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: this is a 36 year old male with hiv, presents with intermittent fever, chills, diaphoresis times five weeks, progressive shortness of breath and cough times two to three weeks. cough is productive of white sputum. he also complains of sore throat, nausea and vomiting times one. the patient was seen at clinic on and given short course of bactrim which improved symptoms only temporarily. review of systems: no headache, neck stiffness, chest pain, orthopnea, edema, abdominal pain, diarrhea, dysuria, rectal or penile discharge, or blood in urine or stool. the patient reports ten pound weight loss over the last five weeks. the patient notes new rash on chest which is non pruritic and nontender. past medical history: 1.) hiv diagnosed in . cd-4 count was 264. viral load greater than 100,000. the patient has been on various haart regimens in the past, complicated by skin reactions. the patient self-discontinued his last regimen about a year ago. the patient denies prior opportunistic infections. 2.) status post cholecystectomy. medications on admission: tylenol prn. allergies: hiv medications, unspecified. reaction is a skin rash. social history: the patient reports smoking one-half pack per day times ten years, none in the past five weeks. he reports social alcohol consumption and occasional cocaine use. the patient is homosexual in a monogamous relationship times five years. the patient is an accountant. physical examination: on admission, temperature is 98.4; pulse 87; blood pressure 117/60; respiratory rate 24; saturation 95% on room air. general: thin male, appearing fatigued, tachypneic, no accessory muscle use. the patient is able to speak incomplete sentences. head, eyes, ears, nose and throat: pupils are equal, round, and reactive to light and accommodation. sclera anicteric. oropharynx and tongue with white plaques. neck: no lymphadenopathy, jugular venous distention or thyromegaly. cardiac: regular rate and rhythm, normal s1 and s2, no murmurs, rubs or gallops. lungs: bibasilar crackles, rare inspiratory rhonchi, right base. no egophony. abdomen: soft, nontender, nondistended, no hepatosplenomegaly, normoactive bowel sounds. extremities: warm with no edema and 2+ distal pulses. skin: erythematous macular rash over chest and back. no lesions over extremities, palms and soles. laboratory data: white blood cell count of 10.2; hemoglobin of 12.8; hematocrit of 36.4; platelets 208. glucose 141; bun 12; creatinine 0.7; sodium of 129; potassium of 4.3; chloride 93; bicarbonate 24; ldh 712. chest x-ray with diffuse bilateral increased pulmonary parenchymal opacity. no evidence of pneumothorax or pleural effusion. soft tissue and osseous structures unremarkable. hospital course: 1.) pulmonary: the patient was admitted to on for respiratory decompensation. started on empiric bactrim and high dose steroids for pcp. patient responded well to treatment and was transferred to medical floor on . on , sputum cultures were positive for pcp. patient's respiratory status decompensated on and the patient required transfer to intensive care unit and intubation. he was started empirically on ganciclovir, levofloxacin, flagyl and ambazone to treat possible coinfection. cmv viral load, 812. ganciclovir was discontinued as low viral count of cmv was felt unlikely to contribute to respiratory status. on , levofloxacin, flagyl and ambazone were discontinued and vancomycin was begun to cover possible methicillin resistant staphylococcus aureus ventilator associated pneumonia as the patient grew gram positive cocci in sputum. respiratory status improved and the patient was extubated on and vancomycin was discontinued. on , the patient with tachypnea and hypoxia with oxygen saturations 88 to 91% on nrb, following possible aspiration. chest x-ray at that time showed bilateral and fluffy infiltrates. the patient was transferred to intensive care unit and empirically treated with ceftazidime and vancomycin. the patient was reintubated on for respiratory distress. his respiratory status improved and he was extubated on and ceftazidime and vancomycin were discontinued at that time as decompensation was felt secondary to a chemical pneumonitis from aspiration rather than super infection. on , the patient's left subclavian line was removed as the patient had right picc line placed, after which the patient desaturated to 40% non rebreather and required reintubation. ct angiogram confirmed right lower lobe subsections thrombus and heparin drip was started. the patient's respiratory status improved and the patient was extubated on and started on coumadin on . the patient was transferred to the floor on where respiratory status has remained good with oxygen saturation 96% on room air at rest, decreasing to 92% on room air with ambulation. at the time of the discharge, the patient remains on heparin as coumadin is not yet therapeutic. goal inr of two to three. inr at the time of discharge is 1.2. the patient will be discharged off heparin when coumadin is therapeutic. at the time of discharge, the patient had completed a 21 day course of bactrim for pcp pneumonia and had begun prednisone taper. 