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 55 year old man with past medical history significant for end stage renal disease, peritoneal dialysis times one year, status post glomerulonephritis, renal transplant three times and aortic valve replacement secondary to calcific aorta who comes in complaining of temperature of 100.6 on the day of admission back in . he also comes in with a minor complaint of back pain and some chills. he denied any localizing symptoms, no cough, no chest pain, no shortness of breath, no abdominal pain and no flank pain. he did have some mild nausea earlier on the day of admission which had resolved. he called his primary care physician and was told to go to the emergency room. the day prior to admission the patient had an magnetic resonance angiography to evaluate his brachioplexus because of an ischemic second and third finger of his right hand. past medical history: as mentioned, end stage renal disease status post peritoneal dialysis times one year, post glomerulonephritis, renal transplant times three, chronic anemia, hypertension, aortic valve replacement secondary to calcific aorta, otitis and gastrointestinal polyps. hospital course: please see the prior discharge summaries to describe his hospital course. once transferred to the floor dr. improved from a cardiovascular standpoint. 1. coronary artery disease, no issues or medications at this time. 2. hypertension, his blood pressures were followed, at times he was hypotensive to about 108 systolic at which time he was given 500 cc of normal saline bolus to which he responded well and that is what was given for his pressor support. there were no other issues. electrophysiologically there were no issues, no telemetry was needed. congestive heart failure, there were no issues. pulmonary, he was kept on oxygen. he was also given physical therapy. he remained at 98% on 3 liters of oxygen improving and he was followed and kept on aspiration precautions to prevent any subsequent aspiration pneumonias. renal, the team followed and recommended daily dialysis management of his daily peritoneal dialysis which he continued to do. his electrolytes were followed and replaced as needed. at the time of discharge on his potassium was low so he was being given two days of potassium resupplementation. gastrointestinal, the patient was given his tube feeds via an nasogastric tube, however, it became plugged secondary most likely to medications and the patient refused twice to have his nasogastric tube replaced, so his nutrition was maintained by his taking medications and feeding p.o. his swallow study described in the neurological section, but essentially his ability to eat and drink improved considerably over the time while he was on the floor. there were no signs of obstruction and it was recommended that if he has any worsening abdominal distention, a kub should be done. there will be no plan for esophagogastroduodenoscopy according to the gastrointestinal service following him. neurological/psychiatrist, the patient needs extensive rehabilitation to regain his strength from what was described as a medicine intensive care unit neuropathy. he has been given ativan prn, aspiration precautions were maintained. speech and swallow has been following him. the most recent recommendation based on the , evaluation says to continue thin liquids, he may have ground solids, soft solids as tolerated, possible for p.o. intake. the patient requires assistance with self feeding. he should be monitored for aspiration and acute rehabilitation with dysphagia management and full cognitive communication assessment was the recommendation. endocrine, he is given nph insulin as dialysate, regular insulin sliding scale with fingersticks done. the patient had chronic steroids at home in a way of suppressing his rejection of his current kidneys. on the medicine intensive care unit he was given stress dose steroids. he has now been tapered down to 10 mg p.o. of prednisone and a taper further can be considered down to perhaps what was at 3.75 mg p.o. q. day. hydrochlorothiazide can be used intravenously if there is no heme access. heme, he was mechanical atrial valve so his titered inr was 2.5 to 3.5. he was maintained on heparin gtt, or he started on warfarin. his inr most recently was 1.9 and so he should be continued on the warfarin and also the heparin drip to maintain him in an appropriate therapeutic range to protect him from complications related to his atrial valve. infectious disease, he remained afebrile during his time on the floor. he finished a course of antibiotics. i never found what the cause of his sepsis was. he did also have clostridium difficile which was also treated. disposition: the patient remains full code. he will be discharged to rehabilitation as soon as possible, in other words, . communication has been with his wife, dr. , phone . , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances diagnostic ultrasound of heart insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous abdominal drainage endoscopic destruction of other lesion or tissue of large intestine trocar cholecystostomy diagnoses: pneumonia, organism unspecified acidosis unspecified septicemia defibrination syndrome ventricular fibrillation acute pancreatitis unspecified vascular insufficiency of intestine 

Answer: The patient is high likely exposed to