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: tape attending: chief complaint: sepsis major surgical or invasive procedure: tracheostomy placement peg tube placement intubated and ventilated history of present illness: 89 y/o m h/o end stage parkinson's, dysphagia, gerd presented to ed after episode of choking in the afternoon. of note he has had recent ftt and there was discussion with dr. , his pcp of placing peg tube. he had recently done better tolerating meals over the past few months, past few days he has had episodes of choking with meals with likely aspiration. daughter gave him a few nebulizer treatments and his respiratory distress did not improve so she called ems. . in the ed, respiratory difficulty throughout day, daughter gave nebs, ems tachypneic, 90% room air, 40s rr, tired out, lots of secretions, mental status diminished, intubated in that setting for airway protection. right ij in place, lactate 4.1, cxr with infiltrates. u/a clean. ecg unchanged. 2 liters fluid given, hr decreased from 130s to 80s after fluids. cvp not transduced, apparently good uop. received levofloxacin 750mg, metronidazole 500mg, ceftriaxone 1g, vancomycin 1 g vitals upon leaving er: 100.3 rectally, 81, 95/55, 100% on 100% fio2 ac past medical history: 1. parkinson's disease diagnosed in . 2. macular degeneration. 3. gastroesophageal reflux. 4. coccygeal skin breakdown. 5. bph. 6. cataract. 7. carpal tunnel. 8. cervical stenosis. 9. gait instability with a history of falls. he has a history of right leg buckling under him, and he wears a knee brace for this purpose. he is being followed by physical therapy at home 10. zoster social history: lives in with daughter. chinese immigrant, retired pharmacist. used to smoke cigarettes, but last smoked in the 70s; no alcohol. he is widowed and has 5 children. he walks with a walker or uses a wheelchair. he lives at home and is attended to by his daughter (a dentist) during the evening and overnight; and he has a home health aid who sees him during the day while his daughter is at work. family history: noncontributory. physical exam: vitals: t: bp: hr: rr: o2sat: gen: well-appearing, well-nourished, no acute distress heent: eomi, perrl, sclera anicteric, no epistaxis or rhinorrhea, mmm, op clear 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 ctab, no w/r/r abd: soft, nt, nd, +bs, no hsm, no masses ext: no c/c/e, no palpable cords neuro: alert, oriented to person, place, and time. cn ii ?????? xii grossly intact. moves all 4 extremities. strength 5/5 in upper and lower extremities. patellar dtr +1. plantar reflex downgoing. no gait disturbance. no cerebellar dysfunction. skin: no jaundice, cyanosis, or gross dermatitis. no ecchymoses. pertinent results: 08:02pm wbc-10.2 rbc-3.43* hgb-11.7* hct-35.3* mcv-103* mch-34.0* mchc-33.1 rdw-12.3 08:02pm neuts-88.7* lymphs-8.4* monos-2.6 eos-0.2 basos-0.1 08:02pm ctropnt-<0.01 08:02pm alt(sgpt)-25 ast(sgot)-27 ld(ldh)-232 ck(cpk)-54 alk phos-69 amylase-102* tot bili-0.4 08:13pm lactate-4.1* 09:16pm hgb-10.6* calchct-32 o2 sat-97 frontal chest radiograph indication: 89-year-old man with ards, ventilated. comparison: multiple prior studies, most recent dated . findings: support devices remain in standard positions. multifocal patchy opacities remain present, have increased in extent particularly in perihilar regions, concernign for volume overload. bilateral pleural effusions are stable. impression: worsening of multifocal bilateral opacities, given perihilar predominance concerning for volume overload. frontal chest radiograph indication: 89-year-old man with ards. comparison: multiple prior studies, most recent dated , 5:45 a.m. findings: the support devices are in unchanged standard positions. overall, the appearance of the chest is unchanged from the prior study, including bilateral extensive multifocal opacities as well as small pleural effusions. impression: no interval change from . lower extremity us findings: ultrasound evaluation of the right and left lower extremities deep venous system reveals the veins to be fully compressible with normal color flow, doppler waveforms, augmentation, and respiratory variation in flow. impression: no evidence of dvt involving the right or left lower extremity. head ct impression: no evidence for hemorrhage or acute infarction. brief hospital course: # patient was admitted with septic shock secondary to aspiration, as patient has end stage parkinson's disease and history of difficult swallowing. initial chest x-ray showed bilateral opacities. subsequent chest x-rays showed bilateral opacities consistent with ards, with no significant change over the course of his hospital stay. patient was continued on empiric antibiotics vancomycin and cefepime for aspiration pneumonia, for 8 day course. sputum cultures grew