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: morphine / mirtazapine / ambien attending: chief complaint: chest pain s/p icd firing for sustained vt major surgical or invasive procedure: elective intubation - repeat ablation for recurrent ventricular tachycardia - icd generator change - history of present illness: mr. is a 86 yo man with h/o cad s/p mi and cabg in , chronic afib with v-pacing, chronic systolic chf with ef 20%, multiple recent admission to the ccu for icd firing, readmitted from rehab for left sided chest pain. he reports that he had severe left sided chest pain, worse with inspiration and palpation. he denies any dyspnea, nausea, vomiting, abdominal pain, diaphoresis, left arm or jaw pain or any other complaints. he does not know if his icd fired. of note he has been admitted numerous times recently for vt and icd firing due to sustained vt. during his recent admission from - he was bolused with iv amiodarone twice for episodes of vt during the admission. during that admission he continued to refuse vt ablation and turning off icd. . in the er his vs were stable and he his mental status was at his baseline. he was in vt 120-130s without any changes from before on ecg. however, the er docs were impressed by the abnormalities and wanted to rule him out for mi with ck: 70 mb: notdone trop-t: 0.25. he was admitted to the ccu for unclear reasons given he is dnr/dni and has not wanted to pursue aggresive treatment in the past. . on review of systems, s/he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. s/he denies recent fevers, chills or rigors. s/he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: mi x2 (inferior and anteroseptal) - cabg: lima to lad, svg to om/pda ( ) - afib w/o anticoag (fall risk) - sustained vtach in s/p admission - pacing/icd: biv icd (?). icd generator changed to concerto in . . 3. other past medical history: - legally blind secondary to glaucoma - hiatal hernia - hepatic cysts/hemangioma and lipoma in hepatic flexure - s/p lt bka (wwii trauma ) - bph s/p suprapubic prostatectomy () - s/p cholecystectomy () - chronic low back pain - osteoarthritis - positive ppd in past - depression and anxiety social history: the patient immigrated from 20 years ago; lives at senior center w/ wife. former oncology surgeon w/ one daughter and grandaughter in . -tobacco history: none currently -etoh: none family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: vs: t=99.3 bp=115/76 hr=120 (vt) rr=15 o2 sat=97% general: wdwn in nad. 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 7 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: imaging: ct abdomen/pelvis : 1. focal colitis in the proximal sigmoid colon. differential considerations include various infectious causes, such as c. difficile colitis, less likely inflammatory or ischemic etiology. 2. 2.3 x 2.1 cm lobulated, coarsely calcified pulmonary nodule at the left lung base, most probably represents a pulmonary hamartoma. 3. multiple liver and renal cysts. . cxr portable : 1. persistent left retrocardiac density, which might represent pneumonia/atelectasis. . portable abdomen : dilated bowels with ileus. . micro: c diff : negative urine cx klebsiella 10-100k: sensitive to cipro/ceftriaxone blood cx : negative . labs on admission: wbc 11.6, hb 14.3, hct 42, plt 216 na 133, k 4.2, cl 98, bicarb 18, bun 19, cr 1.3, glu 150 . labs on discharge: brief hospital course: mr. is a 86 y/o russian speaking man with h/o cad s/p mi and cabg in , chronic afib/recurrent vt with v-pacing, chronic systolic chf with ef 20%, recently discharged from ccu with icd firing, now returns with recurrent vt and icd firing. . #. rhythm - pt with known vtach and presents s/p icd firing. during prior ccu admission, patient was confirmed to be dnr/dni/no external shocks/do not hospitalize. patient presented to from rehab due to chest pain associated with icd firing. patient has stable vital signs with his slow vt and was in vt at 120-130s. he was bolused with 450 mg of iv amiodarone in the er and was started on amiodarone gtt. this was transitioned to po amiodarone, as levels were likely supersaturated. iv lidocaine was initiated at 1 mg/min. lengthy discussion with patient and family took place regarding whether to keep the icd on or turn it off (as patient has now presented twice with complaints of icd firing). after discussion, pt and family would like to keep icd on, and realize that it will provide painful shocks if his rhythm becomes irregular and dangerous. patient was informed that repeat ablation is the only way to cure his vt, and he underwent this procedure on . on , pt had five episodes of icd firing for recurrent vt, which finally brought him out of his vt. since that time, his icd has not fired. upon device interrogation, it was noted that the generator would need to be changed at a point in the near future, as battery was running low. this procedure was performed on . upon discharge, patient was in sinus rhythm and stable. . # delerium/ams - pt developed delerium while in the hospital, and on one occasion, pulled out his lines/tubes/clothes. he was initially treated with ativan and zydis. geriatrics was consulted. his narcotics and ativan were discontinued. his mental status and delerium improved without use of further medications such as haldol. . # focal colitis - pt developed diffuse abdominal pain with guarding during hospital stay. ct abdomen and pelvis showed focal colitis in the proximal sigmoid colon. differential considerations included various infectious causes, such as c. difficile colitis, less likely inflammatory or ischemic etiology. lactate was wnl. given rapid elevation in wbc to 25, low grade temperature, and diarrhea stool, clinical concern for c. diff despite negative toxin assay. pt initially placed on po vancomycin and iv flagyl with resolution of wbc. po vancomycin was discontinued. iv flagyl therapy was completed for 5 days. . # klebsiella uti - urine