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: dyspnea major surgical or invasive procedure: intubation and mechanical venillation central venous line placement picc line placement arterial catheter placement history of present illness: 85 y/o m with hx of dm, chf, dementia and sacral ulcers was transferred from his nursing home to the hospital by request of his daughter for decreased consciousness and decreased bp. . initial vitals at osh were 100.4, p 65, r 44, 94% on nrb, 88/55. he was intubated in the ed and went into afib with rvr and dropped his bp, so dilt gtt was started as well as peripheral dopamine. he was noted to have a k of 7.3, was treated with cacl, ns ivfs, and kayexcelate. he was presumed to be septic secondary to his low grade fever, hx of sepsis and high lactate. he was given a total of 4l ns and cefepime 1gm and levofloxacin 750 mg. a femoral cvl was placed. family requested transfer to . . he was transported via ambulance on propofol 20 mg iv prn, dopmaine 40 mg/kg/min, and cardizem 10 mg/hr. he was intubated and sedated, thus there was no more history available. past medical history: copd chf htn afib with rvr dm dementia depression stage 3-4 sacral decub . was hospitalized for proteus urosepsis with course complicated by c.diff colitis social history: living at nursing home for last two years with hx of dementia, wife and daughter involved. family history: noncontributory physical exam: on arrival to floor vitals 97 hr 88 bp 122/66 rr 29 sats 98 ra fsbs 204 gen: awake and alert, non-verbal. non-toxic. nad. heent: normocephalic, anicteric, op benign, mmm neck: no masses or lymphadenopathy cv: heart sounds faint, irregular. pulm: diffuse rhonci b/l. good aeration. abd: soft, nt, nd, bs+ extrem: warm and well perfused, 1+ pitting edema hands b/l and ankles b/l. neuro: moving all 4 extremities. on discharge: general: awake, responsive to simple questions, nad heent: op clear, perrl neck: supple cv: irregular, no murmur pulm: decreased breath sounds in left lower lung, otherwise good aeration abd: soft, nt/nd, +bs ext: warm, 1+ b/l le edema neuro: follows simple commands pertinent results: on admission: 04:26am blood wbc-27.5* rbc-3.60* hgb-10.3* hct-33.5* mcv-93 mch-28.8 mchc-30.8* rdw-15.7* plt ct-359 03:09am blood pt-14.6* ptt-34.8 inr(pt)-1.3* 04:26am blood glucose-268* urean-89* creat-3.2* na-152* k-6.2* cl-120* hco3-20* angap-18 04:26am blood alt-143* ast-68* ld(ldh)-299* ck(cpk)-579* alkphos-320* totbili-0.4 04:26am blood ck-mb-32* mb indx-5.5 ctropnt-0.30* interval labs: 04:45am blood ck-mb-notdone ctropnt-0.16* 05:12am blood lactate-1.8 03:36am blood wbc-12.5* rbc-2.99* hgb-8.4* hct-26.4* mcv-88 mch-28.1 mchc-31.9 rdw-16.2* plt ct-304 06:15am blood wbc-17.1* rbc-3.39* hgb-9.5* hct-30.1* mcv-89 mch-27.9 mchc-31.5 rdw-17.5* plt ct-546* 04:51am blood alt-43* ast-23 ld(ldh)-198 alkphos-255* totbili-0.4 04:51am blood albumin-1.7* calcium-8.9 phos-2.7 mg-1.7 03:36am blood glucose-195* urean-34* creat-1.3* na-150* k-3.0* cl-123* hco3-19* angap-11 on discharge: 05:22am blood wbc-13.4* rbc-3.09* hgb-8.7* hct-26.9* mcv-87 mch-28.4 mchc-32.6 rdw-17.6* plt ct-363 05:22am blood pt-20.8* ptt-29.7 inr(pt)-1.9* 05:22am blood glucose-122* urean-19 creat-1.0 na-141 k-3.5 cl-107 hco3-29 angap-9 05:22am blood calcium-8.1* phos-2.8 mg-2.2 tte: the left atrium is mildly dilated. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. impression: poor technical quality due to patient being on a ventilator. left ventricular function is probably normal, a focal wall motion abnormality cannot be fully excluded. the right ventricle is not well seen. no pathologic valvular abnormality seen. cxr: 1. bibasilar air space opacities, could represent pneumonia. 2. additional opacity in the left infrahilar region, could represent additional focus of infection. attention is recommended to this region on follow up studies to assess for resolution. 3. endotracheal tube is in satisfactory position. ct torso: . left basal effusion and scattered ground-glass opacities in both lungs with more confluent focal opacities in the lower lobes are highly suggestive of areas of infection and pneumonic consolidation. please ensure follow-up to clearance. 