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: penicillins / hydralazine attending: chief complaint: cough and shortness of breath major surgical or invasive procedure: central venous femoral catheter placed central venous femoral catheter dc'd picc line placed history of present illness: 71 yo m with multiple medical problems including diastolic hf, , cva in with baseline l hemiparesis and limited vocalization, alzheimer's dementia, and hx of multiple resistant infections, recent admission in with similar presentation, admitted from nursing home with fever, dyspnea, hypoxia, and hyperglycemia. patient had a recent admission and was treated for pneumonia with vancomycin and ceftazidime for 7 days for which a picc was placed which finished . in the ed, initial vs: 97.1 110 159/79 24 92 on 8l. noted to be rhonchorous bs with cxr with pna. high white count. worsened dyspnea and bp dropped to 90/60 almost intubated started on nrb. given 3l ns fluid. now on 5l nasal cannula. bg at 721. got 10 units of insulin, no gap ? honk. at noon 401. also trop 0.33, twi in v4 started on hep gtt. 96 119/37 33 99% 5l. right femoral tl placed. given levo and vanc. he was weaned to venti and then to 5l ns. currently, patient not responsive at baseline. family at bedside which confirms this. per nursing home notes, patient was noted to be tachypnic to 30s, tachy to 116 and to have temp of 101.1 when he was sent from nursing home. ros: unable to obtain secondary to patient nonverbal at baseline. past medical history: 1. coronary artery disease - () 2. diastolic chf, last echo 3. hypertension 4. hypercholesterolemia 5. h/o bradycardia 6. diabetes 7. history of cva (), baseline l hemiparesis & limited vocalization 8. hydrocephalus, s/p vp shunt (~ @ , no revisions, unknown cause) 9. history of hyperkalemia ( and , ). etiology unclear though acute renal failure and hypoaldosterone states considered. 10. alzheimer's dementia 11. bipolar disorder 12. history of subdural hemorrhages 13. hearing loss, with hearing aids 14. cataracts 15. history of iron deficiency anemia anemia 16. pvd 17. h/o siadh, with fluid restriction of 1l per day 18. h/o recurrent aspiration pnas 20. h/o multiple resistant infections: - vre uti () - h/o esbl klebsiella uti () & sputum/endotracheal () - mrsa, sputum/endotracheal () - recurrent clostridium difficile colitis () 21. skin: - stage ii sacral wounds - unstageable left heel decubitus - (groin & perineum) 22. h/o partial sbo, resolved with bowel rest () 23. h/o brbpr () 24. h/o +ppd, s/p inh rx 25. h/o elevated lfts 26. right suprahilar lung mass social history: resides in nh. used to work as an accountant, 100 pack year smoking history, he is nonverbal at baseline with a peg tube. he is dependent on others for adls. family history: type 2 diabetes mellitus, alzheimer's and bipolar disease. physical exam: general appearance: thin eyes / conjunctiva: perrl, pupils dilated head, ears, nose, throat: poor dentition, jtube cardiovascular: (s1: normal), (s2: normal) peripheral vascular: (right radial pulse: not assessed), (left radial pulse: not assessed), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (expansion: symmetric), (percussion: resonant : , hyperresonant: ) abdominal: soft, non-tender, bowel sounds present extremities: right lower extremity edema: absent, left lower extremity edema: absent musculoskeletal: unable to stand skin: warm neurologic: responds to: verbal stimuli, movement: non -purposeful, tone: decreased, l side paralyzed physical exam on transfer from micu to floor: vitals - t 98.9 bp 126/37 hr 86 rr 19 o2sat 100%4l general: awake, not responding to verbal stimulation, groaning constantly heent: perrla, moving eyes well but unable to do full eom exam, mm appear slightly dry, with nasal cannula cardiac: rrr no apparent murmurs rubs or gallops although difficult to hear given groaning lung: mild rhonchi bilaterally abdomen: slightly firm and with ?tenderness to palpations around umbilical area although hard to determine, bs+, mild distention ext: in pneumoboots, with 1+ edema to ankles. pertinent results: blood cx x3, ngtd urine cx , , ngtd stool cx -ve c.diff toxin (stool) - ve sputum gram stain-final; respiratory culture-final sputum gram stain-final; respiratory culture-preliminary {staph aureus coag +} stool fecal culture-final; campylobacter culture-final inpatient mrsa screen mrsa screen-final {positive for methicillin resistant staph aureus} inpatient 05:55am blood