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: no known allergies / adverse drug reactions attending: chief complaint: impacted food bolus major surgical or invasive procedure: upper endoscopy r ij placement history of present illness: history of present illness: mr. is a 81 year old gentleman with dementia and history of aspiration, presenting from nursing home with food bolus impaction, admitted to micu for urgent upper endoscopy. patient was supposed to be on liquid diet at nursing home and ate a hamburger. he originally presented to osh, where he was given glucagon and nitro with minimal effect, but was transfered to for further management. . of note, he was hospitalized recently at osh for rll pneumonia, thought to be secondary to aspiration. . in the ed, initial vs were as follows: 97.4 123 138/76 91% 2l nasal cannula. patient was noted to be drooling and spitting up some pieces of meat. airway was intact. patient was awake and responsive. cxr showed copd with patchy opacities in setting of bronchiectasis which could represent aspiration, and no radiopaque foreign bodies appreciated. vitals in ed prior to transfer to icu were as follows: 97 117/74 97% 3l nc. . on arrival to the icu, patient appeared comfortable. he was noted to have occasional dry cough. denied fevers, shortness of breath, chest pain, abdominal pain, sore throat. past medical history: - dementia - dysphagia - bph - right inguinal scrotal hernia - history of aspiration pneumonia social history: lives in den nursing home, dependent on 24hr caregivers. is hcp. dnr/. per last discharge summary from osh, patient has no recent smoking or alcohol. family history: unable to obtain due to patient's dementia. physical exam: on addmission vitals: t: 99.4 bp: 112/49 p: 117 r: 29 o2: 95% 2.5l nc general: alert, oriented to "hospital" and self, no acute distress heent: sclera anicteric, dry mucus membranes, oropharynx clear neck: supple, jvp not elevated, no lad lungs: harsh crackles in lll cv: regular rhythm, rate rapid, 2/6 systolic murmur loudest at apex abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, no leg edema on discharge: pe: t97.3, bp106/60, h63, r16, s94%ra gen: aaox1, nad, lying comfortably in his hospital bed. cardiac: rrr, +2/6 systolic murmur loudest at apex pulm: ctab anteriorly, good air entry. abd: s/nt/nd, normoactive bs, no hsm, no rebound or guarding. ext: all 4 extremeities warmer to touch, no cce. gu: has foley placed neuro: a+o x1, responds to greeting, unchanged, +masked facies. pertinent results: 08:40pm glucose-154* urea n-17 creat-1.1 sodium-140 potassium-4.5 chloride-103 total co2-25 anion gap-17 08:40pm wbc-11.2* rbc-4.96 hgb-15.7 hct-45.0 mcv-91 mch-31.7 mchc-35.0 rdw-13.7 08:40pm neuts-80.6* lymphs-15.1* monos-3.1 eos-0.6 basos-0.7 02:41 40.9* cortisol mrsa screen (final ): positive for methicillin resistant staph aureus. upper endoscopy : erythema in the whole esophagus. no impacted food noted in esophagus. large hiatal hernia otherwise normal egd to stomach antrum. cxr : impression: copd with patchy opacities in both lung bases in the setting of bronchiectasis, which could represent infection, inflammation or aspiration. probable trace right pleural effusion. enlargement of the hila may reflect pulmonary arterial hypertension. no radiopaque foreign bodies were identified. 07:15am blood wbc-5.2 rbc-3.74* hgb-12.2* hct-33.7* mcv-90 mch-32.6* mchc-36.1* rdw-13.1 plt ct-148* 07:15am blood glucose-87 urean-13 creat-1.2 na-139 k-3.7 cl-108 hco3-27 angap-8 07:15am blood calcium-7.9* phos-2.3* mg-2.1 brief hospital course: 81m with hx of dementia presenting with drooling and inability to take pos, presumed to have food bolus impaction in esophagus, admitted to micu for urgent endoscopy. . # impacted food bolus: patient was admitted to micu for urgent endoscopy to remove suspected impacted food bolus. gi preformed upper endoscopy and did not observe any residual food in the esophagus, but did show a large amount of erythema. it was recommended to follow-up with endoscopist within 6 weeks, and to avoid chocolate, peppermint, alcohol, caffeine, onions, aspirin. elevate the head of the bed 3 inches. he is to go to bed with an empty stomach and take a ppi. . # likely aspiration pneumonia vs pneumonitis: patient had a history of dysphagia and aspiration pneumonia presenting with mildly elevated wbc, low grade temperature and hypoxia. because patient was a nursing home resident with history of aspiration pneumonia and low