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: history of present illness: the patient is a 75-year-old male with history of diabetes, hypertension, hypercholesterolemia, cad, ventricular tachycardia, status post implantable defibrillator with newly diagnosed right upper lobe transferred from for right main stem bronchus stent for recurrent ex vacuo effusion, status post thoracentesis times three. the patient was admitted to on , with ventricular tachycardia following a motor vehicle accident. an implantable defibrillator was placed at that time. he was then readmitted on , for a recurrent pleural effusion, for which he received a pigtail catheter and consideration of possible pleurodesis. however, he was not a candidate for pleurodesis secondary to the pleural effusion ex vacuo. thus ct surgery placed a chest tube, which was accidentally pulled out by the patient during movement on . on , the patient became acutely short of breath with drop in sense requiring non- rebreather. further decompensation occurred while the patient was transferred to the ccu and he ultimately required emergent intubation. pre-intubation gas 7.42/41/79. the patient's blood pressure decreased following intubation requiring iv fluids and neo-synephrine. the patient was transferred to for a right main stem bronchus shunt to hopefully resolve his pleural effusion ex vacuo, which was thought to be secondary to right lobar collapse secondary to his obstruction. past medical history: diabetes, hypertension, cad status post mi in , status post lad stent, catheterization in showed three-vessel disease with 50 percent narrowing of the lad, 30 percent narrowing of the proximal sarc and 60 percent narrowing of the marginal branch. echo in , showed an ef of 50 percent, mild mr ; and a normal pulmonary artery pressure, history of ventricular tachycardia status post implantable defibrillator, right upper lobe mass diagnosed as squamous cell carcinoma, no endobronchial disease on bronchoscopy done at (status post pleuracentesis, fluid was non malignant, mri revealed mediastinal involvement, thus the patient was considered non- resectable; status post 12 radiation treatments in addition to a course of paxil and carboplatin), hypercholesterolemia, and history of atrial fibrillation, taken off coumadin four weeks ago. medications: 1. avandia 4 mg p.o. q.p.m. 2. lipitor 20 mg p.o. q.p.m. 3. trazodone 50 mg p.o. q.h.s. 4. megace 100 mg p.o. q.d. 5. amiodarone 200 mg p.o. q.d. 6. lopressor 25 mg p.o. b.i.d. allergies: no known drug allergies. family history: brother was deceased in his 50s secondary to lung cancer with positive history of tobacco, multiple members with early cad. social history: the patient is positive tobacco, 0.5 packs per day times 50 years, no alcohol, and worked as a fish cutter in the past. physical examination: temperature is 97.2, blood pressure 72/25 with a cvp of four, and heart rate of 65. the patient is on ac with a tidal volume of 600 and respiratory rate of 14, with a pip of 5, fio2 of 60 percent, with an o2 saturation of 95 percent. abg was 7.43/31/75. in general, the patient is intubated, sedated in no apparent distress. skin, no rash. heent, pupils are equally round and reactive to light and accommodation. sclerae anicteric. cardiovascular, bradycardia with regular rhythm, no murmurs, rubs, or gallops. pulmonary, coarse breath sounds on the left, poor air movement on the right. abdomen, normoactive bowel sounds, soft, nontender, nondistended, no masses or hepatosplenomegaly. extremities, 1 to 2 plus pitting edema in the upper extremities, left greater than the right, no clubbing or cyanosis. neurologically, alert, follows commands, strength 4/4 bilaterally in the upper and lower extremities, 1 plus reflexes bilaterally. laboratory data and diagnostics: white count is 3.9, hematocrit 32.2, platelets 88 with 86 percent neutrophils, 12 percents lymphocytes, and 2 percent monocytes. sodium is 136, potassium 4.5, bicarbonate 20, bun 59, creatinine 1.7, and lactate 1.2. ekg, paced at 66 beats per minute, left bundle branch block, questionable new t-wave inversion in v5- v6. chest x-ray, right upper lobe collapse, positive atelectasis/wide-out of the remainder of the right lung. hospital course: this is a 75-year-old male with a history of diabetes, hypertension, hypercholesterolemia, cad status post mi and lad stent, ventricular tachycardia status post defibrillator, transferred from for right main stem bronchus stent for obstructing right lung mass, diagnosed as squamous cell carcinoma complicated by an ex vacuo pleural effusion. right lung mass. the patient presents with a diagnosis of non-small cell lung cancer identified as stage 3b squamous carcinoma with mediastinal involvement by mri with a non- malignant ex vacuo pleural effusion and associated lung collapse, status post 12 radiation treatments and a course of paxil and carboplatin. plan for an initial right main stem bronchus stent, however, bronchoscopy revealed multiple endobronchial lesions, thus be more appropriate treatment was thought to be photodynamic therapy. the patient was activated with photodynamic therapy on . he required three subsequent bronchoscopies for removal of debridement from the right main stem bronchus. unfortunately, his lung did not re-expand following this intervention and the patient passed before any significant recovery could occur. during his hospital stay, hematology- oncology was consulted to discuss further management as daughter looking to shift care to . discussion initially was made of further chemotherapy. radiation oncology was consulted and felt no further radiation was indicated as the patient has progressed through 12 treatments of radiation. however, the patient, as stated earlier, passed before recovery from his immediate ailment. right pleural effusion ex vacuo. the patient presented with a right chest tube in place. the chest tube remained water sealed. our hope was that this chest tube could be removed following the re-expansion of his lungs after intervention to open up his right main stem bronchus. unfortunately, his lung did not re-expand and the chest tube remained in