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: respiratory distress major surgical or invasive procedure: endotracheal intubation history of present illness: y/o m with history of afib, htn, cva's and severe dementia (nonverbal at baseline), with recent admission to for respiratory failure, discharged two days ago, now presenting from rehab with respiratory failure. the patient was found on evening rounds to be hypoxic with o2 sats in the 70s on room air. he was given furosemide 80 mg via ng tube and morphine 2 mg sl x1, to treat presumed chf exacerbation, without significant improvement. the patient vomited bilious emesis. rehab facility documentation reports patient was having increased amounts of thick, white secretions. he was placed on a non-rebreather, and ems was called to bring the patient to the ed. in the ed, initial vs were 118/50, 131, 33, 99% on bipap. the patient was intubated with etomidate and succinylcholine, and sedated with fentanyl/midazolam. he was given vancomycin 1g and cefepime 2g for presumed hap. he was also given acetaminophen 650 mg pr x1. labs were notable for wbc 27.5, bnp 15k. he has been in afib with rvr to the 120s, which improved to the 100s with 3l ns and no rate control. bp was generally stable in the ed, with systolic bp readings between 95-125. upon arrival to the micu, the patient is afebrile with stable vital signs. he is intubated and sedated, not requiring hemodynamic support with vasopressors. of note, the patient's recent admission to featured respiratory failure and multifactorial (cardiogenic and septic) shock, with acute on chronic chf and multifocal pneumonia. several conversations were held between the micu and floor teams, and the patient's brother and nieces, identifying what the patient's wishes would be in regards to his goals of care. according to the discharge summary from , the patient's brother and nieces all agreed to a code status of dnr/dni and agreed he should not be reintubated if he failed extubation. past medical history: -atrial fibrillation -r mca embolic stroke -cerebellar hemorrhage s/p craniotomy -alzheimers dementia and nonverbal / peg fed since stroke in -colon ca stage iii s/p resection -coronary artery dementia -hypertension -mitral regurg -left ventricular hypertropy -cervical radiculopathy/myelopathy -t12 compression fracture -gastroesophageal reflux -liver hemangioma -chronic kidney disease -bph s/p turp -history of bowel obstruction -history of multiple falls -history of etoh abuse -remote history of pulmonary tuberculosis ('s) social history: immigrated from in , at baseline speaks & understands limited english - translator needed. positive h/o alcohol abuse, none for >1 yr. he does not smoke. previously employed as a photographer. brother states patient is a holocaust survivor. has lived in facility >1 yr. nonverbal and fed by peg. family history: both parents died in in the ghetto. physical exam: vs: temp:99.8 bp:113/73 hr:109 (afib) rr:22 o2sat:100% assist/control 500*16, fio2 50%, peep 5 gen: intubated, sedated, nad, appears comfortable heent: anisocoria with l > r pupil. sluggish reactivity to light bilaterally, anicteric, mmm, op without lesions, no supraclavicular or cervical lymphadenopathy, jvp at sternal notch, no carotid bruits, no thyromegaly resp: bilateral rhonchorous breath sounds with crackles, no wheeze cv: irregularly irregular. no m/r/g abd: nd, nabsx4, soft, nt, no masses or hepatosplenomegaly ext: no c/c/e skin: no rashes/no jaundice/no splinters neuro: aaox3. cn ii-xii intact. 5/5 strength throughout. no sensory deficits to light touch appreciated. no pass-pointing on finger to nose. 2+dtr's-patellar and biceps rectal: reportedly guaiac negative in ed. pertinent results: initial labs: 03:50am wbc-27.5* rbc-4.20* hgb-10.4* hct-33.7* mcv-80* mch-24.9* mchc-30.9* rdw-16.1* 03:50am neuts-93.1* lymphs-2.6* monos-4.0 eos-0.1 basos-0.2 03:50am pt-15.8* ptt-29.1 inr(pt)-1.4* 03:50am plt count-428 03:50am fibrinoge-427* 03:50am calcium-8.7 phosphate-4.6* magnesium-2.7* 03:50am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 03:50am lipase-81* 03:50am ctropnt-0.04* 03:50am probnp-* 04:05am urine blood-tr nitrite-neg protein-75 glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 04:05am urine rbc-1 wbc-1 bacteria-mod yeast-none epi-1 04:05am urine hyaline-* 06:36am blood wbc-9.7 rbc-3.55* hgb-9.0* hct-29.2* mcv-82 mch-25.4* mchc-31.0 rdw-18.4* plt ct-193 01:00pm blood wbc-7.9 rbc-3.58* hgb-9.0* hct-29.3* mcv-82 mch-25.2* mchc-30.7* rdw-18.0* plt ct-245 09:25am blood wbc-6.2 rbc-3.35* hgb-8.4* hct-27.9* mcv-83 mch-25.2* mchc-30.2* rdw-18.0* plt ct-242 04:15am blood wbc-7.4 rbc-3.85* hgb-9.3* hct-30.6* mcv-79* mch-24.1* mchc-30.3* rdw-17.6* plt ct-264 06:15am blood wbc-8.4 rbc-3.94* hgb-9.9* hct-31.9* mcv-81* mch-25.0* mchc-30.9* rdw-17.4* plt ct-368 06:15am blood wbc-7.3 rbc-3.83* hgb-9.7* hct-31.4* mcv-82 mch-25.3* mchc-30.8* rdw-17.0* plt ct-356 05:39am blood wbc-8.8 