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: evaluation for failure to wean from vent. possible pneumonia major surgical or invasive procedure: flexible bronchoscopy history of present illness: 78 m with complicated past medical history presented from for rigid bronchoscopy and possible tracheal stenting. patient spirometry consistent with copd and asthma. in he underwent a tracheostomy for prolonged intubation and has failed weaning since. recent symptoms include shortness of breath while on tracheostomy and increasing secretions. prior to admission to , sputum cultures were consistent with stenotrophomonas and pseudomonas bacteria as well as enterobacter. recent urine culture from was consistent with mrsa and proteus. - past medical history: copd, htn, diverticulosis, c.diff colitis in past, prostate ca s/p resection, peripheral vascular disease, chf with diastolic dysfunction, non st elevation mi in , chronic pain (l2 compression fracture, 9th rib fracture), hyperlipidemia, chronic anemia. social history: married. 50 pack-year history, quit 20 years ago. married. denies alcohol use. physical exam: no acute distress. sclerae anicteric. perrl. neck supple, no lymphadenopathy. tracheostomy in place. clean, dry. regular rate and rhythm. s1 s2 normal. no rubs, gallops mild end-expiratory wheezes. abdomen with peg tube in place. clean and dry. bowel sounds diminished but present. extremities cool but well perfused. limited movement of extremities. no edema. pertinent results: 03:47am blood wbc-17.5*# rbc-3.41* hgb-10.7* hct-33.6* mcv-99* mch-31.5 mchc-31.9 rdw-16.9* plt ct-738* 12:10am blood wbc-10.5 rbc-2.98* hgb-9.7* hct-28.5* mcv-96 mch-32.4* mchc-33.9 rdw-17.2* plt ct-746* 03:47am blood plt ct-738* 12:10am blood plt ct-746* 12:10am blood pt-12.0 ptt-notified d inr(pt)-1.0 03:47am blood glucose-112* urean-49* creat-1.3* na-140 k-4.4 cl-98 hco3-30 angap-16 12:10am blood glucose-90 urean-49* creat-0.9 na-143 k-4.7 cl-99 hco3-34* angap-15 12:10am blood alt-33 ast-23 alkphos-227* amylase-40 totbili-0.5 03:47am blood calcium-9.1 phos-5.1* mg-2.4 12:10am blood albumin-3.4 calcium-9.9 phos-4.9* mg-2.7* 12:10am blood vanco-<2.0* 12:10am blood greenhd-hold 10:59pm blood type-art po2-106* pco2-49* ph-7.48* caltco2-38* base xs-11 12:10am urine color-straw appear-clear sp -1.015 10:57pm urine blood-tr nitrite-neg protein-100 glucose-neg ketone-tr bilirub-sm urobiln-0.2 ph-5.0 leuks-sm 12:10am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-7.0 leuks-sm 10:57pm urine rbc-0-2 wbc-* bacteri-mod yeast-none epi-0 12:10am urine rbc-0 wbc-* bacteri-none yeast-none epi-1 10:57 pm sputum site: endotracheal gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 1+ (<1 per 1000x field): gram negative rod(s). 1+ (<1 per 1000x field): gram positive cocci. in pairs. 11:38 pm sputum site: endotracheal source: endotracheal. gram stain (final ): <10 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gram positive cocci. in pairs and clusters. 2+ (1-5 per 1000x field): gram negative rod(s). quality of specimen cannot be assessed. respiratory culture (pending): cardiology report echo study date of patient/test information: indication: left ventricular function. weight (lb): 145 bp (mm hg): 115/40 hr (bpm): 59 status: inpatient date/time: at 14:43 test: portable tte (complete) doppler: full doppler and color doppler contrast: none tape number: 2006w052-0:37 test location: west sicu/ctic/vicu technical quality: suboptimal referring doctor: dr. measurements: left atrium - long axis dimension: 3.7 cm (nl <= 4.0 cm) left ventricle - septal wall thickness: 1.0 cm (nl 0.6 - 1.1 cm) left ventricle - inferolateral thickness: 1.0 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 4.7 cm (nl <= 5.6 cm) left ventricle - systolic dimension: 2.7 cm left ventricle - fractional shortening: 0.43 (nl >= 0.29) left ventricle - ejection fraction: 70% (nl >=55%) aorta - valve