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 year old gentleman who was a former head of pathology here for many years who was recently discharged from the status post right open reduction and internal fixation complicated by aspiration pneumonia with recent swallowing evaluation which showed severe profound oropharyngeal dysphagia with inability to safely swallow saliva; this is on top of his chronic neurologic dysphagia for the past ten years and had an acute decline postoperatively. he has also had decreased appetite and change in his speech, but that is only when he is not using his dental bridge. he has also had some increase in somnolence and some chronic cough with mucosy sputum production. he denies fevers, chills and is otherwise doing well postoperatively. he has not been drinking fluids because of fear of aspiration. he was admitted for dehydration, failure to thrive and concern for aspiration. past medical history: 1. atrial fibrillation. 2. coronary artery disease, status post myocardial infarction with an ejection fraction of 50%, three plus mitral regurgitation and two plus tricuspid regurgitation; moderate paroxysmal atrial fibrillation. 3. hypertension. 4. gait instability. 5. glaucoma. 6. osteoporosis. 7. cataract. 8. history of tuberculosis, status post right open reduction and internal fixation on . 9. hypothyroidism. 10. aspiration pneumonia. 11. anemia. medications on admission: 1. isosorbide. 2. metoprolol. 3. procardia xl. 4. digoxin. 5. brimonidine drops. 6. colace. 7. senna. 8. tylenol p.r.n. 9. levoxyl. 10. coumadin. 11. ensure supplements. allergies: no known drug allergies. social history: is a former pathologist here at the for many years. he lives with his wife but currently at rehabilitation postoperatively for rehabilitation after hip surgery. otherwise, no smoking or alcohol history. family history: mother with cardiac disease and a father who had a cerebrovascular accident. physical examination: vital signs on admission were temperature 97.3 f.; blood pressure 160/52; pulse 52; respiratory rate 20; o2 95% on room air. in general, he is awake, alert and oriented, in no acute distress. clinically, chronically ill appearing, cachectic gentleman. heent: pupils equally round and reactive to light. positive scleral icterus. positive pallor of conjunctivae. mucous membranes were moist. positive thrush. positive tongue deviation. clear oropharynx. positive temporal wasting, positive subclavicular wasting. chest was clear to auscultation bilaterally. cardiovascular is irregularly irregular. abdomen is soft, nontender, nondistended, positive bowel sounds. extremities with no cyanosis, clubbing or edema. one plus dorsalis pedis pulses bilaterally. status post right open reduction and internal fixation with stable hips. neurologic examination with good strength and sensation bilateral extremities. laboratory: on admission white blood cell count 11.3, hematocrit 39, platelets 249, 90% neutrophils, 5% lymphs, 5% monocytes. sodium 127, potassium 4.7, chloride 90, bicarbonate 28, bun 39, creatinine 0.9, glucose 118. chest x-ray with left lower lobe opacity, otherwise unchanged. hospital course: a year old gentleman status post recent admission for open reduction and internal fixation with progressive dysphagia and recurrent aspiration here with failure to thrive and dehydration. 1. failure to thrive: the patient accepted placement of an ng dobbhoff tube for nutrition. the patient had an ng tube placed on the night of admission and was started on tube feeds and titrated up per nutrition consultation and tolerated the feeds well. the patient's medicines were also given through the dobbhoff tube. the patient had repeat evaluation by speech and swallow who continued to see severe profound dysphagia, unchanged from his last admission. the patient then agreed to have peg tube placed per surgery for continued nutrition which can be continued in rehabilitation. this was placed on , without difficulty and the patient had 24 hours postoperatively to wait before using the tube, but then will be restarted at tube feeds at 70 cc an hour of the probalance and the tube will be flushed with 100 cc of free water every six hours. the patient will continue to have residuals checked every six hours and tube feeds will be held if residuals are greater than 200 cc. the patient's electrolytes were continued to be monitored and replaced as started refeeding. the patient's potassium, phosphorus and magnesium remained low and continued to be repleted throughout the course of his admission. 