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: no known allergies / adverse drug reactions attending: chief complaint: transfer from osh for dental abscess major surgical or invasive procedure: 1. incision and drainage of submandibular cellulitis 2. intubation 3. extubation history of present illness: 45 year old male with past medical history of hypertesion and severe obesity who has not seeked regular medical or dental care presents to osh with 10 day history of right lower tootache, fever and chills. he heard a one day ago with associated pain and progressive swelling which prompted him to go to hospital. at hospital, ct neck showed soft tissure infection with phlegmon in the right perimandibular region likely originating from dental infection of tooth #7 in the right lower jaw. labs significant for normal wbc and hga1c of 12%. he was started on vancomycin and unasyn. he was also started on lantus 10 units qam. he was transferred to as hospital does not have omfs service on call. on the floor, he reports dysphagia. he also reports having few episodes of unresponsiveness with drooping of face and slurring of his speech over past few years. last episode one month ago. past medical history: 1. new diagnosis of diabetes mellitus 2. hypertension 3. severe obesity 4. likely obstructive sleep apnea social history: 1 ppd. over 50 year pack year history of smoking. social alcohol use. no ivdu. lives with daughter and her husband. works as a . has four dogs at home. family history: mother diet of breast cancer. he has 13 siblings of whom four passed away. physical exam: admission physical exam 100.2 149/90 92 20 95%ra gen: ill appearing obese male with right submandibular swelling heent: perrla. eomi. fundoscopic normal. poor dentition. right last molar is partially mandibular and mostly submandibular space tender to palpation without any fluctuation palpable in this area neck: submandibular area is tender to palpation and progress towards lateral clavicular area chest: ctab. no crackles or wheezing noted heart: regular rate and rhythm. no murmurs or gallops appreciated abdomen: soft, nontender and nondistended. nabs. external: no edema. r shin 3 cm wound neuro: alert and oriented x 3. cn 2-12 intact. muscle strength. sensation intact discharge physical exam objective: 98.4 126-127/70-85 70-76 20 96-100%2lnc 181/184/235 gen: obese male nad. mild fluctuations noted around right submandibular area heent: perrla. eomi. fundoscopic normal. poor dentition. chest: ctab. no crackles or wheezing noted heart: regular rate and rhythm. no murmurs or gallops appreciated abdomen: soft, nontender and nondistended. nabs. external: 1+ edema. r shin 3 cm wound neuro: alert and oriented x 3. cn 2-12 intact. muscle strength. sensation intact pertinent results: 03:43am blood wbc-14.3* rbc-5.05 hgb-14.5 hct-43.6 mcv-86 mch-28.7 mchc-33.2 rdw-13.6 plt ct-189 07:35am blood wbc-9.6 rbc-4.38* hgb-12.6* hct-38.2* mcv-87 mch-28.7 mchc-33.0 rdw-13.5 plt ct-223 08:00am blood wbc-10.1 rbc-4.56* hgb-12.9* hct-38.2* mcv-84 mch-28.2 mchc-33.7 rdw-13.4 plt ct-343 08:00am blood esr-100* 03:43am blood glucose-311* urean-15 creat-1.0 na-131* k-4.8 cl-95* hco3-26 angap-15 04:13am blood glucose-289* urean-30* creat-1.2 na-136 k-4.1 cl-100 hco3-26 angap-14 08:31am blood glucose-178* urean-10 creat-0.9 na-138 k-3.9 cl-100 hco3-29 angap-13 03:43am blood alt-120* ast-117* alkphos-99 totbili-1.9* 07:35am blood alt-102* ast-51* alkphos-101 07:35am blood triglyc-382* hdl-33 chol/hd-6.4 ldlcalc-101 07:35am blood calcium-8.4 phos-2.8 mg-2.2 cholest-210* 07:35am blood tsh-1.8 08:00am blood crp-30.7* ekg () sinus tachycardia. right axis deviation. non-diagnostic repolarization abnormalities. no previous tracing available for comparison. tte () the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 65%). the right ventricular free wall thickness is normal. the right ventricular cavity is dilated with focal hypokinesis of the apical free wall. