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: albendazole attending: chief complaint: brbpr major surgical or invasive procedure: none history of present illness: pt is a chronically ill 67m with dm2, chf, afib, avr, cri, gib (pud s/p billroth, colonic ulcerations), splenic vein thrombosis and gastric varices presents with 1 bloody bm at his rehab. he was recently admitted for draining lue ulcer and is s/p removal of hardware, on iv abx. he was at rehab in his usual state of ill-health when he passed a maroon bowel movement, no associated sx, on the day prior to admission. he has had no bm since, no n/v since, though he does have frequent vomiting when he tries to eat solid food; there's been no hematemesis. has chronic diarrhea, no recent changes. he denies lightheadedness, chest pain, palpitations, shortness of breath, or dyspnea on exertion, though it should be said, he rarely exerts himself, spending most time in bed, sitting, or in a wheelchair secondary to extensive deconditioning during multiple hospitalizations. the remainder of his ros is positive for a chronic cough with sputum, with no recent change in either; he denies f/c, ha, chest pain, palpitations, back pain, hemoptysis, abd pain, hematuria. he says he's had a bloody bm once before and had a colonoscopy showing "ulcers." however, his pmh is most significant for bleeding pud ending in a billroth ii. in the ed, his g-tube was aspirated, showing occasional blood clots in straw colored fluid, not bilious. he got a unit of prbcs for a hct of 25, pantoprazole. past medical history: -dm2 -chf -afib -bioprosthetic avr -gastric ulcer with peforation resulting in billroth ii -splenic vein thrombosis -s/p splenectomy -gastric varices -cri -etoh abuse with recurrent pancreatitis, pseudocysts, pancr insuffc -peripheral neuropathy -neurogenic bladder with chronic indwelling foley social history: lives at health care with wife, recently at . former etoh abuse. family history: non-contributory. physical exam: : t 98.9, bp 122/64, hr 90, rr 18, spo2 99%ra gen- chronically-ill, cachectic appearing male, poor functioning, mustache, non-tox, nad heent- anicteric, op clear but slightly dry neck- no jvd/lad/thyromegaly cv- rrr, s1s2, no m/r/g pul- moves air well, bibasilar rales abd- well healed scars, soft, mild rlq pain, no rebound/guarding, no hsm, nabs back- no cva tenderness extrm- no cyanosis/edema, warm/dry nails- mild clubbing, nails neuro- a&ox3, no focal cn/motor deficits, though has difficulty moving left arm due to recent procedures pertinent results: ecg: sinus tach, nl axis, nl intervals, laa, 1mm st elevation v2 (old) . cxr: flat diaphragms, bilateral pleural effusions, bilateral lower increased opacification . notable labs: ck 21/tn 0.11, hct 25 (baseline 27-28), wbc 14.6 (n:39 band:1 l:19 m:11 e:29 bas:0 metas: 1), cr 1.5 (baseline 1.0), alb 2.2 03:00am blood wbc-14.8* rbc-3.10* hgb-9.9* hct-29.2* mcv-94 mch-31.9 mchc-33.8 rdw-17.2* plt ct-443* 08:25pm blood wbc-14.6* rbc-2.45* hgb-8.2* hct-25.0* mcv-102* mch-33.3* mchc-32.6 rdw-17.2* plt ct-438 05:49am blood neuts-65 bands-0 lymphs-12* monos-19* eos-3 baso-0 atyps-0 metas-1* myelos-0 nrbc-1* 08:25pm blood neuts-39* bands-1 lymphs-19 monos-11 eos-29* baso-0 atyps-0 metas-1* myelos-0 03:00am blood plt ct-443* 03:00am blood pt-19.1* ptt-54.3* inr(pt)-1.8* 08:25pm blood pt-14.9* ptt-36.5* inr(pt)-1.3* 03:00am blood glucose-126* urean-49* creat-4.2* na-139 k-4.2 cl-105 hco3-19* angap-19 08:25pm blood glucose-89 urean-53* creat-1.5* na-132* k-3.9 cl-100 hco3-21* angap-15 03:00am blood alt-36 ast-113* ld(ldh)-370* ck(cpk)-1245* alkphos-205* totbili-0.9 08:25pm blood ck-mb-1 ctropnt-0.11* 03:00am blood ck-mb-11* mb indx-0.9 ctropnt-2.52* 05:05am blood vanco-18.9* 05:22am blood crp-78.9* 09:00am blood lactate-2.4* . please see hospital course for reference to important imaging and micro studies. brief hospital course: 1) respiratory distress: pt had an episode of respiratory distress on in the micu with presumed lll mucus plugging, with good response to chest pt, nebs, and o2. also with b/l pleural effusions, as well as sputum growing gnr. he was started on ceftazidime . after transfer out of the unit the patient had an episode of tachypnea on with increasing o2 requirements. cxr showed volume overload and he was diuresed with iv lasix and symptoms improved. he had a known h/o diastolic dysfunction and had received fluids in the micu, which could have contributed to this. while