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: univasc / celexa / heparin agents attending: chief complaint: hypoxia and diarrhea major surgical or invasive procedure: intubation, arterial line insertion history of present illness: per micu admission note 80 yo male with pmh of brain tumor, recently admitted after intracranial hemorrhage. was at rehab today when found unresponsive with o2 sat of 50%. recently has been on trach collar during day and vent at night. initial workup at osh ed. he was briefly placed back on vent and transferred to .he was normotensive here and not hypoxic on 100% but with altered mental status. narcan did not help and no new focal findings. head ct was unchanged. cta torso - no pe, belly ok. wbc of 33. transiently hypotensive. 2l ns ok. got a-line and semi clean groin line. vanc, cefepime, flagyl. a little more awake upon admission. vs: 99.8 r, 63 122/73, 550 x 16 on 5 peep 100% fio2 - satting 100%. past medical history: brain tumor: mr c/w low grade glioma; has been followed since hemorrhagic stroke at site of biopsy cad s/p cabg x 4 (lima->lad, svg->om1, om2, pda) . htn afib no longer on coumadin (has been on amiodarone) dyslipidemia myelodysplastic syndrome: bm bx mds vs cml, followed by prostate cancer s/p radictal prostatectomy and simultaneous penile implant hyperparathyroidism h/o dvt, no cta done b/c of ckd--treated w/ ivc filter and lovenox, filter has since been removed. was on warfarin until hemorrhagic stroke. gout subclinical hypothyroidism allergic rhinitis reflux pharyngitis colonic polyps ? essential tremor anhedonia, attempted celexa but became lightheaded low back pain, ? spinal stenosis peripheral neuropathy h/o fen/phen use social history: soc hx: married. has been in nursing home. no tobacco, etoh, drug use family history: nc physical exam: initial micu pe gen: nad, interactive, though non-verbal. heent: at, scar present over right pariatal area, trancheostomy in place with very mild skin breakdown. cv: rrr, nl s1 and s2, no mrg - sounds are distant. pulm: course mechanical bs throughout. no true rhonchi or crackles. abd: peg in place and site is c/d/i, nt/nd, obese, with present bs. ext: no pitting edema, pale nail beds, no wounds, no cyanosis. neuro: moderate left sided hemiparesis (at baseline), non-verbal but able to answer with simple questions. pe on transfer to floor pe: t 96.9 102-120/52-62 hr 69 rr22 95% 50% fm gen: nad, interactive, though non-verbal. heent: at, scar present over right parietal area, trancheostomy in place with very minimal skin breakdown and erythema. cv: rrr, nl s1 and s2, no mrg - sounds are distant and difficult to auscultate over coarse bs. pulm: course bs throughout and transmitted upper airway sounds. no crackles. abd: peg in place and site is c/d/i, nt/nd, obese, with present bs. ext: no pitting edema, pale nail beds, no wounds, no cyanosis. left foot with nonpitting edema neuro: moderate left sided hemiparesis (at baseline), non-verbal but able to answer with simple questions, nods head. pertinent results: 04:22pm blood wbc-33.5*# rbc-3.11* hgb-9.2* hct-29.3* mcv-94 mch-29.4 mchc-31.2 rdw-14.0 plt ct-67* 04:27am blood wbc-18.0* rbc-2.76* hgb-8.2* hct-25.0* mcv-90 mch-29.6 mchc-32.8 rdw-14.9 plt ct-60* 07:49am blood wbc-19.0* rbc-2.81* hgb-8.3* hct-25.2* mcv-90 mch-29.5 mchc-32.9 rdw-15.1 plt ct-67* 04:22pm blood neuts-18* bands-2 lymphs-10* monos-61* eos-3 baso-0 atyps-0 metas-2* myelos-4* 03:54am blood neuts-22* bands-1 lymphs-8* monos-60* eos-5* baso-1 atyps-1* metas-1* myelos-1* 04:22pm blood glucose-169* urean-86* creat-1.1 na-149* k-4.6 cl-111* hco3-32 angap-11 03:38pm blood glucose-130* urean-56* creat-0.7 na-148* k-3.9 cl-118* hco3-26 angap-8 07:49am blood glucose-113* urean-45* creat-0.8 na-142 k-4.3 cl-107 hco3-30 angap-9 04:22pm blood alt-13 ast-18 ck(cpk)-7* alkphos-101 totbili-0.2 04:10am blood ld(ldh)-119 ck(cpk)-3* 03:18pm blood ck(cpk)-7* 04:22pm blood ctropnt-0.07* 04:10am blood ck-mb-notdone ctropnt-0.05* 