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: penicillins / sulfonamides / latex / lactose attending: chief complaint: fever, tachycardia major surgical or invasive procedure: none history of present illness: 70yo with pmh significant for chronic afib on coumadin, rate-controlled, and relatively recent soft tissue surgery with fever, cough productive of brown sputum x 4 d, starting 1d after receiving dtap and pnuemovax. + cough, shaking chills, + lethargy, describes poor/minimal po intake. - dysuria, + loose stools x 2 months. no cp, sob, n/v/diarrhea. . went to , where she was 101.5 in office, o2 sats 97%, crackles at right base, with hr in the 180s. she was then sent to ed for iv fluids, blood cultures, cxr, antibiotics. in ed, initially, sbps >100, but sbps dropped to 70s upon standing for cxr. got ivfs, bp unresponsive, so sepsis line placed and started on neosynephrine. asymptomatic throughout. cxr showed rll pna, so pt. was started on ceftriaxone/azithromycin. lactate 2.3-->1.8. pt. got cardiology consult in ed, who recommended not to start amio, and to treat infectious process. past medical history: atrial fibrillation, was on amio, but stopped achilles tendonitis osteoarthritis rectal prolapse hyperlipidemia osteopenia social history: worked as psychiatric social worker at in past, currently in private practice as a psychologisy smoke until , no smoking since. + occasional etoh. family history: nc physical exam: on admission: vitals: 99.1, 123/87 on 1 mg/kg/min neo, 135 in afib, 20/ 95% on 3l svo2 75%, cvp 14-16 gen: tired appearing, pleasant, cooperative, nad heent: perrl, eomi, mm slightly dry. cv: tachy, irrefularly irregular, no mrgs noted pulm: decreased bs r base, + mild crackles and egophany in same area. no wheezes abd: soft, non distended, nontender, +bs ext: lukewarm extremiteis, dp 2+ bilaterally neuro/psych: alert and oriented, cn iii-xii individually tested and intact pertinent results: 11:40am blood wbc-9.6 rbc-4.36 hgb-14.1 hct-42.3 mcv-97 mch-32.3* mchc-33.3 rdw-12.8 plt ct-237 07:55am blood wbc-17.5* rbc-3.52* hgb-11.6* hct-34.0* mcv-96 mch-32.9* mchc-34.1 rdw-14.3 plt ct-341 10:00am blood wbc-10.9 rbc-3.59* hgb-11.8* hct-35.1* mcv-98 mch-32.9* mchc-33.6 rdw-13.6 plt ct-473* 09:35pm blood neuts-76.0* bands-0 lymphs-19.3 monos-3.5 eos-0.5 baso-0.7 10:00am blood glucose-143* urean-19 creat-1.1 na-140 k-4.1 cl-106 hco3-30 angap-8 11:40am blood glucose-127* urean-18 creat-1.0 na-137 k-3.9 cl-102 hco3-23 angap-16 10:00am blood calcium-9.4 phos-3.2 mg-2.2 11:40am blood tsh-0.64 05:15am blood vitb12-669 folate-12.1 11:40am blood t4-7.2 05:06am blood cortsol-34.6* 11:34pm blood cortsol-12.5 03:44pm blood lactate-2.3* 02:08am blood lactate-1.5 cxr : 1. right ij cvl tip within the mid svc. no evidence of pneumothorax. 2. developing right lower lobe pneumonia cxr :in comparison with the study of , there is again an area of increased opacification at the right base medially consistent with the clinical impression of pneumonia. this appears to be less prominent than on the previous examination. the right central catheter has been removed. brief hospital course: 70yo with chronic afib with hypotension and afib with rvr, likely pneumonial sepsis . # afib with rvr: it was felt to be likely an exacerbation secondary to infection. her tsh was normal. given her hypotension, we initially avoided diltiazem and beta blockade. she was digoxin loaded for rate control with good effect, and as blood pressure increased, changed to beta blocade with uptitration of metoprolol. cardiology recommended against amiodarone given thyroid toxicity. upon transfer to the floor her metoprolol was further uptitrated to the maximum dose of 450mg per day. while her blood pressure remained stable in the 100s/60s, her hr continued to be in the 120's with increases to 140-150 upon ambulation. she was again digoxin loaded and begun on a standing dose of 0.125mg daily. this controlled her hr well and allowed her metoprolol to be decreased to 100mg po tid. she restarted on her coumadin at 5mg but her inr became supratherapeutic, likely in conjuction with the levofloxacin. her coumadin was held and her inr was allowed to drift to therapeutic levels, after which she was started on 2mg daily with stabilization of her inr betwen . this will continue to be monitored by her pcp and . . # sepsis. she was nitially treated with iv boluses to keep cvp>8, maintaining svo2 >70%, (no dobutamine given tachycardia, and hct was above 30, and neo for maps>65. given her infiltrate on cxr and focal