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 / erythromycin base attending: chief complaint: hypotension, mental status change major surgical or invasive procedure: placement of right ij central venous catheter placement of left subclavian central venous catheter attempted dcc cardioversion placement of arterial line left radial artery intubation and extubation history of present illness: patient is a year old rehab resident who presented to the ed from center with change in mental status. according to his family he has not been himself for the past few days and has been progressively more confused. according to the nurse on the floor he has been confused for two days. he refused food today and his bp was lower than usual. usually he runs in the 110-120s systolic. today his daughter went to visit him and he did not recognize herand did not know where he was. of note, his right leg has been weak lately, and he has been noted to have more difficulty ambulating. on he fell and hit his head. today at rehab his temperature was 96.2, pulse 91, bp 88/60 and o2 sat 94% on room air. his blood glucose was 39. . in the ed his first set of vitals were t 96, hr 65, bp 92/50, rr 21, 100% 2l and fs 339 and he was oriented x 2 and confused. repeat bp was 80/32 with hr 66. lactate was 3.4 with wbc 16.6, na 129, creatinine 3.0. ua showed > 1000 wbc with moderate bacteria. he received four liters of fluid and bp was still 69/33. he was started on dopamine. a rij was placed and he was switched to levophed at 0.03 mcg/kg/min and map came up to 75-80. . he was started on the sepsis protocol. he received vancomycin, ceftriaxone and flagyl. he received a total of 5500 cc in ed and had 500 cc of uop. . he ruled in for mi with ck: 435 mb: 20 mbi: 4. depressions in v2-5. past medical history: 1. cad with 3vd noted on cath after mibi with resulting mi 2. mild right hemiparesis 3. psoriasis 4. vocal cord hoarseness 5. diabetes 6. htn 7. pvd with ulceration 8. right foot dry gangrene 9. bladder cancer 10. peripheral neuropathy 11. ataxia 12. osteoarthritis 13. depression 14. h/o bipolar disorder 15. h/o recurrent falls 16. s/p cataract surgery . mitral regurgitation 18. history of bladder cancer s/p bladder fulgerations 19. history of uretheral stricture s/p uretheraotomy social history: mr. has lived at rehab for the past ten years since his wife passed away. he has two daughters and one son. his daughter, , is his health care proxy. has an advance directive that states that if there is no hope for recovery he does not want to be keep alive on a ventilator. he also has a dnr/dni form but has confirmed and his family has confirmed that he would want to be intubated and shocked if it was medically necessary now. family history: unknown physical exam: t 97.6 r hr 87 bp 133/52 rr 23 o2 sat 90% 2l gen: elderly gentleman who appears younger than his stated age, lying in bed, comfortable in nad. heent: perrl, eomi, sclera anicteric, mmm. neck: no lad, jvd or thyromegly. cv: rrr with no m/r/g lungs: decreased breath sounds at bases bilaterally without crackles. abd: soft, nt, nd active bs, no hepatosplenomegly. ext: extensive skin changes consistent with arterial insufficiency. there is 2+ edema on the right and 1+ edema on the left. there is an area of erythema on the right calf that is not warm to touch. there is an open shallow wound on the left calf that is covered. there is a 4 inch ulcer on the dorsal aspect of the right foot which is dry in some areas with eschar and wet in some areas. there is extensive fungal infection between the toes. pertinent results: 129 | 92 | 67 / 291 agap=20 5.0 | 22 | 3.0\ ck: 435 mb: 20 mbi: 4.6 trop-*t*: 1.46 mcv 81 16.6 \10.1/364 /29.7\ n:88.3 band:0 l:8.3 m:3.2 e:0.2 bas:0.1 microcy: 1+ pt: 12.0 ptt: 28.3 inr: 1.0 lactate:3.4 ua: color yellow appear cloudy specgr 1.012 ph 5.0 urobil neg bili neg leuk mod bld mod nitr neg prot 30 glu 100 ket neg rbc 21-50 wbc >1000 bact few yeast none epi <1 . studies: cxr: there is a new opacity at the left base probably a combination of consolidation with a small left pleural effusion. also noted is patchy opacity at the right base which obscures the right heart border. the upper lungs zones are clear. again demonstrated is scoliosis of the lower thoracic spine convex right. impression: small left pleural effusion and bilateral lower lobe consolidations consistent with pneumonia. . ecg: sinus at 70 bpm. normal intervals. left axis deviation. compared to prior , no acute change. . #2 ns at 77 bpm, normal intervls. lad. st depressions of 2 mm in v2-3 and 1 mm in v4-5, new from prior . ct abd: 1. moderate-sized bilateral pleural effusions with associated atelectatic changes/consolidation. 2. ascites. 3. layering gallstones and a mildly dilated gallbladder. 4. wall thickening especially of the ascending colon. this may be secondary to third spacing, however the differential diagnosis includes colitis from inflammatory, infectious, and ischemic processes. 5. unchanged appearance of adrenal lesions. 6. right kidney stone. . echo : 1. the left ventricular cavity size is normal. there is severe global left ventricular hypokinesis to akinesis with some preservation of basal wall motion. overall left ventricular systolic function is severely depressed. 2. the aortic valve leaflets (3) are mildly thickened. 3. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. 