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: neomycin sulfate/hc / tape / beet attending: chief complaint: hypotension major surgical or invasive procedure: picc line placement ij placed on history of present illness: 79 yo male with pmh of cad s/p stents in and ef 21% in . came in after telling pcp that systolic was 70s this am, who wanted him to present to the ed. he keeps a chart of his daily blood pressures, which have ranged 80s to 90s systolic (long term baseline) until yesterday, when it was 74/43 and today at 73/43. he is completely asymptomatic and specifically denies lh, sob, cp, palpitations, f/c, abd pain. he reports that his uop has been down and his urine has been darker. he has intentionally limited his fluid intake per his cardiologist's recommendations, but that has been over the course of months. he endorses thirst. . he had a recent admission at hospital for ugib with gastric ulcers. he was placed on a ppi. on , his bun/cr was 51/1.9. he was given 2u prbcs with discharge hct 30. an abdominal u/s noted small to moderate acites in the upper abdomen. . he has also undergone 2 mechanical falls in the last month. he has residual left knee pain/swelling and left leg echymosis. . in the ed, initial vs were 97.1 57 68/47 18 89%ra. he was given a 350cc of gentle fluid. surgery was consulted and they are following. his stool was guaiac positive and melenotic. gi was consulted, but have not seen him yet. he had a ct pelvis showing ascites with no other abnormalities. bedside echo showed no effusion. he had a le u/s because of asymmetry in his legs which showed no dvt. no cta was done because of his renal failure. before transfer to the floor, vs were 75/54 48 100% 2l. . on arrival to the icu, he is still asymptomatic. his systolic bp is in the 80s. past medical history: mi and cabg in (svg-d1-lad, svg-om2, svg-om3, svg-am-pda) nstemi bms to 80% om2 stenosis ejection fraction 21% by exercise mibi , 20% by echo with moderate mr. status post appendectomy in . seasonal allergies to ragweed, moth dust, and oak. history of prostatitis. recently diagnosed herpes of the cornea od. prostate cancer-radioactive seeds placed in gout bladder cancer-s/pchemo and scrape mgus cataracts spinal stenosis svt, a-tach vs aflutter by holter social history: lives with wife. retired chemical engineer, quit smoking , rare etoh. family history: father passed away of a mi at age 54, and numerous uncles had coronary artery disease in their 50s. physical exam: vitals: t: 96.0 bp: 84/47 p: 49 r: 18 o2: 97% 2l general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: jvp 10-12 cm, no lad lungs: bilateral rales 1/2 up lung fields l>r cv: bradycardic, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, mildly distended, bowel sounds present. no rebound tenderness or guarding. liver felt below costal margin. no splenomegaly. + shifting dullness. ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis. 1+ le edema. diffuse echymoses over right leg. + effusion in right knee. pertinent results: cxr : impression: interval enlargement of the cardiac silhouette, without evidence of pulmonary edema. findings are concerning for a pericardial effusion or early cardiac decompensation. findings discussed with dr. at the time of interpretation. the study and the report were reviewed by the staff radiologist. 02:01pm urine hours-random urea n-495 creat-81 sodium-39 tot prot-15 prot/crea-0.2 02:01pm urine u-pep-negative f 01:20pm urine color-yellow appear-clear sp -1.011 01:20pm urine blood-sm nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 01:20pm urine rbc-* wbc-* bacteria-0 yeast-none epi-0 01:20pm urine hyaline-0-2 09:50am glucose-111* urea n-108* creat-4.0*# sodium-143 potassium-4.8 chloride-105 total co2-23 anion gap-20 09:50am estgfr-using this 09:50am alt(sgpt)-19 ast(sgot)-21 ld(ldh)-311* ck(cpk)-80 alk phos-188* tot bili-1.3 09:50am ck-mb-notdone ctropnt-0.09* 09:50am albumin-3.7 globulin-3.0 calcium-9.0 phosphate-5.7*# magnesium-3.0* 09:50am hbsag-negative hbs ab-negative hbc ab-negative 09:50am hcv ab-negative 09:50am wbc-6.3 rbc-3.30* hgb-10.6* hct-32.0* mcv-97 mch-32.0 mchc-33.0 rdw-17.4* 09:50am neuts-70 bands-0 lymphs-14* monos-8 eos-5* basos-0 atyps-3* metas-0 myelos-0 09:50am hypochrom-normal anisocyt-1+ poikilocy-occasional macrocyt-1+ microcyt-normal polychrom-occasional ovalocyt-occasional schistocy-occasional teardrop-occasional 09:50am plt smr-low plt count-104* 09:50am pt-18.0* ptt-34.2 inr(pt)-1.6* . echo: the left atrium is mildly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. no masses or thrombi are seen in the left ventricle. overall left ventricular systolic function is severely depressed (lvef= 20 %). there is no ventricular septal defect. the right ventricular cavity is mildly dilated with moderate global free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the prior study (images reviewed) of , the degree of mitral and tricuspid regurgitation have slightly decreased. foot xray: no localizing history is available. there is mild diffuse osteopenia. there is probable mild soft tissue swelling along the dorsum of the foot. no fracture or dislocation is detected. recommend correlation with specific site of symptoms for full assessment. brief hospital course: 79 yo with pmh of cad p/w acute on chronic heart failure biventricular with ef 20%. . # acute on chronic systolic and diastolic biventricular heart failure: patient was started on lasix gtt but was hypotensive and had low uo. an ij was placed and he was started on milranone and phenylephrine. he diuresed well and his bp improved to his baseline which in 80s/50s. he was weaned off the pressors but kept on the lasix gtt with good diureses. he was net 10l negative. his repeat echo showed overall improvement in mr r but ef unchanged. his symptoms improved and he was able to be weaned off oxygen. he was discharged on 40mg torsemide daily. # acute kidney injury: feurea suggests pre-renal etiology which is likely poor forward from heart failure, improved wih diureses. . # gib/ulcers: hct stable. cont ppi, restarted on 81mg asa given stability . # cad: cont asa, statin . # thrombocytopenia: mild and stable throughout admission . # lle injury: to falls. knee has effusion and is erythematous. joint tap negative. afebrile without leukocytosis. r foot painful with ambulation but improved with tylenol. cont cephalexin to complete 10 days course. r foot plain films were negative for fracture. follow pt recs for pt eval at home for safety. discontinued ambien as he had sundowning in the hospital and ambien certainly was worsening disorientation. . # general care: no ivf, replete electrolytes, cardiac diet, prophylaxis: pneumoboots, ppi, access: 2 18g pivs, picc (d/ced upon discharge), ij (d/ced upon discharge). code: dnr/dni confirmed with patient medications on admission: carvedilol 6.25 qday carvedilol 3.125mg qday enalapril 20 qday lasix 120 and 80 every other day simvastatin 40 mg qday zolpidem 5mg qhs prn amiodarone 100mg qday ec asa 325 qday ntg 0.4 mg sl prn folic acid 400 mcg qday mvi loratadine 10mg qday prn omeprazole 40mg qday discharge medications: 1. cephalexin 500 mg capsule sig: one (1) capsule po q12h (every 12 hours) for 5 days: please discontinue on . . disp:*10 capsule(s)* refills:*0* 2. amiodarone 200 mg tablet sig: 0.5 tablet po bid (2 times a day). 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 5. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 7. loratadine 10 mg tablet sig: one (1) tablet po once a day as needed for allergy symptoms. 8. torsemide 20 mg tablet sig: two (2) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 10. outpatient lab work check on : cbc, chem 7 including bun and creatinine fax results to dr. office: office phone (. discharge disposition: home with service facility: area vna discharge diagnosis: primary diagnosis: 1. congestive heart failure exacerbation 2. acute on chronic renal insufficiency 3. cellulitis discharge condition: stable. patient has returned to his baseline condition. discharge instructions: you were admitted to the hospital with shortness of breath and were found to have a congestive heart failure exacerbation. you were treated aggressively with intravenous medications to help remove your fluid. after doing this, your breathing, your blood pressure, and your kidney function improved. . we made the following changes to your medications: - cephalexin - this is an antibiotic to treat the skin infection on your knee. please continue this medication through . - change carvedilol to 3.125 mg twice a day - your enalapril has been held because your blood pressure was low and your kidney function was worse. please follow up with your cardiologist to restart this in the future. - we started 40mg torsemide po daily instead of the lasix - you should stop taking ambien as this may be constributing to your falls . please return to the hospital if you develop fevers, shaking chills, night sweats, shortness of breath, lower extremity swelling, light-headedness, dizziness, or syncope. weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 2l a day followup instructions: please follow up with dr. on at 11:30am. , 7th building. phone . please follow up with dr. within two weeks: . we could not make the appointment for you because dr. office was unavailable. other appointments: provider: , .d. phone: date/time: 2:30 procedure: venous catheterization, not elsewhere classified arthrocentesis diagnoses: thrombocytopenia, unspecified congestive heart failure, unspecified acute kidney failure, unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status cellulitis and abscess of leg, except foot cardiogenic shock acute on chronic combined systolic and diastolic heart failure 

Answer: The patient is high likely exposed to