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: vtach major surgical or invasive procedure: none history of present illness: mr. is an 83 yo man with pmhx cad s/p multiple stents, afib, chf with ef 30%, s/p prophylactic aicd in , htn, hyperlipidemia who presented from his nursing home with sustained vtach. patient reports that this morning he was "not feeling well and unable to get confortable." he is unable to provide any more specific details but endorses feeling short of breath. he denies any chest pain. he did not lose consciousness. family states that nursing staff found him to be tachypneic, tachycardic, and hypotensive. . on review of symptoms, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for the presence of ankle edema and dyspnea on exertion. it is notable for the absence of chest pain, paroxysmal nocturnal dyspnea, orthopnea, palpitations, syncope or presyncope. . at , bp 86/50, hr 125-130, spo2 84-85% on ra. on arrival to ed at , t 97.8, hr 129, bp 90/45, rr 20, spo2 99%. in the ed, rhythm spontaneously conveted to atrial fibrillation with a rate in the 70's. device was interrogated by ep fellow, revealing no detected vt. cxr was performed and patient received asa 325 mg. past medical history: vt cad s/p multiple stents chf with ef 15-20% pericardial effusion s/p pericardial window x2 icd for primary prevention htn hypercholesterolemia pvd social history: social history is significant for the absence of current tobacco use. smoked cig per day x 20 years and quit in . occasional etoh, few beers per month. no illicits family history: daughter died at 52 of arrythmia. no family history of cad or cancer. physical exam: vs: t 97.5, bp 99/59, hr 86, rr 22, o2 97% on 2l gen: cachectic elderly white male in nad, resp or otherwise. oriented x1. mood, affect appropriate. pleasant. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with jvp of cm. cv: pmi located in 5th intercostal space, midclavicular line. irregular, irregular rhythm, normal s1, s2. no s4, no s3. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. + crackles at the bases with scattered rhonchi. abd: flat, soft, ntnd, no hsm or tenderness. no abdominial bruits. ext: 2+ pitting edema in lower extremities. no femoral bruits. skin: + gluteal ulcer. no stasis dermatitis, scars, or xanthomas. pulses: right: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp left: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp . pertinent results: wbc 5.6, hct 27.5, plt 194 . 140 | 107 | 23 ----|-----|---< 84 3.7 | 26 |1.0 . ck 20, trop 0.05 inr 2.3 lactate 1.6 ua - negative . cxr performed on demonstrated: 1. enlarging moderate pleural effusions. 2. persistent bibasilar opacities which may represent atelectasis and/or airspace consolidation. 3. mild central pulmonary vascular congestion with no evidence of alveolar edema. brief hospital course: vt: patient presented with recurrence of sustained ventricular tachycardia on amiodarone + digoxin + toprol. icd interrogation revealed that his vtach was not detected due to irregularithy of the rhythm (e.g., interspersed pvc's). following transfer he spontaneously converted to atrial fibrillation. his icd was reprogrammed at this time to fire at a rate of 110, and he was started on mexilitine, and continued on amiodarone. he persisted in having vt that was not sensed by the icd. he was put on a lidocaine drip, which controlled the vt. after further conversations with the family, he was made dnr/dni, and but defibrillation in the vt zone were kept on. he does not want external defibrillation. additionally, vt zone detection was made more sensitive (8 beats, 12 redetect). lidocaine was dc/ed. he was continued on mexilitine to medically reduce further episodes of vt. digoxin was discontinued as it was felt that digoxin could potentially contribute to increased arrhythmogenicity. his beta blocker was reduced due to hypotension. he was continued on anticoagulation for his underlying atrial fibrillation. . acute on chronic systolic chf: on admission, he was found to be fluid overloaded. heart failure exacerbation was in the setting of vt and increased cardiac demand. a repeat echocardiogram showed severe global left ventricular hypokinesis (lvef = 25-30 %). he was diursed with iv lasix and was relatively euvolemic on discharge. he was discharged on lasix 120 po daily. . cad: he had a small troponin leak in the setting of vt. his cad was medically managed with asa, statin, beta blocker. . anemia: on admission, his hct was found