place at the time of his death. respiratory failure. due to the patient's obstructing mass leading to a pleural effusion ex vacuo, the patient suffered hypoxic respiratory failure. at the outside hospital, a chest tube was placed. it was accidentally dislodged, but ultimately required replacement as the patient had respiratory decompensation. he was transferred, intubated on assist control. he was tried on pressor-support during the course of his icu stay. however, he was unable to be weaned from the ventilator. hypotension. the patient presented with blood pressure of 72/25 with a cvp of four on peripheral neo-synephrine. his hypotension was initially thought to be due to decreased pre- loads secondary to increased inter-chest pressures from his pleural effusion ex vacuo and positive pressure ventilation. his cortisol was found to be within normal limits. his blood pressure did respond to p.r.n. fluid boluses. he was maintained on neo-synephrine. during the course of his stay vasopressin was added to further support his blood pressures. the patient's condition began to decompensate. during this hospital stay, the patient became septic from likely pulmonary source and required increasing amounts of pressors for support. he ceased to respond to iv fluid boluses and pressor-support was thought to be maximized. the patient was maintained on all these medications till the time of his death. cardiovascular. ischemia. the patient's beta-blocker was held due to his hypotension. troponins were slightly elevated at level of 0.05; however, ck mb remained negative, and ekg unchanged. rhythm. the patient has a history of atrial fibrillation and ventricular tachycardia, but was paced at a rate of 66 on presentation and remained in sinus. pump. the patient had significant amount of third spacing; however, no evidence of obvious heart failure. his ef was noted to be 35 to 40 percent. upper extremity edema. the patient presented with bilateral upper extremity edema, left greater than right; bilateral dopplers were negative for dvt. this was thought to be secondary to third spacing from aggressive fluid resuscitation. neutropenic fever. the patient with low-grade fever in the setting of neutropenia. thus, he was started on empiric ceftazidime. vancomycin was later added for persistent hypotension, but was subsequently discontinued when the patient was able to be weaned off all pressors. the patient was administered gcsf in hopes of recovering his white blood count and this medication was discontinued when he was no longer neutropenic. unfortunately, the patient developed worsening functions. sputum culture grew gram-negative rods with moderate haemophilus. he was thus continued on his ceftazidime and vancomycin was restarted in addition to cipro for double-pseudomonas coverage. unfortunately, the patient subsequently developed a copious amounts of diarrhea, and was empirically treated for c. diff. colitis, subsequent toxins were positive. he was continued on flagyl and his diarrhea subsided. kub was assessed during the course of his icu stay and was negative for toxic megacolon. the patient continued to deteriorate. his coagulase were increased. he was administered vitamin k and dic panel was negative. an id consult was obtained and on , mucolytic cultures were then growing yeast. the patient was thus started on ambisome, which was changed to iv fluconazole upon the identification of leukopenia in the patient's blood. ultimately, the patient's ceftazidime was discontinued secondary to drop in platelets and eminent death as this medication was thought to be doing more harm than good. acute renal failure. the patient presented with elevated creatinine. his renal function worsened in the first few days of his icu admission. a fena at the time was 0.3 percent. his creatinine came down with iv fluids and his urine output responded to fluid boluses. however, later in his icu stay, his creatinine again rose. urine eos were negative. protein to creatinine was 1.0; fena at that time was 0.9 percent with urine output of 423. the patient's progressive worsening renal failure was thought to be due to hen and secondary to hypotension and sepsis. his creatinine reached as high as 4.2. diabetes. the patient was initially on a sliding scale insulin, however, he was quickly changed to an insulin drug for improved blood sugar control. prophylaxis. the patient maintained on ppi, subcutaneous heparin, and neutropenic precautions. fen. the patient's nutritional status maintained with tube feeds. nutrition followed and provided guidance along the way. code status. as the patient rapidly declined near the end of his stay, despite attempted intervention and photodynamic therapy to improve his overall outcome, a number of family meetings were organized to discuss the patient's wishes regarding further intervention. his daughter had significant difficulties with the decision making. ethics was consulted to aid and supporting her and making these difficult decisions. multiple staff were uncomfortable with perceived discomfort on the part of the patient. it was the opinion of ethics that we would continue to support the daughter's wishes as likely this gentleman would desire that, and the daughter did come to a point at which she began to withdraw care. please see death certificate for the date and time of this patient's death. dictation on the patient's date of death to be done by the intern covering at that time. , m.d. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more fiber-optic bronchoscopy fiber-optic bronchoscopy fiber-optic bronchoscopy other lavage of bronchus and trachea endoscopic excision or destruction of lesion or tissue of bronchus endoscopic excision or destruction of lesion or tissue of bronchus endoscopic excision or destruction of lesion or tissue of bronchus diagnoses: pneumonia, organism unspecified acute kidney failure with lesion of tubular necrosis unspecified pleural effusion diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia pulmonary collapse acute respiratory failure malignant neoplasm of upper lobe, bronchus or lung septic shock 

Answer: The patient is high likely exposed to