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: levofloxacin attending: chief complaint: abdominal pain major surgical or invasive procedure: none history of present illness: 67 yo aam w pmhx of copd on 4l home o2 and nightly bipap, htn, chronic lbp, presented to ed w llq abd pain. pt was given levaquin in ed (has noted allergy to it) and developed rash on his forearms. on floor, he also developed tachypnea and transferred to icu. per icu team, they think it was likely from not using bipap; initially they did not believe had copd exacerbation or drug reaction. he was continued on prednisone taper. for his diverticulitis he was started on rocephin and flagyl. he was never intubated. pt was transferred to the floor the next day. currently he reports his sob at baseline, denies cp and denies abd pain. he had noted mild hematochezia prior to admission but none since. he denies nausea, vomiting. he thinks the rash is improving ros: otherwise neg past medical history: - copd on 4l nc at home, fev1 24%; fev/fvc 35% - h/o vre uti - hx of mrsa - cad s/p nstemi (): cath with minimal disease, tte with preserved biventricular function in - hypertension - hyperlipidemia - chronic low back pain l1-2 laminectomy from accident at work - cataracts bilaterally - s/p surgery for both - gerd - bph s/p turp social history: retired, lives with wife. son recently had restraining order placed against him by patient violent behavior. previous smoker, occasional alcohol, quit marijuana 3 years ago. originally from , moved here to live with grandmother after primary school. family history: mother w/ asthma, alzheimer's disease. father w/ cancer. physical exam: vitals: t 100.9, p 88-110, bp 93-130/50-65, rr 20-26, sats 95% on 3l gen nad eye anicteric ent moist op cv rrr resp cta w good air entry gi snt nabs gu no cvat msk warm, no edema skin - minimal eryhtematous macular rash on forearm ( rn this is likely from levaquin he got in er, improving per pt) neuro a&ox3, sensation/motor non-focal psych calm heme/ no ln access peri pertinent results: 05:41am wbc-14.0* rbc-3.74* hgb-10.3* hct-31.8* mcv-85 mch-27.5 mchc-32.3 rdw-15.2 12:10am urine color-yellow appear-clear sp -1.039* 12:10am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 09:05pm glucose-120* urea n-22* creat-0.7 sodium-139 potassium-4.2 chloride-95* total co2-37* anion gap-11 09:05pm alt(sgpt)-14 ast(sgot)-18 alk phos-75 tot bili-0.8 09:05pm lipase-24 ct abd/pelv: 1. very mild stranding adjacent to the diverticula in the proximal sigmoid , which may reflect presence of mild or early acute uncomplicated diverticulitis. 2. severe emphysema. 3. right basal bronchiectasis with associated patchy consolidation. brief hospital course: 67 yo aa male w pmhx of severe copd on 4l home o2, nightly bipap, htn, chronic lbp presented w/ diverticulitis. . micu course : the patient was doing well on the floor nearing discharge for home on tapered steroids and a course of antibiotics when he developed acute respiratory distress with tachypnea and shortness of breath. the patient reportedly awoke from sleep needing to go to the bathroom. after removing his overnight bipap device and attempting to ambulate to the toilet, he was found yelling for help with severe shortness of breath and tachypnea. vitals at that time were 97.0 93 115/60 22 98% while receiving a nebulizer treatment. on exam, he was noted to have minimal air movement and abg revealed a respiratory acidosis 7.28/66/150, but bicarb 32 indicating chronic respiratory acidosis, pco2 never noted to be below 50. the patient received solumedrol 125mg once and nebulizers. the patient was transferred to the icu for further respiatory care. on arrival to the icu the patient appeared comfortable and reported he was back at his baseline. he was given standing nebulizers, and his steroid dose was increased to 40 mg daily and he was given azithromycin for what now appeared to be a copd flare. -during his micu course, he had 2 more episodes of respiratory distress noted as tachypnea with lots of anxiety. patient responded well to 1mg of ativan with bipap. it is believed that there is a large component of anxiety to his resp distress in addition to his severe copd. also patient often refused nebs. we discussed that the patient need scheduled nebs when he has a flare and can go back to prn when he is out of the hospital. he was continued on nightly bipap and prednisone for presumed copd flare. . the following is his course on the floor: . # copd flare: as described above in his micu course, mr. has severe copd with steroid and oxygen dependency. he had 2 episodes of respiratory failure requiring icu admission. he was treated with iv steroids, as well as ativan for anxiety, and also with azithromycin. he was also treated with prophylactic bactrim given his high steroid requirement. the patient was treated with a prednisone taper. he was tapered down from 60 mg daily, in increments of 5 mg less every 3 days. he had been on prednisone 10 mg daily at home, and should probably increase to 20 mg daily at home. he will be tapered down to 20 mg daily. he was continued on tiotropium, advair, and albuterol/atrovent nebs. he will need outpatient follow up with dr. of pulmonary. he also remains on 4 l nc and bipap at 12/5 at night. #diverticulitis. he was admitted with abdominal pain, and was found to have mild diverticulitis. he was initially started on iv antibiotics (ctx/flagyl), and subsequently transitioned to po antibiotics with augmentin to complete a 10 day course. he was tolerating an oral diet, and having normal bowel movements. he likely would not tolerate a colonoscopy to further evaluate his , but colonoscopy in showed diverticuli, no malignancy. . #chronic