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: pneumonia major surgical or invasive procedure: intubation/mechanical ventilation history of present illness: 79 yo m w/pmhx sx for atrial fibrillation on coumadin, alzheimer's dementia, and congestive heart failure who presents as a transfer from hospital. patient initially presented to hospital early yesterday morning with fevers and chest congestion starting the night prior. on the morning of admission, he was noted to be shaky on his feet, and had a fever to 101, and his wife called his pcp who advised that he be brought to the hospital. wife states that she was sick with uri symptoms and suspects that she may have infected him. patient did receive his flu shot this year. she states that he did not complain of nausea/vomiting/chest pain/diarrhea/dysuria. he was initially admitted to the medicine floor at with a diagnosis of viral pneumonia based on a positive influenza dfa. at the time he was noted to be in af with rvr. over the course of the day, however, he became more febrile and hypotensive, with hypoxia to the 80s-90s and became more obtunded on exam. he was then sent to the er where he was intubated and a central line was placed. he was then transferred to the ed where he was given 2 more liters of ivf and started on levophed. past medical history: alzheimer's dementia--baseline oriented to wife, conversational; needs assist with bathing, dressing congestive heart failure atrial fibrillation nkda social history: lives at home with his wife. is independent in eating. needs assistance with dressing and bathing. he is a retired papercutter. denies alcohol or smoking. remote smoking hx in high school. family history: nc physical exam: 98.2 115/78 93 14 100% on vent gen: intubated. heent: mmm. no oral ulcers. hrt: irregularly irregular. no murmurs or rubs. lungs: rales at the left base anteriorly. no rhonchi or wheezes. good air movement throughout. abd: soft, nontender, nondistended. normoactive bs. ext: wwp. no cce. neuro: unresponsive to sternal rub or loud voice. pupils pinpoint. toes mute bilaterally. reflexes 1+ patella bilaterally. pertinent results: 02:20am blood wbc-3.5* rbc-3.70* hgb-11.9* hct-35.2* mcv-95 mch-32.1* mchc-33.6 rdw-13.2 plt ct-125* 02:20am blood glucose-118* urean-17 creat-0.9 na-139 k-4.2 cl-109* hco3-22 angap-12 04:01am blood vitb12-1248* folate-greater th 04:01am blood ammonia-29 04:01am blood tsh-1.6 imaging: cxr : tip of the new left supraclavicular central venous line projects over the upper svc. no pneumothorax or mediastinal widening. dense consolidation in the left lower lobe accompanied by a small left pleural effusion is stable. there is new opacification at the right lung base which could represent another region of atelectasis or aspiration. et tube in standard placement. right jugular line ends in the upper svc. no pneumothorax. tte : the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal. there is severe global left ventricular hypokinesis/akinesis (lvef = 20 %). the basal inferior and septal segments have relatively preserved contractility. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. impression: severe global left ventricular hypokinesis/akinesis. mild mitral regurgitaiton. borderline pulmonary artery systolic hypertension. no prior echo for comparison. ct head : there is no evidence of mass, mass effect or large acute territorial infarct, however, acute/subacute ischemic changes cannot be completely excluded, mri is recommended if clinically warranted. in the brain parenchyma, there are multiple areas with low density in the subcortical white matter, likely consistent with microvascular ischemic changes. dense arteriosclerotic calcifications noted in both carotid siphons as well as in the left vertebral artery as described above. mucosal thickening is identified in the maxillary sinuses with mucous retention cysts, there is also mucosal thickening in the sphenoidal, ethmoidal and left mastoid air cells as described above. ct abd/pelvis : 1. moderately large left retroperitoneal hematoma expanding the left psoas and quadratus lumborum. 2. no evidence of bowel obstruction. sigmoid diverticulosis without definitive evidence of acute diverticulitis. 3. cholelithiasis. 4. left greater than right bibasilar pleural effusions. 5. copious stool within rectum. 6. hypoattenuating segment ii liver lesion likely represents a cyst. cxr : left lower lobe retrocardiac consolidation is persistent. small-to-moderate left pleural effusion and probable small right pleural effusion are unchanged. cardiomediastinum is within normal limits. ng tube tip is in the stomach. new faint ill-defined opacity in the right upper lobe could be due to aspiration given the clinical history. brief hospital course: mr. is a 79 yo m w/pmhx sx for chf and dementia admitted with respiratory failure in the setting of viral pneumonia secondary to influenza. #. respiratory failure. viral pneumonia. patient supported with mechanical ventilation and treated with tamiflu for influenza. although he was initially treated with antibiotics for possible bacterial superinfection, he was transitioned to nafcillin for bronchial washings positive for mssa. he was successfully extubated , and his tamiflu was stopped after 5 days. during his course in the icu, he developed new leukocytosis in the setting of having ng tube placed. he was started on vancomycin/cipro/zosyn to cover possible aspiration pneumonia or hospital aquired pneumonia. course completed . he is stable on ra at the time of transfer. #. septic shock. felt to be due to viral pneumonia with associated fever, bandemia, tachycardia, hypotension. patient was supported with aggressive hydration and levophed during his initial course in the icu. his septic physiology