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: history of present illness: the patient is a 57 year old male with a known history of coronary artery disease status post percutaneous transluminal coronary angioplasty approximately a year and a half prior to admission with stent placement to the left ramus, who presented as a transfer from an outside hospital after a witnessed cardiac arrest at the beach. of note, the patient has a history of hitting his head on a seawall prior to the event where he collapsed. the patient collapsed and went into ventricular fibrillation arrest on the beach, and was subsequently shocked six times and received 30 minutes of cpr resuscitation by a bystander. the patient was sent to where he was in electrical mechanical dissociation at 20 beats per minute, given epinephrine, atropine and lidocaine 100 mg intravenous bolus and 2 mg intravenous drip, where his heart rate then returned to 100 to 110, and the patient became hypertensive. at this point, the patient was intubated. ekg showed a right bundle branch block and left anterior fascicular block, deep st segment depressions in v2 through v4 suggestive of an anterior septal myocardial infarction. there is no comparison ekg available. the patient was given a heparin intravenous bolus and no 2b 3a inhibitor secondary to the history of head trauma. the patient was sent to the for urgent catheterization. initial arterial blood gas upon arrival at the was 7.16, 48, 76, and the patient had a lactate of 4.5. the patient had coffee ground on ng lavage which was guaiac negative. upon catheterization, it was found that the patient had a large patent foramen ovale with no left to right shunting. he received three ampules of bicarbonate for worsening acidosis. his anatomy showed aneurysmal left main and left anterior descending. his wedge pressure was elevated at 24. an intra-aortic balloon pump was placed, which was complicated by a left groin bleed. the left anterior descending artery was stented. during the procedure, the patient received lasix, three ampules of bicarbonate and was on a nitroglycerin drip. subsequent to stenting, the patient coded for electrical mechanical dissociation and severely dropped his blood pressure. the patient's status was reversed with atropine, dopamine, transdermal epinephrine and aggressive chest compressions. he was sent up to the cardiac care unit on an iabp and pressors. past medical history: 1. coronary artery disease status post catheterization in with stent to the left ramus. 2. ulcerative colitis, for which he sees dr. . 3. gastroesophageal reflux disease times 15 years. 4. recent prostatitis for which he was on a course of ciprofloxacin. medications upon admission: 1. atenolol. 2. zestril 10. 3. aspirin 81 mg. 4. pentasa. 5. sublingual nitroglycerin as needed for chest pain. allergies: no known drug allergies. social history: the patient is married. he lived in . he has four children and seven grandchildren. he is a real estate . he has a 20 pack year history of tobacco and quit approximately 20 years ago. the patient drinks a few drinks per week of alcohol. family history: the patient's father died at age 66 of an myocardial infarction. the patient has two brothers with heart problems. physical examination: upon admission, vital signs with temperature of 96.2 f.; heart rate of 150 to 160; blood pressure of 80 to 100/50 to 60. intakes and outputs were 1500/300 in three hours. upon arrival to the cardiac care unit, his vent setting is controlled total volume of 800, respiratory rate of 24, peep of 14, 100% fio2, saturating at 99 to 100% on these setting. arterial blood gas 7.23, 49, and 114. swan revealed right atrial pressures of 41, right ventricle pressure of 40, pa pressure of 38/19; wedge pressure of 24. cardiac index of 2.56 which decreased to 1.3. generally, the patient is an ill-appearing gentleman who was paralyzed and sedated. heent examination: pupils were small and minimally responsive to light. ng tube was in place. et tube was in place. neck examination: unable to assess secondary to his cervical collar. cardiovascular examination: increased rate, normal sounding s1, s2. no murmurs, rubs or gallops. lung examination upon anterior and lateral auscultation, there were coarse breath sounds diffusely with no wheezing. abdominal examination, protuberant abdomen, soft, nontender, nondistended. extremities: he had doppler-able dorsalis pedis pulses bilaterally with cold extremities. no peripheral edema. groin clamp was in place over the left groin. positive 1 cm hematoma. arterial venous sheath in place in the right groin with bleeding surrounding it. neurologically, the patient was paralyzed and sedated. laboratory: upon admission to the were white blood cell count of 9.9, hematocrit of 50.5, platelets of 290. sodium 142, potassium 3.7, chloride 106, bicarbonate 