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: respiratory distress. major surgical or invasive procedure: intubation history of present illness: 63 -old male with history of schizoaffective disorder and no known medical history who was admitted to psychiatory with psychotic episode, question of mania. he was transferred to micu with hypercarbic/hypoxic respiratory failure. . per psychiatry records the patient was brought to by the police for "false psychiatric issues." he was angry at nwh and requested transfer to . on presentation, he reportedly expressed manic behaviors, had not slept for 4 days, and denied suicidal and homicidal ideation. his vitals on initial presentation were (t 98.4 hr 80 bp 146/70 rr 16 98%ra). he was noted to have an elevated wbc 15.5, and his ua and tox screen were negative. he received 1mg klonopin in the ed. he was then admitted to inpatient psychiatry where he received 10mg zyprexa and 1mg klonopin for sleeplessness and agitation. per report, he denied chest pain and shortness of breath at the time. he then became somnolent, desaturated to 87%ra, and was transferred to the medical service. . initial vitals on tranfer to 3 were t92.4ax hr 85 bp 151/74 rr 16 93%4lnc. he desaturated to 78% and was placed on nonrebreather; abg 7.10/98/192. he continued to be somnolent, arousable to voice and pain but not responding to questions or commands. the pt was given lasix 40 mg iv. he was placed temporarily on bipap, and then intubated when he remained unarousable, pulling low tidal volumes. the pts initial cxr was more c/w pulmonary edema, but subsequent chest films are more c/w bilateral aspiration pneumonia (most notably on ap cxr from ). the pt was started on azithromycin, ceftriaxone and flagyl on for this presumed asp pneumonia in the setting of a wbc up to 16.3 on . the pt was extubated on and has been satting well on both face tent at times and 3 l nc. pt was started on hydrazalzine after sbp has been up to 180-200 s/p extubation. per nurses, pt has autodiuresed over 3 liters since his micu transfer. . history was difficult to obtain from the pt due to his sleepy state. the pt indicates he is not in any pain and is not having any sob or cough at this time. past medical history: - schizoaffective disoder with psychotic features - questionable h/o etoh abuse per report social history: he had been living with his mother passed away a few months ago. he continues to live alone in his mother's house. he has a brother from whom he is estranged. per old records, the patient had a history of alcohol abuse. family history: unknown. physical exam: pe: t 92.4ax hr 67 bp 163/84 rr 18 90%4lnc gen: obese man, somnolent, snoring loudly, arousable with agitation to loud voice/ sternal rub heent: perrl, anicteric, mmm neck: supple, jvp unable to assess cv: rrr, ii/vi sem resp: coarse with intubation, no crackles, no rhonchi abd: obese, +bs, soft, nt, nd ext: 2+ pitting edema b, + dp pulses, warm neuro: arousable but does not follow commands, maew pertinent results: initial labs in the ed: 15.5>38.5<390 n:75.7 l:17.6 m:4.8 e:1.6 bas:0.3 . |107|25 /79 4.0|26 |1.1\ . serum asa, etoh, acetamnphn, benzo, barb, tricyc: negative urine benzos, barbs, opiates, cocaine, amphet, mthdne: negative . ua dipstick negative . labs after episode of somnolence: abg: 7.10/98/192 . 9.1>39.4<252 . |105|23 /131 4.5|32 |1.2\ . ca:8.7 mg:2.0 p:5.7 . pt:12.0 ptt:20.9 inr:0.9 . alt:219 ast:90 ap:92 ldh:440 tbili:0.4 alb:4.1 . ck:1048 mb:23 mbi:2.2 tropt:0.01 . bnp:665 . cxr: pulmonary congestion consistent with chf. ecg: rate 90bpm, normal axis, rbbb, q-waves in i, ii, avl, v3-v6. brief hospital course: 63 year-old male with history of schizoaffective disorder who was admitted to the psychiatry service and was transferred to the micu for hypercarbic and hypoxic respiratory failure. pt then transferred to medicine service for further management. . 1) respiratory failure: while on the psychiatry service, he was acutely agitated and then experienced acute shortness of breath. at the time, his blood pressure was elevated. he likely experienced flash pulmonary edema. his poor ventilation and oxygenation was likely contributed to by some degree of presumed osa given his body habitus. it is unclear whether or not the medications (olanzapine and clonazepam) that he was given contributed to his somnolence. he was intubated given his poor oxygenation and ventilation and was given a dose of furosemide. on hospital day 2, he had evidence of questionable aspiration pneumonia on his chest x-ray. it is possible that he aspirated during the episode of somnolence. it is also possible that he had a community acquired pneumonia that was not evident on earlier x-rays. he was started on azithromycin, ceftriaxone, and metronidazole. an echocardiogram was performed to evaluate for heart failure. he had a hyperdynamic ef > 75%. there was evidence of mild lv hypertrophy with impaired relaxation. he was extubated on hospital day 3. the pt was tranferred to medicine on 3 l nc. he was continued on broad spectrum antibiotics for a total duration of 10 days (ceftriaxone iv was changed to cefpodoxime po), and the pt was given a/a nebs. the pt was given 40 mg iv lasix prior to intubation in the micu and received intermittent po lasix (20-60mg po qd) during the last 3 days of his stay on the medicine floor. ap cxr revealed improving pulmonary edema and no comment on infiltrate. cxr from was negative for interval change in lll or bibasilar atelectasis. prior to discharge the pt was satting at 98%ra sitting and 92-94% ra walking. consideration may be given to evaluating this pt for cpap as an outpt if pt is willing to be compliant. . 