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: hypotension major surgical or invasive procedure: r femoral line r ij r a-line history of present illness: 66 year old man with history of cad s/p stemi and stenting, with severe ischemic cmp (ef 15-20%) on home milrinone + pseudoephedrine, dm, pvd, copd who presents from rehab with hypotension and hypothermia. . pt with worsening renal fxn at rehab. received kayexelate, insulin and d50 on for hyperkalemia. then found to have bp 50s-70s systolics with wbc of and 7% bands sent to ed. . of note, had recent prolonged hospitalization from to with rsv and mrsa pna infections and subsequent volume overload. pt was again admitted from to for atypical cp relieved by gi cocktail. course c/b acute on chronic chf. . in the ed, his vs were t96.2, 73, 66/45, 22, 92% nrb. wbc of 26 with left shift. lactate of 5.2 -> 4.1. arf with cr of 3.7 and hyperkalemic. inr of 22. cxr with mild pulmonary edema and unchanged old l lung opacification (s/p pneumonectomy). r fem line placed b/o inr of 22. pt was intubated for respiratory distress with succ, etomidate and versed. 1l ivf, then started on dopa gtt with map remaining abovee 60. pt received vanc and zosyn. vit k 10 iv and 2 bags of ffp for inr of 22. also 1 amp bicarb, 5u insulin and amp d50 for hyperkalemia. pt being admitted for sepsis to icu. . on arrival to the micu, he was nonresponsive, intubated on 100%fio2. past medical history: 1) cad: most recent cath with bms stents to rca/om1 - anterior stemi in with stents x 2 to lad, course c/b cardiogenic shock requiring balloon pump. - h/o bms to proximal and distal lad in 2) chf, severe regional left ventricular systolic dysfunction, ef 15-20% on home milrinone 3) copd: on 2l nc at home. pft's : marked obstructive ventilatory defect. the reduced fvc is likely due to gas trapping but a coexisting restrictive defect cannot be excluded. suggest lung volume measurements if clinically indicated. fvc 62% predicted, fev1 39% predicted, fev1/fvc 63% predicted. 4) hypercholesterolemia 5) gout 6) pvd s/p left iliac artery stent in . 7) diabetes mellitus 8) non-small-cell lung carcinoma, status post left pneumonectomy 9) gastroesophageal reflux disease 10) paroxysmal atrial fibrillation, chronically anticoagulated on coumadin 11) hypertension social history: h/o prior tobacco abuse x 60 pack years; quit in . there is no history of alcohol abuse. family history: there is no family history of premature coronary artery disease or sudden death. father had cad in old age. sister with mvp. physical exam: vs: t 96.9, bp 82/54 (on dopa), hr 85, rr 17, o2 82% on ac 500x16, fio2 0.5, peep 5 -> o2 100% on fio2 1.0 gen: wdwn middle aged male, intubated, sedated. heent: ncat. perrl. ett in place. neck: supple. jvd difficult to assess. cv: rr, normal s1, s2. systolic murmur, best heard over apex. chest: no bs over l lung. r lung cta anteriorly. abd: obese, soft, ntnd, r femoral line in place ext: faint peripheral pulses, cool, no significant edema skin: abdominal wall hematomas, no rash. neuro: nonresponsive, sedated. pertinent results: on admission: 116 83 74 =========== 132 6.4 17 3.7 . ck: 25 mb: notdone ca: 9.1 mg: 2.3 alt: 81 ap: tbili: 2.4 alb: ast: 89 ldh: dbili: tprot: : lip: 15 . wbc 26.2, hct 31.4, plt 335 . lactate 5.2 inr 22 . cxr in ed: post-left pneumonectomy changes are again evident. consistent with the given history, picc line has been placed from a left upper extremity approach. the distal tip overlies the mediastinum. it is approximately at the superior cavoatrial junction. please note the extreme right costophrenic angle has been excluded from view as it has been on prior exams. there is mild prominence of the pulmonary vasculature likely indicative of mild edema. no definite large effusion is seen. there is no pneumothorax. impression: picc line as above. mild volume overload. . echo in ed: the left atrium is markedly dilated. the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. the mitral valve leaflets are moderately thickened. moderate (2+) mitral regurgitation is seen. severe tricuspid regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. impression: severely depressed left systolic function with ef of 10%- slightly less than on prior study. moderate mr and severe tr. mild pulmonary hypertension. preliminary report developed by a cardiology fellow. not reviewed/approved by the attending echo physician. . echo : the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is moderate regional left ventricular systolic dysfunction with near akinesis of the inferior wall and the distal half of the anterior septum and anterior wall, distal lateral wall. the apex is mildly aneurysmal and akinetic. the remaining segments are moderately hypokinetic. no masses or thrombi are seen in the left ventricle. the right ventricle is mildly dilated with moderate global free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: normal left ventricular cavity size with extensive regional systolic dysfunction c/w multivessel cad. mild mitral regurgitation. moderate pulmonary artery systolic hypertension. compared with the fellow study of earlier in the day, an inferior aneurysm is not appreciated on the current study. it likely represented and off-axis apical view. . renal u/s: no obstruction or hydro . previous studies: . cardiac cath on 1. two vessel coronary artery disease. 2. successful stenting of the om and rca with bare metal stents. . cardiac catheterization 1. three vessel coronary artery disease. 2. cardiogenic shock. 3. acute anterior myocardial infarction 4. successful ptca and stenting of the proximal-mid left anterior descending artery with two overlapping bare metal stents. 