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: altered mental status major surgical or invasive procedure: none history of present illness: history obtained via pt.'s family at bedside as pt. sleeping and unable to answer questions with any consistency. this is a 83 year-old man with a history of myeloma who presents from rehab with fever to 100.1, lethargy, tachypnea. he has been on vanc/zosyn for known health-care associated pna since and flagyl for c. difficile colitis, which was restarted after a period off of it. he received one dose of imipenum at prior to being sent to . apparently had known c. diff. treated for two weeks, with recrudescence of diarrhea about a week after flagyl stopped. his family reports confusion, difficulty putting sentences together, lethargy, decreased appetite and diarrhea over the last week. diarrhea has improved. he has had a stable unproductive cough, only associated with taking pos over the last few weeks. wife multiple episodes of liquid-associated coughing. in addition, he has sacral decub stage 2 on coccyx. he received one dose of imipenem and was transferred to ed. . in the ed, he had initial vitals of 98.6 bp 134/76 hr 110 rr 32 96% on 3l, 91%ra. he had wbc to 17.9 with 3% bands, cr to 1.3 (nl bl<1.0), lactate 3.2 and had blood cx. drawn. u/a negative and received 2l ivfs and stress-dose steroids given chronic prednisone for myeloma. . ros: + weight change (weight loss over last year), no nausea, vomiting, abdominal pain, + diarrhea, as above that is improving, constipation, melena, hematochezia, chest pain, mild shortness of breath. no orthopnea, pnd, lower extremity edema, urinary sx. no ha rash. past medical history: - hypertension - bph - hypercholesterolemia - b12 def dx'd 2y ago by pcp, . - grade i diastolic dysfunction by echo in - myeloma/mds: kappa light chain myeloma. presented with mgus without evidence of end organ damage. initially observed until when monoclonal protein rose and patient treated with 6 cycles melphalan/prednisone. patient remained stable until when protein rose again and was treated with 8 cycles melphalan/prednisone finishing . he then remained off treatment until when began to develop anemia/bone pain. found to have smear consistent with mds involving all 3 lineages. began treatment with velcade/revalmid and epo, then mephalan/prednisone d/c'd earlier this year due to inability to tolerate. also had t9 and t11 involvement s/p radiation in . he was receiving treatment for his myeloma until /dexamethasone/revlamide/alkaran but it was dc'ed to inability to tolerate regimen. - h/o hyponatremia - h/o multiple pnas requiring hospitalization - h/o c.diff. social history: retired accountant, lives at rehab. no tobacco now or previously, no etoh now or previously. family history: no fh of malignancies. physical exam: vitals: t: 97.8 bp: 96/47 hr: 94 rr: 19 o2sat: 98%/3l gen: elderly man, sleeping, cachetic, follows commands, aa&ox1. answers some questions clearly, but mumbled rambling for others heent: eomi, perrl, sclera anicteric, no epistaxis or rhinorrhea, mmm, op with thrush neck: no jvd, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline cor: rrr, no m/g/r, normal s1 s2, radial pulses +2 pulm: lungs with decreased bs at r base., sl. crackles at bases, improve with cough abd: soft, nt, nd, +bs, no hsm, no masses ext: no c/c/e, multiple ecchymoses over arms and legs bilaterally neuro: cn ii ?????? xii grossly intact. moves all 4 extremities. skin: stage 2 decub over coccyx pertinent results: admission labs 03:50pm pt-17.6* ptt-32.1 inr(pt)-1.6* plt smr-very low plt count-53*# hypochrom-normal anisocyt-1+ poikilocy-normal macrocyt-normal microcyt-normal polychrom-1+ neuts-55 bands-3 lymphs-29 monos-0 eos-0 basos-0 atyps-10* metas-1* myelos-2* wbc-17.9*# rbc-3.51* hgb-10.7* hct-30.3* mcv-86# mch-30.5 mchc-35.4* rdw-16.8* osmolal-312* albumin-1.9* calcium-9.3 phosphate-3.0 magnesium-1.9 lipase-18 alt(sgpt)-7 ast(sgot)-30 alk phos-45 tot bili-0.4 estgfr-using this glucose-144* urea n-35* creat-1.3* sodium-138 potassium-4.9 chloride-112* total co2-21* anion gap-10 lactate-3.7* 04:54pm urine amorph-many ca oxal-occ rbc-0 wbc-0 bacteria-mod yeast-none epi-0 bood-neg nitrite-neg protein-30 glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-6.0 leuk-neg color-yellow appear-cloudy sp -1.017 cxr impression: moderate pulmonary edema and more focal consolidation in the right lower lobe, which may represent superimposed pneumonia brief hospital course: altered mental status: patient initially admitted to icu for close monitoring before being transferred to the inpatient floor the following day. initially it was thought the patient may have a worsening pneumonia. patient was noted to be aspirating with copious secretions. the patient failed speech and swallow evaluation. work up for altered mental status was done, including cultures, head ct, metabolic problems was all neagtive. in the end the altered mental status was believed to be a result of severe deconditioning from multiple acute medical problems on top of his multiple myeloma/mds. there was not much else that we could do for the patient. the family did not want to put the patient through any uncomfortable procedures such as an lp. they did not want a feeding tube placed. the patient was not a candidate for any treatment for his myeloma. palliative care consult was obtained and after careful discussion the family made the decision to make the patient cmo. all nonessential meds were stopped and the patient expired peacefully on . . medications on admission: - vancomycin iv 1gq12h - zosyn q6h, switched to imipenem as above - flagyl 500tid - prednisone 15mg qdaily - lactobacillus - caco3 650 - vitd 1000 u qdaily - cyanocobalamin 500mcg qod - atrovent - lactobacillus - mg oxide 400bid - megace 400 - omeprazole 40bid - kcl 20meq tid po - nacl 1g qdaily - bactrim ds 1 tab q mwf - tylenol prn discharge medications: patient expired discharge disposition: expired discharge diagnosis: patient expired discharge condition: patient expired discharge instructions: patient expired followup instructions: patient expired md procedure: injection or infusion of immunoglobulin diagnoses: thrombocytopenia, unspecified congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) candidiasis of mouth other b-complex deficiencies pneumonitis due to inhalation of food or vomitus intestinal infection due to clostridium difficile pressure ulcer, lower back multiple myeloma, without mention of having achieved remission chronic diastolic heart failure hypercalcemia pressure ulcer, stage ii 

Answer: The patient is high likely exposed to