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: metoprolol attending: chief complaint: history of emphysematous cholecystitis. major or invasive procedure: laparoscopic cholecystectomy - . history of present illness: in summary, mr. is a 84 year old arabic-speaking gentleman with a history of a lengthy admission downtown for emphysematous cholecystitis. this was managed with a percutaneous cholecystostomy tube by one of my colleagues prior to his care being turned over to myself. he required icu care and multiple antibiotic courses for bacteremia and sepsis. during his hospital stay, he improved with regard to the cholecystitis. subsequent imaging failed to show any further gas in the wall of the gallbladder. the percutaneous cholecystostomy tube did have to be replaced secondary to this being displaced. he also had acute-on-chronic renal failure. he has some baseline renal insufficiency, but did require cvvh and then dialysis during his hospital stay. he typically follows with dr. for his renal disease. during the prior hospital stay, he also had diastolic chf, which responded to diuresis, which was continued upon discharge. he has had an additional brief admission for hyperkalemia but was again discharged to where he is having his rehabilitation. according to him and his daughter, he has been eating well, tolerating a diet. he has been moving his bowels. he has been beginning to walk with help at the rehabilitation facility. he has no abdominal pain and no complaints. he was admitted for planned laparoscopic cholecytectomy. past medical history: sepsis, respiratory failure --> gangrenous gallbladder ( - ), hypertension, type 2 dm, hyperlipidemia, benign prostatic hyperplasia, chronic renal insufficiency, left inguinal hernia, e. coli urosepsis in , cataracts, gout. social history: resident since prolonged admission for septic shock (7/9-21/09). previously lived with wife in , retired, immigrated from 12 years ago. no recent travel abroad. denies alcohol and tobacco. family history: wife denies any heart problems in family. physical exam: pre-operative physcial: . on physical exam, elderly gentleman, in no apparent distress, pleasant and appropriate. heent: normocephalic, atraumatic. perrl, equal ocular movement intact. moist mucous membranes. no scleral icterus. neck: no jvd. carotids full without bruit. heart: regular rate and rhythm, normal s1, s2. pmi nondisplaced. no murmurs/rubs/gallops. chest: rales at bilateral bases, no wheeze or rhonchi. abdomen: soft, benign, nontender, and nondistended. extremities: with trace bilateral lower extremity edema. good distal pulses. neuro: is intact, good strength in all four extremities. . at discharge: avss/afebrile. heent: sclerae anicteric. o-p clear. neck: supple. no . no jvd. lungs: cta(b) with few rales at bases. cor: rrr abd: lap. incisions with steri-strips c/d/i. bsx4. soft/nt/nd. extrem: no c/c/e. neuro: a+ox3. non-focal. language barrier (arabic, no english). pertinent results: 10:25am glucose-154* urea n-70* creat-4.5* sodium-141 potassium-4.4 chloride-107 total co2-23 anion gap-15 10:25am calcium-8.1* phosphate-5.3* magnesium-2.5 10:25am hct-26.8* 08:50am type-art po2-213* pco2-42 ph-7.35 total co2-24 base xs--2 08:50am glucose-139* lactate-0.9 na+-137 k+-4.4 cl--102 08:50am hgb-9.1* calchct-27 o2 sat-99 08:50am freeca-1.16 09:12am blood wbc-11.5* rbc-3.19* hgb-8.8* hct-29.0* mcv-91 mch-27.4 mchc-30.2* rdw-16.7* plt ct-246 10:25am blood glucose-154* urean-70* creat-4.5* na-141 k-4.4 cl-107 hco3-23 angap-15 09:12am blood alt-17 ast-41* alkphos-112 totbili-0.3 . specimen submitted: gallbladder. diagnosis: gallbladder: - chronic cholecystitis. - cholelithiasis, pigment type. - adherent cauterized benign liver parenchyma. clinical: cholelithiasis. gross: the specimen is received fresh labeled with the patient's name, ", " and the medical record number and "gallbladder." it consists of an already disrupted gallbladder measuring overall 6.8 x 3 x 1.6 cm. there is significant cautery on the external surface. no cystic duct lymph node is identified. the opened gallbladder contains no bile and gallstones numbering approximately 20. the stones are of the pigment type and measure 2.4 x 1.2 cm in aggregate. the gallbladder mucosa is erythematous and velvety. the gallbladder wall measures to be 0.7 cm in greatest dimension. the gallbladder wall is thickened but soft. the specimen is then represented as follows: a = cystic duct mucosa and sections of gallbladder wall, b = additional sections of gallbladder wall. . renal u/s: renal ultrasound: there is no evidence of hydronephrosis in the kidneys. there are multiple bilateral renal cysts, the largest on the right measuring up to 9.1 x 8.3 x 6.5 cm. the right kidney measures 15.4 cm which includes measurement of the exophytic cyst at the lower pole. the left kidney measures 10.6 cm. the bladder is decompressed by foley catheter, incompletely evaluated. impression: 1. no evidence of hydronephrosis. 