2. bilateral renal lesions, some of which are likely simple cysts but others are more dense and a mass cannot be excluded. a dedicated renal ultrasound would help clarify further. 3. distended gallbladder, without evidence of wall thickening or pericholecystic fluid or inflammatory change. 8:17 am rapid respiratory viral screen & culture source: nasopharyngeal swab. **final report ** respiratory viral culture (final ): no respiratory viruses isolated. culture screened for adenovirus, influenza a & b, parainfluenza type 1,2 & 3, and respiratory syncytial virus.. detection of viruses other than those listed above will only be performed on specific request. please call virology at within 1 week if additional testing is needed. respiratory viral antigen screen (final ): negative for respiratory viral antigen. specimen screened for: adeno, parainfluenza 1, 2, 3, influenza a, b, and rsv by immunofluorescence. refer to respiratory viral culture for further information brief hospital course: 85 y/o m with hx of chf, dm, sacral decubs, afib and dementia who presented with pneumonia and septic shock including altered mental status and hypotension, complicated by afib with rvr during presentation. #. respiratory failure and pneumonia: initially intubated and admitted to the micu where he was started on broad spectrum antibiotics and vasopressors. weaned from the vent and extubated without incident. was ruled out for flu. blood pressure normalized and was weened of pressors. antibiotics continued for hap and complicated by aspiration. received 14d course vancomycin and cefepime and 6 days of flagyl. respiratory status was complicated by a component of volume overload and received several doses of iv lasix with good results, which was continued for a daily dose of 40mg po lasix. this medication is new and may need to be decreased or stopped in the future when back to dry weight. also with underlying copd, which likely further reduced respiratory function. since arrival to the floor respiratory status has been stable on nc, intermittantly with some decreased saturations that improved with deep suctioning. tube feeds were also adjusted for a lower volume so that aspiration risk is minimized and hyoscyamine was started to decrease secreations. patient is unable to tolerate anything by mouth. # afib with rvr: in micu with heart rates in the 190s with drop in bps. started on a diltiazem drip and eventually hemodynamics normalized. likely exacerbated with dopamine used as initial pressor. transitioned to levophed with improvement. after weening of vasopressors, restarted on home metoprolol amd amiodarone doses with good effect. on day of discharge, metoprolol was decreased from qid to tid for hr in the 60s. on coumadin for anticoagulation with inr 1.9-2.1. dose adjusted to 6mg daily, but will need continued monitoring and adjustment. . #. chf: history of chf, echo in micu with mild pa htn and ef >55%. also episode of demand nstemi with elevated trops but an unchanged ekg, likely related to demand in setting of septic shock. started on lasix as above with good effect. continued on aspirin and statin. . # hypernatremia: likely from poor po intake and free water deficit. given iv d5w and adjusted free water flushes in tube feeds. at time of discharge, sodium normalized, but should be monitored with free water adjusted accordingly. . # arf: on admission had a rising creatinine to a peak of 3.2. etiology likely prerenal given it improved quickly with ivf and resolution of septic shock. now creatinine normalized and with good urine output. unknown baseline for patient, peaked at 3.2 but improved rapidly to 1.3 after ivf and resolution of shock . # dementia - mostly non-verbal at baseline. on presentation more altered likely due to underlying infeciton. on discharge at baseline according to family. . # dm - well controlled on basic sliding scale and home latus 18qhs. . # anemia: hct stable throughout hospitalization without evidence of gross bleeding or hemorhage. likely combination of anemia of chronic disease and dilutional effect with copious fluids given throughout hospitalization. . #. goals of care: there