level: 3.2 cm (nl <= 3.6 cm) aortic valve - peak velocity: 1.4 m/sec (nl <= 2.0 m/sec) mitral valve - e wave: 0.8 m/sec mitral valve - a wave: 0.9 m/sec mitral valve - e/a ratio: 0.89 mitral valve - e wave deceleration time: 252 msec interpretation: findings: left atrium: normal la size. right atrium/interatrial septum: normal ra size. left ventricle: normal lv wall thickness. normal lv cavity size. suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. overall normal lvef (>55%). tvi e/e' >15, suggesting pcwp>18mmhg. transmitral doppler and tvi c/w grade i (mild) lv diastolic dysfunction. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic root diameter. focal calcifications in aortic root. aortic valve: aortic valve not well seen. no as. mitral valve: mildly thickened mitral valve leaflets. no mvp. mild mitral annular calcification. mild thickening of mitral valve chordae. calcified tips of papillary muscles. no ms. mild (1+) mr. prolonged (>250ms) transmitral e-wave decel time. lv inflow pattern c/w impaired relaxation. pericardium: no pericardial effusion. general comments: suboptimal image quality - poor echo windows. suboptimal image quality - poor parasternal views. suboptimal image quality - poor apical views. conclusions: the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef 70%). tissue velocity imaging e/e' is elevated (>15) suggesting increased left ventricular filling pressure (pcwp>18mmhg). transmitral doppler and tissue velocity imaging are consistent with grade i (mild) lv diastolic dysfunction. right ventricular chamber size and free wall motion are normal. the aortic valve is not well seen. there is no aortic valve stenosis. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. there is no pericardial effusion. electronically signed by , md on 15:21. physician: radiology final report portable abdomen 8:08 am portable abdomen reason: nausea / vomiting r/o obstruction medical condition: 78 year old man with resp failure s/p aspiration reason for this examination: nausea / vomiting r/o obstruction indication: 78-year-old man with respiratory failure status post aspiration. nausea and vomiting. rule out obstruction. comparison: none. technique: a single supine portable radiograph of the abdomen and pelvis was obtained. a paucity of bowel gas is identified with no obviously dilated bowel identified. stool is identified within the colon. g tube is identified and appears unremarkable. no obvious evidence of free intraperitoneal air, however, full evaluation for free air is limited by supine technique. evaluation of osseous structures reveals an ill-defined bony formation abuting the right acetabulum. involvement of the right femur cannot be excluded. recommend plain radiograph of hips for further evaluation if a work up has not been performed in the past. the study and the report were reviewed by the staff radiologist. brief hospital course: patient was admitted to the csru at in the evening of for further evaluation. vancomycin and zosyn was started for suspected pneumonia. urine, sputum and blood cultures were sent with sputum gram stain showing 4+ (>10 per 1000x field): gram positive cocci n pairs and clusters, and 2+ (1-5 per 1000x field): gram negative rod(s). cultures are pending. urine showed staph aureus coag +. 10,000-100,000 organisms/ml. with sensitivites pending. echocardiogram was obtained and showed lvef = 70%. patient underwent a flexible bronchoscopy on that showed severe epiglottic and supra-epiglottic edema. because of this, it was deemed unsafe to proceed with a rigid bronchoscopy. gram . on patient also experienced nausea and a probable aspiratory event. he remained hemodynamically stable and respiratory status was not compromised. on the evening of he spiked a fever to 103 degrees f. this was thought to be secondary to the aspiration event. repeat gram stain cultures showed 1+ (<1 per 1000x field): gram negative rod(s), 1+ (<1 per 1000x field): gram positive cocci in pairs. because of this, antibiotics were changed to linezolid and cefepime. famotidine frequency was increased to and patient was started on reglan. he is being discharged to rehabilitation facility on an 8 day course of antibiotics and will follow up with dr. for possible rigid bronchoscopy in 4 weeks. discharge medications: 1. bisacodyl 10 mg suppository : suppositorys rectal hs (at bedtime) as needed. 