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: dilated hypocontractile right ventricle cxr () in comparison with the study of , cardiac silhouette is at the upper limits of normal. the pulmonary opacifications have decreased, consistent with improved vascularity. some of this could reflect the upright position rather than supine. area of increased opacification at the right base is worrisome for possible pneumonia. endotracheal tube and nasogastric tubes have been removed. ct neck () phlegmonous changes in the right submandibular region/floor of mouth without residual drainable fluid collection. 1:43 am swab site: mandible right. gram stain (final ): 4+ (>10 per 1000x field): polymorphonuclear leukocytes. 2+ (1-5 per 1000x field): gram negative rod(s). 1+ (<1 per 1000x field): gram positive cocci. in pairs. wound culture (preliminary): due to mixed bacterial types (>=3) an abbreviated workup is performed; p.aeruginosa, s.aureus and beta strep. are reported if present. susceptibility will be performed on p.aeruginosa and s.aureus if sparse growth or greater.. sparse growth mixed bacterial flora ( >=3 colony types) consistent with oropharyngeal flora. work up requested per dr. # . staphylococcus, coagulase negative. rare growth. staphylococcus, coagulase negative. rare growth. second morphology. streptococcus anginosus (milleri) group. rare growth. sensitivity testing performed by sensititre. clindamycin is sensitive at 0.12mcg/ml. viridans streptococci. rare growth. sensitivity testing performed by sensititre. clindamycin is sensitive at 0.12 mcg/ml . penicillin is resistant at >=8 mcg/ml. sensitivities: mic expressed in mcg/ml _________________________________________________________ staphylococcus, coagulase negative | streptococcus anginosus (milleri) grou | | viridans streptococci | | | clindamycin-----------<=0.25 s s s erythromycin----------<=0.25 s <=0.25 s 2 r gentamicin------------ <=0.5 s levofloxacin---------- 2 i oxacillin-------------<=0.25 s penicillin g---------- <=0.06 s r tetracycline---------- <=1 s vancomycin------------ 1 s <=1 s <=1 s anaerobic culture (preliminary): mixed bacterial flora-culture screened for b. fragilis, c. perfringens, and c. septicum. id per dr. . prevotella species. sparse growth. beta lactamase negative. brief hospital course: 45 year old male with past medical history of hypertension and severe obesity without regular medical or dental care presents to osh with submandibular abscess now status post tooth extraction. 1. right submandibular osteomyelitis: likely due to molar infection. he was continued on iv unaysn/vancomcyin. he was taken to the or the night of admission where he had extra-oral incision and drainage of the right submandibular space that was connected with the right lateral pharyngeal space. two penrose drains were placed in right lateral pharyngeal space. after incision and drainage, tooth was removed that was thought to be source. he was continued on iv unasyn to cover polymicrobial flora. infectious disease was consulted. repeat ct neck showed no drainable collection but there was concern for jaw osteomyelitis. culture from his or specimen showed polymicrobiol flora with coagulase negative staph, anaerobes and gram negative rods. he was started on iv vancomycin and continued on iv unasyn. after seven days of iv antibiotics, he was discharged home on linezolid, ciprofloxacin and flagyl. 2. type 2 dm: hga1c of 12% from osh. he was treated with insulin lantus 15 units in the morning with sliding scale humalog. he was discharged home on metformin 1000 mg po bid and glyburide 10 mg in the morning and 5 mg in the afternoon. he was started on aspirin and lisinopril. he was risk stratified with lipids which showed dysplipidemia. 3. hypertension: untreated in the past per patient. he was started on lisinopril 40 mg po qdaily and chlorthalidone 25 mg po qdaily. 4. smoking: kept on nicotine 14 mg patch follow up for pcp 1. weekly lab work (cbc with diff, chem-7, esr and crp) to be faxed to dr. (fax: ) 2. he will need to have his type 2 dm regimen optimized. we were not able to obtain a glucometer for him to monitor his blood sugar levels. 