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: addendum: this is the patient's discharge summary. peg placement procedure is written in the normal discharge summary. chief complaint: hypoxemia, confusion major surgical or invasive procedure: peg tube placement history of present illness: 88 m nh () pt, apparently sent to c/o chest pain. rn, pt doing well until 1d pta, when "not feeling well", denied cp, sob, fever, had cxr, kub and labs at nh which were normal per report. . pt takent to - with c/o cp and neckpain , no sob, n/v, mildly confused. vs=90.8 52 119/80 20 up to 92.8 with bear hugger, bcx drawn, lactate 0.7, ekg=lbbb (old), cxr bilateral infilrtrate, given levo/flagyl, 20 iv lasix. sats 98%2l. . pt transferreed to , vs= 98.3 78 139/91 94-98%ra, taken to ct abd/pelvis (bilateral pleural effusion, small pericardial effusion), for c/o vague abd pain, and upon returning, noted to have increasing o2 requiringment 99%4l-> 92%6l. abg= 7.39/46/74 on 6l nc. pt given lasix 20mg iv x 1, combivent nebs. per ed resident, pt confused, tachypnic (though rr=24), and per anesthesia note, pt combative, he was therefore intubated for apparent hypoxia as he would not wear nrb mask. pt then sent for ct head given delta ms, to r/o sah, and admitted to micu for further management. past medical history: -htn x >30 yr. -cv -depression -lymphedema -pvd social history: primary caretakers are two sons, and . per sons, rare etoh, no smoking history, no illicit drugs. family history: hypertension in family. physical exam: vs: 97.0 92 (irreg) 110/73 16 97% ac 550x16 60% peep 5 gen: intubated, sedated. heent: perrla, eomi, sclera anicteric, mmm, no lad, no carotid bruits. jvd to angle of jaw. cv: regular, nl s1, s2, no m/r/g. pulm: coarse breath sounds anteriorly, no r/r/w. abd: soft, obese nt, nd, + bs, no hsm. ext: warm, 1+ dp/radial pulses bl. neuro: intubated, sedated. pertinent results: 10:06pm sodium-146* 10:06pm ck(cpk)-71 10:06pm ck-mb-notdone ctropnt-0.15* 06:59pm glucose-83 potassium-3.7 06:59pm magnesium-2.2 06:59pm hct-34.0* 03:16pm ck(cpk)-64 03:16pm ck-mb-notdone ctropnt-0.15* 03:16pm haptoglob-101 03:16pm fdp-0-10 03:16pm d-dimer-290 11:04am glucose-64* urea n-34* creat-1.2 sodium-150* potassium-3.8 chloride-113* total co2-27 anion gap-14 11:04am calcium-8.8 phosphate-3.0 magnesium-2.3 11:04am haptoglob-95 11:04am wbc-11.0# rbc-4.10* hgb-12.1* hct-34.2* mcv-84 mch-29.4 mchc-35.2* rdw-17.3* 11:04am hypochrom-2+ anisocyt-2+ poikilocy-1+ macrocyt-2+ microcyt-occasional polychrom-occasional target-1+ burr-occasional 11:04am plt count-89*# 11:04am pt-14.9* ptt-41.7* inr(pt)-1.3* 11:04am fibrinoge-443* d-dimer-300 10:45am rates-16/ tidal vol-500 peep-5 o2-50 po2-106* pco2-39 ph-7.47* total co2-29 base xs-4 intubated-intubated vent-controlled 10:45am lactate-1.3 10:45am freeca-1.17 10:28am urine hours-random urea n-771 creat-50 sodium-48 10:28am urine hours-random 10:28am urine osmolal-569 10:28am urine gr hold-hold 10:28am urine color-yellow appear-clear sp -1.030 10:28am urine blood-sm nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-8.0 leuk-neg 10:28am urine rbc-0-2 wbc-0-2 bacteria-none yeast-none epi-0-2 06:08am type-art temp-36.1 tidal vol-550 peep-5 po2-89 pco2-37 ph-7.47* total co2-28 base xs-3 intubated-intubated 06:08am lactate-1.2 06:08am o2 sat-96 02:47am type-art po2-74* pco2-46* ph-7.39 total co2-29 base xs-1 intubated-not intuba 02:47am o2 sat-94 01:35am urine hours-random 01:35am urine gr hold-hold 01:35am urine color-yellow appear-clear sp -1.015 01:35am urine blood-lg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-sm 01:35am urine rbc-21-50* wbc- bacteria-none yeast-none epi-0-2 11:35pm glucose-71 urea n-35* creat-1.2 sodium-149* potassium-5.2* chloride-114* total co2-25 anion gap-15 11:35pm estgfr-using this 11:35pm ck(cpk)-79 11:35pm ck-mb-14* mb indx-17.7* ctropnt-0.07* 11:35pm iron-50 11:35pm caltibc-291 vit b12-1280* folate-13.8 ferritin-198 trf-224 11:35pm osmolal-309 11:35pm tsh-4.7* 11:35pm cortisol-49.6* 09:16pm comments-green top 09:16pm lactate-0.7 09:00pm wbc-5.0 rbc-4.15* hgb-12.3* hct-36.0* mcv-87 mch-29.7 mchc-34.2 rdw-17.3* 09:00pm neuts-84.2* bands-0 