pain. he has chronic back pain, unchanged from prior, treated with percocet with good effect. he has been seen in the pain clinic in the past with trigger point injections and good relief, so this can be considered in the future. . #hyperglycemia: likely chronic prednisone use. his fs ranged from 80s to low 200s. he required at most 4 u of insulin during the day. his fingersticks should be monitored with his prednisone taper with sliding scale insulin as needed. consideration can be given to starting low dose lantus if the patient has persistent low dose insulin requirements with his prednisone taper. . # htn: bp well controlled on verapamil . # cad: continued asa, statin. he was not on bb or ace. likely no bb due to many copd exacerbations. low dose lisinopril 5 mg daily was restarted. . # code: he is full cardiac resuscitation but dni (do not intubate). this was discussed with the patient at the time of discharge. medications on admission: 1. prednisolone 1% drops each eye 2. advair 250/50mcg qd 3. finasteride 5mg qd 4. sertraline 50mg qd 5. bactrim one tab q mwf 6. asa 81mg qd 7. pravastatin 40mg qd 8. omeprazole 40mg 9. spiriva one inhaled qd 10. prednisone 10mg qd until seen by pulmonologist 11. vitamin d 400 unit qd 12. alendronate 70mg qd 13. colace 100mg 14. calcium 600mg 15. percocet 325/7.5mg 1-2tabs upto 5 times a day as needed 16.verapamil 120mgsr qd discharge medications: 1. prednisolone acetate 1 % drops, suspension sig: one (1) drop ophthalmic (2 times a day). 2. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 3. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 4. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. trimethoprim-sulfamethoxazole 80-400 mg tablet sig: one (1) tablet po 3x/week (mo,we,fr). 7. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 8. pravastatin 20 mg tablet sig: two (2) tablet po daily (daily). 9. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 10. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed. 11. alendronate 70 mg tablet sig: one (1) tablet po qmon (every monday). 12. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 13. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po twice a day. 14. verapamil 120 mg tablet sustained release sig: one (1) tablet sustained release po once a day. 15. calcium 600 + d 600 (1,500)-200 mg-unit tablet sig: one (1) tablet po twice a day. 16. prednisone 5 mg tablet sig: one (1) tablet po as instructed: on take 55 mg (11 tablets); on take 50 mg (10 tablets); on take 45 mg (9 tablets); on take 40 mg (8 tablets); on take 35 mg (7 tablets); on take 30 mg (6 tablets); on take 25 mg (5 tablets); thereafter take 20 mg ongoing (4 tablets). 17. polysaccharide iron complex 150 mg capsule sig: one (1) capsule po daily (daily). 18. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 19. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation inhalation q4h (every 4 hours) as needed. 20. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day). 21. lorazepam 1 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for anxiety,agitation. 22. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed. 23. insulin lispro 100 unit/ml solution sig: one (1) units subcutaneous as directed: for fs of: 150-199 give 2 units; 200-249 give 4 units; 250-299 give 6 units; 300-349 give 8 units; 350-399 give 10 units; above 400 call ho. discharge disposition: extended care facility: discharge diagnosis: diverticulitis copd exacerbation severe copd discharge condition: stable on l nc discharge instructions: you were admitted with abdominal pain. you underwent a ct scan, which showed diverticulitis or inflammation of part of your . you were treated with antibiotics. you were briefly in the icu because you felt increasing shortness of breath. this was likely because you did not get bipap at night. in addition, you also were felt to have a flare of your copd. your symptoms improved with bipap and steroids. you were continued on your prior medications. . please return to ed if you notice fevers, chills, worsening abdominal pain, blood in stool, worsening shortness of breath or cough. we have changed your primary care appointment to this friday, please keep that appointment followup instructions: ** please follow up with dr. (your primary care doctor) 3pm this friday at , , . call his office at with any questions. . ***you should follow up with your pulmonologist, dr. . you have an appointment with him on thursday at 12:00 noon. he is located at the building, . you may call his office at with any questions. it is very important that you make it to this appointment. . you have an appointment with your ophthalmologist, , on at 9am. call his office at with any questions. . you have an appointment with your ent doctor, , on at 2:45pm. call his office at with any questions. procedure: non-invasive mechanical ventilation diagnoses: acidosis obstructive sleep apnea (adult)(pediatric) other chronic pain coronary atherosclerosis of native coronary artery esophageal reflux unspecified essential hypertension long-term (current) use of steroids diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled obstructive chronic bronchitis with (acute) exacerbation personal history of tobacco use hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) acute respiratory failure disorders of phosphorus metabolism old myocardial infarction iron deficiency anemia, unspecified other constipation dermatitis due to drugs and medicines taken internally lumbago other specified antibiotics causing adverse effects in therapeutic use diverticulitis of colon (without mention of hemorrhage) other dependence on machines, supplemental oxygen other cataract 

Answer: The patient is high likely exposed to