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 40-year-old male with no significant past medical history who presented to an outside hospital on with complaints of two to three days of fever, cough productive of yellow sputum and shortness of breath. oxygen saturations were 79% on room air and the patient's vitals were blood pressure 152/72, respiratory rate 24 to 30, heart rate 133, temperature of 96.3??????. an arterial blood gas was performed which showed ph 7.46, pco2 32, po2 40. chest x-ray showed bilateral infiltrates. the patient was given intravenous levofloxacin, ceftriaxone, bactrim and solu-medrol. the patient was placed on 100% nonrebreather. approximately eight hours later he was noted to have increased labored breathing and his saturations were 87% to 88% on the 100% nonrebreather. the patient was intubated at that time. the patient's admission labs at the outside hospital were noted for a positive urine and serum toxicology screen for cocaine and opiates, as well as a white count of 15.8 with 14% bands. a pa line was placed at the outside hospital showing ra pressure of 18, rv pressure of 42/15, pa pressure of 42/30 and a pulmonary capillary wedge pressure of 30. cardiology was consulted and the patient was diuresed. repeat values showed pa pressure 43/25 and a pulmonary capillary wedge pressure of 14. according to reports, the patient became agitated and required sedation which caused a drop in his blood pressure. the patient was started on neo-synephrine at that time. the patient also underwent bilateral lower extremity ultrasounds which were negative for deep venous thrombosis at the outside hospital. on arrival, the patient's vent settings were ac of 18 with a tidal volume of 700 and peep of 12. the patient had received fentanyl and had been paralyzed with vecuronium in transit. his oxygen saturations were in the mid 90s on 100% fio2. arterial blood gases on arrival showed ph of 7.29, pco2 of 55 and po2 of 82. the neo-synephrine was weaned off quickly without difficulty on presentation here. past medical history: none known. home medications: none known. allergies: no known drug allergies. transfer medications: 1. bactrim 2. solu-medrol 3. levaquin 4. rocephin 5. propofol 6. heparin subcutaneous 7. carafate 8. neo-synephrine 9. prevacid social history: the patient is single and unemployed. he smokes one pack per day and denies drug use. (this was obtained from outside records). admission physical exam: vital signs: temperature 100.0??????, pulse 117, blood pressure 155/69, respiratory rate 18, oxygen 94% on fio2 100%. general: he was intubated and sedated, as well as paralyzed. head, ears, eyes, nose and throat: pupils equal, round and reactive to light. cardiovascular: regular rhythm, tachycardic, no murmurs appreciated. lungs: coarse breath sounds bilaterally. abdomen: soft, obese, decreased bowel sounds. extremities: trace edema bilaterally, warm. labs at presentation to outside hospital: chem-7 132, 4.1, 93, 26, 8, 0.9, 155. calcium 8.8, phos 5.0, magnesium 1.6, ast 49, alt 44, alkaline phosphatase 118, ldh 231, ck 242, mb index negative, troponin negative. hemoglobin a1c of 6.5. pt 13.7, ptt 26, inr 1.3, d-dimer less than 250. cbc showed white count of 15.8 with 14% bands, hematocrit of 49.7, platelets of 254. alcohol level less than 10. aspirin level less than 2.8. amylase 22, lipase 5. the following day, the patient's white count was up to 18.1 with 34% bands. admission labs here: white count 13.3 with 8% bands, hematocrit 43, platelets 201. chem-7: sodium 130, potassium 3.4, chloride 93, bicarbonate 24, bun 23, creatinine 1.5, glucose 408. hospital course by system: 1. pulmonary: the patient had bilateral pulmonary infiltrates and hypoxic and hypercapnic respiratory failure with very low po2 to fio2 ratio. this was consistent with a diagnosis of ards. this is thought to be likely secondary to pneumonia (although all sputum cultures have been negative) or due to pneumonitis (the patient has a history of drug use). on presentation, the patient was paralyzed and maintained on ac. on , the ventilator mode was changed to pressure control with a driving pressure of 25 and peep of 15. a bronchoscopy was done that day in which bal samples were taken. the airways showed minimal secretion and some inflammation. bal studies are all negative at the time of this dictation. due to elevated total pressures to approximately 40, an esophageal balloon was placed on . this showed a transpulmonary pressure of only 15, indicating that the patient's elevated total pressures are likely due to non pulmonary causes such as his marked obesity. due to this finding, the patient's peak was elevated to 20. on , the paralytics were discontinued and in the following days a slow wean of the patient's driving pressure was done. this went well and on , the patient was switched to pressure support ventilation and was able to maintain excellent tidal volumes with a pressure support of only 5. by this time, his fio2 had been weaned down to 40% to 50%. over the following days, a slow wean of the patient's peep was done. at the time of this dictation, the patient's vent settings are a pressure support of 5, peep of 15 and fio2 of 50%. 2. infectious disease: the patient was initially started on empiric treatment for pneumocystis carinii pneumonia at the outside hospital with bactrim and steroids. this was continued here until the bal samples were negative on . the patient was initially treated with vancomycin and levofloxacin to cover a pneumonia. the vancomycin was discontinued on after five days when all cultures were returning negative. the patient completed a 10 day course of levofloxacin on as empiric coverage for community acquired pneumonia. on , the patient again spiked temperatures to 101?????? to 102??????. he was again pan cultured. all of this data is pending at the time of this dictation. 3. cardiovascular: the patient is reported to have had a wedge of 30 at the outside hospital. this corrected with diuresis and the patient's wedge pressures continued to be normal here. the swan-ganz catheter was discontinued on . an echocardiogram was done on which was a suboptimal study due to body habitus positioning, but indicated a normal ejection fraction. 4. renal: the patient had a mild creatinine bump to 1.5 at presentation. this is likely prerenal secondary to the brief episode of hypotension at the outside hospital. this quickly resolved and there were no further renal issues. 5. endocrine: the patient is not known to be a diabetic. however, the patient had a hemoglobin a1c of 6.5 at the outside hospital. the patient was placed on an insulin drip and continued on this for 10 days for aggressive blood sugar control. during this time, the patient required 4 units of insulin an hour to maintain blood sugars in the 80 to 130 range. on (due to access issues) the insulin drip was discontinued and the patient was placed on nph with a regular insulin sliding scale. 6. gastrointestinal: initially, the patient was poorly tolerating his tube feeds. this resolved with the initiation of standing reglan. note: this discharge summary covers the dates of to . subsequent hospital course and discharge information will be dictated by the intern taking over this patient's care. dr., 11-575 dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more closed [endoscopic] biopsy of bronchus diagnoses: pneumonia, organism unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure morbid obesity infection and inflammatory reaction due to other vascular device, implant, and graft opioid abuse, unspecified other staphylococcal septicemia hallucinogen abuse, unspecified 

Answer: The patient is high likely exposed to