19, bun 22, creatinine 1.1, glucose of 210. pt of 14, inr of 1.4, ptt of 36.1. ck, initial set 129, second set 666, troponin initial set less than 0.2, second set 38.0. chest x-ray revealed a questionable adult respiratory distress syndrome versus congestive heart failure. head ct scan was negative for an intracranial bleed. report from the cardiac catheterization revealed large pfo aneurysmal left main, left anterior descending notable for a long 80% lesion, with a focal 90% lesion at the distal portion of the mid - left anterior descending. the ramus with stent which was occluded. the left circumflex artery was clear. the right coronary artery was large with minor irregularities. hospital course: briefly, the patient is a 57 year old gentleman with a history of coronary artery disease status post stent placement in , who presented following ventricular fibrillation arrest and prolonged resuscitation with ekg changes suggestive of an anterior septal myocardial infarction in the setting of increased troponin. the patient is status post an urgent catheterization with stent to the left anterior descending and transfer to the cardiac care unit in cardiogenic shock with intra-aortic balloon pump in place. 1. cardiovascular: a) coronary artery disease: the patient has a history of coronary artery disease status post stent to the left ramus in , now with ekg and enzymes suggestive of anterior septal myocardial infarction with stent placement to the left anterior descending. cardiac enzymes were cycled and initial ck was 129. cpk reached a peak at midnight on at 4,087 and the mb peaked on at 77. the patient was treated with aspirin 325 mg, plavix 75 mg; lipitor 10 mg. during his hospital stay, imdur was added on . b) the hospital course was complicated by cardiogenic shock requiring pressors in the cardiac care unit, which were ultimately weaned off within the first two days of hospitalization and intra-aortic balloon pump was also discontinued. the patient had an echocardiogram on , which revealed an ejection fraction of 20 to 30%. his course was complicated by episodes of hypertension particularly during the time while we were attempting to extubate the patient. pressures increased up to 230/110 transiently, which were reversed with lopressor. the patient was on a regimen of high dose lopressor and captopril during his stay which was switched to once a day dosing of enalapril 40 and atenolol 100 a few days prior to discharge. the patient was also started on 10 of norvasc for good blood pressure control. upon discharge, the pressures were consistently stable in the 120s to 130. c) rhythm: the patient is status post ventricular fibrillation arrest. he was seen by electrophysiology attending who recommended defibrillator placement. he had an abnormal signal average ecg on , abnormal for long filtered qrs. an icd was placed on , and the patient is scheduled to follow-up with electrophysiology service, dr. , as an outpatient. 2. pulmonary: the patient was intubated from until . he was successfully extubated on , and for the remainder of his hospital stay was saturating well from 93 to 98% on two liters of oxygen. chest x-ray on showed evidence of bilateral lower lobe aspiration pneumonia, which appears to be improving on a subsequent chest x-ray on . the patient completed a 14 day course of triple antibiotic therapy. please see infectious disease below for specifics of the antibiotic regimen. 3. infectious disease: on hospital day number two, the patient spiked a temperature to 102.5 f., and continued to have persistent fevers for approximately five to seven days. he was started on an empiric triple antibiotic regimen on , of vancomycin, flagyl and levaquin. etiology of his fevers remained unclear. possible causes are aspiration pneumonia as evidenced on chest x-ray. a ct scan of the head revealed some evidence of sinusitis. ct scan of the abdomen revealed no evidence of retroperitoneal abscesses or hematoma. blood cultures and urine cultures were sent times three, which all returned negative. the patient's sputum grew gram positive cocci in pairs and clusters. the patient continued on a 14 day course of triple antibiotic therapy, completing his course of vancomycin, cefepime and flagyl on . the patient remained afebrile from until discharge. infectious disease was consulted early in the hospital course for their recommendations upon appropriate antibiotic coverage for nosocomial infection. 4. hematology: the patient was admitted with a hematocrit of 50 which subsequently dropped three days later to the low 30s. it was unclear where the patient was bleeding. upon admission, he had some coffee ground emesis that was guaiac negative. all his stools were guaiac negative as well. a ct scan of the abdomen revealed no evidence of retroperitoneal hematoma. it was thought that the decrease in his hematocrit may have been secondary to initial concentration followed by dilutional effect of large amounts of fluid early in his hospital course. the patient was transfused one unit of blood during his hospital course and his hematocrit remained stable in the low 30s for the remainder of his course. 