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: respiratory distress. major surgical or invasive procedure: intubation mechanical ventilation arterial line placement history of present illness: 80 m with hx cad s/p cabg presents with cough and sob. the patient reports that about a week ago he went to for the funeral of his brother. there he had fever/chills, and a productive cough as well as rhinorrhea for the last week. he decided to come back one week earlier and came back yesterday. today his sob worsened and he decided to come into the hospital. he denied cp, pedal edema or calf pain. in the ed, the patient was hypoxic to 81% on ra on arrival. other vitals included t 98.1, 71, 190/89, rr20. a cxr was done with no significant infiltrates. a cta was performed without pe or infiltrate. the patient was then noted to be progressivley more wheezing and short of breath. he was given several nebs back to back with initial improvement but then continued with laboured breathing. methylprednisolone 125mg was given x1 and levofloxacin 750mg. the pt appeared progressively more tired and in respiratory distress. a gas showed ph 6.93 pco2 132 po2 113. the patient was intubated with succinylcholin, etomidate and ativan. lactate was 1.2. he received a total of 2l of ns. repeat abg: ph 7.14 pco2 69 po2 83. ros: pt intubated and sedated, unable to obtain. according to nurse, pt received a double dose of his atenolol today past medical history: 1. coronary artery disease. 2. status post myocardial infarction thirty years ago. - cabg: lima to lad, svg to lpl jump pda - stent to lcx, occl noted svg at lpl-pda segment - stent svg-omb - stent svg-plv - des to the distal svg-lpl and balloon angioplasty of the proximal in-stent restenosis. ef = 50%- mild anterolateral hypokinesis 3. history of aaa, elective repair 6.6cm on . 4. hypertension. 5. peripheral vascular disease - angio: severe bilateral lower extremity peripheral vascular disease with severe bilateral sfa disease and single vessel runoff bilaterally. 6. appendectomy 50 years ago. 7. diverticulitis. 8. pud 9. hypercholesterolemia social history: widower, he lives with his daughter. his is a retired auto mechanic. smokes cigarettes/day. (1/2-1 ppd x 70 years) family history: his brother died of an mi at 68 years of age. physical exam: t 97.2 bp 118/61 hr 102 rr 20 o2sat 95 ac 0.3/550/20/5 gen: nad, comfortable and sedated heent: nc/at, perrla, mmm, hard exophytic mass over left forehead neck: no lad, no jvd, no carotid bruit cor: s1s2, irregularly regular rhythm, no m/r/g pulm: moderate air movement, mild diffuse wheezing, no rhonchi abd: + bowel sounds, soft, nd, nt skin: warm extremities, no rash, venostasis changes ext: 2+ dp, no edema/c/c, no cva tenderness neuro: moving all extremities, sedated, perrla, reflexes 2+ b/l pertinent results: ekg: nsr, hr 80, na, ni, mild tw changes in i, avl. (unchanged) . cxr: single upright frontal bedside chest radiograph is compared to . the lungs are clear. the heart, mediastinal contours, and pulmonary vasculature are unchanged in appearance, remarkable for tortuous aorta. the patient is status post cabg. impression: no acute cardiopulmonary process. . ct chest with contrast: the pulmonary arteries opacify without filling defects. the patient is status post cabg, and there are marked coronary artery calcifications within the lad and circumflex. the heart appears normal. there are multiple small right hilar lymph nodes as well as a more prominent 12 mm lymph node. there is no pathologic mediastinal or axillary adenopathy. there is emphysema of the lungs, but lungs are otherwise clear. note is made of a tiny calcified granuloma in the right base. there is no pleural effusion. the airways are patent to the subsegmental level. there are multilevel degenerative changes in the osseous structures. the patient is status post median sternotomy. no suspicious lesions are identified. the visualized portions of the abdomen are unremarkable. there is atherosclerotic disease of the aorta with multiple areas of mural thrombus. impression: 1. no evidence for pulmonary embolism. 