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 attending: chief complaint: found down at work with st-elevation myocardial infarction. major surgical or invasive procedure: cardiac catheterization, . history of present illness: 42 year old male with dm, current tob use who presented to osh with st elevation mi (inferior and posterior mi). patient was at work (painter) when his colleagues found him down and unresponsive, unclear for how long, called ems. patient was in vfib arrest and was coded, shocked 7 times, intubated and transferred here for urgent cardiac catheterization. during cath, patient was found to have 3vd, stents placed in totally occluded prox rca, lad and om1 of lcx. patient also with ph 7.2, metabolic acidosis, anion gap 23, blood sugar 316 likely dka with wbc 21. past medical history: 1. diabetes mellitus 2. hypercholesterolemia social history: lives with wife (not legally married), no children, (+)tobacco. family history: unknown. physical exam: gen: sedated, intubated, not responsive. heent: pupils equal minimally reactive from 4 to 3mm, intubated cv: rrr/st, nl s1/s2, no murmurs pulm: ctab abd: (+) bs, soft, nd/nt ext: wwp, no edema, 1+ dp pulses b/l neuro: pupils reactive to light and accomodation, no tone, intact gag/swallow, hypo/a-reflexic, downgoing toes b/l. pertinent results: eeg : abnormal eeg due to the slow and relatively low voltage background with occasional bursts of generalized slowing. these findings indicate a widespread encephalopathic condition affecting both cortical and subcortical structures. medications, metabolic disturbances, infection, and anoxia are among many possible causes. there were no areas of persistent focal slowing, and there were no epileptiform features. . brain mr : there is no mr evidence of subacute hemorrhage, edema, midline shift, mass effect or hydrocephalus or extraaxial collections. moderate brain atrophy noted. periventricular deep white matter ischemic changes noted suggestive of mild small vessel disease. diffusion-weighted images demonstrate no definite evidence of restricted diffusion to suggest acute infarct. mucosal thickening is noted in the maxillary, ethmoid and sphenoid sinuses. . eeg : mildly abnormal eeg due to a reduced voltage and mildly slowed posterior background indicating a mild diffuse encephalopathy. . cxr : heterogeneous opacification in the left infrahilar lung represent early pneumonia. pulmonary vascular congestion indicates borderline cardiac function. the heart size is normal and there is no pleural effusion. nasogastric tube tip projects over the region of the pylorus. no pneumothorax or appreciable pleural effusion. . echo : lvef 45-50%; the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is mild regional left ventricular systolic dysfunction. overall left ventricular systolic function is mildly depressed. resting regional wall motion abnormalities include basal septal hypokinesis and inferior and inferolateral hypokinesis. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets appear normal. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no pericardial effusion. . cath : 1. 3vd in this r dominant circulation. the lmca was without angiographically apparent flow limiting disease. the mid lad had an 80% stenosis spanning the origin of a moderate sized d2. the d1 was a small vessel without flow limiting disease. the lcx gave off a large om1 that had a 90% thrombotic stenosis in its lower pole. the rca had a 100% proximal stenosis consistent with fresh thrombus. 2. resting hemodynamics demonstrated markedly elevated left and right sided filling pressures and depressed cardiac output/index (4 l/min and 2.0 l/min/m2) consistent with cardiogenic shock. 3. the patient had 2 episodes of unstable ventricular tachycardia which responded to 200 j cardioversion. 4. left ventriculogram was not performed to decrease contrast load. 5. successful pci of the rca with two overlapping cypher des (2.5 x 28 mm distally and 3.0 x 33 mm proximally), and rescue of the jailed marginal branch with a 1.5 mm balloon. 6. successful placement of an 8 french 40 cc iabp in the rfa. 7. successful pci of the lcx with a 3.0 x 28 mm cypher des. 8. successful pci of the lad with a 2.5 x 28 mm cypher des. final diagnosis: 1. three vessel coronary artery disease. 2. severe lv systolic and diastolic ventricular dysfunction. 3. cardiogenic shock. 4. acute inferior st elevation myocardial infarction, managed by pci of proximal rca, mid om1 and mid lad with cypher stents. 5. unstable ventricular tachycardia requiring dc cardioverion. 6. placement of intra-aortic balloon pump via right femoral artery. brief hospital course: 42 year old male with dm, transferred from osh for emergent cath found to have 3vd s/p stents to 100% rca ( 2), lad ( 1), om ( 1). . cardiac: pt. treated with asa, plavix, bb, statin, ace-i, and ccb. bb and ace-i doses titrated up for htn. echo revealed lvef=45-50% with basal septal hypokinesis and inferior and inferolateral hypokinesis. pt. was monitored continuously on telemetry and remained in nsr/st with only occasional pvcs. pt. may undergo repeat tte in months to evaluate interval changes in ef/valve function. . pulmonary: pt. was intubated upon arrival to the hospital. during a pressure-support trial off sedation, the pt. bit through the cuff inflator tube, and was therefore extubated. anesthesia saw the pt. immediately and the pt. was able to protect his