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: anticholinergics,other / valium / flomax / tamsulosin / antihistamine / seroquel / ropinirole attending: chief complaint: respiratory failure major surgical or invasive procedure: intubation, central line placement history of present illness: 67 y/o m from nursing home at center with h/o parkinson's disease, crf, bph, aspiration pneumonia, g-tube, esophagitis. story of recent febrile illness with respiratory symptoms treated for 2 days with azithromycin. on day of admission was noted by staff to be non-verbal and responsive to pain only. ems was called, per ems report patient was found agitative and combative, warm and dry, with tachypnea to the 30's, audible upper airway congestion and scattered ronchi, with hypoxia to 85-90% on ra, bp 130/90, hr in the 90's. was brought to the ed on ambu bag. . in the ed admission vitals were 97/50, 93, 28, 87% o2 sat on ambu. patient was intubated and ventilated, rij was placed, bp's went down to 70/30 with cvp of 6. cvp was 16 with 5th l hanging and bps 80s/50s so levophed was started. cxr was notable for bilateral ll infiltrates especially impressive on the right. labs were notable for leukopenia wbc 2.1, 83% neutrophils, lactate of 2.7, cr: bun 2.0:60 (from 1.2:26 at baseline), cefepim + vanco were given. in the ed recieved total of 7 l ns. transfer vitals were t100.8 pr hr 74 88/50 rr 26 o2 99%, abg was 7.35/33/227 on peep 10 fio2 100% r 14 vt 600. ed attendig talked to the family: pt is full code. . past medical history: past medical history: . -parkinson's disease: dx age 40. s/p palidotomy 10yrs ago and then neurotransmitters bilaterally 6yrs ago. -bph - crf - aspiration pneumonia - esophagitis . social history: (per brother , ), retired psychiatrist, worked in navy. lived for years with male partner who is his hcp. since deterioration in adl d/t advanced parkinson disease. now in nursing home, unable to ambulate, moves 4 extremities, not independent in adl. of note brother concerned that hcp does not have best interests of patient at heart. mentions episode of physical abuse in . no hx of tobacco or alcohol use. . family history: non contributory, unable to assess . physical exam: admission physical exam: vs: temp: 96.6 bp:117/53 hr:77 rr: 14 o2sat on levophed 0.06mg/kg/h psv 14, peep 5, abg: 7.36/31/94. gen: intubated and sedated on fentanyl 100mg/h and midazolam 4mg/h, unresponsive heent: pinpoint pupils minimally responsive to light, anicteric, no jvd, no carotid bruits, no thyromegaly resp: cta anteriorly b/l cv: rrr, s1 and s2 wnl, no m/r/g abd: nd, +b/s, soft, nt, no masses or hepatosplenomegaly ext: no c/c/e, good peripheral pulses skin: no rashes/no jaundice/no cellulitis neuro: limited exam, sedated. fine cogwheeling in right arm, normal symetric dtr's, babinsky reflex is hyporeactive bil. . pertinent results: admission labs/studies: . ekg: sinus rythm, rate 70, border line left axis ~ 30*, srwp v1-v4, low voltage limb leads, normal intervals, no signs of acute ischemia. . 05:30pm blood wbc-2.1*# rbc-3.93* hgb-12.4* hct-36.0* mcv-92 mch-31.7# mchc-34.5 rdw-14.1 plt ct-212 05:30pm blood neuts-83* bands-2 lymphs-10* monos-5 eos-0 baso-0 atyps-0 metas-0 myelos-0 05:30pm blood hypochr-normal anisocy-normal poiklo-occasional macrocy-1+ microcy-normal polychr-normal ovalocy-occasional tear dr 05:30pm blood plt smr-normal plt ct-212 05:30pm blood glucose-148* urean-60* creat-2.0* na-143 k-4.6 cl-109* hco3-23 angap-16 04:02am blood alt-47* ast-110* ld(ldh)-455* alkphos-77 totbili-0.4 05:30pm blood ctropnt-<0.01 04:02am blood albumin-2.4* calcium-7.7* phos-2.2* mg-1.8 08:15pm blood type-art peep-10 po2-227* pco2-33* ph-7.35 caltco2-19* base xs--6 -assist/con intubat-intubated 05:39pm blood lactate-2.7* 08:15pm blood o2 sat-99 . imaging: cxr : impression: nearly nondiagnostic study. there are extensive bilateral basilar opacities, which presumably in the acute setting may represent aspiration and/or pneumonia with edema less likely. endotracheal tube in satisfactory position. . head ct : impression: no acute intracranial process. mild maxillary and sphenoidal sinus disease. ct chest abdomen/pelvis : impression: 1. no pulmonary embolism, or acute aortic injury. 2. no abnormal fluid collections at the lung bases, or in the upper abdomen. 3. multifocal tree-in- opacities and ground-glass opacities and areas of consolidation concerning for multifocal pneumonia, likely in the setting of aspiration. mediastinal lymph nodes, likely reactive due to current infection. 4. air in the hilum of an atrophic left kidney. while this could be due to emphysematous pyelonephritis, air introduced iatrogenically either by foley or other instrumentation is possible. this was further evaluated on a ct abdomen performed . kub : impression: 1. no sign of obstruction. air-filled large bowel with minimal stool. 