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: codeine attending: chief complaint: mental status change major surgical or invasive procedure: central venous catheter placement history of present illness: this is a year-old man with coronary artery disease, diabetes mellitus, chronic renal insufficiency and dementia presenting from rehab with altered mental status. as per report there, patient noted to be shivering and moaning earlier tonight. (baseline as per report is alert, verbal but confused and completely dependent for adl's.) vital signs largely unremarkable at that time. cbc/chem-10 sent and patient noted to be hyperglycemic to 800's, hypernatremic to 149, potassium of 7. 2, creatinine 3.6 and crit of 30 (unknown baselines). he was given levoquin and transferred to for further management. . in the er, patient afebrile, tachycardic to 102, tachypneic to 20's, bp's 130's to 140's, patient moaning, responsive to pain, moving all four extremities. above lab abnormalities confirmed, lactate of 3.3, cxr revealed rml pneumonia, dirty u/a with apparent uti, treated with 10 units insulin followed by drip, bicarbonate, calcium gluconate, 2 liters ns, vancomycin, levoquin and flagyl. urine output not recorded but by report, good. past medical history: 1. coronary artery disease 2. diabetes mellitus 3. chronic renal insufficiency 4. dementia 5. uti's 6. suprapubic prostatectomy/catheter 7. s/p right nephrectomy? 8. hypertension social history: lives at . former cook at in , travelled extensively with the merchant marines, ? tobacco history. family history: unavailable physical exam: on admission- vs: temp: 98.4/98.2 bp:122/58 hr:105 rr:24 95%rm airo2sat . general: responds to pain, moves all four extremities, intermittenly responds to name, cachectic heent: eomi, anicteric, no sinus tenderness, mmdry, op without lesions, no jvd lungs: crackles at right base, left lung field clear heart: rr, s1 and s2 wnl, no murmurs, rubs or gallops appreciated abdomen: nd, +b/s, multiple scars, suprapubic catheter in place without surrounding erythema, soft, nt extremities: no edema skin/nails: no rashes/no jaundice/ neuro: unable to follow commands, intermittently responds to voice, moves all four extremities . pertinent results: 01:05am blood wbc-20.6*# rbc-3.26* hgb-10.3* hct-31.5* mcv-97# mch-31.6 mchc-32.7 rdw-15.4 plt ct-473* 07:05am blood wbc-15.3* rbc-3.69* hgb-11.2* hct-34.4* mcv-93 mch-30.3 mchc-32.5 rdw-15.3 plt ct-510* 07:05am blood glucose-32* urean-41* creat-2.5* na-144 k-4.7 cl-113* hco3-17* angap-19 03:52am blood alt-19 ast-25 alkphos-93 amylase-296* totbili-0.4 06:50am blood lipase-57 07:05am blood calcium-9.7 phos-3.6 mg-2.3 06:50am blood caltibc-183* ferritn-421* trf-141* 03:52am blood %hba1c-7.5* . renal u.s. 4:08 pm renal ultrasound: study is limited due to patient cooperativity. no gross abnormality seen in the right renal bed. the left kidney measures 9.7 cm. there is no hydronephrosis. there is a small cyst in the mid-to-lower pole measuring up to 14 mm. there is no overt solid mass. probable extrarenal pelvis. no hydronephrosis. . chest portable 2:02 am findings: placement of right internal jugular venous catheter is identified in the expected region of the mid svc. no pleural effusion or pneumothorax identified. again noted is airspace opacity within the right lower lobe. impression: 1. normal placement of right internal jugular venous catheter without pneumothorax identified. 2. right lower lobe pneumonia as described previously. . brief hospital course: this is a year-old man with history of dementia, cad, diabetes mellitus, chronic renal insufficiency who presented with mental status change, work up remarkable for honk, hypernatremia, pneumonia, uti. 1)mental status change: multifactorial in secondary to hyperglycemia, hypernatremia, pneumonia, metabolic derangements. the patient's mental status returned to baseline once metabolic derangements and infections were treated. 2)endocrine: the patient has an unclear history of dm, but not presently on medications. hyperosmolar state (honk) likely precipitated by pneumonia/uti. he was given aggressive fluids with ns initially, then changed to d5w since hypernatremia was not improving. briefly required an insulin drip, added d5 when sugar <200, converted to long-acting insulin on . he was tapered to standing nph insulin, then later became hypoglycemic with treatment of his infection. he was discharged on humalog sliding scale. treatment with an oral antidiabetic should be considered as an outpatient as pt's hgb a1c was 7.5 on admission. 4)acute on chronic renal failure: pt is s/p l nephrectomy. likely secondary to atn in setting of hypotension, hypovolemia. pt's baseline creatinine is 1.9 according to pcp. improved from 3.8 to 3.0 with iv fluids, but was in plateau phase for several days. renal service was consulted, renal ultrasound did not reveal hydroureter. gentle intravenous fluids continued to improved pt's cr clearance leading up until discharge. his medications were renally dosed. 