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: morphine attending: chief complaint: fungating facial mass major surgical or invasive procedure: intubation and extubation reintubation in the or and extubation embolization of distal internal maxillary arteries history of present illness: 57 yo man, hx of squamous cell cancer of face, with large fungating mass, transferred from osh for second opinion. . admitted to with hgb/hct 1.9/6.1 due to bleeding from mass. he received 7 units of blood. he also had an initial leukocytosis of 69 thouusand. he was evaluated by oncology who recommended palliative radiation, but he was unable to tolerate it due to claustrophobia. he intermittently refused treatment and was evaluated by psychiatry and thought to be overall competent. he was treated with ancef and vancomycin givne mrsa colonization, as well as acinetobacter and polymicrobial infection. he requested discharge ama on , but per the records, he subsequently requested transfer to a tertiary care facility for possible surgical treatment. . on review, per the patient, he first noticed the mass in , and sought medical treatment, but he was refused as he did not have health insurance. he did receive some treatment at , where he was initially seen, but he refused the offered surgery with eye resection and radiation. he states that the mass grew to its current size approximately 1 year ago and has been constant since then. he tends to pick at it, and cut off pieces of it. it has been bleeding slowly for several months. . more recently, he went to hospital and had a biopsy which showed squamous cell cancer. it is unclear what subseqquently happened. . while i was evaluating him, i noticed bleeding from the medial portion of the mass. subseqently, the bleeding accelerated. attempt was made to reveal the location of bleeding. due to inability to stop the bleeding, multiple teams were called for evaluation and treatment, and he was transferred to the icu. past medical history: facial squamous cell carcinoma for which pt has intermittently refused medical care x 4 years. ?psychiatric history- seems to have features c/w schizoid or schizotypal personality disorder. social history: recently quit smoking. lives alone, previously worked. sister is his hcp and nephew is also involved. family history: sister died of uterine cancer in her 50s. physical exam: physical exam on discharge: tm 97.3 tc 97.1 bp 106/74 hr 80 r 20 o2 sat 99% on ra gen- nad, cachectic, comfortable in bed but occassionally picking at face and wound dressing skin- erythema and swelling around right eye heent- large, fungating, purulent and foul smelling mass on left face with serosanguinous drainage. cv- rrr, nl s1, s2 no m/r/g lungs- cta bilat abd- + bs, soft, ntnd ext- no pedal edema, 2+ dp bilat neuro- aa+ox3. conversational. has persistent delusions re: being a miracle and at times states that he thinks his prognosis is good. however, at other times, acknowledges that he "doesn't have much time left" and appears to comprehend risks of, for instance, eating despite failing speech and swallow. of note, in the evenings, pt frequently becomes delerious and oriented only x1. pertinent results: osh labs prior to transfer: hct 31, wbc 46 cr 0.7. head ct at osh: large right facial mass with involvement of right orbit, right maxillary sinus, right mandibular condyle. facial bones ct at osh: 1. 14 cm mass involving the right side of face with destruction of much of the right maxillary sinus, involvement or right orbit, right mandible, and surrounding musculature and superficial right parotid 2. 2.5 cm cystic area anterior to the right maxiallary antrum adjacent to the lateral aspect of the right side of the nose, possibly hematoma, necrosis, or infection 3. asymmetry of the soft tissues along lateral posterior aspect of the right side of the tongue, possibly with local tonsillar enlargement or soft tissue mass. 4. bilateral submandibular and upper julular region adenopathy. . last labs prior to discharge: 06:25am blood wbc-78.6* rbc-3.92* hgb-11.4* hct-34.5* mcv-88 mch-29.1 mchc-33.1 rdw-17.0* plt ct-682* 06:25am blood plt ct-682* 06:25am blood glucose-70 urean-11 creat-1.1 na-144 k-3.8 cl-109* hco3-23 angap-16 06:25am blood calcium-12.3* phos-3.0 mg-2.2 . imaging: ct head and neck: impression: large fungating/necrotic right facial mass which, although extensive, does not appear to have intradural involvement despite bony erosion. . cxr: imaged left lung widespread opacities are unchanged, except increasing left retrocardiac opacity, could be atelectasis. there is no right pleural effusion. the right lung remains clear. the cardiomediastinal silhouette and hilar contours are normal. . video oropharyngeal swallow test: impression: there is gross aspiration of both puree and nectar thick liquid boluses. limited evaluation due to the patient's cooperation and physical status. the swallowing pattern correlate to a dysphasia outcome severity scale (doss) rating of 1, unable to safely tolerate p.o. brief hospital course: this is a 57m with squamous carcinoma involvement of right face and hostory of facial bleeding, transferred to the with active facial bleeding. . #.facial mass: from large fungating growth of squamous cell carcinoma, requiring 6 units prbcs in the . he was intubated and transferred to the micu where he underwent successful embolization of bilateral sphenopalatine artery. he required two more unit of prbcs after embolization for drifting hct associated with oozing from his mass. medical oncology was consulted and felt there to be no indication for systemic therapy. radiation oncology was consulted for palliative radiation; however, this was not pursued as patient was previously unable to tolerate radiation treatment. he was subsequently transferred to the medicine service