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: mr. is an 83-year-old male with a history of congestive heart failure, hypertension, atrial fibrillation, meningioma, gastroesophageal reflux disease, and pacemaker placement who presented with severe hypoxia and hypotension requiring emergent intubation. several days prior to admission, the patient had been placed on levofloxacin at his nursing home for pneumonia. on the day of admission, he was noted by his nursing home staff to have a peripheral oxygen saturation of 77%, dyspnea, and increased pedal edema. on arrival to the emergency room, his blood pressure was 64/33. he was given a 500-cc normal saline bolus with some improvement in his blood pressure. a portable chest x-ray was read as consistent with acute pulmonary edema. the patient had worsening hypoxia by peripheral saturations, and the emergency department team was unable to obtain an arterial blood gas. the patient was placed on noninvasive positive pressure ventilation. his blood pressure dropped at that time to 56/palpation, and the patient was placed on a dopamine intravenous drip at 5 mcg/kg per minute. the patient's blood pressure improved to 150/63, and the patient was given lasix 20 mg intravenously. however, at 2:30 p.m. on the day of admission, the patient's po2 was noted to be 46, and the patient was endotracheally intubated for hypoxia. initial laboratory work was notable for a decreased hematocrit and an elevated international normalized ratio. nasogastric lavage was performed and was negative. a right internal jugular cordis was placed in the emergency room. after failed attempts at a right radial and right axillary arterial line, a left femoral arterial line was eventually placed in the emergency room. during the course of these procedures, the patient's blood pressure dropped to 50 systolic, and he responded to an increase in dopamine to 10 mcg/kg per minute. past medical history: 1. congestive heart failure, with repeated admissions for exacerbations. 2. hypertension. 3. atrial fibrillation. 4. meningioma. 5. lumbago. 6. gastroesophageal reflux disease. 7. status post placement overdose dual-chamber pacemaker for tachy-brady syndrome. 8. benign prostatic hypertrophy, status post transurethral resection of prostate. 9. psoriasis. 10. sjogren syndrome. medications on admission: 1. colace 100 mg p.o. b.i.d. 2. albuterol meter-dosed inhaler 2 puffs q.i.d. 3. multivitamin 1 tablet p.o. q.d. 4. nitroglycerin patch 0.4 mg topically q.d. 5. lisinopril 10 mg p.o. b.i.d. 6. citalopram 20 mg p.o. q.d. 7. aspirin 325 mg p.o. q.d. 8. dilantin 300 mg p.o. q.a.m. and 200 mg p.o. q.p.m. 9. lasix 80 mg p.o. q.d. 10. ................ 2.5 mg p.o. q.d. 11. potassium 20 meq p.o. q.d. 12. coumadin 5 mg p.o. q.d. 13. levofloxacin 500 mg p.o. q.d. (of unknown duration). allergies: the patient had no known drug allergies. social history: the patient is a resident at home since . per his wife , he is a full code. his primary care physician is . . physical examination on presentation: at the time of presentation the patient was afebrile, with a blood pressure of 125/60 (on dopamine 10 mcg/kg per minute), and a heart rate of 70. he had an oxygen saturation of 95%, and a central venous pressure of 15 with u waves. his skin was warm and well perfused with good capillary refill. head and neck revealed the patient was intubated. pupils were equal, round, and reactive to light. the lungs were clear to auscultation anteriorly. the heart had a regular rate and rhythm, with a holosystolic murmur at the base without radiation. the abdomen was slightly firm but nontender with an anterior ventral hernia and positive bowel sounds, and he had 3+ symmetrical lower extremity edema. pertinent laboratory data on presentation: at the time of admission the patient had a white blood cell count of 14.3, a hematocrit of 29.4, and platelets of 235. he had a sodium of 141, potassium of 5.4, chloride of 100, bicarbonate of 24, blood urea nitrogen of 109, creatinine of 3.4, and blood glucose of 111. his inr was 5.4, and ptt of 41. his initial arterial blood gas prior to intubation was 7.35/50/46 with a lactate of 1. his urinalysis showed moderate blood and 50 red blood cells, but only 3 to 5 white blood cells, and no casts. radiology/imaging: his chest x-ray showed mild cardiomegaly, a right lower lobe consolidation with effusion, and mild congestive heart failure. electrocardiogram was av paced, poor anterior r wave progression, question anterior infarct of undefined age. hospital course by system: 1. cardiovascular: the patient's hypotension was initially thought secondary to sepsis, and he was started on broad spectrum antibiotics including vancomycin, ceftriaxone, and flagyl; and blood cultures were drawn. based on the initial suspicion that his septic etiology may be related to abdominal pathology, a surgery consultation was obtained. the surgery consultation recommended an i- ct scan of the abdomen and serial examinations. the i- cat scan revealed free fluid in the right pericolic