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: lethargy, altered ms, hyperglycemia major surgical or invasive procedure: percutaneous tracheostomy intubation/mechanical intubation central line placement lumbar puncture history of present illness: 58 yo m w/ brittle dmi c/b neuropathy, narcotics abuse, past etoh abuse, cri, htn, bipolar, p/w lethargy, confusion at home and became unresponsive in the ed. admitted to the micu for respitory failure (now intubated), hypotension, hyperglycemia. per pts. partner he has been disoriented with intermittent hallucinations, nonsensical speech, difficulty ambulating and poor po intake for the past several days. he has also had uri symptoms and a dry cough for 1 week. his partner was a sick contact (uri w/ cough). he was brought in to by his partner. . in the ed: t 97.5 hr 73 bp 109/62 rr 16 spo2 98% fs 443 initial labs were significant for a k of 6.1 with peaked t waves on ecg. he was given calcium, insulin, and ivf (total 6l of ns). a cxr showed dilated loops of bowel on initial read, therefore, an ogt placement was attempted. during this procedure the pt. desaturated to 86% on ra, this in combination with the pts. poor ms resulted in the patient being intubated (w/ etomidate/rocuronium) for airway protection and hypoxia. a ct scan of the abdomen showed no acute pathology but did reveal bibasilar lung consolidation (l>r). he was given levoflox 500 iv x1 and zosyn 4.5gm iv x 1. a head ct was significant for a left parietal 1 cm lesion (per partner this is old). also pts. ua was + bacteria and nitrates. additionally, in the , pts. bp transiently dropped to 85/53 and he was started on a levophed gtt. past medical history: iddm cri chronic fatigue gout bipolar disorder gerd etoh abuse (sober x 6 years) narcotics abuse multiple tia's htn known brain lesion (yearly mri) social history: 1 ppd x 40 years. no etoh in last six years. no recreational drugs. lives with gf, on disability. family history: 15 brothers/sisters, 5 of whom died of brain tumors physical exam: vs: temp:95.1 bp: 108/62 hr:67 rr:16 o2sat 100% on ac 550/18 peep 5 fi02 100% gen: intubated, responsive to pain (off sedation) heent: perrl anicteric,intubated, poor dentition neck: no jvd, right ij in place resp: clear anteriorly cv: rr, distant heart sounds, no murmurs abd: nd, +b/s, soft, nt, no masses or hepatosplenomegaly ext: 1+ ankle edema bilat. 2+dp on right and 1+ dp on left skin: no rashes/no jaundice pertinent results: hematology 05:30pm blood wbc-10.4 rbc-3.84* hgb-11.4* hct-33.4* mcv-87 mch-29.6 mchc-34.0 rdw-17.0* plt ct-234 12:56am blood wbc-7.6 rbc-3.27* hgb-9.5* hct-29.0* mcv-89 mch-29.1 mchc-32.8 rdw-16.3* plt ct-191 03:02am blood wbc-17.0* rbc-2.80* hgb-8.1* hct-24.2* mcv-86 mch-28.8 mchc-33.4 rdw-18.3* plt ct-477* 03:47am blood wbc-16.4* rbc-2.57* hgb-7.5* hct-22.5* mcv-88 mch-29.2 mchc-33.4 rdw-18.3* plt ct-510* 05:30pm blood neuts-67 bands-7* lymphs-17* monos-8 eos-1 baso-0 atyps-0 metas-0 myelos-0 coagulation 12:56am blood pt-12.6 ptt-38.5* inr(pt)-1.1 chemistry 05:30pm blood glucose-491* urean-55* creat-4.6* na-132* k-6.3* cl-104 hco3-12* angap-22* 07:51pm blood glucose-377* urean-52* creat-3.8* na-137 k-4.6 cl-113* hco3-13* angap-16 03:47am blood glucose-207* urean-37* creat-2.4* na-152* cl-122* hco3-20* lfts 07:51pm blood alt-13 ast-14 ld(ldh)-131 alkphos-146* totbili-0.2 05:34am blood alt-18 ast-18 ld(ldh)-189 alkphos-128* totbili-0.5 03:02am blood alt-29 ast-23 ld(ldh)-205 alkphos-268* totbili-1.0 ca/mg/phos 05:30pm blood calcium-9.1 phos-6.4* mg-1.7 05:53am blood albumin-2.6* calcium-8.1* phos-4.2 mg-1.9 05:34am blood albumin-2.6* calcium-7.8* phos-4.6* mg-1.7 vitamin 03:02am blood vitb12-* 02:49am blood caltibc-113* vitb12-greater th folate-16.0 ferritn-1062* trf-87* 03:23am blood vitb12-1742* ammonia 07:51pm blood ammonia-8* thyroid 02:49am blood tsh-1.4 02:49am blood free t4-0.65* immune 05:53am blood igg-663* toxicology 05:30pm blood asa-neg ethanol-neg acetmnp-neg barbitr-neg tricycl-pos blood gas 09:06pm blood type-art rates-/14 peep-5 fio2-100 po2-295* pco2-43 ph-7.13* caltco2-15* base xs--14 aado2-395 req o2-68 -assist/con intubat-intubated 02:24am blood type-art po2-183* pco2-38 ph-7.18* caltco2-15* base xs--13 05:22am blood comment-green top 05:35pm blood lactate-1.9 k-6.4* csf analysis wbc rbc polys lymphs monos 05:20pm 11 1* 02 87 13 tube#4 chemistry totprot glucose ld(ldh) 05:20pm 20 108 21 culture negative hsv negative negative for malignant cells urine: culture group b strep sputum: coag aureus mssa flu: positive b rpr: nr stool: negative for c. diff head ct2/24/08 1. no evidence of acute intracranial hemorrhage. 