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: aricept attending: chief complaint: hypoxia major surgical or invasive procedure: picc placement history of present illness: 89 yo m with pna treansferred to micu for hypoxia. found unresponsive at nursing home and found to have o2 sat 66% on ra. the patient had an asymptomatic pna about a week ago which was not treated. the daughter noticed that his mental status has decreased over the past 2 days with decreased po intake. . in the ed, patient given vanc, ctx, azith. received lasix by emt. ed physician spoke with daughter who confirmed dnr/dni. . on arrival to the floor, the patient was stable on 2.5l nc. he awoke to voice but was confused and could not answer questions. past medical history: right sided stroke with residual l-sided weakness. htn atrial fibrillation dementia depression failure to thrive frequent falls bph urine/stool incontinence social history: mother with breast cancer at age 58. father with lung cancer at age 68. family history: distant cigar smoker. no alcohol. retired accountant. nursing home resident. physical exam: vs - 97.3 54 142/67 18 96% on 2.5l gen - confused, somnolent heent - op clear, perrl neck - supple, no lad cor - irreg, irreg chest - uncooperative on exam, loud upper airway sounds, decreased bs on right abd - s/nt/bd +bs ext - w/wp, no edmema neuro - uncooperative, moving all ext pertinent results: ekg - afib 65 bpm, rbbb, no change from prior . cxr - large right pleural effusion. significant atelectasis in the right lung with rightward shift of mediastinal contents. abrupt cutoff of the right main stem bronchus. chest ct or bronchoscopy is recommended for further evaluation. . chest ct - 1. right middle lobe consolidation. 2. moderately large right pleural effusion with fluid-like density, and likely adjacent compressive atelectasis. 3. coronary artery calcifications. 4. small aneurysm of the ascending aorta to 4.4 cm in dilatation. 5. calcified granuloma in the left upper lobe, with no other lung nodules identified. 6. likely hepatic cyst, incompletely evaluated and visualized here. . echo - mild regional left ventricular systolic dysfunction. mild global right ventricular systolic dysfunction. moderate mitral regurgitation. mild-moderate aortic regurgitation. moderate pulmonary hypertension. ef 50% . admission labs: 141 105 37 --------------< 162 6.5 30 1.5 *hemolyzed* trop 0.02 ck: 91 mb: notdone ca: 8.7 mg: 2.3 p: 5.2 d probnp: 5808 . 13.9 11.2 >----< 199 42.4 n:91.0 l:5.8 m:2.9 e:0.2 bas:0.1 pt: 13.5 ptt: 30.1 inr: 1.2 . trends: 01:45am blood wbc-11.2* rbc-4.15* hgb-13.9* hct-42.4 mcv-102*# mch-33.4* mchc-32.7 rdw-15.0 plt ct-199 04:57am blood wbc-9.0 rbc-3.69* hgb-12.5* hct-37.8* mcv-102* mch-34.0* mchc-33.2 rdw-14.7 plt ct-171 01:45am blood glucose-162* urean-37* creat-1.5* na-141 k-6.5* cl-105 hco3-30 angap-13 04:57am blood glucose-81 urean-38* creat-1.3* na-147* k-3.4 cl-108 hco3-31 angap-11 01:45am blood ck(cpk)-91 04:57am blood ck(cpk)-35* 01:45am blood ctropnt-0.02* 10:15am blood ck-mb-notdone ctropnt-0.04* 04:57am blood ck-mb-3 ctropnt-0.05* 01:41am blood lactate-2.4* . micro: 1:45 am blood culture aerobic bottle (preliminary): reported by phone to at 11:40 pm. gram positive coccus(cocci). in clusters. being isolated. further identification to follow. anaerobic bottle (preliminary): gram positive coccus(cocci). in clusters. being isolated further identification to follow. brief hospital course: 89 yo m with pna. hospital course by problem: . # hypoxia - profound hypoxia on admission with complete white out of right lung on cxr. this prompted an admission to the micu. ct scan significant for large effusion and diffuse mucous plugging. differential includes post-obstructive pneumonia from mucous plugging, lymphadenopathy, or mass. prior chest ct showed right middle lobe consolidation in , making malignancy more concerning. he had gm pos cocci in clusters which grew out of his blood cultures. we treated him initially with vanco and zosyn to cover broadly for possible mrsa and pseudomonas. these were started on and we recommend completion of a 14 day course. . # goals of care: the patient had a questionable mass seen on the right lung concerning for tumor with postobstructive changes. we met with the family. the family does not want to be aggressive with care (i.e. no bronchoscopy for fear of need for intubation, thoracentesis, etc.). would like to maintain treatment with antibiotics, pulmonary toilet and chest pt. if decompensates the desire is to make the patient comfortable. . # afib: rate controlled, no anticoagulation given past history of falls and supratherapeutic inr. continued asa. we also decreased lopressor from 100 tid to 25 given bradycardia. this may need to be adjusted further. . # chf: the patient was dry initially so we did not treat him with lasix. in fact, he required fluid boluses on occasion. he aimed to keep i=o. . # htn - continued lopressor . # dementia/depression - we initially held his home meds given aspiration risk. but as the patient requested food and our goals of care were somewhat shifted as above, we restarted his meds. a speech and swallow study suggested nectar thickened liquids with soft consistency solids. . # bph - we initially held terazosin and proscar while asp risk. these were restarted. . # fen - patient on nectar thick diet with ensure . # ppx - hep sc, ppi . # access: a picc was placed for access given prolonged abx course. . # communication - daughter, (hcp) - . # status - dnr/dni, form from nh in chart, conf with daughter medications on admission: rivastigmine 1.5mg asa 325 mg qday tylenol prn nexium memantine 10mg proscar 5mg qday citalopram 20mg qday terazosin 2mg qhs metoprolol 100mg discharge medications: 1. vancomycin in dextrose 1 g/200 ml piggyback sig: one (1) intravenous q 24h (every 24 hours) for 10 days: may adjust for renal function. 2. piperacillin-tazobactam 2.25 g recon soln sig: one (1) recon soln intravenous q6h (every 6 hours) for 10 days. 3. rivastigmine 1.5 mg capsule sig: one (1) capsule po bid (). 4. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 6. nexium 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 7. memantine 5 mg tablet sig: two (2) tablet po bid (). 8. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 9. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 10. terazosin 1 mg capsule sig: two (2) capsule po hs (at bedtime). 11. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day): may need to titrate up as tolerated. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: primary: - pneumonia - bacteremia - hypoxia - pleural effusion - atrial fibrillation secondary: - chf - htn - dementia/depression - bph - fen discharge condition: fair discharge instructions: you were admitted with a pneumonia. we treated you with iv antibiotics and you improved. . please take your abx as instructed. please take your other medications as instructed. . please followup with your pcp within the next 2 weeks. . please return to the ed or contact your pcp if you experience worsening shortness of breath, chest pain, abdominal pain, fevers, or chills. followup instructions: provider: , m.d. phone: date/time: 9:00 procedure: venous catheterization, not elsewhere classified diagnoses: unspecified pleural effusion unspecified essential hypertension atrial fibrillation mitral valve insufficiency and aortic valve insufficiency hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) rheumatic heart failure (congestive) pneumonitis due to inhalation of food or vomitus bacteremia other late effects of cerebrovascular disease hypoxemia 

Answer: The patient is high likely exposed to