2.) cardiac: following pulmonary embolism on , electrocardiogram showed new q waves in iii and avf with st elevations in iii, avf, v1, v2. cardiac enzymes showed ck of 273 and troponin of 0.53. the patient likely had a myocardial infarction in the setting of strain due to a pulmonary embolism, in the setting of prior use of cocaine. of note, pulmonary embolism occurred while the patient was on subcutaneous heparin. the patient is to follow-up with cardiologist as an outpatient. 3.) hiv: the patient is currently markedly immunocompromised secondary to hiv. the patient was placed on azithromycin mac prophylaxis. the patient received a seven day course of acyclovir for crusty nasal lesions felt consistent with hsv. as mentioned above, low cmv viral load at 812 copies, felt noncontributory to pulmonary status. at that time, ophthalmology was consulted and performed dilated funduscopy. at that time, findings were not consistent with cmv retinitis and the patient was taken off ganciclovir. however, follow-up cmv viral load on was 6,690. infectious disease service felt that ganciclovir was not warranted at this time and scheduled outpatient follow-up with dr. . the patient received repeat cmv viral titers on to have results forwarded to dr. . dr. will determine whether ganciclovir should be instituted. the patient received a repeat ophthalmology evaluation on which noted normal eye examination, no evidence of cmv retinitis. at this time, the patient remains off any haart regimens. dr. will institute appropriate regimen as an outpatient. 4.) fluids, electrolytes and nutrition: the patient noted to have hyponatremia on admission. sodium remained low throughout admission, reaching nadir at of 125. hyponatremia was thought likely to be due to ciadh based on renal studies as patient had significant pulmonary process. the patient's sodium stabilized at 131 at the time of discharge. the patient will require further follow-up but, as the patient is asymptomatic with stable sodium, no treatment was undertaken at this time. 5.) gastrointestinal: the patient was noted to have increased amylase and lipase on with amylase 703 and lipase of 172. this was felt likely due to bactrim. the patient remained on bactrim and amylase and lipase returned to levels at the time of discharge, with amylase of 76 and lipase of 53. at the time of transfer to floor , the patient was noted to have a four cm, mildly tender right mid abdomen mass. potential causes include hernia as patient has a history of distant cholecystectomy. however, lymphoma needs to be considered given the patient's immunocompromised status. the patient will be worked up for this mass as an outpatient. 6.) hematology: the patient was noted to have anemia on admission with hematocrit reaching nadir of 29.8 on . however, hematocrit stabilized at 34.7 at the time of discharge. prior work-up for anemia on consistent with anemia of chronic disease. the patient will require further evaluation of anemia as an outpatient with primary care physician. condition on discharge: stable. discharge status: to acute rehabilitation facility. discharge diagnoses: respiratory failure. pneumocystis carinii pneumonia. pulmonary embolism. myocardial infarction. hiv. discharge medications: heparin drip on weight base protocol. guaifenesin 5 to 10 mls p.o. every six hours. nystatin swish and swallow four times a day. wolfram 7.5 mg p.o. q h.s. lansoprazole 30 mg p.o. q. day. azithromycin 1,200 mg p.o. q. week. lisinopril 2.5 mg p.o. q. day. metoprolol 12.5 mg twice a day. asa 325 mg p.o. q. day. prednisone 40 mg p.o. q. day times five days, to . prednisone 20 mg p.o. q. day times five days, to . prednisone 10 mg p.o. q. day times five days, to . dulcosate sodium 100 mg p.o. twice a day. senna 15 mls p.o. q. day. zolpidem 2.5 mg p.o. q h.s. albuterol and atrovent mdi q. six hours prn p.o. q h.s. prn. follow-up: the patient is to follow-up with on at 11:00 a.m. at vi at . the patient is to follow-up with dr. from cardiology on a.m. the patient is to follow-up with primary care physician, on at 1:15 p.m. the patient will be discharged to rehabilitation facility. the patient will require cmv viral titer on with results sent to dr. . , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization arterial catheterization closed [endoscopic] biopsy of bronchus diagnoses: subendocardial infarction, initial episode of care human immunodeficiency virus [hiv] disease acute respiratory failure pneumonitis due to inhalation of food or vomitus pneumocystosis methicillin susceptible pneumonia due to staphylococcus aureus other disorders of neurohypophysis cytomegaloviral disease acute pancreatitis 

Answer: The patient is high likely exposed to