2. emphysema, but no evidence for pneumonia. . ct head comparison study: , head ct scan, also performed for a history of mental status changes, interpreted by drs. and as revealing "no acute intracranial abnormalities detected. unchanged expansile osseous lesion consistent with an osseous hemangioma. destruction of the outer table suggests aggressive potential and further evaluation is indicated." findings: the images of the posterior fossa region are mildly degraded by patient motion, although a repeat imaging sequence is of reasonably good diagnostic quality in this region. there is no definite interval change in either the appearance of the brain or osseous lesion in the one-week interval between scans. there is no intracranial hemorrhage or shift of normally midline structures observed. conclusion: stable, abnormal study as noted above. if acute brain ischemia is a clinical consideration, mri scanning, if feasible, is a more sensitive diagnostic modality. . chest ct 1. two 3-mm left upper lobe pulmonary nodules. statistically, these are most likely benign. however, given the patient's history, followup ct in three to six months can be obtained if clinically warranted to exclude an atypical distribution of small metastases. 2. new bilateral lower lobe dependent centrilobular opacities most likely secondary to aspiration or infectious bronchiolitis. 05:34am blood wbc-8.5 rbc-3.82* hgb-12.3* hct-36.2* mcv-95 mch-32.3* mchc-34.1 rdw-16.2* plt ct-209 10:29pm blood wbc-8.9 rbc-4.33* hgb-14.0 hct-40.1 mcv-93 mch-32.3* mchc-34.9 rdw-13.8 plt ct-185 05:34am blood glucose-152* urean-28* creat-0.7 na-137 k-3.7 cl-98 hco3-32 angap-11 10:29pm blood glucose-175* urean-26* creat-1.1 na-130* k-4.4 cl-92* hco3-29 angap-13 04:46am blood alt-25 ast-21 ld(ldh)-140 alkphos-59 totbili-0.3 03:04am blood lipase-57 03:05am blood ck-mb-notdone ctropnt-0.02* 08:18pm blood ck-mb-notdone ctropnt-0.02* 12:03pm blood ck-mb-notdone ctropnt-<0.01 08:14am blood tsh-0.13* 08:14am blood free t4-1.4 brief hospital course: a/p: 80 y.o. m with cad s/p cabg, pvd & copd who p/w hypercarbic respiratory failure, likely copd exacerbation and flu, with hospital stay complicated by dts and prolonged ams after being off sedation. . # hypercarbic respiratory failure: pt presented with profound acidosis hypercarbic resp failure and was intubated, found to have influenza complicated by newly diagnosed copd. ct consistent with emphysema and long standing tobacco abuse make diagnosis very likely in the abscence of pfts. pt was extubated after 5 days but required reintubation recurrent hypercarbic resp failure in setting of significant valium administration and ms depression. second intubation course was prolonged due to depressed ms and likely delayed clearance of benzodiazpines. pulm status has been stable since extubation on standing nebs, guaifenesin & pulm toilet. pt has been afebrile, sating well on ra and secretions have decreased with mobilization. repeat chest ct was performed to evaluate for metastatic disease from left frontal osteohemangioma. ct reported 2 x 3mm pulm nodules that will require a follow up ct in 6mths but were thought to be likely benign. centrilobar opacities likely c/w aspiration that have been clinically silent and may be residual from repeat intubations. pt will need to complete last three days of prednisone taper, albuterol & atrovent nebs & guaifenesin tid. . # altered mental status: pt was initially treated with valium due to possible dts, then required re-intubation for hypercarbic resp failure. pt had a prolonged 2nd intubation due to sedation that responded to flumazenil (likely benzo induced ms changes). pt was extubated on and is currently alert & responding to commands but still disoriented, no focal deficits on neuro exam, though diffusely weak & deconditioned. etiology of prolonged ms changes thought due to prolong intubation and icu stay. per neuro surgery, it is very unlikely that osteohemangioma mass is contributing to ms. steroids could also be contributing to ms. please continue with aggressive rehab. . # new onset afib: etiology unclear, tsh was mildly decreased but t4 was wnl. there was initial problems with hr control in the icu, however, hr has been well controlled in 80-90s on metoprolol with can be increased prn. pt has a chads score of 2 and will need to discuss the risks/benefits of initiating anti-coagulation as an outpt. however, due to his recent h/o gi bleed, decision was made not to anti-coagulate him while in house. pt was recently changed to metoprolol 100mg & was continued on asa 325 & plavix 75mg. recommend f/u thyroid function tests as outpt. . # scull tumor: neuro surgery was consulted for a ct read of invasive osteohemangioma. per neuro, this