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: cough and fever. major surgical or invasive procedure: none history of present illness: 79 yo m dnr/dni in hospice with end-stage chf and cardiac ascites admitted with pneumonia. the patient was in his usual state of health until 24 hours prior to admission when he developed fevers to 103, cough and shaking chills. the patient requested that he be taken to the hospital for care. in the ed, t 101.4 103 74/48 18 95% ra. the patient had a cxr revealing a likely right middle lobe pneumonia. he received 1gm ceftriaxone and was admitted to the floor. on presentation to the , the patient was found to be hypotensive to 50-60 systolic with poor mental status. the patient received a total of 500cc ns prior to transfer to the icu. past medical history: 1. congestive heart failure, lvef equals 20% to 25% ( ). 2. severe tricuspid regurgitation. 3. moderate to severe mitral regurgitation. 4. status post mechanical aortic valve replacement done in in . 5. chronic atrial fibrillation on coumadin. 6. chronic renal insufficiency (baseline creatinine 2.2-2.6) 7. cirrhosis (right heart failure). 8. ascites. 9. gi bleed (small bowel avm) 10. mrsa bacteremia with neg endocarditis w/u 11. s/p right hip fracture, orif social history: patient is jordanian. arabic speaking. former farmer. quit smoking 30 years ago (1ppd x 24 years). any alcohol or other drug use history. large extended family that is actively involved in patient's care. family history: mother with history of stomach cancer. father died of unknown causes. no family history of liver disease physical exam: 96.0 78 82/38 18 100% 2l nc gen: nad. a&ox3 though waxing and alertness. heent: perrl. cv: rrr. normal s1 and s2. no m/r/g. pulm: rhoncorous sounds bilaterally. abd: soft, mildly distended. ext: 2+ edema in the bilateral lower extremities. neuro: a&ox3 with waxing and alertness. pertinent results: 12:40am ammonia-45 12:45am pt-16.9* ptt-31.6 inr(pt)-1.6* 12:45am plt smr-normal plt count-229 12:45am neuts-87.9* bands-0 lymphs-5.2* monos-6.6 eos-0.2 basos-0.1 12:45am wbc-8.3 rbc-2.83* hgb-7.9* hct-24.4* mcv-86 mch-27.9 mchc-32.5 rdw-16.3* 12:45am albumin-2.6* 12:45am lipase-60 12:45am alt(sgpt)-9 ast(sgot)-28 alk phos-269* amylase-65 tot bili-0.7 12:45am glucose-123* urea n-57* creat-2.2* sodium-131* potassium-4.6 chloride-102 total co2-22 anion gap-12 12:53am lactate-0.9 brief hospital course: a/p: 79 yo m dnr/dni in hospice with end-stage chf and cardiac ascites admitted with pneumonia, transferred to the micu for hypotension and then to the floor after hypotension improved. . #pneumonia-he was admitted with fever and cough and was found to have a right lower lobe pneumonia. he was satting well, and started on ceftriaxone and vancomycin as he is chronically hospitalized. his cough improved throughout his hospitalization. his blood cultures, urine cultures and sputum cultures had no growth. a urine legionella angtigen was negative. after several days on ceftriaxone and vancomycin his antibiotic treatment was changed to levofloxacin. on the medical floor he was satting in the high nineties on room air and reported that his cough had improved significantly. . # hypotension-he has baseline low bp secondary to severely impaired cardiac function. bp appeared below baseline in the micu possibly secondary to sepsis physiology (with some signs of underperfusion including waxing and mental status). source of infection pulmonary, though sbp could not be excluded. after 24 hours of antibiotics his mental status improved as did his hypotension. he also received ivf prn. once transferred to the floor he was not hypotensive below his baseline (systolic in the 70's). his mental status was stably alert and oriented times three. . # hyponatremia-he is hyponatremic at baseline, likely secondary to liver disease from heart failure. his hyponatremia was stable and was not treated with fluids management as he is fluid overloaded but hypotensive and was not symptomatic. . # end-stage chf complicated by cardiac hospital day 3 he became uncomfortable with the amount of fluid in his abdomen. his abdominal port was accessed and 6 liters were removed. his abdomen was less tense and his breathing improved afterwards. his poor prognosis was discussed further with son and reason for hospice. a conversation occurred with his son, himself, his wife about his code status and they wished to have his code status changed from dnr/dni to full code. . # renal insufficiency. his creatinine was at baseline and stable. medications were renally dosed. . # anemia. his anemia was at baseline and stable . # fen: full diet. . # prophylaxis: hep subq, ppi. . # access: peripheral iv. . # comm. health care proxy is son or . # code: full code (spoke with son ), also spoke with mr. himself and he expressed that he is interested in pursuing medical treatments that his medical team would feel would be helpful. he stated that he has discussed this multiple times with his family and they know what he would like. . please note that his change in code status back to full code appears to have been influenced by his acute presentation, though he did not require pressors or any intubation this admission. on further conversation with the pt after he was clinically improved, he stated that "i've had many discussions with my doctors about this in the past; i want to receive treatments that the doctors think help me but do not want the ones that would not benefit me." he did seem to understand that intubation and resuscitation with his underlying conditions likely would not result in improved quality of life and successful recovery to his prior status; i.e. he likely would not recover and leave the icu setting. nonetheless, his code status remains full at this time and we have communicated with his hospice nurse (who knows him well) that this should continue to be addressed with the patient and family. medications on admission: warfarin 3 mg po at bedtime furosemide 40 mg daily prilosec 40mg daily flutic-salmeterol 100-50 mcg/dose disk inhalation 2 times a day pantoprazole 40 mg daily tramadol 50 mg at bedtime medications: 1. warfarin 1 mg tablet sig: three (3) tablet po qhs (once a day (at bedtime)). 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 10 days. 6. trazodone 50 mg tablet sig: 0.5 tablet po once (once) for 1 doses. 7. fluticasone-salmeterol 100-50 mcg/dose disk with device sig: one (1) inhalation twice a day. 8. lasix 40mg once a day disposition: extended care facility: nursing & rehab center - diagnosis: pneumonia cardiac ascites chf, lvef equals 20% to 25% (). severe tricuspid regurgitation. moderate to severe mitral regurgitation. s/p mechanical avr done in in . chronic atrial fibrillation on coumadin. chronic renal insufficiency (baseline creatinine 2.2-2.6) cirrhosis (right heart failure). ascites. gi bleed (small bowel avm) mrsa bacteremia with neg endocarditis w/u s/p right hip fracture, orif condition: stable, afebrile, satting well on room air, good po intake instructions: you were admitted with a pneumonia, you also had very low blood pressure. you were treated in the micu with antibiotics. your pneumonia and low blood pressure improved and you were transferred to the medical floor. you continued to improve. you had a paracentesis through your abdominal port. please continue to take your medications as prescribed. you will have to continue taking your antibiotics for the next 10 days. please follow up as directed below: call your doctor for any shortness of breath, increased coughing, chest pain, abdominal pain, or any other concerning symptoms. weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction:one liter followup instructions: dr. :00am md procedure: percutaneous abdominal drainage diagnoses: anemia, unspecified mitral valve disorders hyposmolality and/or hyponatremia atrial fibrillation chronic kidney disease, unspecified heart valve replaced by other means cardiogenic shock long-term (current) use of anticoagulants other ascites acute on chronic systolic heart failure diseases of tricuspid valve bacterial pneumonia, unspecified chronic passive congestion of liver 

Answer: The patient is high likely exposed to