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: phenylephrine attending: chief complaint: altered mental status, hypotension, respiratory distress major surgical or invasive procedure: none history of present illness: mr. is a 83 yo russian-speaking male with a history of three vessel cad, schf, af, as, dm, ckd and a history of aspiration events, recently discharged from the ccu service who re-presents from his rehab facility to the ed today. around 10am on the day of admission, the patient was noted to acutely desaturate and his rehab and become lethargic. initial abg demonstrated 7.34/50/54. his supplemental oxygen was increased and he was eventually placed on nippv. his po2 increased to 93 with this but he remained somnolent. he was also noted to become hypotensive with sbps in the 60s, shortly prior to his transfer to the ed. he was given 250cc ns bolus x 2 for this and for poor urine output. he was also noted to have tremulous extremities. . in the ed, the patient was found to be hypoxic, with sats in the 70s on 100% fio2, as well as hypotensive to the 60s systolic. a chest x-ray was concerning for chf. the patient was intubated for progressive respiratory distress. a femoral line was placed and he was started on dopamine and levophed for blood pressure support after receiving 3l ns. his serum k was noted to be elevated and he was treated with ca, insulin, glucose and bicarb. he was also emperically treated with ciprofloxacin and flagyl. . the patient's most recent admission was for evaluation of hypotension in the setting of receiving sl ntg despite his known as. his hospital course was complicated by hematuria, a uti, and a new diagnosis of frequent aspiration. just prior to that admission, he had been hospitalized at medical center for an nstemi complicated by cardiogenic shock. during that hospitilization, pci for the patient's known cad was attempted but could not be performed. while on the ccu service, the patient's cath films were obtained and reviewed by both interventional cardiology and cardiac surgery; he was not felt to be a candidate for revascularization. . on arrival to the ccu, the patient is somnolent and unresponsive to painful stimuli. ros is unable to be obtained. . past medical history: 1. cardiac risk factors: hypertension 2. cardiac history: -percutaneous coronary interventions: 3. other past medical history: . mr as, severe chf, systolic and diastolic dysfunction, recurrent mi with cardiogenic shock . multiple pci procedures pad with ic right foot plantar ulcer cri. bronchiectasis/emphysema/recurrent bronchitis diabetic neuropathy, possible early diabetic nephropathy chronic recurrent left ear infection social history: lives at home with wife. -tobacco history: denies. -etoh: rare social etoh. -illicit drugs: family history: noncontributory. social history . no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: general: critically ill adult male, intubated, sedated. diffuse, intermittent muscle twitching. : ncat. sclera anicteric. perrl but sluggish to respond. conjunctiva pink, no pallor or cyanosis of the oral mucosa. neck: supple; neck veins difficult to assess. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no r/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. mechanical breath sounds. decreased breath sounds at bases bilaterally. few rhonchi; no frank wheezing. abdomen: distended, tympanitic abdomen with decreased bowel sounds. no hsm. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: mild stasis dermatitis changes. no other ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ dp 2+ left: carotid 2+ femoral 2+ dp 2+ pertinent results: 11:43pm glucose-199* urea n-58* creat-3.6* sodium-130* potassium-6.1* chloride-98 total co2-21* anion gap-17 11:43pm alt(sgpt)-122* ast(sgot)-108* ld(ldh)-394* ck(cpk)-51 alk phos-218* tot bili-0.6 11:43pm wbc-15.7*# rbc-3.63* hgb-10.7* hct-34.4* mcv-95 mch-29.5 mchc-31.1 rdw-15.3 04:50pm wbc-8.8 rbc-3.08* hgb-9.3* hct-28.9* mcv-94 mch-30.1 mchc-32.1 rdw-15.4 10:26pm lactate-2.1* k+-6.2* 04:50pm ctropnt-0.11* 04:50pm ck-mb-notdone probnp-* ekg: sinus bradycardia at 59. na; first degree av delay. lbbb. compared to prior tracing from , qrs duration is wider and qrs axis has shifted to the right. . 