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: no known allergies / adverse drug reactions attending: chief complaint: unresponsive, abdominal pain, s/p intubation, hypotension major surgical or invasive procedure: endotracheal intubation, right subclavian vein catheritization history of present illness: mr. is a 74 yo man with a history of parkinson's disease, chf, and aortic stenosis who presents from rehab after he was found in his bed altered and moaning at 1030pm. vital signs were checked at that time and were 73/44, 126, 28-30, 87% on ra. he was then brought to the ed. of note, he had an unwitnessed fall on to his knees earlier that day at 4:30pm but he denied any pain afterwards. he appeared to be in his usual state of health at dinner that evening. no abnormalities were noted until he was found altered at 10:30 pm. . in the ed, initial vs were: 96.8, 125, 77/56, 28, 96% on nonrebreather. 700cc of fluid was suctioned from his throat and there was concern that he was not protecting his airway therefore he was intubated. he also demonstrated abdominal tenderness and diffuse diarrhea that was foul smelling, brown/black, but guaiac negative. there was concern for dissection vs. abd source so he had cta of his chest/abd. this showed diffuse small bowel thickening but no pe or dissection. bps stayed low despite 4 liters of fluid so a right subclavian line was placed and he was started on phenylephrine. surgery evaluated the patient in the ed and felt no surgery was indicated at this time. flexiseal was placed to contain copious liquid stool. he received a dose of vancomycin and zosyn prior to transfer. . on arrival to the micu, patient is intubated and sedated. past medical history: parkinson's disease (advanced). bedbound. dementia aortic stenosis chf htn anxiety osteoarthritis pressure ulcers of coccyx (stage 4) and heal (blister) dysphagia social history: unable to obtain as patient is intubated. family history: unable to obtain as patient is intubated. physical exam: admission physical exam: vs: 96.8, 125, 77/56, 28, 96% general: intubated; sedated heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad cv: tachycardic, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: foley ext: pulses dopplerable , no clubbing, cyanosis or edema. wound: stage iv decub ulcer on sacrum discharge physical exam 97.8 69 122/49 97% ra general: following simple commands, somnolent, cough heent: sclera anicteric, mmm, oropharynx clear, perrl neck: supple, jvp not elevated, no lad cv: rrr, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi, harsh breath sounds abdomen: bowel sounds decreased, +guarding, nondistended, slightly rigid(improving), diffuse tenderness on deep palpation, no organomegaly gu: foley ext: pulses dopplerable , +1 peripheral pulses, no clubbing, cyanosis, +2 pitting edema. mild increased rue worsened edema. wound: stage iv decub ulcer on sacrum pertinent results: labs: on admission: 12:40am blood wbc-30.5* rbc-5.17 hgb-16.8 hct-48.2 mcv-93 mch-32.6* mchc-34.9 rdw-13.2 plt ct-316 12:40am blood neuts-88* bands-2 lymphs-2* monos-8 eos-0 baso-0 atyps-0 metas-0 myelos-0 12:40am blood fibrino-327 08:20am blood glucose-192* urean-40* creat-1.6* na-142 k-3.8 cl-111* hco3-19* angap-16 12:40am blood alt-9 ast-30 ck(cpk)-88 alkphos-108 12:40am blood lipase-41 12:40am blood ck-mb-5 12:40am blood ctropnt-0.20* 12:40am blood albumin-3.4* 12:40am blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg on discharge: 03:18am blood wbc-8.7 rbc-3.70* hgb-11.8* hct-34.0* mcv-92 mch-31.9 mchc-34.7 rdw-13.5 plt ct-156 03:45am blood neuts-80.7* lymphs-14.6* monos-4.0 eos-0.5 baso-0.2 03:18am blood glucose-113* urean-20 creat-0.9 na-145 k-3.5 cl-114* hco3-25 angap-10 03:18am blood calcium-7.5* phos-2.5* mg-2.0 imaging: cta chest/abd: 1. no pe/aortic dissection 2. bibasilar consolidations, l>r with foci of low density in l consolidation may refelct aspiration though early necrotizing process a consideration. 3. diffuse sb thickening (beginning in prox jejunum) as well as distal colonic wall thickening - near target sign - no signif bowel dilation- target sign suggests acute inflammation or ischemia - vessels appear patent - no free fluid in abd/pelvis may relfect enteroclitis. 4 -large rectal fecal load with rectal tube in palce. 