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: this is a 74 year old male with a history of chronic obstructive pulmonary disease, alcohol abuse, portal gastropathy, admitted for psychiatric unit for the last five weeks. he presents with fever, cough and chills with a temperature to 102.0. he was referred to the emergency department for further work-up. he is not forthcoming as a historian but denies any recent vomiting. review of systems: positive for fever, cough, paroxysmal nocturnal dyspnea but no lower extremity edema. he is unable and unwilling to provide further history in regards to the onset of these symptoms. he denies any melena or bright red blood per rectum. it was noted by the nursing staff that he has poor oral intake. past medical history: the patient's past medical history is significant for the following: the patient has alcohol induced psychosis. portal gastropathy. chronic obstructive pulmonary disease. osteoarthritis. status post partial gastrectomy. cancer of the gums. the patient has no known drug allergies. medications on admission: the patient was on the following medications at the time of admission to : haldol 0.5 mg p.o. twice a day. vistaril 25 mg p.o. twice a day. zyprexa 10 mg p.o. twice a day. dietrol la 4 mg p.o. q. day. social history: the patient's social history is significant for the following: the patient has quit tobacco. he doesn't remember his last drink. physical examination: physical examination at the time of admission to revealed the following: temperature 100.7; blood pressure 189/83; heart rate of 112; 83% on room air; 93% on six liters. in general, the patient is in no acute distress. the patient is alert and oriented times three. head, eyes, ears, nose and throat: anicteric sclera. oropharynx is dry. neck is supple. no lymphadenopathy. lungs: rhonchorus breath sounds bilaterally. slight decrease in breath sounds t the right base with occasional expiratory wheezes. cardiovascular examination: s1 and s2, tachycardiac. abdominal examination: soft, nontender, nondistended with bowel sounds present. extremities: no edema and warm. neurologic examination: alert, positive tremor. laboratory data: white count of 21.2; 90% neutrophils, 2% bands, 3% lymphocytes. hematocrit of 40.6. platelets of 270. chemistry 7 revealed a sodium of 150; potassium of 4; chloride of 110; c02 of 28; bun 33; creatinine 1.1; glucose 149. urinalysis was yellow, clear, specific gravity of 1.025. small blood, 30 protein, trace ketones, small bilirubin, 0 to 2 white blood cells, rare bacteria. chest x-ray reveals no effusion, no congestive heart failure. a right lower lobe infiltrate consistent with aspiration or pneumonia. electrocardiogram revealed sinus tachycardia with a heart rate of 113, normal axis and intervals and no st or t wave abnormalities. hospital course: aspiration pneumonia. based on his initial chest x-ray, it appeared that his fevers were secondary to a pneumonia, questionable aspiration pneumonia. further history is obtained from the nursing home. it was found that he is on a mechanical soft diet with the nursing staff not aware of any gross aspiration. blood and sputum cultures were obtained, of which the sputum culture grew out moderate growth of coagulase positive staph aureus which was oxacillin sensitive. he was initiated on levofloxacin 500 mg q. 24 hours as well as flagyl 500 mg q. 24 hours with suspected aspiration pneumonia. a bedside swallowing evaluation was obtained on hospital day number two which revealed severe oral motor weakness and difficulty initiating swallows, probable aspiration of apple sauce and water and was, therefore, placed n.p.o. as a diet. the neurology service was consulted for further evaluation of the etiology of his oropharyngeal dysphagia. they recommended performing an egrophonium test during a repeated speech and swallow to evaluate for possible myasthenia . a repeat speech and swallow evaluation with this tensilon was performed with similar results to his initial evaluation -- namely considerable aspiration with inability to propel pureed foods as well as inability to protect his airway. oxacillin was added to his antibiotic regimen for further coverage of his aspiration pneumonia and his persistence of a leukocytosis. with this antibiotic regimen, he continued to remain afebrile and completed a two week course in total of these antibiotics. however, his leukocytosis did not resolve despite clinical improvement and it was felt that this was a leukomoid reaction, unrelated to current infection. on hospital day number ten, consent was obtained from his legal guardian, , phone # and a percutaneous gastric jejunostomy tube was placed without complications. tube feeds were initiated through this gastrojejunostomy tube and the patient tolerated goal feeds of ultra-cal