2. left parietal ovoid lesion with questionable punctate central calcification. recommend mri with gadolinium for better evaluation. no appreciable surrounding edema. no mass effect. ct abd/pelvis 1. no evidence of bowel obstruction. 2. air and stool-filled colon. 3. bibasilar consolidations, left significantly greater than right, likely representing aspiration or other pneumonia. 4. nonspecific periportal edema. possible etiologies include acute intravenous hydration, hypoalbuminemia, or hepatitis or other liver disease, or hiv-related disease. mri/mra of head there is an area of susceptibility artifact in the left periatrial region with a central portion of high signal on t2 images consistent with a cavernoma. there is no mass effect, midline shift or hydrocephalus seen. no acute infarct is identified. there is fluid seen in bilateral mastoid air cells. impression: no evidence of acute infarct. cavernoma left periatrial region of the parietal lobe. brief hospital course: respiratory failure / influenza b / mssa pneumonia mr. was brought to the ed for altered mental status, and became unresponsive while in the emergency department, primarily for airway protection. he exhibited sepsis physiology with hypotension, and was treated started on levophed initially. ct of the abdomen revealed consolidation at the lung bases. trials to wean the vent toward extubation were difficult with decreased oxygenation. dfa revealed that the patient was influenza b positive. culture of sputum was positive for methicillin sensitive staph aureus, and this was felt to be high likelihood for staph superinfection. because of his respiratory failure, he was covered broadly with vancomycin and zosyn for a ten day course. because of his protracted vent course, he underwent tracheostomy placement on . post-tracheostomy, his respiratory status improved and he had stable o2 saturation. on his trach fell out and he was transferred to the micu for further management, but he continued to have stable respiratory status post-trach and was transferred back to the floor. by discharge, his o2 saturation was 100% on room air. . altered mental status the patient had a history of confusion and of dropping objects per his family/partner just prior to admission. tox screen on admission was negative in urine, and positive for tca in serum. when sedation was weaned, he became hemodynamically agitated but mainly unresponsive with disconjugate gaze. mri/mra showed no acute infarct. eeg showed diffuse slowing consistent with toxic/metabolic encephalopathy. neurology was consulted and followed the patient while in house through the work-up. the patient had no gross thyroid function abnormality. an rpr was negative. ultimately, he was weaned off of his sedation of versed and fentanyl in a very slow manner, and over 2-3 days became arousable and eventually conversant. by discharge, he was oriented to name, not place and date but was able to carry out simple conversations. mini mental status score was 17 at discharge. . recalcitrant hypertension as sedation was weaned for extubation, the patient's blood pressure rose to 190-200 / 70s-80s consistently. he was treated with a mixture of labetolol gtt, hydralazine iv/po, and isordil. he was started on captopril given stable though lower renal function/egfr and this was titrated upwards. he additionally was continued on po labetolol, hydralazine, and isosorbide mononitrate. his captopril was switched to lisinopril, and labetolol to metoprolol by discharge. . aspiration on suctioning of the trach, it was discovered that the patient had been aspirating tube feeds and also crushed fragments of pills. a post-pyloric dobhoff was placed with success, but was eventually lost. rn trial of po pills at the bedside was successful. . acute on chronic kidney failure/disease the patient's creatinine on admission was 