2. bilateral renal cysts, not significantly changed from prior. . ecg: sinus tachycardia, rate 108. left ventricular hypertrophy. left anterior hemiblock. consider biatrial enlargement. poor r wave progression. non-specific st-t wave changes in leads i, avl and leads v5-v6. compared to the previous tracing of the rate has increased and the lateral t wave changes are slightly more prominent. intervals axes: rate pr qrs qt/qtc p qrs t 108 172 98 330/414 54 -44 107 . cxr: findings: cardiac silhouette is mildly enlarged but has decreased in size with associated improvement in reported pulmonary vascular congestion. lung volumes are slightly greater in the interval, and there has been marked improved aeration at the left base. there remains a confluent area of opacification in the right retrocardiac region, as well as small bilateral pleural effusions. impression: 1. right basilar retrocardiac opacification, which could reflect pneumonia in the appropriate clinical setting. 2. near-resolution of left basilar opacity. 3. small pleural effusions, with improvement on the right. brief hospital course: the patient was admitted to the general service for evaluation of the aforementioned problem. on , the patient underwent a laparoscopic cholecystectomy, which went well without complication (reader referred to the operative note for details). after a brief, uneventful stay in the pacu, the patient arrived on the floor tolerating a clear liquid diet, on iv fluids, with a foley catheter and jp drain in place, and percocet po and morphine iv prn for pain control. he received two doses of iv ciprofloxacin peri-operatively. the patient was hemodynamically stable. pod#1: pain well controlled on percocet. tolerated clear to regular diet. failed to void after foley discontinued; foley replaced. jp discontinued. pod#2: experienced two episodes emesis; diet returned to npo. given zofran. ivf restarted. renal service consulted for progressively increase creatinine in context of the patient's history of chronic renal insufficiency. renal ultrasound performed -no hydronephrosis, bladder decompressed by foley. acute on chronic renal failure believed secondary to post-renal obstruction from bph. later in evening, became agitated and confused. temporary limb restraints applied. lasix discontinued. ngt replaced. patient self-discontinued. pod#3: continued agitation, confusion overnight. again required restraints and frequent re-orientation. given fluid bolus for low urine output with good response. renal followed closely. pod#4: triggered for diaphoresis, sob, and tachypnea. transfered to the ticu for respiratory acidosis and acute respiratory failure with fluid overload. echo revealed grade ii (moderate) lv diastolic dysfunction with lvef >55%. diuresis with lasix continued. oxygen by face mask. ekg and serial troponins. renal followed. pod#5: respiratory status significantly improved. urine output adequate. renal functions improved. ticu plan continued. renal followed; no dialysis at this time. pod#6: cxr with mildly improved pulmonary edema and (r) basilar atelectasis. transferred back to floor npo except medications, on iv fluids, oral medications, and a foley catheter in place. hemodynamically stable. pod#7: diet advanced to clears. pain well controlled. pt & ot consulted. aggressive respiratory toilet. pod#8: diet advanced to renal regular. minimal post-operative pain; well controlled. cxr showed right basilar retrocardiac opacification, which could reflect pneumonia. u/a and ucx sent for question uti. started on iv levofloxacin. pod#9: hemodynamically stable. no complaints. ambulated with pt and nursing. renal following. pod#10: loose bowel movement; cdiff sent. remained stable. pod#11: tolerated diet. pain well controlled. foley discontinued; voided adequately. urine culture revealed vre uti senstive to linazolid; started on linezolid for 2 week course. rehabilitation screen underway. pod#12: tolerating diet. pain well controlled. continued on levofloxacin and linezolid. voided adequately without problem. at the time of discharge on , the patient was doing well, afebrile with stable vital signs. the patient was tolerating a renal regular diet, ambulating with assistance, voiding without assistance, and pain was well controlled. the patient was discharged to a rehabilitation facility. the patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. medications on admission: 1. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 2. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 3. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 5. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 6. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 7. verapamil 80 mg tablet sig: one (1) tablet po q8h (every 8 hours). 8. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation every six (6) hours as needed for shortness of breath or wheezing. 9. allopurinol 100 mg tablet sig: one (1) tablet po every other day. 10. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 11. calcitriol 0.25 mcg capsule sig: one (1) capsule po once a day. 12. atorvastatin 20 mg tablet sig: one (1) tablet po at bedtime. 