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: scopolamine / iv dye, iodine containing / levaquin attending: chief complaint: hematemesis major surgical or invasive procedure: none history of present illness: this is an 80 y.o. male with complicated past medical history including cognitive impairment, untreated non-small cell lung cancer with lymphangitic spread, recurrent pneumonias, indwelling foley with recurrent uti's, who is a chronic resident and presents today with hematemesis. the patient is unable to relate history due to cognitive impairment so the following comes from the wife and reports of others. apparently, the patient has been complaining to his wife of abdominal pain for approximately one week and then yesterday complained of nausea and had a large amount of hematemesis. today he had more hematemesis and complained of persistent nausea and pain so he was brought to the ed for further evaluation. initial ed vitals afebrile, hr 126, bp 85/47, o2 84% on 5 l nc. he had an episode of hematemesis in front of the ed staff. he received pantoprazole bolus and drip and was given 3l of saline with resolution of his hypotension, though he remained tachycardic. while in the ed he spiked to 102.6 f and was put on a 100% nrb mask. he received ceftazidime for broad antibiotic coverage. g-tube lavage showed coffee grounds that cleared. rectal with guiac + brown stool. gi evaluated the patient and felt very high bar for endoscopy given no signs of active bleeding and precarious respiratory status. vs prior to transfer to icu 102.6, 124, 154/75, 92% on nrb. currently, patient is unable to provide any history. review of systems is similarly unobtainable due to his inability to provide any history. past medical history: - h/o sepsis secondary to aspiration pneumonia - h/o proteus mirabilis and albicans in drainage culture of the abdomen - h/o aspiration - gastroesophageal reflux disease - history of cll and non-hodgkin's lymphoma, also sll lymphoma - nonsmall cell lung cancer resected in , later found to be node positive. patient was discovered to have metastatic adenocarcinoma/recurrent lung cancer with lymphangitic spread. he has progression of mediastinal lymphadenopathy, right upper lobe and left lower lobe lung nodules, prominent periaortic lymphadenopathy. - bedbound at baseline with history of decubitus ulcer - diverticulosis - g-tube dependent - depression - anemia of chronic disease - diabetes mellitus - history of recurrent pneumonia - right inguinal hernia repair. - history of upper gi bleed in , which showed esophagitis on egd in - rectosigmoid polypectomy in - h/o appendectomy as a child - h/o frx of pelvic bone after a fall in - h/o facial abscess following dental work social history: married for 58 years, has lived at since . per medical records, pt has smoked in the past and drank occasionally (one to two beers a week). no illicit drug use. family history: per medical records, he has an estranged brother. his mother is deceased from old age. his father is deceased with a question of leukemia but never diagnosed. he has three children physical exam: vs: 100.2, 118, 145/51, 22, 95% on 100% nrb gen: chronically ill appearing male appearing older than stated age, intermittently moaning heent: anicteric, mm dry appearing, op without lesions, no jvd appreciated resp: diffuse wet crackles bilaterally with audible gurgling from the upper airway cv: tachycardic, no obvious murmurs though difficult to appreciate due to prominent upper airway sounds. abd: pt withdraws to pressing on abdomen, ?voluntary guarding, g-tube in place without surrounding cellulitis ext: no c/c/e skin: no rashes/no jaundice/no splinters neuro: a and o*1, moaning, opens eyes to voice, withdraws to pain pertinent results: 07:25pm wbc-9.5# rbc-3.42* hgb-9.1* hct-28.3* mcv-83 mch-26.7* mchc-32.3 rdw-16.5* 07:25pm neuts-84* bands-9* lymphs-5* monos-2 eos-0 basos-0 atyps-0 metas-0 myelos-0 07:25pm hypochrom-2+ anisocyt-1+ poikilocy-normal macrocyt-occasional microcyt-1+ polychrom-1+ 07:25pm plt count-232 07:25pm pt-12.6 ptt-25.9 inr(pt)-1.1 07:25pm glucose-100 urea n-24* creat-0.6 sodium-143 potassium-4.2 chloride-114* total co2-22 anion gap-11 07:32pm lactate-2.2* 09:52pm urine color-yellow appear-cloudy sp -1.019 09:52pm urine blood-lg nitrite-pos protein-75 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-mod 09:52pm urine rbc-* wbc->50 bacteria-many yeast-none epi-<1 09:52pm urine granular-0-2 imaging: cxr :increased reticular interstitial opacities, most pronounced within the lung bases. findings could represent underlying chronic interstitial abnormality, but superimposed infection or pulmonary edema is not excluded. liver u/s: 1. distended gallbladder with cholelithiasis. while there are no specific signs to suggest acute cholecystitis on this exam, if there is continued clinical concern, further evaluation with a hepatobiliary nuclear medicine scan can be performed. 2. multiple well-circumscribed echogenic lesions within the liver, which correspond with findings on previous ct scan and are compatible with hemangiomas. microbiology: : 1 of 2 blood cx + coag negative staph aureus : urine culture pseudomonas aeruginosa. >100,000 organisms/ml.. yeast. 