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: history of present illness: mr. is an 83-year-old greek-speaking gentleman, who was at rehabilitation. he was transferred to the medical intensive care unit from on for hypotension and possible sepsis and then ruled in for a myocardial infarction. the patient has known coronary artery disease with a myocardial infarction in , and unstable angina, with catheterization in which showed 3-vessel disease (70% left main, 90% proximal right coronary artery, 95% distal right coronary artery, 70% ramus, and 50% second obtuse marginal). an adenosine mibi done at the same showed reversible inferior wall and lateral wall defects. the patient refused a coronary artery bypass graft at that time. the patient had a recent admission to hospital for urosepsis from to . during that time, he had intermittent angina with flat creatine kinase levels but with increased troponin i levels which peaked at 5.8. the patient completed a course of levofloxacin two days prior to admission. on the day prior to admission, the patient experienced some left-sided chest pain and was found to have a temperature of 100.6 degrees fahrenheit. the patient had complained of chills and diaphoresis and was noted to be tachycardic to 100. his blood pressure was 88/50. he was taken to the emergency department where he received ceftriaxone, vancomycin, and flagyl. his white blood cell count on admission was 38.2, and his initial creatine kinase was 287. electrocardiogram on admission showed a normal sinus rhythm at a rate of 75 with first-degree atrioventricular block and right bundle-branch block; which was unchanged from prior electrocardiogram. the patient was transferred to the medical intensive care unit where his blood pressure improved with fluid boluses and where he was maintained on antibiotics. the patient remained afebrile, and his white blood cell count decreased on antibiotics. the patient ruled in for a myocardial infarction with a creatine kinase that peaked at 642 and a troponin i that peaked at 1.68. the patient was placed on heparin and integrilin as well as aspirin and a beta blocker. his diuretics were held. the patient was sent directly to the cardiac catheterization laboratory from the medical intensive care unit for stenting of his right coronary artery lesion and was admitted from the cardiac catheterization laboratory to the cardiology floor. past medical history: 1. coronary artery disease. (a) status post non-st-elevation myocardial infarction in . (b) status post percutaneous transluminal coronary angioplasty in . (c) status post catheterization in which showed a 70% stenosis of the left main coronary artery, and 90% stenosis of the proximal right coronary artery, and 95% stenosis of the distal right coronary artery, and 70% stenosis of the ramus, and 50% stenosis of the second obtuse marginal. (d) adenosine mibi in showed reversible inferior wall and lateral wall defects. the patient has refused coronary artery bypass graft. 2. congestive heart failure (with an ejection fraction of 58%). 3. hypertension. 4. aortic stenosis with an aortic valve area of 0.87 cm2. 5. parkinson disease. 6. anemia. 7. gout. 8. paroxysmal atrial fibrillation. 9. spinal stenosis. 10. benign prostatic hypertrophy. 11. methicillin-sensitive staphylococcus aureus bacteremia in the past. 12. osteoarthritis. medications on admission: 1. neurontin 300 mg by mouth three times per day. 2. colace 100 mg by mouth twice per day. 3. finasteride 5 mg by mouth every day. 4. sinemet 25/100 by mouth three times per day. 5. simvastatin 40 mg by mouth once per day. 6. protonix 40 mg by mouth once per day. 7. heparin infusion. 8. enteric-coated aspirin by mouth once per day. 9. zosyn. 10. vancomycin. 11. integrilin infusion. allergies: the patient has no known drug allergies. social history: the patient lives at . his granddaughter is his health care proxy. the patient is wheelchair dependent due to his spinal stenosis. the patient is greek-speaking. of note, the patient has received all of his care at . physical examination on presentation: on physical examination, the patient's temperature was 98.1 degrees fahrenheit, his heart rate was 63 to 75, his blood pressure was 152/80, his respiratory rate was 16, and the patient's oxygen saturation was 100% on 2 liters of oxygen. physical examination was notable only for lungs which were clear anteriorly with no wheezes. cardiovascular examination was regular with a 4/6 systolic ejection murmur at the right upper sternal border with radiation to the carotids and heard throughout the precordium. the abdomen was obese with no masses or tenderness. there was 3+ peripheral edema bilaterally. it was difficult to evaluate the jugular venous pulsation due to the patient's obesity. pertinent laboratory values on presentation: on transfer to the floor, laboratories were notable for a white blood cell count of 18 (which had decreased from 38.2), his hematocrit was 27.4 (which had decreased from 32.1), and his creatinine was 1.2 (which had decreased from 1.4 on admission). concise summary of hospital course by issue/system: the patient was admitted to the cardiology service. 