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: trazodone attending: chief complaint: altered mental status, tachypnea, anemia major surgical or invasive procedure: rij central line placement history of present illness: mr. is an 88 yo m with cad s/p cabg, mvr, chf, copd, afib, with recent admission for chronic l pleural effusion/hemothorax, s/p vats with decortication complicated by hap, who presents from rehab with altered mental status. . he was admitted to from for evaluation and management of l pleural effusion/hemothorax. he underwent partial decortication and parietal pleurectomy on . his course was complicated by repeat mucous plugging requiring bronchosocopy. he was also treated for cap with levofloxacin and hap with vanco/zosyn through . furthermore, he failed multiple swallow evaluations, undergoing a g tube for tube feeds. hematology evaluated the patient for persistent thrombocytopenia, which was felt to be due to mds. his inr was also persistently high, despite having his coumadin held for his procedures. after a prolonged hospitalization, he was discharged to rehab. . at rehab, his mental status had been below baseline but was slowly improving. however, over the last 24 hr his mental status became worse, with more somnolence. at baseline he is awake and conversant according to his son. the staff also noted an increasing fluid collection in his lle. blood work was sent which showed a hct of 22 and new leukocytosis. also there was a question of bloody stool. he was therefore sent to ed for evaluation. . in the ed, t96, bp 97/41, hr 68, rr 16, 96% 2l. lle fluid collection aspirated. given 1g vanco, zosyn for ? infection. appeared to calm slightly during the course of the ed stay. cxr, ct head, lle lenis performed. he was noted to be tachypneic but with stable 02 sats. . on arrival to the floor, he is moaning and tachypneic. he is able to nod yes-no to simple questions, but is non-conversant. . ros: as per above, otherwise unable to obtain past medical history: cad, s/p two vessel cabg in -mvr at the time of cabg in -htn -cervical laminectomy in or '- pt noted that it was done in attempt to treat leg weakness -gout -s/p removal of rle hematoma and skin grafting -s/p thr in social history: lived with his wife on prior to last hospitalization but admitted from rehab. has hired live-in help. they also have in . he is a semi-retired owner of a manufacturing plant in aerospace materials and offshore oil. he is a former cigar smoker, but quit two-three years ago. he drinks 2 alcoholic beverages (mostly mixed drinks) per day. denies illicit drug use. family history: notable for father with cardiac disease. no known history of neurologic disease. physical exam: vs: t 96.5, hr 100, bp 142/71, rr 38, 94% 4l nc gen: awake, moaning, not answering questions, moderate work of breathing heent: anicteric sclera, mm dry, perrl neck: supple, rij intact heart: tachy, irregular, no obvious murmurs lung: coarse bs diffusely with decreased bs at l base. wet upper airway sounds abd: soft, nt + bs ext: 2+ edema on l, brown discoloration bilat. large firm lle fluid collection behind popliteal fossa with mild skin break down and erythema skin: multiple ecchymoses neuro: awake but moaning, not answering questions. perrl, corneal reflexes intact, moving upper ext with good strength pertinent results: na 139 / cl 107 / bun 72 / bg 103 k 5.4 / co2 28 / cr 2.4 . wbc 13.5 / hct 24.5 / hb 8.0 / plt 205 n:58.0 l:35.0 m:3.8 e:2.6 bas:0.6 . pt: 15.1 ptt: 38.2 inr: 1.3 . abg: 7.37/48/116, lact 0.9 . portable cxr - continued left mid and lower lung opacification, unchanged. resolving right lower lobe opacities. no new consolidations seen. . ct head - no evidence of acute intracranial hemorrhage or large masses. . left leni - 1. no dvt seen though evaluation incompletee due to patient discomfort. 2. large heterogeneous mass in the popliteal/ calf region, most compatible with large hematoma. . echo the left atrium is moderately dilated. the right atrium is moderately dilated. left ventricular wall thicknesses are normal. the left ventricular cavity is mildly dilated. there is mild regional left ventricular systolic dysfunction with lateral hypokinesis. no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. at least moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. . ct torso w/o contrast: chest: there is consolidation within the right lower lobe. there is consolidation/collapse of the left lower lobe, with a small amount of pleural effusion on the left. there is no axillary, mediastinal, or hilar lymphadenopathy by size criteria. coronary calcifications are noted. post-cabg changes are noted. abdomen: a nasogastric tube is in place. the evaluation of the solid organs is limited by non-contrast technique. allowing for this limitation, there is no gross contour abnormality associated with the liver, spleen, pancreas, or adrenals. the kidneys are atrophic bilaterally, and