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: meprobamate attending: chief complaint: diarrhea, nausea, malaise major surgical or invasive procedure: intubation history of present illness: the pt. is a 56 year-old male who presented to the ed this am after 5 days of gi symptoms, malaise and weakness. was in his usual state of good health until sunday, when he began experiencing profuse bouts of non-bloody, watery diarrhea; denied abd pain. the following day, had an episode of nausea followed by non-bilious emesis x2 and dry heaves. denies any fevers at this point, and attributed these symptoms to a viral abd. flu. by thursday am, due to his poor appetite and poor po intake, he came to the the ed. . in the ed, found to have a rul consolidation, with neg ct of the abd. labs notable for a brisk leukocytes (pmn 93% with toxic granulations). . on review of systems, the pt. denied high fevers (only ~99 max at home) or chills. no night sweats, ~10 # weight loss this week. denied headache, sinus tenderness, rhinorrhea or congestion. has noted paroxysms of coughing over the past 3 days, non production, only, "spit". denies any shortness of breath, cp, pnd, orthopnea no recent travel or sick contacts. diarrhea has resolved, and has had normal bm without brbpr or melana. + dehydration. has not been checking his blood sugars at home. . in the ed, patient received flagyl and levo and ivf past medical history: obesity dm2 gout htn social history: works as a teacher, drink 2-3 beers/whisky day. remote tobacco ~20py quit in . family history: no dm2, htn, cad physical exam: vitals: tm/tc: 99.9 p:92 r:16-20 bp:107/66 sao2:98-99% ra bsfs 118 general: awake, alert, nad. heent: nc/at, perrla, pupils 5mm, eomi without nystagmus, no scleral icterus noted, multiple telangictasias, mm dry, no lesions noted in op. normal dentition. neck: supple, with large nucal fat pad, no jvp or carotid bruits appreciated. has pronounced r>l enlargement of parotids no bruits, no discreet mass appreciated. no thyromeg. pulmonary: clear with diminished bs on right anterior lung field + egophony, no tracheal dev. sm telangictasia by left clavicle. cardiac: irreg irreg, without mrg abdomen: obese, soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: no c/c/e bilaterally, full +2 dp and pt pulses lymphatics: no cervical, supraclavicular, axillary or inguinal lymphadenopathy noted. parotids as above. skin: no rashes or lesions noted. neurologic: -mental status: alert, oriented x 3. able to relate history without difficulty. fine asterixis: pertinent results: ua: coloramber appearhazy specgr1.018 ph 5.0 urobil8 bilism leukneg bldsm nitrneg protneg glutr kettr rbc0-2 wbc3-5 bactmod yeastnone epi0-2 comments: abn color affect dipstick other urine countscastgr: casthy: . lactate:1.5 *123* 88 24 104 agap=16 3.9 19 *1.5* . alt: 32 ap: 91 tbili: 2.6 ast: 83 : 27 lip: 20 . ....13.596 20.8>---< 182 .....36.9 n:93 band:0 l:5 m:2 e:0 bas:0 . . . ekg: st at 103, with nl axis and intervals, rll/laa, no st or q's . radiologic data:cxr: pna large right upper lobe opacity consistent with pneumonia. no evidence of vol loss. . ct abd: ct of the abdomen with iv contrast: the imaged portions of the lung bases are clear. the liver, gallbladder, pancreas, spleen, adrenal glands, and kidneys are unremarkable. loops of small and large bowel are of normal caliber with no wall thickening. there are scattered large bowel diverticula without evidence of diverticulitis. no intra-abdominal free air or free fluid. no pathologically enlarged lymph nodes. ct of the pelvis with iv contrast: there are scattered sigmoid diverticula without evidence of diverticulitis. bladder is decompressed. prostate gland and seminal vesicles are grossly unremarkable. no pelvic or inguinal lymphadenopathy. bone windows reveal no suspicious lytic or sclerotic lesions. impression: no acute pathology seen to explain the patient's symptoms. no intraabdominal abscess is present. . echo: the left atrium is elongated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic arch is mildly dilated. the aortic valve leaflets (3) are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is a trivial/physiologic pericardial effusion. . cxr endotracheal tube, central venous catheter unchanged in position. a nasogastric tube has been placed and terminates in the stomach. there remains consolidation in the right upper lobe, which show some interval improvement, particularly centrally and at the apex. no new or progressive areas of consolidation are evident in the remainder of the lungs. brief hospital course: 56 yo male with h/o of htn, dm2, etoh use, p/w 5 days of n/v/d and malaise, found to have a rul pna. patient deniesdany aspiration event in associate with emesis, and upper lobe was not typical for entrainment of gi contents, but patient reports being supine during most of his illness. did have viral uri illness, but ~>1 month ago. did not appear to be an obstructing lesion on cxr without no vol. loss. he was admitted to the medicine service and treated with vanc, flagyl, and levo. . on pt was on the general floor when he began to become more agitated and triggered his ciwa scale. a code purple was called as the pt was trying to leave