reserve, it was elected to treat as pneumonia covered broadly with vanc/zosyn for an 7 day course, which completed and his symptoms resolved. he has been afebrile over the last 4 days prior to discharge and has been saturating well. he was evaluated by speech who did not find any evidence of dysphagia, so he was put on a mechanical soft diet with thin liquids. he was also kept on aspiration precautions and the head of his bed was kept at 45 degress. . # bradycardia/hypotension: patient was noted to have intermittent heart rates to the 40s with systolics in the 80s. he never exhibited any symptoms during these episodes, continuing to mentate at his baseline. ekgs showed 1st degree av block. patient had a random cortisol of 40.9 suggesting he was not adrenally insufficient. on the floor, his sbp averaged 95-110 and his heart rate was around the 60s. he was not symptomatic at all during this time. . # bph his proscar and flomax were initially held, however once he was cleared by speech and swallow they were restarted. . # psych: unclear whether patient has psychiatric history but is on depakote and abilify as an outpatient at nursing home. pshyc meds delivered via ng tube while patient was npo and then transition ed to po once he was able to tolerate taking pills. ___________________________________________ pending: -none ___________________________________________ transition of care: -pt has a follow up appointment with gi on 01:00p gi, ra (/ complex), gi clinic (sb) medications on admission: - abilify 10mg po daily - depakote 125mg po tid - ativan 0.25mg po bid prn anxiety - trazodone 50mg po at bedtime - proscar 5mg po daily - flomax 0.4mg po daily - prn acetaminophen - prn milk of mag - prn fleets enema - prn dulcolax - prn immodium discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aripiprazole 10 mg tablet sig: one (1) tablet po daily (daily). 3. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. tablet(s) 4. divalproex 125 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po tid (3 times a day). 5. tamsulosin 0.4 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po hs (at bedtime). 6. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 7. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain, fever. 8. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po daily prn () as needed for constipation. 9. imodium a-d 2 mg tablet sig: one (1) tablet po once a day as needed for constipation. 10. ativan 0.5 mg tablet sig: 0.5 tablet tablet po twice a day as needed for anxiety: prn anxiety. 11. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day: take 30 minutes before breakfast. disp:*30 capsule, delayed release(e.c.)(s)* refills:*5* discharge disposition: extended care facility: rehabilitation & nursing center - discharge diagnosis: primary diagnosis: food impaction hospital acquired pneumonia discharge condition: awake and oriented to person. level of consciousness: alert and interactive. discharge instructions: it was a pleasure taking care of you during this hospitalization. you were brought to the hospital because it was thought that you had a piece of food stuck in you throat. we looked down your throat with a scope and we did not see any food. you were found to have inflammation of your esophagus. we have you a medication called omeprazole to help with this inflammation. we also thought that you had pneumonia. we gave you antibiotics through your veins for 7 days and your symptoms have improved. you do not need anymore antibiotics. we hope you continue to feel better. medications changes: start: omeprazole 40mg daily- this is a medication for the inflammation in your throat. followup instructions: please make sure to see your primary care doctor in the next 2 days. department: div. of gastroenterology when: tuesday at 1 pm with: , md building: ra (/ complex) campus: east best parking: main garage procedure: other endoscopy of small intestine central venous catheter placement with guidance diagnoses: unspecified septicemia severe sepsis hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) other persistent mental disorders due to conditions classified elsewhere diaphragmatic hernia without mention of obstruction or gangrene pneumonitis due to inhalation of food or vomitus septic shock do not resuscitate status esophagitis, unspecified inguinal hernia, without mention of obstruction or gangrene, unilateral or unspecified (not specified as recurrent) 

Answer: The patient is high likely exposed to