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: cough major surgical or invasive procedure: bipap history of present illness: 70 yo m with a history of prostate cancer, copd with an fev1 33% predicted, and cirrhosis presents from his group home with cough. patient is a poor historian, but reports 2-3 days of new onset cough productive of clear sputum. he denies fevers, chills, dyspnea, pnd, chest pain, and le swelling. ems documentation noted an initial peripheral saturation of 50% with altered mental status, which approved on arrival to . . in the er, initial vital signs noted that patient was 99.7, 118, 114/53, 24, 100% nrb, and exam noted diffuse wheezing, and occasional scattered rhonchi. xray revealed a possible retrocardiac infiltrate, so he was treated with vanco 1 g ivx1, ceftriaxone 1 g iv x1, and levaquin 750 mg iv x1, as well as solumedrol 125 mg iv x1 and combivent nebs x1. on transfer, vs were 101 bpm, 106/57, 15, 100% nrb. . in the icu, the patient reported breathing feels at baseline. he continues to deny chest pain. . review of sytems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denied shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. past medical history: - schizophrenia (followed by ) - prostate ca on lupron since - anemia of chronic disease with macrocytosis. - cryptogenic cirrhosis, followed by the liver center until recently, but he no longer wishes to see hepatology. it is thought to be probably secondary to prior alcohol abuse. - copd with fev1 33% in - compression fracture status post vertebroplasty. - very large inguinoscrotal hernia, for which he has deferred surgery. - pyruvate kinase deficiency - splenomegaly. - status post cholecystectomy. social history: lives at a group home for his schizophrenia () which has help daily, but not at night. ex-wife is still quite involved. smokes 1 ppd for "a long time", approximately 20 years. reports prior history of etoh abuse, approximately 10 beers per day for about 20 years. denies ivdu. family history: he has 4 sisters that he does not keep in regular contact with. unsure of what his parents died from. physical exam: on admission - vitals: t: 98.7 bp 108/51 p: 104 r: 17 o2: 99% 3l nc general: alert, oriented, no acute distress heent: + icteric sclerae, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: 08:25am plt count-290 08:25am neuts-91.6* lymphs-4.3* monos-3.7 eos-0.1 basos-0.3 08:25am wbc-11.1*# rbc-3.36* hgb-11.1* hct-33.5* mcv-100* mch-33.1* mchc-33.2 rdw-16.2* 08:25am caltibc-233* vit b12-791 folate-10.0 ferritin-greater th trf-179* 08:25am iron-161* 08:25am ctropnt-0.03* 08:25am glucose-160* urea n-36* creat-1.6* sodium-127* potassium-5.2* chloride-89* total co2-28 anion gap-15 08:33am lactate-1.9 08:33pm pt-12.5 ptt-21.9* inr(pt)-1.1 08:33pm plt count-266 08:33pm neuts-91.4* lymphs-4.4* monos-3.8 eos-0.1 basos-0.3 08:33pm wbc-12.3* rbc-3.36* hgb-11.2* hct-33.5* mcv-100* mch-33.4* mchc-33.6 rdw-16.4* 08:33pm voidspec-rejected d 09:23pm type-art po2-112* pco2-69* ph-7.17* total co2-26 base xs--4 09:26pm urine mucous-rare 09:26pm urine amorph-occ 09:26pm urine hyaline-20* 09:26pm urine rbc-5* wbc-1 bacteria-none yeast-none epi-1 09:26pm urine blood-mod nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-sm urobilngn-8* ph-5.5 leuk-neg 09:26pm urine color-dkamb appear-hazy sp -1.016 09:26pm urine osmolal-481 09:26pm urine hours-random urea n-683 creat-90 sodium-less than potassium-54 chloride-less than 11:11pm albumin-3.7 calcium-8.4 phosphate-4.9* magnesium-2.2 11:11pm ck-mb-9 ctropnt-<0.01 11:11pm alt(sgpt)-52* ast(sgot)-64* ld(ldh)-229 ck(cpk)-609* alk phos-147* tot bili-3.3* 11:11pm glucose-126* urea n-33* creat-1.1 sodium-130* potassium-5.2* chloride-95* total co2-28 anion gap-12 11:34pm lactate-0.7 11:34pm type-art po2-46* pco2-74* ph-7.19* total co2-30 base xs--1 ekg: sinus tachycardia. low voltage. late r wave progression. minor t wave abnormalities. since the previous tracing of the atrial ectopy is not seen at a faster rate. cxr : as compared to the previous radiograph, an area of parenchymal opacity has newly occurred at the right lung base. although, the area could correspond to atelectasis, the possibility of early pneumonia should not be discarded in the appropriate clinical context. minimal new retrocardiac atelectasis. minimal overhydration that is unchanged. moderate cardiomegaly. no pleural effusions. tte: the left atrium is moderately dilated. the right atrium is moderately dilated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). the right ventricular cavity is moderately dilated with normal free wall contractility. