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: chest pressure major surgical or invasive procedure: 1. cardiac catheterization 2. percutaneous coronary intervention with stenting of the right coronary artery with cypher stent history of present illness: 70yo man w/ pmh of dm on insulin admitted with chest pressure x 2days. he noted sscp 9.5/10 beginning on sunday and lasting through monday. he reported associated lethargy, but no dyspnea, nausea, vomiting, lightheadedness, radiation, or aggravating/alleviating factors. on tuesday morning, the pain had resolved but he went to his pcp (dr. on request of his wife and was found to have an ekg with q waves and st elevations in the inferior leads. he was sent to hospital, which sent him here. in the cath lab, he was found to have a mid rca 99% long lesion at the acute marginal take off with slow flow. he was stented with a 3.0 x 23 mm cypher des with resulting good flow. the acute marginal was jailed by the stent but maintained good flow. he was noted to have an ra pressure equal to the pcwp at 19 and was thus admitted to the ccu. on arrival to the ccu, he denied any chest pressure, lethargy, dyspnea, nausea, vomiting, pain, or other complaints. on ros, he notes leg paresthesias that are worse in the am and not worse with exercise. he reports an exercise tolerance of flights of stairs. he reports poor compliance with diabetic diet. notes significant past history of alcohol and tobacco use (multiple admissions for detox quitting 30yrs ago and 100pack-year history ending 15 years ago). denies any significant family history. past medical history: dm, adult onset (x15yrs), on insulin (never taken po meds) no htn, hyperlipidemia, cva. social history: married with 3 children, retired from customer service job. tobacco 2-3ppd x 40yrs, quit 15yrs ago; etoh w/ multiple admissions for detox, quit 30yrs ago; no drug use. family history: negative for dm, cva, htn, hyperlipidemia physical exam: vs: t 97.6, hr 75-89, bp 118-126/58-74, mean 79-91, abp 137/73 on admission, rr 10-20, sao2 92-96%/ra, 96%/2l, wt 88.5kg integrilin drip 2mcg/kg/min genl: pleasant man lying comfortably flat in bed heent: ncat, perrl, mmm, op clear neck: jvp unable to be appreciated, +hjr cv: rrr, distant heart sounds, nl s1, s2, no m/r/g chest: cta bilaterally from anterior and lateral approach, no wheezes, rales, rhonchi abd: soft, nontender, nondistended, bs+ gu: dressing c/d/i, nontender, no hematoma, no bruit ext: dry, no edema, pp 2+ bilaterally neuro: grossly nl pertinent results: labs from outside: trop 22.1, ck 604, mb 20.6; wbc 15.4, h/h 14.6/43.5, plt 232; inr 1.1; na 137, k 3.8, bun/cr 29/0.8 . admission labs: cbc: wbc-13.7* hgb-13.4* hct-40.4 plt ct-214 diff: neuts-83.9* lymphs-10.8* monos-4.9 eos-0.2 baso-0.3 coags: pt-13.2 ptt-25.5 inr(pt)-1.2 chem 10: glucose-166* urean-27* creat-0.9 na-137 k-3.8 cl-103 hco3-27 calcium-8.5 phos-2.9 mg-1.8 enzs: alt-27 ast-73* ld(ldh)-510* ck(cpk)-577* alkphos-88 totbili-0.9 cardiac enzymes: ck-mb-20* mb indx-3.5 ctropnt-2.78* abg: po2-73* pco2-39 ph-7.43 calhco3-27 comment-2l np lipid panel: triglyc-102 hdl-39 chol/hd-3.7 ldlcalc-87 hba1c: 8.8 discharge labs: cbc: wbc-10.3 hgb-12.3* hct-37.5* plt ct-219 chem 7: glucose-359* urean-21* creat-0.9 na-133 k-4.2 cl-103 hco3-22 mg-1.9 cardiac enzymes: ck(cpk)-207* . ekg: nsr @ 90bpm, l axis, nl qrs, increased pr interval, q waves in iii, avf, ?ii; st elevations 1-2mm in iii, avf, likely ii. . cath report: final diagnosis: 1. one vessel coronary artery disease. 2. mild systolic ventricular dysfunction. 3. completed acute inferior myocardial infarction, managed by pci of the mid-rca. comments: 1. selective coronary angiography demonstrated a right dominant system. lmca, lad and lcx had very minimal disease. the rca had a mid 99% long lesion at the acute marginal take off. initial flow was timi one. 2. left ventriculography showed a normal ejection fraction with no wall motion abnormalities and no mitral regurgitation. 3. hemodynamic assessment showed elevated rvedp of 19 mm hg with rvedp/lvedp ration > 0.8. rv pulse pressure was depressed. y descent on the ra tracing was accentuated. ci was depressed at 1.4 l/min/m2. this was consistent with rv infarction physiology. systemic aortic pressure was low normal. 4. successful pci of the mid-rca with a 3.0 x 23 mm cypher des. . imaging: osh cxr by report: limited study, ?rll consolidation cxr (pa/lat): 1. probable right lower lobe pneumonia. please confirm resolution after treatment to exclude the possibility of underlying neoplastic process. 2. prominent mediastinum indicating mediastinal fat vs. lymphadenopathy. cxr (ap): a roughly triangular region of opacification extends inferiorly from the right hilus is probably largely atelectasis but raises concern for bronchial obstruction and should be followed until clear. right hilus is slightly larger than the left, also a concern for adenopathy. heart size is normal. there is mild fullness in the mediastinum, particularly in the right paratracheal area, another region of possible adenopathy or alternatively vascular engorgement. there are no pleural abnormalities. remainder of the lungs is clear. . brief hospital course: assessment: 70yo man with several cardiac risk factors including dm, h/o tobacco use, presenting with q waves and st elevations in the inferior distribution after resolving chest pain, noted to have a 99% occluded rca by cath now s/p stent, but sent to the ccu for ra pressures = pcwp and concern of rv infarct. . hospital course is reviewed below by problem: . 