rbc-3.90* hgb-9.7* hct-31.6* mcv-81* mch-25.0* mchc-30.8* rdw-16.4* plt ct-331 04:16am blood neuts-75.4* lymphs-12.0* monos-3.1 eos-8.9* baso-0.6 03:50am blood neuts-93.1* lymphs-2.6* monos-4.0 eos-0.1 baso-0.2 06:36am blood glucose-111* urean-35* creat-1.2 na-141 k-4.8 cl-105 hco3-26 angap-15 01:00pm blood glucose-102* urean-38* creat-1.4* na-141 k-4.8 cl-105 hco3-29 angap-12 09:25am blood glucose-125* urean-35* creat-1.4* na-147* k-4.4 cl-111* hco3-29 angap-11 03:40am blood glucose-122* urean-38* creat-1.6* na-147* k-3.6 cl-109* hco3-31 angap-11 04:15am blood glucose-108* urean-44* creat-1.9* na-146* k-3.6 cl-108 hco3-29 angap-13 06:15am blood glucose-110* urean-45* creat-1.5* na-149* k-4.7 cl-114* hco3-25 angap-15 06:15am blood glucose-108* urean-47* creat-1.4* na-147* k-4.7 cl-113* hco3-23 angap-16 04:16am blood alt-18 ast-27 ld(ldh)-227 alkphos-50 totbili-0.5 03:50am blood lipase-81* 03:50am blood probnp-* 03:50am blood ctropnt-0.04* 06:36am blood calcium-8.4 phos-2.9 mg-2.2 01:00pm blood calcium-8.3* phos-3.7 mg-2.3 03:40am blood calcium-8.4 phos-3.1# mg-2.2 06:15am blood calcium-8.5 phos-4.4 mg-2.3 05:39am blood calcium-8.8 phos-4.0 mg-2.3 06:37am blood vanco-17.4 09:25am blood vanco-20.6* 06:15am blood vanco-25.0* 06:15am blood vanco-17.7 03:50am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 10:36am blood type-art po2-108* pco2-44 ph-7.40 caltco2-28 base xs-1 intubat-not intuba 09:44pm blood type-art po2-78* pco2-32* ph-7.44 caltco2-22 base xs-0 06:07am blood type-art temp-38.9 tidal v-500 fio2-100 po2-302* pco2-50* ph-7.41 caltco2-33* base xs-6 aado2-378 req o2-65 -assist/con intubat-intubated 06:07am blood glucose-122* lactate-2.2* na-142 k-3.9 cl-102 03:55am blood glucose-115* lactate-2.7* na-145 k-4.9 cl-101 calhco3-31* microbiology: : gpc in clusters imaging: : cxr mild pulmonary edema. patchy airspace opacities bilaterally. ? pulmonary edema, aspiration, or pneumonic infiltrates. . kub: nonspecific gas pattern. retrocardiac opacity better evaluated on recent chest x-ray. . cxr: impression: ap chest compared to through : worsening opacification at the base of the right hemithorax could be due to increasing moderate pleural effusion alone or pleural fluid in association with lower lobe consolidation, a finding that would most readily be explained by aspiration. no endotracheal tube is seen below c7, the upper margin of this film and there is some tapering of the airway suggesting edema from a recent endotracheal tube. left lower lobe opacification is persistent since , another focus of either atelectasis or pneumonia. pulmonary vasculature is mildly engorged but there is no edema and mild-to-moderate cardiomegaly is unchanged. no pneumothorax. . cxr: reason for exam: respiratory distress, status post flash pulmonary edema in setting of a-fib. comparison is made with prior study performed a day earlier. there is stable mild-to-moderate cardiomegaly. asymmetric opacities in the lungs, right greater than left could be due to asymmetric edema but aspiration is also a possibility. left lower lobe retrocardiac opacities have improved consistent with improving atelectasis. right lower lobe opacities consistent with atelectasis has increased. small bilateral effusions are unchanged. calcifications in the right upper lobe is again noted. . brief hospital course: y/o nonverbal male with afib, cad, htn, and recent admission for cardiogenic/septic shock multifocal pneumonia, discharged to rehab on , presenting with worsening respiratory distress leading to intubation in ed. . # goals of care: conversations between care teams and patient's family members during last hospitalization well documented in discharge summary and other notes. patient nonverbal at baseline and not able to speak for himself. spoke with patient's brother over the phone, who stated that he wishes for patient to be intubated and wanted everything done but does not want his brother to undergo cpr. this was contiuously readdressed given the patient's very poor prognosis. he was ultimately made dnr/dni. his nieces felt that the patient would be most appropriately cmo, but his brother did not agree. palliative care was consulted and met with the brother who insisted on "everything to be done" without intubation. given clinical improvement, pt was sent back to rehab, should continue to hold discussion with brother regarding whether hospice care would be more appropriate in this setting given high potential for multiple readmissions without improvement in prognosis. . # hypoxia/respiratory distress: pt was initially admitted to micu for respiratory distress, intubated and quickly extubated. after transfer to floor on antibiotics for multifocal pneumonia, he had an episode of respiratory distress with tachypnea and labored breathing, the family was contact and brother reported that he wanted pt transferred back to the micu. cxr most consistent with recurrent multifocal airspace disease or infection (patient at high risk for aspiration of tube feeds). he was