2. dehydration: the patient's electrolytes on admission were very consistent with dehydration. the patient had urine electrolytes sent off with the fena of 0.1% which was also consistent with a prerenal syndrome. the patient had a good ejection fraction from recent echocardiogram and was hydrated aggressively over the first 24 to 48 hours and then as tube feeds were started, the patient's intravenous fluids were discontinued until the patient was again npo and then tube intravenous fluids were again restarted; otherwise the patient symptomatically improved. his oral thrush improved with hydration and was symptomatically better. 3. dysphagia, aspiration: the patient had the left lower lobe findings on chest x-ray with history of aspiration and known dysphagia and was restarted on a course of levofloxacin and flagyl, which will be continued for another ten days post discharge. the patient was also seen and evaluated by the neurology service with plans for a ct scan of the head which showed no intracranial mass lesion or shift of structures. no major or minor vascular or territorial infarctions were apparent. the density of the brain parenchyma was within normal limits. there was evidence of atrophy of the brain and incidental note of calcifications within the tentorium and dural calcifications located at the falx were noted. otherwise, no signs of hemorrhage. the patient was also to have a tensilon test to rule out myasthenia ; results of that test were still pending at the time of this dictation. 4. cardiovascular: the patient was still in atrial fibrillation and was continued on his nitrites and beta blockers and calcium channel blockers. the patient's medicines had to be arranged in the non-extended release form so as could be crushed to be given through the ng tube and later through the g-tube. otherwise, the patient was doing well except postoperatively did go into rapid atrial fibrillation which responded to intravenous metoprolol and was stable on arrival to the floor. otherwise, the patient did have some episodes of hypertension on the floor with blood pressures up to 170/80 systolic likely secondary to missing his longer acting calcium channel blocker which was restarted then on a three times a day regimen so as to be continued to be able to be crushed through his g-tube. the patient's coumadin was held prior to surgery and postoperatively for one day. the patient's inr will continue to be followed and coumadin to be be restarted 1 day post peg at 1 mg q. h.s. dose. 5. hypothyroidism: the patient's tsh regimen of levoxyl was stable and otherwise no difficulties. 6. constipation: for the patient's constipation, he previously had been on fiber secondary to use of the g-tube and was started on lactulose as a daily 30 cc q. day with colace syrup twice a day. 7. fluids, electrolytes and nutrition: the patient was on the tube feeds as described above and had his electrolytes repleted again as his potassium, magnesium and phosphate secondary to refeeding syndrome and were watched very closely and repleted as needed. prophylaxis: the patient was started on lansoprazole which can be given through his tube for his gi prophylaxis. coumadin was being held for two days and otherwise was continued. the patient had a physical therapy evaluation that continued to work with him using the walker and the patient will return to rehabilitation to continue with physical therapy. condition at discharge: good. the patient is ambulating with assistance of a walker, oriented to time and place. he is tolerating feeds through tubes and otherwise not requiring oxygen. discharge status: discharged to for continued physical therapy and strength training. discharge diagnoses: 1. failure to thrive. 2. dehydration. 3. dysphagia. 4. aspiration pneumonia. 5. atrial fibrillation. 6. hypertension. 7. hypothyroidism. 8. constipation. 9. refeeding syndrome. discharge medications: 1. tylenol 325 mg to 650 mg p.o. q. four to six p.r.n. 2. isosorbide dinitrate 10 mg p.o. three times a day. 3. metoprolol 12.5 mg p.o. three times a day. 4. digoxin 0.125 mg p.o. q. day. 5. levothyroxine 50 micrograms p.o. q. day. 6. milk of magnesia 30 ml p.o. q. six p.r.n. 7. lansoprazole 30 mg per ng q. day. 8. docusate 100 mg ng twice a day. 9. lactulose 30 ml per g tube q. day. 10. nifedipine 10 mg ng q. eight. 11. flagyl 500 mg ng q. eight. 12. levofloxacin 500 mg ng q. day. 13. coumadin 1 mg per g tube q. day. 14. brimonidine one drop o.s. twice a day. discharge instructions: 1. the patient is to follow-up with his primary care physician in seven to ten days. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] diagnoses: unspecified septicemia unspecified acquired hypothyroidism atrial fibrillation acute respiratory failure pneumonitis due to inhalation of food or vomitus septic shock unspecified transient cerebral ischemia 

Answer: The patient is high likely exposed to