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: heparinoids attending: chief complaint: hypotension major surgical or invasive procedure: hemodialysis history of present illness: 85 year old male well known to our service presents from vent rehab () with tachypnea and hypotension, after recent discharge from micu on for esrd pancreatitis. he is a gentleman with h/o cad s/p 3v-cabg x 3 (osh in fla) c/b mediastinal hemorrhage requiring re-exploration (), post-op afib, prolonged vent wean requiring trach () and peg (), acute on chronic renal failure requiring dialysis, and persistent post-op afib and transfered to on for cholangitits c/p ercp pancreatitis. at the time of his discharge, he systolic bp ~100's after aggressive hd and uf on . he underwent uf on but was run even, with instuctions to discontinue his hydralazine. . at rehab it is noted that he became increasinly tachypneic and aggitated with sbp in the ~200's. (no hypoxia noted). he received 2mg ativan and morphine. sbp dropping to 80's after sedation. in ems, recieved 500cc ns and bp on arrival was 99-113/70-80's. "agitated" in the ed--->ativan 1mg iv and fent 50mcg, with drop in sbp 70-80's. received levo/flagy/amp past medical history: 1) cad - cath 30% lm, 90% lad, 70% rca, 60% om - 3v-cabg c/b mediastinal hemorrhage, post-op afib 2) esrd on hd, rij tunneled hd catheter placed 3) tracheostomy 4) peg placement 5) thrombocytopenia hit ab neg. 6) stenotrophomonas cx'd from sputum , on tmp/smx 7) right carotid stenosis: 80-99% by u/s 8) htn 9) pvd 10) hypothyroidism 11) prostate ca s/p xrt 12) r renal artery stenosis; l renal artery occlusion 13) 4 cm infrarenal aaa 14) djd 15) bilateral thr 16) s/p appy 17) bilateral inguinal hernia repair 18) cholelithiasis: ercp which showed diffuse dilation of cbd up to 10 mm without filling defects (although gallstones noted in gb) and dilation of pancreatic duct to 6 mm; the cbd was stented, c/b post-ercp pancreatitis. 19) mrsa and vre screens--->neg. 20) ercp pancreatitis. social history: no tobacco, no ethanol family history: non-contributory physical exam: pe: tc 99.0, 78/38, 69, simv 500x12x5 (30resp). ps 15/5, peep 5, fio2 40%, 100% gen: elderly, ill appearing, sedated heent: pupils non-reactive to light, eomi, ommm, op clear, trach in place with dried thick secretions on dressing. cardiac: irregularly irregular, no m/r/g. soft hs. pulmonary: coarse bs throughout with late wheezes r>l abd: scaphoid abd, nabs, nt/nd, no masses, no hsm: peg site no erythema or discharge ext: no cyanosis or edema. bilateral heel ulcers, clean-based. pneumoboots in place neuro: sedated, unresponsive to noxious stim access: right tunnelled sc dialysis cath c/d/i, left sc c/d/i. pertinent results: 08:24pm lactate-1.4 08:00pm glucose-141* urea n-93* creat-4.9* sodium-137 potassium-5.2* chloride-100 total co2-21* anion gap-21* 08:00pm alt(sgpt)-20 ast(sgot)-25 ck(cpk)-28* alk phos-180* amylase-46 tot bili-1.8* 08:00pm lipase-53 08:00pm ck-mb-notdone ctropnt-0.14* 08:00pm albumin-3.0* calcium-7.7* phosphate-4.7* magnesium-1.9 08:00pm wbc-4.4# rbc-3.48* hgb-10.8* hct-33.2* mcv-96 mch-30.9 mchc-32.4 rdw-22.1* 08:00pm neuts-80* bands-0 lymphs-7* monos-13* eos-0 basos-0 atyps-0 metas-0 myelos-0 08:00pm hypochrom-2+ anisocyt-3+ poikilocy-1+ macrocyt-3+ microcyt-normal polychrom-1+ schistocy-2+ burr-1+ acanthocy-1+ 08:00pm plt smr-normal plt count-287 08:00pm pt-16.2* ptt-37.4* inr(pt)-1.6 . sputum cx: stenotrophomonas vre screen positive sputum cx: stenotrophomonas . echo: preserved global left ventricular systolic function. mild aortic regurgitation. mild mitral regurgitation. . cxr: improving left retrocardiac opacity and left pleural effusion. no significant change in patchy right basilar opacity. . cxr: interval increase in size of the left pleural effusion with compression atelectasis of the left lower lobe. improvement in the opacity at the right lung base. lines and tubes are unchanged. brief hospital course: 85 year man with a history of cad s/p recent cabg, afib, s/p recent cholangitis and ercp, post-ercp pancreatitis, presented with a change in mental status and hypotension after receiving benzodiazepines and narcotics for aggitation. . # hypotension: the patient was initially started on levophed but weaned off in less than 24 hours. upon admission he received a total of 1l ns boluses to stablize his blood pressure. his blood pressure remained stable during the hospital course but was very sensitive to zyprexa. a tte on showed an ef of 50% with normal lv size and function, 1+ ar/mr/tr. he ruled out for an mi by enzymes and ekgs. he was afebrile, with a normal wbc, normal lfts//lip, and no new culture data. . # altered mental status: improved quickly once the benzos and narcotics wore off and patient returned to his pre-hospital / rehab mental status per family within 24 hours. a ct head on showed no acute pathology, and an mri head was not performed due to concern of pacer wires (reportedly in place but not seen on cxr) and metal clips in his sinuses. given the improvement in his mental status no further imaging was pursued. . # agitation: pt occasionally has problems with agitation with increased respiratory rate. it is very important to avoid narcotics, benzodiazepines in this patient as he becomes hypotensive after administration of these medications. pt also became somnolent and hypotensive after 5mg of zyprexa. zyprexa can be used but at much lower doses: start at 1mg of zyprexa and increase as needed. haldol can also be used but should be started at very low doses. . # lower gi bleed: the patient had a small smount of brbpr on and . a peg tube lavage was heme negative, and on rectal exam the patient had an internal hemorroid. his hematocrit remained stable between 28 - 30. . # respiratory failure: patient was brought in from a trach rehab were his was attempting a slow respiratory wean. cxr on showed an increase in size