he was in acute respiratory distress the patient re-affrimed he was dni, even though he knew that he could potentially die. his son was called and was made aware of the situation. he discussed this with his father and they both re-affirmed he was dnr/dni. abx were again started in the setting of respiratory distress and fevers. he had a thoracentesis on with discovery of transudative r pleural effusion. no evidence of pna was found, so ceftriaxone dc'd. he recieved prn lasix. near the end of his admission the patient was tachypneic for several days. abgs showed good oxygenation and his sats were stable. ekg showed no changes. this was thought to be to respiratory compensation from primary metabolic acidosis from uremia. he also had a component of volume overload but we were unable to diurese him to hypotension. cardiac enzyems were checked and were elevated, suggesting he had an nstemi. this was likely to hypotension vs. subdendocaridal ishcemia to volume overload. aggressive treatment was not pursued during the end of his admission due to the family's wishes. he remained significantly volume overloaded,causing respiratory distress and was unable to be diuresed to hypotension. after d/w the family it was decided not to send the patient to the unit for pressors, or to dialyze him for his arf and he was made cmo. he was seen by palliative care and given morphine for . he expired on . 2)gi bleed: 62 yo male with dm, chf, afib, avr, cri, pud s/p biliroth, gastric varices and splenic v. thrombosis s/p splenectomy who presented s/p one episode of bloody bm at rehab. on he had several large maroon bowel movements on the floor. he remained hemodynamically stable with stable hct. attempted to lavage g tube but were unable to do so. what came back out looked bilious. pt was sent for tagged rbc which showed only a faint blush in luq on 2 hour images (not enough to intervene). he received 2 units of prbcs and was transferred to the micu. colonoscopy was done on and showed diverticulosis of the sigmoid colon and descending colon and erythema in the descending colon. egd was also done and was negative. he remained hemodynamically stable with guiac + stool. he was continued on a ppi. hct slowly trended down over his admission and he was transfused another unit of prbcs. . 3) acute renal failure: at his most recent admission cr was between 1-1.5 and was most recently 1 on . at admission cr was 1.5 thought to be d/t hypovolemia from bleed, dehydration from decreased pos or possibly ain in the setting of eosinophilia. nafcillan stopped and patient switched to vancomycin. urine eos were found to be negative initially. his uop dropped during his stay and cr trended up from 1.1 to 4.6. potentially to contrast nephropathy from imaging studies. could also have had a component of ain to ceftaz, as he had a few eos in his urine. renal ultrasound was normal. he had hd cath placed by ir and dialysis was initiated. dialysis was stopped after discussion the the patient and his son and measures were initiated . 4) fungemia: in the micu the patient was found to have fungemia from bcx on and his picc line was pulled, and he was started on fluconazole on . optho exam was negative and subsequent bcx were negative for . he had a tee that was negative for endocarditis. . 5) l knee erythema: pt stated he has had chronic, intermittent stiffness of his left knee. his left knee looked erythematous, and was too painful for him to move. knee x-ray showed osteopenia and ortho was unable to aspirate much fluid from the joint. he was treated with tylenol for pain b/c narcotics increased his confusion. an mri of his knee was ordered but was unable to be completed b/c the patient could not straighten his leg. . 6)mssa osteomyelitis: patient was found to have mssa osteomyelitis at last admission. he was on nafcillan as an outpatient but was changed from nafcillan to vancomycin at admission b/c of renal insufficiency. ortho was consulted, saw the patient and thought his shoulder appeared stable. . 7)eosinophilia - had eosinophila at admission. thought potentially to naficillin,as he has had no exposures to warrant o&p and has been in nh/hosp/rehab for months/years now. urine eos were negative but he was changed from naficillan to vancomycin. upep was negative for monoclonal ig / bence protein and eos trended down. stool o + p negative x 3 . 8) atrial fibrillation: hx was unclear. pt was in nsr during admission. he was followed on tele and atenolol was held in setting of a gi bleed. . 