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, increased secretions major surgical or invasive procedure: none history of present illness: 54yo male s/p crt who was d/c'd on after treatment for a presumed chf exacerbation. pt now presents with again with sob. pt sent to osh and thought to be in respiratory distres. pt transferred to on for management. past medical history: htn dm polycystic kidney disease renal dgf physical exam: aao times 3 rrr s1+s2 diffuse crackles throughout both lung fields soft, nt/nd small wound at base of graft, 2-3cm, healing well mild bilat le edema pertinent results: 10:50am blood glucose-143* urean-30* creat-1.5* na-134 k-3.8 cl-95* hco3-25 angap-18 06:00am blood glucose-72 urean-42* creat-2.4* na-138 k-3.9 cl-99 hco3-28 angap-15 06:00am blood glucose-108* urean-38* creat-1.9* na-135 k-3.6 cl-98 hco3-24 angap-17 10:55am urine blood-neg nitrite-neg protein-30 glucose-neg ketone-tr bilirub-neg urobiln-neg ph-5.0 leuks-neg 10:55 am sputum source: induced. gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gram negative rod(s). 2+ (1-5 per 1000x field): gram positive rod(s). 1+ (<1 per 1000x field): gram positive cocci in pairs. respiratory culture (final ): sparse growth oropharyngeal flora. due to mixed bacterial types ( >= 3 colony types) an abbreviated workup will be performed appropriate to the isolates recovered from this site. pseudomonas aeruginosa. moderate growth. gram negative rod #2. moderate growth. gram negative rod #3. moderate growth. sensitivities: mic expressed in mcg/ml pseudomonas aeruginosa cefepime-------------- 16 i ceftazidime----------- =>64 r ciprofloxacin--------- 0.5 s gentamicin------------ 4 s meropenem------------- 2 s piperacillin---------- =>128 r piperacillin/tazo----- =>128 r tobramycin------------ <=1 s chest (portable ap) 1:53 pm impression: 1. left lower lobe pneumonia. 2. bilateral edema with cardiomegaly. 3. no pneumothorax. chest (pa & lat) 7:32 pm impression: significant improvement in severity of the bilateral pulmonary infiltrates. persistent lv enlargement with minimal evidence of residual cardiac failure. brief hospital course: pt admitted on with presumed respiratory distress. pt admitted to the icu and a cvl was placed. at the time of admission, pt had stabilized and o2 sat at 100% on a non-rebreather. pt was diuresed and cards consulted for chf med optimization. hctz d/c'd and pt continued lasix, hydralazine, lopressor, clonidine and imdur. in additon pt with low hct, pt cont on epogen and transfused 1u prbc. a cxr showed a possible lll pneumonia, sputum sent and pt started on zosyn prophylaxis. pt improved and pt transferred to the floor. sputum cx grew pseudomanas sensitive to meropenem. in addition, team was contact by rehab to state that a sputum cx from grew klebsiella also sensitive to meropenem. zosyn d/c'd and pt started on meropenem. repeat cxr revealed resolving pneumonia. pt hct stabilized and continued to improve clinically. pt d/c'd to on in stable condition discharge medications: 1. trimethoprim-sulfamethoxazole 80-400 mg tablet sig: one (1) tablet po qd (once a day). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. metoprolol tartrate 50 mg tablet sig: three (3) tablet po bid (2 times a day). 5. prednisone 2.5 mg tablet sig: three (3) tablet po qd (once a day). 6. epoetin alfa 4,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-). 7. beclomethasone diprop monohyd 0.042 % aerosol, spray sig: one (1) spray nasal (2 times a day). 8. lactulose 10 g/15 ml syrup sig: twenty (20) ml po qd (once a day). 9. metoclopramide hcl 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). 10. hydralazine hcl 50 mg tablet sig: one (1) tablet po q6h (every 6 hours). 11. azathioprine 50 mg tablet sig: 1.5 tablets po qd (once a day). 12. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 13. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po qd (once a day). 14. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po hs (at bedtime) as needed. 15. spironolactone 25 mg tablet sig: one (1) tablet po qd (once a day). 16. sertraline hcl 50 mg tablet sig: one (1) tablet po qd (once a day). 17. isosorbide mononitrate 30 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po qd (once a day). 18. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day). 19. valganciclovir hcl 450 mg tablet sig: one (1) tablet po qd (once a day). 20. clonidine hcl 0.2 mg tablet sig: one (1) tablet po bid (2 times a day). 21. furosemide 20 mg tablet sig: one (1) tablet po qd (once a day). 22. sirolimus 1 mg tablet sig: four (4) tablet po qd (once a day). 23. meropenem 1 g recon soln sig: one (1) intravenous every twelve (12) hours for 12 days. discharge disposition: extended care facility: & rehab center - discharge diagnosis: pneumonia discharge condition: stable discharge instructions: please return for all follow-up appointments take all medications as prescribed reutrn to the hospital if any chest pain, shortness of breath, nausea and vomitting, redness or swelling, significant weight gain or loss, or fevers followup instructions: provider: where: surgical specialties phone: date/time: 9:30 provider: : please call ( for an appointment md, procedure: venous catheterization, not elsewhere classified transfusion of packed cells diagnoses: pneumonia, organism unspecified esophageal reflux congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease personal history of malignant neoplasm of kidney cocaine dependence, continuous 

Answer: The patient is high likely exposed to