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 attending: chief complaint: hypotension major surgical or invasive procedure: intubation , extubation history of present illness: hpi: this is a 82 year old man with pmh significant for cardiac arrest 2 months ago complicated by prolongen intubation, atn, gi bleed, pneumonia, during g tube placement procedure, who presents from after an episode of hypotension the morning of . he was thought to still be mentating but concern was raised for infection. . in the ed, he was found to be hypotensive to the 80's with a temp of 103.8 degrees rectally. he was given 500 mg flagyl iv and blood cultures were sent. o2 sat dropped to 77% and the decision was made by his son in the room to reverse his dnr/dni status to intubate him. his blood pressure fell to sbp 70's and dopamine was started, but this was changed to levophed after it was not found to be effective. his sbp's remained in the 70's but then gradually increased after fluid resissitation with 2l of fluid and titrating up levophed. he was given 100 of hydrocort once. a groin line was placed and he was transferred to the micu after confirming with the son that this patient would want full medical measures administered. past medical history: pmh: cardiac arrest pneumonia proteus bacteremia gi bleed x 1 with small hct drop 8/05 acute renal failure from atn, baseline cr 1.5 adrenal insufficiency zosyn induced thrombocytopenia hypopituitarism pituitary adenoma hypothyroidism osteoarthritis bph depression uti osa traumatic encephalopathy in cholecystecomy social history: sh: the patient is a resident at . family history: fh: noncontributory physical exam: pe: tm 103.8 tc 96.3 bp 109/63 p81 r17 o2 100% ventilated ac 650x16 80% peep 10 abg 7.25/35/80 gen: opens eyes, moves to simple command, intubated. larger build. heent: perrla, op with ett in place resp: coarse rhonchi bilaterally cv: irreg rhythm, low pitched systolic murmur across precordium abd: soft ntnd + normoactive bowel sounds. peg tub in place ext: left arm erythmatous, legs with marked pedal edema bilaterlly, warm to touch, 2+ radial pulses bilaterally neuro: nonverbal, intubated, responsive to pain pertinent results: ct head: 1. no evidence of acute intracranial hemorrhage. 2. pituitary macroadenoma as previously described. 3. hypodensity within the cerebral periventricular white matter, consistent with chronic microvascular disease. 4. mucosal thickening within the visualized paranasal sinuses and left mastoid air cells. . ct abdomen/pelvis: 1 bibasilar consolidations versus atelectasis. this may represent the source of the patient's fever. there is no acute inflammatory pathology identified within the abdomen and pelvis to account for the patient's symptoms otherwise. 2 trace amount of free fluid in the abdomen, greatest in the left upper quadrant surrounding the spleen and superior posteriorly. there is also trace free fluid in the pelvis adjacent to a loop of distal ileum that is unremarkable in appearance. 3 sluggish enhancement of the kidneys, consistent with medical disease. 4 ill-defined hypodensities within the liver, which may represent irregular fatty infiltration. 5. sclerosis and thickening of the left ileum, which may represent paget's disease. . ekg: irregular sinus rhythm with pac's. low signal. no st changes or q waves. . cxr: no acute cardiopulmonary process, left base with atelectasis . labs: see below for full. notable for wbc = 30 with 73 n and no bands, hct 47-> 37 post hydration, lactate 8.4, creatinine 1.7->2.1 post fluid, bicarb 17-> 19 after 1 amp bicarb, abg as above . 