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: diphenhydramine attending: chief complaint: syncope. major surgical or invasive procedure: 1. thoracentesis () 2. endotracheal intubation () 3. bronchoscopy () history of present illness: mr. is a 77 year old male with depressed lv function and esrd on dialysis who presented to on with witnessed syncope at dialysis. cpr was administered; from vague report, it sounds as though he had an aed placed but was not in shockable rhythm. he was admitted to and continued to have runs of vt so transferred here for icd. on , he was noted to have a 12 beat run of nsvt. he has been referred to dr. for icd placement. of note, he was dialyzed on tues and wed this week so did not have dialysis today, thurs, one of his normal dialysis days. he was transferred for icd placement. on arrival to , he was noted to be hypoxic with ra sats in low 80's, pleural effusion on right crackles on left, jvp up. past medical history: 1. cardiac history: a. cad s/p cabg b. ischemic cm, ef 30% c. atrial fibrillation d. hypertension e. 3rd degree heart block s/p dual chamber prodigy (dr7860) placed 2. cva yrs ago with residual speaking difficulty 3. esrd, hd m/w/f x 6 years 4. type ii diabetes-runs low in the am 5. s/p right bka 5 yrs ago-has a dry scab on bka site r/t poorly fitting prosthesis, no drainage 6. copd social history: patient resides with son who is his primary caretaker. has been aphasic since his stroke 4 years ago. he never smoke or drank alcohol. family history: non-contributory. physical exam: t 96.3, bp 97/49, hr 66, rr 18, spo2 100% on 3.5l nc o2 gen: elderly ill-appearing , supine in bed, in nad heent: op clear, mmm, perrl neck: supple, no jvp, no carotid bruits cv: irregular rhythm, distant heart sounds, nl s1 s2, 2/6 sem resp: decreased breath sounds right base with scant crackles over rll and rml abdomen: +bs, abd soft extrem: s/p r bka, left le with no, 2+ femoral pulses skin: no tenderness at r ij hd cath, dressing intact and clean neuro: expressive aphasia, otherwise nonfocal pertinent results: admit labs: . cbc: wbc-5.1 rbc-4.47*# hgb-12.4*# hct-40.8# mcv-91# mch-27.8 mchc-30.4* rdw-16.6* plt ct-126* . coags: pt-15.1* ptt-31.1 inr(pt)-1.4* . chemistries: glucose-68* urean-33* creat-5.1*# na-138 k-5.3* cl-99 hco3-27 angap-17 calcium-8.9 phos-5.4* mg-2.7* . misc: caltibc-130* hapto-267* ferritn-872* trf-100* tsh-1.8 tsh-2.7 free t4-0.92* . 2d-echocardiogram performed on demonstrated: the left atrium is elongated. the estimated right atrial pressure is 11-15mmhg. there is mild symmetric left ventricular hypertrophy with normal cavity size with moderate global hypokinesis. regional left ventricular wall motion is normal.the right ventricular cavity is mildly dilated. right ventricular systolic function is normal. the aortic valve leaflets are moderately thickened. there is a minimally increased gradient consistent with minimal aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. . impression: mild symmetric left ventricular hypertrophy with moderate global hypokinesis c/w diffuse process (toxin, metabolic; cannot fully exclude multivessel cad but less likely). moderate pulmonary artery systolic hypertension. minimal aortic valve stenosis. compared with the prior report (images unavailable for review) of , minimal aortic valve stenosis, symmetric left ventricular hypertrophy, and pulmonary artery systolic hypertension are now identified. global left ventricular systolic function appears similar. in the absence of a history of hypertension, the presence of symmetric hypertrophy raises the possibility of an infiltrative process (e.g., amyloid). . chest ct (): 1. multiple dense masses within complex large right effusion are atypical in appearance for pleural tumor, more likely hematoma, but malignancy is still the top diagnostic consideration. a change in position with prone imaging would favor hematoma. if not, transthoracic needle aspiration is indicated, and should be feasible, for presumed mass. 2. right middle and lower bronchial occlusion with possible occlusive mass. evaluation with contrast by ct (or mr if patient cannot tolerate iodinated contrast) would be helpful. 3. bilateral airspace consolidation, pneumonia or atelectasis. 4. small volume of ascites. . carotid u/s (): 1. left ica - 100% occlusion 2. right ica - 40-59% occlusion brief hospital course: pt is a 77 year old male with cad s/p 5v cabg, icm with depressed lv function ef 30%, esrd on hd, atrial fibrillation, chb s/p ppm, initially transferred for ? icd placement, found to be in pulseless arrest and transferred to the ccu post-resuscitation. patient remains intubated and workup of intrapulmonary issues are underway. patient has collapsed right lung with possible mass vs. hematoma, now s/p vats and chest tube placement. . 