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: tx from hospital for resp failure major surgical or invasive procedure: none history of present illness: 51 yo m with h/o ipf was in usoh at home until 7 days pta when he developed inc brown sptum, sob, and chills. developed diarrhea 3 days pta. last few days sob got worse. during the last few days, his pulm increased steroids ans stated on a zpack. over the next day, had decreased eating and inc weakness. he is normally on 1.5 l nc o2 at home since his dc from . wife called ems at midnight of . who brought him to hosp ed. ems was unable to obtain an o2 sat and placed him on nrb. on presentation to the ed, his o2 sat was 55% on arrival and then 79% on nrb. abg pn nrb was 7.44/27/72. he was given tylenol, ativen, rochephin, solumedrol 125 iv, bactrim, flagyl, and azithro in the ed. was intubated in the icu at at 0245. while intubated, becamse hypotensive and was started on neo and given fluids. was switched to levophed and vasopression in the icu. bp reported at 60's systolic. under sterile conditions, placed l ij and l art groin line him being clamped down. gave aggressive ivf (4l). cvp went from 10 -> 30 with fluids. abg after intubation 7.05/40/86 on ac 500/30/10/100. he was noted to have wbc of 29 with 8% bands and given ceftax, vanc, flagyl (?cdiff) in the icu. also wanted to give bactrim for pcp, did not get b/f transfer. got a dfa for flu which is neg. also noted to be in arf with cr 2.1. also . transfered via to . on route, required vecuronium an fentanyl bolus. stopped propofol for hypotension. on presentation to the icu, gas was 6.98/66/84 on ac 500/18/13/100. was on levophed and vasopression and bicarb gtt. past medical history: 1. niddm 2. htn 3. intersitial pulm fibrosis - starting in , the patietn started to have some sob. admitted to osh and ct showed pulm infilatrates and honeycoming. vats-bx at hosp showed diffuse aveolar damage. felt to have rapidly accerleating ipf. that admission was started on steroids and went into rehab. dc from rehab in on 1.5 l home o2. on a very slow pred taper. 4. hyperchol social history: non smoker, worked at ge. according to wife, never had been sick before this. is an avid golfer. in the last few weeks, has been using his arms to climb stairs, some sob. family history: nc physical exam: pcv 31, peep 13 rate 27 fio2 100% levophed 0.09 vaso 2.4 general: unarousable, sedated. heent: nc/at, pinpoint pupils, fixed and symmetric, eomi without nystagmus, no scleral icterus. mucous membranes dry. neck: supple, no jvd or carotid bruits appreciated. echymoses and erythema at sight of ij. pulmonary: diminished breath sounds bilaterally, + bibasalar crackles, or no wheezing heard. cardiac: rrr, nl. s1s2, no m/r/g noted, soft heart sounds abdomen: soft, nt/nd, distant bowel sounds extremities: aka, no lesions, echymoses. ext very cool, mottled. distal pulses dopplerable skin: no rashes or lesions noted. neurologic: sedated pertinent results: labs from osh: bnp 956 picograms/ml na 137 k 4.3 cl 101 bicarb 22 bun 19 cr 2.1 ca 8, alt p, ast 40, ap 68, alb 2.2, chol 139, inr 1.5, ptt 35 wbc 29 with 8 band, 74 neut, hct 41, plt 352 trop i 0.96 (normal < 0.06) ddimer 3.69 ug/ml (normal 0 - 0.49) ua 1030, 2+ prot, -le, +nit . notable for inr 2.9, k 6.3, elevated lfts, elevated ddimer. . ekg: sinus tach, normal axis, st depressions v5 - v6, q in iii and twi iii, q and twi in iii and f . reports: no radiology sent from osh. cxr on admission here: diffuse bilateral interstial markings eparing the lul. no effusions, ett 8cm from carina. . 08:38am fibrinoge-667* d-dimer-6285* 08:38am wbc-20.0* rbc-4.06* hgb-12.1* hct-39.0* mcv-96 mch-29.8 mchc-31.1 rdw-13.4 08:38am albumin-2.3* calcium-7.1* phosphate-9.1* magnesium-2.2 uric acid-8.9* 08:38am ck-mb-3 ctropnt-0.17* 08:38am alt(sgpt)-133* ast(sgot)-197* ld(ldh)-860* ck(cpk)-78 alk phos-64 amylase-52 tot bili-1.6* 08:55am lactate-7.8* 08:55am type-art rates-18/0 tidal vol-500 peep-13 o2-100 po2-84* pco2-66* ph-6.98* total co2-17* base xs--17 aado2-576 req o2-93 -assist/con intubated-intubated 05:15pm lactate-11.1* k+-4.5 11:03pm o2 sat-88 11:54pm type-art po2-69* pco2-45 ph-7.11* total co2-15* base xs--15 . chest (portable ap) 6:50 pm slight worsening of bilateral interstitial/alveolar opacities bilaterally, which may represent pulmonary edema. . ekg sinus tachycardia. compared to the previous tracing of the t wave inversions in the inferior leads