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: history of present illness: baby is a 29 and 2/7 weeks gestational age twin boy born at 1290 grams to a 28- year-old gravida 1, para 0 mother with the following prenatal laboratories. blood type o negative, antibody negative, rubella immune, rapid plasma reagin nonreactive, hepatitis b surface antigen negative, gc/chlamydia negative. this is a spontaneous amnionic-dichorionic twin pregnancy uncomplicated until cervical shortening observed on . the mother was treated with betamethasone at that time. she presented to on the day prior to delivery with preterm labor and further cervical changes. at this point, she was transferred to for further medical care. mother had spontaneous rupture of membranes three hours prior to delivery. delivery was by cesarean section secondary to breech presentation. this baby emerged with excellent tone and a vigorous cry. the infant was bulb suctioned and given blow- by oxygen for essential cyanosis which resolved after several seconds. the infant was subsequently transferred to the neonatal intensive care unit for further care. physical examination on presentation: weight was 1290 grams, length was 40.5 cm, and head circumference was 28 cm. vital signs revealed temperature was 97.8, heart rate was 148, respiratory rate was 42, blood pressure was 58/29 with a mean of 43, and oxygen saturation was 97 percent on room air. in general, a preterm male in radiant warmer. in no apparent distress. heent revealed af/of. the oropharynx was clear. palate intact. the neck was supple. there was no crepitus. red reflex intact bilaterally. respiratory revealed the lungs were clear to auscultation bilaterally. good air entry. mild intermittent retractions. cardiovascular examination revealed a regular rate and rhythm. first heart sounds and second heart sounds were normal. a 2/6 systolic ejection murmur heard optimally at the left sternal border. the abdomen was soft and nondistended. hypoactive bowel sounds. no hepatosplenomegaly. the anus was patent. extremities were well perfused. no cyanosis or edema. femoral pulses were 2 plus bilaterally. no ortolani or barlow sign present. neurologically, spontaneous mae. appropriate tone on examination. suck, moro, palmar, plantar grasp intact. summary of hospital course by system: 1. respiratory: the patient was transferred to the neonatal intensive care unit for further management and secondary to irregular respirations and increased work of breathing, was intubated on hospital day one. the patient was subsequently extubated on hospital day three and remained on room air without problems throughout the remainder of his hospital course. on approximately hospital day #10, the patient was observed to have increasing tachypnea on physical examination. a follow- up echocardiogram revealed cardiac defects which will be described later in this discharge summary. the patient remained tachypneic until his surgical correction on . the patient exhibited signs of apnea of prematurity on hospital day three and was loaded with caffeine citrate. the patient remained on caffeine citrate throughout his hospital course up until the day of interim discharge summary on . 2. cardiac: secondary to a cardiac murmur which was auscultated on hospital day three, the patient received an echocardiogram which revealed a large unrestricted ventricular septal defect on day of life four. the patient remained asymptomatic until approximately hospital day 10, at which point he was noted to be consequently tachypneic with respiratory rates ranging from 40 to 70 breaths per minute. by hospital day 12, the patient grew increasingly tachypneic with increased work of breathing with respiratory rates ranging from 60 to 80 breaths per minute. at this point, the patient received repeat echocardiogram on day of life 12 showing a large membranous unrestricted ventral septal defect as well as mild ventricular and atrial dilatation. the patient was started on lasix 2 mg/kg by mouth three times per day as well as aldactone. the patient was also started on potassium chloride supplementation. the patient remained on this medical therapy with persistent tachypnea and increased work of breathing until ; at which point the decision was made to transfer for correction of ventricular septal defect at . the patient was transferred to the on and received a dacron patch closure of the large unrestricted ventricular septal defect via atrial approach. the patient also had a ligation of the ligamentum arteriosum. the patient's immediate postoperative course was complicated by hypertension, treated with nitroprusside as well as residual pulmonary congestion which was improved over the next week of his hospital course. the patient was transferred back to on . a follow-up echocardiogram on this date showed good biventricular function and minimal regurgitation across the repaired ventral septal defect. a small residual vsd was noted. the patient remained on lasix 2 mg/kg by mouth twice daily as well as potassium chloride supplementation. the patient remained stable on room air at the time of this interim discharge summary. follow-up recommendations per cardiology service include a repeat echocardiogram prior to discharge. in addition, due to the residual vsd, endocarditis prophylaxis is recommended for any dental procedures. 3. fluids, electrolytes and nutrition: the patient was nothing by mouth on hospital day one on parenteral nutrition 80 cc/kg per day. the patient was started on enteral feedings on hospital day four and gradually increased to full feedings by day of life 10. the patient did have a brief period perioperatively at approximately day of life 22 - on - where he did not receive any enteral nutrition and was exclusively on parenteral nutrition. enteral nutrition was restarted during his hospital course at . at the time of interim discharge summary - on - the patient is on feedings of breast milk 32 kilocalories per ounce at 160 cc/kg per day. the patient shows no signs of intolerance. 4. hematology: the patient's initial complete blood count was benign with a white count of 6.5, a hematocrit of 45.7, and platelets of 217. white count differential with 38 polys and 50 lymphocytes. the patient was started on ampicillin and gentamicin secondary to maternal sepsis risk factors which was discontinued on hospital day two at 48 hours of life. on hospital day 18, secondary to increased spells and increased work of breathing, the patient received a sepsis workup with blood cultures and complete blood count and was started on vancomycin and gentamicin. the patient also received a lumbar puncture which was normal. the patient remained on this antibiotic regimen until his surgical correction on . during his hospitalization at the , the patient was revealed to have a gram-negative sepsis secondary to a line infection on for which ceftazidime and gentamicin were started. this organism was subsequently identified as klebsiella pneumonia. the patient remains on a 5-day course of gentamicin as well as day course of ceftazidime at the time of this interim discharge summary on . 6. neurologic: the patient remained neurologically stable throughout his hospital course. a head ultrasound performed on was normal. care recommendations: 1. feedings: breast milk at 32 kilocalories per ounce at 150 cc/kg per day. 2. medications: lasix 2 mg/kg by mouth three times per day, potassium chloride supplementation, caffeine citrate, vitamin e, and ferrous sulfate. 3. immunizations: no immunizations administered as of yet. 4. will need endocarditis prophylaxis. discharge diagnoses: 1. prematurity at 29 and 2/7 weeks gestational age. 2. respiratory distress - resolved. 3. large membranous unrestricted ventral septal defect - repaired with residual small vsd 4. apnea of prematurity. 5. immature feeding. 6. sepsis. , dictated by: medquist36 d: 14:42:59 t: 16:07:52 job#: procedure: spinal tap incision of lung enteral infusion of concentrated nutritional substances prophylactic administration of vaccine against other diseases prophylactic administration of vaccine against other diseases circumcision bilateral repair of inguinal hernia, not otherwise specified orchiopexy diagnoses: friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site need for prophylactic vaccination and inoculation against viral hepatitis primary apnea of newborn ventricular septal defect routine or ritual circumcision other preterm infants, 1,250-1,499 grams bacteremia 29-30 completed weeks of gestation infection and inflammatory reaction due to other vascular device, implant, and graft undescended testis inguinal hernia, without mention of obstruction or gangrene, bilateral (not specified as recurrent) need for prophylactic vaccination and inoculation against respiratory syncytial virus (rsv) 

Answer: The patient is high likely exposed to