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: sepsis and hypoxia- direct admit (intubated) from ed major surgical or invasive procedure: orif left femur history of present illness: 77 yo m w/ cad, htn, afib on coumadin presented to ed today from rehab when he was found roncherous in acute distress with o2 sats low 66% 2l nc and tachy to 120s. he had cough but no cp. in the , pt was doing well and ruled out for cta when o2 sats fell to 70s and sbp was low in 30s. he was started on levophed, intubated and started on vanc/flagyl/zosyn for probable aspiration pna. cxr revealed mild failure. he was subsequently transferred to the , intubated, for further workup. . of note, he was discharged after an admission for left femur fracture/ 5th metatarsal fracture complicated by hypoxic respiratory failure and a micu stay and intubation during that admission. he was found to have an aspiration pna and discharged to rehab on levoquin to complete a 10 day course past medical history: 1. hypertension. 2. peptic ulcer disease. 3. gastroesophageal reflux disease. 4. atrial fibrillation. 5. coronary artery disease status post mi in with severely decreased left ventricular ejection fraction - 20% in 3/00,. 6. hypercholesterolemia. 7. history of liver abscess. 8. status post meckel diverticulum in . 9. status post nissen fundoplication in . 10. status post left inguinal hernia repair in . 11. status post small bowel hernia/resection in of . 12. type 2 dm. 13. dementia. 14. right inguinal hernia social history: he lives in . he never smoked. he drinks on m, w, fs a few beers/wine. his last drink was friday. he walks up and down 1 flight of stairs from his apartment to the dining room every day without shortness of breath. he rarely walks outside. family history: non-contributory physical exam: pe: 100.6 121/69 101 18 93% o2 sats on ac 100% tv 600, peep 5, rr 14 gen: elderly man intubated resting in bed, responsive to stimuli, but sedate genl: nad heent: eomi, perrla, sclera anicteric, sl dry mm, no op lesions neck: jvp - 7cm, supple pulm: loud ronchi ant/lat cv: rrr, nl s1, s2, no murmurs, rubs, or gallops. abd: soft, nontender, and nondistended, positive bowel sounds. well healed midline scar, large right inguinal hernia ext: l femoral scar, no c/c/e pertinent results: 06:38am pt-26.4* ptt-38.5* inr(pt)-2.7* 06:38am wbc-13.0* rbc-3.45* hgb-11.0* hct-31.9* mcv-93 mch-31.8 mchc-34.4 rdw-14.6 06:38am calcium-7.9* phosphate-3.0 magnesium-2.2 06:38am plt count-325 06:38am glucose-106* urea n-26* creat-1.1 sodium-142 potassium-4.5 chloride-107 total co2-26 anion gap-14 09:17am pt-42.5* ptt-41.7* inr(pt)-4.8* 09:17am plt smr-normal plt count-331 09:17am hypochrom-normal anisocyt-1+ poikilocy-normal macrocyt-normal microcyt-normal polychrom-2+ 09:17am neuts-86* bands-5 lymphs-5* monos-2 eos-0 basos-0 atyps-0 metas-1* myelos-1* 09:17am wbc-18.1* rbc-3.07* hgb-10.2* hct-28.7* mcv-93 mch-33.2* mchc-35.6* rdw-14.7 09:17am ck-mb-9 ctropnt-0.05* 09:17am lipase-90* 09:17am alt(sgpt)-41* ast(sgot)-99* ck(cpk)-328* alk phos-65 amylase-53 tot bili-1.4 09:17am estgfr-using this 09:17am glucose-217* urea n-33* creat-1.3* sodium-143 potassium-4.3 chloride-104 total co2-24 anion gap-19 09:33am lactate-2.7* 10:25am urine amorph-few 10:25am urine hyaline-0-2 . cxr impression: bibasilar patchy opacities may represent atelectasis or aspiration. peripheral right lung opacity appears slightly improved, and may represent slowly resolving infectious pneumonia or, in the appropriate setting, chronic eosinophilic pneumonia. . ct abd and cta chest impression: 1. new bilateral basilar airspace opacities and associated pleural effusions. findings may represent multifocal pneumonia or aspiration. 