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: cardiopulmonary arrest major surgical or invasive procedure: endotracheal intubation percutaneous gastrostomy tube placement tracheostomy history of present illness: 58 year old male with dm, htn, elevated cholesterol s/p witnessed cardiopulmonary arrest. per patients wife, he was in his usual state of health, working as an emt, able to climb multiple flights of stairs until when he felt nauseated and diaphoretic with chills. he went to sleep and then began to have agonal breathing at 1am and rolled onto his right side. he was unresponsive for 5-10 minutes and then his wife called ems. when they arrived he was pulseless, aed was attached and 2 shocks were given, patient was still pulseless and cpr was started. he received 2 more aed shocks which restored pulse and breathing. patient was transiently hypotensive to sbp of 60. he was given 4 liters ns, lidocaine, heparin and dopamine drip. he was intubated for airway protection with pancuronium. ecg with rbbb/lafb, afib with rvr. labs notable for wbc of 11.9 with 20% bandemia. ck 573, tn-i 0.29. patient was then transferred to ccu. past medical history: hyperlipidemia nec/nos obesity hypertension screen mal neop-prostate cellulitis nos pure hypercholesterolem intestinal obstruction social history: married, retired fireman/emt in the town of , ma. no tobacco, no etoh, no recreational drugs. family history: mother with mi at 84 physical exam: vit: t 98.6 hr 132 bp 159/90 ht. 6'4" wt 330 lbs gen: obese man, intubated heent: bleeding from mouth, perla 2mm-->1mm neck: obese, could not assess jvd cv: irregular rhythm, normal s1, soft s2, no murmurs, no s3 or s4, no carotid bruit pulm: ctab, no w/c/r abd: obese ext: no peripheral edema, no femoral bruit neuro: gcs 4t, moving all extremities, downgoing toes, no reflexes b pertinent results: admission labs: 24.2 > 14.1/43.2 < 209 mcv - 91 . n:84 band:9 l:2 m:5 e:0 bas:0 . 142 / 111 / 31 --------------< 189 3.2 / 20 / 1.5 . ca: 8.6 mg: 1.4 p: 2.5 . pt: 15.1 ptt: 113.9 inr: 1.5 . alt: 40 ast: 44 . 0500 - ck: mb: 10 mbi: 0.5 trop-*t*: 0.49 1415 - ck: 516 mb: 12 mbi: 2.3 trop-*t*: 0.21 . imaging: . cxr : 1) the et tube is in good position. 2) cardiomegaly. 3) left lower lobe consolidation vs. atelectasis. the differential diagnosis include aspiration in this patient with cardiac arrest. 4) plate-like atelectasis in the left mid lung zone. 5) questionable pulmonary edema. this could be better evaluated with an repeat chest radiograph. . ct head without iv contrast : there is no evidence of acute intracranial hemorrhage. there is no shift of normally midline structures. the ventricles, cisterns, and sulci are unremarkable. there is preservation of the grey-white differentiation. there is mucosal thickening in the maxillary and ethmoid sinuses bilaterally. impression: no evidence of intracranial hemorrhage. . echo : the left atrium is elongated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is moderately dilated. there is severe global left ventricular hypokinesis (ejection fraction 20-30 percent). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. the right ventricular cavity is dilated. right ventricular systolic function is borderline normal. the ascending aorta is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. there is no pericardial effusion. . echo : the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is moderately dilated. overall systolic function is normal. left ventricle - ejection fraction >= 55%. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is a trivial/physiologic pericardial effusion. impression: symmetric left ventricular hypertrophy with cavity dilation but preserved global biventricular systolic function. compared with the prior study (tape reviewed) of , there has been a marked improvement in left ventricular systolic function (the ventricular rate isalso slower) . eeg : background: is a markedly low voltage 8 hz alpha frequency rhythm. hyperventilation: could not be performed due to the patient's clinical condition. intermittent photic stimulation: could not be performed because this was a portable study. sleep: normal transitions of the sleep architecture were not seen. cardiac monitor: initially, there was a normal sinus rhythm with a rate of 72 bpm with intermittent ventricular ectopies. in addition, there are two episodes where the ventricular rhythm showed the sudden onset of a left bundle branch block which lasted for 30-60 seconds and then reverted to a normal conduction pattern. impression: this eeg is with in normal limits but shows a low voltage background with excessive drowsiness. no lateralizing or epileptiform abnormalities were seen. two episodes of a change from normal cardiac ventricular conduction to one with a left bundle branch block were noted. . ekg : atrial fibrillation with a rapid ventricular response. left axis deviation with left anterior fascicular block. mild inferior st-t wave changes which are non-specific. low qrs voltage in the preordial leads. . ekg : probable idioventricular rhythm or accelerated idioventricular rhythm, rate 87,with retrograde p waves. . ekg : sinus rhythm. since the previous tracing of atrial fibrillation is no longer present and the q-t interval has increased. . left le dopplers : impression: negative left lower extremity dvt study. brief hospital course: # s/p cp arrest: reports were obtained from emts and town of police department. patient was determined to be in polymorphic vt and vf and after receiving aed shocks x4, he was converted to atrial fibrillation and started on lidocaine drip in the field. when he arrived at the lidocaine was discontinued and he was loaded on amiodarone. he continued to have occasional runs of aivr and afib, but after 10 days in the hospital, he reverted to stable nsr and was continued on amiodarone 400 mg qd. reports from show the patient had an ett-mibi on which showed: "reversible anterior wall defect, partially reversible defects of the inferior and apical walls consistent with ischemia and scarring, ef is 44%," without revascularization, making ischemic injury likely as the initiating