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 73-year-old gentleman with severe chronic obstructive pulmonary disease who presents with progressive shortness of breath times two days which was associated with a cough productive of white sputum. the patient denies any chest pain, fevers, chills, nausea, or vomiting. he denies orthopnea or increased lower extremity edema. there is a questioned episode of paroxysmal nocturnal dyspnea approximately three days prior to admission. of note, the patient's wife returned from europe approximately ten days ago with upper respiratory tract symptoms. she had encouraged her husband to seek and evaluation for his shortness of breath earlier, but the patient refused. he was brought to the emergency department at the via emergency medical service on the morning of admission due to extreme difficulty breathing overnight. in the emergency department, his vital signs revealed a temperature of 100.2, heart rate was 128, respiratory rate was 40, and blood pressure was 146/86. he was saturating 96% on 6 liters. a chest x-ray was done and showed no evidence of pneumonia of congestive heart failure. electrocardiograms were done showing no evidence of active ischemia. the patient was given 80 mg of solu-medrol, 500 mg of levofloxacin, and continued on his albuterol nebulizers for a presumed acute chronic obstructive pulmonary disease exacerbation. initial blood gas at that time was 7.2/67/93. the patient continued to be tachypneic and breathing using accessory muscles. therefore, he was placed on a -level positive airway pressure machine with improvement in comfort level and respiratory rates. he was then transferred to the medical intensive care unit. past medical history: (past medical history significant for) 1. hypertension. 2. chronic atrial fibrillation. 3. severe chronic obstructive pulmonary disease (with the last pulmonary function tests in revealing an fev1 of 0.64 (which is 21% of predicted value), an fvc of 2.27 (which is 48% of predicted value), and an fev1:fvc ratio of 28 (which is 43% of predicted value). 4. he has a history of an upper gastrointestinal bleed in . 5. history of depression. 6. history of alcohol abuse. 7. his last echocardiogram in revealed a normal ejection fraction of greater than 55%, right ventricular hypertrophy, moderate-to-severe tricuspid regurgitation, and moderate pulmonary artery systolic hypertension. allergies: the patient is allergic to penicillin (which causes him to have mouth swelling) and sonata (gives him a rash). medications on admission: (the patient's home medications were) 1. metoprolol 50 mg p.o. twice per day. 2. digoxin 0.25 mg p.o. once per day. 3. coumadin 5 mg p.o. q.h.s. 4. ativan 1 mg p.o. three times per day. 5. captopril 25 mg p.o. twice per day. 6. hydrochlorothiazide 25 mg p.o. once per day. 7. albuterol meter-dosed inhaler and atrovent meter-dosed inhaler. social history: the patient is married and lives with his wife in . he is a retired psychologist and contractor. per his wife, he continues to smoke; however, the exact amount of cigarettes was unclear. additionally, per his wife, he continues to drink alcohol; although the amount of alcohol consumption is unknown as well. physical examination on presentation: on physical examination, his vital signs revealed temperature was 100.2, heart rate was 138, blood pressure was 148/64, respiratory rate was 36, and oxygen saturation was 100% on -level positive airway pressure. in general, he was somewhat uncomfortable-appearing and was breathing with accessory muscles. his head, eyes, ears, nose, and throat examination was notable for pupils which were equal, round, and reactive to light. his extraocular movements were intact. his mucous membranes were slightly dry. pulmonary examination was notable for coarse breath sounds bilaterally. cardiovascular examination was notable for tachycardia with an irregular rhythm. no murmurs were appreciated. abdominal examination showed a nondistended abdomen with positive bowel sounds. the abdomen was soft and nontender. his extremities were warm and well perfused and without edema, and there were no rashes noted on his skin. pertinent laboratory values on presentation: laboratory values in the emergency department revealed his white blood cell count was 7.8, his hematocrit was 39.9, and platelets were 222. his chemistry-7 revealed sodium was 130, potassium was 5.1, chloride was 95, bicarbonate was 24, blood urea nitrogen was 22, creatinine was 1.7, and blood glucose was 135. coagulations revealed prothrombin time was 20.8, partial thromboplastin time was 35.1, and inr was 2.9. pertinent radiology/imaging: a chest x-ray revealed hyperinflation with no focal infiltrates and no pleural effusions. electrocardiogram revealed atrial fibrillation at a rate of 115 with left axis deviation. there were q waves in leads iii and avf (which were new since ). there were no st segment changes. hospital course by issue/system: 1. chronic obstructive pulmonary disease exacerbation issues: the etiology of the shortness of breath and dyspnea was thought to be secondary to an exacerbation due to an upper respiratory tract infection. he was initially managed on noninvasive ventilation with continuous albumin and atrovent nebulizer treatments as well as steroids and antibiotics. on the evening of admission, the patient became increasingly agitated, and hypertensive, and tachycardic; complaining of hallucinations and confusion. it was thought that these symptoms were due to alcohol withdrawal. he later became increasingly hypercarbic with progressive mental status changes and was intubated secondary to hypercarbic respiratory failure in the setting of alcohol withdrawal and mental status changes early in the morning on hospital day two. the patient was extubated on hospital day four after exhibiting clinical improvement and stable arterial blood gases. later that evening, the patient became progressively more uncomfortable on face mask and increasingly more somnolent. blood gas again revealed hypercarbia, and the patient was reintubated for hypercarbic respiratory failure secondary to increasing oral secretions in the setting of progressive sedation. the sedation and secretions improved in the subsequent days, and the patient was extubated on hospital day eight and remained stable. throughout his medical intensive care unit course, his chronic obstructive pulmonary disease flare was continually managed with levofloxacin (of which he completed 9 days of a 10-day course), steroids, and albuterol/atrovent nebulizers. 2. atrial fibrillation issues: the patient remained persistently in atrial fibrillation throughout his medical intensive care unit course. his rate was initially managed with intravenous lopressor with good control. however, toward the end of his medical intensive care unit admission, the rate control was no longer adequate with lopressor and diltiazem was added for rate control. his coumadin was initially held at the beginning of this admission given his inr of 2.9 and the interactions of coumadin with levofloxacin. however, the coumadin was restarted several days later, and the patient remained with a therapeutic inr. 3. hypertensive issues: the patient's blood pressure was initially managed with beta blockade alone; however, several days into the admission, the patient remained persistently hypertensive with systolic blood pressures ranging in the 160s to 170s and was subsequently started on captopril with improvement of his systolic blood pressures. 4. renal issues: the patient was admitted in acute renal failure with a creatinine of 1.7 (with his baseline being 1.1 to 1.4). this acute renal failure was thought to be due to hypovolemia. consequently, his hydrochlorothiazide was held throughout this admission, and the patient was managed with repeated fluid boluses with a return of his creatinine to baseline. additionally, the patient had hyperkalemia with a potassium of 5.1. he never showed any electrocardiogram changes related to that potassium level and was managed with kayexalate with a return of his potassium to normal levels. discharge disposition/condition: the patient was called out to the floor on hospital day eight in fair condition. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: hyperpotassemia acute kidney failure, unspecified atrial fibrillation obstructive chronic bronchitis with (acute) exacerbation acute respiratory failure hemorrhage of gastrointestinal tract, unspecified alcohol abuse, continuous alcohol-induced psychotic disorder with hallucinations 

Answer: The patient is high likely exposed to