was not likely contributing to any ms changes but recommended ct chest for staging which showed two different 3mm pulm nodules, unlikely to be metastatic, will need f/u ct in 6mths. . # cad: pt s/p cabg in and denied any cp throughout admission. pt was ruled out for mi on admission and was continued on asa, plavix, metoprolol, pravastatin. pt was switched from captopril to lisinopril 10mg once daily. . # pvd: pt is s/p mult peripheral vasc interventions, denied any lower extremity pain thoughout admission, lower extremities warm & pt pulses palpable bilaterally. pt should continue asa & plavix. . # fen: pt had doboff placed on and has been managed with pulm nutren tube feeds. speech & swallow recommended continuing tf for now & advancing a pureed diet with nectar thickened, strict aspiration precautions and 100% monitoring with feeds. . # prophylaxis: heparin sc, bowel regimen & protonix medications on admission: clopidogrel 75 mg po daily aspirin 325 mg po daily atenolol 25 mg po daily lisinopril 40 mg po once a day. pravastatin 40 mg po once a day. norvasc 10 mg po once a day. viagra discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 4. pravastatin 10 mg tablet sig: four (4) tablet po daily (daily). 5. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 6. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 7. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed. 8. albuterol sulfate 2.5 mg/3 ml solution for nebulization sig: one (1) inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 9. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 10. prednisone 5 mg tablet sig: one (1) tablet po daily (daily) for 3 days. 11. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po tid (3 times a day) as needed for cough. 12. metoprolol tartrate 100 mg tablet sig: one (1) tablet po bid (2 times a day). 13. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 14. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. discharge disposition: extended care facility: - discharge diagnosis: primary: 1. influenza b 2. hypercarbic respiratory failure 3. atrial fibrillation 4. osteohemangioma of the skull 5. hyponatremia 6. acute renal failure 7. incidentally noted pulmonary nodules secondary: 1. coronary artery disease 2. peripheral vascular disease 3. chronic obstructive pulmonary disease discharge condition: fair discharge instructions: you were admitted with influenza & copd exacerbation. you were intubated and required an icu stay for respiratory failure and mental status changes. you were noted to develop an arrythmia called atrial fibrillation, this has been rate controlled with medications. you will need to discuss long term plans regarding anti-coagulation for a.fib with your pcp and family. you will likely require a long rehabilitation stay. upon discharge from rehab, it is important that you call dr. to set up a follow up appointment. you will need to obtain a follow up chest ct scan to evaluate incidentally noted nodules in your chest. this scan should be done 3-6 months from now. we would also recommend follow up thyroid function tests as outpt. followup instructions: please follow-up with dr. at following your rehabilitation. please discuss with your primary care physician to obtain follow up chest ct scan in months to evaluate pulmonary nodules. you should discuss the atrial fibrillation with your pcp and discuss the risks/benefits of anticoagulation. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube enteral infusion of concentrated nutritional substances injection or infusion of other therapeutic or prophylactic substance arterial catheterization injection of antibiotic diagnoses: acidosis coronary atherosclerosis of native coronary artery tobacco use disorder unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation obstructive chronic bronchitis with (acute) exacerbation aortocoronary bypass status percutaneous transluminal coronary angioplasty status pulmonary collapse acute respiratory failure old myocardial infarction atherosclerosis of native arteries of the extremities, unspecified other alteration of consciousness alcohol withdrawal delirium influenza with other respiratory manifestations benzodiazepine-based tranquilizers causing adverse effects in therapeutic use family history of other cardiovascular diseases neoplasm of unspecified nature of bone, soft tissue, and skin 

Answer: The patient is high likely exposed to