1. pea arrest: initially presented to for possible icd placement. while in-house, had pea arrest with possible respiratory etiology. telemetry showed inability of ppm to capture during code possibly due to metabolic derangement vs. pacer lead dislodgement. ep interrogated pacer and believes lead is in place - increased voltage that pacer lead is putting out. during the code, the patient was intubated. patient remained intubated for a prolonged period but with improved mental status when off sedation. neurology signed off. he was continued on amiodarone for h/o vt. he will continue on 400 mg of amiodarone for 1 more week then decrease to 200 mg daily thereafter. . 2. hypotension: this was initially felt likely secondary to aspiration pneumonia/hospital acquired pneumonia for he completed a course of antibiotics. over the course of his hospital stay, he had persistent pressor requirements. ultimately this was felt to be due to a combination of poor inotropy from his cardiomyopathy and from poor peripheral vascular tone from his diabetes and renal failure. for this combination, he was started on digoxin and midodrine with adequate stablization of his blood pressures. . 3. respiratory failure: admitted s/p respiratory arrest c/b pea. unclear whether initial respiratory event precipitated his cardiac arrest. etiology likely multifactorial including baseline copd, large r pleural effusion, collapsed r lung due to possible lung mass. bronchoscopy unable to obtain tissue for diagnosis. now s/p vats, tissue biopsy on . vats revealed thickened parietal pleura and dense fibrothorax. within dense fibrothorax there was 400cc of old blood which was evacuated. gram stain negative, biopsies sent to path, cytology and micro. he completed rx with vanco/zosyn x 14 days for post obstructive/aspiration pneumonia. he was kept intubated for a prolonged period because of overbreathing each time an sbt has been performed. after the vats, he was tolerating ps 18/5. pulmonary was also consulted at this point and performed another sbt which the patient tolerated with improvement in his abg. at this point a decision was made to extubate the patient on . he tolerated the extubation initially, however after 2 hours he became progressively more tachypneic and hypoxic with os sats 90% on 100% oxygen. abg at this time revealed a significant respiratory acidosis and the patient required reintubation. given his primary medical issues were pulmonary in nature it was felt that transfering the patient to the micu service would be more appropriate. the patient underwent tracheostomy and was able to begin gradually weaning from the ventilator. on discharge he was comfortable on pressure support ventilation with 8 of ps, 8 of peep, fio2 of 0.4. the patient's respiratory alkalosis was felt likely secondary to a central drive as he was without fever, pain, or hypoxia as alternative explanations. . 4. anemia: this was felt secondary to intermittent phlebotomy, the bleeding from the chest tube and vats in a patient with underlying low epo state from his renal failure. he continued on epoetin with his hd sessions. there was no evidence of iron deficiency. . 5. cad: no evidence of acs per ekg or biomarkers. in evaluation of his hypotension as above, he was found to have a new anterior septal wall motion abnormality. the change in his lv function could be related to a peri-vats mi although this could not be confirmed. given his lack of chest pain and his overall co-morbidities, proceeding to cardiac cath was deferred. his lv apex was found to be akinetic but without thrombus. he will be anticoagulated for this indication as well. beta-blockers and acei were discontinued secondary to the hypotension. as he recovers from his acute illness and his midodrine can be weaned, an ace inhibitor can be restarted. . 6. rhythm: a) afib. was on heparin gtt for anticoagulation which was held b/o hct drop after vats procedure and significant serosanquinous fluid drainage from chest tube. he remained pacer dependent at ~70 bpm. he will be discharged on a heparin drip which will be used to bridge him to therapeutic inr with coumadin. . b) h/o vt. continued amiodarone as above. c) chb, s/p ppm. v-paced rhythm. . 7. head ct finding: on presentation a head ct was notable for a potential subacute infarct. there was no clear evidence of neurologic compromise. he will continue anti-coagulation as above. . 8. esrd: patient is anuric, hd schedule was changed from m/w/f to t/th/sa schedule. continued nephrocaps. renally dosed meds. he should continue to receive his epo with his hd. . 9. dm ii: glucoses under moderate control. he will continue regular insulin sliding scale. . 10. hyperlipidemia: continued statin . 11. fen: tube feeds . 12. ppx: anti-coagulated, ppi . 13. code: full . 14. dispo: the patient was discharged to ltac for vent weaning, inr titration, and rehab. medications on admission: 1. asa 81mg daily 2. plavix 75mg daily 3. coreg 3.215mg 4. lisinopril 10mg qstthsat 5. imdur 30mg daily 6. zocor 80mg daily 7. coumadin 8. ceclor 250mg po bid 9. phos-lo 667 tid 10. folic acid 1mg daily 11. nephrocaps discharge medications: 1. amiodarone 200 mg tablet : two (2) tablet po daily (daily) for 7 days. 2. amiodarone 200 mg tablet : one (1) tablet po once a day: to start after 400 mg dosing completed. 