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: sob, chest pain major surgical or invasive procedure: cardiac catherization cardiac catherization with stenting of the left anterior descneding artery intubation central line placement left thoracotomy with lung biopsy of present illness: mr. is a 68m with history of 2vd s/p stent placement, chf (admitted to hospital), dm2, htn, hyperlipidemia, past tobacco, and lung ca s/p lul resection , who presents with chest pain and sob. patient awoke @ 3:30 a.m. to urinate and when returning to bed had chest pain , substernal, radiating to left shoulder, accompanied by sob. no diaphoresis, jaw pain, nausea, vomiting, lightheadedness; did not radiate down arm or to back. took 2 sl nitro and pain did not resolve (usually does with 1 slntg), so wife called 911. resolved after ems administered ntg spray (~ 7:30 am), and it has not recurred since. patient states that he has chest pain 3-4 times per week, but is usually relieved with one sl nitro. patient's episodes have been becoming more frequent over last few weeks. he denies exertional or other triggers. usually relieved with rest. + doe with minimal activity - able to walk feet before he usually gets sob, sometimes has mild associated chest pain. plan prior to this ed admission was for cabg in with dr. . . at osh patient found to be 81% on ra, bp stable at 129/68. ekg done which showed st depressions i, ii, v3-v6, lvh, and st elevation of avr. trop 1.6, anemic with hct 30, arf with cr 3 ( on ). patient was started on integrillin but developed hemoptysis and this was stopped. no further therapy and patient was transferred to for further evaluation. . upon arrival to , patient denied cp, sob, dizziness, diaphoresis, nausea, vomiting. patient relates episode of hemoptysis this a.m., but states that this is not new, occurring a couple times a week, unable to quantify amount (coughs, may have brb, but next cough productive of clear sputum). + cough, worse ever since being intubated in during catheterization. + chills, no fevers, no weight loss. past medical history: - bp: 99-119/43-77, hr 81-107 sats 89-97% ra afebrile at home # cad: - mi - cardiac cath , s/p 6 stents (see below) - 50% lmca unchanged from , 60% lad, 50% om1 (lcx), dominant rca was proximally occluded with robust l->r collaterals, # chf - ef 30% - weight: 206-208 lbs # htn # dyslipidemia # dm2 - iddm # renal artery stenosis # pvd - s/p aortobifemoral, by dr. ; right femoral-popliteal in ; toe amputations; renal artery graft during aortobifemoral # gerd # lung ca s/p lul resection - dr. , dr. - 3 and 5 cm masses resected - . ct demonstrated a return of his mediastinal adenopathy back to the baseline that was present in . there is no evidence of recurrent tumor. # anemia - due to chronic disease, baseline 30s. most likely due to chronic disease, although nl epogen level. suspect bm suppression. . past surgical history: right fem- bypass aortofem bpg multiple foot surgeries - bilateral halux amputations, most recent on r graft in renal artery endarterectomy umbilical hernia repair left upper lobectomy social history: lives independently with wife, limited mobility lately, ex-smoker 15 years ago x 30 pack year, no etoh. family history: mother deceased 54 - dm father deceased 58 - accident sister - cad/mi/stroke daughter - bladder ca physical exam: pe: vitals: 93.1 136/52 80 24 100%3l nc gen: elder, pleasant, male, nad heent: aniceric, no jvd, + 1 carotid bruit's b/l, faint thrills b/l, mmm cv: rrr, nl s1, s2, no extra hs appreciated lungs: crackles b/l r>l, with decrease breath sounds over llb abd: + bs, snt/nd, no hsm ext: trace edema, pink, warm, no ulcers, several amputated toes, + 1 palpable r dp, nonpalpable/doplerable l dp, + 1 weak b/l pt. neuro: axox3, patient appropriate pertinent results: trop-*t*: 0.66 135 104 39 agap=19 -------------< 121 5.2 17 1.4 ck: 346 mb: 14 mbi: 4.0 84 3.7 \ 8.6 / 328 / 25.5\ n:72.4 l:18.1 m:8.8 e:0.5 bas:0.3 hypochr: 1+ anisocy: 2+ poiklo: 1+ microcy: 1+ pt: 14.8 ptt: 31.0 inr: 1.3 11:07am blood esr-80* 09:00pm blood ret aut-4.5* 05:30am blood ck(cpk)-708* 12:00pm blood alt-40 ast-46* ld(ldh)-403* ck(cpk)-294* alkphos-51 totbili-0.3 04:38am blood ck-mb-12* mb indx-15.0* ctropnt-0.26* 05:30am blood ck-mb-93* mb indx-13.1* ctropnt-3.06* 04:09am blood hapto-256* 05:08am blood caltibc-127* ferritn-1826* trf-98* 12:00pm blood tsh-8.6* 05:30am blood t4-5.8 t3-62* free t4-1.2 06:00am blood cortsol-32.8* 07:21am blood cortsol-39.3* 11:09am blood anca-negative b 11:09am blood anti-gbm-test <3 (negative) brief hospital course: #) - pt with known 3vd and was admitted with chest pain. he had on admission in setting of severe anemia then, had repeat on in setting of high fever and tachycardia with troponin peak of 3.0 and ck pear in the 700's. cardiac cath repeated on and unchanged since : lm 50%, mlad 60%, lcx 60%, t.o. rca. the enzyme leak was thought to be due to lack of flow through collaterals. ct surgery was consulted, but determined that he was not a cabg candidate due to extensive aortic calcifications, so he was taken back to cath on and had a single cypher stent placed to his mid-lad on . he had decreasing troponins and no further chest pain from that point. he was kept on plavix to 75mg, asa back to 325, statin, beta blocker, and ace as tolerated for the remainder of hospitalization. #) respiratory failure/hemoptysis/silent aspiration - the patient has a history of lung cancer and there was concern for recurrent lung cancer in the setting of hemoptysis and enlarged tracheal nodes on admission. interventional pulmonary was consulted and performed transbronchial biopsy of the mediastinum, which