where his hematocrit remained stable until the evening of when he again developed a brisk bleed from his facial mass. he was transfused 4 units prbc's, and a tamponade dressing was placed. repeat embolization procedure was discussed with neuro ir, but the decision was made not to proceed with the procedure as the patient would again have to be electively intubated for the procedure and the bleeding had subsided with conservative measures. a meeting was held involving the icu team, ethics, social work and palliative care where it was decided that there would not be any more interventions for this mass and that it was within the province of the physicians treating the patient to decide not to intervene in this situation. dressing changes were continued per wound care recommendations . #. respiratory status: patient underwent nasotracheal intubation in preparation for elective embolization by neuro ir. the placement of his nasotracheal tube was never ideal and was not able to be passed further because it was already hubbed to his nose. following embolization, patient became hypoxic and self-extubated. he was emergently taken to the or for reintubation. this time he was able to be intubated orally. subsequently, he was found to have total collapse of his left lung, likely secondary to the interval development of copious secretions and a presume vap. he underwent bronchoscopy for reexpansion of the left lung. he was treated with an 8-day course of vancomycin and zosyn for a ventilator-associated pneumonia. secretions gradually improved, and he was extubated on successfully. his code status was subsequently revised to include a do not intubate order. . #. wound: cultured with acinetobacter, enterobacter cloacae, and mssa. he was initially covered with cefazolin and ciprofloxacin with clindamycin for oral secretions empirically. with concern for vap during his mucous plugging event, his antibiotics were changed to vanc/zosyn, which covered his wound culture from osh by sensitivities. at the time of discharge, he is no longer on any antibiotics for his wound as he is cmo. # hypercalcemia: this was presumed secondary to pth-rp secretion by squamous cell tumor. given overall goals of care, no further intervention was pursued. # nutrition: following extubation, patient failed his speech and swallow evaluation. a video swallow study was performed and he was assessed to be have a dysphagia outcome severity scale (doss) rating of 1, unable to safely tolerate po. aspiration risks were discussed with patient and family. the patient expresses a strong desire to eat despite the risks. it was felt to be his decision in light of his prognosis and he was allowed to eat and drink. # goals of care: the palliative care team was involved throughout the duration of this hospitalization. patient's code status was dnr/dni. there will be no further interventions for the mass. on , the pt decided he wanted to be made cmo and focus on comfort. he was then transferred to . medications on admission: ancef vancomycin tylenol discharge medications: 1. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q4h (every 4 hours) as needed. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. guaifenesin 100 mg/5 ml syrup sig: fifteen (15) ml po q6h (every 6 hours) as needed. 4. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. ativan 1 mg tablet sig: one (1) tablet po q4h as needed: give sublingually. disp:*90 tablet(s)* refills:*0* 8. dilaudid 2 mg tablet sig: one (1) tablet po q2h as needed for pain: give sublingually. disp:*90 tablet(s)* refills:*0* 9. risperidone 0.5 mg tablet sig: one (1) tablet po hs (at bedtime): give sublingually. disp:*30 tablet(s)* refills:*0* discharge disposition: extended care facility: house discharge diagnosis: squamous cell carcinoma of the face aspiration ventilator associated pneumonia blood loss anemia hypercalcemia associated with malignancy cellulitis discharge condition: good- vss. o2 sat mid to upper 90's on room air. pt denying pain. discharge instructions: you were admitted for evaluation of your right sided face mass. while you were here, you hemorrhaged from your facial tumor several times. we embolized part of your tumor to stop some of this bleeding. we also intubated you for this procedure. while you were intubated, you developed pneumonia which was treated with antibiotics. we have consulted oncology, ent, and radiation oncology about your care and they are in agreement to your discharge to at this time. . we added the attached medications to your regimen. you can talk to the doctors about if you need to continue all these medications. at the time of your discharge, you are not requiring any medications for pain. if you should want such medications, talk to the doctors about this. . please follow up with the doctors at the facility. . please talk to your doctor about any concerning symptoms you have. they can discuss this you treatment options. followup instructions: please follow up with the physicians at . procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances injection or infusion of other therapeutic or prophylactic substance closed [endoscopic] biopsy of bronchus diagnoses: pneumonia, organism unspecified iron deficiency anemia secondary to blood loss (chronic) personal history of tobacco use pulmonary collapse other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure pneumonitis due to inhalation of food or vomitus methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] hyperosmolality and/or hypernatremia ventilator associated pneumonia delirium due to conditions classified elsewhere leukocytosis, unspecified hypercalcemia hemorrhage, unspecified cellulitis and abscess of face malignant neoplasm of connective and other soft tissue of head, face, and neck 

Answer: The patient is high likely exposed to