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: transfer from osh c severe sepsis major surgical or invasive procedure: -intubation -central venous line placement -arterial line placement history of present illness: this is a 74 y.o. male with history of adrenal insufficiency, hypothyroidism, paranoid schizophrenia, and dm ii presenting with sepsis of unclear etiology. on the day prior to admission the patient's family reports he had decreased po intake as well as congestion symptoms. last night his family noted that he was a little weak and put him to bed. although he did not complain of any fevers his family noted that he was extremely cold to the touch and gave him several blankets and heating blankets to help him stay warm. the next day they noted that he was awake but was not verbal. given this he was taken to ed. at he was noted to be very hypotensive to 40s-50s. he was given solumedrol 125mng x 1, he was also noted to be bradycardic to 40s and received atropine. azithromycin, zosyn were initiated and a headct was performed which was negative. he was also intubated and started on dopamine, levophed and neo. . in the , pt was given 2gm of vancomycin and 750mg of levofloxacin. he was also given stress dose steroids of hydrocortisone 100mg iv x 1, peep was increased to 10 and pt was set on ardsnet protocol. he also received a total of 8l of ns. his labs were notable for leukopenia, thrombocytopenia 116, creatinine 3.7, bun 93. troponin was noted to be 0.06 with a ck of 1836 and ck-mb that was pending. urine and serum tox were negative. abg obtained after intubation noted to be ph 7.28, pco2, 43, o2 60, hco3 21 on peep of 5 that was increased to 10. . review of systems: unable to obtain ros intubation past medical history: paranoid schizophrenia (unable to care for self at baseline) htn dm ii copd h.o. pna requiring hospitalization nephrectomy mild cri social history: pt lives with family at home. per pcp family is not able to care for pt adequately and home is in disrepair and has been investigated by department of health with consideration for condemning the property family history: noncontributory physical exam: general: elderly caucasian male intubated in nard. psych: localizes to pain, opens eyes to verbal stimuli heent: sclera anicteric, mmm neck: difficult to eval jvp given ij lungs: crackles noted diffusely on anterior exam with diminished crackles over left lung field. cv: borderline bradycardic (50), s1 + s2, no murmurs, rubs, gallops abdomen: no grimacing noted on abdominal palpation, non-distended, obese, + bowel sounds present, no rebound tenderness or guarding left groin: hematoma noted from femoral line placement, appears better rn from ed after warm compress ext: 2+ edema noted in all extremities. pertinent results: labs on admission: 06:50pm blood wbc-2.6* rbc-3.77* hgb-11.2* hct-35.7* mcv-95 mch-29.7 mchc-31.4 rdw-17.1* plt ct-116* 06:50pm blood neuts-37* bands-29* lymphs-27 monos-1* eos-0 baso-0 atyps-0 metas-4* myelos-2* 06:50pm blood hypochr-normal anisocy-1+ poiklo-occasional macrocy-1+ microcy-normal polychr-normal burr-occasional 06:50pm blood pt-12.8 ptt-32.7 inr(pt)-1.1 06:50pm blood fibrino-623* 06:50pm blood glucose-332* urean-93* creat-3.7* na-145 k-4.8 cl-107 hco3-22 angap-21* 06:50pm blood alt-74* ast-109* ck(cpk)-1836* alkphos-59 totbili-0.2 06:50pm blood ck-mb-230* mb indx-12.5* 06:50pm blood calcium-8.3* phos-4.5 mg-2.3 from osh: blood culture 2/4 bottles growing 2 species of coag neg staph urine cx growing >100,000 vre sensitive to ampicillin, daptomycin and linezolid gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 3+ (5-10 per 1000x field): multiple organisms consistent with oropharyngeal flora. 2+ (1-5 per 1000x field): budding yeast with pseudohyphae. respiratory culture (preliminary): further incubation required to determine the presence or absence of commensal respiratory flora. yeast. moderate growth. acinetobacter baumannii complex. sparse growth. sensitivities: mic expressed in mcg/m _________________________________________________________ acinetobacter baumannii complex | ampicillin/sulbactam-- =>32 r cefepime-------------- 32 r ceftazidime----------- =>64 r ciprofloxacin--------- =>4 r gentamicin------------ 8 i imipenem-------------- 2 s tobramycin------------ <=1 s trimethoprim/sulfa---- =>16 r urine culture (final ): enterococcus sp.. >100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ enterococcus sp. | ampicillin------------ <=2 s linezolid------------- 2 s nitrofurantoin-------- <=16 s tetracycline---------- =>16 r vancomycin------------ =>32 r brief hospital course: this is a 74 y.o. male with h.o. hypothyroidism p/w septic shock, nstemi, hypothermia with suspected