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: fever, respiratory distress, a-fib with rvr major surgical or invasive procedure: none history of present illness: yr old male with past medical hx significant for recurrent c-diff and urosepsis, cva non-verbal with primary progressive aphasia minimally responsive at baseline presenting with volume depletion, respiratory distress and fever. of note patient was hospice care. . recent admit with fever, diarrhea with urosepsis went to . per report patient appeared lethargic on thursday. md ordered labs with increasing wbc and low grade fever. restarted po vanc for c-diff at that time per daughter oral vanc via g tube. appears to have completed course on hospice nurse presented to facility and noted patient to be in respiratory distress, tachypneic, lethargic. she felt the patient would not survive the day. g tube was also noted to be clogged and he couldnt get his po meds or hydration. patient made comfort measures but daughter emotionally unwell with idea of "starving and withholding iv fluids. over the course of the night patient looked uncomfortable and did not expire, distressing to the daughter. attempted iv for hydration but unable to place. daughter decided to take her father to the initially for iv hydration. . in the ed, initial vs were: t 101 p 68 bp 122/58 r 12 o2 sat 100%. cxr with no consolidation, ekg a-fibb with rvr 140's. patient was given morphine 2 mg, flagyl 500 mg iv, vancomycin 1 gram, metoprolol 5 mg iv and zosyn. lactate 2.8. wbc 16.9 n 61, no bands. hct 30.9 (baseline 20's). na 152, cr 1.9(baseline 0.9-1.1) in discussion with family decided want for iv hydration and abx. she not want any cardiac enzymes or lft's. per discussion it would be ok to give usual lopressor but no pressors if unstable. can give iv fluids. continue dnr/dni. on 6l 02. hr 120's. systolic 95-105. family is ok with the tachycardia to 120's. 3l ns given. family wanted limited draws to once daily. family decided if g tube clogged to not replace. ordered vanc iv did not receive and zosyn which patient received one dose. admitted to icu given family still in discussion regarding goals of care and patient with heavy oxygen requirement, a-fibb with rvr. past medical history: - anemia - bph - atrial fibrillation - benign hypertension - history of hemorrhagic prostatitis () - history of stroke with late effects - primary progressive aphasia and dysphagia s/p g tube - glaucoma - history of mrsa bacteremia - history of enterococcal bacteremia - history of fungemia - history of recurrent utis, urosepsis - history of c. diff - history of obturator internis abscess social history: the patient is currently a resident at . he has been hospitalized multiple times over the last few months, is generally described as minimally communicative at baseline. the patient is fully dependent for all adl. was to go home with hospice but family discussion prior to this patient decided to be brought in to ed for iv hydration only, then change to iv abx but other specific orders as per daughter in regards to management and avoidance of aggressive care. no smoking, no alcohol, no illicit drug use. aphasic. pt was on hospice family history: non-contributory physical exam: vitals: hr 140, 106/68, 87% 6l when agitated, rr 32 temp 101.2 general: cachectic ill appearing elderly male tachypneic : sclera anicteric, mm dry lungs: poor inspiratory effort, decreased bases. no crackles cv: tachycardic, irregular abdomen: soft, non-tender based on lack of grimace, non-distended, bowel sounds hypoactive. g tube with small drainage at sides. able to flush without draw back. ext: warm, well perfused, cachectic skin: no mottling, sacral decub ulcer neuro: aphasic, tonic jerks, does not respond to external stimuli. responsive to sternal rub. contracted upper and lower extremities, no posturing. pertinent results: 01:15pm wbc-16.9*# rbc-3.30* hgb-9.9* hct-30.9* mcv-94 mch-30.1 mchc-32.2 rdw-15.9* plt ct-277 08:12am wbc-13.3* rbc-2.89* hgb-8.3* hct-26.3* mcv-91 mch-28.6 mchc-31.4 rdw-15.7* plt ct-246 01:15pm neuts-61.0 lymphs-32.0 monos-6.1 eos-0.5 baso-0.4 08:12am pt-14.1* ptt-26.8 inr(pt)-1.2* 01:15pm glucose-89 urean-54* creat-1.9* na-152* k-4.5 cl-116* hco3-27 angap-14 08:12am glucose-118* urean-47* creat-1.9* na-146* k-4.0 cl-117* hco3-22 angap-11 08:12am calcium-8.0* phos-3.3 mg-2.4 01:31pm lactate-2.8* 01:15pm urine -lg nitrite-neg protein-30 glucose-neg ketone-tr bilirub-neg urobiln-neg ph-5.0 leuks-mod 01:15pm urine rbc-0 wbc->50 bacteri-few yeast-none epi-0 urine culture: contaminated culture: gpcs in clusters -coag negative staph sensitive to gentamicin c diff negative abdominal x-ray pfi: gastrostomy tube projects over the left upper quadrant. there is new opacity seen in the left hemithorax, new since chest radiograph performed the same day several hours prior. this is incompletely visualized. please see recent chest radiograph for further characterization. g tube study: g tube in standard location. left hemothorax opacity partly seen is unchanged cxr new heterogeneous opacification in the left lung could be atelectasis alone, but there is new small-to-moderate left pleural effusion, unexplained. right lung is clear. the heart is difficult to separate from adjacent pleural and parenchymal abnormalities in the left chest. findings, including the likelihood of major aspiration, were discussed by telephone with dr. at the time of dictation. transvenous right ventricular pacer lead unchanged in standard placement. no pneumothorax. brief hospital course: this is a year old male with multiple medical issues including progressive aphasia, c-diff colitis, recurrent urosepsis presenting with fever, lethargy, respiratory distress, volume depletion. 