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: fall major surgical or invasive procedure: : s/p open reduction internal fixation, left hip. history of present illness: 88 year old male s/p fall resulting in a left hip fracture requiring surgical management. past medical history: alzhiemers hypertension hypercholexterolemia bph social history: nursing home patient, no alcohol, tobacco or drug use family history: n/a physical exam: temp:96.3 hr:97 bp:138/78 resp:16 o(2)sat:94 constitutional: awake, agitated heent: pupils equal, round and reactive to light, extraocular muscles intact oropharynx within normal limits c-collar in place chest: clear to auscultation abdominal: soft, nontender, nondistended gu/flank: no costovertebral angle tenderness extr/back: no cyanosis, clubbing or edema neuro: unable to answer basic questions. moves all extremities pertinent results: 06:00pm glucose-134* urea n-18 creat-0.6 sodium-144 potassium-4.0 chloride-108 total co2-27 anion gap-13 06:00pm estgfr-using this 06:00pm wbc-5.5 rbc-3.44* hgb-10.6* hct-31.8* mcv-92 mch-30.8 mchc-33.4 rdw-14.3 06:00pm neuts-69.4 lymphs-19.4 monos-9.9 eos-0.6 basos-0.8 06:00pm plt count-177 06:00pm pt-13.2 ptt-21.4* inr(pt)-1.1 brief hospital course: summary: mr. is an 88 year old gentleman with a past medical history significant for hyperlipidemia, hypertension, and dementia admitted for a fall with a left hip fracture on s/p orif on with hospital course complicated by tachycardia, hypotension, and hypoxia. . hip fracture s/p orif: pt. tolerated the procedure well after with no major complications from the surgery. orthopedic surgery followed him during his admission and they recommended weight-bearing activity on the left leg. his dressings on his left leg were changed twice a day to reduce the risk of infection to the joint. in addition, they recommended follow-up in 2 weeks post-operatively. . hypoxia: post-operatively, the patient had one episode of aspiration. his o2 saturations were persitently low after this event and he was unreposnsive to neublizer treatments. he was transferred to the micu on due to persistently low o2 saturations. after transfer to the micu, the patient was found to have a bibasilar infiltrates that were concerning for an aspiration event. he was started on vancomycin and cefepime in the unit for concern for possible hospital-acquired pneumonia in addition to his recent aspiration event. once his o2 saturations were stable, he was transferred back to the medicine floor. his antibiotics were changed from cefepime to zosyn because this antibiotic had better anaerobic coverage. he was continued on the vancomycin and zosyn and he remained afebrile during his time out of the intensive care unit. he should continue vancomycin (day 7) and zosyn (day 5). for a 10 day course. . tachycardia: had intermitent atrial flutter in setting of his recent orif and his aspiration pneumonia. he was started on telemetry when he was transferred to the micu. we discontinued his home dose of amlodipine and started av nodal blockade with metoprolol 10mg iv q6h in the micu. his heart rate declined into the after he was started on iv metoprolol. there were no acute changes on telemetry after his transfer to the unit. he can be switched to metoprolol by mouth twice a day once he is able to tolerate po intake. . urinary retention: pt. had distended bladder after he was transferred from the micu. he had a bladder scan that showed greater than 1l in his bladder. pt. was noted to have hyospadias on examination and a small urethra. he was maintained on his home dose of terazosin. a 14 coude catheter was placed with some difficulty into the urethra and his urine output has been adequate since the foley was placed. he should follow-up with urology as an outpatient. . delirium: likely multifactorial, with contributing factors including aspiration pneumonitis/hcap, recent surgery, hearing loss, and hospital admission. geriatrics was consulted and they recommeded zydis to control his delirium. we started with low doses of zydis and his medication was adjust so that he takes zydis at 10mg qhs and increased to 5mg in the mornings yesterday and zydis 2.5mg q6h prn agitation. . nutrition: was unable to take food by mouth post-operatively d/t risk of aspiration. speech and swallow evaluated the patient and agreed after his aspiration event that it was safer to keep the patient npo than to give him food. he was started on ppn on . nutrition recommended switching over to tpn until his mental status improved. a picc line was placed on to deliver antibiotics. the picc line will also be his main access for nutrition with tpn. . neck pain: pt. currently in soft collar. there was concern about injury to the cervical spine on admission. an mri was ordered, but was not completed during the admission because the patient developed worsening shortness of breath and was sent to the intensive care unit. neurosurgery followed the patient and there were no signs of fracture/misalignment based on ct scan on admission. they recommended continuing with a soft collar and having the patient follow-up in 1 to 2 weeks. on ct scan, there was a large hypodense right thyroid lobe lesion, measuring 3.0 x 1.3 cm. you should see your primary care physician to discuss this finding further. . htn: amlodipine was discontinued during hospitalization. metoprolol was started for better rate control and some blood pressure control. . bph: continued home dose of finasteride and terazosin. a foley catheter was placed and continues to drain clear urine. . hyperlipidemia: continued atorvastatin throughout admission. . ppx: enoxaparin. will continue for 4 weeks post-operatively from . access: picc line placed on code: full medications on admission: outpatient medications: 1. amlodipine 5mg po 2. finasteride 5mg po 3. lovastatin 40mg po 4. terazosin 2mg po discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. senna 8.6 mg tablet sig: one (1) tablet po hs (at bedtime). 