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: beta-adrenergic blocking agents attending: chief complaint: dysnpnea major surgical or invasive procedure: endotracheal intubation, thrombectomy, ivc filter placement, central venous catheter placement history of present illness: mr. is an 84yo man with h/o cad, diastolic chf c ef 55%, copd on home o2 at 2lnc, and recent strep pneumo pna requiring intubation (5d) one month ago, discharged to home from rehab 1 week ago with new diagnosis of cdiff now s/p 14d po vanco/flagyl. yesterday he noted increased dyspnea and his visiting nurse crackles. he seemed weak per his daughter, and continued to have diarrhea. last night his edema (usually trace only) and breathing began worsening and he had increased lethargy and decreased mentation today, for which he was brought by ems to an osh. . at , abg was 7.18/65/163 for which he was put on bipap - repeat abg was 7.26/60/444. he was treated for copd exacerbation with 125mg iv solumedrol, nebs, and was given 80mg iv lasix x 1 after his bnp returned as 35,000 to which he put out only 100cc, and was transferred to the . on arrival here his sbp was in the 70s-80 (per daughter his baseline is high 80s-90s since last year). he continued on bipap with o2 sats in the 90s. femoral line was placed and he was initially started on dopamine drip however this caused tachycardia and drip was stopped before transfer to icu with sbp remaining in the 80s. he was given a dose of levoflox, despite cxr negative for infiltrate (also no sign of pulmonary edema, but did show underlying copd and bronchiectasis). ekg was reportedly unremarkable. repeat bnp here was pending at the time of admission. . he denies having had cp, n/v/diaphoresis, dizziness, dysuria, or any other symptoms besides shortness of breath and weakness as above. no cough, no fever or chills. . ros: currently states breathing feels better than earlier today, no cp, abd pain, n/v. past medical history: - htn, however per daughter no longer, and now hypotensive - diastolic chf with ef 55% - hypercholesterolemia; - cad s/p imi in - tia/aphasia ; s/p l cea - copd (fev1 1.57 per pfts, ratio 82% due to poor effort,but tracing appeared obstructive per report); on home 2lnc o2 - bph s/p turp ; - balanitis s/p circumcision ; - remote nephrolithiasis; - former tobacco use (80 pack/year hx), - s. pneumoniae pneumonia , intubated for hypercarbia - c diff diagnosed social history: before admission in had lived alone with wife. for last week since d/c from rehab he and wife have been living iwth daughter, who is a nurse here at . 80 pack years of smoking, quit 5 years ago. family history: noncontributory physical exam: vs 96.4, 100, 86/47, 31, 95% on noninvasive bipap 15/8 at fio2 0.35 gen: responds with hand gestures and nods to questions, wearing bipap mask, uses abdominal muscles for exhalation heent: pupils small but minimally reactive neck: jvp mildly distended at 10cm cor: very decreased heart sounds, s1s2, no murmur pulm: r base with rales, left lung clear abd: soft, nt, nd, +bs ext: + pitting edema bilateral le to just below knees neuro: moves all four, responds to commands skin: obvious bruises and thin, fragile skin throughout gu: concentrated brown/ urine in foley pertinent results: wbc-21.1* rbc-4.58* hgb-13.7* hct-42.4 mcv-93 mch-30.0 mchc-32.4 rdw-15.4 plt count-285 - neuts-96.7* bands-0 lymphs-1.5* monos-1.5* eos-0.1 basos-0.1 glucose-177* urea n-38* creat-1.3* sodium-141 potassium-5.4* chloride-105 total co2-27 calcium-8.8 phosphate-6.0*# magnesium-1.9 ck(cpk)-19* ->17, ctropnt-0.03* ->0.03 probnp-* pt-15.0* ptt-46.0* inr(pt)-1.3* cxr: linear and tubular opacities and ring shadows r>l base consistent with chronic bronchiectasis and scarring from copd. no new opacity, no significant pleural effusion or edema, but prominent pulmonary arteries suggesting possible pulm artery hypertension. . ekg: unclear baseline in er. repeat on floor: afib at 83, poor r wave progression, old q in ii, iii, f, new twi v1-4. low voltage. no ste. . echo : the left atrium is elongated. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). the right ventricular free wall is hypertrophied. the right ventricular cavity is dilated. there is mild global right ventricular free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. brief hospital course: a/p: 84yo man with h/o cad, diastolic chf, copd, recent strep pna pneumonia s/p intubation and c diff colitis presented acutely with respiratory failure, right heart failure from massive pe, extensive le dvt, new afib who developed mrsa pneumonia and aspergilus. given his lack of improvement in respiration without mechanical ventilation or ability to maintain blood pressure without pressors his family made the decision to change goals of care to comfort. he passed away comfortably with his family at the bedside shortly after. 1. respiratory failure: this was due to massive pe with high dead space fraction of 92. fatigued so required intubation to support ventilation. initially requiring high minute-ventilation (ac 700x32) because of high dead space fraction, tolerating high rates despite copd. echocardiogram with rv strain on . no clear source of hypercoagulability such as known malignancy or prolonged immobility. unable to perform cta due to hemodynamic instability and anuric renal failure. he underwent lysis with tpa on , without any bleeding complications and had improvement in hemodynamics transiently. he then went for catheter directed thrombectomy on , and was found to have right-upper and left-lower main that were extracted with angiojet. these clots were thought to have been embolizstion from lysis of larger main pa clot. leni's were + so had retractable ivc filter placed by ir . he made only minimal improvement in his respiratory failure, and developed subsequent mrsa pneumonia, treated initially with vancomycin then linezolid. he also had aspergilus in his bal so was started on voriconazole. despite these measures he was not able to tolerate even a pressure support mode of ventilation due to his persistent high minute ventilation requirement. 