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: cc: major surgical or invasive procedure: pacemaker placement ddd history of present illness: hpi: 84 year old female with htn, hypercholesterolemia, dementia presents from nursing home after they noted that her heart rate was in the 30's. she was noted to be in complete heart block, on arrival to hospital, sbp decreased to 80's systolic and she was started on dopamine gtt at 13 cc/hr. past medical history: htn hypercholesterolemia dementia with agitation hypothyroidism depression syncope social history: soc hx: lives in nursing home. (+) tobacco 1ppd x 50 yrs, quit > 15 family history: family history: sister cva in her 60s. father cva in his 70s. physical exam: phys exam: 98.1f hr 60 bp 151/64 rr 14 100%/intubated gen: sedated, intubated, responsive to pain heent: perrl, intubated cv: distant s1, s2, ?systolic murmur chest: external pacer in place with dsg c/d/i pulm: diffuse rhonchi and occasional wheeze bilaterally abd: (+) bs, soft, obese, nontender ext: wwp, faint dp pulses b/l, 2+ pitting le edema b/l pertinent results: 09:36pm blood wbc-13.5*# rbc-3.89* hgb-11.3* hct-32.5* mcv-84 mch-29.1 mchc-34.8 rdw-15.6* plt ct-222 07:35am blood wbc-10.4 rbc-3.81* hgb-11.4* hct-31.7* mcv-83 mch-30.0 mchc-36.0* rdw-15.6* plt ct-222 05:18am blood neuts-79.2* lymphs-14.0* monos-3.0 eos-3.7 baso-0.1 09:36pm blood pt-12.6 ptt-24.9 inr(pt)-1.1 05:42am blood pt-13.3 ptt-27.2 inr(pt)-1.2 07:15am blood pt-12.6 ptt-25.0 inr(pt)-1.1 09:36pm blood glucose-148* urean-22* creat-1.0 na-136 k-4.5 cl-101 hco3-24 angap-16 07:35am blood glucose-107* urean-14 creat-0.8 na-136 k-4.2 cl-100 hco3-27 angap-13 09:36pm blood alt-28 ast-28 ck(cpk)-57 alkphos-77 totbili-1.0 05:42am blood ck-mb-notdone ctropnt-0.04* 05:42am blood tsh-6.6* 05:42am blood free t4-0.8* 09:41pm blood type-art po2-428* pco2-38 ph-7.43 calhco3-26 base xs-1 12:13pm blood type-art temp-37.2 fio2-40 po2-94 pco2-36 ph-7.48* calhco3-28 base xs-3 intubat-not intuba echo conclusions: the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there is moderate aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is severe mitral annular calcification with a moderate inflow gradient (in part due to significant regurgitation). moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is severe pulmonary artery systolic hypertension. there is no pericardial effusion. chest x ray: chest: a single semi-upright ap view at 9:30 p.m. is compared to previous examination earlier from the same day. since the previous exam the interstitial edema has decreased. there is an endotracheal tube with the tip approximately 4.5 cm proximal to the carina. there is a new single lead pacemaker with the lead overlying the right ventricle. there is no evidence of pneumothorax. there are probable pleural calcifications in left lower lung. there is focal opacity in right upper lobe which may represent pneumonia. brief hospital course: a/p: 84 year old female with htn, hyperlipidemia, recently diagnosed pneumonia treated with antibiotics, found by nursing home to have hr 30's, found to be in complete heart block. . 1. cv: rhythm: patient was taken to the cath lab, intubated for agitation, and a external screw-in pacemaker was placed. unclear source of complete heart block, given she r/o for ischemia, more likely worsening conduction system with age. a permanent ddd pacemaker was placed on with no complications. patient should have a follow up appointment with device clinic in 1 week. pump: patient on admission appeared volume overloaded, and her lasix dose was increased from 40 po day to 40 iv q day. patient responded well, and later on was transitioned back to her home dose40 po/day echo on echo on .ef >55%mod as, mod mr and severe pulmonary artery systolic htn on echo. ischemia: patient rule out for mi, enzymes negative. bp: patient was initially hypotensive on admission, and was started on dopamine. after procedure, she was transfer to ccu and dopamine was weaned off over the following 12 hours. cad: patient was continued on aspirin, statin, and ace was re-started once patient was transfer to the floor. 2. pulm: patient was extubated succesfully in the morning of . patient did well after extubation. . 3. id: pneumonia, was treated at nh with erythromycin. chest x ray on admission compatible with right upper lobe pneumonia. patient was switched to azytromycin- ceftriaxone. sputum final showed sparse oropharingeal flora. per id recomendation, and given good clinical conditions, antibiotics were stopped on . per electrophisiology recs, she received vancomycin for 48 hours after procedure, since patient will be d/c after 24h, she will receive 1 more day of keflex. . 4. hypothyroidism: patient with high tsh and low free t4 on admission. levothyroxine dose was increased from 75 to 100mcg/day. . 5. dementia: continue namenda. . 6. fen: cardiac heart diet monitor electrolytes and replete prn. . medications on admission: lipitor 20 qhs lasix 40 po qday lisinopril 2.5 po qday mvi os-cal 500mg qday asa 81 qday namenda 10 qday levoxyl 75 mcg qday tylenol prn erythromycin 333 tid (for pna) discharge medications: 1. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for fever. 2. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. memantine 5 mg tablet sig: two (2) tablet po qday (). 5. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 6. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 7. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: puffs inhalation q4h (every 4 hours) as needed for wheeze. 8. keflex 250 mg capsule sig: one (1) capsule po four times a day for 1 days. 9. multivitamin capsule sig: one (1) capsule po once a day. 10. os-cal 500 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: healthcare - discharge diagnosis: compleat heart block community acquired pneumonia hypothyroidism discharge condition: good discharge instructions: please take your medications as prescribed. please follow up your appointments as schedule. a pacemaker device was implanted durint this hospitalization. your levothyroxine dose was increased during your hospital stay. if shortness of breath, chest pain, or any other symptoms that may concern you please call your pcp or come to the emergency department. followup instructions: please call your pcp for follow up appointment in about 2 weeks. please call pacemaker and device clinic at ( to make an appointment in 1 week. please recheck tsh in 1 month. procedure: initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle insertion of temporary transvenous pacemaker system infusion of vasopressor agent diagnoses: pneumonia, organism unspecified pure hypercholesterolemia mitral valve disorders unspecified essential hypertension unspecified acquired hypothyroidism other chronic pulmonary heart diseases atrioventricular block, complete alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance 

Answer: The patient is high likely exposed to