2) fever/leukocytosis: the likely source of his fever and leukocytosis is pneumonia. once he was treated with antibiotics, he remained afebrile. blood, urine, and sputum cultures were all negative. wbc rose to 16 on but cxr was negative for change in infiltrate, ua negative for signs of infection, and no localizing symptoms were found. the pt remained afebrile at discharge. . 3) hypertension: he denies any history of hypertension. he was initially treated with hydralazine. his blood pressures remained under good control while he was sedated. once he was extubated, is blood pressures were sometimes elevated to 200 systolic. the pt was started on hydralazine 10 mg po q 6hr. the pts sbp continued to be as high as 200, so the pt was also started on metoprolol and lisinopril which were titrated up to metoprolol 50 mg po tid and lisinopril 10 mg qd. . 4) psych: patient was initially sedated. once he was extubated, he required iv haldol and iv ativan for agitation. he was followed by psychiatry. the pt was continued on standing haldol and ativan as well as prn haldol and ativan. the haldol was initially given iv, however the pt continued to pull out his ivs so it was then given im. per psychiatry recommendations, the pt was started on lithium . the pt frequently required the prn haldol and ativan im doses, and always had a 1:1 sitter. he also required 4 point leather restraints on the first 3 nights after transfer, with security being called nearly every night for the pt attempting to leave the hospital. the pt did not require restraints the last 2 nights prior to discharge. he was much more alert and oriented prior to discharge than he had been on days prior prior. the pts im haldol/ativan was switched to po prior to discharge. . 5.lower extremity edema: likely secondary to some diastolic dysfunction. the pt had only mild bibasilar rales but did have some pulmonary vascular congestion on cxr. as previously stated, the pt received lasix 40 mg iv prior to intubation and autodiuresed over 3 liters in the micu. the pt continued to appear slightly fluid overloaded and was given lasix po (20-60 as need. urine output was difficult to monitor as the pt was incontinent most of the time. the pts lung exam was improved prior to discharge. medications on admission: he denies taking any medications on admission. later during the admission, he admitted to being on lithium and clonazepam, but he decided to stop taking those medications 1 month ago. discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 3. hydralazine 10 mg tablet sig: one (1) tablet po q6h (every 6 hours). 4. lansoprazole 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours). 7. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 2 days. 8. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 9. cefpodoxime proxetil 200 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 2 days. 10. azithromycin 250 mg capsule sig: one (1) capsule po q24h (every 24 hours) for 2 days. 11. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 12. lithium carbonate 300 mg capsule sig: one (1) capsule po qam (once a day (in the morning)). 13. lithium carbonate 300 mg capsule sig: two (2) capsule po qhs (once a day (at bedtime)). 14. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 15. haloperidol 10 mg tablet sig: one (1) tablet po hs (at bedtime). 16. haloperidol 5 mg tablet sig: one (1) tablet po at 8 am and 2 pm (). 17. lorazepam 1 mg tablet sig: one (1) tablet po tid (3 times a day). 18. lasix 20 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: four discharge diagnosis: s/p hypercarbic hypoxic respiratory distress schizoaffective disorder osa diastolic dysfunction discharge condition: stable, satting at 98% on ra, alert and oriented discharge instructions: please take all medications as prescribed. . please return to the ed or call your primary care doctor if your symptoms return or worsen. followup instructions: please keep all scheduled appointments with your psychiatrist and follow up after discharge from the hospital with your primary care physician for follow up of the issues raised during your hospitalization. md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube non-invasive mechanical ventilation diagnoses: unspecified essential hypertension acute and chronic respiratory failure pneumonitis due to inhalation of food or vomitus other diseases of pharynx, not elsewhere classified unspecified sleep apnea diarrhea diastolic heart failure, unspecified delirium due to conditions classified elsewhere other specified disease of white blood cells urinary incontinence, unspecified schizoaffective disorder, chronic with acute exacerbation 

Answer: The patient is high likely exposed to