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 an 81 year old caucasian male who was brought into the emergency department for mental status changes and decreased p.o. intake. the patient was just recently admitted to the hospital for a urinary tract infection and was treated with antibiotics. the patient also complains of a recent fall and low back pain. of note, the patient was a poor historian on his admission to interviewer. therefore, the details of his history of present illness are limited. in addition to the above symptoms, the patient also complains of increased urinary frequency and nocturia. the patient denies any loss of consciousness or trauma to the head during his falls. the patient states he was not sure why he fell but felt that his legs fell from under him. of note, the patient was started on ultram for several days prior to discharge. past medical history: 1. restrictive lung disease secondary to remote tuberculosis infection, status post pleurectomy and decortication for recurrent effusion. 2. paroxysmal atrial fibrillation. 3. hypertension. 4. chronic obstructive pulmonary disease. 5. hypothyroidism. 6. mild atrial insufficiency, 7. glaucoma. 8. history of urinary tract infection. medications on admission: 1. colace 100 mg twice a day. 2. captopril 12.5 mg p.o. three times a day. 3. levothyroxine 75 mcg once daily. 4. coumadin 1 mg q.h.s. 5. amiodarone 200 mg once daily. 6. senna two tablets at bedtime as needed. 7. atrovent two puffs four times a day. 8. protonix 40 mg once daily. 9. ultram 25 mg p.o. three times a day as needed of pain. 10. lactulose 30 three times a day. allergies: no known drug allergies. physical examination: on admission, vital signs revealed temperature of 98.4, blood pressure 168/73, pulse 70, respiratory rate 20, oxygen saturation 97% in room air. in general, the patient is in no apparent distress, alert but not oriented and agitated. head, eyes, ears, nose and throat examination - the pupils are equal, round, and reactive to light and accommodation. mucous membranes are moist. sclera anicteric. neck examination - there is no jugular venous distention, and there is no nuchal rigidity. heart examination - normal s1 and s2, ii/vi systolic murmur. no rubs and no gallops. lungs - rales at the left base; otherwise clear. abdominal examination is benign with a negative stool occult blood test. extremities are cool to touch, dorsalis pedis pulses and popliteal pulses were not palpable. neurologic - the patient is agitated, not oriented, confused. the patient is yelling when no one is in the room. laboratory data: on admission, complete blood count showed a white blood cell count 15.2, 90% neutrophils and no bands, hematocrit 46.2, platelet count 535,000. chem7 shows a sodium of 131, potassium 5.8 though the sample was moderately hemolyzed; otherwise the chemistries are normal. urinalysis shows no evidence of urinary tract infection. chest x-ray is unchanged with no evidence of infection. head ct was done which shows no acute process. electrocardiogram shows normal sinus rhythm at 61 beats per minute with isolated st elevation in v2 which is seen on previous electrocardiogram. hospital course: 1. change in mental status - the patient's change in mental status was likely multifactorial. the leading cause may be ultram which was recently started prior to this admission. other possible causes which were worked up were infection, hypothyroidism. a lumbar puncture was done which did not show any evidence of central nervous system infection. the patient was scheduled for a magnetic resonance scan of the head to further evaluate, however, he was not able to tolerate the study. benzodiazepine and other sedative medications were avoided initially. tsh level was checked and returned within normal limits. neurology consultation was obtained for further evaluation. they suggested that the cause is most likely toxic or metabolic. the patient's mental status did show some improvement, however, he was subsequently intubated due to respiratory failure. upon extubation, the patient's mental status seemed good. he was oriented and able to respond appropriately to questions and commands. no other definitive cause to his mental status changes was discovered to this point. 2. respiratory - initially on admission, the patient had no respiratory issues. initially was kept on his outpatient chronic obstructive pulmonary disease medications including his bronchodilators. however, after several days in the hospital, the patient had acute respiratory failure requiring transfer to the intensive care unit and intubation. blood gases showed that the patient had hypercapnic respiratory failure. cultures were taken including sputum culture. the patient was started on vancomycin and ceftazidime for hospital acquired pneumonia. subsequently, sputum culture grew out pseudomonas and the patient was maintained on cefepime and ciprofloxacin for double coverage of pseudomonas. the vancomycin was eventually discontinued as there was no evidence of a gram positive infection. the patient showed gradual improvement on the mechanical ventilation with antibiotics and nebulizers and chest physical therapy. his first extubation attempt, however, failed. after a short time of extubation, the patient again had acute respiratory distress likely due to mucous plugging and had to be reintubated. the patient remained intubated for approximately five days and then was again extubated. this time the patient maintained good respiratory status off mechanical ventilation. he did require shovel mask for hypoxia. 3. cardiovascular - the patient's hypertension medications were initially held for low blood pressure. the patient's amiodarone which he had been on for history of atrial fibrillation was also held. he maintained rate control despite intermittent atrial fibrillation. he was ruled out for myocardial infarction. once his blood pressure restabilized, the antihypertensive medications of ace inhibitor and beta blocker were restarted. the patient remained in normal sinus rhythm for most of the rest of his intensive care unit stay. 4. hypothyroidism - the patient's levoxyl dose was decreased to 75 mcg once daily as his tsh was near normal limits and his dose had recently been increased. he was continued on this dose and no further thyroid function tests were checked. 5. gastrointestinal - the patient presented with ileus. he required an aggressive bowel regimen for resolution of this. clostridium difficile toxin assay was also sent off which was negative times one. subsequently in the hospitalization, the patient had increasing white blood cell count without fevers. there was concern again for clostridium difficile infection due to multiple antibiotics that he had been on. repeat clostridium difficile studies are still pending. the rest of the hospital course and the rest of this discharge summary will be dictated by another physician. , 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 insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization laryngoscopy and other tracheoscopy transfusion of packed cells diagnoses: acute kidney failure with lesion of tubular necrosis unspecified septicemia unspecified protein-calorie malnutrition atrial fibrillation obstructive chronic bronchitis with (acute) exacerbation acute respiratory failure pneumonia due to pseudomonas cardiac arrest metabolic encephalopathy 

Answer: The patient is high likely exposed to