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: history of present illness: this is a 71-year-old male, with a history of extensive cad status post multiple interventions, chf with an ef of 20%, status post icd placement, hypertension, diabetes mellitus, who presented with pneumonia and non-st elevation mi at , diagnosed on transfer from , and transferred to for catheterization. at approximately 5:00 pm on , he had an episode of hypertension, sbp in the 200s, a heart rate of 140s with shortness of breath and satting 80% on liters of oxygen, treated with nitropaste, 10 mg iv metoprolol, lasix 40 iv, and morphine with improvement. then again on in the morning had shortness of breath and was treated with morphine x 4 mg, nitropaste and iv lasix. the patient presented to outside hospital on with one day of chest pain, cough, fever, shortness of breath, progressive decreased exercise tolerance x 1 month, increasing lethargy. the patient also reports having had a light cold, mild cough, and rhinorrhea for 2 days. positive shaking and shivering and a sore throat with fever to 101.3. positive green sputum. the patient denied paroxysmal nocturnal dyspnea with stable orthopnea. denies leg swelling. denies chest pain or pressure at the time on transfer, palpitations, nausea, vomiting, diaphoresis. review of systems: no diarrhea, constipation, melena, bright red blood per rectum. no dysuria, hematuria, or changes in frequency. past medical history: 1. cad status post multiple interventions. multiple ptca of the lad. rca stent in with a 40% mid-rca lesion, 50% left main. relook cath on - 80% proximal lad, 80% d1 lesion, 60% ramus, 100% om2. cypher stent to proximal lad. 2. ef of 22% on mibi in with a history of chf. 3. diabetes mellitus. 4. status post icd placement secondary to syncope and v-tach in setting of an mi. 5. status post mi in . 6. hypertension. 7. gallstones. 8. gout. 9. chronic renal insufficiency with a baseline creatinine of 1.5-2.4. medications at home: 1. amiodarone 200 mg q pm. 2. insulin 70/30 sliding scale. 3. lasix 40 mg po q am, 20 mg po q pm. 4. metoprolol 50 mg po bid. 5. isordil 20 mg po bid. 6. enteric-coated aspirin 325 mg po qd. 7. folate 1 mg po qd. 8. allopurinol 150 mg po qd. 9. plavix 75 mg po qd. 10.zocor 60 mg po qd. 11.digoxin 0.125 mg po qd. 12.sublingual nitroglycerin prn. allergies: oyster. medications on transfer from outside hospital: 1. heparin drip. 2. metoprolol 75 mg po bid. 3. lasix 40 mg iv bid. 4. sliding scale insulin. 5. zocor 60 mg po qd. 6. amiodarone 200 mg po qd. 7. folate 1 mg po qd. 8. plavix 75 mg po qd. 9. mucomyst. 10.digoxin 0.125 mg po qd. 11.tequin 200 mg iv. 12.aspirin 325 mg po qd. 13.allopurinol 100 mg po qd. social history: he is an ex-smoker, quit 30-35 years ago, and before then had a 2-pack per day history x 15-20 years. occasional alcohol, approximately 1 drink a day. lives with wife. family history: noncontributory. physical exam: temperature 98.3, blood pressure 134/58, heart rate 64, respiratory rate 24, satting 95% on 3 liters. in general, this was a pleasant elderly gentleman, reclining comfortably. heent: sclerae anicteric. mucous membranes moist. oropharynx erythematous. neck: jvp approximately 10-12 cm. 2+ carotid pulses. no bruits. no lymphadenopathy. coronary: regular rate and rhythm. normal s1, s2. positive s4. a i/vi systolic murmur on the left upper sternal border. abdomen: soft, nontender, obese. positive bowel sounds. no hepatosplenomegaly. lungs: crackles approximately halfway up. positive dullness, right greater than left. wheezing. extremities: warm. positive edema bilaterally to midcalves. neuro: pupils equal, round and reactive to light. extraocular movements intact. tongue midline. smile symmetrical. no pronator drift. finger-nose-finger intact. 2+ deep tendon reflexes. plantar flexion and toe extension. pertinent laboratory at outside hospital: creatinine 2.6, potassium 3.7, white blood cell count 5.0, hematocrit 37.2, ptt 79.3, inr 1.13. initial ck 1103 in the am of 27, mb 102, index 10.5, troponin greater than 50. hospital course - 1) coronary artery disease: the patient's enzymes continued to be trended, and they continued to trend down from the outside admission labs. the patient was maintained on iv heparin, metoprolol, aspirin, isosorbide. the patient was chest pain-free upon arrival. given his acute renal failure, ace inhibitor was held, and the patient was not maintained on a iib/iii inhibitor. the patient was delayed catheterization until