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 85-year-old man with a history of methicillin-resistant staphylococcus aureus, hypertension, hypothyroidism, insulin-dependent diabetes times 60 years, and peripheral vascular disease, status post a fem- bypass, who came to the emergency department with an episode of substernal chest pain at 11:30 a.m. on . the patient tried milk of magnesia and sublingual nitroglycerin times two without relief. the patient also had nitroglycerin drip and oxygen, and the pain was relieved. the patient denied any shortness of breath, nausea, vomiting, or syncope on the day of the episode. the patient was a poor historian and a bit confused during the history taking. as per the history, this was the patient's first episode of chest pain. he denied cough, fever, and chills. he does have some difficulty hearing. currently, at the time of admission, denies any chest pain, shortness of breath or palpitations and was admitted to the c-med service. past medical history: 1. methicillin-resistant staphylococcus aureus infection in the area of his right lower leg wound from his fem- bypass. he finished a course of vancomycin on . 2. hypertension. 3. hypothyroidism, on synthroid. 4. insulin-dependent diabetes mellitus. 5. hyponatremia. 6. peripheral vascular disease, status post right fem- bypass surgery. 7. hypoglycemia. on admission: on admission include insulin nph 4 units q.d., vitamin b12, vitamin c, synthroid, and lopressor. allergies: allergic to aspirin; it causes a rash. he is allergic to penicillin. social history: he lives alone at . he has a son. has occasional alcohol use. he quit smoking around 65 years ago. physical examination on admission: his vital signs were a temperature of 100.6, pulse 84, blood pressure 80/50, and he was satting 97% on 2 liters. generally, he is an 85-year-old male lying comfortably, in no acute distress. lungs revealed he had pectus excavatum. his lungs were clear to auscultation bilaterally. his neck revealed he had a positive jugular venous distention, supple. heart revealed distant heart sounds. abdomen was soft and nontender, positive bowel sounds. extremities with 2+ edema. neurologically, alert and oriented times two (to time and place). laboratory data on admission: laboratories on admission were a white blood cell count of 8.1, hematocrit 32, platelets 368. sodium 136, potassium 4.4, chloride 100, bicarbonate 27, bun 24, creatinine 0.7, glucose 118. his first creatine kinase was 191. second creatine kinase was 512 with a mb fraction of 16, index of 3. radiology/imaging: electrocardiogram showed a regular rate and rhythm at 110 beats per minute, low voltage with a right bundle-branch block. chest x-ray showed pleural effusions bilaterally. assessment: initial assessment was that he was an 85-year-old male with a history of peripheral vascular disease, hypertension, and hypothyroidism who was admitted for an episode of chest pain relieved by sublingual nitroglycerin. this is his first episode of chest pain, and was considered to be possibly likely to ischemia especially given rising creatine kinases. hospital course: the patient was begun on heparin, aspirin, continued on lopressor, and taken to the c-med service. the patient was eventually diagnosed with a non-q-wave myocardial infarction with a creatine phosphokinase of 645 and a troponin of 3. he was asymptomatic. however, on the night following admission he had a systolic blood pressure in the 80s and 90s, and on the following admission was called for an episode of rapid atrial fibrillation with a rate in the 150s complicated by hypotension with blood pressures in the 60s to 70s systolic. he was still mentating at baseline at that time. he had a semi-elective cardioversion at 360 joules times three which was unsuccessful. he was resuscitated with approximately 2 liters of normal saline but had no effect on his blood pressure or heart rate, and the patient was admitted to the coronary care unit for amiodarone intravenously in an attempt to re-cardiovert him was planned. on arrival at the coronary care unit team, the patient was in atrial fibrillation with a rate of 150, systolic blood pressure of 60 to 70 on an amiodarone drip. the patient was continued on amiodarone drip and was placed on a dopamine drip as well for support of blood pressure. he then reverted spontaneously to normal sinus rhythm with the amiodarone drip and dopamine; however, at that point his heart rate was in the 30s to 50s, and he was started on levophed. the patient also had an echocardiogram which showed left ventricular ejection fraction of about 10% with was significantly decreased from an ejection fraction of about 50% on a recent hospitalization. the patient continued after being weaned from pressors with a normal sinus rhythm at around 80 with a systolic blood pressure in the 90s, and he was transferred out to the floor for expected titration of his heart failure , and at that time the decision was made not to continue him on long-term amiodarone since this was his first event of atrial fibrillation. however, on , the coronary care unit team was called again to see the patient early in the morning when he re-developed rapid atrial fibrillation with a rate of 180, and again with hypotension with a systolic rate in the 50s and 60s. the patient was again transferred to the coronary care unit and reloaded with intravenous amiodarone. he was cardioverted times two unsuccessfully. then he spontaneously cardioverted to a junctional rhythm and then a sinus rhythm with a rate of about 40 to 50 beats per minute, and a systolic pressure in the 60s. at this time, electrophysiology was called, and they elected to place a temporary wire in the coronary sinus to maintain and adequate baseline heart rate, although they had to set the pacer at maximum output in order to capture. during