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: sob, intubation, hypotension requiring pressors major or invasive procedure: egd bronchoscopy percutaneous tracheostomy history of present illness: mr. is a 63 yo male with h/o cva, htn, type 2 dm, hypothyroidism who presented for the in respiratory distress. per report, he was coughing this morning. cxr at house showed a left lower lobe infiltrate. he was started on levaquin 750 mg daily. later in the day, he was noted to be lethargic and hypotensive with bp of 65/41. he was hypoxic to 91% on 2lnc. he was noted to have inspiratory wheezing and crackles. . upon arrival to the icu, he was hypoxic to 90% on nrb and was felt not to be protecting his airway, so he was intubated. he was hypotensive to the 70s so was given 3lns and placed on levophed at 0.l5. a cxr was performed which showed multifocal pneumonia. he was given vanco/zosyn. . upon arrival to the unable to obtain further history as patient is intubated and sedated. past medical history: hypertension hypothyroidism h/o cva (bilateral embolic cerebellar , hemorrhagic left thalamic ) type ii diabetes mellitus peripheral neuropathy depression h/o dvt atrial fibrillation peripheral vascular disease hyperlipidemia anemia of chronic disease c.diff colitis in requiring total abdominal colectomy with end ileostomy social history: resident of . family very involved in patient's care. patient does not take anything by mouth due to history of aspiration. spanish-speaking. patient is a former 60 py smoker, but quit in . patient denies alcohol or drug use. family history: patient has a morther with diabetes and brother with heart disease. physical exam: vitals: t 97.0, hr 68, rr 17, bp 125/50 on 0.15 of levophed, 100% intubated general: intubated, sedated, not responding to commands heent: sclera anicteric, mmm, et tube present lungs: rhonchi diffusely anteriorly, no wheezes cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly, + peg in place, + ileiostomy gu: + foley ext: cool extremities, no edema pertinent results: 07:15pm blood wbc-12.4* rbc-3.75* hgb-9.0* hct-27.6* mcv-74* mch-23.9* mchc-32.6 rdw-14.5 plt ct-169 07:15pm blood neuts-81.0* lymphs-11.7* monos-6.5 eos-0.5 baso-0.3 07:15pm blood pt-25.4* ptt-91.4* inr(pt)-2.4* 07:15pm blood glucose-82 urean-22* creat-0.7 na-144 k-3.8 cl-111* hco3-25 angap-12 04:35am blood alt-25 ast-26 ld(ldh)-181 alkphos-66 totbili-0.7 04:35am blood albumin-3.0* calcium-6.9* phos-2.4* mg-1.8 iron-16* 07:15pm blood ctropnt-0.07* 07:15pm blood ck-mb-2 04:35am blood albumin-3.0* calcium-6.9* phos-2.4* mg-1.8 iron-16* 04:35am blood caltibc-185* ferritn-423* trf-142* 05:56am blood type-art po2-120* pco2-42 ph-7.34* caltco2-24 base xs--2 intubat-intubated 05:56am blood freeca-1.11* 05:56am blood lactate-0.9 ct chest 1. large areas of parenchymal opacification involving bilateral lower lobes, and to a lesser extent the upper lobes, which likely reflect a combination of atelectases and pneumonia. 2. small bilateral pleural effusions. tte suboptimal image quality. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. there is no valvular aortic stenosis. the increased transaortic velocity is likely related to high cardiac output. no aortic regurgitation is seen. no mitral regurgitation is seen. there is no pericardial effusion. egd there were multiple superficial erosions and ulcers throughout the esophagus c/w erosive esophagitis. there was no active bleeding. there was no evidence of recent bleeding; no coffee grounds or red blood. stomach mucosa was normal. g-j tube was seen in good position extending from gastric body to post-pyloric location in duodenum. otherwise normal egd to third part of the duodenum respiratory pseudomonas aeruginosa | cefepime-------------- 32 r ceftazidime----------- =>64 r ciprofloxacin--------- 0.5 s gentamicin------------ 4 s meropenem------------- 2 s piperacillin/tazo----- =>128 r tobramycin------------ <=1 s brief hospital course: mr. is a 63 yo male with htn, type 2 db, hypothyroidism, a. fib on coumadin, here with pna. his course was complicated by hypotension, intubation, reintubation, and blood loss anemia. he was admitted to the transferred to the floor after extubation and returned to the icu with respiratory distress and brief period of hypotension. in the icu, his antibiotics were rationalized, he received a tracheostomy and was discharged off of any ventillatory support. . 1. respiratory failure. patient intubated for hypoxia (90% on nrb) and for "airway protection". cxr showed infiltatres. patient started on vanco/zosyn for pna as patient is a nursing home resident. patient had very weak cough and bronch that yielded copious purulent material that ultimately grew highly resistant pseudomonas. he received a tracheostomy and was discharged to complete a course of meropenem, to be completed as directed. he requires q3 hour suctioning as he is making copious secretions. 