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: past medical history: 1. diabetes type 2 treated with oral medication. 2. cerebrovascular disease, status post left carotid endarterectomy in . 3. status post right cerebrovascular accident in with residual left-sided weakness. 4. status post right carotid endarterectomy on . 5. fall from standing on with resultant displaced radial fracture which was reduced, closed, and casted. 6. hypertension. 7. coronary artery disease. no history of catheterization prior to admission to the . 8. chronic renal insufficiency with a baseline creatinine of 2.0 to 2.7. medications on transfer the : 1. lovenox 1 mg per kilogram subcutaneously b.i.d. 2. aspirin 81 mg p.o. q.d. 3. lopressor 50 mg p.o. b.i.d. 4. lansoprazole 30 mg p.o. q.d. 5. regular insulin sliding scale. 6. captopril 6.25 mg q.i.d. 7. lasix drip at 2 per hour. 8. versed drip. 9. tpn. physical examination on admission: this is a gentleman who is intubated, comfortable, with minimal sedation. he was afebrile with a temperature of 99.1. his pulse was in the 70s, blood pressure 119/58. he was breathing 12 per minute and saturating 98%. his cvp is ranging from . he was intubated and has a nasogastric tube. his neck has a well-healed right carotid endarterectomy scar. there is also a well-healing tracheostomy scar. the lungs were clear to auscultation bilaterally. the heart was regular with an s1 and s2. the abdomen was soft, nontender, nondistended with normoactive bowel sounds. the extremities were without edema. the left arm was in a cast. hospital course: mr. was admitted to the ccu at the . upon admission, he was treated for his pneumonia. he was medically managed for chf and underwent a cardiac catheterization on . his catheterization revealed 70% stenosis of the distal left main coronary artery, 90% stenosis of the lad, 80% stenosis of the circumflex, 90% stenosis of om2 and a proximally occluded right coronary artery. after reviewing cardiac catheterization data, a consultation was made with cardiothoracic surgery who deemed that he was a good candidate for coronary artery bypass grafting. over the ensuing days, mr. chf was managed by the ccu team and he received treatment for what was now determined to be a klebsiella pneumonia. he was treated with a full course of zosyn. on , mr. went to the operating room with dr. . he underwent a coronary artery bypass graft of four vessels. he had a saphenous vein graft to his lad and diagonal in a sequential fashion, saphenous vein graft to his pda and a saphenous vein graft to his om. the procedure was performed by dr. and assisted by dr. ..................... the patient tolerated the procedure well without complication and was transferred to the cardiac surgery recovery unit without complication. please see the previously dictated operative note for more details. mr. had a long postoperative course. his postoperative course was complicated by hypertension which was managed medically. during his postoperative course, he did not suffer from any arrhythmias nor did he have any episode of hypotension. at the time of discharge, he was on a stable antihypertensive regimen appropriate for someone with a decreased ejection fraction. mr. had had a long protracted period of intubation prior to the operation. the status of mr. pulmonary system necessitated a prolonged postoperative intubation. after a very slow wean from ventilatory support, mr. was successfully extubated on postoperative day number nine. he continued to be very tenuous from a pulmonary point of view and required frequent chest pt. for this reason, mr. was kept in the intensive care unit where very close monitoring could be performed. in addition, he had chest pt performed at very regular intervals by the icu staff. his pulmonary status was so tenuous that we were unable to transfer him to the regular patient care floor during his hospitalization. mr. had an emergent cricothyroidotomy followed by a formal tracheostomy at the outside hospital. there is much scarring surrounding his larynx. such a situation frequently makes it very difficult to swallow without aspirating. as is expected, mr. failed a swallowing study early on in his hospital course. the study was repeated and yet again mr. was unable to swallow without evidence of aspiration. after a prolonged period of being fed via nasogastric tube, mr. finally had a formal percutaneous endoscopic gastrostomy tube placed in the intensive care unit. this was performed on , postoperative day number 21. this procedure was performed by dr. and assisted by dr. . the procedure was performed under endoscopic guidance in the intensive care unit without complication. please see the previously dictated operative note for more details. mr. a distal radius fracture prior to arriving to the hospital. this injury had been reduced and casted at the outside institution. postoperatively, there was much edema associated in the postoperative course from coronary artery bypass grafting. his cast was removed by the orthopedic service in anticipation of this edema and to avoid compartment syndrome. the cast was replaced by a plaster splint. mr. should follow-up with his orthopedic surgeon in the for reassessment of his injury and possible removal of the splint. by postoperative day number 23, mr. pulmonary status was deemed sufficiently stable. his hypertension was well controlled and he was tolerating tube feeds. at this point, he was ready to be discharged to rehabilitation. discharge diagnosis: 1. coronary artery disease, status post coronary artery bypass graft, four vessels. 2. congestive heart failure. 3. klebsiella pneumonia. 4. failed swallow study status post percutaneous endoscopic gastrostomy tube placement. 5. central line culture positive for coagulase-negative staphylococcus aureus, status post a 14 day treatment with vancomycin and removal of the line. medications on discharge: 1. methylphenidate 5 mg p.o. q.d. 2. lasix 40 mg p.o. b.i.d. 3. captopril 50 mg p.o. t.i.d. 4. glyburide 10 mg p.o. b.i.d. 5. miconazole powder 2%, apply q.i.d. p.r.n. 6. paxil 20 mg p.o. q.d. 7. albuterol nebulizer solution one nebulizer q. four hours. 8. metoprolol 100 mg p.o. t.i.d. 9. heparin 5,000 units subcutaneously q. 12 hours. 10. amlodipine 5 mg p.o. b.i.d. 11. percocet one to two tablets p.o. q. four hours p.r.n. pain. 12. colace 100 mg p.o. b.i.d. 13. aspirin 325 mg p.o. q.d. 14. tube feedings; mr. is to be discharged on tube feeds, promote, with fiber full-strength at 80 cc per hour around the clock. his peg tube should be flushed with 30 cc of water after every use. activity: mr. activity is ad lib. he is also to be strict n.p.o. he should be n.p.o. until he has a repeat swallow evaluation which demonstrates his ability to swallow without aspiration. follow-up: the patient will follow-up with dr. in his office in four to six weeks. the patient should follow-up with his primary care physician within one week. the patient should follow-up with his orthopedic surgeon at the next convenient time to determine the length of duration of his casting. condition on discharge: stable. physical examination on discharge: mr. is afebrile with a temperature of 97.1, pulse 77, sinus rhythm. his blood pressure was 142/68, breathing 21 breaths per minute, 94% on 2 liters nasal cannula. his pupils were equal, round, and reactive. extraocular muscles intact. his head was normocephalic, atraumatic. the lungs were clear to auscultation bilaterally. the heart revealed a regular rate and rhythm. the abdomen was soft, nontender, nondistended. he had a peg tube in his left upper quadrant. the site was clean and dry. there was no evidence of necrosis, erythema or exudate at the site. the extremities were warm and well perfuse. there was trace edema in both lower extremities. his right lower extremity has ecchymosis related to a saphenectomy site. this ecchymosis is much improved from previous examinations. there was no increased warmth over this area nor is there any exudate from his wounds. all of his wounds including sternotomy wound were clean, dry, and intact. , m.d. dictated by: medquist36 procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances (aorto)coronary bypass of four or more coronary arteries percutaneous [endoscopic] gastrostomy [peg] diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled infection and inflammatory reaction due to other vascular device, implant, and graft pneumonia due to klebsiella pneumoniae 

Answer: The patient is high likely exposed to