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: penicillins / sulfa (sulfonamides) / flomax attending: chief complaint: pna major surgical or invasive procedure: none history of present illness: mr. is an 87 yom nh resident with pmh of alzheimer's dementia and no known lung disease or smoking history who initially presented to for sob and dyspnea after being found with a sat of 83% at his nh on room air. other vs included tachycardia and a fsg of >400. at that time he complained of n/v and by report, was incontinent of b/b, and more confused than baseline. he was brought to and treated overnight for presumed chf with lasix 40 mg. he was also given a dose of levaquin for pna. he was also found to have a wbc of 23 and new renal insufficiency with cr 2.4. a ck was elevated at 2800. he was transferred to for further w/u of pna, as well as concern for r/o mi if possible need for cath. . in the ed, vs were rectal temp of 102, 126/79, 110, 96% nrb at 10l, rr 25; appeared comfortable. didn't sound wet on exam, with no edema, and no obvious volume overload on cxr here. probnp was 3600. however, his cxr was concerning for a retrocardiac infiltrate. blood cultures were drawn, and they added vanco in addition to levofloxacin b/c of his nh status and concern for pna. his tachycardia prompted consideration of pe, but he could not receive a ct-a due to his poor renal function. a v/q scan was ordered. was not heparinized empirically b/c he was found to be guiaic positive. finally, a ct head was performed for ? altered ms, which was negative for acute bleed or fracture. past medical history: # polymyalgia rheumatica - not recently on any steroids # gerd # h/o collagenous collitis # alzheimer's dementia # turp-- 20+ years ago social history: no etoh or tobacco history. married, retired, lives at ( ). at baseline, is alert and verbal but with confusion/dementia (oriented to person only). ambulates independently with walker, able to feed himself. family history: no cad, father w/ memory problems at 90's; physical exam: vs: 97.0 109 (sinus tach) 142/102 23 92% on nrb--> weaned to 92% on 5l nc gen: elderly male, nad, a+o x 1 heent: nc/at, pale cor: rrr resp: ctab abd: s/nt/nd/ +bs ext: wwp, no c/c/e pertinent results: 09:10am blood wbc-14.0* rbc-4.97 hgb-16.0 hct-45.1 mcv-91 mch-32.3* mchc-35.6* rdw-14.5 plt ct-186 12:39pm blood wbc-13.0* rbc-4.64 hgb-15.4 hct-41.6 mcv-90 mch-33.1* mchc-37.0* rdw-14.3 plt ct-186 05:10am blood wbc-10.4 rbc-4.30* hgb-13.8* hct-38.4* mcv-89 mch-32.1* mchc-36.0* rdw-14.3 plt ct-190 . 09:10am blood pt-14.8* ptt-29.3 inr(pt)-1.3* 12:39pm blood pt-14.3* ptt-27.3 inr(pt)-1.2* . 12:39pm blood glucose-189* urean-80* creat-3.2*# na-146* k-4.1 cl-109* hco3-21* angap-20 05:10am blood glucose-141* urean-67* creat-2.4* na-153* k-3.4 cl-119* hco3-22 angap-15 . 12:39pm blood ck(cpk)-1873* ck-mb-16* mb indx-0.9 ctropnt-0.06* 05:10am blood ck(cpk)-779* ck-mb-8 ctropnt-0.06* . 08:28am blood probnp-3653* . 08:33am blood lactate-2.4* . studies . cxr left retrocardiac opacity concerning for pneumonia. . head ct no acute intracranial hemorrhage or fracture. . cxr ap and lat 1. new opacity right mid/upper zone--?aspiration or pneumonic infiltrate. 2. suspect left lower lobe infiltrate. 3. lower lobe effusion on at least one side, ? bilateral . chest ct multifocal bilateral lung consolidation and ground glass changes involving all lobes worse at the right apex and bases. pneumonic consolidations and/or aspiration events should be considered with debris noted within the esophagus. small bilateral pleural effusions. . cxr brief hospital course: 87 year-old man, nursing home resident, presenting with health-care associated pneumonia, acute renal failure, and hypernatremia. . 1. health-care associated pneumonia. he was admitted initially to the icu for monitoring in the setting of pneumonia and hypernatremia. cxr showed retrocardiac opacity. he was covered broadly with vancomycin, ceftazadime, and azithromycin. on the second hospital day, his oxygen saturations had improved and he was transferred to the floors on 2l oxygen by nasal cannula. over the weekend, he was continued on vanco/ceftaz but was noted to have increased tachypnea, tachycardia, fevers to 101, and worsening mental status. his antibiotic coverage was broadened to flagyl for anaerobes (given concern of aspiration risk) as well as azithromycin and he was transferred back to the intensive care unit, while in the unit he was intubated. his blood pressures continued to drop and he required fluids to maintain them. when they , attempt was made to diurese the patient with lasix. he had good output, but remained non-responsive despite no sedation. per the family, a decision was made to extubate the patient. his breathing became agonal and 12 hours later he expired. . 2. acute renal failure. he was admitted with creatinine of 3.2 up from baseline 1.2-1.4. his acute renal failure resolved with iv hydration. . 3. rule-out myocardial infarction. he received one dose of asa in the ed. there was low suspicion for acs. cardiac enzymes were negative x2. . 4. diabetes mellitus. he has no diagnosis of diabetes but his sugars during this admission were elevated. his hga1c was 6.3. he was kept on insulin sliding scale. . 5. dementia we continued his outpatient namenda. . 6. hypernatremia. this was believed due to hypovolemia in the setting of overdiuresis and aggressive rehydration with normal saline. on transfer to the floor, he was started on d5 1/2 ns for volume resuscitation and correction of hypernatremia. sodium levels were followed every six hours to avoid overcorrection. when his creatinine normalized, ivf were switched to d5w at 150 cc hour. with this treatment, his sodium gradually corrected. . 7. polymyalgia rheumatica. this was not actively being treated at time of admission. . # fen -- hh dm diet if able to tolerate po -- s/s consult as appears to be aspirating . # access -- piv . # code: -- full per nh documents . # comm: -- -- wife or . # dispo: transfer to floor medications on admission: namenda 10 daily kcl 20meq daily lasix 20mg daily omega 3 mvi prilosec 20 sertraline 50 qhs senna/colace compazine 25mg pr daily discharge medications: na discharge disposition: expired discharge diagnosis: expired secondary to: multifocal health-care associtated pneumonia . secondary diagnoses alzheimer's dementia polymyalgia rheumatica gastroesophageal reflux disease history of collagenous colitis history of transurethral resection of the prostate discharge condition: vital signs stable. afebrile. discharge instructions: na followup instructions: na md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization diagnoses: pneumonia, organism unspecified polymyalgia rheumatica esophageal reflux diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified acute respiratory failure alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance hyperosmolality and/or hypernatremia 

Answer: The patient is high likely exposed to