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: admitted due to failure of out-pt treatment of pneumonia w/ levaquin. major surgical or invasive procedure: none history of present illness: mr. is a yo male with dementia, admitted from a nh b/c he is failing out-patient management of a pneumonia. it is unclear where and when he was diagnosed with this pneumonia, but per the ed's coversation with the nh, he has "failed" tx with levaquin. he was also reportedly dehydrated. in the ed, vs were t 99.8, bp , hr and satting 99% 5l. he received doses of ceftriaxone and flagyl. . in addition, he had right-sided rib fractures noted on cxr; nh said he had a fall three weeks ago. ct chest done in ed showed acute fractures that appeared less than three weeks, but there is no other history documenting a more recent fall. he has spine films that were clear, and trauma saw him and recommended an epidural for pain control. past medical history: aspiration pna hiatal hernia pneumonia gerd dementia anemia social history: lives at , widowed, no living children. he has a nephew, and a brother. is actively involved in caring for him and has been making his health care decisions. family history: noncontributory physical exam: vital signs: t = 96.3, bp = 125/71:, p = 73:, rr= 20:, o2sat= 93% on ra confirmed myself:, bm - unclear when his last bm was : general: grooming ok, hygiene- ok , mentation- alert, somnolent but can be aroused. heent: ncat,eomi,perrl, dry oral mucosa with crusted dried crusted secretions. cerumen impacted with wax b/l. neck: thyroid not palpable, no cervical lad, carotid pulse 2+b, no jvd resp: decreased bs througout but poor exam as patient could not consistently obey commands to take deep breaths. he coughs up thick secretions which i am able to suction but he is unable to completely expectorate. cor: s1s2, rrr, no murmur abd: +bs, soft, nontender, non-distended, no hsm rectal: vault full of soft stool. guiac negative. pulses: 1 r dpp, none appreicated on the right. ext: no cyanosis, clubbing or edema. skin: no rash, lesion or ulceration neuro: a an o to self only. simple one word answers, inattentive, cranial nerve ii through xii: grossly nonfocal, - increased cogwheeling of the upper extremities - brisk 2+ biceps reflexes b/l. no reflexes in lower extremities. - muscle strength 5/5 in bilateral upper and lower extremities pertinent results: imaging: cxr : acute fractures involving the anterolateral right eighth through tenth ribs. bibasilar atelectasis with no definite pneumonia. ct head : 1.no evidence of acute intracranial hemorrhage or fracture. 2. cerebral atrophy consistent with stated age and small vessel angiopathy. ct chest/abdomen/pelvis: 1. multiple right-sided rib fractures extending from 8th through 12th ribs as described above without pneumothorax, pulmonary contusion or pleural effusion. 2. bibasilar consolidations more dense on the right side could reflect atelectasis, however, acute on chronic aspiration/pneumonia cannot be excluded. 3. stable enlargement of the prostate gland. . glucose-136* urea n-40* creat-2.3* sodium-147* potassium-4.2 chloride-114* total co2-20* anion gap-17 alt(sgpt)-14 ast(sgot)-25 alk phos-110 tot bili-0.5 lipase-38 albumin-3.3* calcium-8.9 phosphate-3.8 magnesium-2.7* wbc-19.9*# rbc-5.13 hgb-14.3 hct-43.0 mcv-84 mch-27.9 mchc-33.3 rdw-14.2 neuts-92.4* lymphs-5.8* monos-1.7* eos-0.1 basos-0.1 plt count-534*# brief hospital course: is a yo male who is a nursing home resident with dementia who was admitted with bilat lower lobe infiltrates after failed out-patient treatment of pna. patient was found to have bibasilar consolidation on chest ct with an oxygen requirement, and was on levofloxacin as an outpatient. he had a leukocytosis to 18 prior to admission, and was given vancomycin and ceftriaxone, with improvement in his symptoms. he was initially admitted to the , and was then transferred to the floor for continuation of antibiotics. his blood cultures were negative, and he will need to complete a 7 day course of antibiotics. a picc line was placed for this indication. he was seen by speech and swallow due to concern for aspiration. he had a video swallow evaluation performed, which showed silent aspiration. a discussion with the health care proxy confirmed that a feeding tube was not something that the patient would wish for, and he was given nectar thickened liquids and a pureed diet with aspiration precautions with the understanding that he is at risk to aspirate. he was noted to have multiple acute rib fractures on chest ct. he denied any pain. he was given pain control with tylenol, and encouraged to use an incentive spirometer and placed on falls precautions. he was asymptomatic, on room air, at discharge. he was evaluated by trauma surgery, who recommended conservative management. he was hypernatremic and had acute renal failure which resolved, which resolved with iv fluids. he remained dnr/dni during his admission. medications on admission: prilosec 20mg daily levofloxacin 500mg daily prozac 10mg qday risperdal 0.125mg daily (decreased from 0.25 on ) discharge medications: 1. fluoxetine 10 mg capsule sig: one (1) capsule po daily (daily). 2. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours). 3. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 4. acetaminophen 160 mg/5 ml solution sig: six y (650) mg po q 8h (every 8 hours): until no further pain from rib fractures. disp:*100 cc* refills:*2* 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. bisacodyl 10 mg suppository sig: one (1) suppository rectal hs (at bedtime) as needed. 7. vancomycin 500 mg recon soln sig: one (1) recon soln intravenous q48h (every 48 hours) for 2 doses. 8. ceftriaxone 1 gram recon soln sig: one (1) injection intravenous once a day for 4 doses. 9. picc line care picc line care per protocol. d/c picc line after four days when antibiotics are complete. 10. prilosec 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 11. risperdal 0.25 mg tablet sig: tablet po once a day. 12. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection three times a day. discharge disposition: extended care facility: nursing home - discharge diagnosis: aspiration pneumonia multiple rib fractures acute renal failure hypernatremia aspiration, silent discharge condition: stable discharge instructions: you were admitted to the hospital with pneumonia. you were treated with intravenous antibiotics, o2 and nebulizer breathing treatments. if you develop shortness of breath, fevers, chills, or chest pain, please call your primary care doctor or go to the emergency room. followup instructions: provider: , md phone: date/time: 3:30 procedure: venous catheterization, not elsewhere classified diagnoses: esophageal reflux acute kidney failure, unspecified unspecified fall other persistent mental disorders due to conditions classified elsewhere hypopotassemia pneumonitis due to inhalation of food or vomitus personal history of noncompliance with medical treatment, presenting hazards to health dehydration hyperosmolality and/or hypernatremia closed fracture of multiple ribs, unspecified 

Answer: The patient is high likely exposed to