2d-echocardiogram: () the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. lv systolic function appears depressed (ejection fraction 30 percent) secondary to akinesis of the posterior wall and anterior septum, and hypokinesis of the rest of the left ventricle. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are severely thickened/deformed. there is severe aortic valve stenosis. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the supporting structures of the tricuspid valve are thickened/fibrotic. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. . cxr (): 1. moderate congestive heart failure with small bilateral pleural effusions. 2. bibasilar opacities may reflect atelectasis, but infection is not excluded. . ct c/a/p () (pfi): pulmonary edema, bilateral plueral effusions. fluid in trachea and bronchi concerning for aspiration. gallbladder severely enlarged with stone in neck may relate to cholecystitis. us should be considered for further evaluation. . ct head () (pfi): no acute intracranial pathology; chronic small vessel ischemic changes; fluid in the nasopharynx likely due to intubation. . pfts (): mild obstructive ventilatory defect. the reduced fvc may be due to gas trapping but a coexisting restrictive defect cannot be excluded. suggest lung volume measurements if clinically . compared to the prior study of the fvc has increased by 0.35 l (+16%). . brief hospital course: 83 yom with multiple medical problems including extensive cad, as, schf, af, dm and ckd presents from rehab with lethargy, hypoxic respiratory failure and hypotension. pt was brought to the ccu intubated and on pressors. some ecg changes were noted on admission, likely due to pt's significant acidemia. pt was significantly fluid overloaded by cxr. exact precipitant was unclear but pt was given cautious diuresis. pt was simultaneously hypotensive, on dopamine and levophed. hypoxic respiratory failure/respiratory acidosis/question aspiration persisted and vent settings had to be maximized. pt's muscle fasciculations continued in ccu, likely related to his uremia or hyperkalemia. despite aggressive medical management, pt's condition continued to deteriorate rapidly in the ccu. a family meeting was called where goals of care were discussed and patient made dnr/dni. pt was found unresponsive, without electrical activity on cardiac monitor and with no pupillary reflex. pt expired at 4:19 am on w/ pt's wife present at the bedside. medical examiner declined the case and autopsy declined by the family. medications on admission: 1. fluticasone-salmeterol 250-50 2. allopurinol 150 mg daily 3. spironolactone 12.5 mg daily 4. gabapentin 600 mg 5. lisinopril 5 mg daily 6. simvastatin 80 mg daily 7. aspirin 81 mg daily 8. pantoprazole 40 mg daily 9. ferrous sulfate 325 daily 10. amiodarone 200 mg daily 11. metoprolol tartrate 25 mg 12. furosemide 40 mg daily 13. lantus 50 units qhs 14. insulin lispro sliding scale 15. simethicone 80 mg four times daily prn 16. polyethylene glycol prn constipation 17. senna 8.6 mg 1-2 tabs prn 18. bactrim ds through for uti . allergies: phenylephrine discharge medications: none discharge disposition: expired discharge diagnosis: congestive heart failure acute renal failure respiratory failure acidosis discharge condition: expired discharge instructions: patient expired followup instructions: expired procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube diagnoses: other primary cardiomyopathies hyperpotassemia urinary tract infection, site not specified congestive heart failure, unspecified acute kidney failure, unspecified hyposmolality and/or hyponatremia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation aortic valve disorders diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes chronic kidney disease, unspecified acute respiratory failure pneumonitis due to inhalation of food or vomitus cardiogenic shock other emphysema subendocardial infarction, subsequent episode of care diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled calculus of gallbladder with acute cholecystitis, without mention of obstruction mixed acid-base balance disorder acute on chronic combined systolic and diastolic heart failure diabetes with peripheral circulatory disorders, type ii or unspecified type, not stated as uncontrolled peripheral angiopathy in diseases classified elsewhere personal history of methicillin resistant staphylococcus aureus 

Answer: The patient is high likely exposed to