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: confusion, shortness of breath, cough major surgical or invasive procedure: none history of present illness: mr. is an 89 yo male with htn and mild dementia at baseline, who presented with delirium, shortness of breath, and cough. his cough was present for one week prior to presentation and was productive of a clear sputum. at home his temperature was 102.2 degrees f on the morning of admission, according to his home health aide. he also complained of generalized weakness. his home health aide reported that he had not been himself for the several days pta as he has been increasingly confused and not able to complete his adls. at baseline, he pays his own bills and keeps up with the daily stock report. in the ed t 98.1, hr 86, bp 120/84, rr 28-30, o2 sat 97% 2l nc. he received tylenol 650 mg po at 6 am. levofloxacin 750 mg iv was given in the ed for a presumed pna and blood cultures were sent. he was stable and tranferred to the floor. past medical history: bph htn social history: patient lives at home with his wife. a nurse alliance sees the couple twice a week on mondays and wednesdays. he denies tobacco use and drug use, but does drink glasses of wine/day. family history: non-contributory physical exam: admission physical exam: vitals: t 101.2/101.2, bp 4133/63, p 91, rr 18,o2 sat97-100%3lnc general: pleasant, elderly male sitting comfortably heent: ncat, perrl, eomi, no cervical lad, neck supple chest/cv: rrr, nl s1/s2, no m/r/g lungs: course rhonchi b/l back/cva,flank: no cva tenderness, kyphosis abd: ntnd, + bs ext: warm, 2+ pulses, no c/c/e neuro: alert, not oriented to date/place cn 2-12 intact; bilateral strength skin: no rashes, skin damage pertinent results: admission labs: 12:00pm blood wbc-5.4 rbc-3.92* hgb-12.4* hct-35.4* mcv-90# mch-31.6 mchc-34.9 rdw-12.5 plt ct-317 12:00pm blood neuts-71.9* lymphs-15.7* monos-11.7* eos-0.4 baso-0.3 05:30pm blood pt-13.9* ptt-31.9 inr(pt)-1.2* 12:00pm blood glucose-110* urean-19 creat-0.9 na-132* k-3.9 cl-97 hco3-25 angap-14 06:15am blood calcium-8.1* phos-3.8# mg-1.8 cardiac markers: 05:30pm blood ck(cpk)-76 02:49am blood ck(cpk)-101 05:30pm blood ck-mb-notdone ctropnt-0.10* 02:49am blood ck-mb-5 ctropnt-0.12* 12:27am blood ck-mb-notdone ctropnt-0.04* 05:48am blood probnp-* anemia studies: 02:12am blood caltibc-122* vitb12-835 folate-17.1 ferritn-1020* trf-94* urine studies: 01:30pm urine color-yellow appear-clear sp -1.024 01:30pm urine blood-neg nitrite-neg protein-tr glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.5 leuks-neg 01:30pm urine rbc-0-2 wbc-0-2 bacteri-few yeast-none epi-0-2 microbiology: , , , blood cultures: negative urine cultures: negative urine legionella: positive influenza dfa: a-positive; b-negative sputum culture: >25 pmns and <10 epithelial cells/100x field; sparse growth of oropharyngeal flora; sparse growth of yeast. imaging: ct head: no evidence of infarction or hemorrhage. cxr pa and lateral: no focal consolidation to suggest pneumonia. cxr portable: in comparison with the study of , focal areas of opacification adjacent to the aortic arch, in the left lower lung zone and at the right base. this raises the possibility of multiple areas of pneumonia, though some of this apparent change may reflect differences in technique. the possibility of a central source of infection must be considered and echocardiography could be helpful. tte: the left atrium is elongated. left ventricular wall thicknesses and cavity size are normal. there is mild-moderate regional dysfunction with focal hypokinesis of the apical half of the septum, anterior, apical and lateral walls. basal segments contract best (lvef = 40-45%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mitral regurgitation is present but cannot be quantified. there is a trivial/physiologic pericardial effusion. compared with the prior study (images reviewed) of , regional left ventricular hypokinesis is now identified (and the severity of mitral regurgitation is not as well characterized). cta chest: 1. no central pulmonary embolism. evaluation of distal pulmonary artery branches is limited by respiratory motion artifact. 2. findings suggestive of chf versus fluid overload. 3. extensive peripheral ground-glass opacities, most prominent in the upper lobes with areas of honeycombing. these findings may be related to chronic interstitial process/pulmonary fibrosis. however, a more acute superimposed process such as viral or atypical pneumonia cannot be excluded. 4. nodular opacities in the right middle lobe which may be infectious in etiology. 5. pleural calcifications suggesting asbestos-related pleural disease. 6. subacute rib fractures involving multiple posterior ribs. additional old healed fractures of several right lateral ribs. 7. several thoracic compression fractures of indeterminate age. 8. cardiomegaly. reflux of contrast into the hepatic veins suggestive of right- sided heart failure. 