4.6, eventually declining over the course of hospital stay to 1.9. this was felt to be consistent with an acute kidney injury picture. . diarrhea the patient briefly exhibited large stool volumes, and c.diff associated diarrhea/colitis was considered given hospital and antibiotic exposure. a toxin was eventually positive. he was started on treatment with a 14-day course of metronidazole to be finished on . . diabetes: his fs was mostly high in the 200s-300s during most of the hospital stay but decreased by discharge. he was discharged with glargine 8 units at hs and a sliding scale. his insulin regimen would likely need to be adjusted at rehab for better glucose control. . nutrition the patient was not immediately peg'd given possibility of awakening after sedation was weaned off. he was supported with tube feeds for a short time then was able to tolerate liquid diet. he was discharged with soft solids and thin liquids. . code status/disposition the patient was a full code. medications on admission: allopurinol 300mg 2 per day aolchicine 0.6mg po daily atenolol 100mg po daily lisinopril 20mg po daily protonix 40mg po daily oxycontin 40mg q8h oxycodone 30mg prn soma/carisiprodol 350mg tablets lipram 4500 cap rxmeal humalog 75/25 ss levemir flex pen ?units discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) unit injection tid (3 times a day). 2. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. lidocaine (pf) 1 % (10 mg/ml) solution sig: three (3) ml injection q2h (every 2 hours) as needed for cough. 5. hydralazine 50 mg tablet sig: one (1) tablet po q6h (every 6 hours). 6. isosorbide dinitrate 20 mg tablet sig: two (2) tablet po tid (3 times a day). 7. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 6 days: until . 8. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever > 101.0. 9. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 10. albuterol sulfate 2.5 mg/3 ml solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours) as needed. 11. insulin regular human 300 unit/3 ml insulin pen sig: see comment subcutaneous four times a day: pre-meal fs 100-150: 2 unit; 151-200: 3 units; 201-250: 6 units; 251-300: 9 units; 301-350: 12 units. bedtime fs 200-250: 3 units; 251-300: 6 units; 301-350: 9 units. 12. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 13. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 14. metoprolol succinate 25 mg tablet sustained release 24 hr sig: three (3) tablet sustained release 24 hr po tid (3 times a day). 15. insulin glargine 100 unit/ml solution sig: eight (8) unit subcutaneous at bedtime. discharge disposition: extended care facility: hospital discharge diagnosis: primary diagnoses: influenza, mssa infection, clostrodium difficile colitis secondary diagnoses: insulin-dependent diabetes mellitus, chronic kidney disease, chronic fatigue, gout, bipolar disorder, gerd, alcohol abuse, narcotics abuse, multiple tia's, hypertension, known brain lesion (yearly mri) discharge condition: stable discharge instructions: you presented to with unresponsiveness and respiratory failure. you were found to have a lung infection. you were intubated and later underwent a tracheostomy. the tracheostomy tube later fell out but your respiratory status continued to improve greatly. you also had an infection of your colon called c. diff colitis and were started on metronidazole to be finished on . please take all your medications and go to your follow-up appointment as instructed below. if you develop recurrent respiratory difficulty, fevers, chills, abdominal pain, diarrhea, or any other concerning symptom, please call your physician or go to the nearest emergency room. followup instructions: * dr. , : 11:15 am, . 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 other bronchoscopy temporary tracheostomy diagnoses: acidosis toxic encephalopathy acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified polyneuropathy in diabetes chronic kidney disease, unspecified acute respiratory failure intestinal infection due to clostridium difficile methicillin susceptible pneumonia due to staphylococcus aureus diabetes with neurological manifestations, type i [juvenile type], uncontrolled influenza with pneumonia 

Answer: The patient is high likely exposed to