5) heme: anemia consistent with akd in combination with chronic kidney disease. guaiac negative. renal recommended starting epo q m,w,f. hematocrit was stable on serial checks. 6) infectious disease: a) pneumonia: required icu admission --vancomycin, ceftriaxone, levoquin initially - was changed to vanc/zosyn on for a health care associated pneumonia. he should complete a full 14 day course of vancomycin as his sputum grew mrsa. b) uti--grew cipro and bactrim resistant e. coli- 14 day course of ceftriaxone for complicated uti c) pt developed copius diarrhea on hd #4, was started on empiric flagyl po, c. diff x 2 negative. his stools normalized following initiation of treatment. he should complete a 14 day course following the last day of vancomycin and ceftriaxone. 7) suprapubic catheter: pt was noted to have copious urine drainage from around his suprapubic catheter, without evidence for skin infection. urology was consulted and recommended tolteridine 1mg for potential bladder spasm. he has a 24 fr foley. there is no further role for intervention except for continued monitoring to assure his catheter flushed, dressed properly for good position within the bladder. 8) speech and swallowing evaluation: recommended po diet of soft solids with thin liquids, pills crushed as allowable. aspiration precautions with 1:1 assist at meals. code status: dnr/dni per discussion with or (lives in ) and (lives in ) pt's grandchildren and hcp. at this time, ms. expressed that they would not be opposed to dialysis should mr. eventually require it. medications on admission: (as notes): 1. omeprazole 20mg daily 2. felodipine 10mg daily 3. mvi 4. mom 5. bisacodyl 6. tylenol prn 7. levoquin started discharge medications: 1. docusate sodium 50 mg/5 ml liquid sig: po bid (2 times a day). 2. senna 8.6 mg capsule sig: one (1) tablet po bid (2 times a day) as needed. 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. heparin flush cvl (100 units/ml) 1 ml iv daily:prn 10ml ns followed by 1ml of 100 units/ml heparin (100 units heparin) each lumen qd and prn. inspect site every shift 5. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift 6. epoetin alfa 3,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-friday). 7. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day): day 1 is . continue for two weeks once vancomycin and ceftriaxone is given. 8. acetaminophen 650 mg suppository sig: suppositorys rectal q6h (every 6 hours) as needed. 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 10. humalog 100 unit/ml solution sig: per sliding scale protocol subcutaneous four times a day. 11. ceftriaxone-dextrose (iso-osm) 1 g/50 ml piggyback sig: one (1) gram intravenous q24h (every 24 hours) for 4 days. 12. tolterodine 2 mg tablet sig: 0.5 tablet po bid (2 times a day). 13. vancomycin in dextrose 1 g/200 ml piggyback sig: one (1) intravenous q48h (every 48 hours) for 4 days. discharge disposition: extended care facility: - discharge diagnosis: hyperosmolar nonketotic hyperglycemia delirium hospital acquired pneumonia urinary tract infection clostridium dificile colitis hyponatremia anemia acute renal failure secondary 1. coronary artery disease 2. diabetes mellitus 3. chronic renal insufficiency 4. dementia 5. chronic uti's 6. suprapubic prostatectomy/catheter 7. s/p right nephrectomy? 8. hypertension discharge condition: stable discharge instructions: take all medications as prescribed. do not stop or change any medications without first speaking to your physician. follow up as outlined below. please contact your primary care physician if you experience any pain, shortness of breath, fever, chills, or any other concerning symptoms. followup instructions: you have an appointment with sedo, the nurse practitioner who works with your primary care doctor dr. at 1:30 pm on . call if you have any questions about thsi appointment. md procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified diagnoses: hyperpotassemia anemia in chronic kidney disease acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified infection with microorganisms resistant to penicillins other persistent mental disorders due to conditions classified elsewhere chronic kidney disease, unspecified pressure ulcer, other site intestinal infection due to clostridium difficile methicillin susceptible pneumonia due to staphylococcus aureus pressure ulcer, lower back pressure ulcer, heel hyperosmolality and/or hypernatremia volume depletion, unspecified diabetes with ketoacidosis, type ii or unspecified type, uncontrolled 

Answer: The patient is high likely exposed to