were several family meetings thoughout the hospitalization with the patient's daughter and wife (who is healthcare proxy). the decision was made to make patient dnr/dni although antibiotics were continued for a full course. there seems to be a difference in opinion of what treatments to pursue among family members. wife who is at home and is the actual proxy also agrees with dni and just wants him to be comfortable, with minimal invasive procedures and avoiding painful procedures. the daughter is more willing to have some aggressive measures taken, including potential for rehospitalization. at time of discharge, family was in agreement that patient would receive hospice services at the nursing facility. medications on admission: jevity 1.5 at 83ml/hr for 20hrs; 380 cc h2o q8hr coumadin 5 mg daily morphine liquid prn paxil 30 mg daily lantus 18 u qhs novalog sliding scale scopolamine patch 1.5mg q72hrs asa 81 mg daily captopril 50 mg q8hr meotprolol 25 mg q6hr sq heparin tid amiodarone 400 mg daily discharge medications: 1. warfarin 2 mg tablet sig: three (3) tablet po once daily at 4 pm. 2. morphine concentrate 20 mg/ml solution sig: fifteen (15) mg po q2hours as needed for severe dyspnea. 3. morphine concentrate 20 mg/ml solution sig: five (5) mg po q2hours as needed for mild dyspnea. 4. paroxetine hcl 30 mg tablet sig: one (1) tablet po daily (daily). 5. insulin glargine 100 unit/ml cartridge sig: eighteen (18) units subcutaneous at bedtime. 6. insulin lispro 100 unit/ml cartridge sig: per sliding scale subcutaneous four times a day: glucose range: <70: give 12.5gm d50, 70-150: no intervention, 151-200: 2 units, 201-250: 4 units, 251-300: 6 units, 301-350: 8 units, 351-400: 10 units, >400: contact md. 7. hyoscyamine sulfate 0.125 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual qid (4 times a day). 8. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day): hold for sbp<100, hr<60. 10. amiodarone 200 mg tablet sig: two (2) tablet po daily (daily). 11. furosemide 40 mg tablet sig: one (1) tablet po once a day. 12. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q4h (every 4 hours) as needed for wheezing. 13. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for wheezing. discharge disposition: extended care facility: pheasant discharge diagnosis: primary: healthcare associated pneumonia resulting in respiratory failure and septic shock acute renal failure secondary: dementia atrial fibrillation diabetes mellitus chronic diastolic heart failure discharge condition: mental status:minimally verbal level of consciousness:lethargic but arousable activity status:bedbound discharge instructions: you were admitted to for pneumonia and kidney injury. your kidneys improved with fluids. we treated you with antibiotics and gradually your infection improved. we later gave you furosemide, a diuretic, to help remove extra fluid that had built up in your body. you are being discharged to a nursing facility where the primary focus of your care will be comfort. we have made the following medication changes: - decreased your metroprolol from 4x per day to 3x per day. - stopped your captopril. - stopped your heparin injection. - changed scopolamine patch to hyoscyamine for secretions. - started nebulizers as needed for wheezing. - increased your warfarin dose from 5mg daily to 6mg daily. - started furosemide 40mg daily. followup instructions: please follow up with the physicians at your skilled nursing facility. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances arterial catheterization excisional debridement of wound, infection, or burn diagnoses: pneumonia, organism unspecified hyperpotassemia subendocardial infarction, initial episode of care anemia, unspecified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia severe sepsis chronic airway obstruction, not elsewhere classified atrial fibrillation acute on chronic diastolic heart failure other persistent mental disorders due to conditions classified elsewhere acute respiratory failure septic shock pressure ulcer, lower back hyperosmolality and/or hypernatremia gastrostomy status pressure ulcer, stage iii 

Answer: The patient is high likely exposed to