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: no known allergies / adverse drug reactions attending: chief complaint: weakness, fevers, and cough major surgical or invasive procedure: none history of present illness: 82yo greek speaking male w/ hx of copd, chf, dm been having increased cough, fevers, weakness, and worsening sob over the past few weeks. he was seen at the end of in and was treated for a copd exacerbation with steriods. during the first two weeks in he would have fevers, increasing weakness, and cough. he saw pcp and treated him with im ceftriaxone and augmentin. the pcp ordered ct chest on due to concern about post-obstructive pneumonia. he defervesed with the ceftriaxone, but the course of that finished and he began having fevers again. he was restarted on the ceftriaxone was told he had a double pneumnoia on . he normally uses 3l of nc at home 24 hours a day. his blood sugars have been increasing recently since the steriod course in with sugars in the 4-500s, which is new for him as his a1c is typically in the 6 range per the pcp. started him on regular insulin and 10 of lanuts recently to deal with the blood sugars. he was treated int he ed with vanc/ / and ceftriaxone and was given 3l of fluid. originally he was hypoxic and tachypnic was put on a venti mask, he was weaned to a 50% non rebreather. he was also given tylenol for a fever of 101.5. on arrival to the micu, the patient is in nad with slightly increased wob on 12 l non rebreather. the patient is greek speaking, but is able to communicate through his family that is at the bedside. he is moving all extremities, acting appropriately, and following commands. review of systems: (+) per hpi (-) denies recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies arthralgias or myalgias. past medical history: copd chf cor pulmonale dm pud right leg pvd s/p fem fem bypass social history: 140 year pack hx smoker, with abotu 70 years 1.5-2 packs per day. no etoh, no drugs. lives with daughter. family history: mother and father died of strokes. physical exam: admission exam: vitals: t:99.5 bp: 107/74 p: 105 r: 22 o2:99% general: alert, oriented, no acute distress w heent: non rebreather mask on, sclera anicteric, mmm, eomi, perrl neck: supple, jvp not elevated, no lad cv: distant heart sounds lungs: wheezes thoughout crackles at the right base abdomen: soft, non-tender, non-distended, bowel sounds present gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation discharge exam: general: awake, interactive, breathing comfortably. heent: perrl, anticteric sclera. cv: s1s2 rrr w/o m/r/g??????s. lungs: coarse bibasilar bs??????s and crackles, somewhat better yesterday. no wheezing. ab: positive bs??????s, nt/nd, no hsm noted. ext: no c/e, mild bilateral clubbing. 2+ dp in ue and le. neuro: alert, appropriately oriented. no focal motor deficits noted. pertinent results: 12:30pm lactate-3.8* 12:15pm glucose-361* urea n-24* creat-1.1 sodium-133 potassium-4.1 chloride-89* total co2-31 anion gap-17 12:15pm estgfr-using this 12:15pm ctropnt-0.01 12:15pm wbc-8.5 rbc-4.81 hgb-12.8* hct-41.3 mcv-86 mch-26.5* mchc-30.9* rdw-14.3 12:15pm neuts-76.0* lymphs-15.4* monos-7.3 eos-1.1 basos-0.2 12:15pm plt count-338 12:15pm pt-12.0 ptt-28.0 inr(pt)-1.1 cxr: final 12:15pm blood wbc-8.5 rbc-4.81 hgb-12.8* hct-41.3 mcv-86 mch-26.5* mchc-30.9* rdw-14.3 plt ct-338 04:52am blood wbc-5.0 rbc-3.69* hgb-9.9* hct-31.3* mcv-85 mch-26.9* mchc-31.7 rdw-14.4 plt ct-232 05:03am blood wbc-4.9 rbc-4.19* hgb-11.3* hct-35.4* mcv-85 mch-27.0 mchc-31.9 rdw-14.3 plt ct-279 12:30pm blood lactate-3.8* 12:15pm blood glucose-361* urean-24* creat-1.1 na-133 k-4.1 cl-89* hco3-31 angap-17 04:52am blood glucose-187* urean-15 creat-0.8 na-139 k-3.4 cl-104 hco3-28 angap-10 05:38pm blood glucose-319* na-137 k-4.3 cl-93* 05:03am blood glucose-220* urean-15 creat-0.9 na-136 k-4.1 cl-95* hco3-36* angap-9 04:00am blood glucose-156* urean-16 creat-0.9 na-137 k-3.8 cl-94* hco3-37* angap-10 brief hospital course: 82yo greek speaking male w/ hx of copd on 3l nc, chf, dm with pna that has been resistent to treatment over the past two weeks per his pcp. acute diagnoses # pneumonia / copd cxr shows mutiple inflitrates, febrile, no leukocytosis, history of copd on home oxygen, pcp says he had recurrent rml pneumonia, also long smoking history of 90 pk/years. ct chest from showed pneumonia and recs followup imaging for evaluation of any underlaying pathology such as neoplasm causing recurrent pna and obstructive picture when pneumonia has resolved. while in the micu his pneumonia was treated with iv