10,000-100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ pseudomonas aeruginosa | cefepime-------------- 16 i ceftazidime----------- 4 s ciprofloxacin--------- =>4 r gentamicin------------ 4 s meropenem------------- 4 s piperacillin/tazo----- 32 s tobramycin------------ <=1 s blood cx - : ntd brief hospital course: 80 y.o. male with multiple chronic medical problems including stage iv nsclc, cognitive impairment, chronic foley, and very poor functional status presenting with abdominal pain and likely hematemesis. 1. ugib: present with episode of hematemesis, guiac + brown stool, and abdominal pain most suggestive of ugib. reportedly had esophagitis in at osh egd but none since then despite multiple episodes of hematemesis/ hemoptysis. given abdominal pain would be most concerned about ulcer or gastritis. esophagitis would be less likely though hard to assess given no real way to establish dysphagia. finally, metastatic disease could also be responsible for presentation. per report g-tube lavage cleared. for management, given malignancy and multiple comorbidities as well as fact this developed while on ppi, odds of endoscopy fixable bleeding source likely low and would need to be intubated in order for safe endoscopy. managed conservatively with protonix gtt and transfusion of blood products prn. serial hct stabilized with no intervention and patient was switched to protonix with no further evidence of hemorrhage. 2. fever: multifactorial from chronic multidrug resistent uti and aspiration pna in setting of hemetemesis. placed on empiric broad spectrum abx with vanc/ ceftazidime/ metronidazole with subsequent defervescence. urine cx showed pseudomonas with resistance to ciprofloxacin and cefepime. sputum cx showed normal respiratory flora. 1 of 2 blood cx from the ed did grow coagulase negative staph but this was felt to be a contaminant and subsequent blood cx were negatives. later in hospital course, developped recurrent fever and septic like physiology with low blood pressure. antibiotics were switched to vancomycin/ meropenem for better coverage of pseudomonas species. repeat urine cx showed persistent gnr and cxr showed worsening infiltrates. 3. hypoxia: multiple etiologies including lymphangitic spread of maligancy, aspiration pna, and chronic restriction given lobectomy. at baseline, patient required 4-54l nc and this was increased to 50-100% fio2 face mask. patient also required aggressive suctioning and almost constant nursing care. initially, patient improved with antibiotic course; however, he continued to have copius secretions, high oxygen requirements and relative tachypnea. towards end of hospital course with worsening mental status, he was noted to have periods of central apnea. 4. altered ms: baseline dementia with prominent sundowning at baseline. likely component of delerium from hospitalization and infection. initially, due to concerns of severe infection and sepsis, methadone was held. it was felt that patient was in a significant amount of distress, so methadone was restarted at 10mg with olanzapine 2.5mg qhs prn. over course of hospitalization, mental status declined and patient became nonverbal and inattentive. with decline in mental status, worsening pulmonary status with continued copious secretions and increasing oxygen requirements; goals of care evolved to a focus on comfort measures alone. patient was started on a morphine drip with scopolamine patch to manage secretions. patient passed away from respiratory arrest on at 12:26pm medications on admission: 1. levothyroxine 112 mcg po daily 2. acetaminophen 650 mg/20.3 ml solution po q 8h 3. pantoprazole 40 mg susp,delayed release po once a day. ( documentation difficult to interpret appears recently pantoprazole 20 mg po bid) discharge medications: n/a discharge disposition: expired discharge diagnosis: respiratory failure secondary to pneumonia, metastatic nsclc discharge condition: deceased discharge instructions: n/a followup instructions: n/a procedure: venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances diagnoses: urinary tract infection, site not specified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis unspecified acquired hypothyroidism depressive disorder, not elsewhere classified other persistent mental disorders due to conditions classified elsewhere personal history of other lymphatic and hematopoietic neoplasms acute respiratory failure pneumonitis due to inhalation of food or vomitus malignant neoplasm of upper lobe, bronchus or lung personal history of urinary calculi do not resuscitate status hematemesis secondary and unspecified malignant neoplasm of intrathoracic lymph nodes delirium due to conditions classified elsewhere malignant neoplasm of lower lobe, bronchus or lung diverticulosis of colon (without mention of hemorrhage) gastrostomy status pseudomonas infection in conditions classified elsewhere and of unspecified site personal history of colonic polyps history of fall personal history of methicillin resistant staphylococcus aureus unspecified persistent mental disorders due to conditions classified elsewhere 

Answer: The patient is high likely exposed to