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. there is an anterior space which most likely represents a prominent fat pad. compared with the prior study (images reviewed) of , the findings are similar with normal biventricular systolic function, dilated right ventricle and moderate pulmonary artery systolic hypertension. mrsa screen (final ): no mrsa isolated. legionella urinary antigen (final ): negative for legionella serogroup 1 antigen. gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 3+ (5-10 per 1000x field): multiple organisms consistent with oropharyngeal flora. respiratory culture (final ): moderate growth commensal respiratory flora. haemophilus influenzae, beta-lactamase negative. moderate growth. beta-lactamse negative: presumptively sensitive to ampicillin. confirmation should be requested in cases of treatment failure in life-threatening infections.. brief hospital course: 70 yo m with a history of prostate cancer, copd with an fev1 33% predicted, and cirrhosis who presented from his group home with hypoxia found to have a pneumonia and a copd exacerbation. . #. pneumonia, hypoxia: diagnosis supported by leukocytosis, high normal temperature, symptoms and consolidation on cxr in the setting of a respiratory culture which grew h.flu. he was initially covered for hcap with double gram negative coverage with 3rd generation cephalosporin and fluroquinolone, and vancomycin for mrsa coverage. his antibiotics were narrowed when his mrsa screen returned negative and his sputum grew h. flu. he should complete an 8 day course of levofloxacin. the patient was intermittently hypoxic when he took his oxygen off but his oxygen was weaned to 3l prior to discharge with goal sats in the 88-92 range. his oxygenation also improved prior to discharge after receiving lasix 60mg iv once with large volume urine output. there was some concern for aspiration so he was evaluated at the bedside by speech and swallow and was felt to be safe to eat a regular diet without evidence of aspiration. . #. hypercapnic respiratory failure: the patient's initial abg was consistent with acute respiratory acidosis most likely in the setting of some degree of chronic hypercarbia given his severe copd. he was treated for a copd exacerbation with steroids, and nebulizers. he was placed on bipap to assist with both his oxygenation and ventilation with good effect. he did not require bipap aside from the first night of his hospitalization but was placed on bipap intermittently overnight for rest. . # acute kidney injury: creatinine was initially 1.6 from baseline 1, with fena 0.1 and hyponatremia felt to be pre-renal azotemia in the setting of pneumonia and poor po intake. his home lasix and spironolactone were intially held but were restarted on his day of discharge. his creatinine improved to 0.6 on the day of discharge. . # scleral icterus: has history of ? cryptogenic cirrhosis vs alcoholic cirrhosis. baseline bilirubin 1.5 - 4 with intact inr. he remained compensated during his stay without evidence of encephalopathy. . # anemia of chronic disease: hct baseline 27 - 33 with elevated mcv on folate with elevated ferritin and iron:tibc ratio ~50%. the patient's hct was 26 on his day of discharge. this should be trended to ensure no further decrease. . # hydrocele: a foley was placed by urology while the patient was on bedrest to reduce risk of falls. the foley was left in place but should be taken out prior to discharge from the macu. the patient has refused surgical reduction/repair several times in the past. . # schizophrenia: benztropine, ativan and risperidal should be continued. . # prostate cancer: on long-term hormonal therapy for metastatic bone disease. medications on admission: albuterol sulfate - 2.5 mg/3 ml (0.083 %) solution for nebulization - 1 solution(s) inhaled every six (6) hours as needed for wheezing albuterol sulfate hfa - 90 mcg/actuation hfa aerosol inhaler - 1 puff inhaled every six (6) hours as needed for sob alendronate - 70 mg tablet - 1 tablet(s) by mouth q week take first thing in the morning and stay upright for 30 minutes after taking benztropine - (prescribed by other provider: ) - 1 mg tablet - 1 tablet(s) by mouth daily commode - - use as needed use