treated with 5 days of vancomycin and cefepime and then continued for total of 9 days on vanco and cipro, therefore completing his course for pneumonia. pt had copious secretions which require regular suctioning. prior to discharge, his o2 sats were 95% on ra, he was afebrile and no leukocytosis. his breathing improved after second discharge from micu and was not labored. clinically lungs still sound congested with coarse rhonchi, but no evidence of persistent pneumonia. . # atrial fibrillation: tachycardic to 110s on arrival, with improved rate after ivf resuscitation. no new ischemic changes on ecg. possibly exacerbated by severe hypoxia. he was amiodarone loaded and continued on metoprolol. he intermittently had rvr requiring iv metoprolol, and his po dose was uptitrated. after 4 days of amiodarone 450mg , he was transitioned to 450mg daily. he was maintained on metoprolol 50mg . on discharge, hr was mostly in the 80s-90s. he was monitored on telemetry without significant events. . # dementia/hx of cva: during the micu course, he was sometimes not responsive at all, other times tracking but usually not following commands or answering questions appropriately, even when -speaking staff were talking to him. after second transfer to the floor, his mental status improved though he was still aox1, he was more awake and followed commands, responded in 1-word answers. tube feeds were continued for nutrition. . # frank blood in foley. patient's foley was irrigated because of poor uop and revealed frank blood. urology was consulted and help tamponade the bleeding. prior to discharge, foley was draining clear yellow urine with adequate urine output. . # code status - dnr/dni contacts: hcp - brother, - , es - ; medications on admission: -amiodarone 400 mg po bid (please take 400mg twice daily for 5 additional days until , then decrease your dose to 200mg daily until followup with a cardiologist) -docusate sodium po bid -ipratropium bromide inh q4 hrs prn sob, wheezing -senna 8.6 mg po bid prn constipation -metoprolol tartrate 125 po tid -nystatin five ml po qid prn oral thrush -mirtazapine 30 mg po hs -heparin 5,000 sc tid -brimonidine 0.15 % drops oc -latanoprost 0.005 % drops oc qhs -bisacodyl 10 mg pr qm,w,f -acetaminophen 650 mg pr q4h prn pain -aspirin 325 mg po daily -cholecalciferol (vitamin d3) 1,000 unit po daily -ativan 0.5 mg po bid prn -ambien 5 mg po qhs -sorbitol 70% thirty ml po daily -magnesium citrate 150 cc po qm,w,f -maalox po q6h prn -albuterol sulfate neb q4h prn shortness of breath or wheezing -ipratropium bromide neb tid -omeprazole po daily -levsin/sl 0.25 mg tablet, sl q4h prn -scopolamine patch 72 hr : one patch q72h -tube feedings: nutren 2.0 @ 35 or 55 ml/hr discharge medications: 1. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 2. brimonidine 0.15 % drops : one (1) drop ophthalmic (2 times a day). 3. latanoprost 0.005 % drops : one (1) drop ophthalmic hs (at bedtime). 4. cholecalciferol (vitamin d3) 400 unit tablet : 2.5 tablets po daily (daily). 5. ipratropium bromide 0.02 % solution : one (1) treatment inhalation q6h (every 6 hours). 6. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 7. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) treatment treatment inhalation q4h (every 4 hours). 8. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 9. simethicone 80 mg tablet, chewable : one (1) tablet, chewable po qid (4 times a day) as needed for abd pain. 10. acetaminophen 500 mg tablet : two (2) tablet po tid (3 times a day). 11. metoprolol tartrate 50 mg tablet : one (1) tablet po bid (2 times a day). 12. amiodarone 200 mg tablet : two (2) tablet po daily (daily). 13. hyoscyamine sulfate 0.125 mg tablet, sublingual : one (1) tablet, sublingual sublingual qid (4 times a day). 14. polyethylene glycol 3350 17 gram/dose powder : one (1) po daily (daily). 15. morphine 2 mg/ml syringe : one (1) mg injection q4h (every 4 hours) as needed for pain. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: primary: multifocal pneumonia . secondary: atrial fibrillation alzheimer's dementia discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: out of bed with assistance to chair or wheelchair. followup instructions: you will follow-up with your pcp and providers at rehab facility. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube laryngoscopy and other tracheoscopy replacement of gastrostomy tube diagnoses: hemangioma of intra-abdominal structures mitral valve disorders acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified pulmonary collapse other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure pneumonitis due to inhalation of food or vomitus bacteremia personal history of malignant neoplasm of large intestine accidents occurring in other specified places alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance hyperosmolality and/or hypernatremia hematuria, unspecified mechanical complication of gastrostomy 

Answer: The patient is high likely exposed to