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: cc: major surgical or invasive procedure: tracheal stent(removed) tracheostomy history of present illness: 80yom with recent mitral valve repair and one vessel cabg , course complicated by polymicrobial empyema (e. coli, enterococcus, actinomyces), cardiogenci shock, respiratory failure, with prolonged vent weant and renal failure and was subsequently transferred to rehab hospital. was initially taken to medical center on after being found down, intubated enroute. initially hypotensive in the ed, afebrile, thought sepsis of unclear source started on dopamine and vasopressin also given linezolid and zosyn. stim with inadequte response and he was given fludricort/hydrocort. patient also with positive troponin thought to be nstemi in setting of demand ischemia. . following day patient noted to be doing better and was extubated and later reintubated after ct report with tracheal stenosis. patient also taekn off linezolid after no source identified. tee done at osh negative for vegetation, ef 20% per report. patient is now being transferred for w/u tracheal stenosis. . on transfer, pt denies any complaints. past medical history: s/p cabg x 1 vessel and mitral valve repair s/p annuloplasty. course complicated by empyema, cardiogenic shock and renal insufficiency, difficult to wean and had trach/peg . anemia post operative atrial fibrillation h/o gi bleed hperlipidemia gerd social history: retired stock broker, widowed, smoking history unknon, etoh unknown. family history: n/c physical exam: t 97.9 bp 112/69 hr 86 rr 14 o2sat 100% vent settings: ac 600x 12, p5, fio2 40%. . general: elderly male lying in bed. heent: perrl, no scleral icterus noted, mmm neck: supple pulmonary: lungs ctab cardiac: rrr, nl. s1s2, +systolic mumor at apex abdomen: soft, nt/nd, peg and ostomy site clean extremities: no c/c/e bilaterally skin: stage iii decub neurologic: able to follow commands. moves all extremities. pertinent results: ekg: nsr at 88, nl axis, nl intevals. q waves in iii, f, v1, v2 no baseline for comparision. 03:31am pt-18.5* ptt-56.2* inr(pt)-1.7* 03:31am plt count-167 03:31am wbc-10.0 rbc-3.92* hgb-10.8* hct-35.0* mcv-89 mch-27.5 mchc-30.9* rdw-18.7* 03:31am albumin-3.2* calcium-9.4 phosphate-2.2* magnesium-2.5 03:31am ck-mb-notdone ctropnt-0.11* 03:31am alt(sgpt)-73* ast(sgot)-63* ld(ldh)-203 ck(cpk)-11* alk phos-95 tot bili-1.0 03:31am glucose-128* urea n-39* creat-1.2 sodium-147* potassium-3.5 chloride-113* total co2-25 anion gap-13 . - echo - the left atrium is elongated. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is top normal/borderline dilated. there is mild to moderate regional left ventricular systolic dysfunction with inferior akinesis and hypokinesis of the infero-septum and infero-lateral walls. no masses or thrombi are seen in the left ventricle. right ventricular chamber size is normal. there is mild global right ventricular free wall hypokinesis. there is abnormal septal motion/position. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild to moderate (+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. a mitral valve annuloplasty ring is present. the transmitral gradient is normal for this ring. mild to moderate (+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. ct neck w/contrast (eg:parotids) 4:20 pm findings: patient is intubated with the endotracheal tube through the oropharynx. the bulb of the endotracheal tube is inflated. due to the presence of the endotracheal tube and inflated bulb, it is impossible to evaluate for subglottic stenosis or or larynx. there is a band-like structure noted along the posterior aspect of the distal trachea beyond the tip of the endotracheal tube (series 401b, image 30), which could be due to a web. in addition, there are secretions, partly aerosolized within the oropharynx and the trachea. the end of the endotracheal tube is approximately 4.6 cm above the tip of the carina. evidence of bilateral lung disease, incompletely evaluated on the present ct scan. evidence of degenerative changes involving the cervical and thoracic vertebral bodies in the form of osteophytes and facet joint degeneration. status post cabg.degenerative changes are also noted in bilateral sternoclavicular joints and distal ends of the clavicles. impression: 1. as the patient is intubated with inflated bulb of the ett, it is impossible to assess for subglottic or laryngeal stenosis. recommend direct visualization for assessment. 2. bilateral lung disease, incompletely evaluated and characterized on the present study. to consider ct of the chest for better evaluation. 