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 an 83 year old female with a past medical history of parkinson's with dementia, stroke times two ( and complicated by left hemiparesis, slurred speech, and dysphagia), as well as hypertension, diabetes mellitus, glaucoma, spinal stenosis, gerd, depression who was admitted from with fever and dyspnea times two days. per the patient's daughter, patient had increased "gurgling," increased hyperglycemia on finger stick blood glucoses, and anorexia secondary to increasing dysphagia. patient lacks cough reflex secondary to remote strokes and so did not have any productive cough, but was noted to have increasing secretions and confusion. the patient was also noted to have "foul smelling" urine by nursing home workers. patient was also noted to have recent weight loss. prior to admission, the patient's finger stick glucoses were noted to be greater than 500 and her temperature was measured at 101.6 on the evening prior to admission. in the emergency room, the patient was noted to have a lactate of 6 and was sent to the medical intensive care unit via the sepsis protocol and received vancomycin, ceftriaxone, and flagyl prior to transfer to the medical intensive care unit. past medical history: 1. parkinson's with dementia. 2. stroke times two and , complicated by left hemiparesis, slurred speech, and dysphagia. 3. hypertension. 4. diabetes mellitus. 5. glaucoma. 6. spinal stenosis status post surgery. 7. gastroesophageal reflux disease. 8. depression. 9. history of falls. allergies: no known drug allergies. medications on admission: 1. insulin nph 8 units twice a day. 2. aspirin 81 once daily. 3. atorvastatin 10 once daily. 4. lisinopril 15 once daily. 5. clopidogrel 75 once daily. 6. metoprolol 25 three times a day. 7. methylphenidate 2.5 twice a day. 8. mirtazapine 15 once daily. 9. rimantadine 150 once daily. 10. regular insulin sliding scale. 11. senna two twice a day. 12. colace 100 twice a day. social history: patient is a former smoker though quit in , no alcohol, no illicit drug use. nursing home resident, wheelchair bound. physical examination on admission: temperature 104.2; blood pressure 157/56; pulse 106; respiratory rate 30; 95% on 2 liters by nasal cannula. general: this is a cachectic elderly female in moderate distress. head, eyes, ears, nose and throat: no sinus tenderness, mucous membranes dry, oropharynx without any lesions. neck: soft, supple, no lymphadenopathy, no jugular venous distention. cardiovascular: tachycardic, normal rhythm with a grade holosystolic murmur at the apex. pulmonary: shallow respirations with crackles on the left axillary line anteriorly. abdomen: soft, non-tender, non-distended, normal active bowel sounds, no rebound or guarding. back: no costovertebral angle tenderness. extremities: 1+ pulses, warm, no edema, no calf tenderness. neurological examination: patient was non-verbal, pin point pupils bilaterally, not following simple commands. labs on admission: white blood count 30.3; hematocrit 43.7; platelets 391; sodium 153; potassium 6; chloride 114; bicarbonate 28; bun 63; creatinine 1.5; glucose 411; lactate 6.4; 89 neutrophils; 0 bands. urinalysis showed ph 5 with moderate leukocyte esterase, 250 glucose, red cells, greater than 50 white cells, many bacteria. chest film showed full lung volumes, no ..........., pleural effusions or pneumothorax with a possible lingular infiltrate; electrocardiogram showed sinus tachycardia at 105 beats per minute with normal axis, normal intervals, borderline left ventricular hypertrophy by voltage, no st or t-segment changes when compared with a prior electrocardiogram and no t-waves. hospital course: patient was begun on broad spectrum antibiotics, initially started on vancomycin, ceftriaxone, and flagyl and later broadened to levofloxacin for possible pseudomonal infection, though none was documented. patient was noted to have a metabolic acidosis with anion gap that was presumably secondary to diabetic ketoacidosis on admission and was begun on an intravenous insulin drip. the patient's anion gap closed. the patient was converted to a regular insulin sliding scale. patient was also noted to have acute renal failure that was likely pre-renal in nature with a creatinine elevation to 1.8 from her baseline of 0.8. her creatinine improved somewhat over the course of hospitalization, it was 1.6 on transfer from the medical intensive care unit to the general medical floor. the patient also was noted to have a significant pre-water deficit and hyponatremia that was slowly corrected in the medical intensive care unit and was 153 on transfer from the medical intensive care unit to the general medical floor. patient was noted to be in ongoing significant respiratory distress, presumably secondary to pneumonia as well as congestive heart failure. patient was transferred from the medical intensive care unit to the general medical floor on the 24th. prior to transfer to the floor, a family meeting was held and the decision was made to change the patient's code status to "do not resuscitate" "do not intubate." patient was noted on the floor to have a temperature of 101 as well as worsening respiratory distress. the patient's oxygen saturation rate was 96% on 3 liters initially on transfer to the medical floor, though subsequently, patient developed a worsening oxygen requirement and was noted to desaturate to 86% on 3 liters with a respiratory rate of 48 followed by the initiation of a non-rebreather with improvement of her oxygen saturation rate to 90%. arterial blood gases demonstrated significant hypoxemia with ph of 7.40, co2 of 28, and an o2 of 69 on the non-rebreather. the patient was given 40 mg of intravenous lasix for diuresis. all intravenous fluids were discontinued as the patient was felt to be in worsening congestive heart failure. given the patient's "do not resuscitate" "do not intubate" status, further discussions about the patient's level of care were carried out with the patient's family and with the medical team. the patient's family, again, stressed the importance of the patient's comfort and changed the patient's level of care to comfort measures only. although, they decided that they wanted to continue with antibiotics as well as diuresis, though did want to have a morphine drip started for sedation and discontinuation of any blood draws for further laboratory analysis. the patient expired on the at approximately 1:30 a.m. the family was present and was aware. the patient's attending, dr. , was notified. the patient's family declined postmortem examination. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified diagnoses: congestive heart failure, unspecified acute kidney failure, unspecified other pulmonary insufficiency, not elsewhere classified paralysis agitans pneumonitis due to inhalation of food or vomitus encounter for palliative care hyperosmolality and/or hypernatremia diabetes with ketoacidosis, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to