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: difficulty breathing major surgical or invasive procedure: radiation sessions for esophageal cancer a-line placement endotracheal intubation central line placement history of present illness: fr. is an 88 year old man with esophageal esophageal and prostate cancer s/p prostatectomy (), severe as s/p valvuloplasty. he was admitted from xrt for sob, hypervolemia. . his family states that he has had poor po intake for the past few weeks odynophagia thought to be to his esophageal ca. he usually is on a regimen of 40mg po furosemide . however, given his poor po intake and diarrhea this was stopped. after he was noted to be more edematous last week his furosemide was restarted 40mg daily. he has undergone xrt over the past 2 weeks and has received boluses of ns during each treatment session. he was undergoing xrt today when he was noted to be mildly tachypneic and total body overloaded. . past medical history: . past oncologic history: pt was originally diagnosed with prostate cancer and underwent a prostatectomy in . on he was noted to be hypotensive at home and was taken to the hospital where he was found to be severely anemic. he had an egd and colonoscopy which showed a large mass in the ge junction. biopsy showed poorly differentiated adenocarcinoma with signet features. he underwent a pet/cat scan which showed focus at the ge junction. he is currently on oxaliplatin x 6weeks and xeloda every other week in addition to xrt. . other past medical history: severe as s/p valvuloplasty ( ranged from 0.8->1.6 per daughter) - hypertension - multivessel cad - radical prostatectomy for prostate cancer in - lymphedema of the left leg following prostatectomy - left inguinal hernia - hiatal hernia - renal calculi - copd - hypertension - hyperlipidemia. social history: he is an armenian priest. is originally from . he came to the us in . he has five children, four living. one of his daughters died in the peripartum period after she gave birth to her child. he has seven grandchildren, five boys and two girls. he recently retired from the priesthood. smoked four to five cigarettes a day for 40 years and quit 20 years ago. he rarely drinks alcohol. family history: mother had died of an aneurysm. father is unclear. sister died when her gallbladder ruptured at age 27. physical exam: gen: grossly fluid overloaded male sitting up in examination chair with mild tachypnea heent: eomi, mmm, sclera anicteric neck: difficult to ascertain jvp 2/2 neck size cv: distant s1, s2, no m/g/r, rrr pulm: distant breath sounds, wheezes and crackles noted diffusely abd: obese, distended (at baseline), tenderness in epigastric area with palpation, +bs x 4 limbs: 2+ edema noted b/l in upper extremities, + edema noted in the lle to level of knee, 3+ edema noted in the (pt usually has edema l>r following prostatectomy) neuro: obtained history with the aid of pt's daughter, x 3, cn ii-xii intact. pertinent results: microbiology results test result reference range/units aspergillus antigen 0.1 <0.5 . test ---- fungitell (tm) assay for (1,3)-b-d-glucans results reference ranges ------- ---------------- 113 pg/ml negative less than 60 pg/ml indeterminate 60 - 79 pg/ml positive greater than or equal to 80 pg/ml . test result ---- ------ heparin dependent antibodies negative comment: negative for heparin pf4 antibody test by complete report on file in the laboratory . 5:51 pm blood culture source: venipuncture. **final report ** blood culture, routine (final ): acinetobacter baumannii complex. final sensitivities. "note, for amp/sulbactam, higher-than-standard dosing needs to be used, since therapeutic efficacy relies on intrinsic activity of the sulbactam component". sensitivities: mic expressed in mcg/ml _________________________________________________________ acinetobacter baumannii complex | ampicillin/sulbactam-- <=2 s cefepime-------------- 8 s ceftazidime----------- 8 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s imipenem-------------- <=1 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s . 10:28 am sputum source: expectorated. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gram positive cocci. in pairs and chains. 1+ (<1 per 1000x field): gram positive rod(s). respiratory culture (final ): sparse growth commensal respiratory flora. # requests organism identifications and negative rod sensitivities . acinetobacter baumannii complex. sparse growth. "note, for amp/sulbactam, higher-than-standard dosing needs to be used, since therapeutic efficacy relies on intrinsic activity of the sulbactam component". klebsiella oxytoca. rare growth. aspergillus fumigatus. rare growth. sensitivities: mic expressed in mcg/ml _________________________________________________________ acinetobacter baumannii complex | klebsiella oxytoca | | ampicillin/sulbactam-- <=2 s 4 s cefazolin------------- <=4 s cefepime-------------- 4 s <=1 s ceftazidime----------- 8 s <=1 s ceftriaxone----------- <=1 s ciprofloxacin---------<=0.25 s <=0.25 s gentamicin------------ <=1 s <=1 s imipenem-------------- <=1 s meropenem------------- <=0.25 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s <=1 s trimethoprim/sulfa---- <=1 s <=1 s . 