3. degenerative changes noted involving the cervical and thoracic spine, bilateral sternoclavicular joints. (the case was discussed with the chest radiology team by dr. , regarding the possibility of better assessment on ct chest per tracheal stenosis protocol. however, the chest radiology team prefers direct visualization of the larynx to 3d ct, considering the fact that the patient is intubated with inflated bulb of the ett). . brief hospital course: 80 with history of recent cabg, mv repair admitted to outside hospital for hypotension after being found down, concerning for sepsis. patient was transferred to us for tracheal stenosis management. . # respiratory failure/tracheal stenosis patient was intubated on arrival. however, he extubated himself while in the icu. he developed acute hypoxic respiratory failure and was promptly re-intubated. he was evaluated by interventional pulmonary and had tracheal stent placed on . the stent however migrated on and was then removed. he was then evaluated by ent who recommended tracheostomy, which he received on . direcet laryngoscopy reveals soft anterior stenosis area 2cm below vocal cords, taking up to approximately 70% of lumen. #6 portex trach was placed/ he is scheduled to have follow up with ent in weekd for future co2 ablation. at that time, interventional pulmonary would assist with placement of t tube. . # sepsis patient had been normotensive since transfer to . no clear source of infection per workup at outside hospital. all antibiotic was discontinued. he remained afebrile, normal wbc and normal blood pressure. all culture data remained negative as well. . # post trach fever - post trach patient had a low grade fever of 100.1, o2 sat was 93-95% on 30% fio2. cxr with mild pulm edema. sputum culture and urine cultures were sent. he was given 1 dose of 10mg iv lasix and started on zosyn again for presumed vap (he received one dose prior to transfer). please call micro at to follw up the culture data. . # cardiac patient had episodes of chest pain while in the icu. ekg did not show any changes from baseline. cardiac enzymes were cycled and remained negative. echocardiogramwas performed, revealing ef 35-40%. cardiology consult was obtained prior to general anesthesia for rigid bronchoscopy and he was cleared for the procedure. he was continued on aspirin and metoprolol. - strict i/os. . # a. fib patient was rate controlled on metoprolol. he was also continued on heparin drip. coumadin should be restarted. # prophylaxis patient remained on famotidine and heparin drip throughout icu stay # nutrition he remained on tube feeds while intubated #access:peripheral ivs #code status: full medications on admission: famotidine 20 mg iv each day fludricortisone tablet 0.1mg, tab daily hydrocortisone 50 mg q6 hours ipratropium inhaler 2 puffs q6h megesterol suspension 40 mg/ml 400 mg metoprolol 5 mg iv qhours zosyn 2.25 grams every 6 hours zoloft 75mg each day heparin gtt discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 2. sertraline 50 mg tablet sig: 1.5 tablets po daily (daily). 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 5. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 6. lidocaine hcl 1 % solution sig: five (5) ml injection q1-2h () as needed for cough. 7. penicillin v potassium 250 mg tablet sig: four (4) tablet po q6h (every 6 hours). 8. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day). 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed. 10. lorazepam 1-2 mg iv q4h:prn 11. morphine 2 mg/ml syringe sig: two (2) mg injection q4-6h (every 4 to 6 hours) as needed. 12. heparin (porcine) in d5w 100 unit/ml parenteral solution sig: as directed as directed intravenous asdir (as directed): currently at 1100u/h. please adjust according to your hospital protocol for heparin drip. 13. piperacillin-tazobactam na 4.5 gm iv q8h discharge disposition: extended care facility: medical center discharge diagnosis: 1. tracheal stenosis 2. hypotension from ?sepsis 3. atrial fibrillation discharge condition: stable discharge instructions: you have been discharged to medical center icu. your care will be dictated by the doctors at that hospital. please direct your questions and concerns to them. if you have any questions or concerns about your course here please call us at . followup instructions: 1. please follow up with ent in 2 weeks for follow up procedures. please call ( for ent department if you run into any problems. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances other bronchoscopy other intubation of respiratory tract laryngoscopy and other tracheoscopy temporary tracheostomy removal of intraluminal foreign body from trachea and bronchus without incision diagnoses: pneumonia, organism unspecified congestive heart failure, unspecified atrial fibrillation aortocoronary bypass status other chronic pulmonary heart diseases chronic kidney disease, unspecified other specified forms of chronic ischemic heart disease other and unspecified angina pectoris old myocardial infarction pressure ulcer, lower back chronic respiratory failure colostomy status other diseases of trachea and bronchus stenosis of larynx personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus 

Answer: The patient is high likely exposed to