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: the patient is a pleasant 60 year old gentleman who has an extensive past medical history consisting of cerebrovascular accident, hypertension, depression, who was recently discharged from the on , after presenting here with rhabdomyolysis, status post fall at home. the patient was sent to the on discharge with his cks trending down and his renal function improving. on the morning of admission, the patient was found on the floor at the and was sent immediately to the emergency department where he was found to be in respiratory distress. from the notes, it could be gathered that the patient did present with some earlier shortness of breath and acute mental status change the day prior to admission but had improved with nebulizers on the day of admission. the patient's symptoms worsened and the patient was found questionably unresponsive on the floor and so was immediately brought into the emergency department. in the emergency department, his oxygen saturation was found to be 70% in room air and it only improved to 78 to 80% on four liters nasal cannula. the patient was immediately intubated and sepsis protocol was initiated given the white blood cell count was 23.4 and lactate was 9.1. in addition, a chest x-ray was also obtained that showed bilateral alveolar opacities, right side worse than the left, and so was given ceftriaxone and clindamycin for concern of aspiration pneumonia. the patient also was found to have elevated potassium and in acute renal failure and so received kayexalate, insulin, dextrose and was transfused with two liters of intravenous fluids and transferred to the intensive care unit. past medical history: 1. cerebrovascular accident - three times. 2. hypertension. 3. depression. 4. history of alcohol abuse with withdrawal seizures. 5. osteoarthritis. 6. hypercholesterolemia. 7. status post appendectomy. 8. status post tonsillectomy. allergies: questionable percodan. medications on admission: 1. phenytoin 350 mg p.o. q.a.m. 2. aspirin 325 mg p.o. once daily. 3. protonix 40 mg p.o. once daily. 4. celexa 20 mg p.o. once daily. 5. percocet one to two tablets p.o. q4-6hours p.r.n. 6. plavix 75 mg p.o. once daily. 7. ativan 0.5 to 1.0 mg p.o. q4-6hours p.r.n. 8. atenolol 25 mg p.o. once daily. social history: the patient used to live by himself but after most recent admission for rhabdomyolysis, the patient was sent to the and comes in today from the . he has a twenty pack year smoking history. he used to drink but has had nothing for the past three years. he denies any intravenous drug abuse. physical examination: vital signs revealed temperature 101.4, pulse 89, blood pressure 78/26, respiratory rate 18, intubated, ac 400 times 18, fio2 100%. in general, comfortable, intubated. head, eyes, ears, nose and throat examination - dry mucous membranes. lungs revealed decreased breath sounds with crackles at the right lower bases. the heart shows s1 and s2, regular rate and rhythm, distant heart sounds. abdomen reveals decreased bowel sounds, nondistended, nontender. neurologically, intubated. extremities no cyanosis, clubbing or edema, warm, good pulses. laboratory data: on admission, white blood cell count 23.4, hematocrit 26.5, platelet count 803,000, neutrophils 49, bands 19, lymphocytes 25, monocytes 5. sodium 143, potassium 4.5, chloride 113, bicarbonate 18, blood urea nitrogen 81, creatinine 3.2, glucose 251, calcium 9.5, magnesium 2.8, phosphorus 4.6. electrocardiogram showed rate in the 90s, normal sinus rhythm, normal axis, nonspecific st-t wave changes. urinalysis and urine culture were negative. hospital course: 1. hypoxic respiratory failure - the patient was intubated secondary to respiratory distress. the initial working diagnosis was community acquired pneumonia versus aspiration pneumonia versus adult respiratory distress syndrome and so the patient was started on levofloxacin and flagyl to cover for aspiration pneumonia. the patient's ventilation setting also adjusted for concern for adult respiratory distress syndrome. the patient initially was placed on assist control and seemed to have done well. the patient was switched over to pressure support of 10 and 5 and started bringing up a lot of secretions. the sputum was sent for culture and stain and was found to be positive for methicillin resistant staphylococcus aureus. hence, the patient was started on vancomycin to cover for methicillin resistant staphylococcus aureus pneumonia. an attempt was made for spontaneous breathing trial in which it was found that the patient began to work very hard and was over breathing the vent. the patient was kept on pressure