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: s/p motor vehicle collision major surgical or invasive procedure: bilateral chest tubes placed tracheostomy/peg placement history of present illness: 78 yo m with cad, chf, h/o afib s/p ppm was the restrained driver in a mvc which occurred after he lost consciousness at the wheel. taken to , where c-spine was cleared by imaging and exam and hct showed no bleed or infarct. pt was in respiratory distress b/l rib fx and sternal fx and decision was made to intubate pt for transport to . past medical history: cad, chf, afib, dddr ppm, chronic pleural effusions social history: 2 sons involved with care family history: wife in an home physical exam: at the time of arrival, the patient was intubated, respiratory distress but had no other evidence of traumatic injuries pertinent results: 10:11pm type-art po2-180* pco2-38 ph-7.36 total co2-22 base xs--3 10:11pm lactate-0.9 10:11pm freeca-1.15 10:01pm glucose-272* urea n-38* creat-1.2 sodium-138 potassium-4.3 chloride-105 total co2-20* anion gap-17 10:01pm ck-mb-25* ctropnt-1.21* 10:01pm calcium-8.2* phosphate-4.9*# magnesium-1.6 10:01pm wbc-8.3 rbc-3.14* hgb-8.6* hct-28.4* mcv-90 mch-27.5 mchc-30.4* rdw-16.3* 10:01pm pt-63.3* ptt-57.3* inr(pt)-7.2* 10:01pm plt count-248 08:34pm type-art rates-/20 tidal vol-550 peep-10 o2-100 po2-68* pco2-50* ph-7.26* total co2-23 base xs--4 -assist/con intubated-intubated comments-received w 08:34pm glucose-270* 07:16pm type-art po2-78* pco2-58* ph-7.21* total co2-24 base xs--5 intubated-intubated 06:53pm glucose-285* lactate-1.5 na+-138 k+-4.7 cl--102 tco2-24 06:41pm urea n-39* creat-1.3* 06:41pm estgfr-using this 06:41pm lipase-42 06:41pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 06:41pm urine hours-random 06:41pm urine bnzodzpn-pos barbitrt-neg opiates-pos cocaine-neg amphetmn-neg mthdone-neg 06:41pm wbc-9.3 rbc-3.38* hgb-9.5* hct-31.2* mcv-93 mch-28.0 mchc-30.3* rdw-16.3* 06:41pm pt-67.2* ptt-48.2* inr(pt)-7.8* 06:41pm plt count-233 06:41pm fibrinoge-532* 06:41pm urine color-straw appear-clear sp -1.010 06:41pm urine blood-lg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 06:41pm urine rbc-* wbc-0-2 bacteria-few yeast-none epi-0-2 06:36pm type- ph-7.43 comments-green top 06:36pm glucose-278* lactate-1.2 na+-139 k+-4.6 cl--106 tco2-19* 06:36pm hgb-11.1* calchct-33 o2 sat-90 carboxyhb-7* met hgb-0 06:36pm freeca-0.88* brief hospital course: the patient was transferred to intubated in respiratory distress with bilateral rib fractures and a sternal fracture, intubated and sedated. given his bilateral pleural effusions, bilateral chest tubes were placed at the time of admission on . the patient underwent an echocardiogram shortly after admission which demonstrated marked lv anterior wall hypokinesis, and his serum troponin rose to a highest level of approximately 4. he spiked a fever within 24 hours of admission and cultures were sent. on , the patient had low urine output and was transfused 1u prbc to improve his hemodynamics. his urine culture grew enterococcus, and he was started on vancomcin. his creatinine continued to rise despite ivf resuscitation, and he was administered tube feeds which were advanced toward goal. given his rising creatinine despite apparently adequate fluid resuscitation, was placed for hemodynamic monitoring. his urine output picked up and his creatinine decreased over time. he had elevated serum glucose levels, and his insulin sliding scale was tightened. on , the patient had a 1 minute episode of ventricular tachycardia, which was self limited and did not recur thereafter. the electrophysiology service was consulted, and recommended switching him to metoprolol from sotalol given his renal dysfunction. he was taken off his home atenolol per their recommendations. he was stabilized on metoprolol prior to the time of discharge. on , the patient underwent tracheostomy and peg placement which was uneventful. his chest tubes were placed to water seal and removed sequentially thereafter without clinically significant pneumothorax or pleural effusion. he was restarted on coumadin and he was administered free water via his peg to help correct his hyponatremia. at the time of discharge, he was receiving 100 cc of free water q4hrs via his peg tube. over the next week prior to discharge, the patient's mental status improved slowly. he was tolerating trach collar trials for increasing time periods. he was working with pt to regain his strength. at the time of discharge, the patient's active status and plan by system is as follows: neuro: comfortable. moves all extremities, non focal. speaking with pmv and communicating appropriately. - neuro checks q: routine - analgesia roxycodone, tylenol prn. - trazodone prn qhs cv: h/o cad, chf, afib, hypercholesterolemia, cardiac contusion with low cardiac output. - metoprolol 25 mg , off home sotalol and atenolol per electrophysiology service - echo with overall left