only symptom he had of the developing pneumonia. . # hypothyroid: tsh was elevated at 14. the patient was treated with levothyroxine 50 mcg iv daily. . # thrombocytopenia: thought to be related to bone marrow suppression secondary to overwhelming sepsis. heme/onc was consulted, agreed with above. eventually the thrombocytopenia developed into a thrombocytosis likely secondary to infection as well. . # conjunctival edema: likely from volume overload. ophthalmology consulted and recommended diuresis and lacrilube ointment applied to the eyes. . # fen: ivf as above, replete electrolytes, tube feeds . # prophylaxis: pneumoboots . # access: rij placed , r femoral art line placed medications on admission: levothyroxine 100 mcg daily lisinopril 5 mg daily asa 325mg daily discharge medications: n/a discharge disposition: expired discharge diagnosis: underlying diagnosis unknown at time of death, sepsis of unknown cause discharge condition: expired discharge instructions: n/a followup instructions: n/a md procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more diagnostic ultrasound of heart insertion of endotracheal tube hemodialysis other electric countershock of heart venous catheterization for renal dialysis arterial catheterization closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus diagnoses: pneumonia, organism unspecified acidosis thrombocytopenia, unspecified mitral valve disorders unspecified pleural effusion acute and subacute necrosis of liver acute kidney failure, unspecified other pulmonary insufficiency, not elsewhere classified unspecified septicemia severe sepsis chronic kidney disease, unspecified paroxysmal ventricular tachycardia cardiac arrest septic shock personal history of malignant neoplasm of testis postsurgical hypothyroidism pectus excavatum 

Answer: The patient is high likely exposed to