2. radio-opaque density projecting over the stomach is of uncertain etiology but metallic density newly appeared on . this could potentially represent an ingested foreign body. ruq u/s : impression: limited right upper quadrant examination with nondistended gallbladder and no son evidence of cholecystitis. no intra- or extra-hepatic biliary dilatation. . cxr -history: possible foreign body over stomach. in comparison with study of , the metallic opacification is again seen just medial to the region of the stomach. this is consistent with a gunshot fragment. obliquity of the patient makes it difficult to evaluate the heart and lungs. the endotracheal tube has been removed. . cxr-findings: as compared to the previous radiograph, there is no relevant change. decreasing right lower lobe opacity. unchanged left lower lobe opacity. unchanged position of the pacemakers. in the interval, the patient has been extubated. metallic particle projecting over the stomach. . date 6 lab # specimen tests ordered by all all blood culture catheter tip-iv immunology (cmv) influenza a/b by dfa mrsa screen sputum urine urine not processed all emergency inpatient blood culture blood culture, routine-pending inpatient blood culture blood culture, routine-pending inpatient urine urine culture-final inpatient urine urine culture-final inpatient blood culture blood culture, routine-final inpatient sputum gram stain-final; respiratory culture-final {staph aureus coag +, staph aureus coag +, yeast} inpatient blood culture blood culture, routine-final inpatient immunology (cmv) cmv viral load-final inpatient blood culture blood culture, routine-final inpatient sputum gram stain-final; respiratory culture-final {staph aureus coag +} inpatient urine urine culture-final inpatient catheter tip-iv wound culture-final inpatient catheter tip-iv wound culture-final inpatient sputum gram stain-final; respiratory culture-final {staph aureus coag +, yeast} inpatient blood culture blood culture, routine-final inpatient blood culture blood culture, routine-final inpatient urine urine culture-final inpatient blood culture blood culture, routine-final inpatient urine urine culture-final inpatient blood culture blood culture, routine-final inpatient blood culture blood culture, routine-final {staphylococcus, coagulase negative}; anaerobic bottle gram stain-final inpatient blood culture blood culture, routine-final inpatient urine urine culture-final inpatient sputum gram stain-final; respiratory culture-final {staph aureus coag +, klebsiella pneumoniae, klebsiella pneumoniae, klebsiella pneumoniae} inpatient blood culture blood culture, routine-final inpatient urine urine culture-final {enterococcus sp.} inpatient blood culture blood culture, routine-final inpatient sputum gram stain-final; respiratory culture-final {staph aureus coag +, klebsiella pneumoniae} inpatient urine legionella urinary antigen -final inpatient mrsa screen mrsa screen-final {positive for methicillin resistant staph aureus} inpatient influenza a/b by dfa direct influenza a antigen test-final; direct influenza b antigen test-final inpatient urine not processed inpatient blood culture blood culture, routine-final inpatient urine urine culture-final {enterococcus sp., beta streptococcus group b} emergency blood culture blood culture, routine-final brief hospital course: 67 y/o m from nursing home at center with h/o parkinson's disease, crf, bph, aspiration pneumonia, g-tube, esophagitis who presented with septic shock and respiratory failure and was found to have bilateral (likely aspiration) pneumonia and uti. # multifocal pneumonia with sepsis: esbl klebsiella and mrsa growing out of sputum. had 4 days of cefepime / vanco / cipro, changed on to meropenem / vanco per sensitivities with a planned 14 day course. respiked on . he had persistent staph growing from his sputum. his fever curve was then trending down after starting linezolid. linezolid is somewhat contraindicated with anti-parkinsons meds due to lack of breakdown of catecholamine metabolites, but benefit outweighs risk as he continued to grow staph in his sputum likely treatment failure on vancomycin. his platelet count continued to increase to 750 which was likely evidence of an acute phase reactant and sign of an infection. meropenem course completed while inpatient. linezolid was continued per request of his hcp although he was made . . # respiratory failure:goals of care- extubated . hypoxic respiratory failure prior to admission likely due to pneumonia and possible aspiration, complicated by underlying parkinson's. baclofen is being used for intractable hiccups. he is positive ~9 l and could tolerate further diuresis, but has likely had significant insensible losses due to his fevers. he initially remained stable after extubation. however, shortly after icu stay while on medical floor, pt began to experience episodes of acute hypoxia, tachypnea and occasional stridor. he then developed a 3-4l oxygen requirement. oxygen requirement remained stable at 3-4l but patient continued to experience episodes of acute tachypnea, excess secretions. given change in course, pt's hcp-his partner was fully updated. goals of care