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: the patient is a year old gentleman with a past medical history significant for intermittent atrial fibrillation and benign prostatic hypertrophy, who was evaluated at an outside hospital for right shoulder pain, unclear of the work-up done at the outside hospital as there was no documentation. history was obtained from the daughter. the patient was seen at an outside hospital and was discharged. the patient continued to have shoulder pain, change in mental status and was sent here to . in the emergency department, the patient had denied chest pain and shortness of breath. he was admitted to the coronary intensive care unit for asymptomatic bradycardia. he was seen by the electrophysiology service who did not see need for pacemaker or asymptomatic winkebach. chest x-ray revealed a retrocardiac opacity, questionable pneumonia and 4 out of 4 blood cultures were positive for gram negative rods which were identified as pan sensitive klebsiella. the patient has reported allergies to multiple antibiotics including cephalosporins which cause anaphylaxis, quinolones which cause rash and unclear childhood penicillin allergy and unclear allergy to macrolides. repeat chest x-ray showed improvement of retrocardiac opacity. the patient was transferred from the ccu to the medical intensive care unit for decreased urine output which had resolved over one day and was transferred to the floor. past medical history: significant for benign prostatic hypertrophy, atrial fibrillation, history of gastrointestinal bleed in . status post skin cancer, in remission, unclear when. skin cancer was diagnosed. unclear of treatment. medications on discharge: the patient was on aztreonam 250 mg q. six hours which was started on , finasteride 5 mg q. day, pantoprazole 40 mg q. day, colace 100 mg twice a day, tylenol prn and heparin subcutaneous. as previously stated, allergies are as follows: cephalosporin causing anaphylaxis, quinolone causing rash, penicillin unclear childhood allergy, macrolides, unclear reaction. home medications: prilosec. finasteride. social history: lives in with private caretaker. family history: noncontributory. physical examination: vital signs on transfer to the floor revealed 97.0; blood pressure 144/86; pulse of 51; saturating 97% on room air. he is lethargic, elderly gentleman, appearing younger than his stated age, in no apparent distress. head, eyes, ears, nose and throat: he has a right surgical pupil. left pupil was 2 mm which was minimally reactive. his oropharynx is dry. neck is supple without lymphadenopathy. no jugular venous distention. chest: he had bronchial breath sounds bilaterally throughout. cardiac examination: bradycardiac and irregular with a normal s1 and s2, no murmurs. abdomen: quiet bowel sounds, some slight tenderness on deep palpation but otherwise soft. no hepatosplenomegaly. extremities: left heel eschar, 2 by 2 cm without erythema or proximal streaking. the patient also has a left thigh pressure sore which does not appear to be infected. neurologically, he is alert and oriented times one. laboratory data: white count of 21.1 with a left shift; 91 neutrophils, 5 lymphocytes, 4 monocytes. hematocrit of 33.0. platelets of 143. ptt of 25.3; inr of 1.1. sodium of 142; potassium of 4.0; chloride of 114; bicarbonate of 20; bun 35; creatinine 1.3; glucose 171. alt of 15; ast of 24; ldh of 148. alkaline phosphatase of 154. total bilirubin of 1.5. albumin 2.7. calcium 8.1. magnesium of 2.1. phosphorus of 3.2. tsh of .68. he did have a calculated of .1%. urinalysis showed large blood, negative leukoesterase, 20 to 50 red cells, 0 to 2 white cells, no bacteria. again, he had blood cultures, four bottles, positive for pansensitive klebsiella. hospital course: on transfer to the floor, the patient was continued on aztreonam until intravenous access was lost. intravenous team could not place another peripheral line. the patient's daughter refused central venous access. the patient was started on oral levofloxacin and continued to do well. klebsiella was sensitive to quinolones, although the patient has a stated rash to quinolones. there was no sign of rash or reaction to the medicine during the course of his hospital stay. his fluoroquinolone should be continued through and discontinued after that. this will give him a total two week course of antibiotics. most likely source of his klebsiella is a pulmonary source. the patient could not tolerate ct of the abdomen. right upper quadrant and total abdominal ultrasound was negative. mental status: the patient was originally admitted for change in mental status. he responded well initially to intravenous fluids and then with improvement of his infection. his third issue is his acute renal failure. the patient did have of less than 1% and slightly elevated creatinine above his baseline. this also responded with intravenous hydration. fourth issue is his asymptomatic bradycardia. he has mobitz type i or wenckebach heart block. he was evaluated by the electrophysiology service. no pacer will be placed. he did have transthoracic echo done which showed an ejection fraction of 40 to 45%. fluids, electrolytes and nutrition: speech and swallow did see the patient at the bedside and assessed adequate function. he was encouraged to take increased p.o. condition on discharge: fair. discharge status: rehabilitation facility. medications on discharge: albuterol neb prn. levofloxacin 250 mg p.o. q. day. should continue through for a full two week course of antibiotics for his klebsiella bacteremia. finasteride 5 mg p.o. q. day. colace 100 mg p.o. twice a day. pantoprazole 40 mg p.o. q. day. tylenol prn. the patient will follow-up with dr. , his primary care provider, discharged from the rehabilitation facility. dr., 12-746 dictated by: medquist36 d: 01:43 t: 07:13 job#: procedure: diagnostic ultrasound of heart diagnoses: pneumonia, organism unspecified acute kidney failure, unspecified atrial fibrillation other septicemia due to gram-negative organisms adult failure to thrive pain in joint, shoulder region other second degree atrioventricular block 

Answer: The patient is high likely exposed to