contain punctate non- obstructing calculi. there are bilateral exophytic renal lesions which cannot be characterized as simple cysts. there is no hydronephrosis. abdominal aortic aneurysm is again identified, unchanged, measuring approximately 3.9 cm in maximal diameter. there is no retroperitoneal hematoma. there is no abdominal lymphadenopathy. pelvis: evaluation of the pelvis is limited due to extensive streak artifact from patient's bilateral hip arthroplasties. allowing for this limitation, there is no gross fluid collection or abnormality within the pelvis. lower extremities: there is a large hematoma within the left calf, starting at the level of the popliteal fossa, extending for approximately 20 cm craniocaudad. there is extensive soft tissue edema and thickening of the facial planes superior to the hematoma. extensive arterial calcifications are noted in the lower extremities bilaterally. osseous structures: there is diffuse osteopenia. there is extensive degenerative change. bilateral hip arthroplasties are noted. there are no destructive osseous lesions. impression: 1. large left calf hematoma. no retroperitoneal bleed. 2. bilateral lower lobe consolidation/atelectasis as described above. . ct chest findings: compared to the recent study, there is interval increase in the secretions within the trachea as well as within the left main bronchus, and left upper and left lower lobe bronchi with subsequent development of an atelectasis which involves almost entire left lower lobe with and a significant part of left upper lobe with sparing of the apex. these findings may contribute to the fluid-like appearance of the chest radiograph but actually no interval worsening of pleural effusion has been demonstrated. the right pleural effusion has increased in the interim but still small. at the right base, there is interval development of consolidation that is disproportional to the amount of pleural fluid and might represent an area of infection/aspiration. the rest of the right lower lobe and the right upper lobe is grossly unremarkable but note is made that the quality of the study is not optimal due to the presence of motion artifact. in the superior portion of the left upper lobe, there are areas of consolidation as well as pleural thickening that have progressed since and most likely are sequelae of the atelectasis rather than interval development of lymphangitic spread of the tumor. the extensive mediastinal lymphadenopathy is unchanged with lymph nodes in the aortopulmonic window, right upper and lower paratracheal area and prevascular location ranging up to 13 mm and the paraortic lymph node, 4:112, is 17 x 12 mm, all of them unchanged since the prior study. the heart size is significantly enlarged, unchanged including all . there is a focal dilatation of the aorta at the level of the aortic arch, 4:62, which appears to be accompanied by medial displacement of the mural calcification that can be followed toward the descending aorta and might represent area of dissection. correlation with contrast-enhanced studies is recommended. enlargement of pulmonary arteries is present with the main pulmonary artery ranging up to 4 cm, right main 3.3 cm and left 2.7 cm consistent with pulmonary hypertension. the patient is after median sternotomy and cabg with appearance has not been changed since the recent prior study. degenerative changes of the thoracic spine are present, unchanged. impression: 1. the original dictation has been lost and the study that was done on , has been redictated today on . 2. there is interval development of atelectasis of almost entire left lower lobe that may also be accompanied by consolidation and the presence of extensive secretions in the left main, left upper and lower lobe that might be consistent with the increase in consolidation on the chest radiograph. the shift of the mediastinum to the left is consistent with volume loss and atelectasis. 3. increasing right lower lobe consolidation accompanied by new pleural effusion that might represent infection and parapneumonic effusion or aspiration. 4. suspected aortic arch and descending aorta dissection, chronicity undetermined and should be evaluated with contrast-enhanced study. 5. extensive mediastinal lymph nodes that appears to be unchanged since but in the absence of more remote comparison, the chronicity and nature is difficult to assess and they may be either reactive or malignant and should be followed closely in not more than three months. 