13. aspirin 81 mg tablet sig: one (1) tablet po once a day. 14. phoslo 667 mg capsule sig: one (1) capsule po three times a day. 15. glipizide 5 mg tablet sig: one (1) tablet po once a day. 16. iron (ferrous sulfate) 325 mg (65 mg iron) tablet sig: one (1) tablet po twice a day. 17. calcium carbonate 500 mg (1,250 mg) tablet sig: one (1) tablet po twice a day. 18. b complex-vitamin c-folic acid 0.9 mg/15 ml syrup sig: one y (120) ml po twice a day. 19. procrit 10,000 unit/ml solution sig: 10,000 units injection every 10 days: hold for hgb greater than/ equal to 10. 20. miralax 17 gram powder in packet sig: seventeen (17) gm (1 pkt) in 8oz water or juice po once a day as needed for constipation. discharge medications: 1. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 2. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: two (2) capsule, sust. release 24 hr po hs (at bedtime). 3. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 5. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 6. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 7. verapamil 120 mg tablet sig: one (1) tablet po q8h (every 8 hours). 8. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation every six (6) hours as needed for shortness of breath or wheezing. 9. allopurinol 100 mg tablet sig: one (1) tablet po every other day. 10. acetaminophen 325 mg tablet sig: 1-2 tablets po every hours as needed for fever or pain. 11. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 12. calcitriol 0.25 mcg capsule sig: one (1) capsule po once a day. 13. atorvastatin 20 mg tablet sig: one (1) tablet po at bedtime. 14. aspirin 81 mg tablet sig: one (1) tablet po once a day. 15. phoslo 667 mg capsule sig: one (1) capsule po three times a day. 16. glipizide 5 mg tablet sig: one (1) tablet po once a day. 17. iron (ferrous sulfate) 325 mg (65 mg iron) tablet sig: one (1) tablet po twice a day. 18. calcium carbonate 500 mg (1,250 mg) tablet sig: one (1) tablet po twice a day. 19. b complex-vitamin c-folic acid 0.9 mg/15 ml syrup sig: one y (120) ml po twice a day. 20. procrit 10,000 unit/ml solution sig: 10,000 units injection every 10 days: hold for hgb greater than/ equal to 10. 21. miralax 17 gram powder in packet sig: seventeen (17) gm (1 pkt) in 8oz water or juice po once a day as needed for constipation. 22. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 23. levofloxacin 250 mg tablet sig: one (1) tablet po every other day for 13 days: for pneumonia. completion date: . 24. linezolid 600 mg tablet sig: one (1) tablet po every twelve (12) hours for 13 days: for vre uti. completion date: . 25. lantus 100 unit/ml solution sig: eight (8) units subcutaneous at bedtime. 26. insulin lispro 100 unit/ml solution sig: 2-12 units subcutaneous as directed per humalog insulin sliding scale. discharge disposition: extended care facility: highgate manor discharge diagnosis: primary: 1. prior emphysematous cholecystitis 2. acute on chronic renal failure 3. acute respiratory failure - resolved. 4. (r) basilar pneumonia - continued on levofloxacin 5. vre uti - continued on linezolid . secondary: 1. bph 2. type ii dm 3. diastolic heart failure discharge condition: stable. discharge instructions: please call your doctor or nurse practitioner or return to the emergency department for any of the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *your pain is not improving within 8-12 hours or is not gone within 24 hours. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon. avoid driving or operating heavy machinery while taking pain medications. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash incisions with a mild soap and warm water. gently pat the area dry. *if you have staples, they will be removed at your follow-up appointment. *if you have steri-strips, they will fall off on their own. please remove any remaining strips 7-10 days after surgery. followup instructions: please call ( to schedule a follow-up appointment with dr. (surgery) in weeks. . please call ( to arrange a follow-up appointment with dr. (pcp) in weeks. . provider: , .d. (cardiology) phone: date/time: 10:00 . please call ( to arrange a follow-up appointment with dr. , md (renal) in weeks. procedure: laparoscopic cholecystectomy diagnoses: pneumonia, organism unspecified chronic kidney disease, stage v acidosis urinary tract infection, site not specified congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified gout, unspecified acute on chronic diastolic heart failure pulmonary collapse hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (luts) calculus of gallbladder with other cholecystitis, without mention of obstruction infection with microorganisms without mention of resistance to multiple drugs streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] urinary complications, not elsewhere classified delirium due to conditions classified elsewhere inguinal hernia, without mention of obstruction or gangrene, unilateral or unspecified (not specified as recurrent) personal history, urinary (tract) infection other cataract 

Answer: The patient is high likely exposed to