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: no known allergies / adverse drug reactions attending: chief complaint: shortness of breath major surgical or invasive procedure: endotracheal intubation, central venous line placement history of present illness: history of present illness: 47 year old male smoker with asthma (mild intermittent on albuterol prn and occasionally on flovent) who, according to his wife typically has worsening asthma in the spring due to allergies. she noticed he was using his inhaler more frequently started 5 days ago. he remained stable until last night when he had fever to 101.2, and worsening of his shortness of breath (couldn't sleep). the patient was going to see his pcp this morning but the cab never came so he rescheduled for tomorrow. however, his wife noticed he was working to breathe this evening so she brought him to the ed. last night and in the ed, the patient reported nausea and vomited for the first time in the ed . of note, the patient's wife and 10 year old daughter have had mild symptoms over the past two weeks. the patient did receive his flu shot this year. his last travel to was in . he requires yearly tuberculosis testing for his job and was last ppd positive about 4 years ago and had 9 months of inh. . in the ed initial vital signs were 98.6 121 sbp 166 22 97% ra. labs notable for wbc of 6.5 (14% bands), creatinine of 4.7, lactate of 6.5. cxr showed lll opacification obscuring left hemidiaphragm concerning for infection. patient initially given albuterol and ipratropium nebs and levofloxacin. however, his pressures started to decrease and he triggered for sbp 60. at the same time, he was reportedly on a non-breather so he was intubated and sedated with midaz, fentanyl and 10 of vec. central line was placed and patient started on levophed and neo. tried on left to get aline but failed. vanc/ctx were ordered. he was given 4l of ivf. bedside ultrasound with ? poorly squeezing heart. on transfer, hr 129 bp 115/81 on neo at 1mcg/kg and levophed at 0.3, rr 24 on a/c, 15/5, volumes of 410, rate of 15, 100% fi02. . on arrival to the floor, the patient's initial sbp was 155 but on repeat it was 43. he appeared mottled and cool and he became progressively hypoxic. attempt was made to place a femoral aline but was unsuccessful. labs were drawn and vbg showed 6.96/60/213/15. patient was given 6l of fluids and put on max doses of 3 pressors (levo, neo and vasopressin). he continued to become more mottled and his abdomen became rigid. he was very difficult to ventilate and had to come off of the vent an be bagged. he was given several amps of bicarb as well as calcium citrate for low ionized calcium of .076 and magnesium for mg of 0.7 finally, anesthesia was able to place an arterial line and abg showed: 6.97/106/79/hco3/26. his pressure on the a-line were improved from the cuff readings and he was weaned off of pressors. . he remained difficult to ventilate and this was felt likely secondary to volume overload as well as developing ards. he was given 80 iv lasix and he put out >1l of urine before the am. renal was called in for possible dialysis for volume removal. they spun his urine and saw muddy brown casts consistent with atn. he was eventually paralyzed and put back on the vent and was more synchronous. on pressure control ventilation with driving pressures of 50 and peep of 15 and rate of 30 and his respiratory acidosis started to improve. he was able to wean down to pressure of 40, peep of 15 but fi02 of 100%. after being bolused with sedation prior to vec, his sbp again dropped to the high 70s so low dose levophed was started. serial lactates stayed stable around 4.7-4.9. . review of systems: (+) per hpi (-) per hpi: past medical history: asthma tobacco abuse social history: tobacco, denies etoh or other illicit drugs. he is married with one daughter. at in research. is originally from , last travelled to family history: positive for oral cancer (father), osteoarthritis (mother). physical exam: gen: aox3, nad heent: mmm, no jvd, neck supple, no cervical, supraclavicular, or axillary lad cards: rr s1/s2 normal, no murmurs/gallops/rubs pulm: no dullness to percussion, ctab no crackles or wheezes abd: bs+, soft, nt, no rebound/guarding, no hsm limbs: no le edema, no tremors or asterixis skin: no rashes or bruising neuro: cns ii-xii intact. 