showed a clot in the right bronchus and negative cytology. his hemoptysis resolved. he was diuresed and his oxygen requirement disappeared. on , the day after cath, he had acutely worsened respiratory distress, fever, and hypotension with worsened cxr and was put on ceftriaxone/vancomycin/azithro for hospital acquired pneumonia. he continued to spike and was changed vanc/zosyn on . his fevers gradually resolved. on , he became febrile again and vanc/zosyn were restarted. he was kept on bipap without success for 1 day then intubated. he was put on levophedrine for hypotension on , and meropenem was substituted for vancomycin. during this whole time he was diuresed for potential chf, but his fluid status was unclear so a swan was placed with initial wedge 62/30 wedge 14-24 co 5.9 ci 2.6 svr 1100. he continued to be diuresed. pulmonary was consulted and performed bronchoscopy with negative cultures and negative cytology. he gradually improved over 3 days and was extubated, but still had a significant oxygen requirement, with pao2/fio2 ratio < 200 and bilateral infiltrates. at this point he was changed from the ccu team to the micu team as his primary problem was respiratory failure. the ddx of his hypoxic respiratory failure was chf, persistent pneumonia (atypical or other), lymphangitic spread of cancer, silent aspiration, wegener's, interstitial lung disease. ppd, anca, anti-gbm, sputum for cytology and pcp were negative. all sputum cultures showed only oropharyngeal flora. a bedside swallow showed no clinical signs of aspiration but video swallow showed significant aspiration. the decision was made to start empiric steroids, solumedrol 125 q6h, which appeared to help for 2 days but then he started to become more hypoxic again. he was re-intubated for hypoxia and taken to or for left sided thoracotomy. biopsy results showed diffuse alveolar damage consistent with ards picture. no obvious signs of boop. steroids were weaned off. also, culture data grew enterococus from bal and biopsy site. he was initially treated with vancomycin and transitioned to ampicillin based on sensitivities. id consultation felt it was contamination and antibiotics were discontinued. #) pump/chf - patient has severe class iii symptoms at home with lasix 40 po bid dose. echo showed: 40% ef, global hypokinesis with + 1 mr. after stenting showed ef >55%. he was agressively diuresed throughout the hospitalization and responded well to frequent doses of 40 iv lasix. pulmonary artery catheterization showed intermittent high wedge, range . he was maintained on metoprolol and captopril as tolerated. #) adrenal insufficiency - for hypotension, stim was done which bumped from 33-39 so he was started on hydrocort/fludricort. then he was changed . #) anemia - pt has aenmia likely due to chronic disease, baseline 30s with although nl epogen level. suspect bm suppression. he needed 7 units prbc throughout hospitalization. #) arf - baseline 1.0-1.3, but his creatinine became elevated from agressive diuresis and low bp up to peak of 1.9. his ace was held but then restarted in the setting of chf with improvement back to his baseline of 1.1. then his creatinine started to rise again likley combination of atn and pre-renal state. #) gi bleeding - on pm he was noted to have melenotic stools and several point hematocrit drop. #) code status - this was discussed and confirmed at multiple points throughout his hospitalization. however, given his progressive decline with increasing renal failure, new gi bleeding, progressive hypoxia, intermittent sepsis, ards, ventricular arrythmias he was made dnr/dni on . after family meeting on patient was made cmo and he quickly passed off pressors. medications on admission: lasix 40 vytorin 40 levothyroxine 0.05 nph 15units qam, 20units qpm reg 10units am, 15 lisinopril 10 qd asa metoprolol 100 iron colace isosorbide mononitrate 60 qd stopped spironolactone d/t hyperkalemia discharge disposition: home discharge diagnosis: non-st elevation myocardial infarction congestive heart failure anemia acute renal failure diabetes nsvt 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 combined right and left heart cardiac catheterization coronary arteriography using two catheters coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization diagnostic ultrasound of heart insertion of endotracheal tube fiber-optic bronchoscopy other bronchoscopy non-invasive mechanical ventilation arterial catheterization closed [endoscopic] biopsy of bronchus graft of muscle or fascia closed endoscopic biopsy of lung transfusion of packed cells other local excision or destruction of lesion or tissue of lung insertion of drug-eluting coronary artery stent(s) biopsy of diaphragm cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel thoracoplasty diagnoses: pneumonia, organism unspecified thrombocytopenia, unspecified anemia of other chronic disease subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery esophageal reflux urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia chronic airway obstruction, not elsewhere classified personal history of malignant neoplasm of bronchus and lung aortocoronary bypass status sepsis paroxysmal ventricular tachycardia other specified forms of chronic ischemic heart disease atherosclerosis of renal artery pneumonitis due to inhalation of food or vomitus blood in stool hematemesis atherosclerosis of native arteries of the extremities, unspecified surgical or other procedure not carried out because of contraindication chronic ulcer of other specified sites other specified alveolar and parietoalveolar pneumonopathies 

Answer: The patient is high likely exposed to