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: fever & chills major surgical or invasive procedure: intubation/extubation central line placement a-line placement midline placement history of present illness: mr. is a 73 year-old man with a history of recent turp () who presents with respiratory failure and uti. . per family, the patient was generally feeling well until one day prior to admission when he "wasn't feeling that great" and felt as though he was "coming down with something". a slight fever (100) was noted along with chills. took tylenol and dayquil. additionally noted a burning sensation and blood in urine. additionally noted a cough since last week with sputum, no blood. . regarding his breathing, the family felt that this was generally unchanged. he has had increasing doe, worsening over the last few months. he gets sob after one flight of stairs. he does not get chest pains. family has also noted significant weight over last few months, mostly in abdomen. . ems reports show an initial bp of 124/103 with a rr of 30 and o2 of 89% on room air. their notes indicate that the patient was "sitting in bed shaking violently. states he can't breath." . in the ed, bp was initially 224/91, hr 120, rr 35, 99% on unclear amount of oxygen. spiked to 104.8. blood pressures trended down (200s to 80s systolic). when an ekg showed inferior st-elevations, a code stemi was called. before taking the patient to the cath lab, it was noted that bps were unequal so a cta was obtained. this was negative for dissection and initially was thought to show a pe. soon thereafter, the patient was intubated with a propofol gtt started. was also given labetolol iv for hypertension. soon after, blood pressure fell to 118/56, then to 80s systolic. a total of 5+ liters of normal saline were given, along with the following medications: - aspirin 325mg - zofran - levaquin 750mg iv past medical history: 1. diabetes 2. dyslipidemia 3. hypertension 4. benign prostatic hypertrophy 5. arthritis 6. gout 7. bladder stone social history: previous history of smoking, quit 10 years ago. not currently drinking. worked as a cook. family history: non-contributory. physical exam: vitals - t 100.1, bp 138/48, hr 98, ac 600/16, peep 5, fio2 100% gen - intubated. does not respond to commands but is moving all extremities. heent - surgical pupil on the right; 3mm -> 2mm on left. cv - difficult to hear heart sounds. no obvious murmurs. pulm - no rales/wheeze. abd - soft. non-tender. guaiac + per ed. ext - warm. no edema. pertinent results: admission labs urine benzos, barbs, opiates, cocaine, amphet, mthdne negative serum asa, etoh, , , tricyc negative . ua: 1.017 / 6.5 leuk mod bld lg nitr pos prot 500 glu 250 ket neg . lactate:4.3 . : 56 lip: serum acetmnphn 8.5 . trop-t: <0.01 . pt: 13.7 ptt: 27.6 inr: 1.2 fibrinogen: 869 . wbc: 9.6 plt: 296 hct: 41.7 . ecg: sinus tachycardia with long pr interval. st-elevations in ii/ii/f with q-waves in same leads. q-waves are old. . cxr (): respiratory motion blurs the hemidiaphragms. grossly, no consolidation or edema is evident. a tortuous atherosclerotic aorta is identified. the cardiac silhouette is within normal limits for size. no definite effusion or pneumothorax is seen. the osseous structures demonstrate a relatively short segment levoconcave curvature of the mid and lower thoracic spine with associated osteophyte changes. . cta (): 1. no evidence of aortic dissection. 2. equivocal filling defect in a right upper lobe subsegmental branch of the pulmonary artery. no evidence of pulmonary embolism. 3. enlarged pulmonary artery may reflect an element of underlying pulmonary hypertension. 4. mild upper lobe centrilobular emphysematous changes. 5. markedly atrophic left kidney with associated dystrophic calcification and extensive cortical thinning and scar. correlation with prior surgical history and medical history recommended. 6. mild right renal hydronephrosis. 7. fatty infiltration of the liver. 8. air in the bladder is likely related to introduction of foley balloon catheter, but clinical correlation is recommended. brief hospital course: assessement/plan: 73 yo m s/p turp procedure c/b uti resistant to ciprofloxacin, developed urosepsis requiring intubation and icu stay, also developed atrial flutter this admission. . # urosepsis due to e. coli: urosepsis was felt to be secondary to recent procedure, which placed patient at high risk for uti. he received cipro post-procedure but on presentation had a markedly positive ua. urine & blood cultures grew e.coli. blood cultures with e.coli were sensitive to zosyn and ceftriaxone but resistant to cipro; ceftriaxone was given. changed antibiotics to ceftriaxone -> cefazolin iv -> keflex po, currently started on meropenem iv on day of discharge. changed from keflex to meropenem due to possibility of ain, rising creatinine as well as urine with eos. will need to complete 2 week course of antibiotics with 5 additional days of meropenem. . # atrial flutter: the patient had developed atrial flutter with poor rate control, without prior history. increased po metoprolol to 100 tid for rate control. the patient was started on heparin in the icu, then bridging with lovenox to coumadin. . ep consulted