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: oxycodone / morphine / codeine attending: chief complaint: hemoptysis major surgical or invasive procedure: bronchoscopy history of present illness: the patient is a 75 yo f with h/o cad s/p cabg, copd, gerd, ibs, dm who is transferred from with endobronchial mass and hemoptysis for possibility of lymph node biopsy by ip. she initially presnted this past juanuary with dyspnea. this did not improve to two courses of antibiotics. a cxr ordered by her pcp showed cavitary lesion confirmed on ct. she also developed hemoptysis. she went for bronch today which showed: airway erythema of the left main bronchus, evidence of tumor in the left upper and left lower lobe bronchi. the tumor was friable and bled readily. brushings and endobronchial biopsies were obtained. hemostasis was achieved with epi. she was maintianted intubated on the vent and transferred here for further evaluation and possible transbronchial lymph node biopsy. . she reports having subjective fever and cough at home with pleuritic chest pain. she denies weight loss. she has a history of smoking but quit 30 years ago. she had a negative ppd 5 years ago. she does travel out of the coutry to the carribean yearly, stays in hotels. ros: c/o pain at back of throat past medical history: cad, s/p cabg dm copd gerd ibs hypothyroid hld social history: quit smoking 30 yrs ago family history: nc physical exam: vs: tc 96.7, tm 101.8, bp 95-125/63, hr 82, rr 22, o2sat 98% ra ga: aox3, nad heent: perrla. mmm. no lad. no jvd. neck supple. cards: pmi palpable at 5/6th ic space. no rvh. rrr s1/s2 heard. no murmurs/gallops/rubs. pulm: crackles diffusely, left > right, no wheeze abd: soft, nt, +bs. no g/rt. neg hsm. neg sign. extremities: wwp, no edema. dps, pts 2+. skin: neuro/psych: cns ii-xii intact. 5/5 strength in u/l extremities. dtrs 2+ bl (biceps, achilles, patellar). sensation intact to lt, pain, temperature, vibration, proprioception. cerebellar fxn intact (ftn, hts). gait wnl. pertinent results: 1. labs on admission: 10:45pm blood wbc-9.1 rbc-2.97* hgb-8.5* hct-25.3* mcv-85 mch-28.5 mchc-33.6 rdw-14.6 plt ct-206 06:18pm blood hct-24.0* 03:09am blood wbc-8.2 rbc-3.46* hgb-10.2* hct-30.0* mcv-87 mch-29.6 mchc-34.1 rdw-14.7 plt ct-163 10:45pm blood neuts-86.6* lymphs-9.0* monos-3.0 eos-1.1 baso-0.3 10:45pm blood pt-12.2 ptt-25.3 inr(pt)-1.0 10:45pm blood glucose-155* urean-12 creat-0.9 na-130* k-3.5 cl-98 hco3-22 angap-14 10:45pm blood calcium-8.2* phos-3.3 mg-1.8 . 2. labs on discharge: 07:25am blood wbc-8.9 rbc-3.92* hgb-11.4* hct-33.8* mcv-86 mch-29.1 mchc-33.8 rdw-14.8 plt ct-215 07:25am blood glucose-145* urean-7 creat-0.7 na-135 k-4.0 cl-98 hco3-26 angap-15 06:18pm blood ck(cpk)-53 06:18pm blood ck-mb-2 ctropnt-<0.01 07:25am blood calcium-8.9 phos-2.8 mg-1.6 . urine studies: 05:12pm urine color-yellow appear-hazy sp -1.013 05:12pm urine blood-mod nitrite-pos protein-tr glucose-neg ketone-tr bilirub-neg urobiln-neg ph-5.0 leuks-lg 05:12pm urine rbc->182* wbc-87* bacteri-few yeast-none epi-<1 . urine culture (): gram negative rods . 3. imaging/diagnostics: - cxr (): the heart size is enlarged. the patient is after median sternotomy, most likely due to cabg. in the left lung, there is a cavitary lesion approximately 5.5 cm in diameter. there is significant central lucency and relatively thin walls up to 9 mm in diameter, representing aknown neoplasm as per outside ct report (discusssed with dr ) . the cavity appears at the level of the left hilus. it is unclear if connected or not connected to the left hilus. there is faint opacity in the right lower lung that might represent developing infectious process. there is no evidence of pulmonary edema. . - cxr (): bibasilar opacities consistent with a combination of atelectasis and pleural effusion left greater than right have worsened. cardiomegaly is stable. patient has been extubated. cavitary lesion in the left lung with significant central lucency and thin walls representing neoplasm as per outside ct report is unchanged. the mass measures up to 5.4 cm and the peripheral rim is also unchanged at 9 mm. mediastinal wires are aligned. there is mild vascular congestion. . - bronchoscopy (): left main carina very abnormal friable mucosa, elecrocautary used to acheive hemostasis and ebus used to fna station 7 4r and left hilar mass, as well as bal of lul sent for micro. otherwise normal to tracheobronchial tree. . pending results on discharge (to be followed by inpatient provider and outpatient pulmonologist) - sputum culture () - bronchoalveolar lavage () - blood culture () - endobronchial mass biopsy () brief hospital course: 75 yo f with endobronchial mass and hemoptysis, intubated for airway protection and transferred for further evaluation, possible ln biopsy. # hemoptysis/endobronchial mass - hemoptysi most likely secondary to endobronchial mass in proximate left upper and left lower lobe bronchi. she arrived intubated for airway protection given friability of masses on bronch at osh. on hospital day 2, she