wbc-13.2* rbc-3.70* hgb-9.2* hct-31.8* mcv-86 mch-24.9* mchc-29.0* rdw-15.1 plt ct-284 05:55am blood plt ct-284 01:48pm blood na-145 cl-114* 05:55am blood calcium-7.7* phos-2.8 mg-2.1 06:50am wbc-32.2*# rbc-4.81# hgb-12.6*# hct-42.4# mcv-88 mch-26.1* mchc-29.7* rdw-15.9* 06:50am plt count-432 06:50am glucose-721* urea n-72* creat-1.1 sodium-157* potassium-4.5 chloride-110* total co2-36* anion gap-16 07:06am lactate-3.8* ekg: sinus tach, na, ni, v4 tw now upright but likely lead placement, no acute sttw changes chest, portable upright frontal view: the suprahilar right lung mass is again identified, now measuring 3.9cm (previously 2.9cm). right apical opacity may reflect atelectasis, pneumonia or pulmonary infarct. the cardiac silhouette is unchanged. hilar contours are stable. there is no effusion on this frontal view. shunt catheter courses over the right lung into the peritoneum. impression: 1. interval growth of right suprahilar lung mass. 2. right apical opacity is a non-specific finding, may reflect atelectasis, pneumonia, or pulmonary infarct. a wet read was entered into the ed dashboard on . chest xray : left lung is clear. right infrahilar consolidation slightly worse today compared to . right suprahilar mass noted. heart size is normal though increased over 24 hours. right pleural effusion is small if any. no pneumothorax. brief hospital course: 71 year old male with multiple medical problems including diastolic hf, , cva in with baseline l hemiparesis and limited vocalization, alzheimer's dementia, and hx of multiple resistant infections, recent admission in with similar presentation, admitted from nursing home with fever, dyspnea, hypoxia, and hyperglycemia found to have sepsis/pna. 1. hypovolemic shock and sepsis:he was originally admitted to the medical icu with leukocytosis and tachypnea. a central venous femoral catheter was placed for access. he was noted to have a right apical infiltrate and enlarging right upper lobe mass on chest x-ray. this was most consistent with post-obstructive vs. health-care associated pneumonia. given his history of mrsa and esbl klebsiella pneumonia, he was started on vancomycin and meropenen for a total course of 14 days. he was given iv fluids in the ed and in the icu. despite this, he became hypotensive and levophed was started. a few hours after levophed initiation, he became bradycardic with a heart rate in the 30s and systolic blood pressure noted to be as low as 65. he was given 1 amp of atropine and 1 amp of sodium bicarbonate. levophed was increased and 2 liters of normal saline were bolused. his heart rate and blood pressure recovered and he never lost his pulse. he was thought to be significantly hypovolemic given an increased bun/cr ratio, hypernatremia and physical exam. he was given ivf boluses and the levophed was weaned. he subsequently remained hemodynamically stable for the duration of hospitalization. he had a picc line placed in order to receive iv antibiotics at his extended care facility, and his central venous femoral catheter was discontinued. 2. hypernatremia: he had persistent hypernatremia after fluid resuscitation and antibiotic initiation. he was felt to be hypovolemic and his hypernatremia improved with free water boluses via his g tube and d5w administration. 3. leukocytosis: he had a leukocytosis on admission that was likely secondary to pneumonia. he had stool cultures negative for c diff. he also has a stage ii sacral decubitus ulcer which did not appear infected but was considered as a possible cause of his leukocytosis. his leukocytosis has trended down consistent with resolving infection in the setting of successful antibiotic therapy. 4. hypertension: he is on captopril, metoprolol, and clonidine as outpatient. these were initially held due to hypotension on presentation. he was restarted on low dose metoprolol 12.5 mg po bid during his stay and his blood pressure tolerated this well. he is being discharged on his home doses of metoprolol, clonidie, and captopril. 5. hyperglycemia: his blood glucose was in the 700s on admission without an anion gap. he was managed with his home lantus and insulin sliding scale and did not require an insulin drip. after initial fluid resuscitation and treatment, his blood sugars remained well-controlled. 6. cad: ekg initially showed twi in v4. he was started on heparin gtt in ed. cardiac enzymes were cycled and he was monitored on telemetry. the heparin drip was discontinued in the micu as it was not believed he had an ischemic event. telemetry monitoring was discontinued. he was continued on daily aspirin. 