about treatment, after discussion with family, family wanted to pursue option of anticoagulation prior to cardioversion. they did not want tee and cardioversion during this hospitalization. inr 3.1 on day of discharge, decreased coumadin from 5 -> 4mg on day of discharge, holding tonight's dose. pt will need frequent inr checks until stabilized. pt will need to follow up with general cardiology 2weeks after discharge for managment of atrial flutter as well as cad. . # cad: pt without prior history of cad or mi, however ecg and echocardiogram revealed mild lvh with regional left ventricular systolic dysfunction consistent with cad. pt was initially started on low dose lisinopril, however holding due to worsening creatinine. would restart once creatinine at baseline 1.2-1.5. pt already on aspirin, simvastatin and metoprolol. he will need follow up with general cardiology for mangament of atrial flutter as well as cad. . # acute on chronic kidney disease: baseline creatinine is variable, though 1.7 in icu seemed somewhat elevated compared to when scr was 1.2. there are ct findings suggestive of mild hydro on the right though no stone was seen. also has an atrophic left kidney. increasing creatinine with +eos in urine, ?ain from antibiotics, changed keflex to meropenem iv. metformin also discontinued. would check daily creatinine levels to monitor for improvement. . # diabetes: oral hypoglycemics were intially held given the patient's acute renal failure, also with dye load from ct imaging. however, restarted with improvement in renal function. fingersticks well controlled on oral agents and sliding scale humalog. discontinued metformin due to worsening renal function. would need to restart once creatinine improved. . # hyperlipidemia: continued on home regimen of simvastatin . # hypoxia/resp failure (resolved): extubated o/n . unclear etiology of hypoxic failure. initially felt to be secondary to pe, though the second read is unclear. there is no infliltrate or failure on cxr. given recent admission, dfa for influenza was performed and was negative. there were some changes consistent with emphysema on ct, though there are no wheeze noted at this time. sputum culture was unremarkable. . pt is being discharged to rehab facility. he is to follow up with cardiology for management of cad as well as atrial flutter. medications on admission: 1. amlodipine 5 mg daily 2. hctz 25mg daily? 3. atenolol 50 mg daily 4. metformin 500mg daily 5. glyburide 5mg daily 6. simvastatin 40 mg daily discharge medications: 1. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 2. haloperidol 5 mg tablet sig: one (1) tablet po hs (at bedtime). 3. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 4. glyburide 2.5 mg tablet sig: two (2) tablet po daily (daily). 5. warfarin 5 mg tablet sig: one (1) tablet po hs (at bedtime). 6. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). disp:*54 tablet(s)* refills:*2* 7. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 8. meropenem 500 mg recon soln sig: one (1) recon soln intravenous q8h (every 8 hours) for 5 days: start stop . 9. warfarin 4 mg tablet sig: one (1) tablet po hs (at bedtime): please hold dose. 10. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po at bedtime as needed for agitation. 11. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 12. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 13. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. discharge disposition: extended care facility: - discharge diagnosis: urosepsis atrial flutter bph s/p turp hypertension discharge condition: hemodynamically stable, aferile discharge instructions: you were admitted with an infection of your bladder which was significant enough for you to be in the icu. we are treating you with antibiotics. you developed an atypical rhythm of your heart called atrial flutter . please continue meropenem iv x 5 days for the infection. we have also started you on coumadin because of the atrial flutter to decrease the risk of any clot formed to cause a stroke. . please follow up with a cardiologist at 2 weeks to evaluate your heart rhythm. he will discuss if & what further procedures need to be done. . please call your doctor or return to the emergency room if you have any of the following: chestpain, shortness of breath, palpitations or any other worrisome rhythm. followup instructions: urology: please follow up with dr. for post/op evaluation. s/p turp on at 1115am. . you will need to follow up with cardiology for your atypical heart rhythm in 2 weeks. you or your family will be contact with an appointment. please call , if you haven't been contact in 1 week. . pcp: , . please follow up within weeks of discharge. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube arterial catheterization diagnoses: coronary atherosclerosis of native coronary artery other postoperative infection urinary tract infection, site not specified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified atrial flutter sepsis chronic kidney disease, unspecified other and unspecified hyperlipidemia acute respiratory failure septic shock septicemia due to escherichia coli [e. coli] hydronephrosis 

Answer: The patient is high likely exposed to