2. hypotension. likely secondary infection/sepsis. normal admission lactate. swiftly weaned from pressors. later, on the floor, in respiratory distress was briefly hypotensive leading to atn (see below). was discharged normotensive. follow up: restart antihypertensives (2.5 lisinopril, metoprolol 12.5mg tid) if blood pressure and heart rate can tolerate 3. anemia and melanotic stools: patient had acute hct drop with melanotic stools in the setting of aggressive, frequent suctioning. egd performed yielded mild erosive esophagitis. heparin restarted on to ensure stable hct before restarting coumadin. discharged on coumadin. (below) 4. type 2 diabetes. continue home meds on discharge 5. a.fib. held coumadin in when hct was down trending. restarted coumadin on discharge. follow up: his inrs must be followed followed daily as he may become supratherapeutic while on antibiotics. adjust the dose of his coumadin according to his inr. follow up: restart metoprol 12.5 tid at your discretion 5. hypothyroidism. continue levothyroxine 6. ileostomy. recent colectomy with iliostomy last month secondary to severe c. diff. abdomen exam currently benign. 7. depression. cymbalta, mirtazapine 8. acute renal failure - had arf (cr 0.6 --> 1.9) in the setting of contrast (ct), hypotension and vancomycin. we renally dosed his medication. discharged with cr. of 1.4 follow up: as renal function improves, his medications will need to be redosed. for example, he will need his gabapentin switched to tid. 8. chronic back and leg pain. - gabapentin 300 mg -->tid (as above), baclofen 20 mg qid, morphine 15 mg qid, fentanyl patch 50 mcg follow ups afib: his inrs must be followed followed daily as he may become supratherapeutic while on antibiotics. adjust the dose of his coumadin according to his inr. afib: restart metoprol 12.5 tid at your discretion renal function: as renal function improves, his medications will need to be redosed. for example, he will need his gabapentin switched to tid htn: restart antihypertensives (2.5 lisinopril, metoprolol 12.5mg tid) if blood pressure and heart rate can tolerate medications on admission: medications: levothyroxine 25 mcg daily lisinopril 5 mg daily cymbalta 30 mg glipizide 2.5 mg daily metoprolol tartrate 12.5 mg tid gabapentin 600 mg tid baclofen 20 mg qid mirtazapine 7.5 mg qhs ranitidine hcl 75 mg coumadin 3.5 mg daily mvi daily acetaminophen prn morphine 15 mg q 4 hours fentanyl patch 50 q 72 hours discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 3. docusate sodium 50 mg/5 ml liquid : one (1) dose po bid (2 times a day). 4. levothyroxine 25 mcg tablet : one (1) tablet po daily (daily). 5. therapeutic multivitamin liquid : one (1) tablet po daily (daily). 6. glipizide 2.5 mg tablet extended rel 24 hr : one (1) tablet extended rel 24 hr po once a day. 7. mirtazapine 15 mg tablet : 0.5 tablet po hs (at bedtime). 8. gabapentin 300 mg capsule : one (1) capsule po q12h (every 12 hours). 9. duloxetine 30 mg capsule, delayed release(e.c.) : one (1) capsule, delayed release(e.c.) po bid (2 times a day). 10. meropenem 500 mg recon soln : one (1) unit intravenous every eight (8) hours for 11 days. 11. baclofen 10 mg tablet : two (2) tablet po qid (4 times a day). 12. fentanyl 50 mcg/hr patch 72 hr : one (1) patch 72 hr transdermal q72h (every 72 hours). 13. heparin, porcine (pf) 10 unit/ml syringe : one (1) unit intravenous prn (as needed) as needed for line flush. 14. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) neb inhalation q2h (every 2 hours) as needed for sob, wheeze. 15. warfarin 1 mg tablet : 3.5 tablets po once daily at 4 pm. 16. ipratropium bromide 0.02 % solution : one (1) neb inhalation q6h (every 6 hours) as needed for sob, wheeze. 17. morphine 15 mg tablet : one (1) tablet po q4h (every 4 hours) as needed for pain. 18. outpatient lab work check inr on , . if inr > 3, then reduce coumadin dose. if 3-3.5, then give dose. if 3.5-4 then hold coumadin x 1 day. if > 4 then hold coumadin and check inr daily, restarting when inr < 2.5 19. pantoprazole 40 mg tablet, delayed release (e.c.) : one (1) tablet, delayed release (e.c.) po twice a day. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: respiratory failure pneumonia (klebsiella) and weakness s/p cva atrial fibrillation chronic pain discharge condition: mental status: confused - sometimes. level of consciousness: lethargic but arousable. activity status: bedbound. discharge instructions: you were admitted with respiratory distress. this was because of a pneumonia and weakness such that you could not caugh up your phlegm. because of the frequent need to suction your lungs, you bled and required a procedure to ensure that you weren't bleeding from your stomach. additionally, we performed a "tracheostomy" to permit better ventillation of your lungs. new medication - meropenem - an antibiotic - last day is - pantoprazole - an acid reducer held medication - lisinopril - metoprolol - ranitidine - using ppi in place of h2 blocker. these medications can be restarted at the discretion of your doctors followup instructions: please schedule an appointment within 1-2 weeks with pcp: , provider: ,three phone: date/time: 8:30 provider: west outpatient radiology phone: date/time: 10:00 md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances other intubation of respiratory tract temporary tracheostomy diagnoses: unspecified essential hypertension acute kidney failure, unspecified iron deficiency anemia secondary to blood loss (chronic) hyposmolality and/or hyponatremia unspecified acquired hypothyroidism atrial fibrillation diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes other and unspecified hyperlipidemia acute respiratory failure pneumonitis due to inhalation of food or vomitus hematemesis other esophagitis 

Answer: The patient is high likely exposed to