event for the arrest. . # cad: patient was started on empiric aspirin, atorvastatin and a heparin drip. he was hypertensive on admission and was put on a nitro drip, he was then converted to medications per ng/peg tube. his discharge antihypertensive regimen includes: metoprolol 100 mg tid, hydralazine 100 mg qid, lisinopril 20 mg , lasix 40 mg , and isosorbide dinitrate 20 mg tid. . # pump: ef 20-30% on initial admission echo, repeat echo on showed improvement in ef to greater than 55%, mild lvh with moderate dilation, no ar, trivial mr. systolic function is normal. lasix 40 mg maintained the patient at fluid neutral. . # pneumonia: wbc count was elevated on admission and his initial cxr showed an opacity in the left lower lobe. he was started on zosyn for possible aspiration pneumonia and completed a 10 day course of zosyn with resolution of wbc count and fevers. . # cellulitis: patient was noted to have a cellulitis on his left anterior leg on day 2 of admission. dvt was ruled out with u/s. cellulitis resolved with course of zosyn started for pneumonia. . # respiratory failure: patient was intubated in the field and after one week on the ventilator a tracheostomy tube was placed. the patient had spontaneous respirations on cpap with ps, but given lack of a gag reflex and excessive secretions he was unable to be weaned from the ventilator. albuterol and atrovent nebs were given on a prn basis. . # anoxic brain injury: initial head ct was (-) for bleed. neurology was consulted for recommendations regarding further work up and for assessment of prognosis. they recommended an eeg, which showed diffuse slowing without epileptiform activity, and an mri. the mri could not be obtained since the patient's shoulders are too broad for our mri. their assessment after 10 days of hospitalization was: "eventual prognosis for meaningful recovery is unpredictable at this point. he has sustained a significant anoxic brain injury and at this point, has brainstem and thalamic function (?sleep-wake cycles?) but no meaningful evidence for higher cortical functions that would predict a good prognosis. time may help to determine his eventual recovery, so we have agreed that beginning to move towards nursing home placement would be in order." he was weaned from propofol iv drip to ativan 2 mg q4hr and 5 mg zyprexa qhs for agitation. . # fen: his electrolytes were repleted throughout the admission to maintain potassium greater than 4 and magnesium greater than 2. a peg was placed for long term feeding, and he was titrated up to 80 cc/hr of promote with fiber with residuals less than 10 cc. free water boluses were added as needed for hypernatremia. reglan was given to improve gastric motility. he was continued on lansoprazole for gastric ulcer prophylaxis. . # dm: the patient was kept on an insulin sliding scale throughout the admission and was given lantus at night. at the time of discharge his lantus dose was in the process of being titrated to achieve blood sugars between 100-125. at discharge his evening lantus dose was 24 units qhs and his blood sugars ranged from 150-200. . # prophylaxis: heparin iv was continued until the patient developed hematuria and heme positive stools. the heparin was discontinued and pneumoboots were used for dvt prophylaxis. . # dispo: the patient had a trach/peg placed as he was not able to be weaned from the ventilator and will require placement at a long term acute care facility. he has a picc line in place. . # code status: dnr (discussed with family on ) . medications on admission: lisinopril 40 mg qd actos 45 mg qd tiazac 360 mg qd atenolol 50 mg qd nitrostat 0.4 mg prn insulin lipitor 10 mg qd timolol 0.5% qd in r eye discharge medications: 1. artificial tear ointment 0.1-0.1 % ointment sig: one (1) appl ophthalmic prn (as needed). 2. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q4h (every 4 hours) as needed. 3. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 4. lisinopril 20 mg tablet sig: one (1) tablet po bid (2 times a day). 5. hydralazine 50 mg tablet sig: two (2) tablet po q6h (every 6 hours). 6. atorvastatin calcium 80 mg tablet sig: one (1) tablet po daily (daily). 7. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed. 8. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed for rash/itching. 9. isosorbide dinitrate 20 mg tablet sig: one (1) tablet po tid (3 times a day). 10. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 11. white petrolatum-mineral oil cream sig: one (1) appl topical (2 times a day) as needed. 12. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 13. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 14. lorazepam 1 mg tablet sig: two (2) tablet po q4h (every 4 hours). 15. olanzapine 5 mg tablet sig: one (1) tablet po daily (daily). 16. amiodarone 200 mg tablet sig: two (2) tablet po daily (daily). 17. lansoprazole 30 mg susp,delayed release for recon sig: thirty (30) mg po daily (daily). 18. insulin zinc extended human 100 unit/ml suspension sig: one (1) injection subcutaneous asdir: see sliding scale. 19. metoclopramide 10 mg tablet sig: one (1) tablet po qid (4 times a day) as needed. 20. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). 21. heparin flush picc (100 units/ml) 2 ml iv daily:prn 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. discharge disposition: extended care facility: specialty discharge diagnosis: cardiopulmonary arrest coronary artery disease anoxic brain injury discharge condition: stable discharge instructions: check weight every morning, md if weight > 3 lbs. fluid restriction: 1 liter please notify care takers of bed sores, fevers, difficulty breathing or swelling of the legs followup instructions: please follow-up with your cardiologist, dr. within 2 weeks. please follow-up with your primary doctor, attar, . procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation acute respiratory failure pneumonitis due to inhalation of food or vomitus cardiac arrest anoxic brain damage cellulitis and abscess of leg, except foot blood in stool ventricular fibrillation hyperosmolality and/or hypernatremia 

Answer: The patient is high likely exposed to