2. heparin (porcine) 5,000 unit/ml solution : one (1) injection tid (3 times a day). 3. acetaminophen 160 mg/5 ml solution : po q4-6h (every 4 to 6 hours) as needed for fever. 4. simethicone 80 mg tablet, chewable : one (1) tablet, chewable po qid (4 times a day) as needed for gas pain. 5. buspirone 5 mg tablet : one (1) tablet po tid (3 times a day). 6. isosorbide dinitrate 10 mg tablet : one (1) tablet po tid (3 times a day). 7. cefepime 2 g recon soln : one (1) recon soln injection q24h (every 24 hours) for 8 days. disp:*8 recon soln(s)* refills:*0* 8. metoclopramide 5 mg/ml solution : one (1) injection q6h (every 6 hours). 9. linezolid 600 mg tablet : one (1) tablet po q12h (every 12 hours) for 8 days. 10. ferrous sulfate 300 mg/5 ml liquid : one (1) po daily (daily). 11. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 12. metoprolol tartrate 50 mg tablet : one (1) tablet po bid (2 times a day). 13. senna 8.6 mg tablet : 1-2 tablets po bid (2 times a day) as needed. 14. therapeutic multivitamin liquid : one (1) cap po daily (daily). 15. docusate sodium 150 mg/15 ml liquid : one (1) po bid (2 times a day). 16. fluticasone-salmeterol 250-50 mcg/dose disk with device : one (1) disk with device inhalation (2 times a day). 17. albuterol-ipratropium 103-18 mcg/actuation aerosol : two (2) puff inhalation q4h (every 4 hours). 18. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr po bid (2 times a day). 19. lorazepam 2 mg/ml syringe : one (1) injection prn () as needed for anxiety. 20. morphine 2 mg/ml syringe : one (1) injection q4h (every 4 hours) as needed for pain. 21. tube feeds 1. tubefeeding: start now; nutren pulmonary full strength; starting rate: 20 ml/hr; advance rate by 20 ml q4h goal rate: 65 ml/hr residual check: q4h hold feeding for residual >= : 100 ml flush w/ 30 ml water q8h 22. outpatient lab work please check liver function tests, chem 7 and cbc once per week of more freaquently if deemed necessary. repleate electrolytes as needed. discharge disposition: extended care facility: - discharge diagnosis: upper airway swelling, aspiration pneumonia, copd, failure to wean from vent. discharge condition: stable to rehabilitation facility. discharge instructions: come to er if having worsening pains, fevers, chills, nausea, vomiting, shortness of breath, chest pain, redness or drainage about the wounds, or if there are any questions or concerns. patient to take antibiotics and other medications as directed. patient to take all medications as directed. please keep all follow up appointments. please call dr. office at with questions or concerns. followup instructions: please follow up with your primary care physician. call dr. at to schedule your follow up appointment. your appointment should be in 4 weeks. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnostic ultrasound of heart other bronchoscopy diagnoses: congestive heart failure, unspecified unspecified essential hypertension personal history of malignant neoplasm of prostate peripheral vascular disease, unspecified other and unspecified hyperlipidemia pneumonitis due to inhalation of food or vomitus methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site old myocardial infarction chronic obstructive asthma, unspecified diastolic heart failure, unspecified chronic respiratory failure tracheostomy status other diseases of trachea and bronchus edema of larynx 

Answer: The patient is high likely exposed to