4. compared with the prior study (images reviewed) of , left ventricular systolic function has deteriorated. . ruq u/s : mild distended gallbladder with sludge in its lumen and mild wall edema. hida scan is recommended to rule out acute cholecystitis. brief hospital course: year old man with history of cad, chf, bladder cancer, diabetes, severe peripheral vascular disease with right foot dry gangrene presents from nursing home with change in mental status and hypotension. . 1) hypotension/sepsis: the patient was found to be in urosepsis due to enterococcal uti. he required pressor support with levofloxacin and vasopressin. initially he was started only on levofloxacin. by day two of his hospitalization and he became more acidemic, and was unable to compensated adequately, and was intubated for improved ventilation. he required >20l iv fluids during his three day hospital course to maintain cvp >10 and urine output >30cc/hr. he also suffered an nstemi in setting of hypotension (see below for details) and went into afib rvr. enterococcal uti was treated with vancomcyin initially, then linezolid until sensitivities returned. it was not vre, and vancomycin was resumed. he was not adrenally insufficient, and stress dose steroids were not started. his svo2 deteriorated suggesting worsening cardiac output, but chronotropic/inotropic agents were not started on account of his tachycardia and hypotension. on day three the decision was made by his two daughters and son to withdraw care as the patient had expressed desire previously not be on ventilator for prolonged period and not to be supported if he would not return to his previous functional state. he died . 2) hypercarbic respiratory failure: in the setting of severe sepsis and hypotension patient developed a lactic acidosis with bicarbonate of 9 and was unable to compensate from a respiratory standpoint. he was intubated on and also started on a bicarbonate drip. 3) myocardial infarction: patient developed dynamic ecg changes that developed in the ed in the setting of map < 60. he had know 3vd that had not been repaired. this was thought to be demand ischemia. echo revealed a severely depressed ef of 20% from prior with focal lv wall motion abnormalities. 4) atrial fibrillation with rvr 170s: on day two of hospitalization the patient went into afib iwth rvr, hr 170s and acute blood pressure drop. he was shocked twice at 200j with brief conversion to sinus rhythm and then return to afib. he was loaded with amiodarone and digoxin. it was not known whether afib occurred in the setting of acute cardiac event or worsening sepsis as his troponin and lactic acidosis had been improving at the time. he later developed worsening sepsis and elevated cardiac enzymes, peak tropt 8.32. the amiodarone was discontinued in setting of worsening hypotension. he continued on the digoxin, and was in sinus rhythm by day three of hospitalization. 5) arf: baseline creatinine is 0.9. creatinine on admission was 3.0 in setting of hypoperfusion due to septic shock. renal function improved with iv fluid hydration. medications were renally dosed for admission crcl <15. he maintained adequate urine ouput on average >30cc/hr, but occasionally dropped to 10cc/hr. 6) diabetes: he was treated with insulin drip. 7) mental status changes: initially improved with fluid repletion but then worsened again in the setting of worsing sepsis. ct head showed no sign of sdh or stroke. he was intubated and sedated at time of decision to withdraw care. 8) on day four of hospitalization, a family meeting was held. the patient had improved in terms of sepsis, but had sustained substantial cardiac insult following the mi. the patient's family discussed that hte patient had previously been a dnr/dni and had requested he not have prolonged mechanical support, especially if his prognosis was not to return to his baseline functional status. ventilatory support was withdrawn on and the patient expired due to sepsis and concurrent respiratory failure. medications on admission: acetaminophen 650 mg q6 prn nitroglycerin 0.3 mg prn senna 2 tabs daily plaxiv 75 daily lisinopril 5 mg daily cilostazol 100 mg clindamycin 600 mg prn metformin 850 mg aluminum hydroxide 30 ml q shift tramadol 25 mg q shift magnesium hydroxide 30 ml daily prn glyburide 7.5 mg am and 7.5 mg pm aspirin 325 mg po daily lasix 20 mg folice acid 1 mg daily oxazepam 30 mg qpm fexofenadine 30 mg tramadol 25 mg daily gabapentin 300 mg qhs bacitracin 1 daily menthol/camphor to rash triamcinolone acetate 0.1 prn metoprolol 25 daily tramadol 25 qhs discharge medications: expired discharge disposition: expired discharge diagnosis: urosepsis nstemi discharge condition: expired discharge instructions: expired followup instructions: expired procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube other electric countershock of heart arterial catheterization transfusion of packed cells infusion of vasopressor agent diagnoses: acidosis subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery mitral valve disorders urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia severe sepsis atrial fibrillation acute respiratory failure septic shock old myocardial infarction personal history of malignant neoplasm of bladder unspecified hereditary and idiopathic peripheral neuropathy bipolar i disorder, most recent episode (or current) unspecified atherosclerosis of native arteries of the extremities with ulceration ulcer of heel and midfoot ulcer of ankle 

Answer: The patient is high likely exposed to