11:56pm lactate-12.1* 09:16pm type-art po2-82* pco2-23* ph-7.12* total co2-8* base xs--20 09:16pm lactate-12.6* 09:05pm glucose-255* urea n-47* creat-1.9* sodium-138 potassium-4.2 chloride-105 total co2-7* anion gap-30* 09:05pm ck(cpk)-101 09:05pm ck-mb-11* mb indx-10.9* ctropnt-0.28* 09:05pm calcium-7.1* phosphate-4.4 magnesium-2.7* 09:05pm wbc-38.4* rbc-4.48* hgb-13.6* hct-41.5 mcv-93 mch-30.4 mchc-32.8 rdw-16.0* 09:05pm neuts-91.8* lymphs-6.0* monos-1.9* eos-0 basos-0.3 09:05pm hypochrom-2+ anisocyt-1+ poikilocy-1+ macrocyt-1+ 09:05pm plt count-278 08:15pm lactate-12.2* 07:12pm lactate-11.8* 06:29pm type-art temp-35.7 tidal vol-650 peep-8 o2-60 po2-90 pco2-28* ph-7.14* total co2-10* base xs--18 intubated-intubated 06:29pm lactate-10.2* 05:30pm cortisol-60.7* 05:08pm type-art temp-35.7 rates-16/ tidal vol-650 peep-10 o2-100 po2-93 pco2-32* ph-7.16* total co2-12* base xs--16 aado2-587 req o2-96 intubated-intubated comments-mismatched 05:08pm lactate-9.2* 05:00pm cortisol-74.2* 04:48pm type-mix 04:48pm hgb-13.3* calchct-40 o2 sat-75 03:54pm temp-35.7 rates-14/8 tidal vol-600 peep-8 o2-100 po2-174* pco2-35 ph-7.18* total co2-14* base xs--14 aado2-503 req o2-85 intubated-intubated 03:54pm lactate-8.4* 02:41pm glucose-155* urea n-51* creat-2.1* sodium-141 potassium-3.7 chloride-106 total co2-19* anion gap-20 02:41pm alt(sgpt)-173* ast(sgot)-165* ld(ldh)-447* ck(cpk)-61 alk phos-78 amylase-83 tot bili-0.9 02:41pm lipase-90* 02:41pm ck-mb-notdone ctropnt-0.34* 02:41pm albumin-2.1* calcium-7.0* phosphate-3.1 magnesium-1.3* 02:41pm tsh-0.09* 02:41pm free t4-0.7* 02:41pm cortisol-83.4* 02:41pm wbc-26.0* rbc-3.94* hgb-11.9*# hct-37.3*# mcv-95 mch-30.1 mchc-31.9 rdw-16.0* 02:41pm plt count-240 02:41pm pt-16.5* ptt-58.4* inr(pt)-1.9 02:41pm fibrinoge-325 d-dimer-2057* 02:13pm type-art po2-80* pco2-35 ph-7.25* total co2-16* base xs--10 02:13pm lactate-7.7* k+-3.5 02:13pm o2 sat-93 02:13pm freeca-1.04* 11:55am urine color-yellow appear-clear sp -1.012 11:55am urine blood-sm nitrite-neg protein-100 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-sm 11:55am urine rbc-* wbc- bacteria-rare yeast-none epi-0-2 11:55am urine uric acid-few 11:52am lactate-8.4* 11:30am glucose-133* urea n-53* creat-1.7* sodium-134 potassium-5.3* chloride-97 total co2-17* anion gap-25* 11:30am alt(sgpt)-71* ast(sgot)-89* ld(ldh)-546* alk phos-116 tot bili-1.1 11:30am lipase-95* 11:30am tsh-0.14* 11:30am wbc-30.9*# rbc-5.01 hgb-15.1 hct-47.5 mcv-95 mch-30.1 mchc-31.7 rdw-15.5 11:30am neuts-73* bands-0 lymphs-17* monos-3 eos-0 basos-1 atyps-6* metas-0 myelos-0 11:30am hypochrom-1+ anisocyt-1+ poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 11:30am plt smr-normal plt count-334# pltclm-1+ brief hospital course: hospital course: 82 year old male with a history of panhypopituitarism, recent cardiac arrest, pneumonia requiring intubation, admitted on from , with vancomycin-resistant enterococcus (vre) urosepsis and mrsa pna. . # septic shock: etiology of septic shock was likely vre urosepsis and mrsa pneumonia, with positive urine culture and positive sputum culture. stool culture was negative, and c diff was also negative x 1. ct abdomen/pelvis was negative for an intraabdominal source. the patient was admitted to the micu, where he gradually improved on linezolid and ceftazidime (the patient had briefly been on vancomycin at the start of admission). the patient had a rij and a left a line placed. he was intubated, received one dose of hydrocort, and was supported hemodynamically with levophed (dopamine pressor was changed to levophed, since dopamine was not working well). map readings were maintained > 65. the patient improved and was weaned off of pressors on . the patient was weaned off the ventilator, with rsbi<80, and was extubated without complication on . the patient's code was changed to dnr/dni per patient's son. on discharge is for ceftazidime and linezolid to continue for 6 more days, to treat vre in the urine and mrsa in the sputum. . # hypoxic respiratory failure: the patient was hypoxic in the ed, with sats to 77%. code status was changed from dnr/dni by patient's son (health care proxy), and the patient was intubated. cxr and ct chest showed a lll pneumonia with effusion, with mild volume overload. by ultrasound, the effusion was not large enough to tap. the patient was status post ardsnet protocol. patient was treated with linezolid to cover for vre and mrsa, and with ceftazidime to cover for pseudomonas/gnr (gnr had appeared in the gram stain of the sputum culture), each for a 14 day course. patient was given lasix prn to control volume overload. . # anemia/thrombocytopenia: patient's stool was brown/green-colored and was hemoccult positive. patient was given 1 u rbc, and was hemodynamically stable. goal hct was maintained at > 21, and goal plts was maintained at > 10. since