3. atorvastatin 20 mg tablet sig: two (2) tablet po daily (daily). 4. enoxaparin 40 mg/0.4 ml syringe sig: one (1) subcutaneous daily (daily). 5. alum-mag hydroxide-simeth 200-200-20 mg/5 ml suspension sig: 15-30 mls po q6h (every 6 hours) as needed for dyspepsia. 6. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po bid (2 times a day) as needed for constipation. 7. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 8. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 9. terazosin 1 mg capsule sig: two (2) capsule po hs (at bedtime). 10. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 11. oxycodone 5 mg capsule sig: one (1) capsule po every four (4) hours as needed for pain. 12. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 13. acetaminophen 325 mg tablet sig: two (2) tablet po q 8h (every 8 hours). 14. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po daily (daily). 15. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 16. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed for thrush. 17. bisacodyl 10 mg suppository sig: one (1) suppository rectal hs (at bedtime) as needed for constipation. 18. olanzapine 5 mg tablet, rapid dissolve sig: two (2) tablet, rapid dissolve po qhs (once a day (at bedtime)). 19. olanzapine 5 mg tablet, rapid dissolve sig: 0.5 tablet, rapid dissolve po q6h (every 6 hours) as needed for agitation. 20. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po qam (once a day (in the morning)). 21. metoprolol tartrate 10 mg iv q6h hold for sbp < 100 or hr < 60 22. vancomycin 500 mg recon soln sig: one (1) recon soln intravenous q 12h (every 12 hours): please give 1250mg iv q12hrs. 23. piperacillin-tazobactam-dextrs 4.5 gram/100 ml piggyback sig: one (1) intravenous q8h (every 8 hours). discharge disposition: extended care facility: nursing home - discharge diagnosis: left hip fracture s/p orif delirium aspiration pneumonia discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear mr. , you were admitted for hip fracture on . during your hospitalization, you had an open reduction internal fixation of your hip on . after your surgery, however, your hospital course was complicated by persistently low oxygen levels in your blood and low blood pressure. you were transferred to the medical intensive care unit for further management and you were found have an aspiration pneumonia. you were started on two antibiotics known as vancomycin and zosyn. you should complete a full antibiotic course for 14 days. you are currently on day 8 of vancomycin and day 6 of zosyn. . you were evaluated by speech and swallow and they believe that you are at high risk of aspiration when you ingest food. therefore, we kept you without food during your hospital admission. we ordered a nutrition consult and they recommended starting total parenteral nutrition. nutrition has made several recommendations and these recommendations are available for review on page 1 of the discharge paperwork. . in addition, a geriatrics consult was ordered to evaluate your delirium post-operatively and they made several additions to your home medication that will help to control the delirium more effectively. the medication recommended was zydis and the dosages can be found on the attached medication list. . during your hospitalization, the orthopedic surgeons followed you post-operatively and they recommended keeping your incision clean and dry with daily dressings. they also encouraged physical therapy to work with you in the post-operative period and you are encouraged to be full weight-bearing on the left leg. . please follow-up to see your orthopedic surgery in 2 weeks. in addition, you should also continue to wear a soft collar until you complete an mri of your cervical spine as an outpatient. followup instructions: you should follow up in 2 weeks in the clinic with , np. please call to make this appointment. md procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances open reduction of fracture with internal fixation, femur diagnoses: pure hypercholesterolemia unspecified essential hypertension cardiac complications, not elsewhere classified unspecified fall unspecified transient mental disorder in conditions classified elsewhere atrial flutter hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) pneumonitis due to inhalation of food or vomitus other respiratory complications retention of urine, unspecified alzheimer's disease hyperosmolality and/or hypernatremia nutritional marasmus closed fracture of intertrochanteric section of neck of femur 

Answer: The patient is high likely exposed to