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: this is a 62 year old gentleman with a history of coronary artery disease, status post coronary artery bypass graft and mitral valve replacement times two, history of congestive heart failure who was admitted to the intensive care unit in with respiratory distress. hospital course: he has had a prolonged course including difficulty weaning off of the ventilator, requiring tracheostomy, requiring a percutaneous endoscopic gastrostomy. his percutaneous endoscopic gastrostomy was complicated by hematoma in his intra-abdominal area and it was also complicated by renal failure, necessitating dialysis as well as multiple aspiration pneumonias. 1. respiratory failure - on , the patient had an acute worsening of his respiratory failure with a temperature of 101.7, respiratory rate in the 40s. he was diagnosed with an aspiration pneumonia and sepsis. he was treated with ceftazidime, vancomycin and one dose of intravenous gentamicin. eventually his gram negative rods grew out of his sputum which were speciated as enterobacter and pseudomonas. he was treated initially with ceptaz, single coverage and then levaquin was added to double cover for enterobacter. his respiratory status improved. he was able to be weaned off of pressor support and eventually onto tracheostomy collar. at the time of discharge, he was tolerating a trach collar for 12 hours during the day with resting pressor support overnight. the patient will complete a 14 day course of ceptaz which will be completed on , as well as a seven day course of levaquin which also be completed on and the patient will continue to be weaned off of the ventilator, hopefully achieving trach collar 24 hours a day. 2. hypotension - the patient became hypotensive again on , thought secondary to pneumonia and sepsis. he was initially on pressors, however, we were able to wean off of the levophed, and with broad-spectrum antibiotics his blood pressure improved and he is maintaining maps in the 50s and 60s off all of blood pressure medications. 3. renal failure - the patient has become dialysis-dependent, receiving hemodialysis three times a week. currently the plan is to continue to remove fluid as tolerated. he will continue his hemodialysis three times a week. he will receive erythropoietin with dialysis per renal recommendations. 4. abdominal hematoma - the patient initially suffered a large abdominal hematoma in the setting of percutaneous endoscopic gastrostomy placement and anticoagulation. however, with maintaining the inrs in the 2.5 to 3 range, he has maintained his hematocrit as stable and he has not had any further intra-abdominal bleeding. 5. mitral valve replacement/atrial fibrillation - the patient requires anticoagulation for prosthetic valve as well as atrial fibrillation. the inr goal is 2.5 to 3. currently he is going to be discharged on coumadin 3 mg. should his inr drop below 2.5 we need to restart heparin without a bolus. should his inr get above 3, coumadin needs too be decreased because he has had large intra-abdominal bleeds in the setting of inr greater than 3. 6. diabetes - the patient is tolerating tube feeds at goal and subsequently has required insulin requirement. we are planning to discharge him on 24 units of lantus in the evening, covering with regular insulin sliding scale with goal fingersticks in the 80 to 140 range. 7. nutrition - the patient has been maintained on tube feeds, nepro at full strength at 35 cc/hr, through his percutaneous endoscopic gastrostomy tube. upon further improvement, he will need a repeat speech and swallow evaluation to dictate whether or not p.o. foods can be initiated. 8. access - the patient will be discharged with a right picc line and a left subclavian hemodialysis catheter. 9. prophylaxis - the patient will be discharged on coumadin and lansoprazole proton pump inhibitor. code status: the patient is full code. disposition: the patient will be discharged to rehabilitation where he will undergo further rehabilitation on the ventilator, hopefully coming off the ventilator full time as well as physical therapy as well as speech and swallow therapy to initiate feeding p.o. once again. discharge diagnosis: 1. coronary artery disease, status post coronary artery bypass graft, mitral valve replacement. 2. congestive heart failure with ejection fraction of 20 to 25%. 3. atrial fibrillation on coumadin. 4. prolonged ventilation secondary to congestive heart failure plus aspiration pneumonia, now status post trach and percutaneous endoscopic gastrostomy, requiring a prolonged trach wean. 5. restrictive lung disease thought secondary to ankylosing spondylitis. 6. type 2 diabetes, requiring lantus and sliding scale. 7. history of gastrointestinal bleed and duodenal ulcer. 8. intra-abdominal hematoma secondary to percutaneous endoscopic gastrostomy and anticoagulation. 9. renal failure, now necessitating hemodialysis. 10. history of gout. 11. history of brain abscesses, secondary to septic emboli from endocarditis. discharge medications: 1. ceptaz 1 gm dose at dialysis, to be completed on . 2. levofloxacin 250 mg q. 24, also to be completed . 3. coumadin 3 mg p.o. q.h.s., inr goal 2.5 to 3. 4. lantus 23 units at night, regular insulin sliding scale as needed. 5. lexapro 10 mg q.d. 6. digoxin .125 mg q. 3 days, to check periodic digoxin level. 7. carvedilol 3.125 mg b.i.d. 8. erythropoietin 500 intravenously with dialysis. 9. reglan 5 mg p.o. q.h.s. intravenously prn. 10. vitamin c. 11. zinc. 12. albuterol/atrovent nebulizers as needed. 13. prn oxycodone one q. 6 prn. 14. ativan 1 mg q.h.s. prn. follow up: the patient will follow up with primary care physician after prolonged hospitalization and rehabilitation. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for 96 consecutive hours or more combined right and left heart cardiac catheterization coronary arteriography using two catheters parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy arteriography of other intra-abdominal arteries transfusion of packed cells injection or infusion of nesiritide diagnoses: acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified unspecified septicemia paroxysmal ventricular tachycardia hemorrhage complicating a procedure acute and chronic respiratory failure pneumonitis due to inhalation of food or vomitus pneumonia due to staphylococcus, unspecified postinflammatory pulmonary fibrosis 

Answer: The patient is high likely exposed to