6. hyperdense (25 hounsfield units) right renal cyst. it should be correlated with ultrasound. . ct head findings: there is no acute intracranial hemorrhage, edema, mass effect, shift of normally midline structures or hydrocephalus. the ventricles and sulci remain prominent, likely due age-related parenchymal atrophy. calcifications are noted of vertebral and cavernous carotid arteries. again noted is mild mucosal thickening involving the left maxillary sinus, unchanged. the remainder of the imaged paranasal sinuses and mastoid air cells is unremarkable. osseous structures and soft tissues are stable in appearance. impression: no evidence of acute intracranial process, including no hemorrhage, edema or mass. stable appearance of lacunar infarction. . impression: ap chest 2:39 a.m. submitted for review on compared to : left pleural effusion and left lower lobe consolidation improving since , consolidation at the right lung base and small right pleural effusion unchanged. the heart enlarged but partially obscured by pleural and parenchymal abnormality. no pneumothorax. . 03:54am blood wbc-9.5 rbc-2.81* hgb-8.7* hct-26.3* mcv-94 mch-31.1 mchc-33.2 rdw-18.5* plt ct-112* 02:28am blood pt-15.7* ptt-28.8 inr(pt)-1.4* 02:47pm blood esr-132* 03:54am blood glucose-116* urean-77* creat-2.5* na-147* k-4.2 cl-118* hco3-19* angap-14 03:03am blood alt-13 ast-27 ld(ldh)-223 totbili-1.4 03:45am blood ck(cpk)-8* 03:54am blood calcium-9.6 phos-2.8 mg-2.2 03:03am blood hapto-71 02:47pm blood crp-141.8* 03:03am blood vanco-22.1* 09:03pm blood vanco-15.7 brief hospital course: 88 yo m with cad s/p cabg, mvr, afib, copd, s/p recent admission for vats/decortication/pleurectomy for l hemothorax, who presents with altered mental status and lle hematoma. lmwh was stopped and although he required several units of blood as the result of the lle hematoma, he remained hd stable and the bleeding stopped. his primary residual problems during his hospital course were delirium and aspiration pneumonias. ultimately, as his pneumonias were not improving with antibiotics (he was not able to cough up his secretions and had persistent mucus plugging) he expired from recurrent pneumonia. his family decided that a trach was not consistent with his living will and he was eventually made cmo. . hospital course complicated by the following problems: . 1. altered mental status ddx included multiple medical illnesses and aspiration, underlying infection, arf, metabolic derangement, medications, seizure, chronic hospitalization, lle infection. no evidence of bleed on ct. picture more consistent with delirium over stroke. head ct was negative x2 for acute bleed or stroke. there were no signs of meningitis. lfts wnl. patient was treated for possible pna/aspiration with 8 days of vanc/cefepime. patient also had left lower extremity drained upon arrival and mental status improved, however it continued to wax and wane throughout the hospitalization which was consistent with delirium in the setting of infection. . 2. lle hematoma: patient had an ultrasound on admission that was suggestive of cyst with hemorrhage and clot. he underwent aspiration with serosanguinous fluid drained. patient's hematocrit has remained relatively stable after 4 u prbc and 2 units of ffp and discontinuation of the lmwh. . 4. cad s/p cabg: he remained asymptomatic. he was continued on beta blockade. no symptoms of ischemia. - cont metoprolol - ? not on asa, statin . afib: afib on ekg. - cont metoprolol - hold coumadin/lmwh given bleeding . chf: per osh echo in , ef 40%. likely ischemic in origin given cad. currently no signs of gross fluid overload - cont bb . copd: unclear degree of copd. no pfts available - albuterol, ipratropium prn - 02 as needed . acute on chronic renal failure: baseline cr 2. was slightly above during hospital course. be related to pre-renal physiology given underlying infection. . anemia/thrombocytopenia: recent baseline hct 28. prior plt count 50-70s. per recent hematology eval, anemia likely multifactorial to include mds, inflammation (ferritin >800), ckd. thrombocytopenia likely related to mds. well above baseline currently. guaiac neg and no signs of active bleeding. . htn: cont metoprolol . fen: tf per g-tube were continued until he was made cmo . medications on admission: mvi daily mucomyst inhaled q12 albuterol nebulizer q12 colace 100mg dorzolamide 1 drop r eye ipratropium 4 puff q6 metoprolol 12.5mg miconazole topical q8 calcium + d tid lovenox 80mg sq tylenol 650mg q6 prn discharge medications: none discharge disposition: expired discharge diagnosis: respiratory failure pneumonia lle hematoma l-sided pleural effusion cad chf atrial fibrillation discharge condition: expired discharge instructions: n/a followup instructions: n/a procedure: venous catheterization, not elsewhere classified aspiration of skin and subcutaneous tissue diagnoses: pneumonia, organism unspecified unspecified pleural effusion toxic encephalopathy acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified gout, unspecified atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status pulmonary collapse myelodysplastic syndrome, unspecified chronic kidney disease, stage iii (moderate) anxiety state, unspecified acute respiratory failure hyperosmolality and/or hypernatremia gangrene synovial cyst of popliteal space 

Answer: The patient is high likely exposed to