5/5 strength in u/l extremities. dtrs 2+ bl. sensation intact to lt, cerebellar fxn intact (ftn, hts). gait wnl. pertinent results: 09:00pm blood wbc-6.5 rbc-4.89 hgb-15.0 hct-41.6 mcv-85 mch-30.8# mchc-36.2*# rdw-14.3 plt ct-261 12:32am blood wbc-5.8 rbc-3.14*# hgb-9.4*# hct-29.0*# mcv-92# mch-29.9 mchc-32.4# rdw-14.0 plt ct-155 01:21am blood wbc-5.1 rbc-3.24* hgb-9.7* hct-29.3* mcv-90 mch-30.1 mchc-33.3 rdw-14.2 plt ct-119* 04:15am blood wbc-4.1 rbc-4.21*# hgb-12.9*# hct-36.7*# mcv-87 mch-30.6 mchc-35.1* rdw-14.4 plt ct-124* 09:30am blood wbc-6.8# rbc-3.27* hgb-10.2* hct-30.0* mcv-92 mch-31.2 mchc-34.1 rdw-14.2 plt ct-pnd 09:00pm blood neuts-57 bands-14* lymphs-18 monos-3 eos-2 baso-0 atyps-0 metas-3* myelos-3* 12:32am blood neuts-56 bands-10* lymphs-23 monos-2 eos-2 baso-0 atyps-0 metas-4* myelos-3* 01:21am blood neuts-51 bands-12* lymphs-25 monos-3 eos-1 baso-0 atyps-0 metas-5* myelos-3* 04:15am blood neuts-57 bands-13* lymphs-18 monos-3 eos-0 baso-0 atyps-0 metas-6* myelos-3* 09:00pm blood hypochr-normal anisocy-normal poiklo-normal macrocy-normal microcy-normal polychr-normal 12:32am blood pt-30.5* ptt-150* inr(pt)-3.0* 04:15am blood pt-26.7* ptt-26.7 inr(pt)-2.6* 09:30am blood pt-38.1* ptt-74.4* inr(pt)-3.9* 09:00pm blood glucose-93 urean-36* creat-4.7*# na-130* k-4.9 cl-93* hco3-14* angap-28* 12:32am blood glucose-64* urean-28* creat-2.8*# na-138 k-4.1 cl-118* hco3-12* angap-12 01:21am blood glucose-371* urean-28* creat-3.1* na-139 k-4.6 cl-107 hco3-25 angap-12 04:15am blood glucose-329* urean-31* creat-3.0* na-132* k-4.4 cl-99 hco3-19* angap-18 09:30am blood glucose-309* urean-30* creat-2.5* na-137 k-4.4 cl-101 hco3-24 angap-16 09:00pm blood alt-41* ast-40 ld(ldh)-303* ck(cpk)-417* alkphos-54 totbili-1.3 04:15am blood alt-241* ast-358* ld(ldh)-667* ck(cpk)-257 alkphos-40 totbili-1.4 09:00pm blood ck-mb-5 09:00pm blood ctropnt-<0.01 12:32am blood ck-mb-4 ctropnt-0.010 04:15am blood ck-mb-5 ctropnt-0.04* 12:32am blood calcium-4.2* phos-5.5* mg-0.9* 01:21am blood calcium-6.7* phos-7.0* mg-1.2* 04:15am blood phos-7.8* mg-3.3* 09:30am blood calcium-8.9 phos-6.1*# mg-4.2* 04:15am blood hapto-pnd 12:39am blood type-mix temp-35.8 fio2-100 po2-213* pco2-60* ph-6.96* caltco2-15* base xs--19 aado2-454 req o2-76 intubat-intubated 01:27am blood type-art po2-79* pco2-106* ph-6.97* caltco2-26 base xs--10 02:00am blood type-art po2-81* pco2-85* ph-6.96* caltco2-21 base xs--15 intubat-intubated vent-controlled 02:02am blood type-central ve 02:34am blood type-art po2-60* pco2-62* ph-7.05* caltco2-18* base xs--14 03:17am blood type-art po2-63* pco2-59* ph-7.13* caltco2-21 base xs--10 03:20am blood type-mix comment-green top 04:37am blood type-art po2-46* pco2-49* ph-7.22* caltco2-21 base xs--7 04:59am blood type-mix 05:34am blood type-art po2-50* pco2-47* ph-7.19* caltco2-19* base xs--10 06:34am blood type-art po2-58* pco2-48* ph-7.19* caltco2-19* base xs--9 07:12am blood type-art tidal v-450 peep-12 fio2-100 po2-61* pco2-46* ph-7.29* caltco2-23 base xs--4 aado2-620 req o2-99 -assist/con intubat-intubated 08:19am blood type-art temp-36.2 rates-30/ tidal v-450 peep-12 fio2-100 po2-55* pco2-43 ph-7.30* caltco2-22 base xs--4 aado2-629 req o2-100 intubat-intubated 09:44am blood type-art po2-23* pco2-110* ph-6.94* caltco2-26 base xs--14 09:01pm blood lactate-6.5* k-4.8 12:39am blood lactate-2.8* 01:27am blood lactate-3.7* 02:00am blood glucose-204* lactate-4.4* k-3.4* 02:02am blood lactate-4.9* 02:34am blood lactate-4.9* 03:17am blood lactate-4.8* 04:37am blood lactate-6.8* 04:59am blood lactate-7.3* 05:34am blood lactate-7.5* 06:34am blood lactate-7.3* 07:12am blood lactate-7.9* 08:19am blood lactate-8.0* 09:44am blood lactate-10.6* 12:39am blood freeca-0.73* 01:27am blood freeca-1.05* 02:00am blood freeca-1.07* 02:34am blood freeca-1.20 04:37am blood freeca-1.13 08:19am blood freeca-1.06* 09:44am blood freeca-1.46* micro rapid respiratory viral screen & culture respiratory viral culture-pending; respiratory viral antigen screen-pending inpatient influenza a/b by dfa not processed inpatient blood culture blood culture, routine-pending inpatient mrsa screen mrsa screen-pending inpatient blood culture not processed inpatient urine urine culture-pending inpatient blood culture blood culture, routine-pending emergency blood culture blood culture, routine-pending emergency reports: cxr ap findings: the patient has been intubated with the tip of the et tube 2.8 cm from the carina. an ng tube is in the stomach. there remains extensive opacification at the left base similar to the prior study. there is somewhat worsening of the pulmonary interstitial markings. no pneumothorax is present. impression: satisfactory et tube position. stable left lower lobe opacity. increased in vascular engorgement/vascular congestion. cxr ap our read: worsening bilateral fluffy infiltrates concerning for ards brief hospital course: assessment and plan: 47 year old with mild intermittent asthma who presents with fever, dyspnea who developed hypotension and respiratory failure now intubated and sedated. . # shock: given fever, bandemia and ll opacity, the thought was likely septic shock from pneumonia. however, on bedside echo seemed to have possible global cardiac dysfunction and given pulmonary edema, there may be some component of cardiac stunning/dysfunction. also severe electrolyte abnormalities and acidosis