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: fever major surgical or invasive procedure: none. history of present illness: this is a 79 year old russian speaking male from nursing home with dementia and h/o aspiration pna s/p peg who had a recent admission () at for aspiration pna s/p 10 day course of vanc/levo/flagyl. he presents now from his nursing home with fevers to 103, lethary and increased secretions. . in the ed, vs were: t102.6, bp136/76 -> 80/50, hr 110, rr22, 98-100% 4l nc. he was given 500c ns ivf bolus and his sbp increased to 150s, with hr remaining in the 120s. he was started on levo/flagy/vanco. also received 650mg tylenol pr x1. his midline was removed in the ed and sent for cx. . he was sent to the micu where levo and flagyl was continued. yeast was found in the urine and he was given fluconazole 150mg x1. he remained stable there for 2 days and is transferred to the medical floors for further management. cx. past medical history: # dysphagia s/p peg placement (g-j tube with tip in distal duodenum) # hx of recurrent aspiration pna # dementia # s/p cva # htn # paf # chf # hx of mrsa social history: could not obtain family history: could not obtain physical exam: vs: t97.7 hr96 bp142/100 rr12 o2sat: 96% on 2l nc gen: elderly male, in nad skin: erythematous rash on right antecubetus heent: anicteric sclera. mm dry neck: no elev jvp cv: tachycardic, nml s1,s2. no murmurs resp: right basilar crackles, left side clear abd: soft. ntnd. +peg in place, clean. ext: no edema bilat. pulses symmetric. +area of denudation and erythema at l antecub. neuro: unable to assess ms. moves all ext spont. pertinent results: reports: . ekg: nsr 90. +lad. no st elev/depressions or twis. +laa. no previous to compare. . chest (portable ap) 10:05 am impression: 1. mild cardiomegaly. 2. vague right lower lung zone opacity, which would better be assessed on pa and lateral chest radiographs. 3. right seventh and eighth posterior rib fractures. . ct head w/o contrast 5:42 pm impression: no hemorrhage or mass effect is identified. . labs: 09:45am blood wbc-7.0 hct-36.6* plt ct-169 mcv-94 . 09:45am blood neuts-85* bands-3 lymphs-7* monos-4 eos-0 baso-1 atyps-0 metas-0 myelos-0 . 09:45am blood pt-12.4 ptt-27.2 inr(pt)-1.1 . 09:45am blood na-138 k-4.0 cl-103 hco3-23 urean-25* creat-0.8 glucose-248* . 09:45am blood phos-3.1 mg-2.5 . 09:45am blood alt-26 ast-31 ck(cpk)-42 alkphos-82 amylase-55 totbili-0.4 . 09:52am blood lactate-2.1* . 09:45am blood ck-mb-notdone ctropnt-<0.01 . 03:45pm blood ck-mb-notdone ctropnt-<0.01 . 06:05am blood probnp-* . micro: blood cx: : aerobic bottle (final report on ): klebsiella pneumoniae, proteus mirabilis. both sensitive to zosyn. . follow up blood cx , , have been negative (preliminary results). . urine cx: : yeast. >100,000 organisms/ml.. . sputum cx : gram stain indicates extensive contamination with upper respiratory secretions. bacterial culture results are invalid. brief hospital course: 79 y/o russian speaking man with dementia and h/o aspiration pna s/p peg placement, who presents from his nh with fever to 103, lethargy, and increased secretions. . # fever: blood culture () positive for klebsiella and proteus sensitive to zosyn. he was treated for 3 days and will finish the 14 day iv zosyn course at rehab. a picc in his right arm has been placed. his follow up blood cultures are all negative although they are just preliminary results. . he also grew >100,000 colonies of organisms. he was treated with fluconazole 100mg po x 1. . he could not produce an adequate sputum sample. cxr was equivocal for pna/aspiration pna. . he was afebrile with no leukocytosis as time of discharge. . # secretions: he has secretions but they never compromised his oxygenation. his saturations are 95% on room air at time of discharge. wall suction was used for secretions but he rarely needed this. scopolamine patch was continued with good effect. . # htn: antihypertensives were held at the micu s/p his episode of hypotension (responded to fluid bolus). he was stablized and when he