9) anemia -- pt had a macrocytic anemia. labs from one month prior were c/w acd. some of the anemia was likely acute blood loss in setting of gi bleed. hct bumped appropriately with blood transfusions and he was transfused to keep his hct >27. . 10) htn/hypotension: sbps were elevated at the beginning of admission. bb was not increased in the setting of acute chf. lisinopril and hydralazine were added to his regimen. near the end of his admission he had relative hypotension with sbps in the 90s, so all anti-hypertensives were dc'd. his hct was followed and he was treated for presumed sepsis. an echo was done and showed unchanged cardiac function. . 11) depression: patient stated he wanted us to "let him go" during his admssion and had been depressed regarding his medical sturation. psych was consulted and he was started on celexa. during his admission he had ms changes and appeared more sedated. celexa was stopped b/c it was thought to be contributing to his sedation. . 12) small bowel obstruction: patient complained of some abdominal pain initially during admission and he continued to have fevers with no source. an abdominal ct done in the middle of his admission showed sbo. during that time the patient was not having abdominal distension or pain, but was more somnolent and spiking temps. surgery was consulted and recommended stopping tube feeds and placing gj tube to gravity. his tube feed were re-started when it appeared his ileus was resolving. . 13) mental stauts changes: patient became much more somnolent during his stay. his oxycontin and celexa were dc'd and his ms initially improved. likely delirium d/t multiple underlying medical issues and also uremia. mri of the head was attempted but could not be accomplished due to the acuity of his other medical issues. . 14) fevers: patient spiked intermittent temps during his stay and had been on fluconazole and vancomycin for much of his hospital course. he finished a 2 week course of fluconazole for bacteremia and vancomycin for mssa. he was continued on ceftazidime for possible pna. all blood and urine cultures after continued to show no growth. cxr was not c/w pna and left shoulder looked stable. left knee was likely red to osteoarthritis but he could have had an underlying osteomyelitis. he was unable to fit in the mri scanner d/t his knee contracture to further evaluate this. fevers could have been from sbo, but the exact souce was unknown. ceftazidime was eventually dc'd d/t concern for ain. he was also started on flagyl for potential c. diff, though he was not having any bms. . 15) dm2: he was followed with a riss and given standing lantus. medications on admission: -glargine 18units qhs -riss -pantoprazole 40mg daily -folate 1mg daily -tamsulosin 0.4mg qhs -simvastatin 20mg daily -furosemide 20mg daily -thiamine 100mg daily -atenolol 25mg daily -vit c 2000mg -amylase-lipase-protease tid with meals -temazepam 30mg qhs -citalopram 20mg daily -oxybutynin 5mg tid -iron 325mg daily -docusate 100mg -nafcillin 2gm q4` ongoing from last admission -oxycodone 5mg prn discharge medications: expired discharge disposition: extended care facility: healthcare center - discharge diagnosis: gi bleed chf fungemia discharge condition: expired procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine diagnostic ultrasound of heart enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis thoracentesis colonoscopy arthrocentesis transfusion of packed cells irrigation of gastrostomy or enterostomy diagnoses: end stage renal disease acute kidney failure with lesion of tubular necrosis unspecified pleural effusion congestive heart failure, unspecified intestinal bypass or anastomosis status acute posthemorrhagic anemia alcoholic cirrhosis of liver acquired coagulation factor deficiency other pulmonary insufficiency, not elsewhere classified other and unspecified alcohol dependence, in remission atrial fibrillation hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled pressure ulcer, lower back infection and inflammatory reaction due to other vascular device, implant, and graft heart valve replaced by transplant hemorrhage of gastrointestinal tract, unspecified delirium due to conditions classified elsewhere unspecified intestinal obstruction other and unspecified mycoses neurogenic bladder nos effusion of joint, lower leg chronic osteomyelitis, upper arm 

Answer: The patient is high likely exposed to