1. leukocytosis/fever: patient meeting criteria for sepsis. possible source of infection in urine with + ua, c-diff in addition to meeting two sirs criteria with temp and elevated wbc. patient febrile and tachycardic on admission. cxr shows lll pneumonia. patient was started on iv vancomycin and zosyn for potential pneumonia and uti coverage. on admission it was unclear if g tube was working, so he was empirically started on iv flagyl given history of recurrent c diff. once it was clear that g tube was working, he was also started on po vancomycin. 2. respiratory distress: cxr shows lll pneumonia. no evidence of fluid overload or pneumothorax. unclear whether the patient may have aspirated. stable on fio2 35% face mask on admission. continue vanc/zosyn for pneumonia. patient was started on ipratropium nebulizers. kept npo given concern for aspiration. patient's family did not want patient to have an abg. . 3. atrial fibrillation with rapid ventricular response: patient presented with rates in 110s-150s. pt is rate controlled as outpatient on diltiazem 90mg qid, and metoprolol 100mg tid. patient did not receive bb and ccb for >24 hours. also did not receive any hydration for >24 hours. patient also with potential sepsis with fever. given that g tube wasn't functional at time of admission, patient was given iv lopressor and iv fluid boluses to maintain adequate pressure and goal hr <120. once g tube was functional, he was restarted on diltiazem via g tube. . 4. acute on chronic renal insufficiency: cr baseline is 0.9 to 1.1. patient was given iv fluids. acute renal failure thought to be prerenal in etiology given poor po intake and sepsis. family did not want further draws, so unable to follow creatinine. . # hypernatremia: free water deficit on admission was >3l. patient was given 3l ns in ed. given 2l d5w on admission to icu. family did not want further draws, so unable to assess how this resolved. . # g tube dysfunction: as per nh clogged. as per nurse here able to flush but not return therefore concern for placement. g tube study showed that tube was in correct location. home medications were started via g tube, and patient received tube feeds while in the icu. . # code status/disposition: discussed at length goals of care with family. patient was initially comfort measures only but daughter did not want father to be without basic hydration as was her main concern. patient is now dnr/dni without aggressive care. antibiotics, iv fluids, bp meds were all discontinued on day 2 of admission. labs were drawn on day 2 of admission, and then stopped. if deteriorates over the day or g tube non functioning will not replace and call to family and comfort measures only will be initiated. palliative care consult placed. patient received iv morphine and iv ativan for comfort. patient died at 7:20am. medications on admission: diltiazem hcl 90 mg tablet qid metoprolol tartrate 100 mg tid senna 8.6 mg acetaminophen 160 mg/5 ml solution sig: ml po q6h prn bisacodyl 5 mg tablet sig prn maalox 200-200-20 mg/5 ml suspension sig: 15-30 ml po qid prn latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs dorzolamide-timolol 2-0.5 % drops sig: one drop donepezil 5 mg tablet sig qhs ferrous sulfate 300 mg (60 mg iron)/5 ml liquid sig 5 ml daily. polyethylene glycol 3350 100 % powder sig one packet daily brimonidine 0.15 % drops sig one drop q8 hours heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous prn (as needed) as needed for line flush. cefepime 1 gram q 24 x 4 days ended vancomycin 250 mg capsule sig: one (1) capsule po q6h for 18 days. ended discharge medications: none discharge disposition: expired discharge diagnosis: 1. aspiration pneumonia 2. urinary tract infection 3. atrial fibrillation with rapid ventricular response 4. acute renal failure discharge condition: patient died at 7:20am discharge instructions: patient died at 7:20am followup instructions: none md procedure: enteral infusion of concentrated nutritional substances diagnoses: anemia, unspecified urinary tract infection, site not specified acute kidney failure, unspecified other pulmonary insufficiency, not elsewhere classified severe sepsis atrial fibrillation chronic kidney disease, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure pneumonitis due to inhalation of food or vomitus encounter for palliative care hyperosmolality and/or hypernatremia late effects of cerebrovascular disease, aphasia mechanical complication of gastrostomy other staphylococcal septicemia other late effects of cerebrovascular disease, dysphagia dysphagia, unspecified 

Answer: The patient is high likely exposed to