vancomycin and zosyn. nebulizers were used for copd. a speech and swallow consult was requested during his admission for concern of aspiration risk. blood cx are pending at the time of discharge. # dm elevated blood glucose while in the micu. this was an issue prior to admission and is likely related to both his infectious process and the steriod course he was on prior to admission. both lantus and iss were increased with good control. # rash in groin nystatin was prescribed. chronic diagnoses # chf appeared to be hypo/euvolemic. furosemide was continued. # neuropathy home gabapentin was continued. # pud home omeprazole was continued. # hld home simvastatin was continued. transitional issues: # will need vascular follow up with dr. as well as a follow up cxr to evaluate the resolution of his pna and for any underlaying pathology. he will also need home nursing to follow his picc line and for family education for the duration of his iv antibiotics. # full code # hcp: medications on admission: preadmission medications listed are correct and complete. information was obtained from family/caregiver pcp by phone, estimated insulin dosing. 1. furosemide 60 mg po daily 2. doxazosin 4 mg po daily 3. amoxicillin-clavulanic acid 500 mg po q12h 4. glipizide 10 mg po bid 5. omeprazole 20 mg po daily 6. albuterol inhaler 1 puff ih q6h:prn wheeze 7. gabapentin 800mg qam & 1600mg hs po 8. daliresp *nf* (roflumilast) 500 mcg oral daily 9. simvastatin 20 mg po daily 10. ceftriaxone 1 g im daily 11. humalog 10 units bedtime insulin sc sliding scale using reg insulin 12. aspirin 325 mg po daily 13. lorazepam 1 mg po hs:prn anxiety hold for sedation 14. gabapentin 800 mg po qam discharge medications: 1. piperacillin-tazobactam 4.5 g iv q8h rx *piperacillin-tazobactam 4.5 gram every eight (8) hours disp #*15 vial refills:*0 rx *piperacillin-tazobactam 4.5 gram 4.5 g iv every eight (8) hours disp #*15 vial refills:*0 2. vancomycin 1000 mg iv q 12h rx *vancomycin 1 gram 1 g iv every twelve (12) hours disp #*10 vial refills:*0 3. furosemide 60 mg po daily 4. gabapentin 1600 mg po hs 5. gabapentin 800 mg po qam 6. lorazepam 1 mg po hs:prn anxiety hold for sedation 7. omeprazole 20 mg po daily 8. simvastatin 20 mg po daily 9. albuterol inhaler 1 puff ih q6h:prn wheeze 10. daliresp *nf* (roflumilast) 500 mcg oral daily 11. glipizide 10 mg po bid 12. doxazosin 4 mg po daily 13. aspirin 81 mg po daily rx *adult low dose aspirin 81 mg 81mg tablet(s) by mouth once a day disp #*90 tablet refills:*0 14. glargine 20 units bedtime insulin sc sliding scale using hum insulin discharge disposition: home with service facility: home solutions discharge diagnosis: pneumonia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were diagnosed with pneumonia. this infection required that you have antibiotics given directly into your blood. beacuse of this you will be sent home with a iv in your arm so that you can continue to take these medications at home. it is very important that you take these antiobiotics as directed. a visiting nurse will come to your home and help make sure you and your family understand everything that is involved in caring for your iv and taking your medications. if you have any questions please make sure to claify this with them as the correct timing and amounts of the antibiotics are very important. if you develop a fever of 101.0, chest pain, shortness of breath, worsening cough, redness, swelling, or pain at the iv site please return to the hospital immediately. medication changes: start: zosyn 4.5mg iv every 8 hours for the next five days. vancomycin 1000mg iv every 12 hours for the next five days. change: please change to lantus 10u subcutaenous at night stop: ceftriaxone 1g im daily please continue all of your other medications as prescribed followup instructions: it is very important that you follow up with your pcp in the next 2 days. your pcp will want to discuss your recent admission. procedure: central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified congestive heart failure, unspecified adrenal cortical steroids causing adverse effects in therapeutic use diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled peripheral vascular disease, unspecified personal history of tobacco use mononeuritis of lower limb, unspecified long-term (current) use of insulin other emphysema rash and other nonspecific skin eruption other postprocedural status peptic ulcer of unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction chronic pulmonary heart disease, unspecified 

Answer: The patient is high likely exposed to