cloudy, u/a with 9 wbc, and urine cx showed 10-100k klebsiella. pt was initially started on ciprofloxacin, then switched to ceftriaxone. sent home with 7 day course of cefpodoxime 200mg po bid. . #. pump - no signs of chf at this time. pt with known chronic systolic heart failure with ef of 20%. pt was continued on his home medications: statin, asa, and metoprolol. acei and lasix were held given hypotension. . #. cad - pt with known cad s/p cabg. chest pain free, other than his vt and shocks. asa, statin, bb were continued as above. acei held as above, due to hypotension. enzymes suggest mild cardiac injury after shock, but most likely he is not having acs. . #. oa - pain was well controlled on tylenol and oxycodone prn. . #. code - patient is dnr/dni/not to be externally shocked. . #. contact - next of : ,, relationship: daughter, phone: (home) and (cell). she is hcp. medications on admission: -aspirin 81 mg po daily -digoxin 125 mcg qod -dorzolamide 2% both eyes -escitalopram 10 mg po daily -lasix 120 mg po bid -brimonidine 0.15% both eyes -latanoprost 0.005% qhs -lorazepam 1.5 mg po qhs -polyethylene glycol 3350 100% powed daily -simvastatin 20 mg daily -amiodarone 200 mg po daily -metoprolol tartrate 12.5 tablet po bid -nitroglycerin 0.3 mg sl po prn chest pain -captopril 12.5 mg po tid -isosorbide mononitrate sr 30 mg daily discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. digoxin 125 mcg tablet sig: one (1) tablet po every other day (every other day). 3. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). 4. brimonidine 0.15 % drops sig: one (1) drop ophthalmic (2 times a day). 5. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 6. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 7. dorzolamide 2 % drops sig: one (1) drop ophthalmic (2 times a day). 8. miralax 17 gram (100 %) powder in packet sig: seventeen (17) grams po once a day. 9. verapamil 40 mg tablet sig: one (1) tablet po q8h (every 8 hours). 10. cefpodoxime 100 mg tablet sig: two (2) tablet po q12h (every 12 hours) for 7 days. 11. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day: hold sbp< 100, hr<55. 12. lisinopril 2.5 mg tablet sig: one (1) tablet po once a day: hold sbp<100. 13. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 14. acetaminophen 500 mg tablet sig: 1-2 tablets po three times a day as needed for pain. 15. lorazepam 1 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. 16. senna 8.6 mg capsule sig: capsules po twice a day as needed for constipation. 17. miralax 17 gram (100 %) powder in packet sig: one (1) packet po once a day. discharge disposition: extended care facility: for the aged - ltc discharge diagnosis: ventricular tachycardia urinary tract infection secondary diagnoses: mi x2 (inferior and anteroseptal) - cabg: lima to lad, svg to om/pda ( ) - afib w/o anticoag (fall risk) - sustained vtach in s/p admission - pacing/icd: biv icd (?). icd generator changed to concerto in . - chronic systolic congestive heart failure. ef 35% - legally blind secondary to glaucoma - hiatal hernia - hepatic cysts/hemangioma and lipoma in hepatic flexure - s/p lt bka (wwii trauma ) - bph s/p suprapubic prostatectomy () - s/p cholecystectomy () - chronic low back pain - osteoarthritis - positive ppd in past - depression and anxiety discharge condition: stable, afebrile discharge instructions: you were admitted to hospital for chest pain after repeated icd firings. your heart was found to be in a rhythm known as ventricular tachycardia which was stimulating your icd to fire. your code status was dnr/dni and your options to fix this condition involved either shutting off the icd or reversing your code status temporarily and performing an ablation procedure to fix the part of your heart that was triggering this rhythm. you chose to have the ablation procedure. the first procedure was unsuccessful, but it seems like the second ablation procedure has worked well to stop your ventricular tachycardia and your icd has not fired since . since your icd was firing so often, it was also noted that the battery life on your device was low and needed replacement. you underwent battery replacement prior to discharge on . you were also found to have a urinary tract infection and were treated with antibiotics accordingly. . day or 6 pounds in 3 days. adhere to a 2 gm sodium diet. the following changes have been made to your home medication regimen: -you will continue your antibiotics regimen with cefpodoxime -your ace inhibitor, captopril was -you furosemide was held during your hospital stay and you had no symproms of fluid overload. it will be held until your oral intake improves. please follow-up with all of your outpatient medical appointments listed below. please seek medical care if you experience any concerning symptoms such as chest pain, increased shortness of breath, painful urination, increased abdominal pain, or bright red blood per rectum. followup instructions: cardiology: provider: phone: . date/time: at 3:00pm. clinical center, . , . . device clinic phone: date/time: 1:00. clinical center, . procedure: insertion of endotracheal tube excision or destruction of other lesion or tissue of heart, endovascular approach excision or destruction of other lesion or tissue of heart, endovascular approach cardiac mapping cardiac mapping implantation of automatic cardioverter/defibrillator pulse generator only diagnoses: other and unspecified noninfectious gastroenteritis and colitis mitral valve disorders urinary tract infection, site not specified friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status paroxysmal ventricular tachycardia other specified forms of chronic ischemic heart disease other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure mechanical complication of automatic implantable cardiac defibrillator old myocardial infarction accidents occurring in other specified places legal blindness, as defined in u.s.a. 

Answer: The patient is high likely exposed to