at 75 cc an hour. repeat chest x-ray on hospital day number 14 revealed improving bibasilar densities, consistent with improving pneumonias. however, he continued to sound somewhat congested and may be chronically aspirating despite the placement of the gastrojejunostomy tube. he continues to remain a chronic aspiration risk and was started on bactrim ds p.o. one tablet q. day for prophylaxis. in regards to further work-up of his oral and motor weakness, an otorhinolaryngology consult was obtained to rule out further involvement of his gingival cancer. a biopsy was taken one day prior to discharge with pathology results pending at this time. alcohol induced psychosis. it was difficult to determine the baseline mental status of this patient and given the possibility of neuroleptics causing dystonia, interfering with his oral motor weakness, his psychiatric medications were held, though upon further review of his history, he had speech and swallowing difficulties prior to admission. despite the continuation of his neuroleptic, again his oral and motor function did not improve. the psychiatry service was consulted in regards to further evaluation of his dementia as well as recommended medications that would not interfere with his oral and motor function. multiple laboratory studies were sent including liver function tests, b-12, folate and tsh and rpr all of which were normal and was started on trilafon 8 mg by gastrojejunostomy tube twice a day. the psychiatrist at hospital was informed of his hospital course and will continue further neuropsychiatric evaluation at this facility. dyspnea. on hospital day number four, the nursing staff noticed that the patient was acutely dyspneic. an arterial blood gases was drawn during this event which revealed a ph of 7.17, pc02 of 87 and p02 of 104, indicative of a respiratory acidosis. he was transferred to the medical intensive care unit for a trial of mask ventilation. he was also started on stress dose steroids, solu-medrol 80 mg intravenous three times a day as well as nebulizer treatments. it was thought that the etiology of his dyspnea was secondary to a possible aspiration event, super imposed on his chronic obstructive pulmonary disease. code status was clarified with his legal guardian, stating that he is a dnr/dni patient. after approximately 24 hours of mask ventilation, the patient clinically improved with good oxygen saturations and was significantly less labored in terms of his respiratory status. he was discharged from the medical intensive care unit after a three day stay and sent back to the floor, with continuation of treatment for aspiration pneumonia as primary treatment of his dyspnea. his oxygen requirements gradually tapered throughout the rest of his hospital course, to a requirement of two liters nasal cannula. his nebs were switched to an as needed basis and he was quickly tapered off of steroids over a three day course in total. hypernatremia. the patient was noted to be hypernatremic upon admission with a sodium level of 150. his calculated free water deficit was approximately three liters and, throughout his hospital course, his sodium gradually corrected with the supplementation of free water bolus. however, upon discontinuation of his free water boluses, his hyponatremia worsened. therefore, he will be discharged on a standing order of 250 cc of free water every six hours through his gastrojejunostomy tube to replenish his free water. discharge condition: stable. discharge status: the patient will be discharged to hospital, psychiatric unit, where he will have further evaluation of his mental status and indication for trilafon. discharge diagnoses: aspiration pneumonia, status post gastrojejunostomy tube placement. alcohol induced psychosis. hypernatremia. gingival cancer. chronic obstructive pulmonary disease. discharge medications: trilafon 80 mg by gastrojejunostomy tube twice a day. bactrim one tablet ds, by gastrojejunostomy tube q. day. colace 100 mg by gastrojejunostomy tube twice a day. dulcolax prn. lactulose prn. albuterol and atrovent nebs prn. heparin 5,000 units subcutaneous q. 12 hours. miconazole powder 2% twice a day to intertrigonal areas. menzoprozole oral solution 30 mg in gastrojejunostomy tube q. day. , m.d. dictated by: medquist36 d: 02:00 t: 14:07 job#: procedure: enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] biopsy of gum diagnoses: acidosis unspecified protein-calorie malnutrition obstructive chronic bronchitis with (acute) exacerbation alcohol abuse, unspecified acute respiratory failure pneumonitis due to inhalation of food or vomitus osteoarthrosis, unspecified whether generalized or localized, site unspecified hyperosmolality and/or hypernatremia alcohol-induced persisting amnestic disorder 

Answer: The patient is high likely exposed to