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: history of present illness: this is a 77-year-old man with history of end stage renal disease on hemodialysis, hypertension, non insulin dependent diabetes mellitus, pvd, admitted day #4 postoperatively for elective l4,5 lumbar his operation was uncomplicated, however, he had a presumed aspiration day #1 postoperatively which led to respiratory distress, unresponsiveness requiring intubation and he was transferred to sicu. bronchoscopy was performed on with finding consistent with bleeding from ett trauma and positive evidence of food in lower airway consistent with aspiration. ent consult noted no significant laceration, patient's sicu course was notable for extubation on , he continued hemodialysis per renal team and unexplained hypotension despite increased fluid volume. cortisol stimulation test was done today which was normal. the patient had swallowing evaluation which he failed during the sicu stay. the patient was transferred to medical service on for further management. past medical history: end stage renal disease, non-insulin dependent diabetes mellitus, hypercholesterolemia, peripheral vascular disease, status post right fem tib bypass, status post right toe amputation, pulmonary nodule awaiting biopsy, lbp, l4,l5 stenosis, status post l4,l5 decompressive laminectomy on , glaucoma, hypertension, atrial fibrillation, positive ppd. medications on transfer: insulin sliding scale, xalatan 0.005% gtt q d, alphagan 0.2% gtt , neurontin 200 mg po bid, prandin 0.25 mg po if blood sugar below 150, coreg 6.25 mg po q d, cosopt gtt , lipitor 5 mg po q d, nephrocaps one tablet po q d, prozac 20 mg po q d, phos-lo 667 mg po tid, zantac 50 mg iv q 24 hours, dilaudid 1-2 mg iv q 4 hours prn, albuterol nebulizers q 4 hours prn. allergies: no known drug allergies. social history: the patient denies alcohol or smoking history. lives with his wife. physical examination: on admission patient is afebrile, blood pressure 120/60, heart rate 62, respiratory rate 16, o2 saturation 96 on two liters. the patient is with no acute distress, alert and oriented times three. heent: pupils are equal, round, and reactive to light and accommodation, oropharynx clear, mucus membranes dry. neck, no jugulovenous distension. lungs, rales at the left base, expiratory rhonchi, otherwise clear to auscultation. cardiovascular, irregular irregular, no audible murmurs. abdomen soft, non distended, nontender with positive bowel sounds. extremities without edema and palpable pulsations bilaterally. right second toe status post amputation. skin reveals two skin ulcers with clean dressing, two dry necrotic toe like small ulcers on each foot. hospital course: this is a 77-year-old man who was admitted for decompressive laminectomy l4,l5, who developed postoperative day #1 aspiration resulting in respiratory distress requiring transient intubation, who was initially hospitalized on sicu and then transferred to medicine for further management for dysphagia. 1. pulmonary: the patient developed aspiration postoperative day #1 which led into aspiration/chemical pneumonitis. his treatment consisted of oxygen through nasal cannula but patient was not on antibiotics since he remained afebrile throughout the course of hospitalization. three days post aspiration patient did not require any supplementary oxygen and his lung exam significantly improved. 2. dysphagia: the patient developed severe dysphagia postoperatively, failed three swallowing video studies for solid and liquid food. initially ng tube was inserted with nutritional supplement feeding. he had peg placement inserted on without complications. during endoscopic evaluation there were several ulcers found in his stomach which were biopsied but the results of biopsy are pending on the date of discharge. the patient was seen by a nutrition consult and feeding through the peg was recommended and patient started this on , one day after peg was placed. he also received tpn through iv line for several days prior to peg placement. he will continue on protonix and additional studies such as h. pylori antibody was sent which results are still pending during discharge. if this result is positive, patient should be treated with antibiotics since this could be cause for his findings during endoscopy. the cause of his severe dysphagia was believed to be due to mechanical cause and patient might be evaluated in several months with additional swallowing study. renal, patient has end stage renal disease on hemodialysis, continued hemodialysis during hospitalization without complications. laboratory data: white blood count on discharge 8.1, hematocrit 31.4, hemoglobin 10.1, platelet count 370,000, pt 12.8, ptt 32.5, inr 1.1, glucose 144, bun 43, creatinine 6.3, sodium 140, potassium 4.4, chloride 105, co2 24, liver function tests within normal limits, albumin 2.6, calcium 8.6, phosphorus 5.6, magnesium 2.5, free calcium 1.16. swallowing study revealed aspiration involving thick as well as thin barium, no cough reflex was elicited. ekg revealed sinus rhythm, borderline first degree av block, left atrial abnormality. biopsies from the stomach ulcer are still pending on the day of discharge. discharge diagnosis: 1. status post l4,l5 laminectomy. 2. aspiration pneumonia. 3. dysphagia, status post peg placement on . 4. esrd on hemodialysis. 5. non-insulin dependent diabetes mellitus. 6. peripheral vascular disease. 7. hypertension. 8. glaucoma. discharge medications: nepro 10 cc per hour, could be advanced by 10 cc q 6-8 hours (go 40 units per hour), protonix 40 mg through peg tube , pilocarpine 4% one drop ou , albuterol nebulizers four puffs q 4 hours prn, phos-lo 6.7 mg po tid, prozac 20 mg q d, xalatan 0.005% gtt , alphagan 0.2% gtt , ssri, coreg 6.25 mg q d, nephrocaps one tablet q d, neurontin 200 mg , lipitor 5 mg q d. the patient will be discharged in stable condition to . dr., 12-207 dictated by: medquist36 d: 08:59 t: 09:28 job#: procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis other bronchoscopy percutaneous [endoscopic] gastrostomy [peg] other exploration and decompression of spinal canal other exploration and decompression of spinal canal diagnoses: pure hypercholesterolemia chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease pneumonitis due to inhalation of food or vomitus atherosclerosis of native arteries of the extremities, unspecified diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled spinal stenosis, lumbar region, without neurogenic claudication 

Answer: The patient is high likely exposed to