exam, pt. was thought to have community-acquired pneumonial sepsis and changed from ctx/azithromycin to levofloxacin day 1 . she became hd stable and was taken of the neosynephrine and the central line was removed. she was then transfered to the floor. blood cultures and sputum cultures were ngtd at the time of discharge. she became afebrile with stable blood pressures and breathing comfortably on room air. she was discharged to complete a 14 day course of levofloxacin with follow up from her pcp/ . # gi: she developed diarrhea after starting levofloxacin. c.diff was negative x 2 with resolution of her diarrhea after several percocet to control her chronic arthritis pain. # hypothyroidism: continued on her home levothyroxine with good effect. # hyperlipidemia: continued on her home atorvastatin with good effect # arthritis: continued on home regimen of celebrex, percocet, valium prn with minimal use and good effect. # osteopenia: continued on alendronate, calcium, and vitamin d medications on admission: amitriptyline hcl 25 mg qhs calcium 500 mg qdaily celebrex 200 mg qdaily capsaicin 0.035%--apply to left wrist area, scar twice per day ducodyl 5 mg--2 (two) tablet(s) by mouth once a day estring 7.5 mcg/24 hour--one every 3 months fosamax 70mg - one q week fish oil 1,000 mg--1 (one) cap qdaily glucosamine chondroitin smconc 750 mg-600 mg-55 mg-5 mg; 1 qdaily lipitor 10mg qdaily levothyroxine 50 mcg qdaily, 75mcg on sundays. multivitamin qdaily percocet 5 mg-325 mg-- tabq4h prn toprol xl 75qdaily valium 5mg tidprn vitamin c 1,000 mg-- warfarin 2.5 mg m,w,f,sa, 5 mg tu,th discharge medications: 1. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. celecoxib 200 mg capsule sig: one (1) capsule po qdaily (). 3. flaxseed oil capsule sig: one (1) capsule po daily (daily). 4. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 5. levothyroxine 75 mcg tablet sig: one (1) tablet po qsun (every sunday). 6. levothyroxine 50 mcg tablet sig: one (1) tablet po qdaily monday through saturday (). 7. hexavitamin tablet sig: one (1) cap po daily (daily). 8. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 9. diazepam 5 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for pain , stiffness. 10. ascorbic acid 500 mg tablet sig: two (2) tablet po bid (2 times a day). 11. levofloxacin 250 mg tablet sig: three (3) tablet po daily (daily) for 10 days. disp:*30 tablet(s)* refills:*0* 12. warfarin 2 mg tablet sig: one (1) tablet po daily16 (once daily at 16). disp:*30 tablet(s)* refills:*2* 13. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 14. amitriptyline 25 mg tablet sig: one (1) tablet po hs (at bedtime). 15. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed. disp:*100 ml(s)* refills:*0* 16. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. disp:*30 capsule(s)* refills:*0* 17. senna 8.6 mg capsule sig: one (1) capsule po twice a day as needed for constipation. disp:*30 capsule(s)* refills:*0* 18. toprol xl 100 mg tablet sustained release 24 hr sig: three (3) tablet sustained release 24 hr po once a day. disp:*60 tablet sustained release 24 hr(s)* refills:*2* discharge disposition: home discharge diagnosis: primary: pneumonia of organism atrial fibrillation with rapid ventricular response secondary: osteoarthritis discharge condition: afebrile. all vitals stable. hr well controlled with normal bp. wbc in normal range. ambulatory. discharge instructions: you were admitted for a pneumonia which also exacerbated your atrial fibrillation causing a rapid heart rate. you were treated with antibiotics and medications to slow your heart rate. you should finish your course of antibiotics at home. we have also adjusted your medications to control your heart rate. please take all your medications as prescribed. please call your doctor or return to the hospital if you experience a temperature greater than 100.5, chills, shortness of breath, chest pain, or any other symptoms that concern you. followup instructions: please call dr. office at to schedule a follow up appointment in the next 1-2 weeks. provider: ,nurse date/time: 3:15 provider: , m.d. date/time: 12:10 provider: , md phone: date/time: 1:00 procedure: venous catheterization, not elsewhere classified diagnoses: pneumonia, organism unspecified unspecified septicemia severe sepsis unspecified acquired hypothyroidism atrial fibrillation other and unspecified hyperlipidemia septic shock long-term (current) use of anticoagulants diarrhea disorder of bone and cartilage, unspecified 

Answer: The patient is high likely exposed to