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, elevated lactate, hypoxia major surgical or invasive procedure: none history of present illness: this is a 86 yo male w/pmhx sx for atrial fibrillation on coumadin, parkinson's disease, and osa on home bipap who was admitted for lll pna, on levo/flagyl, who was subsequently 'found down' on floor by roomate this afternoon. on housestaff arrival, patient found to be hypoxic to 84%, increased to 94% on nrb. lungs w/ b/l rales so given 20 iv lasix for diuresis. of note the pt had been on ns 125 cc/hr since that morning. bp's stable in 140's-150's. ekg checked and demonstrated no acute st changes. cxr performed as well. vbg done, demonstrated lactate of 5.0. ph 7.38, co2 25. noted to have fever to 101.7. he presented to the ed on with weakness and productive cough over 1 week with a component of pleuritic cp. patient's caregiver stated that he has had increased secretions over the past week, as well as increased confusion and pulling off of his bipap mask. she also notes that this morning he was very fatigued, and couldn't get out of bed for breakfast. he had no fevers or chills at home. there were no other localizing signs, symptoms, no dysuria or diarrhea. at baseline, he is able to walk with assistance, and is alert and oriented x3. he is able to eat and bath and groom himself. in the ed his vitals were temp 101.9 88 162/97 16 96% ra. he was found to have lll infiltrate on cxr. fever but no wbc. his symptoms were felt c/w cap. he was started on levaquin and clinda and admitted to medicine. past medical history: 1. afib 2. parkinson's disease 3. osa on bipap 4. hydrocele social history: lives at home with his caregiver, , who is his high school sweetheart. they started dating again 23 years ago when she became widowed and moved back into the area. patient is a retired contractor. he has no hx of smoking, drinking or drug use. family history: sister with granulomatosis. no family hx of dementia. +family hx of depression. physical exam: vs: t 101.7 p 70 bp 116/60 12 96% ra gen: awake, communicative, mildly confused heent: perrl eomi cv: irregularly irregular. 2/6 sem at rusb with radiation to neck. lungs: diffuse crackles abd:soft nt/nd, no hsm ext: wwp. no cce. pertinent results: 10:25pm ck(cpk)-86 10:25pm ck-mb-notdone ctropnt-<0.01 04:30pm glucose-95 urea n-17 creat-1.1 sodium-138 potassium-4.3 chloride-103 total co2-23 anion gap-16 04:30pm ck(cpk)-80 04:30pm ck-mb-notdone ctropnt-<0.01 04:30pm wbc-5.9 rbc-3.74* hgb-11.3* hct-33.1* mcv-89 mch-30.2 mchc-34.1 rdw-15.2 04:30pm neuts-74.2* lymphs-17.3* monos-7.4 eos-0.7 basos-0.4 04:30pm plt count-146* 04:30pm pt-26.9* ptt-38.8* inr(pt)-2.8* echocardiogram : prior study was on tape 2001e245 (incorrect on prior report). this study was compared to the prior study of . left atrium: dilated la. right atrium/interatrial septum: moderately dilated ra. left ventricle: normal lv wall thickness. normal lv cavity size. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic root diameter. normal ascending aorta diameter. aortic valve: mildly thickened aortic valve leaflets. mild (1+) ar. mitral valve: moderately thickened mitral valve leaflets. myxomatous mitral valve leaflets. moderate/severe mvp. partial mitral leaflet flail. moderate to severe (3+) mr. eccentric mr jet. tricuspid valve: mildly thickened tricuspid valve leaflets. moderate tr. mild pa systolic hypertension. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. significant pr. pericardium: small pericardial effusion. conclusions: the left atrium is dilated. the right atrium is moderately dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. the mitral valve leaflets are myxomatous. there is moderate/severe mitral valve prolapse. there is partial mitral leaflet flail. moderate to severe (3+) mitral regurgitation is seen. the mitral regurgitation jet is eccentric. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is mild pulmonary artery systolic hypertension. significant pulmonic regurgitation is seen. there is a small pericardial effusion. no definite vegetation seen (cannot exclude). compared with the prior study (images reviewed) of /200, the mitral valve appears similar. mild aortic regurgitation is now present. brief hospital course: 1. respiratory distress: thought to be due to both severe mitral regurgitation (new c/w ) and pneumonia. the patient was quickly weaned from 4l nasal prongs to room air. he was observed in the micu for 48 hours. the pt did have an elevated lactate on admission but this quickly normalized after fluid resuscitation. (lactate fell from 5.0 to 1.5) bnp of 6075 on admission also suggested a large component of left-sided heart failure due to volume resuscitation and severe mr. 2. chf: no previous h/o chf. echo on with new severe mr l mitral leaflet. cardiology (dr. ) was consulted and felt that the patient should be managed medically with afterload reduction and beta-blockers as tolerated by blood pressure and heart rate. the patient was bradycardic with sbp in the 90s, so no beta-blocker or afterload reduction was used. the patient was diuresed with iv lasix ~3 liters with marked improvement in respiratory status. with new onset chf and st depressions on ecg, will need outpt stress. he was ruled out for mi as an inpatient. 3. pna: new lll infiltrate on admission cxr pa/lat. no wbc, but fever to 101.7, increased resp secretions. initially on clinda/levaquin then switched to levaquin monotherapy. will complete a 10-day course of levofloxacin (note interaction with coumadin). blood and sputum cultures without growth at the time of discharge. #delta ms: likely encephalopathy infection on top of baseline parkinsons. head ct without acute abnormality. at baseline he is demented, at best a/o x 2, but has marked difficulty hearing and is easily confused. #. parkinson's disease. patient appears to be at his baseline level of dementia. -continue sinemet for now. #. obstructive sleep apnea. -bipap at night (). provigil for daytime sleepiness, initially held. #. atrial fibrillation. well rate controlled without therapy. -continue coumadin anti-coagulation with goal inr . note interaction of coumadin with levofloxacin. #. anemia. anemia at baseline. appears to be c/w iron deficiency anemia (fe 20, ferritin wnl, tibc elevated). started on ferrous sulfate today. will need outpatient colonoscopy. stools guaiac (-). #. fen. diet with ground consistency per swallow consult recs #. ppx. senna/colace/bisacodyl. warfarin for anticoagulation. ppi #. communication. with patient, caregiver , son (c) and (h), (w) #. code status. full code. #. dispo. d/c to rehab medications on admission: 1. coumadin 2.5 mg qd 2. carbidopa 25/100 1.5 tabs qd. 3. provigil 150 mg qd discharge medications: 1. carbidopa-levodopa 25-100 mg tablet sustained release sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 2. provigil 100 mg tablet sig: 1.5 tablets po once a day. disp:*45 tablet(s)* refills:*0* 3. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours): last dose on . 5. calcium carbonate 500 mg tablet, chewable sig: two (2) tablet, chewable po daily (daily). 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic q24h (every 24 hours). 9. warfarin 2 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care facility: - discharge diagnosis: lll pneumonia requiring icu course chf with preserved ef mitral regurgitation with flail mv leaflet parkinson's dementia discharge condition: stable to be discharged discharge instructions: if develop chest pain, shortness of breath, worsening fevers, cough, or any other symptoms, please call dr. or report to the nearest er. followup instructions: please call dr. at to schedule a follow up appointment. . provider: , md phone: date/time: 4:30 . provider: . & dr. phone: date/time: 10:30 procedure: non-invasive mechanical ventilation diagnoses: pneumonia, organism unspecified obstructive sleep apnea (adult)(pediatric) mitral valve disorders congestive heart failure, unspecified other pulmonary insufficiency, not elsewhere classified atrial fibrillation paralysis agitans iron deficiency anemia, unspecified other encephalopathy 

Answer: The patient is high likely exposed to