2 fever/infection: developed despite tylenol, associated with increased pressor requirement, difficulty with ventialation (had to increase mv), co2 increased and ph decreased. suspected nosocomial infection (mrsa vap), ua + but culture just yeast, repeat cx after foley change neg. his cvc was changed despite all negative blood cultures. his ruq us showed gall stone with gallbladder distension, but subsequent ultrasounds showed improvement in this and the wall edema was attributed to anasarca. his lungs were ultrasounded twice to look for pleural effusions for thoracentesis but there was not enough fluid present to sample. ct scan of head, torso showed only source of infection likely was a rul cavitation which was treated with linezolid for mrsa and voriconazole for aspergilus. he was also treated with zosyn empirically and po vanco given recent history of c.diff colitis, despite negative c.diff toxin x3. id was consulted to exhaust all potential sources of infection. amylase and lipase were sampled periodically to assess for pancreatitis but were normal. 3 hypotension: pt became markedly hypotensive peri-intubation required maximizing levophed and addition of neosynephrine. bedside echocardiogram with markedly dilated rv with hypokinesis and + sign. blood pressure and pressor requirement transiently improved with systemic lysis but had another deterioration on in am. cardiology completed thrombectomy on with some improvement in hemodynamics. neosynephrine weaned . however, worsening pressor requirement thought related to infection/sepsis. he remained on levophed and vasopressin for hemodynamic support throughout his course. ivf resuscitation and empiric steroids did not allow his pressors to be weaned. furthermore any manipulation such as turning or cleaning caused him to drop his blood pressure despite pressor support. 4 pulmonary embolism: echocardiogram with rv strain on . no clear source of hypercoagulability such as known malignancy or prolonged immobility. unable to perform cta due to hemodynamic instability and anuric renal failure. underwent lysis with tpa on . then went for catheter directed thrombectomy on , found to have right-upper and left-lower main . he was treated with heparin drip with goal ptt 60-80 with ivc filter placement. . 5 leukocytosis: he was admitted with wbc of 30 from recent baseline of 20. this was initially thought related to underlying c.diff with stress reaction. his wbc rose with the development of his mrsa vap, but continued to climb despite antiobiotics and improvement in fever. given the severity of the leukocytosis and the number of bands and nucleated red blood cells the smear was reviewed by hem-on, with no unusal forms. this was thought to reflect the response to severe stress. 6 arf/atn: he was initially in anuric renal failure but this improved with early treatment of his obsturctive shock. his gfr then remained stable. 7 new afib: thought related to pe/right heart strain. he returned to sinus rhythm with occaisional runs of nsvt. 8 cad: his aspirin dose was decreased to 81mg daily, he was continued on his statin. 9 copd: home o2 2lnc. will need to administer aggressive mdi to decrease airway resistance. he was restarted on hydrocort given elevated airway resistance, which subsequently improved. 10 ppx: on heparin drip, ppi, bowel regimen, insulin sliding scale. medications on admission: aspirin 81 mg po qday atorvastatin 10 mg po daily fluticasone-salmeterol 500-50 mcg inhale twice a day. furosemide 40 mg po daily lorazepam 0.5 mg twice a day pepcid 20mg po qday prednisone 10 mg po daily tiotropium 18 mcg capsule, inhalation daily florasta 250mg po bid questran packet finished 2w course of po vanco and flagyl yesterday discharge medications: none. discharge disposition: expired discharge diagnosis: pulmonary embouls with severe obstructive shock, septic shock, mrsa pneumonia, aspergilus pneumonia. discharge condition: deceased. md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube interruption of the vena cava angioplasty of other non-coronary vessel(s) injection or infusion of thrombolytic agent arterial catheterization arteriography of pulmonary arteries procedure on single vessel diagnoses: hyperpotassemia anemia, unspecified pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified severe sepsis chronic airway obstruction, not elsewhere classified atrial fibrillation infection with microorganisms resistant to penicillins acute on chronic diastolic heart failure coronary atherosclerosis of unspecified type of vessel, native or graft other chronic pulmonary heart diseases acute respiratory failure hypotension, unspecified cardiogenic shock other specified septicemias septic shock intestinal infection due to clostridium difficile methicillin susceptible pneumonia due to staphylococcus aureus other pulmonary embolism and infarction leukocytosis, unspecified aspergillosis acute venous embolism and thrombosis of unspecified deep vessels of lower extremity other dependence on machines, supplemental oxygen 

Answer: The patient is high likely exposed to