2. slight improvement in peripheral right upper lobe airspace opacity. as mentioned on plain radiograph examination, this could represent chronic eosinophilic pneumonia or resolving acute pneumonia. 3. small amount of air seen in the peripheral left lobe of the liver of uncertain significance. there is no evidence of ischemic bowel. there is no history of biliary intervention. close follow up examination is recommended. 4. large right inguinal hernia containing nonobstructed ascending colon. 5. moderate-to-large hiatal hernia. the ng tube terminates proximal to the ge junction and should be advanced. 6. extensive soft tissue stranding as described above. these findings correlate to ecchymoses seen in the left subcutaneous tissues on clinical exam. 10:25am urine rbc-* wbc-0-2 bacteria-few yeast-none epi-0 10:25am urine blood-lg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 10:25am urine color-yellow appear-clear sp -1.015 01:36pm lactate-2.2* 01:36pm temp-37.7 po2-64* pco2-47* ph-7.35 total co2-27 base xs-0 comments-line 01:37pm hct-30.9* 04:25pm pt-44.2* ptt-47.0* inr(pt)-5.1* 04:25pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-1+ 04:25pm neuts-88.9* bands-0 lymphs-4.0* monos-4.0 eos-1.0 basos-0 metas-2.0* 04:25pm wbc-29.1*# rbc-3.48* hgb-11.1* hct-32.7* mcv-94 mch-31.7 mchc-33.8 rdw-15.2 04:25pm albumin-2.6* calcium-7.8* phosphate-3.7 magnesium-2.2 04:25pm ck-mb-7 ctropnt-0.06* 04:25pm alt(sgpt)-46* ast(sgot)-99* ld(ldh)-465* ck(cpk)-353* alk phos-76 amylase-58 tot bili-1.7* 04:25pm glucose-152* urea n-33* creat-1.2 sodium-142 potassium-4.2 total co2-26 04:34pm lactate-2.7* 04:34pm type-art po2-58* pco2-46* ph-7.39 total co2-29 base xs-1 brief hospital course: assessment: the patient is a 77 yo m w/ cad, htn, afib on coumadin who presented today in respiratory distress and was intubated and found to have new bilateral basilar airspace opacities and associated pleural effusions in setting of hypotension. plan: . # sepsis: pts sbp was in the 30s in the ed. he was intubated with decreased o2 sats and sent to the . he was discharged yesterday to complete a 10 day course of levaquin and flagyl for possible aspiration pneumonia. started on vanco/zosyn for possible nosocomial pna for a total of 2 weeks, has 8 more days at discharge. he was also evaluated by speech/swallow and felt to have aspiration. he was recommended to continue strict aspiration precautions, including chin tuck, crushing all large pills, swallowing twice, and taking a sip from a straw follow all swallows. to continue speech therapy after d/c. . #cad: hx of demand ischemia. continue atorvastatin and asa but holding antihypertensives initially. restarted when bp improved. on a lower dose of metoprolol, which may need to be titrated up at nh. he was noted to be fluid overloaded as well, and his lasix dose was increased to 40 mg daily for continued diuresis. . #afib: he was restarted on coumadin after recent surgery. at discharge yesterday his inr was 2.7 and his discharge coumadin dose was 2.0. on admit inr was 5.1 so coumadin was held, but was then restarted after inr fell. will need to have inr rechecked for goal inr . . #left femur fracture/ 5th metatarsal fracture: s/p orif. he is scheduled to follow up with dr. on . continue pt at . . #dm ii: riss while in the hospital. holding home glucophage. restarted at d/c. . #dementia: aricept to be held while pt is intubated and restarted after extubation. . #gerd: switched to lansoprazole to be easier to swallow. . # code: full . medications on admission: meds: 1. donepezil 5 mg tablet : two (2) tablet po hs (at bedtime). 