to be 27. his hct normalized to his baseline of ~30-31 on discharge. iron studies revealed anemia of chronic illness. epo was discontinued as he had no evidence of renal insufficiency, and no indication for it. iron was also discontinued as there was no evidence for iron deficiency anemia. . pneumonia: found on chest x ray, sputum cultures showing mssa. patient started on vanc/zosym. changed to ceftriazone when sensitivities came back . uti: patient was he was found to have a klebsiella uti for which he was started on bactrim, which was dc/ed when he started treatment for pneumonia. he is currently on ceftriazone. medications on admission: 1. aspirin 325 mg daily 2. ranitidine hcl 150 mg daily 3. simvastatin 20 mg daily 4. amiodarone 200 mg tablet 5. furosemide 40 mg po bid 6. metoprolol tartrate 25 mg daily 7. digoxin 0.0625 mg daily 8. warfarin 1.5 mg daily 9. diamox 250 mg daily 11. colace 100 mg 11. feso4 325 mg 12. mag oxide 400 mg qid 13. miconazole nitrate to sacrum tid 14. k-dur 40 meq qam, 20 meq qpm 15. senna 2 tabs qhs prn 16. ipratropium neb q6 hours prn 17. darbopoeitin alfa 100 mcg qfri discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 2. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po daily (daily) as needed for constipation. 5. simvastatin 20 mg tablet sig: one (1) tablet po at bedtime. 6. colace 100 mg capsule sig: one (1) capsule po bid prn. 7. atrovent 0.03 % aerosol, spray sig: one (1) nasal four times a day. 8. furosemide 80 mg tablet sig: one (1) tablet po twice a day. 9. amiodarone 200 mg tablet sig: one (1) tablet po twice a day. 10. warfarin 1 mg tablet sig: one (1) tablet po at bedtime. 11. ipratropium bromide 17 mcg/actuation aerosol sig: one (1) inhalation q6h prn. 12. ceftriaxone 1 gram piggyback sig: one (1) intravenous once a day for 9 days. 13. mexiletine 200 mg capsule sig: one (1) capsule po q8h (every 8 hours). 14. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 15. guaifenesin 100 mg/5 ml syrup sig: ten (10) ml po q6h (every 6 hours). 16. albuterol sulfate 0.083 % (0.83 mg/ml) solution sig: one (1) neb inhalation every four (4) hours as needed for shortness of breath or wheezing. 17. acetylcysteine 10 % (100 mg/ml) solution sig: one (1) neb miscellaneous q6h (every 6 hours) as needed. discharge disposition: extended care facility: & rehab center - discharge diagnosis: primary: ventricular tachycardia pneumonia uti . secondary: cad anemia discharge condition: stable. sbp's 85-95. discharge instructions: you were admitted after having persistent irregular heart rhythm called ventricular tachycardia. your icd was tested and several settings on your device were modified to make your device more sensitive for detecting irregular heart rhythms. in addition, a few of your medications were adjusted to reduce your likelihood of developing arrhythmias in the future. please see below for your medication modifications. . you also currently have pneumonia and a urinary tract infection, for which you are on an iv antibiotic. . the following medication changes were made during this hospitalizaiton: 1) your digoxin was discontinued. 2) you were started on an antiarrythmic called mexiletine. 3) your metoprolol xl (toprol xl) was decreased to 25 mg daily. 4) your mag oxide and your kdur were also discontinued. 5) diamox, darbopoeitin, and supplemental iron were also discontinued. 6) your coumadin dose was decreased to 1mg daily. 7) your lasix dose has been increased to 120 mg daily. . if you have any of the following symptoms you should return to the ed or see your pcp: pain, difficulty breathing, hypotension (sbp persistently <75), loss of consciousness or any other serious concerns. followup instructions: 1. you should schedule an appointment with your cardiologist, dr. in 1 to 2 weeks. please call on tuesdays or wednesdays between p.m. to schedule this appointment. . 2. we have also scheduled an appointment with you with dr. in the division of electrophysiology at on at 230pm. md, procedure: automatic implantable cardioverter/defibrillator (aicd) check diagnoses: pneumonia, organism unspecified other primary cardiomyopathies anemia of other chronic disease coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation percutaneous transluminal coronary angioplasty status paroxysmal ventricular tachycardia other and unspecified hyperlipidemia acute on chronic systolic heart failure fitting and adjustment of automatic implantable cardiac defibrillator 

Answer: The patient is high likely exposed to