are slightly more prominent. . brief hospital course: assessment: 51 yo m with h/o ipf dx at hospital in here with septic shock and acute resp failure who expired shortly after presentation to the hospital given profound shock. . # resp failure: most likley to acceleration of ipf. was on steroids with a long taper and no pcp that can be ascertained from records we have. therefore, at increased risk for pathogens such as pcp, , , aspergillus, coccidioidomycosis, and nocardia, given his immunocompromised state. diagnostics: sputum cultures, viral screen, u leg antigen. considered bronch but unable to decrease fio2. family was to bring the path slides and ct scans from hosptial pathology and dr. will review them to give second opnion on diagnosis of ipf. theraputics: continued abx which included cefepime for gram pos and pseudomonas coverage; azithro for leginella and mycoplasma coverage; vanc by level for mrsa (no history of mrsa); bactrim for pcp and nocardia. ventilation and oxygenation: esopheal balloon to measure trans plumonary pressures. pt with high chest wall compliance, but very low lung compliance. continued on pcv to limit peak pressures, need to limit peep as well. was initially having very low sats on 100% fio2 and 13 peep. attempted to wean fio2. . # septic shock: most concerning for pulmonary etiology. pan culture and f/u osh cultures. broad spectrum abx. stress dose steroids. attempted to keep cvp > 20 given high peep. monitored uo which slowly decreased to anuria at time of demise. continued levophed and vasopressin. . # gap metabolic acidosis and respiratory acidosis: was on bicarb gtt for most of the day. elevated lactate, which continued to trend up until the patients demise. . # dm: insulin gtt . # arf: cr 2.1 on presentation. no h/o renal failure. could be related to sepsis, volume depletion. fluid repletion, but patient with lactic acidosis, renal failure, anuric at time of demise. . # coagulopathy: concerning for dic. d-dimer high and inr increasing. pe lower on differential since has clear infectious signs and labs. avoided heparin. . # diarrhea, has a h/o ciff in the past and has had 3 days diarrhea since starting zpack. flagyl emperically. c-diff toxin was to be checked x3 . # htn: held hctz while in shock # hyperchol: held statin while has shock liver # fen: npo, bolus for low uo . # communication/code: had family discussion on about expectations. told family that his ipf is a terminal disease and that his chance of making it though this illness is very low. the family was unaware of the severity of the diagnosis and its natural progression for unclear reasons. the patient did not share much of his medical history with the family. of note, he told his wife that he did not want to go to the hospital though he had been very ill for the last few days. the outcome of the meeting was to proceed with very aggressive care for the next 48 hours and then reassess his status if it has not improved for withdrawl of care. unfortunately pt's condition continued to deteriorate. 11:30 pm , in discussion with the family members- decision was made that no chest compressions, or shocks would be delivered in the event of cardiac arrest. the implications of this decision were discussed in detail and decision was confirmed. no chest compressions, defibrillation etc to be delivered to the patient in the event of code. family would like abx, fluids, pressors and other aggressive measures to be continued at this time. soon therafter patient became bradycardic, overwhleming acidosis, renal failure and shock, and pt expired with family by his side. medications on admission: meds on transfer: levophed vasopressin ceftaz 1gm azithrom 500 solumedrol 80 iv flagyl 250 ativan 1mg vanc 1gm heparin sc insulin gtt bicarb gtt . meds at home: pred 25 protonix 40 seroquel 50 simvastain 10 hctz discharge medications: pt expired discharge disposition: expired discharge diagnosis: respiratory failure metabolic acidosis septic shock ipf discharge condition: expired discharge instructions: expired followup instructions: expired procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: pneumonia, organism unspecified hyperpotassemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified acute respiratory failure long-term (current) use of insulin postinflammatory pulmonary fibrosis diarrhea other dependence on machines, supplemental oxygen 

Answer: The patient is high likely exposed to