1. coronary artery disease issues: the patient has a history of coronary artery disease, status post non-st-elevation myocardial infarction in and 3-vessel disease (including left main disease). the patient ruled in for a myocardial infarction on this admission with a troponin t peak of 1.68 and a creatine kinase peak of 652. the patient was maintained on aspirin, statin, heparin, integrilin, and a beta blocker. the patient was taken to the cardiac catheterization laboratory on . this catheterization revealed left main 50% ostial and 50% distal lesions. left anterior descending artery with 40% mid vessel disease. left circumflex with an 80% ostial at the takeoff of the ramus. the right coronary artery was small and co-dominant with 70% to 80% lesion. moderate aortic stenosis. no intervention was pursued given the high ramus takeoff and the 50% left main disease. the patient was felt to be at too high a risk, and it was recommended that he be evaluated for a coronary artery bypass graft and aortic valve replacement. imdur was started status post procedure. the possibility of a coronary artery bypass graft was discussed with the patient who refused a coronary artery bypass graft and preferred medical management at this time. the patient was stabilized on the above cardiac medications with no further recurrence of chest pain or signs of ischemia. 2. hypertension issues: initially, the patient's antihypertensive medications were held due to his low blood pressure; however, they were restarted during this hospital stay without any adverse effects. 3. infectious disease issues: all blood cultures and urine cultures were negative throughout the hospital stay. the patient remained afebrile with no increased white blood cell count. therefore, his antibiotics were discontinued on . he remained without any signs of infection. 4. acute renal failure issues: the patient was noted to have an increased creatinine on admission; however, his creatinine decreased with intravenous fluids, suggesting a prerenal etiology. the patient was given mucomyst prior to catheterization, and his ace inhibitor and diuretics were held prior to catheterization and restarted prior to discharge. 5. decreased hematocrit issues: the patient was noted to have a hematocrit which decreased to 27.4. he did receive one unit of packed red blood cells in order to maintain his hematocrit above 30. his stools were guaiac-positive, but he was continued on his heparin and integrilin considering the setting of acute coronary syndrome. status post catheterization, the patient's hematocrit was 26.6, and he received an additional unit of packed red blood cells. the patient did require another additional unit of packed red blood cells prior to discharge in order to bring his hematocrit up to 33. 6. neurologic issues: when the patient was being evaluated for his coronary artery bypass graft, he did have a carotid ultrasound which showed bilateral internal carotid artery stenosis of 40% to 59%. 7. gastrointestinal issues: the patient was having some diarrhea during his hospital stay. he was found to be clostridium difficile toxin negative. he was found to be guaiac-positive. therefore, it was recommended that he have a colonoscopy done as an outpatient. 8. rhythm issues: the patient was noted to have some supraventricular tachycardia which was thought to be atrioventricular nodal reentrant tachycardia versus atrial tachycardia, which initially resolved on its own. however, the following day the patient did require some nodal filling . the patient was requiring lopressor and diltiazem in order to stay in a sinus rhythm. the patient's lopressor was titrated up in order to maintain him in a sinus rhythm with a slow rate. 9. genitourinary issues: the patient was complaining of some urinary discomfort on the day of discharge. a urinalysis was done which showed no signs of infection; therefore, the patient was discharged, and should this increase it should be followed closely. condition at discharge: condition on discharge was stable. discharge status: discharge status was to home. discharge diagnoses: 1. hypotension. 2. systemic inflammatory response. 3. non-q-wave myocardial infarction. 4. acute renal failure. 5. paroxysmal atrial fibrillation. 6. blood loss anemia. 7. iron deficiency anemia. 8. acute myocardial infarction. 9. coronary artery disease. 10. aortic stenosis. medications on discharge: 1. simvastatin 40 mg by mouth once per day. 2. carbidopa/levodopa 25/100 mg by mouth three times per day. 3. finasteride 5 mg by mouth once per day. 4. gabapentin 300 mg by mouth three times per day. 5. isosorbide mononitrate 60 mg by mouth once per day. 6. clopidogrel 75 mg by mouth once per day. 7. ferrous sulfate 325 mg by mouth once per day. 8. aspirin 325 mg by mouth once per day. 9. pantoprazole 40 mg by mouth once per day. 10. lisinopril 2.5 mg by mouth once per day. 11. toprol-xl 100 mg by mouth once per day. 12. toprol-xl 25 mg by mouth once per day. discharge instructions/followup: 1. the patient was instructed to follow up with dr. katsimaglis in cardiology. 2. the patient was instructed to follow up with his primary care physician (dr. at in one to two weeks to follow up his anemia, blood pressure, heart rate, and urinary symptoms. 3. the patient should have a colonoscopy to evaluate his low hematocrit and his guaiac-positive stools. procedures performed: cardiac catheterization. , m.d. dictated by: medquist36 d: 16:09 t: 07:47 job#: procedure: venous catheterization, not elsewhere classified coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization diagnoses: subendocardial infarction, initial episode of care congestive heart failure, unspecified acute kidney failure, unspecified iron deficiency anemia secondary to blood loss (chronic) atrial fibrillation blood in stool systemic inflammatory response syndrome due to noninfectious process with acute organ dysfunction other specified hypotension congenital stenosis of aortic valve 

Answer: The patient is high likely exposed to