5. successful placement of an iabp via the right common femoral artery. . echo impression: severe regional left ventricular systolic dysfunction, c/w cad. moderate right ventricular systolic dysfunction. moderate mitral and triscuspid regurgitation. moderate pulmonary hypertension. brief hospital course: 66 year old man with history of cad s/p stemi and stenting (), with severe ischemic cmp (ef 15-20%) on home milrinone + pseudoephedrine, dm, pvd, copd who presents from rehab with hypotension and hypothermia, found to in septic shock, pressor dependent, with mrsa bacteremia (from picc line) and esbl klebsiella in urine and sputum. made cmo on . pt died minutes after extubation on at 1:40pm. . # septic shock: ivf-refractory hypotension from sepsis, worse with oliguria again, cardiomyopathy contributing. initial lactate 6.0, repeat 1.9. initially mrsa bacteremia from picc line and esbl klebsiella in urine + sputum. one day of stress dose steroids on admit. transiently on dopa and vasopressin, currently on levophed, vasopressin and milrinone drips, with escalation of pressor requirement . on vanc/zosyn until , switched to vanc/ on b/o esbl klebsiella from urine + sputum. developed worsening vap with increased sputum with gnr's, low-grade fever, worse hypotension, increased wbc, infiltrate. pt was continued on levophed, milrinone gtt, vasopressin, eventually also epinephrin gtt. he was continued on vanc and . sputum with sparse acinetobacter to bactrim, started iv bactrim. also empiric hydrocortizone 50mg iv q6. made cmo on . pt died minutes after extubation on at 1:40pm. . # respiratory failure: intubated in ed for respiratory distress. known copd, also with sepsis. pt has only one lung after resection for lung cancer. failed psv trial on but could be extubated on . required more o2 on bipap, lasix 40 iv w/o effect. frank blood from ngt, reintubated at 5am on . started lasix gtt on , not effective at 10/hr, added on diuril 500 iv bid with good response, stopped as autodiuresing. made cmo on . pt died minutes after extubation on at 1:40pm. . # ams: likely toxic-metabolic (infxn, sedation, hypoxia). . # arf: on admission with creatinine 3.7 up from baseline of 1.2 -1.4. renal u/s w/o obstruction. likely prerenal etiology +/- atn. monitor uop closely with sepsis. holding dig. treat hyperkalemia as needed. appreciate renal recs. hyaline casts in urine c/w pre-renal or poor forward flow. cr nadir at 1.5 () but uop decreasing, likely additional insult from worsening hypotension. . # supratherapeutic inr: inr of 22 on admission in setting of arf on coumadin. received vitamin k 10 iv and 4 bags of ffp, inr came down to 2.0 eventually but is trending up intermittently requiring more vit k and ffp during active bleeds. coumadin was held as well as isolated doses of asa/plavix during severe bleeding (held twice total). pt received ffp and prbc as needed (, )with inr goal < 2.0 and hct >25 during active bleeding episodes. . # thrombocytopenia: improved. plt of 113 on , down from 335 on admission. heparin products were transiently held but hit ab came back negative. dic labs were unremarkable. . # cmp: ef 15%. on home milrinone and pseudoephedrine. cxr with mild pulmonary edema on admission. pt received ivf boluses for hypotension as needed. diuretics initially held then diuresed as above. continued milrinone drip as above. outpatient cards attg was following. . # cad: s/p stemi c/b by cardiogenic shock requiring balloon pump. trop 0.09 -> 0.07 in ed. held intermittently isolated doses of asa/plavix as needed for active bleeding. cardiac enzymes remained not significantly elevated and were not followed further. . # paf: the patient has a h/o paf. holding dig b/o arf. no coumadin or heparin gtt per cards. pt was continued on amio. . # anemia: baseline hct 27-32. intermittent bleeding from ett and brbpr from likely hemorrhoids. received prbc as needed with hct goal > 25 during active bleeds. also vit k and ffp as needed as above. prbc on , . . # lft elevations: likely from shock liver. trended down. were monitored. . #.dm2: fs qid, transiently on insulin gtt, then riss. . # hypothyroidism: tsh wnl. continued l-thyroxin. . #.fen: npo. tfs. held as needed if high residuals. repleted electrolytes as needed. . #.ppx: ppi, p-boots, supratherapeutic inr, bowel regimen . # access: r femoral line , r ij (trauma line) placed , r a-line placed , picc removed medications on admission: lasix 40 milrinone infusion 0.6 mcg/kg/min hydrocodone/tylenol q6h prn lidocaine patch daily tiotropium inhal daily calium/vit d daily mylanta 30ml daily bowel regimen dig 0.125 qod warfarin 1.5mg daily colesevelam 1875 q12h iss amio 200 daily pseudoephedrine 30mg qid levothyroxine 0.125 daily iron 325 daily asa 325 daily ppi 40 daily plavix 75 daily colechaciferol daily mvi daily spironolactone 25 daily tylenol prn discharge medications: made cmo on . pt died minutes after extubation on at 1:40pm. discharge disposition: expired discharge diagnosis: made cmo on . pt died minutes after extubation on at 1:40pm. discharge condition: . discharge instructions: . followup instructions: . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization diagnoses: hyperpotassemia thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux urinary tract infection, site not specified friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver acute kidney failure, unspecified severe sepsis unspecified acquired hypothyroidism atrial fibrillation personal history of malignant neoplasm of bronchus and lung infection with microorganisms resistant to penicillins percutaneous transluminal coronary angioplasty status methicillin susceptible staphylococcus aureus septicemia other specified forms of chronic ischemic heart disease acute respiratory failure cardiogenic shock septic shock old myocardial infarction long-term (current) use of anticoagulants other and unspecified infection due to central venous catheter 

Answer: The patient is high likely exposed to