03:18pm blood ck-mb-notdone ctropnt-0.06* 04:10am blood calcium-11.2* phos-3.3 mg-1.8 03:54am blood albumin-2.9* calcium-10.9* phos-2.5* mg-1.8 04:43pm blood lactate-1.3 cxr : impression: bibasilar opacities, suspicious for pneumonia. interval improvement on the left. evidence for small left effusion unchanged cxr reason for exam: 80-year-old man with hypoxia and respiratory distress and elevated white blood count, please evaluate for pneumonia. since , sternotomy wires are still intact. a tracheostomy is in unchanged position. right picc tip is not seen. bibasilar opacity increased could be atelectasis, pneumonia or aspiration. standard pa and lateral views or better inspiration ap could further characterize this. minimal blunting of the left costophrenic angle is unchanged, altough it was partly excluded on this study. . ct head : impression: unchanged right frontal lobe heterogeneous mass with resolution of post-biopsy hemorrhage and pneumocephalus. no acute intracranial hemorrhage. ct torso : impression: 1. limited study for assessment of pulmonary embolism secondary to technical factors. no central pe. 2. enlarged pulmonary artery reflective of pulmonary hypertension. 3. moderate cardiomegaly. 4. peritracheostomy secretions and debris. 5. cholelithiasis. no evidence of acute cholecystitis. 6. innumerable cysts of the kidneys bilaterally, stable compared to . micro: blood cx ngtd urine cx ng sputum respiratory culture (preliminary): oropharyngeal flora absent. yeast. sparse growth. staph aureus coag +. rare growth. c diff negative x 2 11:35am blood lactate-0.6 brief hospital course: for details regarding previous prolonged hospital course at hospital and , please see prior discharge summary . micu course: mr. was admitted to the micu for a hypoxic episode at rehab. flexible bronchoscopy was performed on arrival and showed focal tracheomalacia with airway occlusion. tracheostomy tube change performed. he was not hypoxic upon arrival and was quickly weaned to trach mask which he tolerated for 48 hours prior to transfer to the floor. he was treated with broad-spectrum antibiotics including zosyn, vancomycin and flagyl for possible hcap/vap and c. diff. antibiotics were weaned quickly as pt was not hypoxic, not febrile, and had a negative chest x-ray. the flagyl was stopped after 3 c. diff stool studies came back negative. the patient was briefly on pressors overnight the night of admission but these were discontinued in the morning and he remained hemodynamically stable. he was kept in the micu for thick secretions requiring frequent suctioning but was transferred to the floor as he was off the vent for over 48 hours and secretions thinning. for his brain tumor, keppra was continued for seizure prophylaxis and his neuro-oncologist was contact. the family was also requesting a new rehab placement and this process was started with case management. floor course on the floor, he remained hemodynamically stable and afebrile. vancomycin was restarted since pt was having increased sputum production, sputum cultures grew mrsa, he had an elevated wbc of 20, and ? bibasilar infiltrates on cxr . he should continue for total 10 day course of vancomycin. he was not continued on zosyn since mrsa was felt to cause of pneumonia given sputum culture results. if he develops fever, increase in wbc, or increased sputum production, would consider broadening coverage but it was not felt to be neccessary at the time of discharge. he continued to have diarrhea with rectal tube in place but had 3 negative c. difficile toxins, most recently . his afib was well controlled on metoprolol 12.5 mg po bid. this dose may need to be titrated based on bp and hr. insulin was stopped since he was not requiring any in house and does not carry diagnosis of diabetes. he was continued on all of his outpatient medications for his chronic medical problems. asa 81mg daily was added given his history of mi and he is now approx. 