airway. he was weaned down to room air, although did initially require frequent suctioning. at the time of discharge, pt. had strong gag and cough reflex, and had o2 saturations in the high 90s. . neuro: pt. was initially sedated in the setting of stemi s/p cath and intubation. sedation discontinued after the pt. was extubated to attempt to assess neurologic status. concern was for anoxic brain injury. eegs revealed mild diffuse encephalopathy and no evidence of seizure activity. mri showed no evidence of infarct. pt. was evaluated by neurology service. approximately 10 days after admission, pt. transitioned from a non-responsive persistent vegetative state to awake, responsive, moving all four extremities. at the time of discharge, his neurologic status was continually improving, but clearly rehabilitation and physical/occupational therapy will be needed to maximize recovery of function. patient has been enrrolled in a study with behavioral neurology. this service is aware of him going to rehab. patient will be contact for a follow up. . diabetes mellitus: pt. had an elevated anion gap on admission, concerning for ketoacidosis. this gap closed with iv-fluid resuscitation and insulin, and the pt. had no other signs of ketoacidosis. his fingersticks were checked regularly and an insulin sliding scale was used in addition to a morning and evening dose of nph 24qam/24qpm. . infection: pt. was found to have an elevated wbc and fever, a cxr was consistent with early pna involving l infra-hilar area. sputum cultures grew coagulase-positive staph aureus and streptococcus pneumoniae. the pt. was treated with levofloxacin for 10-days and flagyl for 7-days. urine and blood cultures were checked and were negative. . dental: pt. has very poor dentition including several missing teeth (likely secondary to no dental insurance). the pt. was seen by the hospital dental service, who recommended routine mouth hygeine. the pt. was also treated with oral chlorhexidine. . fen: tube feeds were initiated after placement of an ng-tube, but were stopped after one day due to high residuals and aspiration risk post-extubation. tpn was started while pt. underwent g-tube placement. tube feeds were reinitiated through g-tube, and were well tolerated. the pt. did become hypernatremic, likely due to free water deficit and concentrated tube feeds; this resolved with free water repletion. medications on admission: humalog mix 75/25 actos 15mg qd discharge medications: 1. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 3. chlorhexidine gluconate 0.12 % mouthwash sig: one (1) ml mucous membrane (2 times a day). 4. docusate sodium 150 mg/15 ml liquid sig: one (1) po bid (2 times a day). 5. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 6. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 7. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 8. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 9. clopidogrel 75 mg tablet sig: two (2) tablet po daily (daily). 10. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 11. lansoprazole 15 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 12. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for fever. 13. metoprolol tartrate 50 mg tablet sig: two (2) tablet po bid (2 times a day). 14. pioglitazone 15 mg tablet sig: one (1) tablet po daily (daily). 15. humalog insulin sliding scale, nph 24u qam / 24u qpm 16. metoclopramide 5 mg/ml solution sig: one (1) injection q6h (every 6 hours) as needed. 17. g-tube care per routine discharge disposition: home with service discharge diagnosis: 1. inferior st-elevation mi, s/p stenting. 2. non-persistent vegetative state. discharge condition: fair, stable. discharge instructions: please continue all medications as prescribed. if you experience chest pain, shortness of breath, or severe nausea/vomiting, please return to the hospital. followup instructions: please follow up with your pcp after rehab. please call cardiology clinic to make an appointment with dr in about 2-3 months ( follow up with dr with behavioral neurology - procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified combined right and left heart cardiac catheterization coronary arteriography using two catheters parenteral infusion of concentrated nutritional substances injection or infusion of platelet inhibitor enteral infusion of concentrated nutritional substances other electric countershock of heart percutaneous [endoscopic] gastrostomy [peg] implant of pulsation balloon nonoperative removal of heart assist system insertion of drug-eluting coronary artery stent(s) infusion of vasopressor agent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] insertion of four or more vascular stents destruction of cranial and peripheral nerves procedure on three vessels diagnoses: tobacco use disorder paroxysmal ventricular tachycardia anoxic brain damage cardiogenic shock long-term (current) use of insulin diabetes with ketoacidosis, type i [juvenile type], not stated as uncontrolled methicillin susceptible pneumonia due to staphylococcus aureus hyperosmolality and/or hypernatremia acute myocardial infarction of inferoposterior wall, initial episode of care pneumonia due to streptococcus, unspecified open wound of tooth (broken) (fractured) (due to trauma), without mention of complication other accident caused by striking against or being struck accidentally by objects or persons 

Answer: The patient is high likely exposed to