7. code status: he remained full code during this hospitalization. medications on admission: -captopril 12.5 mg tab oral three times daily via j-tube -reglan 5 mg tab oral four times daily via j tube -multi-day tab oral once daily via j tube -levothyroxine 25 mcg tab oral once daily via j tube -ascorbic acid 500 mg tab oral once daily via j tube -omeprazole 20 mg oral packet oral twice daily via j tube -clonidine 0.3 1 patch weekly(s) once per week on wednesday -metoprolol tartrate 25 mg tab oral three times daily via j tube -juven oral packet oral1 packet(s) twice daily via j tube -heparin (porcine) 5,000 unit/ml syringe injection three times daily sc - albuterol sulfate 2.5 mg/3 ml (0.083 %) neb solution inhalation 1 solution for nebulization(s) every 6 hrs - aspirin 325 mg tab oral 1 tablet(s) once daily - peridex 0.12 % mouthwash mucous membrane 15ml mouthwash(s) twice daily -lantus 100 unit/ml sub-q subcutaneous 30units solution(s) once daily, at bedtime -humalog 100 unit/ml sub-q subcutaneous sliding scale solution(s) unk times daily discharge medications: 1. captopril 12.5 mg tablet : one (1) tablet po three times a day. 2. reglan 5 mg tablet : one (1) tablet po four times a day. 3. levothyroxine 25 mcg tablet : one (1) tablet po daily (daily). 4. multi-day tablet : one (1) tablet po once a day. 5. ascorbic acid 500 mg tablet : one (1) tablet po daily (daily). 6. omeprazole 20 mg capsule, delayed release(e.c.) : one (1) capsule, delayed release(e.c.) po twice a day. 7. clonidine 0.3 mg/24 hr patch weekly : one (1) patch transdermal once a week. 8. metoprolol tartrate 25 mg tablet : one (1) tablet po three times a day. 9. juven packet : one (1) packet po twice a day. 10. heparin (porcine) 5,000 unit/ml solution : one (1) injection injection tid (3 times a day). 11. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) nebulization inhalation q6h (every 6 hours). 12. aspirin 325 mg tablet : one (1) tablet po daily (daily). 13. chlorhexidine gluconate 0.12 % mouthwash : fifteen (15) ml mucous membrane (2 times a day). 14. lantus 100 unit/ml solution : thirty (30) units subcutaneous at bedtime. 15. humalog 100 unit/ml solution subcutaneous 16. acetaminophen 325 mg tablet : 1-2 tablets po q6h (every 6 hours) as needed for pain, fever. 17. vancomycin in dextrose 1 gram/200 ml piggyback : one (1) gram intravenous q 12h (every 12 hours): please give through . 18. meropenem 500 mg recon soln : one (1) recon soln intravenous q6h (every 6 hours): please give through . discharge disposition: extended care facility: roscommons discharge diagnosis: primary diagnosis: pneumonia sepsis secondary diagnosis: chronic diastolic heart failure alzheimer's dementia chronic diastolic congestive heart failure hypernatremia hyperglycemia hypertension bradycardia discharge condition: good, vital signs stable discharge instructions: you were admitted to the hospital due to difficulty breathing and low blood pressure. you were found to have a pneumonia and you are being treated with iv antibiotics. you also have a mass in your lung that could have caused you to have pneumonia. you were also given iv fluids to help rehydrate you. changes to your medications: added vancomycin 1000 mg iv twice daily through added meropenem 500 mg iv four times daily through if you experience worsening shortness of breath, chest pain, worsening cough, or fevers greater than 101 degrees, you should call 911 or go to the nearest hospital. if you have abdominal pain or constipation, you should call your primary care doctor. followup instructions: please follow up with your primary care provider, , k at you have the following appointments scheduled: provider: ,one date/time: 8:30 provider: west outpatient radiology phone: date/time: 10:00 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified cardiopulmonary resuscitation, not otherwise specified diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis acute respiratory failure septic shock old myocardial infarction pressure ulcer, lower back malignant neoplasm of other parts of bronchus or lung alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance bipolar disorder, unspecified diastolic heart failure, unspecified presence of cerebrospinal fluid drainage device pressure ulcer, stage ii pressure ulcer, unspecified stage 

Answer: The patient is high likely exposed to