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: patient recorded as having no known allergies to drugs attending: chief complaint: sob and fever major surgical or invasive procedure: intubation history of present illness: 61yo m with copd on home o2, type ii dm, and obesity who presents with acute onset of sob. the pt reports he was in his usoh until this am when he awoke with a . the is non-productive but pt believes there is sputum "deep down". since this am, the pt has not been able to "catch his breath". he has not appreciated on any wheezing himself but tried his prn medications without success. in addition, the pt also reports subjective fevers with chills as well. the pt denies any cp, palpitations, le edema, pnd, orthopnea (one pillow), he also denies any abd pain, n/v/d. he reports he has received his flu vaccine this year. in the ed, the pt was found to be febrile to 101, tachycardic and hypertensive. his physical exam was significant for diffuse wheezing throughout the lung fields. he was given ceftriaxone and azithromycin as well as solumedrol and combivent nebulizers with some improvement in his sob. past medical history: 1. copd- on home o2 (3l), fev 590, fev1 20% predicted, fev1/fvc ratio 38% predicted, multiple previous intubations. followed by pulm 2. tobacco abuse 3. dm ii 4. diverticulosis 5. h/o sbo 6. c6-c7 hernitation 7. b12 deficiency- on monthly injections 8. obesity social history: pt is married and lives with wife and 3 children. he is currently umemployed- former restaurant manager tob: smokes 6 cig 2-3x/week. he used to smoke ppd for 40+ years but has been cutting back recently. etoh: last drink was last x-mas. family history: father, mother died of lung cancer in their 60's. physical exam: physical examination: vs: t: 101, hr: 80, bp: 139/56, rr: 23, sao2: 95% 3l gen: obese caucasian male in nad, conversing fluently in full sentences. heent: eomi, anicteric, mmm cv: distant heart sounds, rrr, s1, s2, no m/r/g chest: diffuse wheezing throughout, poor air movement abd: obese, soft, nt, nd, bs+ ext: wwp, no c/c/e pertinent results: lle us: impression: no evidence of left lower extremity deep venous thrombus. spirometry : actual pred %pred fvc 1.77 4.11 43 fev1 0.52 2.92 18 mmf 0.20 2.90 7 fev1/fvc 29 71 41 07:10am blood wbc-11.1* rbc-4.34* hgb-12.5* hct-38.7* mcv-89 mch-28.9 mchc-32.4 rdw-14.0 plt ct-222 05:45pm blood wbc-9.4 rbc-4.41* hgb-13.2* hct-39.6* mcv-90 mch-29.9 mchc-33.3 rdw-13.9 plt ct-166 08:14pm blood neuts-85.5* lymphs-7.2* monos-6.3 eos-0.9 baso-0.2 07:10am blood plt ct-222 03:00am blood pt-12.5 ptt-28.3 inr(pt)-1.1 07:10am blood glucose-147* urean-23* creat-0.7 na-139 k-4.4 cl-98 hco3-35* angap-10 05:45pm blood glucose-147* urean-19 creat-0.8 na-146* k-4.1 cl-103 hco3-34* angap-13 04:50am blood ck(cpk)-108 08:14pm blood ck(cpk)-101 04:50am blood ck-mb-3 ctropnt-<0.01 08:14pm blood ck-mb-4 ctropnt-<0.01 07:10am blood calcium-9.3 phos-2.3* mg-1.8 06:17am blood type-art temp-36.2 po2-96 pco2-75* ph-7.36 calhco3-44* base xs-13 12:02pm blood type-art fio2-91 po2-82* pco2-94* ph-7.22* calhco3-41* base xs-6 aado2-487 req o2-81 brief hospital course: 61yo m with copd on home oxygen (3l) and dm p/w progressive sob and fevers. pt had episode of desat to 60's 2 days ago, treated with nebs, solumedrol, and 100% nrb. o2 sat then recovered to >90% on 3l. pt now with increasing oxygen requirement, although he "feels about the same." very poor air movement and wheezy on exam. . #) copd exacerbation: in the ed, the pt was found to be febrile to 101, tachycardic and hypertensive. his physical exam was significant for diffuse wheezing throughout the lung fields. he was given ceftriaxone and azithromycin as well as solumedrol and combivent nebulizers with some improvement in his sob. admitted to the floor until , when he desaturated and had abg of 7.22/94/82. pt was mentating and plyaing solitaire. given two nebs with some improvement in exam. over the next 15 mins, he became more somnolent, refused noninvasive ventialtion. a code blue was called for intubation. . admitted to the icu for hypercarbic resp failure. his influenza a dfa returned positive and was started on tamiflu. his iuc course was signficant for iv solumedrol, antibiotics (7 days azithromycin) and positive pressure ventilation. he was extubated without complication, when his azithro stopped also. finished day # of tamiflu. was on 6 days of iv solumedrol, now on oral prednisone. in icu, he did not require his baseline ace while on the vent, now needs bp meds. will send patient to rehab on the following oral prednisone taper: 60mg x 7 days, 40 mg x 7 days, 30mg x 7 days, 20mg x 7 days, 10mg x 7 days, then 10mg every other day thereafter. will continue nebs. smoking cessation. low carbohydrate diet, if possible. pt will follow up with dr. as an outpt. . #) dm: cont. outpt regimen of metformin 1000mg . pt says he does not take glyburide hypoglycemia. pt has had elevated fs, likely secondary to steroids. he never had any episodes of hypoglycemia, dka or nk hyperglycemia. will send to rehab with metformin 1000mg and iss. . #) cv: a. cad: the pt has multiple risk factors for cad including age, sex, tob, htn and dm. however, his mortality is limited by critical copd, not coronary disease. will continue asa. ace inhibition will protect his kidneys from diabetic nephropathy. no beta-blocker. . #) anemia: hct stable. the pt is on ferrous sulfate 325mg once daily and iv vit b 12 injections. continue outpt ferrous sulfate. medications on admission: 1. prednisone 10mg qod 2. combivent 2 puffs 3. advair 4. albuterol prn 5. metformin 1000mg 6. glyburide 5mg qod 7. aspirin 325mg once daily 8. lisinopril 20mg once daily 9. furosemide 20mg once daily 10. ferrous sulfate 325mg once daily 11. docusate tid and senna 12. protonix 40mg 13. mag oxide 400mg once daily 14. ranitidine 300mg once daily 15. ibuprofen 600mg tid discharge disposition: home with service facility: vna discharge diagnosis: upper respiratory infections copd secondary: type ii diabetes mellitus obesity viamin b12 deficiency discharge condition: patient had a , but o2 sat was >93% on baseline 3lnc and felt better. discharge instructions: you may return home. please continue your previous medications, and take prednisone in a tapering fashion as outlined below. if you have recurrent problems breathing, , shortness of breath, or other concerns, please call your pcp or return to the ed. followup instructions: dr office will call you with an appointment. if they do not call your house by , call them at (. please follow up with: provider: , np date/time: 2:20 as scheduled. you also have these follow up appointments previously scheduled: provider: , dpm phone: date/time: 11:20 provider: breathing tests phone: date/time: 11:40 md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: acidosis anemia, unspecified esophageal reflux tobacco use disorder congestive heart failure, unspecified obstructive chronic bronchitis with (acute) exacerbation other b-complex deficiencies acute respiratory failure chronic systolic heart failure diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled obesity, unspecified hypovolemia influenza with other respiratory manifestations 

Answer: The patient is high likely exposed to