support of 10 and 5 at the time of this dictation. at the time of this dictation, the patient had already received seven days of levofloxacin 500 mg once daily, seven days of flagyl 500 mg p.o. three times a day, and four days of vancomycin one gram twice a day. 2. sepsis - the patient was admitted on the sepsis protocol since he was tachycardic, hypertensive, febrile, elevated white blood cell count, elevated lactate. the patient was aggressively fluid resuscitated in the first 24 hours to keep a cvp of greater than 8.0. the patient was also started on stress dose steroids, hydrocortisone 100 mg intravenously three times a day which he continued for four days but then was stopped because of growing in his sputum. the patient's blood pressure remained stable and urine output was adequate and the patient did not require any pressors. at the time of this dictation, the patient was on three antibiotics consisting of vancomycin, levofloxacin, and flagyl. there is some concern that if the patient's pneumonia does not improve and the secretions continue, maybe a bronchoscopy should be considered to rule out any infection in the lung tissue. 3. renal - the patient presented to the hospital with acute renal failure and a creatinine of 3.2. this is most likely in the setting of hyperperfusion from him being in sepsis. the patient was aggressively fluid resuscitated and his creatinine improved from 3.2 to 0.8 at the time of this dictation. the patient's creatinine continued to be checked and his medications were adjusted based on the creatinine clearance. 4. cardiology - the patient does have a history of hyperlipidemia at home but was not on any medication. on presentation, the patient's antihypertensive medications were held but they were restarted when the patient's blood pressure was stable. in addition, the patient did rule in with cks in the 1000 and a troponin i peaking at 1.5. it was unclear whether this troponin leak was from demand ischemia versus non st elevation myocardial infarction versus his renal failure, however, an echocardiogram was obtained that showed an ejection fraction of greater than 55% with no wall motion abnormalities, but this was a poor quality echocardiogram and a repeat study was going to be performed. the patient's ck and troponin peak continued to trend down throughout the hospital course. 5. endocrine - the patient initially was critically ill and was started on an insulin drip, however, on day five or six, the patient's insulin drip was stopped and was switched over to regular sliding scale insulin. 6. gastrointestinal - the patient initially was npo and was getting aggressive intravenous fluids. the patient had an episode of coffee ground emesis and there was a drop in his hematocrit which was concerning and so the gastroenterology team was consulted who performed an esophagogastroduodenoscopy. esophagogastroduodenoscopy was unremarkable except for a small erythema found along the fundic region. the patient's hematocrit continued to remain stable. the patient was started on tube feeds. 7. hematology - the patient presented with a low hematocrit in the setting of septic shock and so the patient was transfused with a total of six units of packed red blood cells to help both with his hematocrit and also with volume resuscitation. the patient's hematocrit continued to remain stable since then. 8. neurology - the patient has a history of seizures and was on phenytoin. there was some concern whether the patient being found unresponsive on the floor was from a seizure or not and so a head ct was obtained that ruled out any bleed. a free dilantin level was checked which was found to be 2.0 which was therapeutic and so the patient was continued on 100 mg p.o. suspension twice a day. the patient also has a history of prior cerebrovascular accidents and plavix and aspirin were to be continued. 9. psychiatry - the patient has a history of depression and anxiety. the patient is getting ativan p.r.n. and is on celexa 20 mg p.o. once daily. 10. code - the patient is full code. please note that this discharge summary describes the hospital course events from , up to and including . for the remainder of the hospital course, please see subsequent discharge summary. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] arterial catheterization transfusion of other serum diagnoses: hyperpotassemia acute posthemorrhagic anemia acute kidney failure, unspecified unspecified septicemia other convulsions acute respiratory failure pneumonitis due to inhalation of food or vomitus methicillin susceptible pneumonia due to staphylococcus aureus hematemesis 

Answer: The patient is high likely exposed to