5. thickened bladder wall and bladder calculi - conernign for cystitis- through may refelct chronic irritaiton from stone. . ct head w/o contrast: no acute process. brief hospital course: 74 yo man hx of parkinsons who presents from rehab with ams, hypotension, and hypoxia. active issues: # hypotension/shock: most likely septic shock given the high white count of 30.5 on admission, from gi source (infectious enterocolitis +/- ischemic colitis) vs pulmonary (aspiration, hcap, necrotizing pna) vs urinary (cystitis seen on ct but unremarkable u/a). also likely component of hypovolemia given profuse diarrhea and poor po intake. echo did not show evidence of cardiogenic component. lactate elevated to 5.8 on admission, required large volume fluid resuscitation and pressors to maintain adequate maps. he was started empirically on vanc/zosyn in ed, then switched to vancomycin (iv and po), cefepime and flaygl for possible infectious causes. lactate trended down with fluids and pressors were weaned off by hospital day 2. . # diarrhea/gi bleed: noted initially to have copious amounts of brown, guaiac negative stool. ct abdomen revealed diffuse small bowel and distal colon thickening concerning for infection or ischemia due to low flow state. he was seen by surgery on admission to evaluate for possible mesenteric ischemia, but it was felt that he was not imminently in need of surgery nor was he a good candidate for surgery. po vanco and iv flagyl, cefepime were started empirically, and stool was sent for c diff, o&p and cultures (all were negative). hct was noted to fall from 48 to 33 within 2 days, and though this drop was partially attributable to hemodilution, his stool did begin to have visible blood (guaiac pos). aspirin was held and gi was consulted, who felt that this delayed hematochezia was consistent with intestinal ischemia, perhaps due to infectious enteritis causing profound volume depletion and low flow state. they recommended continuing iv cefepime and flagyl for a 8 day course (day 1 ), and po vancomycin was dc'd after c diff cultures were negative. his hematochezia had stopped and hematocrit was stable on the day of discharge, no signs of hemodynamic compromise. if there is interest in further workup, gi suggested it would be reasonable to repeat ct scan in weeks to determine if there is persistent small bowel thickening, in which case endoscopy could be considered. . #. hypoxia: improved after deep suctioning, however patient was intubated in the ed because of inability to protect airway. ct chest shows area of consolidation in lll concerning for necrotizing pna vs aspiration, so he was started on vancomycin cefepime. he was extubated successfully on hospital day two and was weaned gradually to room air throughout his hospital stay. he did continue to have copious amounts of sputum that he had trouble clearing and required frequent suctioning. he appeared to be having further aspiration events, so speech and swallow recommended keeping him npo with tube feeds. his swallowing ability should be continually reassesed at rehab and diet advanced as tolerated. he should continue the vancomycin and cefepime for presumed hcap vs aspiration pneumonia until for a 8 day course. a right-sided picc was placed on for continuing iv abx therapy at rehab. . #. ams: unclear baseline, does have advanced parkinson's and dementia causing him to be bedbound. likely related to acute infectious process and resulting shock. ct head w/o contrast negative for acute process. his mental status improved throughout his hospital stay with treatment of his other active issues. . #. acute kidney injury- bun/cr elevated on admission to 35/1.7, reportedly normal renal function at baseline. likely pre-renal/atn secondary to profound hypovolemia/shock. cr returned to of 0.9 after aggressive fluid repletion. he was then gently diuresed with lasix following return of kidney function to bring him back to euvolemia. lisinopril initally held due to , however was restarted on hospital day 5. . # rue swelling: right arm noted to be asymmetrically swollen on hospital day 5. venous duplex ultrasound showed no clot. would recommend elevation. . inactive issues: . # hypertension: initially held home lisinopril due to , however this was restarted on prior to discharge. . # decubitus ulcer of coccyx: seen by wound care nurse, frequent turning, and dressing changes daily. . # chronic diastolic chf: echo reported preserved systolic function. given small amounts of lasix for help with diuresis following large