this time, the patient had to be intubated for airway protection and hypotension in the setting of sedation. upon discussion with the team it was decided that the patient did not tolerate rapid atrial fibrillation or sinus bradycardia. they decided to place a permanent ddd pacemaker after multiple discussions with the patient and the family. there was some thought to also pursuing a av node ablation to reduce his rapid atrial fibrillation causing ventricular rapid response rate. however, it was eventually decided not to go ahead and do that procedure. he was restarted on his heart failure therapy with captopril and digoxin. he was diuresed, and eventually the patient was able to go back to the regular medical floor. the patient was also transfused with 1 unit of packed red blood cells for a decreasing hematocrit. the patient was also started on plavix for his coronary artery disease since he gets a rash when he takes aspirin. the patient was able to be extubated on , and tolerated it well. he did have a bit of swelling at the site of his left artery line which was removed; however, he continued to have dopplerable left radial pulse and palpable left ulnar pulse. this pain eventually resolved with continued good blood flow to the hand. the patient was continued on p.o. amiodarone throughout this time. the patient also continued to have significant lower extremity 3 to 4+ pitting edema as well as dependent edema in his arm as well as enlarging bilateral pleural effusions seen on chest x-ray. the patient again was transferred out to the regular medical floor on and continued diuresis with lasix and on amiodarone for rate control. on , the house officers were called to see the patient with an increased heart rate and decreased systolic blood pressure. he was again in rapid atrial fibrillation with a heart rate of around 120 and a blood pressure of 76/50. his electrocardiogram showed no new ischemic changes, but an accelerated rate. the patient was eventually converted back to normal sinus rhythm after receiving 40 mg of intravenous diltiazem, and the patient returned to av pacing with a blood pressure in the 90s/50s. after this time, the patient remained hemodynamically stable throughout the remainder of his hospital course. he was then loaded with p.o. diltiazem and begun on a final dose of 240 mg q.d. the patient also was continued to be diuresed with a bed weight decreasing from 110 kg down to 100 kg over the course of several days. the edema in his extremities also began to resolve. he began to have significantly large bilateral pleural effusions, larger on the left than on the right, and bilateral lower lobe collapse and it was decided to perform a thoracentesis. a thoracentesis was performed on with 1.5 liters of straw-colored fluid removed which was not sent for any laboratories. the patient tolerated the procedure well without complications. throughout this time, the patient was periodically on a nonrebreather mask with an fio2 of 100% overnight for saturations decreasing into the 80s. however, after the thoracentesis his oxygen saturations increased, and the patient had an arterial blood gas on on 6 liters nasal cannula which showed ph 7.48, pco2 of 43, po2 of 66, and bicarbonate of 33. over the course of the next few days the patient was able to be weaned down to 3 liters to 4 liters nasal cannula with good oxygen saturations. of note, the patient has poor peripheral circulation and it was difficult to get an accurate oxygen saturation using his fingers. after discussion with his family on , it was decided to make the patient dnr/dni. the son was the health care proxy. this was discussed with him as well as with the attending. of note, other significant events throughout his hospital course were the patient had hypothermia with a series of temperatures between 95 and 97 fahrenheit for multiple days. his tsh and t4 were retested which were within normal limits. we also tested cosyntropin stimulation test for adrenal insufficiency which was normal, and as the hospital course progressed the patient began to be less hypothermic. while on the floor, the patient was also started on digoxin as well as coumadin once the pacemaker was placed. his captopril dose was titrated up and he continued to be on 80 mg of lasix. amiodarone dose was decreased to 400 mg p.o. q.d. which he will continue for a 2-week course after discharge and then be decreased to 200 mg q.d. a digoxin level was checked on which came back at 2.1, and the patient's digoxin dose was decreased to 0.0625. at the time of discharge the patient was satting well on 3 liters to 4 liters of nasal cannula. on discharge: 1. lasix 80 mg p.o. q.d. 2. captopril 25 mg p.o. t.i.d. 3. diltiazem 240 mg p.o. q.d. 4. amiodarone 400 mg p.o. q.d. to be continued for two weeks and then changed to amiodarone 200 mg p.o. q.d. 5. coumadin 3 mg p.o. q.h.s. 6. plavix 75 mg p.o. q.d. to continue indefinitely for the patient's coronary artery disease. 7. nph 4 units q.a.m. 8. synthroid. 9. zantac. 10. vitamin c. 11. zinc. 12. digoxin 0.0625 mg q.d. discharge status: the patient was to be discharged to a long-term placement facility to be decided by the patient's family, social work, as well as his primary care physician. code status: the patient's code status is to be dnr/dni. condition at discharge: the patient's discharge condition was stable. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours thoracentesis initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle insertion of temporary transvenous pacemaker system diagnoses: subendocardial infarction, initial episode of care unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation cardiogenic shock other vascular complications of medical care, not elsewhere classified diabetes mellitus without mention of complication, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to