the patient has a history of hit antibodies, all heparin products were avoided. coagulation labs were stable throughout admission. . # renal failure: patient's baseline cr is 1.5. renal failure was mild, due to atn due to hypotension (fena was > 1.0), and improved with fluids and improving hemodynamics. improving with fluids and improving hemodynamics. spun urine had no remarkable sediment or casts. patient's hyponatremia resolved with fluid resuscitation. . # transaminitis: lfts were in the 1000s, and were trending down each day. etiology was likely due to shock liver from hypotension. ct abdomen did not reveal any significant findings necessitating intervention. . # neurologic status: ct head was negative, with findings of a chronic pituitary macroadenoma causing panhypopituitarism. the patient grew more and more responsive and developed a good gag reflex. the patient was maintained on levothyroxine and was given one dose of stress dose steroids. . # low voltage ekg: tte showed no pericardial effusion. patient was monitored with no cardiac complication, and with recovering bp over time. . # nutrition, dvt prophylaxis, lines: patient was on tf, ppi iv, and pneumoboots, since no heparin was used. patient had a rij and - placed during admission. . # code: son, , is the hcp, who determined that the patient is dnr/dni. specifically, the hcp does not want the patient given shocks or surgery. medical management is acceptable and in line with the patient's wishes per the hcp. . # communication: hcp is son (h) . medications on admission: meds at prednisone 10 mg pgt qam, 5 mg pgt qpm levothyroxine 150 mcg pgt daily prevacid 30 pgt daily spironolactone 25 pgt daily methylphenidate 5 mg pgt daily ferrous sulfate 325 po daily reglan 10 pgt q 12 h lactobacillus pgt daily aranesp 300 mg sc q friday mvi qd psyllum 1 pkt pgt daily trypsin/castor oil topically pgt q 12 h jevity 1.2 @ 75 cc per hour cycled over 18 hours with flush 200 qd and 1 scoop promod discharge medications: 1. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day) as needed. 2. prevacid 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 3. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 4. prednisone 10 mg tablet sig: one (1) tablet po qam. 5. prednisone 5 mg tablet sig: one (1) tablet po qpm (once a day (in the evening)). 6. levothyroxine 150 mcg tablet sig: one (1) tablet po daily (daily). 7. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 8. metoclopramide 10 mg tablet sig: one (1) tablet po q12h (every 12 hours). 9. aranesp 300 mcg/0.6 ml syringe sig: 0.6 ml injection q friday as needed for anemia. 10. multivitamins tablet, chewable sig: one (1) cap po daily (daily). 11. ceftazidime 2 g recon soln sig: two (2) grams intravenous q24h for 6 days. 12. linezolid 600 mg/300 ml parenteral solution sig: six hundred (600) mg intravenous q12h (every 12 hours) for 6 days. 13. ferrous sulfate 300 mg/5 ml liquid sig: three hundred (300) mg po daily (daily). discharge disposition: extended care facility: - discharge diagnosis: septic shock due to vre urosepsis and mrsa pneumonia discharge condition: stable, vitals are stable, patient is afebrile and at baseline mental status. discharge instructions: 1. please go to the emergency room for fevers, low blood pressure, fatigue. 2. please take all medications as prescribed. followup instructions: 1. your primary care physician, . , be visiting you at , to follow up regarding your hospital admission. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube enteral infusion of concentrated nutritional substances injection or infusion of oxazolidinone class of antibiotics diagnoses: thrombocytopenia, unspecified anemia, unspecified acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified unspecified septicemia hyposmolality and/or hyponatremia severe sepsis unspecified acquired hypothyroidism hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) acute respiratory failure septic shock infection with microorganisms without mention of resistance to multiple drugs methicillin susceptible pneumonia due to staphylococcus aureus panhypopituitarism benign neoplasm of pituitary gland and craniopharyngeal duct 

Answer: The patient is high likely exposed to