underwent bronchoscopy that showed left main carina very abnormal friable mucosa, elecrocautary used to acheive hemostasis and ebus used to fna station 7 4r and left hilar mass, as well as bal of lul sent for micro, otherwise normal to tracheobronchial tree. she was extubated and admitted to the micu for observation. she had no further hemoptysis, dyspnea or hypoxia. possible diagnosis of cancer was discussed with patient. she will follow-up in thoracic oncology clinic, to be arranged by interventional pulmonologyt fellow. . # hypotension - patient was noted to be hypotensive with sbp 80's on night after bronchoscopy. she recieved ivf as well as 2 units prbcs for drop in hct (appropriate increase in hct on check after transfusion). blood pressure improved/ initial concern for possible sepsis given ua that showed evidence of uti and she was started on antibiotics. additionally started vancomycin due to bronch the day prior. she remained hemodynamically stable, hct stable. vancomycin was stopped prior to discharge. . # hyponatremia: na 130 on admission. etiology likely hypovolemic hyponatremia, resolved with ivf and was 135 on discharge. . # urinary tract infection - ua positive for uti, initially started on cefepime for concern of sepsis. due to fact that hyoptension normalized with minimal intervention and patient clinically looked well, tapered antibiotic to po cipro. . #. cad, s/p cabg - held aspirin, metoprolol, statin, valsartan, imdur, and lasix given hemoptysis on admission. restarted on metoprolol prior to discharge. . # gerd: placed on ppi while npo. . # hypothyroid - continued levothyroxine . # diabetes - while inpatient, held oral hypoglycemics, placed on humalog insulin sliding scale. . # copd - continued ipratropium mdi. . pending results on discharge (to be followed by inpatient provider and outpatient pulmonologist) - sputum culture () - bronchoalveolar lavage () - blood culture () - endobronchial mass biopsy () medications on admission: asa 81 calcium carbonate 500 daily cholecalciferol unit daily diflunisal 500mg esomeprazole 40 daily furosemide 40mg daily ginkgo biloba imdure 60 mg daily levothyroxine 25 mcg metoprolol tartrate 25 mg daily mvi pioglitozone/metformin (15/850) 1 tab daily simvastatin 80 qhs tiotroprium bromide 18mcg daily valsartan 160mg daily discharge medications: 1. simvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 2. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) inhalation once a day. 3. pioglitazone-metformin 15-850 mg tablet sig: one (1) tablet po once a day. 4. multivitamin tablet sig: one (1) tablet po once a day. 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po daily (daily). 6. levothyroxine 25 mcg tablet sig: one (1) tablet po daily (daily). 7. ginkgo biloba tablet, soluble sig: one (1) tablet, soluble po once a day. 8. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 9. esomeprazole magnesium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 10. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 2 days: from - for a 3 day course. . disp:*4 tablet(s)* refills:*0* 11. calcium carbonate 500 mg (1,250 mg) tablet sig: one (1) tablet po once a day. 12. cholecalciferol (vitamin d3) 2,000 unit tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: primary diagnosis: endobronchial mass hemoptysis hyponatremia urinary tract infection . secondar diagnosis: coronary artery disease hypothyroidism diabetes copd discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: ms. , you were transferred to the because you were found to have a mass in your bronchi and had blood in your sputum. the interventional pulmonologists did a bronchoscopy and cauterized the bleeding vessels and also obtained a biopsy of the mass. you tolerated the procedure. you developed a urinary tract infection and we gave you medication to treat that which you will finish at home. you have transiently low blood pressure which resolved. we are holding many of your blood pressure medications as a result. please talk to your primary care doctor them. . you will be contact by the pulmonologists regarding follow-up appointment with the thoracic oncology clinic. . medications: added: - ciprofloxacin 500 mg by mouth every 12 hours from - changed: none held (please talk to your primary care doctor this): - aspirin - diflunisal - imdur - valsartan followup instructions: name: , e location: medical p.c. address: , , phone: when: , :30am . *** you will be contact by the interventional pulmonology clinic regarding follow-up with the thoracic oncology clinic. if you do not hear from them, please call ms. at . *** procedure: closed [endoscopic] biopsy of bronchus biopsy of lymphatic structure endoscopic excision or destruction of lesion or tissue of bronchus diagnoses: esophageal reflux urinary tract infection, site not specified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified aortocoronary bypass status hypotension, unspecified swelling, mass, or lump in chest hemoptysis, unspecified 

Answer: The patient is high likely exposed to