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: osh transfer with sepsis major surgical or invasive procedure: placement of right ij line intubation bronchoscopy history of present illness: 79 yo male with hx of cva, cad, osa with recent ed visits for changes in mental status who presents initially with confusion and is being admitted to the icu for fever and hypotension. the patient remained somnolent so hx was taken by the patient's wife . she reports that for the last 2 weeks the patient has complained of generalized weakness worse in his legs with frequent falls. there has been no head trauma or loc with falls. his somnolence has increased to the point where he has been bed bound for 1 week only getting up to go to the bathroom but was occassionally incontinent of urine in the bed. he has not been getting up to urinate or have a bm for the last 2 days and had fallen 3 times but refused to go to the hospital. yesterday the pt's daughter thought he was febrile and urged him to go to the ed, but he again refused. after another fall last night, the police insisted and he was brought to hospital. there he was found to be normotensive but had a fever to 102 and was given a dose of moxifloxacin 400mg x1 and then tranferred to . . in the ed he was found to have a fever to 103 with mild ruq and rlq tenderness. he then developed hypotension with sbp's in the 70's so a precept catheter was placed. he initially had a cvp of 12 so levophed was started and pressures improved quickly. ruq us was equivocal but he was seen by surgery who felt there was no cholecystitis but he was given flagyl. he was ordered for ct abdomen and admitted to micu prior to obtaining the study due to prolonged prep. past medical history: cva- r sided weakness post-concussive syndrome osa-on 2l nc during day and night cad-s/p mi in 3 yrs ago ?sz disorder-on keppra in past stopped for sedating effect anemia- egd with gastritis. colonoscopy with diverticulosis depression rt shoulder surgery knee replacement social history: he lives with his wife with daughter lives downstairs. he does not smoke cigarettes but smoked and quit 22 years ago. no etoh. pt severely depressed for last 3 years due family history: there is prostate cancer and hemorrhagic stroke. physical exam: t 95.9, hr 70, bp 109/61, rr 20, 95% on cpap with 2l/min heent: perrl, mmm, unable to determine jvp cv: rrr, distant hs, no mrg lung: loud transmitted breath sounds from cpap, unable to appreciate adventitial sounds abd: obese, soft, nt, nd, no hsm, no ruq tenderness, nabs, no pulsatile abd mass extrem: trace ankle edema bilat, 2+ rad and dp pulse neuro: somnolent but arousable to lt, not following commands, moving ue spontan but no spont le movement, noncompliant with ue reflexes with increased tone bilaterally, mute patellar and achilles reflexes bilat pertinent results: admission labs: 12:43am lactate-1.0 12:45am pt-15.1* ptt-25.6 inr(pt)-1.4* 12:45am neuts-88.4* bands-0 lymphs-5.7* monos-5.4 eos-0.4 basos-0.1 12:45am wbc-11.7* rbc-4.50* hgb-10.9* hct-33.7* mcv-75*# mch-24.3*# mchc-32.4 rdw-17.3* plt smr-normal plt count-159 12:45am albumin-3.5 12:45am ck-mb-2 ctropnt-0.02* 12:45am lipase-14 12:45am alt(sgpt)-19 ast(sgot)-24 ck(cpk)-142 alk phos-99 amylase-31 tot bili-0.7 12:45am glucose-113* urea n-43* creat-2.8*# sodium-139 potassium-4.9 chloride-105 total co2-20* anion gap-19 01:15am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-tr bilirubin-sm urobilngn-1 ph-5.0 leuk-neg 01:15am urine color-yellow appear-clear sp -1.018 10:40am calcium-7.4* phosphate-3.6 magnesium-1.7 iron-7* 10:40am caltibc-237* ferritin-77 trf-182* . admission cxr: findings: portable chest radiograph reviewed. the lungs are clear. the pleura are normal. the heart is enlarged, the mediastinal contours are stable with a tortuous aorta. prosthetic right humerus is present. . impression: no acute cardiopulmonary process. . ruq us: findings: focused ultrasound of the gallbladder was very limited due to marked patient rigoring throughout exam. the gallbladder was identified. the gallbladder is moderately distended, there is minimal gallbladder wall edema. no stones or sludge was identified. the common bile duct could not be clinically identified, but no large distended duct was present within the area of the common bile duct. . impression: very limited exam, but unlikely acute cholecystitis. . ct abdomen and pelvis: 1. limited study without intravenous contrast . no evidence of active inflammation of the abdomen. 2. 1.4-cm nodule in the right kidney, please further evaluate by ultrasound. 3. diverticulosis. 4. small hypodense lesions in the liver, cannot be further characterized. 