1. - pt was found to have 99% occlusion of the mid-rca, which was stented with a cypher stent. the stent of the rca jailed the acute marginal, but good flow was maintained through this vessel. mi was most likely completed by admission given q waves, resolution of cp, and cks trending down on admission. he was treated post-catheterization with integrilin for 18 hours, then , , lipitor 80mg, lisinopril 5mg. beta-blocker was held on the recommendation of the cardiology fellow given the patient's right-sided infarct and concern for conduction system abnormalities as well as heart failure. 1a. cardiac risk factors: a lipid panel revealed tg 102, hdl 39, ldl 87, chol/hd ratio 3.7. hba1c was 8.8 and the patient reported poor compliance with a diabetic diet. he was encouraged to improve his diet and exercise. . 2. right sided failure - the cardiac catheterization revealed ra pressures of 19, which was elevated and equal to pcwp. this is consistent with rv infarct physiology and implies right sided failure. given this picture, pt was admitted to the ccu for monitoring. his blood pressure remained stable throughout his hospitalization course. he was allowed to auto-diurese as he had good urine output and diuretics had great risk for dropping his preload and causing hypotension. his lvef was 60%. . 3. cardiac dysrhythmias - the patient was noted initially to have first degree av block with a pr interval as long as 340ms (discharge interval). he was monitored by telemetry and daily ekgs and was noted at times to be in weinkebach. beta-blocker was held given concern for further conduction abnormalities with the right sided infarct. this can be started at the discretion of his primary care physician. . 4. hypoxia - on admission, the patient had an oxygen requirement and desaturated to 92% on room air. a cxr report from the osh noted a possible rll consolidation. a repeat cxr revealed an opacity that was consistent with pneumonia, but could not exclude neoplasm, especially as a widened mediastinum that could be secondary to hilar lymphadenopathy was also seen. for a possible pneumonia, the patient was treated with a 7 day course of levofloxacin. his white count, which was elevated to 13.7 on admission, decreased to 10.3 on discharge (see below). he remained afebrile. on discharge, the patient was able to ambulate without any desaturation on room air. given the possibility of neoplasm on cxr, the patient was notified that he had an abnormality on x-ray that was likely pneumonia, but that he would need to get another x-ray after finishing his antibiotics to ensure that it was indeed a pneumonia. his pcp was informed of the cxr findings. follow-up cxr and, if persistently abnormal, follow-up ct were recommended to evaluate opacity. . 5. diabetes - the patient reports poor compliance with diabetic diet. hba1c was 8.8. in the hospital, he was treated with his home insulin regimen (nph 60units qam, 40units qpm) and covered with sliding scale insulin. given elevated afternoon blood glucose readings, his am nph was increased to 70units. he was instructed on the importance of maintaining a diabetic diet and checking his blood sugars regularly. his home insulin regimen will likely need to be readdressed as an outpatient. he was discharged with a prescription for lancets, test strips, and a glucometer. . 6. leukocytosis - the patient was admitted with a wbc of 13.7. this was most likely secondary to his mi, especially as it began trending down at admission. given his cxr findings, however, pneumonia is an alternate etiology, and he was treated empirically with levofloxacin. he remained afebrile throughout his stay. . 7. renal function (dye load + dm) - his creatinine remained stable at 0.8-0.9 even after the dye load from his catheterization. he was started on an ace-i without complications. . 8. hcp - his wife . 9. code status - full medications on admission: nph 60u qam, 40u qpm discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 5 days. disp:*5 tablet(s)* refills:*0* 5. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. insulin nph human recomb 100 unit/ml cartridge sig: seventy (70) units subcutaneous every morning. 7. insulin nph human recomb 100 unit/ml cartridge sig: forty (40) units subcutaneous at dinner. 8. lancets regular misc sig: one (1) miscell. four times a day: please use as directed. disp:*qs * refills:*2* 9. glucometer elite classic kit sig: one (1) glucometer miscell. as dir: use as directed. disp:*1 glucometer* refills:*0* 10. glucometer dex test sensors strip sig: one (1) strip miscell. four times a day: use as directed. disp:*qs * refills:*2* discharge disposition: home discharge diagnosis: primary: 1. acute st elevation myocardial infarction 2. right ventricular failure secondary: 1. diabetes mellitus 2. pulmonary infiltrate, likely pneumonia discharge condition: stable, able to ambulate without desaturation discharge instructions: please take all medications as prescribed, including 5 more days of the antibiotics (levofloxacin). adhere to a diabetic diet and monitor your blood sugar regularly. follow up with your pcp as detailed below. call your doctor or go to the er if you have any chest pressure or pain, feeling lethargic, shortness of breath, nausea, vomiting, lightheadedness, persistent cough, or any other concerning symptoms. followup instructions: please follow up with your pcp, . , on tuesday, at 2:45pm. you will need him to refer you to a cardiologist for follow up in the next several months. you will need to get a repeat chest x-ray when you have finished your course of antibiotics. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures injection or infusion of platelet inhibitor insertion of drug-eluting coronary artery stent(s) diagnoses: pneumonia, organism unspecified subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery congestive heart failure, unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes long-term (current) use of insulin 

Answer: The patient is high likely exposed to