lymphs-7.2* monos-5.6 eos-1.9 basos-1.1 09:00pm hypochrom-1+ anisocyt-1+ poikilocy-1+ macrocyt-normal microcyt-normal polychrom-normal ovalocyt-occasional target-1+ 09:00pm plt smr-very low plt count-50* brief hospital course: 88 m nursing home resident, with history of hypertension, lymphedema, depression, was admitted with confusion and hypoxemia, diagnosed with pneumonia, pleural effusions, nstemi, and lymphedema. . # pneumonia: patient had decompensating o2 sat readings after a ct scan (no shortness of breath, no rash, no itching after baracat however), and was intubated secondary to worsening hypoxemia, confusion, refusal to wear the nrb, and difficulty in defending his airway. cxr showed bilateral pleural effusions and possible pneumonia. he completed 10 day courses of levofloxacin and vancomycin, with clinical improvement in sputum production. sputum cultures were negative. on admission, the patient had been hypothermic to 95.7, normotensive, which was concerning for sepsis, but remained normotensive and normothermic for the rest of hospital stay. he required extensive nt suctioning for several days, and his suctioning needs are still every few hours daily. he does not have a clear gag reflex and may be chronically aspirating without proper suctioning. . # pleural effusions: bilateral on cxr, moderate in size, were not tapped since they were attributed to chf and global right heart failure, and would likely be recurrent. tte showed ef 35%, 1+ mr, 1+ tr. . # nstemi: he had an nstemi on arrival, with a decrease in ef after this mi. he has been maintained on asa 81 daily and metoprolol. . # afib: rate control is metoprolol, with hr 80-110, so metoprolol should be titrated up as an outpatient as bp allows. current bp on discharge is 105/55. he was in normal sinus rhythm with frequent apcs on admission, but is currently in afib. he was not cardioverted since he has structural cardiac disease and kept normotension post-nstemi. he is on no rhythm control. anticoagulation should be started at rehab as an outpatient. . # fluid status/lymphedema/pleural effusions: he was diuresed with lasix 20-80 iv prn to length of stay fluid status of -11.2 l. he is being discharged on no lasix, but his fluid status should be closely followed, since he will likely need lasix on a regular basis on his home regimen. . # change in mental status: he was confused on admission, but his mental status has much improved during his hospital stay, and has now returned to baseline per his family. he is able to follow commands, move all extremities, and communicate his wishes. he had a ct head performed initially to assess confusion, but this was negative. there was concern for ttp/hus since he was anemic, thrombocytopenic, febrile, mild renal failure, but there were no schistocytes on peripheral smear, and dic labs were normal. tsh, b12, and folate were normal. . # nutrition: peg tube was placed on . he was briefly apneic in the setting of peg tube placement, but he recovered with nrb administration. tube feeds should be started at rehab upon arrival. nutrition may advise the type and rate of tube feed, since he was not on tube feeds before admission. speech and swallow assessed him twice, and patient would chew and hold the food in his mouth, but he would not swallow any food or fluids (he would hold the food or fluid in his mouth until it was removed or suctioned out). for this reason, s&s could not assess his ability to swallow, and he was thus kept npo. before his peg tube was placed, he had a dobhoff post-pyloric placed, which the patient pulled out after one day. . # hypertension: well-controlled. he was on nifedipine 60 daily before admission, and is being discharged on metoprolol, which may be titrated up as needed. . # abdominal pain: resolved within the first day of admission after bowel movement. his liver function tests, and pancreatic enzymes were normal. . # diabetes mellitus type 2: he was maintained on insulin sliding scale with good control of glucose. . # hypernatremia: he has a tendency to hypernatremia, with na 145-149. he had been repleted with free water with 1-2 liters of d5w iv