5:21 pm bronchoalveolar lavage bronch lavage. gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. respiratory culture (final ): no growth, <1000 cfu/ml. immunoflourescent test for pneumocystis jirovecii (carinii) (final ): negative for pneumocystis jirovecii (carinii).. fungal culture (preliminary): no fungus isolated. acid fast smear (final ): no acid fast bacilli seen on concentrated smear. acid fast culture (preliminary): no mycobacteria isolated. . 4:58 pm sputum source: endotracheal. **final report ** gram stain (final ): pmns and <10 epithelial cells/100x field. no microorganisms seen. respiratory culture (final ): commensal respiratory flora absent. yeast. rare growth. mold. 1 colony on 1 plate. . 8:42 pm urine source: catheter. **final report ** urine culture (final ): yeast. 10,000-100,000 organisms/ml.. . 9:46 am urine source: catheter. **final report ** urine culture (final ): yeast. ~/ml. . imaging studies cxr: impression: 1. new atelectasis and inflammation probably due to aspiration left lower lobe. 2. severe calcific aortic stenosis. no edema. 3. emphysema. . cta impression: 1. multiple new predominantly peripherally located nodular opacities since , with new small bilateral pleural effusions, favors an infectious process such as fungal infection or cop remains in the differential diagnosis. 2. moderate airways disease as manifested by moderate bronchiectasis. post-treatment radiation change, predominantly affecting the right middle lobe and lingula. 3. component of tracheobronchial collapsibility, not fully assessed on this non-dynamic respiratory phase imaging ct. 4. area of asymmetric soft tissue involving the aortic arch and descending thoracic aorta likely related to plaque though a component of inflammation from post-treatment is not entirely excluded. 5. known esophageal cancer as manifested by circumferential esophageal wall thickening at the gastroesophageal junction. small-to-moderate sized hiatal hernia. . bronchial washings brochial washing: atypical. rare atypical cells in a background of degenerated bronchial cells and macrophages. (see note.) . ct chest, abdomen, pelvis impression: 1. changing appearance of peripheral opacities favors cryptogenic organizing pneumonia over fungal infection or other infectious etiologies (such as septic emboli). 2. bilateral pleural effusion and third spacing inclduing as mild ascites and pronounced scrotal edema are consitent with chf. associated relaxation atelectasis. 3. bilateral adrenal fat- adenomas versus myelolipomas. 4. right hepatic lobe indeterminate lesion may be a cyst or hemangioma. consider outpatient ultrasound followup. 5. small hypodensity in the thyroid. consider obtaining outpatient lfts and if needed ultrasound. . laboratory studies 05:17pm blood wbc-4.4 rbc-4.69 hgb-10.7* hct-33.8* mcv-72* mch-22.9* mchc-31.8 rdw-19.4* plt ct-196 12:45am blood wbc-6.3 rbc-3.61* hgb-8.0* hct-25.9* mcv-72* mch-22.2* mchc-31.0 rdw-18.6* plt ct-84* 04:57am blood wbc-10.0 rbc-4.05* hgb-9.9* hct-31.4* mcv-78* mch-24.5* mchc-31.7 rdw-20.4* plt ct-171 05:17pm blood glucose-135* urean-25* creat-0.9 na-136 k-3.3 cl-98 hco3-28 angap-13 08:30am blood glucose-127* urean-27* creat-1.1 na-131* k-3.2* cl-88* hco3-35* angap-11 07:40am blood glucose-177* urean-24* creat-1.0 na-135 k-3.4 cl-92* hco3-32 angap-14 07:10am blood glucose-141* urean-21* creat-1.1 na-133 k-3.2* cl-89* hco3-34* angap-13 06:37am blood glucose-106* urean-16 creat-0.6 na-137 k-4.1 cl-103 hco3-31 angap-7* 04:57am blood glucose-108* urean-26* creat-0.8 na-141 k-4.7 cl-107 hco3-28 angap-11 12:45am blood alt-27 ast-37 alkphos-115 totbili-0.4 06:37am blood ld(ldh)-307* totbili-0.8 01:04am blood alt-18 ast-31 ld(ldh)-266* alkphos-162* totbili-0.5 03:06am blood alt-16 ast-31 ld(ldh)-331* alkphos-159* totbili-0.5 02:55am blood alt-21 ast-43* ld(ldh)-397* alkphos-183* totbili-0.3 04:57am blood alt-20 ast-57* ld(ldh)-415* alkphos-303* totbili-0.4 dirbili-0.1 indbili-0.3 06:37am blood hapto-250* 04:54am blood vanco-20.9* 06:37pm blood type-art po2-67* pco2-46* ph-7.49* caltco2-36* base xs-10 06:54am blood type-art temp-36.6 rates-/23 tidal v-450 peep-5 fio2-50 po2-85 pco2-56* ph-7.38 caltco2-34* base xs-5 intubat-intubated vent-spontaneou 07:38pm blood type-art temp-37.6 tidal v-380 peep-5 fio2-50 po2-75* pco2-48* ph-7.43 caltco2-33* base xs-6 intubat-intubated vent-spontaneou 04:56am blood type-art temp-38.2 