his creatinine decreased, given the risks of nephrotoxicity, and on , the patient underwent a cardiac catheterization which revealed disease in his mid-lad, and he received a ptca to the mid-lad. lvedp was found to be 40 in the cath , the patient was transferred to the cardiac intensive care unit postcath for tailored therapy. pa diastolic in the 40s on arrival to ccu. the patient got 20 of iv lasix with little effect, and started on an natrecor drip with lasix 40 iv, and diuresed approximately 1,900 cc to a pad of 23. creatinine continued to improve from 2.6-2.0. supplemental oxygen requirement was weaned in conjunction with diuresis, but likely in large part due to percutaneous coronary flow restoration. the patient was transferred back to the service on with improvement of his diuresis, and natrecor was continued. the patient was again maintained on aspirin, plavix, beta blocker, statin, and ace inhibitor was held pending improvement of his acute renal failure prior to discharge. cardiovascular : the patient presented with decompensated systolic heart failure. given his ischemic cardiomyopathy with an ef of 20%, heart association iii baseline, improving, the patient was diuresed to a dry weight of 208 pounds. the patient was maintained on isordil, metoprolol, natrecor and lasix drip. natrecor was dc'd on the day prior to admission, and was started on a po lasix regimen of 40-20 q am and q pm. the patient was fluid restricted of 1,500 liters per day. rhythm: the patient was maintained on telemetry without any events during this hospitalization. the patient is status post aicd placement. we continued his amiodarone during this hospitalization stay. 2) acute on chronic renal failure: the patient had an ultrasound at the outside hospital which was negative for a postobstructive process. the patient's creatinine continued to trend down with further diuresis and improvement of renovascular flow, to a discharge creatinine of 2.1. however, while being maintained on natrecor, his creatinine bumped again to 2.3 up to 2.5, which was likely thought to be due to overaggressive diuresis, and we decreased his lasix dose at that time. ace inhibitor was still held off. 3) diabetes mellitus: the patient had reasonable fingerstick blood sugar control. continued with regular insulin sliding scale and his current regimen. 4) thrush: the patient had an episode of pooled blood in his oropharynx and white exudative thrush on oral mucosa. the patient was evaluated by the ent service on who felt that the patient likely had exudative oropharynx, and the patient was treated with hurricaine spray as needed for tenderness. strep culture was sent which was negative. the patient was maintained on a treatment of nystatin and fluconazole x 7 days with marked improvement. 5) pneumonia: the patient was initially transferred with tequin, and was subsequently changed over to levaquin with renal dosing, for a total 10-day course of levaquin with marked improvement. he had no further episodes of cough or fevers during this hospitalization stay. final diagnoses: 1. acute myocardial infarction, subendocardial, initial episode. 2. cardiomyopathy, secondary, unspecified. 3. congestive heart failure, systolic and diastolic. 4. thrush. 5. community acquired pneumonia. recommended follow-up: please confirm your appointment with dr. , (, scheduled for for location/exact time. discharge condition: stable o2 on room air sats. stable heart rate and blood pressure. afebrile. the patient will be discharged to home with vna services. discharge medications: 1. metoprolol 50 mg po bid. 2. isordil 20 mg po bid. 3. amiodarone 200 mg po d. 4. aspirin 325 mg po qd. 5. plavix 75 mg po qd. 6. simvastatin 60 mg po qd. 7. regular insulin sliding scale. 8. nystatin suspension 5 mg po tid for 2 days, the last dose . 9. fluconazole 100 mg po qd x 3 more days, the last dose . 10.lasix 40 mg po q am, lasix 20 mg po q pm. 11.digoxin 0.125 mg po qd. 12.allopurinol 150 mg po qd. 13.folic acid 1 mg po qd. 14.nitrotab 0.3 mg sublingual, 1 tab to a maximum of 3 until chest pain-free prn chest pain. , m.d. dictated by: medquist36 d: 12:01 t: 12:03 job#: procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters injection or infusion of platelet inhibitor injection or infusion of nesiritide diagnoses: pneumonia, organism unspecified subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other complications due to other cardiac device, implant, and graft 

Answer: The patient is high likely exposed to