the hospital. he was evaluated by psych who found him agitated and ox1. psych felt he was having worsening etoh withdrawal and recommended starting standing ativan and increasing prn doses, as well as starting depakote 500 . he was given 5mg iv valium, and later ativan 2mg iv x 3 over the next few hours. after the 3rd dose of ativan a bg was checked and was 43. pt was given an amp of d50 and an hour later bg was 105, but o2sats were noted to be 68% on ra and pt was minimally responsive. he was placed on a nrb and abg was 7.18/68/178. he was given 40mg iv lasix and had at least 400cc uop. he was placed on nitropaste for a sbp of 220 and given 1 amp of bicarb. he continued to decline and a code was called and he was intubated. pink frothy sputum began to come out of the ett. a nitro gtt was started for hypertension and he was transferred to the . . the patient was brought to the icu where he was found to have hypotension requiring pressors for one day only. this was belived to be secondary to a combination of nitropaste, nitroglycerine drip and propofol. in the icu, cxr revealed a rul pneumonia. blood cultures grew pan-sensitive strep pneumonia and the patient was started on ceftriaxone alone. he remained intubated for respiratory support only until . he continued to do well in the icu and after extubation he did well on a shovel mask only. the patient returned to his historic hypertension after extubation and was started on beta blockers. he is on atenolol as an outpatient and was started on metoprolol for better control and titration while in-house. his ekg showed a wandering atrial pacemaker per curbside discussion with cardiology, but his heart rate and somewhat irregular rhythm remained well controlled and were monitored while in hte unit on telemetry. the patient was seen by psychiatry in an attempt to assess his alcohol use and possible wihtdrawal. after he came off sedation in hte unit he was started on ativan standing per psych recs. he had no symptoms of withdrawal. the plan was to continually decrease this standing ativan on the floor. the patient reports drinking 3 glasses of whiskey per night, but admits to "an occasional fourth." he denied having problems with withdrawal in the past and stated that once a year he avoids alcohol for two weeks. an addictions consult with was ordered and she will see the patient on the floor. he was kept on thiamine and folate supplementation. in the unit the patient briefly had acute renal failure that responded to fluids. he had trouble with low fingersticks for two days while his creatinine was elevated, likely representing insulin stacking in the setting of renal failure, as this resolved when the patient's creatinine returned to baseline levels. he was restarted on allopurinol for his gout after arf resolved. on the floor the pt was doing well. he did not have any more o2 requirement and was ambulating. on the day of discharge the pt had worsening diarrhea and a new rise in white cell count. as the pt was feeling fine and was afebrile, a stool culture was send as well as c.diff toxin, and the pt was empiricially started on flagyl fo c.diff. the pt's pcp was informed to follow up on the c.diff/stool culture and discontinue flagyl if c.diff negative. the pt was instructed to come back tot he hospital if he is notable to tolerate food, develops abdominal pain or fever. medications on admission: glucophage atenolol allopurinol discharge medications: 1. glipizide 5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 2. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 6. allopurinol 300 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. atenolol 50 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 8. metformin 500 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 9. cefpodoxime 200 mg tablet sig: one (1) tablet po twice a day for 7 days. disp:*14 tablet(s)* refills:*0* 10. flagyl 500mg tid for 10 days discharge disposition: home discharge diagnosis: primary diagnosis: 1. aspiration pneumonia 2. hx of alcohol abuse secondary diagnosis: 1. obesity 2. diabetes type ii 3. hypertension discharge condition: good, afebrile, satting well on room air discharge instructions: take all medications. we have given you a 7-day course of antibiotics for your pneumonia. call your physician or come to the er if you experience any shortness of breath, fevers, chills, chest pain, abdominal pain, continued nausea, vomiting or diarrhea or anything else that concerns you. followup instructions: we have made an appointment for you to see dr. on monday, at 1:15pm. it is very important that you go to this appointment. if you need to reschedule the appt, please call the office at . you will need a repeat chest x-ray or chest ct after treatment of your pneumonia. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube enteral infusion of concentrated nutritional substances diagnoses: acute kidney failure, unspecified hyposmolality and/or hyponatremia severe sepsis acute respiratory failure pneumonitis due to inhalation of food or vomitus diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled pneumococcal septicemia [streptococcus pneumoniae septicemia] 

Answer: The patient is high likely exposed to