3. please check creatine and electrolytes at your next visit as we started chlorthalidone and lisinopril during his hospital stay. medications on admission: none discharge medications: 1. linezolid 600 mg tablet sig: one (1) tablet po twice a day for 21 days. disp:*42 tablet(s)* refills:*0* 2. metformin 1,000 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 3. glyburide 5 mg tablet sig: one (1) tablet po qpm . disp:*30 tablet(s)* refills:*2* 4. lisinopril 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 5. chlorthalidone 25 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 7. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours). disp:*60 tablet(s)* refills:*2* 8. metronidazole 500 mg tablet sig: one (1) tablet po q8h (every 8 hours). disp:*90 tablet(s)* refills:*2* 9. glyburide 5 mg tablet sig: two (2) tablet po qam. disp:*60 tablet(s)* refills:*2* 10. outpatient lab work please check weekly cbc with differential, chemistry panel, creatinine, esr and crp. please fax it to dr. (fax: ) discharge disposition: home discharge diagnosis: primary diagnosis: 1. r mandibular cellulitis secondary diagnosis: 2. type ii diabetes mellitus 3. hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to hospital for an infection in your tooth and jaw. you were transferred to for surgery to remove the tooth and the infected tissue. you were intubated during the procedure and remained intubated in the icu for 24 hours to make sure that your airway was stable. two drains were placed in your mouth to help drain any infected fluid from your jaw. both drains were removed prior to your discharge from the hospital. you were then transferred to the medicine floor for antibiotic treatment of your infection. you were treated with iv vancomycin and unasyn while in the hospital. you were switched to oral linezolid to be taken at home for 3 weeks and oral ciprofloxacin and flagyl to be taken for 6 weeks. while you were in the hospital, your blood pressure was high and you were treated with lisinopril and chlorthalidone. you were also diagnosed with type ii diabetes. you were counseled on how to change your diet and exercise to control your diabetes. you were treated with insulin and metformin while you were in the hospital. you were discharged with metformin and glyburide for treatment of your diabetes at home. please have weekly labs drawn and faxed to dr. (fax: ). you should have your first week lab drawn at dr. office. following changes were made to your medications: start: linezolid 600 mg by mouth twice per day for 3 weeks for jaw infection start: ciprofloxacin 500 mg by mouth twice per day for 6 weeks for jaw infection start: flagyl 500 mg by mouth three times a day for 6 weeks for jaw infection start: metformin 1000 mg by mouth twice per day for diabetes start: glyburide 10 mg by mouth in the morning and 5 mg by mouth in the evening start: lisinopril 40 mg by mouth once per day for blood pressure start: chlorthalidone 25 mg by mouth once per day for blood pressure start: aspirin 81 mg by mouth once per day for prevention of heart disease followup instructions: department: internal medicine when: tuesday at 4:00 pm with: , md building: (, ma) campus: off campus best parking: free parking on site *dr. will be your new primary care doctor. department: infectious disease when: friday at 9:20 am with: , md building: lm campus: west best parking: garage of yawkey building . on @ 1pm dr. (phone: ) procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube other incision with drainage of skin and subcutaneous tissue extraction of other tooth drainage of face and floor of mouth diagnoses: other iatrogenic hypotension obstructive sleep apnea (adult)(pediatric) tobacco use disorder unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia hyposmolality and/or hyponatremia sepsis pneumonitis due to inhalation of food or vomitus family history of malignant neoplasm of breast periapical abscess without sinus cellulitis and abscess of face inflammatory conditions of jaw acute apical periodontitis of pulpal origin dysphagia, unspecified cellulitis and abscess of oral soft tissues body mass index 45.0-49.9, adult parapharyngeal abscess 

Answer: The patient is high likely exposed to