resolved over time. #. demand ischemia. patient with elevated troponin, with lateral < depressions on ekg. patient had af with rvr initially in the setting of fever and respiratory distress. medically treated with asa, statin, and beta blockade. evidence of demand ischemia resolved with improved control of heart rate. #. atrial fibrillation. beta blockade for rate control. initially on coumadin, which was held when his inr became elevated to 7. once inr dropped, he was anticoagulated with heparin gtt. his heparin was held on , when a retroperitoneal bleed was identified on ct abdomen and pelvis ordered because of concern for obstruction (there was no evidence of obstruction on ct). his anticoagulation was still on hold at the time he was transferred out of the icu. on the general medical floor he was started on full dose aspirin. no plan at this time to restart coumadin, given his retroperitoneal bleed. #. retroperitoneal bleed: found on imaging done for concern of possible obstruction. of note, patient had had elevated inr to 7.5 early in his course. he was transfused with rbcs and anticoagulation. hct responded appropriately to transfusion and was stable thereafter in hct 32-34 range. #. altered mental status - myoclonus and delerium: patient was noted to have myoclonal jerking after extubation. he was initially not speaking, which was a change from his baseline. neurology was consulted about the myoclonus, and he was felt to have a toxic-metabolic process in the setting of his infection, sepsis, and sedating medications. cns ct imaging was negative for acute changes. over the days following his extubation, his myoclonal jerking decreased and his alertness improved to the point of saying a few words. eeg was consistent with widespread encephalopathy; there was no evidence of epileptiform activity. tsh, lp normal. geriatrics team was consulted and they suggested repeat ct of head to understand whether pt's delerium would ever improve. ct of head showed no stroke. he was unable to stay still for mri. our hope is that mental status may improve somewhat, but to what extent is questionable, given baseline of severe dementia. he has periods of somnolence alternating with spontaneous one or two word response. he knows his name but is otherwise not oriented. # acute on chronic systolic chf: patient noted to have decreased ef to lvef 20%, global hypokinesis in setting of influenza, icu team was concerned that he might have viral cardiomyopathy. ischemic event also possible. patient's volume status improved with diuresis and he is currently appearing euvolemic, not on any lasix. he will need regular weight checks and consideration of diuresis if any significant increase in weight. recommend follow-up echocardiogram in approximately 1-2 months to reassess his lvef. # transaminitis: likely a muscle source give myocolonus. mild elevation wtih slightly increased ck's, ck down to 500's today, good uop. # rash: possibly from zosyn, resolved shortly after discontinuing zosyn, but unclear. #. code. wife asked to change code status to dnr/dni. . # alzheimer's dementia: severe dementia, requiring help dressing and showering before current illness. namendia and aricept held for now at suggestion of geriatrics team. can be reassessed by his pcp and consider restarting aricept 5 daily as outpatient. #aspiration risk: swallow eval with aspiration risk. peg placed with bumper located at 3.5-4 cm marking. needs dry sterile dressing over bumper changed daily, for one week and clean site with hydrogen peroxide daily for one week. needs water/soda flush 10-20cc qid. he will need a repeat swallow evaluation in the near future as his mental status improves to reasses. #nutrition: please continue tube feeds as per site protocol. he is currently on replete with fiber full strength; goal rate: 70 ml/hr residual check: q4h hold feeding for residual >= : 150 ml flush w/ 50 ml water q4h medications on admission: coumadin prilosec metoprolol captopril discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed: give via peg. 2. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed: per peg. 3. simvastatin 40 mg tablet : two (2) tablet po daily (daily): per peg. 4. captopril 12.5 mg tablet : 0.5 tablet po tid (3 times a day): per peg. 5. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 6. metoprolol tartrate 50 mg tablet : two (2) tablet po q6h (every 6 hours): per peg. 7. diltiazem hcl 30 mg tablet : one (1) tablet po qid (4 times a day): per peg. 8. aspirin 325 mg tablet : one (1) tablet po daily (daily): per peg. 9. miconazole nitrate 2 % cream : one (1) appl topical (2 times a day) as needed. 10. albuterol sulfate 2.5 mg/3 ml solution for nebulization : one (1) treatment inhalation q6h (every 6 hours) as needed. 11. camphor-menthol 0.5-0.5 % lotion : one (1) appl topical qid (4 times a day) as needed. discharge disposition: extended care facility: care center discharge diagnosis: pneumonia: influenza, then hospital acquired pneumonia atrial fibrillation hypersensitivity reaction (rash) dementia, severe benign hypertension discharge condition: stable discharge instructions: please md or return to er with any fevers, dizziness, or other concerning symptoms. followup instructions: please follow up with your pcp . md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] diagnoses: congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia atrial fibrillation acute respiratory failure methicillin susceptible pneumonia due to staphylococcus aureus rash and other nonspecific skin eruption alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance encephalopathy, unspecified acute on chronic systolic heart failure hemoperitoneum (nontraumatic) influenza with pneumonia 

Answer: The patient is high likely exposed to