volume resuscitation for shock. . # aortic stenosis: unknown severity at the time of admission, so echo was obtained and showed mild stenosis. . # parkinson's disease: bedridden at baseline and on sinemet. sinemet initially held given patient's hypotension, however this was restarted on the second day of admission. . transfer of care issues: - abx: continue iv vanco, cefepime and flagyl until - gi bleed/diarrhea: if further work of hematochezia/diarrhea is desired, consider repeat ct scan of abdomen in weeks to ensure resolution - aspiration/secretions: monitor swallowing ability and advance diet as tolerated. in the meantime, continue tubefeeds w fibersource hn w goal rate 60ml/hr - rue swelling: venous duplex ultrasound showed no clot. keep elevated and monitor - aspirin: held in setting of gi bleeding, can restart in 1 week () medications on admission: asa 81mg daily omeprazole 20mg po daily senna po daily sinemet 25/100mg half tablet tid lisinopril 2.5mg po daily ergocalciferol 50,000units q3weeks tramadol 25mg plus q4h prn tylenol 650mg po q6h prn dulcolax suppository 10mg daily prn discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day: can restart on . 2. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 3. senna 8.6 mg tablet sig: one (1) tablet po once a day as needed for constipation. 4. carbidopa-levodopa 25-100 mg tablet sig: 0.5 tablet po tid (3 times a day). 5. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). 6. ergocalciferol (vitamin d2) 50,000 unit capsule sig: one (1) capsule po every 3 weeks. 7. tramadol 50 mg tablet sig: 0.5 tablet po twice a day. 8. tramadol 50 mg tablet sig: 0.5 tablet po every four (4) hours as needed for pain. 9. acetaminophen 650 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. 10. bisacodyl 10 mg suppository sig: one (1) capsule rectal once a day as needed for constipation. 11. metronidazole in nacl (iso-os) 500 mg/100 ml piggyback sig: five hundred (500) mg intravenous q8h (every 8 hours) for 4 days: continue until . 12. cefepime 2 gram recon soln sig: two (2) grams injection q12h (every 12 hours) for 4 days: continue until . 13. vancomycin in d5w 1 gram/200 ml piggyback sig: one (1) gram intravenous q 12h (every 12 hours) for 4 days: continue until . discharge disposition: extended care facility: for the aged - macu discharge diagnosis: septic shock mesenteric ischemia gi bleed pneumonia altered mental status acute kidney injury discharge condition: alert but not oriented to person, place, time, or event. fair condition. bedbound. discharge instructions: dear mr. , it was a pleasure to take care of you here in the medical intensive care unit of . you were sent here because you were found by your rehab not acting like yourself. you were brought to the emergency department and your blood pressure was very low and your abdomen was causing you a lot of pain. for that the emergency department put a breathing tube down your throat to help you breathe, and started to give you fluids through your veins. you had a ct scan of your abdomen which was concerning for inflammation of parts of your bowels. we thought that it was a from of infection nad not even blood flow, so you were given antibiotics and fluids to help your blood flow. over time, your blood pressure normalized and the breathing tube was removed so that you could breath on your own. after that happened, you slowly got better while here, as we monitored the levels of your blood. your blood levels were stable, so you were ultimately returned back to rehab. followup instructions: you should be seen by your own doctor regularly, including within 5 days of leaving the hospital here. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified unspecified septicemia severe sepsis aortic valve disorders anxiety state, unspecified acute respiratory failure pneumonitis due to inhalation of food or vomitus septic shock osteoarthrosis, unspecified whether generalized or localized, site unspecified pressure ulcer, lower back diarrhea dementia in conditions classified elsewhere without behavioral disturbance pressure ulcer, heel hypovolemia hyperosmolality and/or hypernatremia acute vascular insufficiency of intestine chronic diastolic heart failure pressure ulcer, stage iv volume depletion, unspecified dementia with lewy bodies pressure ulcer, stage ii swelling of limb dysphagia, unspecified 

Answer: The patient is high likely exposed to