pulmonary versus urine source. ##. septic shock: pt noted to be in septic shock on admission to the ed on multiple pressors. per family pt has a history of pna versus aspiration pna, hospitalized three times over the past year and also had dirty ua and ?pna on cxr from ed. pt was initially started on zosyn, cipro and vancomycin for broad coverage in this frequently hospitalized pt in addition to pressors and xygris given pt's high apache score. stress dose steroids were also started as pt was on dexamethasone as outpt per his med list. influenza antigen and legionella antigen were sent and were negative. pressors able to be weaned and antibiotics switched to linezolid for vre in urine and meropenem for acinetobacter in sputum. antibiotic course was completed on . ##. respiratory failure: pt arrived intubated in ventilatory failure believed to be pna versus ards from urosepsis. this was complicated by fluid overload in the setting of volume repletion. pt's infections were treated and pt was diuresed aggressively with resolution of pulmonary edema at time of discharge. tracheostomy tube placed on . secretions continued to be a problem so t-tube kept in place. # : baseline cr of 1.8-2, which slowly rose to 4.6. etiology was believed to be atn secondary to hypotension in setting of septic shock. renal functions improved with creatinines trending towards baseline (baseline is 1.8-2.0, at time of discharge was 2.3). home lasix, glyburide, flomax, lubripristone, fenofexadine, verapamil held. ##. nstemi: pt showed no ischemic ekg changes in the ed but cardiac enzymes were noted to be positive with a ck of 1836, ckmb 230, ckmbi 12.5, troponin 0.06. twi in i, avl, q in lead iii, small r-wave and avf inferiorly. pt ruled in, likely ischemic from his prolonged episode of hypotension. aspirin was initially held as pt had been started on xygris, but asa was restarted once xygris course completed. in future could consider adding ace inhibitor as renal function resolves. did not start beta blocker given episodes of bradycardia. ##. bradycardia: pt noted to be bradycardic, requiring atropine in the field for hr in the 40s. bradycardia initially thought to likely be due to his hypothermia. however, had additional episodes of sinus bradycardia periodically, particularly in the evening. improved during hospital course, with patient maintaining normal sinus rhythm with regular rate at time of discharge. # anemia: pt??????s hematocrit trended down throughout first few days of admission. likely aggressive fluid hydration. pt does also have h/o peptic ulcers, and was on xygris which increases risk of gib, however, stool and ng aspirate both guiac negative, there was no evidence for rp bleed or intracranial bleed. pt was maintained on ppi and active type and screen maintained. pt was transfused one unit on and his hematocrit did bump appropriately. anemia thought to be secondary to renal failure. was not actively bleeding and hct was stable at time of discharge. #. hypothyroidism: continued on home levothyroxine . #schizophrenia: intially held clozaril and perphenazine while intubated and sedated. pt was then started on linezolid so clozaril and perphenazine were held for concern for seratonin syndrome. linezolid course was completed on . clozaril should be held another 2 weeks, at least, and could be restarted on as long as patient is not sedated. can be continued on perphenazine per home dose. . #copd: continue atrovent and albuterol prn, usually on nebs but switched to inh while intubated. . #? adrenal insufficiency: on dexamethasone 2mg at home, hydrocortisone was initially started at stress doses and then weaned down and eventually transitioned back to dexamethasone. pt can follow up c his pcp regarding whether he will need to continue dexamethasone (this diagnosis is very recent and did not seem definite based on osh records). . # dm: pt with known dm type 2. initially placed on insulin drip as it was felt that his skin was likely too edematous to get good absorption of sc insulin (target range for gtt was 150-200). after diuresis pt was placed on sc insulin. # sw: sw consulted for regarding safety of pt's living situation. they felt that placement at home would not be a good idea and should go to rehab and be further evaluated for placement at time of discharge from rehab. # prophylaxis: subcutaneous heparin , bowel reg # code: full pcp dr medications on admission: per pt list: lasix 40 levothyroxine 50 mcg daily glyburide 2.5 daily amitiza 24 mcg (lubiprostone) flomax 0.4 mg fexofenadine verapamil 120 perphenazine 4 clozaril 200 (recent dc summary says 100??) asa 81 centrum "cenna plus?" dexamethasone 2mg atrovent nebs albuterol nebs discharge medications: 1. docusate sodium 50 mg/5 ml liquid : one (1) po bid (2 times a day). 2. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day). 3. heparin (porcine) 5,000 unit/ml solution : one (1) injection tid (3 times a day). 4. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 5. perphenazine 2 mg tablet : two (2) tablet po bid (2 times a day). 6. levothyroxine 50 mcg tablet : one (1) tablet po daily (daily). 7. dexamethasone 2 mg tablet : one (1) tablet po daily (daily). 8. amlodipine 5 mg tablet : two (2) tablet po daily (daily). 9. chlorhexidine gluconate 0.12 % mouthwash : one (1) ml mucous membrane (2 times a day). 10. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr po bid (2 times a day). 11. ipratropium bromide 17 mcg/actuation aerosol : six (6) puff inhalation qid (4 times a day). 12. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler : six (6) puff inhalation q4h (every 4 hours) as needed for wheeze. discharge disposition: extended care facility: - discharge diagnosis: 1) uro/pneumo sepsis 2) ventilator acquired pneumonia 3) s/p tracheostomy and peg tube placement discharge condition: stable for discharge to rehab. good saturation on 60% fio2 via t-tube. discharge instructions: you were admitted to the icu because you had a severe infection in your urine and in your lungs that caused your blood pressure to fall. while in the icu, we treated you for this by giving you fluids and giving you antibiotics (linezolid and meropenem) for these infections, of which you completed the course. because you had trouble breathing, we started you on a breathing machine. over the course of several days, your infection began to clear, your fevers improved, and your blood pressure returned to normal. you were also getting better at breathing so we took you off the ventilator and put in a tracheostomy, which allows us to give you oxygen safely. when you go to rehab, they will assess you daily to see when your tracheostomy can be safely removed or whether your peg tube can come out once you can safely take food by mouth. . the following medication changes were made: (1) because of renal failure, we stopped your lasix. as your renal failure begins to clear, this can be restarted. (2) we stopped your glyburide because of your renal failure. (3) we stopped your home dose of flomax because of your renal failure. (4) we stopped your verapamil b/c of your renal failure. (5) we stopped your clozaril, because in combination with the linezolid, this can cause your white blood cell count to drop. you can restart clozaril on . (6) you should continue to take perphenazine 4 mg as at home; this can also be given prn for agitation. (7) you should start lansoprazole which protects your stomach from getting irritated. followup instructions: 1) monday, you should follow up with pulmonary with dr . his office is located on the in the building. (2) please follow up with renal on tues am with dr . this is located in the building on the . (2) you should follow up with your primary care physician and your outpatient psychiatrist within 1 month of discharge. you will need to have these appointments scheduled. md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more other gastroscopy enteral infusion of concentrated nutritional substances injection of steroid percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy injection of antibiotic injection of antibiotic bronchoscopy through artificial stoma transfusion of packed cells injection or infusion of oxazolidinone class of antibiotics injection of insulin infusion of drotrecogin alfa (activated) diagnoses: acidosis hyperpotassemia anemia in chronic kidney disease subendocardial infarction, initial episode of care pneumonia due to other gram-negative bacteria acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified acute posthemorrhagic anemia unspecified protein-calorie malnutrition severe sepsis unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, unspecified pulmonary collapse hemorrhage complicating a procedure acute respiratory failure other specified septicemias septic shock other complications due to other vascular device, implant, and graft hyperosmolality and/or hypernatremia streptococcal septicemia surgical or other procedure not carried out because of contraindication acquired absence of kidney diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled paranoid type schizophrenia, chronic other tracheostomy complications methicillin resistant pneumonia due to staphylococcus aureus other adrenal hypofunction benign neoplasm of stomach hypothermia not associated with low environmental temperature other specified diseases of the salivary glands 

Answer: The patient is high likely exposed to