rates-14/10 tidal v-450 peep-10 fio2-50 po2-82* pco2-52* ph-7.37 caltco2-31* base xs-2 -assist/con intubat-intubated 06:37pm blood lactate-2.1* na-128* k-3.2* 08:27pm blood lactate-1.6 09:52am blood freeca-0.95* 11:26am blood freeca-0.95* brief hospital course: fr. is an 88 year old man with esophageal cancer and aortic stenosis s/p valvuloplasty. he presented to the icu with respiratory failure. . ##. sepsis. a cxr was performed on as part of a fever work-up and showed new atelectasis and inflammation probably due to aspiration in left lower lobe. he was started on unasyn 3gm q6 on to cover aspiration which was transitioned to cefepime as prelim sensitivities were resistant to ampicillin. he was then transitioned back to unasyn on when final sensitivities returned. he had blood cultures and sputum cultures that were positive for acinetobacter baumannii. these were pan-sensitive. his sputum culture later grew aspergillus and klebsiella. on he had a worsening of his respiratory status. he was transferred to the icu where he was intubated. his antibiotics were broadened to vancomycin, meropenem, and eventually voriconazole. he required several liters of fluid to help maintain his blood pressure. he was intermittently placed on pressors. he continued to have fevers despite antibiotic treatment. a ct scan was obtained on to look for an abscess. there was no evidence of an abscess. he had large pleural effusions. he had urine and sputum cultures that both grew out yeast. no further invasive procedures were planned per the goals of care discussed with the family. the id team was following his hospital course. . ##. respiratory failure: on initial examination fr. was grossly overloaded with evidence of edema in the upper and lower extremities. he was diuresed on the floor. his low albumin was thought to be contributing to some 3rd spacing due to a decrease in his oncotic pressures. on the day of transfer to the icu he was intubated for respiratory distress. several weaning trials were attempted, but he required more and more ventilator support throughout the hospitalization. he was unable to be weaned from the ventilator. a tracheostomy was discussed with the family, but they did not think this was in the goals of his care. he was briefly started on furosemide in the icu, but his blood pressure would not tolerate it. . ##. esophageal cancer. mr. was scheduled to complete his course of xrt on . no treatment was delivered while in the icu. . ##. malnutrition: mr. had poor po intake which was likely related to his esophageal mass which caused him some odynophagia. he received tube feeds in the icu. . ##. pulmonary embolus: on review of the cta from radiology found a subsegmental pe (amended report). he was started on a heparin gtt. . ##. aortic stenosis: fr. underwent a repeat echo which showed his valve area 0.8-1.1. the cardiology service was consulted for assistance in management of his preload. . ##. goals of care: on admission fr. was a full code and aggressive treatment was pursued. in the icu he was intubated on admission. as his prognosis worsened, his family decided to transition to comfort measures only. he was terminally extubated and passed with his family by his side. medications on admission: diltiazem sr 120mg daily enalapril 10mg qam furosemide 40mg daily (was ) xeloda 2000mg prilosec 20mg colace prn discharge medications: none discharge disposition: expired discharge diagnosis: primary diagnosis sepsis pneumonia esophageal cancer hypoxic respiratory failure aortic stenosis discharge condition: expired discharge instructions: expired followup instructions: expired procedure: 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 arterial catheterization closed [endoscopic] biopsy of bronchus injection or infusion of cancer chemotherapeutic substance other radiotherapeutic procedure diagnoses: other iatrogenic hypotension thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery unspecified essential hypertension acute kidney failure, unspecified unspecified protein-calorie malnutrition severe sepsis chronic airway obstruction, not elsewhere classified personal history of malignant neoplasm of prostate aortic valve disorders candidiasis of mouth acute respiratory failure pneumonitis due to inhalation of food or vomitus septic shock gross hematuria urinary catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute diastolic heart failure septicemia due to anaerobes other pulmonary embolism and infarction delirium due to conditions classified elsewhere aspergillosis pneumonia in aspergillosis late effect of radiation radiological procedure and radiotherapy as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure malignant neoplasm of cardia other esophagitis pneumonia due to anaerobes 

Answer: The patient is high likely exposed to