gutter and a possible gallstone, but no other notable pathology. the patient had a persistent pressor requirement of dopamine 10 mcg/kg per minute throughout the first hospital day. a trial of low-dose dobutamine was attempted on the second hospital day, but the patient's pressure dropped precipitously and it was discontinued. a transthoracic echocardiogram was obtained which showed a left atrium normal in size, right atrium moderately dilated, and mild regional left ventricular systolic dysfunction with hypokinesis of the anterior septum and apex. more notable, there was severe 4+ mitral regurgitation and severe 4+ tricuspid regurgitation. there was mild pulmonary artery systolic hypertension. compared with a prior study of , left and right ventricular function was worse, and tricuspid and mitral regurgitation was worse. this study was also reviewed by dr. who was covering the medical intensive care unit green service on . dr. believed that the patient's left ventricular ejection fraction was closer to 20% than the initial read of 40%. in addition, dr. was convinced that at least half of the patient's stroke volume was flowing backwards as a result of his severe mitral regurgitation. thus, dr. felt that the patient's likelihood of meaningful recovery was minimal, and he conducted a family meeting in which the patient was made do not resuscitate. the patient was continued on broad spectrum antibiotics, despite no evidence of infection on blood, urine, or sputum cultures and on dopamine at 10 mcg/kg per minute. digoxin was started on ; per discussion with the patient's cardiologist (dr. ). several attempts were made to wean the patient's dopamine over the next several days, but all were accompanied by severe drops in the patient's systolic blood pressures to the 40s to 60s. another trial of dobutamine was attempted on which again failed secondary to hypotension. given the patient's severe cardiac dysfunction and valvular disease on echocardiogram, and the team's inability to titrate his pressors after several days of broad spectrum intravenous antibiotics and optimized blood pressures on dopamine, family meetings were undertaken to discuss the patient's poor long-term prognosis. family meetings were held on , , and . the family's concern for the patient's comfort were addressed with increases in sedation; and eventually, on , the decision was made to make no further increases in the patient's dopamine dose. on , the patient's son (his health care proxy, ) came to the decision to withdraw pressor support at 9:15 a.m. pressors were discontinued at approximately 10 a.m. on , and the patient's pressure immediately dropped to the middle 50s. the patient's pressure hovered in this area for several hours until he died at approximately 7 p.m. on . 2. respiratory failure: the patient was intubated in the emergency room, as stated before, and remained intubated throughout his hospital admission. on hospital day two, a thoracentesis was performed to rule out empyema or malignant effusion. the results of the pleural fluid were consistent with a transudate. there was never was any sputum of blood culture evidence of acute pneumonia, and the patient ventilated well throughout his admission. however, several attempts at ventilator weaning from to all failed. as stated above, the patient's pressor support was eventually withdrawn on , and the patient died several hours later. 3. renal: the patient had a significantly increased blood urea nitrogen and creatinine on arrival to the emergency room, which was likely the result of his minimal renal perfusion secondary to severe congestive heart failure and mitral regurgitation. the patient's renal function did improve transiently while on pressors, but over the last two days of his admission it began to rise again. 4. history of seizures: the patient was continued on dilantin throughout his admission with a therapeutic level. 5. increased inr: the patient's inr was increased at the time of admission, likely due to overdosing of coumadin. he was reversed with several doses of subcutaneous vitamin k to good affect. he was not anticoagulated again throughout the course of his admission. 6. psychosocial: as stated above, the patient's family met with the medical intensive care unit team and the medical intensive care unit attending (dr. ) several times throughout this patient's difficult and emotional trying course. they emphasized their interest in the patient's comfort; and to this end, the patient was placed on a fentanyl and ativan drip throughout most of his admission. discharge/death diagnoses: 1. severe congestive heart failure with 4+ mitral regurgitation. 2. respiratory failure. 3. acute renal failure. 4. seizure disorder. 5. increased international normalized ratio. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube thoracentesis diagnoses: esophageal reflux mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation cardiogenic shock cardiac pacemaker in situ diseases of tricuspid valve 

Answer: The patient is high likely exposed to