mrsa, klebsiella and rare gram negative rods. # respiratory failure secondary to aspiration. patient was intubated on admission, and remained ventilator dependent despite efforts to extubate him. he received a tracheostomy after 9 days of intubation and failure to extubate. # hypotension: attributed to sepsis. lowest systolic blood pressure was in the 70s. on admission patient required levophed to maintain blood pressure. this was gradually weaned off prior to discharge. baseline systolic blood pressures 80s-90s. # nutrition: patient was started on tube feeds during hospital stay. a peg tube was placed prior to discharge. # sacral decubitus ulcer: this began months prior to admission. patient was evaluated by wound care nurse. patient was kept on an air mattress, and repositioned q 1-2 hours to keep pressure off coccyx. heels were kept off of the bed surface. lower extremities were moisturized twice daily. # atrial tachycardia: patient developed tachycardia, likely atrial flutter once during admission that resolved with diltiazem rate control. he was started on digoxin with dig level of 1.2 day prior to discharge. cardiac enzymes were negative x3. medications on admission: outpatient medications: adefovir 10 mg daily albuterol 2 puffs up to qid prn alprazolam 1 mg q6 hours prn anxiety dicyclomine 10 mg tid fluticasone 50 mcg sprays in nostrils prn advair diskus 500-50, one inhalation hctz 25 mg daily mirtazapine 15 mg qhs omeprazole 20 mg daily oxazepam 15 po qhs prn zoloft 150 mg daily tiotropium bromide 18 mcg capsule inh daily trazadone 50 mg daily (?) oxygen 1 l/min at rest and 2 l/min during sleep and exertion, for resting sat of 88% on r.a which drops to 78% with exertion. keeping his sat> or = to 90% discharge medications: 1. chlorhexidine gluconate 0.12 % mouthwash sig: 1-2 mls mucous membrane (2 times a day). 2. albuterol 90 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours). 3. ipratropium bromide 17 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 4. carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po qid (4 times a day). 5. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily). 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 7. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 8. neomycin-bacitracin-polymyxin ointment sig: one (1) appl ophthalmic qid (4 times a day) as needed. 9. digoxin 250 mcg tablet sig: one (1) tablet po daily (daily). 10. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po bid (2 times a day) as needed. 11. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for fever. 12. miconazole nitrate 2 % cream sig: one (1) appl topical (2 times a day). 13. pantoprazole 40 mg recon soln sig: one (1) recon soln intravenous q12h (every 12 hours). 14. morphine 10 mg/ml solution sig: one (1) intravenous q4h (every 4 hours) as needed for pain. discharge disposition: extended care facility: & rehab center - discharge diagnosis: primary diagnoses: 1. respiratory failure secondary to ards 2. aspiration pneumonia 3. baseline relative hypotension (systolic blood pressures in 80s-90s) 4. baseline poor neurologic function 5. sacral decubitus ulcer 6. paroxysmal atrial tachycardial: afib vs. mat secondary diagnoses: 1. parkinson's disease diagnosed in . 2. macular degeneration. 3. gastroesophageal reflux. 4. coccygeal skin breakdown. 5. bph. 6. cataract. 7. carpal tunnel. 8. cervical stenosis. 9. gait instability with a history of falls. he has a history of right leg buckling under him, and he wears a knee brace for this purpose. he is being followed by physical therapy at home 10. zoster discharge condition: stable discharge instructions: you were admitted to the intensive care unit with sepsis due to aspiration pneumonia. you were put on a ventilator as you weren't able to breathe for yourself. after 9 days on the ventilator, you had a tracheostomy (a tube put in your throat) and a peg tube placed in your stomach for feeding. you were treated with antibiotics for pneumonia. your decubitus ulcers were treated with wound care. please return to the er, if you are unable to breathe, are unable to maintain systolic blood pressure above 75, or have recurrent fevers, low blood pressure, and increased heart rate over 100. followup instructions: pcp: at noon md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more other endoscopy of small intestine insertion of endotracheal tube fiber-optic bronchoscopy percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy diagnoses: esophageal reflux unspecified septicemia severe sepsis infection with microorganisms resistant to penicillins atrial flutter hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) paralysis agitans pneumonitis due to inhalation of food or vomitus septic shock pressure ulcer, lower back 

Answer: The patient is high likely exposed to