reached the medical floors, metoprolol and nitro patch was restarted. his sbp stayed between 110-130. lisinopril was held. please consult with pcp whether he should restart lisinopril. . # p-afib: not on anticoagulation due to fall risk but was in nsr. he receieved metoprolol. . # diastolic chf: pt with a h/o chf in the setting of nml ef; suggestive of diastolic dysfunction. he had crackles on lung exam, but he never complained of shortness of breath. his saturations remained over 95% at all times. he did not get iv fluids and was making urine. he was never given diuretics, but his bnp upon discharge was . he should follow up with pcp to discuss whether he should be on diuretics. # gross hematuria: resolved. secondary to foley trauma. . # fungal rash: on back and and buttock and l antecubitus area. miconazole cream was given. . # s/p fall out of bed (): no signs of injuries. denied cp/sob. question of whether he hit his head. ct head final read: no hemorrhage. . # anemia: probably a component of dilutional anemia and his hct remained stable. mvc 95. no obvious source of bleed, no reason for hemolysis. guiaic stools negative. . # fen: npo due to aspiration risk tfs, probalance at goal of 85cc/hr. . # access 2 piv and picc on right arm. . # ppx hep sq, h2 blocker , pneumoboots, bowel regimen aspiration precaution, fall precaution . # dispo: full code. . # communication: medications on admission: scopolamine patch q72 lopressor 50 prozac 40 zyprexa 5 asa 81 qd synthroid 75mctg nitrex 0.4mg/hr patch hytrin 1 senna lisinopril 5 lipitor 10 reglan zantac 150 discharge medications: 1. scopolamine base 1.5 mg patch 72hr sig: one (1) patch 72hr transdermal q72 hours (). disp:*10 patch 72hr(s)* refills:*2* 2. nitroglycerin 0.4 mg/hr patch 24hr sig: one (1) patch 24hr transdermal q24h (every 24 hours). 3. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day) as needed. 4. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 5. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 6. senna 8.8 mg/5 ml syrup sig: one (1) tablet po bid (2 times a day). 7. ranitidine hcl 15 mg/ml syrup sig: ten (10) ml po bid (2 times a day). 8. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 9. terazosin 1 mg capsule sig: one (1) capsule po hs (at bedtime). 10. olanzapine 5 mg tablet sig: one (1) tablet po bid (2 times a day). 11. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 12. docusate sodium 150 mg/15 ml liquid sig: ten (10) ml po bid (2 times a day). 13. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 14. fluoxetine 20 mg/5 ml solution sig: ten (10) ml po daily (daily). 15. insulin regular human 100 unit/ml solution sig: as directed by sliding scale injection asdir (as directed). 16. piperacillin-tazobactam 4.5 g recon soln sig: 4.5 grams recon solns intravenous q8h (every 8 hours) for 11 days: through picc in right arm. discharge disposition: extended care facility: nursing home - discharge diagnosis: bacteremia uti aspiration pna ----------- dysphagia s/p peg placement dementia cva htn paroxysmal afib chf hx of mrsa discharge condition: hemodynamically stable, afebrile. discharge instructions: please take all medication as prescribed, including your course of iv zosyn. keep all appointments listed below. if you feel chest pain or shortness of breath, seek medical attention immediately. if you have fever or if your secretions are a problem, please call your doctor. in general, seek help if you don't feel well. followup instructions: please follow up with dr. next week. you should discuss with dr. whether you should start a medication to decrease fluid in your lungs. please discuss with dr. when to re-start your lisinopril, as this medication was held during this admission. procedure: venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances diagnoses: anemia, unspecified urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site atrial fibrillation pneumonitis due to inhalation of food or vomitus bacteremia diastolic heart failure, unspecified 

Answer: The patient is high likely exposed to