5. gastrointestinal: the patient has a history of ulcerative colitis followed by an outpatient gastroenterologist, and was started on pentasa 1 gram four times a day upon admission. a rectal tube was placed during the time when the patient was intubated, and following extubation, the patient had multiple episodes of soft brown bowel movements which peaked in frequency on . the patient's outpatient gastroenterologist, dr. , was contact for recommendations upon further management. the patient was started on imodium once a day and subsequently had decreased frequency of stools. clostridium difficile was sent on multiple occasions which were negative. the patient is to follow-up with his outpatient gi physician following discharge. 6. endocrine: the patient was admitted with elevated blood sugars in the low 200s, started on a regular insulin sliding scale with fingerstick blood sugar monitoring four times a day. the patient last required insulin on , and sugars were within normal limits for the remainder of the patient's hospitalization. the patient should be followed up as an outpatient for further evaluation of diabetes mellitus as he had no prior history prior to admission. 7. neurologic / psychiatric: during the period peri-extubation, the patient was extremely agitated, requiring ativan and p.r.n. haldol. following extubation, the patient had persistent short term memory deficits, however, his long-term memory appears to be intact. he had decreased lower extremity motor strength which has progressively improved during the course of his hospital stay prior to discharge. psychiatry was consulted during his stay for recommendations regarding medical management of his agitation and evaluation of questionable delirium. 8. renal: the patient has no known history of renal insufficiency and tolerated aggressive diuresis during his hospital course without a bump in creatinine. 9. fluids, electrolytes and nutrition: prior to and just following extubation, the patient was aggressively diuresed as it was thought he had extravascular fluid overload. electrolytes were repleted as necessary. the patient tolerated a cardiac prudent diet prior to discharge without problems. 10. prophylaxis: the patient was placed on pneumoboots following the discontinuation of heparin and was up and out of bed and ambulating during the week prior to discharge. the patient was started on protonix 40 mg twice a day. the patient was discharged with the following discharge diagnoses, medications and instructions. discharge diagnoses: 1. coronary artery disease status post anterior septal myocardial infarction with stent placement to the left anterior descending. 2. status post ventricular fibrillation arrest with prolonged resuscitation. 3. ulcerative colitis. 4. gastroesophageal reflux disease. 5. anemia. discharge medications: 1. aspirin 325 mg p.o. q. day. 2. plavix 75 mg p.o. q. day to be discontinued on . 3. lipitor 10 mg p.o. q. day. 4. imdur 60 mg p.o. q. day. 5. atenolol 100 mg p.o. q. day. 6. enalapril 40 mg p.o. q. day. 7. norvasc 10 mg p.o. q. day. 8. lasix 40 mg p.o. q. day. 9. protonix 40 mg p.o. twice a day. 10. mesalamine 1 gram p.o. four times a day. 11. imodium 1 tablet p.o. twice a day. discharge instructions: 1. the patient is to follow-up with outpatient primary care physician, . , phone number , on , at 10 a.m. 2. the patient is to follow-up with electrophysiology service physician, . on , at 02:00 p.m. 3. the patient is to follow-up with dr. , gastroenterology outpatient physician on , at 01:30. 4. the patient is to call primary care physician with any complaints of chest pain, shortness of breath, palpitations, lightheadedness, dizziness, nausea or vomiting, that may be suggestive of cardiac etiology. 5. the patient will be transferred to a rehabilitation facility for physical therapy and rehabilitation. , m.d. dictated by: medquist36 d: 16:45 t: 18:15 job#: procedure: insertion of non-drug-eluting coronary artery stent(s) coronary arteriography using two catheters angiocardiography of left heart structures left heart cardiac catheterization implant of pulsation balloon implantation or replacement of automatic cardioverter/defibrillator, total system [aicd] diagnoses: congestive heart failure, unspecified acute myocardial infarction of other anterior wall, initial episode of care hemorrhage complicating a procedure pneumonitis due to inhalation of food or vomitus cardiac arrest cardiogenic shock ostium secundum type atrial septal defect ventricular fibrillation 

Answer: The patient is high likely exposed to