2 months out from his hemorrhage. we continued to hold coumadin given recent hemorrhagic cva . medications on admission: 1. senna 8.6 mg tablet : 1-2 tablets po bid 2. docusate sodium 50 mg/5 ml liquid 3. metoprolol tartrate 25 mg po bid 4. lansoprazole 30 mg tablet,rapid dissolve, dr daily. 5. allopurinol 100 mg tablet 2 tablet po daily 6. simvastatin 40 mg tablet po daily 7. acetaminophen 325 mg po q6h prn for pain. 8. nystatin 100,000 unit/g cream : apply to affected areas. 9. levetiracetam 500 mg po bid 10. ipratropium bromide 17 mcg/actuation aerosol : six (6) puff inhalation qid (4 times a day). 11. oxycodone-acetaminophen 5-325 5-10 mls po q6h prn for pain. 12. ascorbic acid 90 mg/ml drops po daily 13. zinc sulfate 220 mg 14. insulin regular human 100 unit/ml ss discharge medications: 1. vancomycin in dextrose 1 gram/200 ml piggyback : one (1) gram intravenous q 12h (every 12 hours) for 6 days. 2. senna 8.6 mg tablet : 1-2 tablets po bid (2 times a day) as needed. 3. colace 50 mg/5 ml liquid : five (5) ml po twice a day as needed for constipation. 4. metoprolol tartrate 25 mg tablet : 0.5 tablet po bid (2 times a day). 5. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr once a day. 6. allopurinol 100 mg tablet : two (2) tablet po daily (daily). 7. simvastatin 40 mg tablet : one (1) tablet po daily (daily). 8. acetaminophen 325 mg tablet : one (1) tablet po q6h (every 6 hours) as needed for pain. 9. levetiracetam 500 mg tablet : two (2) tablet po bid (2 times a day). 10. ipratropium bromide 17 mcg/actuation aerosol : two (2) puff inhalation qid (4 times a day). 11. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 12. acetylcysteine 20 % (200 mg/ml) solution : one (1) neb miscellaneous q8h (every 8 hours) as needed for thick secretions. 13. zinc sulfate 220 mg capsule : one (1) capsule po once a day. 14. ascorbic acid 90 mg/ml drops : one (1) ml po once a day. discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis 1. hypoxemic respiratory failure 2. health care associated pneumonia secondary diagnosis brain tumor, likely low grade glioma afib stage 2 sacral decubitus ulcer cad htn mds hit discharge condition: hemodynamically stable, satting high 90s on 50% trach mask, afebrile discharge instructions: you were admitted to the hospital because you had low oxygen saturations at your rehab facility. you had your trachesostomy tube changed on admission . we started antibiotics to treat you for pneumonia and you should complete a 10 day course. we made the following changes to your medications 1. we added vancomycin which you should continue for 6 more days 2. we added asa 81 mg 3. we decreased the dose of your metoprolol in half since your bp was on the lower side 4. we stopped your insulin since you were not requiring this medication and did not have high blood sugars please return to the er or call your primary care physician if you develop shortness of breath, cough, fever, chills, chest pain, numbness or weakness or any other concerning symptoms. followup instructions: provider: , md phone: date/time: 1:00 provider: phone: date/time: 11:55 please also call your primary care doctor at 617 to make an appointment in the next 1-2 weeks. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours bronchoscopy through artificial stoma replacement of tracheostomy tube diagnoses: pneumonia, organism unspecified unspecified essential hypertension gout, unspecified atrial fibrillation personal history of malignant neoplasm of prostate coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status myelodysplastic syndrome, unspecified other and unspecified hyperlipidemia acute respiratory failure pressure ulcer, lower back late effects of cerebrovascular disease, hemiplegia affecting unspecified side hyperparathyroidism, unspecified diarrhea other diseases of trachea and bronchus heparin-induced thrombocytopenia (hit) pressure ulcer, stage ii attention to tracheostomy malignant neoplasm of frontal lobe 

Answer: The patient is high likely exposed to