2. pantoprazole 40 mg tablet, delayed release (e.c.) : one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. atorvastatin 10 mg tablet : one (1) tablet po once a day. 4. glucophage 500 mg tablet : one (1) tablet po twice a day. 5. lisinopril 5 mg tablet : 0.5 tablet po daily (daily). 6. furosemide 20 mg tablet : one (1) tablet po daily (daily). 7. levofloxacin 500 mg tablet : one (1) tablet po q24h (every 24 hours) for 3 days: last day . 8. metronidazole 500 mg tablet : one (1) tablet po tid (3 times a day) for 4 days: last dose on . 9. coumadin 2 mg tablet : one (1) tablet po at bedtime. 10. aspirin 325 mg tablet : one (1) tablet po daily (daily). 11. metoprolol tartrate 25 mg tablet : one (1) tablet po tid (3 times a day). discharge medications: 1. insulin regular human 100 unit/ml solution : sliding scale sliding scale injection asdir (as directed). 2. metformin 500 mg tablet : one (1) tablet po twice a day: may need to be crushed to help swallow. 3. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 4. metoprolol tartrate 25 mg tablet : 0.5 tablet po bid (2 times a day). 5. albuterol sulfate 0.083 % solution : one (1) neb inhalation q6h (every 6 hours). 6. acetylcysteine 10 % (100 mg/ml) solution : one (1) neb miscell. q6h (every 6 hours) as needed for shortness of breath or wheezing. 7. aspirin 325 mg tablet : one (1) tablet po daily (daily). 8. lisinopril 5 mg tablet : 0.5 tablet po daily (daily). 9. atorvastatin 10 mg tablet : one (1) tablet po daily (daily). 10. donepezil 5 mg tablet : two (2) tablet po hs (at bedtime). 11. furosemide 20 mg tablet : two (2) tablet po daily (daily). 12. warfarin 5 mg tablet : one (1) tablet po hs (at bedtime): have inr checked to adjust coumadin dose. 13. piperacillin-tazobactam 4.5 g recon soln : 4.5 g intravenous q8h (every 8 hours) for 8 days. disp:*qs 8 days* refills:*0* 14. vancomycin in dextrose 1 g/200 ml piggyback : one (1) g intravenous q 12h (every 12 hours) for 8 days. disp:*qs 8 days* refills:*0* 15. heparin lock flush (porcine) 100 unit/ml syringe : two (2) ml intravenous daily (daily) as needed. disp:*qs 2 weeks* refills:*0* discharge disposition: extended care facility: - discharge diagnosis: sepsis from aspiration pneumonia systolic congestive heart failure left femur fracture s/p orif diabetes type 2 atrial fibrillation coronary artery disease discharge condition: stable on 3l o2 discharge instructions: please continue your medications as listed. please follow up with dr. and your pcp. call your doctor if you experience increased pain, shortness of breath or other concerning symptoms. please continue strict aspiration precautions. followup instructions: 1. provider: xray (scc 2) phone: date/time: 7:40 2. provider: , md phone: date/time: 8:00 3. please have your coumadin level (inr) checked on to adjust your coumadin dose. 4. please follow up with your pcp weeks. call dr. at for an appointment. 5. please have your picc line removed when you have finished your course of vanco/zosyn procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: subendocardial infarction, initial episode of care esophageal reflux pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis atrial fibrillation other persistent mental disorders due to conditions classified elsewhere acute respiratory failure pneumonitis due to inhalation of food or vomitus old myocardial infarction long-term (current) use of anticoagulants acute on chronic systolic heart failure aftercare for healing traumatic fracture of other bone aftercare for healing traumatic fracture of hip 

Answer: The patient is high likely exposed to