3. albuterol 90 mcg/actuation aerosol : four (4) puff inhalation q6h (every 6 hours). 4. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 5. clopidogrel 75 mg tablet : one (1) tablet po daily (daily). 6. digoxin 125 mcg tablet : tablet po daily (daily). 7. warfarin 2.5 mg tablet : one (1) tablet po at bedtime. 8. folic acid 1 mg tablet : one (1) tablet po daily (daily). 9. nephrocaps 1 mg capsule : one (1) capsule po once a day. 10. simvastatin 80 mg tablet : one (1) tablet po once a day. 11. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 12. docusate sodium 50 mg/5 ml liquid : ten (10) ml po bid (2 times a day). 13. acetaminophen 160 mg/5 ml solution : fifteen (15) ml po q4-6h (every 4 to 6 hours) as needed for fever. 14. heparin (porcine) in d5w 100 unit/ml parenteral solution : 1250 (1250) units intravenous asdir (as directed): titrate to ptt 60-100 until inr >2. 15. lorazepam 0.5 mg tablet : 1-2 tablets po q4h (every 4 hours) as needed for anxiety. 16. insulin regular human 100 unit/ml solution : 2-8 units injection asdir (as directed): per attached sliding scale. 17. ipratropium bromide 17 mcg/actuation aerosol : four (4) puff inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 18. metoclopramide 10 mg tablet : 0.5 tablet po q 12h (every 12 hours). 19. midodrine 5 mg tablet : one (1) tablet po tid (3 times a day). 20. b complex-vitamin c-folic acid 1 mg capsule : one (1) cap po daily (daily). 21. potassium & sodium phosphates mg packet : two (2) packet po twice a day: continue until serum phosphate >2.7. 22. olanzapine 5 mg tablet, rapid dissolve : one (1) tablet, rapid dissolve po bid (2 times a day) as needed for agitation. 23. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 24. simvastatin 40 mg tablet : two (2) tablet po daily (daily). 25. warfarin 2.5 mg tablet : one (1) tablet po hs (at bedtime): adjust dose to achieve inr . discharge disposition: extended care facility: northeast - discharge diagnosis: primary: ventricular tachycardia cardiac arrest fibrothorax respiratory failure hemodialysis line infection hospital acquired pneumonia secondary: end-stage renal failure congestive heart failure coronary artery disease peripheral vascular disease diabetes mellitus type 2 - controlled stroke atrial fibrillation discharge condition: hemodynamically stable. tolerated mechanical ventilation by tracheostomy. discharge instructions: you have been evaluated and treated for an abnormal heart rhythm. your hospital course was complicated by a cardiac arrest likely secondary to severe breathing difficulty. the breathing difficulty was felt related to a large amount of your right lung being trapped by scar tissue. as it you were unable to completely breath on your own, a breathing tube was placed in your neck so that your breathing could be periodically supported. . you were discharged to a long-term acute care facility to work on building up your strength and for gradual weaning from breathing support. . please take the medications as prescribed. . please make (or have someone make) the appointments recommended. . if you develop any new or concerning symptoms such as significant shortness of breath, chest pain or fever to greater than 101f; please seek medical attention at the rehab facility. followup instructions: the physicians at the long-term care facility will evaluate you and arrange follow-up care. procedure: insertion of intercostal catheter for drainage 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 hemodialysis thoracentesis percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy other pleural biopsy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus transfusion of packed cells phlebography of other specified sites using contrast material phlebography of other specified sites using contrast material diagnoses: other primary cardiomyopathies anemia in chronic kidney disease end stage renal disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere congestive heart failure, unspecified atrial fibrillation aortocoronary bypass status pulmonary collapse paroxysmal ventricular tachycardia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified forms of chronic ischemic heart disease acute respiratory failure pneumonitis due to inhalation of food or vomitus cardiac arrest long-term (current) use of insulin pressure ulcer, lower back infection and inflammatory reaction due to other vascular device, implant, and graft late effects of cerebrovascular disease, aphasia diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled fitting and adjustment of cardiac pacemaker above knee amputation status pleurisy without mention of effusion or current tuberculosis diabetes with peripheral circulatory disorders, type ii or unspecified type, not stated as uncontrolled peripheral angiopathy in diseases classified elsewhere dermatophytosis of the body 

Answer: The patient is high likely exposed to