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: cold to touch major surgical or invasive procedure: left subclavian cvl arterial line intubation history of present illness: 84 y.o. man with multiple medical problems admitted to icu for pneumonia, respiratory failure and septic shock. history is per daughter. daughter, he has been feeling weak over the last 10 days or so. on monday, he sufferred a gtc seizure which he has not had in a few years. he came to ed here at , and was evaluated. workup at the time showed no abnormality though cxr showed possible infiltrate. pt was discharged back home where he has 24 hour caretakers. continued to feel weak, but had no other focal complaints. per daughter, he was not complaining of sob, cp, cough, fever. last night, he felt cold. this continued until today, when he felt cold to the touch and a temperature taken showed t=32 celsius. he was brought to the ed. here he was found to be hypotensive to sbp in 80s and 90s. he did not have significant response to fluid bolus (? 2l ). a central line was placed and he was started on dopamine and levophed. cxr showed bibasilar infiltrate so he was treated for pneumonia with ceftriaxone, vancomycine, levaquin and flagyl. due to hypoxia (78% ra, 91% on nrb), he was intubated. he was then transferred up to micu for further management. he received a total of 5.3 l ns in ed. past medical history: 1) deafness 2) hypothyroidism 3) diastolic dysfunction last tte=, mild as, ar, mr, nml lvef. 4) seizure d/o s/p head trauma 8 years ago 5) h/o falls 6) h/o dysphagia with aspiration 7) s/p pneumonia with left para pneumonic effusion that was tapped and then had subsequent talc pleurodesis. 8) s/o b/l tkr 9) glaucoma 10) hiatal hernia 11) osteoporosis. social history: lives with wife with 24 hour caregiver. does not drink or smoke cigarettes (never). pt is wheelchair bound. her formerly worked in landscaping but is now retired. family history: arthritis and cancer in parents. physical exam: t=35 (tmin=31.3) --- bp = 90/47 ---- hr 70s-100s ---- rr=25 ---- o2 sat 97% on ac 500 x 25 peep 5 fio2 0.6 gen sedated, intubated heent: ncat, pupils pinpoint and min reactive, anicteric, noninjected. op with ett and ogt, dry mm. neck: left subclavian line in place without erythema. no jvd cv: rrr, nml s1s2, 2/6 systolic murmur abd: soft, nt, nd, hypoactive bs, no masses ext: 3+ pitting edema r>l (chronic per daughter), mild mottling of . dp pulse dopplerable on right and 1+ on left. both le warm to touch neuro: moves all fours but sedated. pertinent results: 01:20pm wbc-2.9* rbc-3.62* hgb-11.9* hct-34.2* mcv-94 . pt-12.5 ptt-35.6* inr(pt)-1.0 . glucose-176* urea n-39* creat-1.3* sodium-133 potassium-4.7 chloride-93* total co2-29 anion gap-11 lactate-3.4* . ck(cpk)-64 ck-mb-notdone ctropnt-0.07* . cxr: bibasilar atelectasis/consolidation. worsening opacity in the right upper mid lung zones compared to one day prior. . ecg: nsr with nml axis, ints. twi in avl (old). no other st-t changes. _ _ ________________________________________________________________ cardiology report echo study date of patient/test information: indication: congestive heart failure. left ventricular function. weight (lb): 190 bp (mm hg): 108/55 hr (bpm): 83 status: inpatient date/time: at 12:41 test: portable tte (complete) doppler: full doppler and color doppler contrast: none tape number: 2005e000-0:00 test location: east micu technical quality: adequate referring doctor: dr. measurements: left atrium - long axis dimension: *4.5 cm (nl <= 4.0 cm) left atrium - four chamber length: *6.4 cm (nl <= 5.2 cm) right atrium - four chamber length: *6.0 cm (nl <= 5.0 cm) left ventricle - septal wall thickness: *1.3 cm (nl 0.6 - 1.1 cm) left ventricle - inferolateral thickness: 1.1 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 4.6 cm (nl <= 5.6 cm) left ventricle - systolic dimension: 2.3 cm left ventricle - fractional shortening: 0.50 (nl >= 0.29) left ventricle - ejection fraction: 60% to 70% (nl >=55%) aorta - valve level: 3.2 cm (nl <= 3.6 cm) aortic valve - peak velocity: *2.7 m/sec (nl <= 2.0 m/sec) mitral valve - e wave: 1.1 m/sec mitral valve - a wave: 1.4 m/sec mitral valve - e/a ratio: 0.79 mitral valve - e wave deceleration time: 175 msec tr gradient (+ ra = pasp): *38 to 42 mm hg (nl <= 25 mm hg) interpretation: findings: left atrium: mild la enlargement. right atrium/interatrial septum: moderately dilated ra. left ventricle: mild symmetric lvh. normal lv cavity size. overall normal lvef (>55%). no resting lvot gradient. no lv mass/thrombus. no vsd. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic root diameter. focal calcifications in aortic root. normal ascending aorta diameter. focal calcifications in ascending aorta. aortic valve: three aortic valve leaflets. moderately thickened aortic valve leaflets. mild as. moderate (2+) ar. mitral valve: mildly thickened mitral valve leaflets. no mvp. mild mitral annular calcification. mild thickening of mitral valve chordae. calcified tips of papillary muscles. moderate (2+) mr. tricuspid valve: mildly thickened tricuspid valve leaflets. normal tricuspid valve supporting structures. moderate tr. moderate pa systolic hypertension. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. normal main pa. no doppler evidence for pda pericardium: no pericardial effusion. conclusions: the left atrium is mildly dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef 6070%). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. there are three aortic valve leaflets. the aortic valve leaflets are moderately thickened. there is mild aortic valve stenosis. moderate (2+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the findings of the prior report (images unavailable for review) of , mild aortic stenosis is now present; the aortic, mitral, and tricuspid regurgitation are all increased. electronically signed by , md on 13:20. physician: , () _ _ _ _ _ _ _ _ _ _ ________________________________________________________________ brief hospital course: 84 y.o. man with h/o hypothyroidism, pneumonia, seizures, diastolic chf who presents with hypothermia, hypoxia, and hypotension. cxr revealed pneumonia, and hypothermia and hypotension consistent with septic shock from pneumonia. etiology of pneumonia unclear--may have been secondary to aspiration event from seizure, but more likely preceeded seizure given his generalized weakness. .. .. 1) hypoxic respiratory failure: secondary to multilobar pneumonia. initial abg was 7.17/64/106 suggesting respiratory acidosis from hypoventilation. pt was intubated and remained on venilator for 2 wks. he was extubated on . he remained off the ventlator for 1 wk but was re-intubated secondary to hypoxia and hypercarbia. he remained intubated for 1 wk. after discussion with family the goals of care were changed to comfort. he was extubated on and expired 4 hours later. .. 2) pneumonia: covered broadly for pna with zosyn and vancomycin. he competed a 14 day course. sputum cultures at that time showed only op flora and blood cultures were neagative. when he was re-intubated, he had increaed respiratory secretions and was started again on zosyn/vancomycin. sputum cultures were then re-sent and came back positive for serratia marcescens and enterobacter cloacae. zosyn was discontinued and meropenum started. pt expired on meropenum and vancomycin after goals were changed to comfort. . 3) septic shock: pt was hypotensive through out his hospital stay. he had an abnormal cortisol stimulation test and was placed on stress dose steroids. hes was intermitanly on levophed for blood pressure support. medications on admission: 1. depakote 500 mg twice a day. 2. synthroid 75 mcg once a day. 3. protonix 40 mg a day. 4. calcium. 5. vitamin d. 6. colace. 7. senna p.r.n. 8. multivitamin. 9. lasix 20 mg once a day. 10. combivent inhaler. discharge medications: none discharge disposition: expired discharge diagnosis: pneumonia septic shock congestive heart failure discharge condition: expired discharge instructions: none followup instructions: none 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 transfusion of packed cells diagnoses: acidosis thrombocytopenia, unspecified anemia, unspecified pneumonia due to other gram-negative bacteria congestive heart failure, unspecified acute kidney failure, unspecified severe sepsis other convulsions acute respiratory failure septic shock other septicemia due to gram-negative organisms encounter for palliative care hyperosmolality and/or hypernatremia diastolic heart failure, unspecified 

Answer: The patient is high likely exposed to