were discussed. as discussed while in the icu and confirmed on the floor, patient was made a dnr/dni-do not reintubate. given continued acute episodes of tachypnea/hypoxia and excess respiratory secretions, decision was made by hcp to allow current level of care (antibiotics, suctioning, oxygen, parkinson's meds) but to use prn morphine for acute episodes of apparent discomfort described above. hcp also decided that if condition were to worsen/episodes become sustained or more frequent than comfort care would be immediately initiated. hcp was given frequent updates regarding patient's condition and social work was involved. hcp decided that the patient would be discharged on hospice care. he was made on , and managed with morphine and other symptomatic care. he passed away on at 2:22 p.m. from presumed hypoxia. # foreign body: noticed on radiology from . no procedures on those dates. he has a hyperechoic density in his abdomen somewhere between his spleen and stomach. there is significant artifact on imaging, and it is difficult to tell what the foreign body is. on inspection of his mouth he has fillings. gi was consulted and would consider egd in weeks likely as an outpatient if x-ray still shows foreign body is present. radiology reviewed prior images that suggest that patient had more dental fillings in the past compared to present. pt did not display any signs of bowel obstruction. # uti: enterococcus >100,000. urine cultures from , , and showed no growth. there was air in the left kidney on ct , which was concerning for pneumopyelonephritis, but per final ct read this was likely iatrogenic and not pathological. he was treated with vancomycin until it was discontinued on day 9 of treatment and linezolid was started for a planned 14 day course as discussed above. # parkinson??????s: levodopa/carbidopa readjusted to home dose, continued comtan, and restarted rivastigmine (po instead of patch for concern of overdosing in the setting of fevers). continued buproprion and held mirtazapine. # bph: initially held terazosin and doxazosin in the context of hypotension on presentation and continued infection. these medications were restarted on the medical floor. # acute on chronic rf: pre-renal physiology with increased bun:cr ratio and fena = 0.19%, likely to dehydration in the setting of febrile illness in an incapacitated patient who is unable to increase his water intake in response to thirst. cr subsequently stabilized following hydration. . #thrombocytosis-likely reactive given acute inflammation/infection. stable. . #normocytic anemia-hct 26-28 this admit. no signs of active bleeding. likely acd and acute inflammation. . #communication: hcp , partner , w , sister , x relationship between partner and siblings. . #code-on , he was confirmed to be dnr/dni, no reintubation, no escalation. antibiotics ok, oxygen, home meds, and suctioning. morphine for acute episodes of respiratory distress. on , his hcp decided to make him predominantly comfort measures, with the exception of continuing his parkinson's disease medications and linezolid. he was started on a morphine drip for comfort. he passed away on from presumed hypoxia. . medications on admission: - milk of magnesia 400mg/5ml 30mg qd pg-tube prn constipation - biscolax 1 pr qd prn constipation - fleet enema qd prn constipation - senna 8.6mg g-tube qd prn constiopation - docusate sodium 100mg prn constipation - guiafenasine 100mg/5ml via g-tube prn cough - ibuprofen 400mg q6h prn pain - doxazosin 1mg 1 tab famotidine, omeprazole, carbidopa-levodopa, calcium, mitrazapimm, bupropion, terazocine, vitamin d, comtan, loratidine, exelon patch discharge medications: none discharge disposition: expired discharge diagnosis: death from hypoxemia septic shock due to mrsa and klebsiella pneumonia enterococcal urinary tract infection foreign body in the abdomen . parkinson's disease dementia bph discharge condition: expired discharge instructions: n/a followup instructions: n/a procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube arterial catheterization cardiopulmonary resuscitation, not otherwise specified injection or infusion of oxazolidinone class of antibiotics diagnoses: anemia, unspecified urinary tract infection, site not specified acute kidney failure, unspecified severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) methicillin susceptible staphylococcus aureus septicemia chronic kidney disease, unspecified acute respiratory failure pneumonitis due to inhalation of food or vomitus septic shock carrier or suspected carrier of methicillin resistant staphylococcus aureus do not resuscitate status dementia in conditions classified elsewhere without behavioral disturbance hyperosmolality and/or hypernatremia pneumonia due to klebsiella pneumoniae gastrostomy status dementia with lewy bodies nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] methicillin resistant pneumonia due to staphylococcus aureus essential thrombocythemia hiccough 

Answer: The patient is high likely exposed to