ventricular systolic function moderately-to-severely depressed (lvef= 30 %). repeat echo unchanged - pt has dddr pacemaker, underlying rhythm is chb, pm set for av sequential pacing unless atrial rate > 150. - his hematocrit at the time of discharge is 24, but we have intentionally held off on transfusion given his hemodynamic stability; would transfuse for hematocrit less than 21 (given tricc and crit data) pulm: sternal fx, r and l rib fx-bilateral flail, - ciprofloxacin until - perc trachestomy in situ gi: tube feeds/po diet - tf via peg - nectar thick liquids and soft solids started renal: acute on crf, now improved to 1.2. hypernatremia, resolving. - free water to 100 q 4 hours heme: anemia, coagulopathy. critical illness vs. mult phlebotomy. - monitor hct, no evidence of persistent bleeding - coumadin restarted, need to follow inr - d/c sc heparin when inr therepeutic - continue asa 81 mg qd endo: dmii. - restarted oral hypoglycemics - nph 20u , can titrate up as needed msk: right minimally displaced fracture of the coronoid process of the ulna. -ortho c/s-wbat, sling for comfort prn, f/u ortho 4 weeks if pain persists. id: -enterococcus uti sensitive to vancomycin, 10 day course finished ( amp-) -sputum cx with 4+ gnrs on gram stain, sensitive to cefepime/cipro, 7day course planned , switched to po cipro until medications on admission: -allopurinol 300mg daily -atenolol 50mg daily -actos 30mg daily -glyburide 2.5mg -lisinopril 40mg daily -simvastatin 80mg daily -sotalol 80mg -terazosin 2mg qhs -warfarin -prilosec 20mg daily -zoloft 50mg daily -lasix 30mg daily discharge medications: 1. chlorhexidine gluconate 0.12 % mouthwash sig: one (1) ml mucous membrane (2 times a day). 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. docusate sodium 50 mg/5 ml liquid sig: po bid (2 times a day). 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for bowel regimen. 5. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection every eight (8) hours. 6. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 7. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 8. famotidine 20 mg tablet sig: one (1) tablet po q24h (every 24 hours). 9. oxycodone 5 mg/5 ml solution sig: po q4h (every 4 hours) as needed for pain. 10. trazodone 50 mg tablet sig: 0.5 tablet po hs (at bedtime). 11. warfarin 1 mg tablet sig: three (3) tablet po once daily at 4 pm: will be titrated and followed at rehab facility. 12. glyburide 2.5 mg tablet sig: one (1) tablet po bid (2 times a day). 13. pioglitazone 15 mg tablet sig: two (2) tablet po daily (daily). 14. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 15. furosemide 20 mg tablet sig: 1.5 tablets po daily (daily). 16. allopurinol 100 mg tablet sig: two (2) tablet po daily (daily). 17. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po bid (2 times a day) as needed for prn constipation. 18. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours). 19. acetaminophen 650 mg/20.3 ml solution sig: one (1) po q6h (every 6 hours) as needed for pain. 20. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po bid (2 times a day) as needed for agitation. 21. insulin nph & regular human 100 unit/ml (70-30) cartridge sig: twenty (20) units subcutaneous twice a day. discharge disposition: extended care facility: northeast - discharge diagnosis: s/p motor vehicle collision; bilateral rib fractures and sternal fracture blaterl pleural effusions requiring tube thoracostomies heart failure- systolic ventricular tachcardia respiratory failure acute renal failure diabetes mellitus enterococcal urinary tract infection discharge condition: stable, mentating well, appropriate and conversant with pmv, tolerating trach collar discharge instructions: you will be discharged to a rehab facility for ventilator rehabilitation followup instructions: follow-up in trauma surgery clinic in 2 weeks; call to schedule an appointment follow-up with your cardiologist regarding metoprolol therapy (you were previously on atenolol and sotalol) procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for 96 consecutive hours or more fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy diagnoses: other primary cardiomyopathies unspecified pleural effusion urinary tract infection, site not specified congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified protein-calorie malnutrition hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, unspecified paroxysmal ventricular tachycardia chronic systolic heart failure streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] other motor vehicle traffic accident involving collision with motor vehicle injuring driver of motor vehicle other than motorcycle hyperosmolality and/or hypernatremia syncope and collapse flail chest fitting and adjustment of cardiac pacemaker contusion of heart without mention of open wound into thorax closed fracture of coronoid process of ulna 

Answer: The patient is high likely exposed to