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 / amiodarone / clindamycin attending: chief complaint: shortness of breath, weight gain major surgical or invasive procedure: placement of r internal jugular central venous line. placement of l internal jugular dialysis . continuous venovenous hemodialysis. history of present illness: this is a 81 year-old male with a history of systolic and diastolic chf (ef 25-30%), tachy-brady syndrome awaiting pacemaker, h/o atrial fibillation, cad s/p stent lad x 2, stent lcx x 1, dm ii, and cri who presents from rehab with increasing shortness of breath and weight gain. the patient reports he has been in "poor health" since having a partial colectomy in this past for colon ca. since then, he has experienced a 15 lb weight gain with worsening sob. he was recently admitted to between - for cough and was found to have a mrsa presumed hospital acquired pneumonia. he was treated with a 14 day course of vancomycin and ceftriaxone. during the hospital course, the pt was diagnosed with tachy-brady syndrome as well as sotalol toxicity in the setting of arf, and ep was consulted who planned on pacemaker placement once his id issues had further resolved and discontinued sotalol. hospital course was also c/b a l brachial vein dvt and was started on lovenox. he was discharged to rehab where he was switched to iv lasix for diuresis and followed by the renal team for worsening cr up to 1.5; however, on review of omr it appears pt's cr had been at 1.5 prior to discharge. per rehab notes, pt's weight was 208 lbs on and had increased to 212 lbs on with a concordant increase in o2 requirement, sating 91% on 5l nc. his lasix was increased from 40 mg iv bid to 80 mg iv bid with reported poor urinary output. the pt reports he has difficulty ambulating to the restroom without shortness of breath. denies cp, lightheadedness. endorses palpitations on the night prior to presentation. in the ed, initial vitals were t:96.4 hr:105 bp:122/68 rr:21 o2sat:100% nrb, weaned down to 96% 3l nc. ekg showed no new ischemic changes, cxr revealed worsening r and l sided pleural effusions, r > l. he was given vancomycin 1 gm iv x 1, ceftriaxone 2 gm iv x 1, azithromycin 500 mg iv x 1 for possible hap, started on lasix gtt @ 4 cc/hr and was admitted for further evaluation and management. past medical history: coronary artery disease - s/p lad pci ', s/ lad le edema l>r chronic basal cell carcinoma diabetes mellitus x >40 yrs osteoarthritis congestive heart failure (ef 25-30%) atrial fibrillation/flutter - flutter dx , underwent successful ablation - status post cardioversion, but reverted to atrial fib ' - amiodarone dc'd concern of pulmonary tox viral cardiomyopathy chronic renal insufficiency cr 1.0-1.3 h/o mrsa pna s/p partial colectomy for colon ca - not yet followed up with oncologist (doesn't know dr ) - was told ca not metastatic social history: social history is significant for the absence of current tobacco use. smoked cigarettes/day x yrs, quit 60 yrs ago. there is no history of alcohol abuse. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: admission: vs - 97.5 129/66 97 22 91% 2l nc fs 133 wt 103 kg gen: elderly male, speaking in short senteces with mild sob. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 15 cm. cv: rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: no chest wall deformities, scoliosis or kyphosis. resp were mildly unlabored, some accessory muscle use. absent breath sounds over r lung base, decreased bs half-up r lung field, decreased breath sounds at l lung base with rales. abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. well healed surgical scar. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, scars, or xanthomas. stage ii decub ulcer over coccyx. pertinent results: cxr : interval enlargement of the right pleural effusion with atelectasis of the right lower lobe difficult to entirely exclude consolidation given the opacity introduced by the effusion and atelectasis. if indicated, consider decubitus views to assess for mobility of effusions. . cxr : improved pulmonary edema. persistent right greater than left pleural effusions and cardiomegaly. . echo: the left atrium is dilated. the right atrium is markedly dilated. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is moderate global left ventricular hypokinesis (lvef = 30-40 %). there is no ventricular septal defect. the right ventricular cavity is dilated with severe global free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the supporting structures of the tricuspid valve are thickened/fibrotic. moderate to severe tricuspid regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. . renal u/s 1. no evidence of hydronephrosis. 2. septated cyst within the left kidney, which does not meet us criteria for a simple cyst. a 6-month follow-up ultrasound is recommended to ensure stability. . cbc 06:50pm blood wbc-7.2 rbc-3.05* hgb-9.3* hct-30.1* mcv-99* mch-30.6 mchc-31.0 rdw-21.3* plt ct-282# 05:04am blood wbc-7.1 rbc-2.61* hgb-8.0* hct-25.2* mcv-96 mch-30.5 mchc-31.6 rdw-22.5* plt ct-245 02:48am blood wbc-9.4 rbc-2.72* hgb-8.2* hct-26.0* mcv-96 mch-30.3 mchc-31.7 rdw-22.7* plt ct-286 05:50am blood wbc-8.0 rbc-2.99* hgb-9.1* hct-28.5* mcv-95 mch-30.4 mchc-31.8 rdw-22.5* plt ct-216 05:23am blood wbc-6.0 rbc-2.94* hgb-9.2* hct-28.4* mcv-97 mch-31.2 mchc-32.2 rdw-21.5* plt ct-179 05:25am blood wbc-7.3 rbc-3.07* hgb-9.6* hct-30.0* mcv-98 mch-31.1 mchc-31.8 rdw-22.6* plt ct-150 . chem 7 06:50pm blood glucose-165* urean-63* creat-1.8* na-141 k-5.0 cl-100 hco3-29 angap-17 09:00am blood glucose-88 urean-68* creat-2.0* na-143 