of the left pleural effusion with compression atelectasis of the left lower lobe, as well as improvement in the opacity at the right lung base. his sputum grew out stenotrophomonas , and the patient completed a course of bactrim which he had started pre-hospital. . # esrd: the patient was dialyses on (1.5 liters removed) and again on (2 liters removed). he initially presented with a mild anion gap metabolic acidosis, presumably from his renal disease, but his gap and acidosis improved with hd. . # lower extremity weakness: also the lower extremities were hyperreflexive. mri was not performed due to the pacer wires in his heart. the weakness was likely do to deconditioning but could have been due to icu myopathy or an intracranial process. mri imaging was not done due to the question of cardiac pacer wires. the neurologic exam of the lower extremities improvement during the course of the hospitalization. . # atrial fibrillation: which started post-cabg. pacing wires which were placed in were reportedly clipped (but not pulled) during his last admission. the wires were not visualized on cxr, but the concern that wires may be in place caused the patient not to get an mri. while in hospital the patient was rate controlled on amiodarone, and his coumadin was held for two day due to a slow lower gib. his coumadin was restarted in hospital and his hct remained stable between 28-30. this issue should be followed at the rehab clinic (follow daily hct, inr, and guaiac stools). . # cholangitis: patient completed his course of amp/levo/flagyl. lfts & wbc remained wnls. . # htn: antihypertensive medications were held in the setting of hypotension and recently started on hemodialysis. the patient will need to establish a new baseline bp and bp regemine now that he has started hemodialysis. . # chronic anemia: likely due to esrd. patient was given epogen q hd. also a small amount of blood loss from lower gi bleed. . # cad s/p cabg: patient was continued on his asa and his statin. his beta-blocker was held for relative hypotension. medications on admission: amiodarone hcl 200 mg tablet sig: one (1) tablet po daily (daily). b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). acyclovir 5 % ointment sig: one (1) appl topical 6x/d (6 times a day). albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). lansoprazole 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. atorvastatin calcium 40 mg tablet sig: one (1) tablet po daily (daily). acetaminophen 500 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. warfarin sodium 2 mg tablet sig: one (1) tablet po hs (at bedtime). docusate sodium 150 mg/15 ml liquid sig: one hundred (100) mg po bid (2 times a day). heparin flush cvl (100 units/ml) 1 ml iv daily:prn 10ml ns followed by 1ml of 100 units/ml heparin (100 units heparin) each lumen qd and prn. inspect site every shift medications regular insulin sc sliding scale - check finger sticks q6h glucose insulin dose 0-60 amp d50 61-150 0 units 151-200 1 units 201-250 2 units 251-300 3 units 301-350 4 units 351-400 5 units > 400 notify m.d. discharge medications: 1. amiodarone hcl 200 mg tablet sig: one (1) tablet po daily (daily). 2. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 3. acyclovir 5 % ointment sig: one (1) appl topical 6x/d (6 times a day). 4. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 5. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 6. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 7. lansoprazole 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 8. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 9. atorvastatin calcium 40 mg tablet sig: one (1) tablet po daily (daily). 10. acetaminophen 500 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 11. warfarin sodium 2 mg tablet sig: one (1) tablet po hs (at bedtime). 12. docusate sodium 150 mg/15 ml liquid sig: one hundred (100) mg po bid (2 times a day). 13. heparin flush cvl (100 units/ml) 1 ml iv daily:prn 10ml ns followed by 1ml of 100 units/ml heparin (100 units heparin) each lumen qd and prn. inspect site every shift 14. medications regular insulin sc sliding scale - check finger sticks q6h glucose insulin dose 0-60 amp d50 61-150 0 units 151-200 1 units 201-250 2 units 251-300 3 units 301-350 4 units 351-400 5 units > 400 notify m.d. discharge disposition: extended care facility: - discharge diagnosis: change in mental status and hypotension likely due to benzodiazepines . atrial fibrillation esrd on hemodialysis coronary artery disease s/p cabg discharge condition: stable on trach ventilation discharge instructions: please call your doctor if you experience chest pain, shortness of breath or abdominal pain. please take your medication. avoid taking hydralazine, benzodiazepines, or zyprexa all of which significantly decrease your blood pressure. if absolutely necessary to medically control agitation please take zyprexa 1mg po. your last vent settings were ac tv 500, rr 10, fio2 35%, peep 5 followup instructions: when you are discharged from the rehab facility you will need to follow up with your pcp. : , . need repeat ercp in 3 months (please have your primary care provider call for appointment with gi at ) . continue dialysis 3 times per week. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances hemodialysis diagnoses: acidosis other iatrogenic hypotension anemia in chronic kidney disease unspecified acquired hypothyroidism atrial fibrillation personal history of malignant neoplasm of prostate aortocoronary bypass status peripheral vascular disease, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease atherosclerosis of renal artery long-term (current) use of anticoagulants internal hemorrhoids with other complication cholangitis drug-induced delirium gastrostomy status chronic respiratory failure tracheostomy status benzodiazepine-based tranquilizers causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to