9. small pericardial effusion. ekg:resting sinus tachycardia. left atrial abnormality. possible left ventricular hypertrophy. borderline intraventricular conduction delay. non-specific st-t wave changes. p-r interval at the upper limits of normal. compared to the previous tracing of heart rate is faster. brief hospital course: influenza a and pneumonia: the patient was intially on the service, as an admission for influenza a and pneumonia. in the ed, he was evaluated with ekg, cxr, ct head, and labs. he was initially treated with levaquin and standing nebulizer treatments, and was sent to the floor for management and observation. he also received a five day course of tamiflu 75 mg po bid. on a floor trigger was called for sob, hypoxia and increased work of breathing. he o2 sat was found to be in the mid 80s on room air and he was tachypneic to the mid 30's; oxygenation improved to 96% on nrb with abg of 7.38/45/81. cxr from was not significantly different from admission with fluffy basilar predominant infiltrates. he was transferred to the micu. on , he had been improving with stable sats; he was afebrile and had a decreased wbc, so he was transferred out to the floor again. his influenza course was thought to be superimposed with a bacterial pneumonia, as he had persistent temperatures, respiratory distress and worsening infiltrates on cxr . he also had worsening secretions, which he had difficulty clearing without aggressive suctioning, causing occasional hypoxia. he was started on vancomycin and zosyn on , and was completed on a 10 day course to treat the pneumonia. at the time of discharge, he was afebrile, but had persistent secretions that needed to be managed with frequent suctioning. mr. was noted to have an elevated troponin and bnp in the setting of acute lung injury. he had frequent ectopy; aspirin was started and he was maintained on is home dose of metoprolol 25 mg po bid. speech and swallow evaluation: although he was admitted on a regular po diet, mr. failed a speech and swallow evaluation and was made npo. a dobhoff tube was placed and he was started on tube feeds. it is hoped that after he recovers from his acute illness, he will return to his baseline function and be able to take in a po diet again. he should be re-evaluated at the rehabilitation facility. hyponatremia: mr. was noted to have hyponatremia, thought to be secondary to siadh given the urine lytes and lung disease (pneumonia). this may have played a role in his delirium on presentation and throughout the hospital stay. the hyponatremia resolved with 1.5 l fluid restriction and concurrently with clearance of his delirium. delirium: likely secondary to the influenza and then pneumonia given compromised mental reserve in the setting of mild baseline dementia. head ct on admission was negative for an acute process. he had no meningeal signs on exam or headache/photophia/neck stiffness to suggest meningitis; no lp was performed. by the end of his hospital stay, his mental status had improved and was near baseline. medications on admission: lopressor 50 mg tylenol dulcolax calcium carbonate colace senna discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. metoprolol tartrate 25 mg tablet sig: one (1) tablet po every twelve (12) hours. 3. vancomycin 500 mg recon soln sig: 1.5 recon solns intravenous q 12h (every 12 hours): please give through . 4. piperacillin-tazobactam-dextrs 4.5 gram/100 ml piggyback sig: one (1) intravenous q8h (every 8 hours): please give through . 5. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 6. senna oral 7. colace oral 8. dulcolax oral 9. tylenol 325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain, fever. discharge disposition: extended care facility: & rehab center - discharge diagnosis: primary diagnoses: influenza pneumonia secondary diagnoses: hypertension discharge condition: stable-- satting in the mid- to upper 90's on 3 - 4 l nc; breathing comfortably; has an ng tube for feeding. discharge instructions: you were evaluated for your symptoms, and treated for influenza and a post-influenze pneumonia. during your hospital stay, you were taken care of in the intensive care unit and then transitioned to the general medicine floor. you responded well to the medications and respiratory treatements please continue your previous medicine regimen. vancomycin and zosyn should be taken through . please call your doctor or return to the ed if you experience any of the following: fever, chills, difficulty breathing, chest pain, nausea, vomiting or any other symptoms that are worrisome to you. followup instructions: 1. please make an appointment to see your primary care doctor in 2 - 3 weeks for follow-up care. their number is (dr. ) 2. please keep your previously scheduled appointments: provider: xray (scc 2) phone: date/time: 9:55 provider: , md phone: date/time: 10:15 procedure: venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances diagnoses: anemia, unspecified congestive heart failure, unspecified unspecified essential hypertension hyposmolality and/or hyponatremia pulmonary collapse acute respiratory failure other specified cardiac dysrhythmias osteoporosis, unspecified acute on chronic systolic heart failure delirium due to conditions classified elsewhere influenza with pneumonia bacterial pneumonia, unspecified dysphagia, unspecified 

Answer: The patient is high likely exposed to