as needed fluticasone-salmeterol - 250 mcg-50 mcg/dose disk with device - 1 puff inhaled twice a day folic acid - 1 mg tablet - 1 tablet(s) by mouth daily furosemide - 20 mg tablet - 3 tablet(s) by mouth daily lorazepam - (prescribed by other provider: ) - 1 mg tablet - 1 tablet(s) by mouth twice a day as needed for anxiety, insomnia 0.5 mg qam and 1 mg qhs lupron - (prescribed by other provider) - 1 mg/0.2 ml kit - inj q 3 months risperidone - (prescribed by other provider: ) - 1 mg tablet - 1 tablet(s) by mouth at bedtime risperidone microspheres - (prescribed by other provider: ) - 37.5 mg/2 ml syringe - one syringe im q 2 weeks spironolactone - 50 mg tablet - 3 tablet(s) by mouth once a day tiotropium bromide - 18 mcg capsule, w/inhalation device - 1 puff inhal daily medications - otc calcium carbonate - 500 mg (1,250 mg) tablet - 1 tablet(s) by mouth twice a day docusate sodium - 100 mg capsule - 1 capsule(s) by mouth twice a day ergocalciferol (vitamin d2) - 400 unit tablet - 2 tablet(s) by mouth once a day multivitamin - tablet - 1 tablet(s) by mouth once a day thiamine hcl - 100 mg tablet - 1 tablet(s) by mouth daily discharge medications: 1. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours). 2. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q2h (every 2 hours) as needed for sob/wheezing. 3. alendronate 70 mg tablet sig: one (1) tablet po once a day. 4. benztropine 1 mg tablet sig: one (1) tablet po daily (daily). 5. advair diskus 250-50 mcg/dose disk with device sig: one (1) puff inhalation twice a day. 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 7. lasix 20 mg tablet sig: three (3) tablet po once a day. 8. ativan 1 mg tablet sig: one (1) tablet po twice a day as needed for anxiety, insomnia. 9. lupron depot (3 month) intramuscular 10. risperdal 1 mg tablet sig: one (1) tablet po at bedtime. 11. risperidone microspheres 37.5 mg/2 ml syringe sig: one (1) inj intramuscular q2weeks. 12. spironolactone 50 mg tablet sig: three (3) tablet po once a day. 13. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation once a day: being held while on ipratropium nebs. 14. protonix 20 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 15. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 16. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 17. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day) as needed for constipation. 18. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) for 1 weeks. 19. heparin (porcine) 5,000 unit/ml solution sig: one (1) inj injection tid (3 times a day): while sedentary. 20. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 21. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 22. multivitamin tablet sig: one (1) tablet po daily (daily). 23. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 24. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain: not to exceed 2g daily. 25. prednisone 20 mg tablet sig: three (3) tablet po once a day for 5 days. 26. levofloxacin 250 mg tablet sig: three (3) tablet po daily (daily) for 5 days. 27. advair diskus 250-50 mcg/dose disk with device sig: one (1) inhalation twice a day: to start when no longer on standing albuterol/ipratropim nebs. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: h. flu pneumonia copd exacerbation respiratory distress discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair. discharge instructions: you were admitted to the hospital for respiratory distress. you were found to have a pneumonia which led to an exacerbation/worsening of your copd. you were treated with steroids, nebulizers, additional oxygen therapy and antibiotics and you should complete a course of these medications as prescribed. followup instructions: please follow up with your pcp upon discharge from rehab. please also follow up with dr at your already scheduled appointment as below: , md phone: date/time: 9:30 procedure: non-invasive mechanical ventilation diagnoses: acidosis anemia of other chronic disease cirrhosis of liver without mention of alcohol acute kidney failure, unspecified personal history of malignant neoplasm of prostate obstructive chronic bronchitis with (acute) exacerbation acute respiratory failure other specified cardiac dysrhythmias hypoxemia pneumonia due to hemophilus influenzae [h. influenzae] schizophrenic disorders, residual type, chronic other specified types of hydrocele 

Answer: The patient is high likely exposed to