k-5.4* cl-100 hco3-31 angap-17 05:04am blood glucose-212* urean-73* creat-1.9* na-132* k-4.5 cl-94* hco3-31 angap-12 03:08pm blood glucose-120* urean-76* creat-2.6* na-142 k-4.5 cl-101 hco3-30 angap-16 02:48am blood glucose-199* urean-66* creat-2.3* na-138 k-4.7 cl-101 hco3-28 angap-14 09:04am blood glucose-123* urean-59* creat-2.1* na-137 k-5.0 cl-102 hco3-26 angap-14 06:34pm blood glucose-192* urean-49* creat-1.9* na-137 k-4.8 cl-103 hco3-25 angap-14 12:14pm blood glucose-110* na-137 k-4.9 cl-107 hco3-25 angap-10 06:20pm blood glucose-185* urean-30* creat-1.5* na-137 k-5.1 cl-107 hco3-23 angap-12 12:22am blood na-135 k-5.3* cl-107 hco3-21* angap-12 11:53am blood glucose-172* na-136 k-4.9 cl-108 hco3-22 angap-11 06:35pm blood glucose-260* urean-20 creat-1.2 na-133 k-5.0 cl-105 hco3-22 angap-11 05:25am blood glucose-59* urean-16 creat-1.0 na-138 k-4.6 cl-106 hco3-24 angap-13 12:22pm blood k-4.5 . brief hospital course: pt has diastolic and systolic congestive heart failure with ef 35-30%. the patient was admitted with chf exacerbation. he had become more refractory to iv lasix diuresis with worsening weight gain and doe. also with finding of anasarca on exam, concerning for poor nutritional status and/or nephrotic syndrome. on the floor he had worsening shortness of breath. he had a right thoracetesis performed showing a transudative fluid. as his sob worsening and as he became hypotensive, he was transfered to the ccu. he had right ij central line placed. in the ccu, he was placed on lasix drip, diuril and milrinone. his blood pressure continued to trend down and he had almost no urine output despite maximum doses of lasix drip and diuril. when his mental status and bp declined, milrinone was discontinued, and he was placed on levophed. an arterline line was placed to better monitor bp. a left ij dialysis catheter was also placed. the nephrology team began ultrafiltration. lasix and diuril were discontinued. as fluid was removed, his mental status and blood pressure improved. he was weaned off the levophed. after a family meeting, it was decided that the patient should have 1-2 days more of uf in order to remove as much fluid as possible, and then he should be discharged with hospice. the palliative care team assisted with hospice arrangement and comfort recommendations. a total of 10 liters of fluid were removed over his length of stay. he was discharged on lasix 80 . . # code: dnr/dni medications on admission: lasix 80 mg iv q12h asa 81 mg daily norvasc 7.5 mg daily lisinopril 5 mg daily (d/c'd ) colace 100 mg senna prn miconazole powder prn atrovent nebs prn saline nasal spray 2 sprays metformin 1000 mg (d/c'd ) lovenox 80 mg q12h (d/c'd ) repaglinide 0.5 mg mg sitagliptin 100 mg daily heparin 5000 units q12h tylenol prn riss sugar free robitussin q4h prn discharge medications: 1. furosemide 80 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 2. roxanol concentrate 20 mg/ml solution sig: 5-20 mg po q1-q3 as needed for pain: hospice patient. disp:*45 ml* refills:*0* 3. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed: hospice patient. disp:*60 tablet(s)* refills:*0* 4. lorazepam 2 mg/ml concentrate sig: 0.25-2 mg po q2-3 hour prn: hospice patient. disp:*10 ml* refills:*2* 5. levsin 0.125 mg/ml drops sig: one (1) ml po every 4-6 hours as needed for secretions: hospice patient. disp:*10 ml* refills:*0* 6. abhr (ativan-benadryl-haldol-reglan) sig: one (1) suppository every 4-6 hours as needed for discomfort: hospice patient. disp:*3 suppositories* refills:*0* 7. acetaminophen suppository sig: one (1) suppository every 4-6 hours as needed for fever or pain: hospice patient. disp:*1 suppository* refills:*3* 8. haloperidol gel 1 mg/ml sig: 0.5-1 ml ml every 4-6 hours as needed for agitation: hospice patient. disp:*3 ml* refills:*0* 9. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day) as needed. disp:*1 pack* refills:*0* 10. dextromethorphan-guaifenesin 10-100 mg/5 ml liquid sig: mls po q6h (every 6 hours) as needed. disp:*40 ml(s)* refills:*2* 11. sodium chloride 0.65 % aerosol, spray sig: two (2) spray nasal (2 times a day) as needed. disp:*1 bottle* refills:*0* 12. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed). disp:*1 bottle* refills:*2* 13. ipratropium bromide 0.02 % solution sig: one (1) inhalation inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. disp:*1 ampule* refills:*0* 14. albuterol sulfate 2.5 mg/3 ml solution for nebulization sig: one (1) ampule inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. disp:*1 ampule* refills:*0* discharge disposition: home with service facility: hospice east discharge diagnosis: congestive heart failure. discharge condition: fair. no complaints of pain or dyspnea. approximately 10 liters removed at dialysis. discharge instructions: we are discharging you home with hospice services. our hope is that you will be comfortable and enjoy your time with your family. the medications prescirbed are to make you feel comfortable. these medications include lasix which may help keep fluid from accumulating. followup instructions: hospice care. procedure: venous catheterization, not elsewhere classified hemodialysis venous catheterization for renal dialysis thoracentesis diagnoses: other primary cardiomyopathies congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified atrial fibrillation chronic kidney disease, unspecified cardiogenic shock pressure ulcer, lower back personal history of malignant neoplasm of large intestine sinoatrial node dysfunction acute on chronic combined systolic and diastolic heart failure 

Answer: The patient is high likely exposed to