5. atrophic muscles in right thigh. . bilateral lenis: findings: normal flow, compressibility, and augmentations are seen in common femoral, superficial femoral veins, and the left popliteal veins. normal compressibility is seen in right popliteal veins. . impression: no evidence of dvt. . ct head: findings: there is no intracranial mass effect, hydrocephalus, shift of normally midline structures or major vascular territorial infarction. a small area of fluid attenuation in the left lenticular nucleus is unchanged and likely represents an old lacunar infarction. surrounding soft tissue and osseous structures are unremarkable. . impression: no mass effect or hemorrhage. . brief hospital course: 79 yo male with hx of cva, cad, osa with recent ed visits for changes in mental status who presents initially with confusion and is being admitted to the icu for fever and hypotension. . shock/infection: patient was transferred from with septic shock. blood cultures from the osh grew 4/4 bottles klebsiella, providing source of sepsis. source of bacteremia remains unclear, although may be pneumonia that blossomed in retrocardiac region after admission. patient denied history of fever or cough prior to admission, although he did have gi symptoms. he was treated with iv fluid hydration and norepinephrine for bp support. the pressors were weaned by day two. he was treated with iv levofloxacin renally dosed. all surveillance cultures at were negative. he underwent bronchoscopy , airways clear; bal culture was also negative. on the floor pt. was transitioned to po levaquin and was discharged on the rest of a 2 week course. he had no further fevers or hypotension on the floor. . hypercarbic respiratory failure: on day two patient developed decreased mental status, concerning for hypercapneia in setting of respiratory fatigue. there was also concern for airway obstruction given his severe osa. he has previously be diagnosed with osa and recommended cpap, but he refused compliance with cpap (13mmhg). he was intubated on day two, ventilated well, and was extubated on day four of hospitalization. he did not develop evidence of obesity hypoventilation syndrome, and did not have elevated pco2 levels off ventilatory support. he was not noted to have apneic episodes during the night, but per report from his wife, has significant apnea at home. . hypoxemia: felt to be due to pneumonia and bilateral effusions with evidence of diastolic chf. he was diuresed and treated for pneumonia with improvement in oxygentation. he is on home o2 at home. at discharge from the icu he had a persistant moderate left effusion and small lung volumes. d-dimer was elevated, lenis were negative. cta was not performed secondary to concern for renal impairment. pt. was seen by the pulmonary service in house who recommended outpatient pulmonary work up hypoxemia and o2 requirement after resolution of acute event and rehab. . arf: studies consistent with prerenal azotemia in setting of gi illness and shock. renal function returned to baseline (creat 1.7-1.9) with iv hydration. medications were renally dosed for creatinine clearance clearance. lisinopril was restarted on the floor with some appropriate increase in cr with reinstitution (1.6 -> 2.0) creatinine should be monitored at rehab and lisinopril d/ced if cr increases any further. . cad: he ruled out for acute mi. echo consistent with diastolic heart failure. he was started on an asa, and his bb was continued. . htn: bb was restarted in the icu prior to transfer for elevated bps, and titrated up on the floor to 50 mg tid (which was similar to home doses of 75 mg ). low dose ace restarted on the floor (was on 20 mg benazapril qd at home) amlodipine 5 mg qd (home dose) restarted on discharge. . anemia: findings consistent with iron deficiency anemia with baseline hct 33-38. he was stared on supplemental iron with bowel regimen. he has had egd with gastritis and colonoscopy with diverticulosis in medications on admission: plavix 75 mg po daily prozac 20 mg po daily lotrell 1 tab po daily metoprolol 75 mg multivitamin 1 tab po daily fish oil tablet 1 tab po daily. vit b1 protonix 40mg qd folate 1mg qd discharge medications: 1. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 7 days. 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. fluoxetine 20 mg capsule sig: one (1) capsule po daily (daily). 5. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 6. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po bid (2 times a day). 7. multivitamin capsule sig: one (1) cap po daily (daily). 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 10. loperamide 2 mg capsule sig: one (1) capsule po qid (4 times a day) as needed for diarrhea for 7 days: for use for diarrhea levofloxacin. 11. amlodipine 5 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: - discharge diagnosis: primary: klebsiella bacteremia and sepsis, resolved . secondary: s/p cva in ' with residual right sided weakness post-concussive syndrome osa on 2 liters nc o2 at home cad s/p mi several years ago ?remote seizure disorder anemia secondary to diverticulosis/gastritis depression right shoulder surgery ckd (baseline 1.6-1.8) discharge condition: at baseline for home o2 requirement, afebrile. discharge instructions: please call your doctor or go to the er if you have any worsening shortness of breath or are requiring more oxygen to breath comfortably, have any chest pain, fevers, chills, confusion, falls, or any other symptoms that concern you. followup instructions: primary care: please call dr. office at to set up a follow up appointment for after you leave rehab. . after you return home from rehab you should set up an appointment to be seen by a pulmonologist at . you can call ( to set up an appointment. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube enteral infusion of concentrated nutritional substances other bronchoscopy arterial catheterization diagnoses: pneumonia, organism unspecified acidosis thrombocytopenia, unspecified anemia, unspecified congestive heart failure, unspecified acute kidney failure, unspecified severe sepsis acute respiratory failure septic shock other septicemia due to gram-negative organisms hypovolemia diastolic heart failure, unspecified 

Answer: The patient is high likely exposed to