daily, but free water boluses of 250 ml q8h may be started in rehab upon discharge. daily monitoring of sodium should be performed until free water daily needs are determined. . # high bicarbonate: patient had elevated bicarbonate levels, maximum of 49. he was treated with diamox for 2 days before admission, which worked well to reduce bicarb to 41 on discharge. diamox may continue to work for him as an outpatient, in case his bicarb increases again on discharge. . # anemia: stable, likely from chronic disease. . # poor physical conditioning: patient should receive vigorous pt/ot at rehab as he is severely deconditioned from his recent clinical state. . # depression: patient has a previous history of depression, and also exhibited signs of depression during his hospital stay. he stated that he did not wish to live any longer. the icu team had multiple family meetings with his two sons, daughter-in-law, aunt, and cousin, regarding goals of care. the family felt very strongly that the patient has been expressing the same sentiment and symptoms of depression for the past few years whenever he is sick, and then changes his sentiment to being glad that he is living when he is well. the patient's wishes were difficult to assess since the patient was delirious for the initial half of his hospital stay, and his mental status only gradually returned day by day. . # for general health care issues/code status: he was kept on pantoprazole, heparin sc, and a bowel regimen of senna, colace. his code status was confirmed with the patient and his family as dnr/dni. for contact information with his son: : . medications on admission: amoxicillin 1000mg x1 for dental procedures tramadol 50mg tid mvi protonix 40mg po qd tylenol prn nifedipine xl 60mg po qdaily terazosin 10 mg po qdaily calcium carbonate 1000mg tid lorazepam 0.5mg po qdaily nitroglycerin 0.3 mg sl prn loperatmide 2mg po q6h prn fleets prn bisacodyl prn mom prn artificial tears 2 drops tid prn discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 2. insulin regular human 100 unit/ml solution sig: one (1) scale injection asdir (as directed): patient does not receive standing insulin, only on standard insulin sliding scale. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 5. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 6. albuterol sulfate 0.083 % (0.83 mg/ml) solution sig: puffs inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 7. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 8. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 9. amoxicillin 500 mg capsule sig: one (1) capsule po prn (as needed) as needed for dental procedures. 10. tramadol 50 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed. 11. hexavitamin tablet sig: one (1) cap po daily (daily). 12. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 13. terazosin 5 mg capsule sig: two (2) capsule po hs (at bedtime). 14. calcium carbonate 500 mg tablet, chewable sig: two (2) tablet, chewable po tid (3 times a day). 15. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed). 16. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q12h (every 12 hours) as needed. discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis: pneumonia, nstemi secondary diagnosis: hypertension, pleural effusions from chf, ef 35% discharge condition: vss, patient able to talk, able to follow commands, move all extremities. discharge instructions: 1. please return if patient experiences fever, chills, delirium, confusion, difficulty breathing, chest pain. 2. please take all medications as prescribed. followup instructions: 1. please followup with your primary care physician at rehab within 1 week of discharge. md 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 percutaneous [endoscopic] gastrostomy [peg] diagnoses: pneumonia, organism unspecified acidosis thrombocytopenia, unspecified subendocardial infarction, initial episode of care anemia, unspecified pure hypercholesterolemia congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis atrial fibrillation acute respiratory failure hyperosmolality and/or hypernatremia 

Answer: The patient is high likely exposed to