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: past medical history: 1. hypertension. 2. prostate cancer status post prostatectomy in , status post bilateral hip arthroplasty for osteoarthritis in and status post left hip left hip hardware removal for septic joint in . 3. e. coli bacteremia in . 4. epidural abscess in , status post l2 to l4 diskectomy, status post left shoulder prosthesis. 5. anemia on procrit on 6/. 6. monoclonal gammopathy with questionable conversion to multiple myeloma and nonischemic cardiomyopathy with ejection fraction of 23%, 30% lad lesion on cardiac catheterization. 7. hemorrhoids. 8. lyme disease. 9. colon polyps, status post colonoscopy in with polyps found to be precancerous. allergies: the patient is allergic to penicillin and biaxin. social history: the patient is a former history professor ; lives with wife in . there are two grown daughters, one of whom is an medical doctor. family medical history: noncontributory. physical examination: examination revealed the following: vital signs: temperature 99.7; blood pressure 101/51; pulse 95; respiration 12; oxygen saturation 100% on rebreather. general: in general, the patient is a cachectic, white male, who appeared diaphoretic and anxious in respiratory distress with cool extremities. neck was supple. external jugular vein was full and it was difficult to assess his jugular venous distention, since the patient was supine. heart was regular with normal s1 and s2 and an s3 was audible. lungs had rales audible at the bases bilaterally. he had bronchial breath sounds in the mid-lung field on the left. abdomen was soft, nontender, and nondistended with normal bowel sounds; no masses appreciable. skin was cool and diaphoretic. extremities were cool and mottled. he had weak pedal pulses. laboratory data: labs on admission revealed the following: white count 8.0, hematocrit 20.6, platelet count 180; sodium 132; potassium 4.5; chloride 97; bicarbonate 25, bun 65; creatinine 0.9; glucose 143, pt 9.6; inr 2.5, ptt 43.6. initial ck was 190 with mb fraction of 28 for an index of 14.7, initial troponin 22.9. chest x-ray revealed tortuous aorta, cardiomegaly, hilar prominence on the right with fluid in the right fissure. the interstitium appeared congested with no large pleural effusions. the ekg revealed the following: normal sinus rhythm at 98 beats per minute with normal axis; intraventricular conduction delay; and st elevations of 1-mm in leads v1 to v2, and st depressions in v4 through v6 of 3-mm. compared with the previous ekg, there was no much change, but in the previous ekg, the patient had a troponin level of more than 20. when compared to the ekg from , the patient then had no intraventricular conduction delay and no st elevations or depressions. hospital course: in the emergency room, the patient's blood pressure declined to 69/37 and the oxygen saturation also worsened. he was started on a dopamine drip and in this setting he became increasingly diaphoretic, agitated and confused. he was, therefore, intubated for airway protection and hypoxia. he was given ativan and haldol for sedation. a central venous catheter was placed in his right internal jugular vein, which was later changed to a cordis for placement of a swan-ganz catheter. the patient was given packed red blood cells quickly and he was transfused a total of four units on his first night as he was transferred to the medical intensive care unit. a swan-ganz catheter was placed and revealed initial readings which showed a pulmonary capillary wedge pressure of 24, pa pressure of 46/27, central venous pressure of 11, cardiac output of 3.6, cardiac index of 1.8, and systemic vascular resistance of 1326. these values were on 9 mcg per minute of dopamine. hospital course: the hospital course by system is as follows: #1. cardiovascular: the patient was felt to be in cardiogenic shock secondary to a non-q-wave mi in the setting of demand ischemia from his fallen hematocrit. his pulmonary function was supported with dobutamine, which improved his cardiac output by swan-ganz catheter. as the dobutamine was weaned off, however, the patient experienced worsening congestive heart failure and worsening renal perfusion. therefore, the dobutamine was restarted and hydralazine was added in an effort to afterload reduce his obviously failing heart. the patient's blood pressure remained relatively low due to his poor cardiac output and digoxin was started in an effort to improved his cardiac output. at discharge, the patient's dopamine had been weaned off, but he was still requiring dobutamine for inotropic support. as far as his heart rhythm, the patient went into atrial fibrillation, which was new for him while on dobutamine. he did not respond to iv diltiazem. dc cardioversion was also attempted without success. he was then loaded on amiodarone with the hopes of another attempt at cardioversion; however, he spontaneously reverted to a sinus rhythm. unfortunately, as the dobutamine was restarted, the patient again went into atrial fibrillation, but again, spontaneously converted after less than 48 hours. by previous cardiac catheterization it was known that the patient had only 30% stenosis in his lad. cardiology was consulted and felt that the catheterization was not warranted in this patient. his cardiac enzymes, ck peaked at a level of 422; with an peak index of 13.0. troponin peaked at 37. #2. pulmonary: the patient was initially treated for a possibility pneumonia with vancomycin. however, it was quickly felt that the patient did not have an infectious pneumonia. the patient did, however, go into worsening pulmonary edema, and he was initially intubated for hypoxic failure. the patient was extubated on hospital day #3, and did fairly well with a blow-by face mask. on physical examination he was found to have bilateral pleural effusions. he also continued to have crackles at the bases. however, he could not tolerate diuresis given his tenuous blood pressure. #3. gastrointestinal: the patient was presumed to have a hematocrit drop from a gi bleed, however, the patient at no time had melena or further bright red blood per rectum. the patient has a history of internal hemorrhoids and it was postulated that this was the source of his bleeding. abdominal ct showed no evidence of retroperitoneal bleed. the patient was transfused to keep his hematocrit greater than 30, given his ischemic heart condition. he required a total of 11 units of packed red blood cells. #4. infectious disease: the patient was initially treated with levofloxacin and vancomycin. this was thought to cover not only the e. coli bacteremia, for which he was hospitalized several months earlier, but also to cover possible pneumonia for bacteremia. blood cultures grew one out of four bottles of coagulase-negative staphylococcus aureus and the vancomycin was subsequently discontinued. #5. renal: in the setting of poor cardiac output and hypotension, the patient experienced acute renal failure and had decreased urine output. he had an increase in his creatinine from a baseline of 0.7 to 1.4. his urine output eventually improved. his electrolytes remained stable. condition on discharge: fair. discharge status: the patient is being discharged home with hospice care. after extensive discussion with the patient and his family, it was decided that he had an extremely poor prognosis given his poor cardiac status on admission, combined with this further insult during this admission. it was the patient and the patient's family wishes that he return home to be treated with compassionate care. discharge diagnoses: 1. non-q-wave myocardial infarction. 2. cardiogenic shock. 3. gi bleed. 4. congestive heart failure. discharge medications: (discharge medications will be added in an addendum to follow). , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube other electric countershock of heart pulmonary artery wedge monitoring monitoring of cardiac output by other technique other irrigation of (naso-)gastric tube diagnoses: subendocardial infarction, initial episode of care congestive heart failure, unspecified acute kidney failure, unspecified iron deficiency anemia secondary to blood loss (chronic) atrial fibrillation acute respiratory failure bacteremia cardiogenic shock hemorrhage of gastrointestinal tract, unspecified 

Answer: The patient is high likely exposed to