contributing to cardiac dysfunction and hypotension. the patient was emperically started on vanco/cefepime/levoflox (renally dosed) and was started on levophed as needed to maintain map <65. ivf was given to maintain a cvp <8 (particularly if patient has massive urine output but will otherwise be gentle given his arf and volume overload). blood and urine cultures remained negative, and viral aspirate was pending. sputum was ordered but not yet registered as pending. renal was consulted for potential hd. electrolyte abnormalities were aggressively treated. the patient was aggressively fluid rescucitated. the patient was eventually started on dobutamine at maximum dose in addition to max dose levophed. vasopressin was also started in addition to this. code blue: the patient went into asystolic arrest at 9:10am on in the setting of acute community acquired pneumonia, severe septic shock with multiorgan system failure, acute respiratory distress syndrome, acute kidney injury, lactic acidosis, hypoxemic respiratory failure. the patient was on max dose levophed, dobutamine, and on vasopressin on vancomycin, cefepime, levofloxacin, and osteltamivir at the time of the arrest. id was consulted in the morning who recommended continuing the current antibiotics and obtaining sputum. the patient went into asystolic arrest at 0910 in the morning and cpr was started within seconds. the patient was given multiple rounds of epinephrine, calcium, bicarbonate, dextrose, insulin to treat for possible hyperkalemia and hypomagnesemia. the patient's recent blood glucose was in the 300s. the patient was also given atropine during one episode of slow pea. no pericardial effusion was seen on recent echo to suggest tamponade. the patient had bilateral breath sounds throughout the entire code which pointed away from pneumothorax. the patient was eventually started on an epinephrine gtt. the patient never regained a pulse throughout the entire code. the patient underwent cpr for 46 minutes with minimal interruption. the patient was pronounced dead at 0946 on . the chief cause of death was acute community acquired bacterial pneumonia. the immediate cause of death was asystolic cardiac arrest secondary to severe septic shock with multiorgan system failure, acute respiratory distress syndrome, acute kidney injury, lactic acidosis, hypoxemic respiratory failure. the family was notified of his decompensation and his death. medical examiner was notified. as a sidenote, patient's parainfluenza type iii returned positive after cardiac arrest. . # respiratory failure: initial respiratory distress, was likely pneumonia and asthma. however after that developed hypercarbic respiratory failure due to pulmonary edema from ivf (and renal failure). patient is now diuresing but may require dialysis for more volume removal. the patient diuresed sgnificantly secondary to lasix. throughout the night, the patient began to develop acute respiratory distress syndrome. repeat cxr was consistent with ards. he required fio2 100% and peep 12 to maintain po2 > 50. # acidosis: on arrival to the ed, the patient appeared to have an anion gap lactic acidosis. then the patient developed a concominant respiratory acidosis with a pc02 of >100. he was given bicarbonate for the acidosis, both prior to and during the code. . # acute renal failure: likely pre-renal/hypotensive injury to the kidneys causing atn. renal team was notified for possible need for dialysis; however, patient went into pea/asystolic arrest on morning of (see above). . # anemia: after 7+ liters of fluid, patient hct 41 to 29. doubt bleeding, as no current signs, but this is possible. patient was not transfused as hct improved to > 30 and no signs of bleeding. . # coagulopathy: ? dic in the setting of sepsis. however, fibrinogen was normal. . . expired due to pea/asystolic arrest (see above). medications on admission: albuterol (per notes taking about daily) fluticasone (per notes taking only intermittently) discharge medications: expired discharge disposition: expired discharge diagnosis: 1. pea/asystolic cardiac arrest 2. hypoxic respiratory failure 3. acute tubular necrosis (atn) 4. metabolic acidosis discharge condition: expired discharge instructions: expired followup instructions: n/a procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube arterial catheterization cardiopulmonary resuscitation, not otherwise specified diagnoses: acidosis hyperpotassemia anemia, unspecified acute kidney failure with lesion of tubular necrosis unspecified septicemia severe sepsis asthma, unspecified type, unspecified acute respiratory failure cardiac arrest septic shock other and unspecified coagulation defects examination of participant in clinical trial disorders of magnesium metabolism bacterial pneumonia, unspecified other fluid overload 

Answer: The patient is high likely exposed to