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 a stat dictation addendum to prior discharge summary from . hospital course by systems: occasional episodes of hypertension with continued decompensated heart failure with increased rales on pulmonary examination, peripheral edema, decreased urine output and continued supplemental oxygen requirement. the patient's captopril dose was increased to 75 mg p.o. three times a day to maximize after load reduction. the patient remained normotensive on a low dose beta blocker and elevated dose of patient received one dose of p.o. lasix for symptomatic shortness of breath with subsequent transient hypotension. the lasix was discontinued and reserved for a p.r.n. basis. the patient remained with decompensated heart failure with continued oxygen requirement (though stable), tachypnea and rales of the way up bilaterally on pulmonary examination. the patient also remained oliguric likely due to decreased effective circulation secondary to heart failure. despite the patient's biventricular failure with relative decompensation, the patient remained stable without requiring continued diuresis. the patient continued in atrial fibrillation, rate controlled, with a low dose beta blocker. the patient's coumadin was held initially secondary to the potential surgical intervention. with the decision to defer surgery indefinitely, the coumadin was then held secondary to the patient's request to minimize interventions including blood draws. the patient continued on subcutaneous heparin without evidence of thromboembolic events. the patient, with known peripheral vascular disease and likely coronary artery disease, was continued on a statin and aspirin for the duration of the hospitalization. 2. infectious disease: the patient completed a ten day course of empiric antibiotics for a multi-lobar pneumonia. at the completion of the antibiotic course, the patient remained afebrile with no further evidence of infection. 3. vascular: the surgical team continued to follow the patient throughout the hospital course. because the patient was deemed a particularly high risk surgical candidate, the surgery service deferred right lower extremity amputation indefinitely. the patient continued with daily dry dressing changes with wound care and splinting. there was no evidence of infection and the patient's pain was adequately controlled with darvocet. 4. pulmonary: the patient has known chronic bilateral pleural effusions, right greater than left, with decompensated heart failure. the patient remained persistently tachypneic and short of breath with stable oxygen requirement, however, continued to defer therapeutic thoracentesis. 5. endocrine: the patient continued on a sliding scale insulin for diabetes mellitus management. the patient's insulin requirement was minimal to none, and the patient's fingerstick glucose monitoring was changed to twice a day. 6. renal: the patient remained oliguric with persistent urine output less than 50 cc. per hour for greater than one week. no labs were drawn during this time to document the progression of the renal failure. the patient's progressive renal failure is likely secondary to both decreased effective and actual intervascular volume. the patient continued on an ace inhibitor despite the worsening renal function for needed afterload reduction. the patient's urinary output did not improve with a trial of fluid boluses to positively effect the intravascular volume, nor did it respond to attempts to diurese with lasix. 7. fluids, electrolytes and nutrition: the patient continued with poor appetite and minimal oral intake. no labs were drawn during the last week of hospitalization to evaluate electrolyte status. without the recommended option for surgery, discussions regarding the medical management were ongoing with both patient and family. the patient requested to minimize aggressive interventions, however, opted to continue current therapy. the palliative care service was consulted in order to facilitate discussion with the patient and family regarding end of life care. at the time of dictation, the patient continues on the current medication regimen with the addition of several medications for symptomatic management. condition on discharge: fair. discharge diagnoses: 1. multi-lobar pneumonia with sepsis. 2. severe peripheral vascular disease with dry right lower extremity gangrene, status post multiple femoral-popliteal bypass grafts. 3. insulin dependent diabetes mellitus. 4. -ventricular failure, decompensated congestive heart failure. 5. atrial fibrillation with rapid ventricular rate. 6. peripheral neuropathy. 7. mitral regurgitation. 8. oliguric renal failure. discharge medications: 1. captopril 50 mg p.o. three times a day (hold for systolic blood pressure less than 100). 2. lopressor 25 mg p.o. twice a day (hold for systolic blood pressure less than 100, heart rate less than 55). 3. darvocet n100, one pill p.o. q. six hours p.r.n. pain. 4. pravastatin 20 mg p.o. q. day. 5. aspirin 81 mg p.o. q. day. 6. sliding scale insulin (regular insulin). 7. heparin 5000 units subcutaneously q. 12 hours. 8. lansoprazole 30 mg p.o. q. day. 9. scopolamine patch one transdermal q. 72 hours p.r.n. secretions. 10. ativan 0.5 mg p.o. (sublingual) q. two hours p.r.n. agitation/shortness of breath. 11. percocet elixir 2.5 to 20 ml p.o. q. three hours p.r.n. pain / shortness of breath. discharge instructions: 1. the patient is to be discharged to prior nursing facility for continued management and discussion of goals of care. , m.d. dictated by: medquist36 procedure: pulmonary artery wedge monitoring diagnoses: pneumonia, organism unspecified unspecified pleural effusion acute kidney failure, unspecified unspecified septicemia atrial fibrillation mitral valve insufficiency and aortic valve insufficiency rheumatic heart failure (congestive) atherosclerosis of native arteries of the extremities with gangrene diseases of tricuspid valve 

Answer: The patient is high likely exposed to