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 an 80-year-old male with coronary artery disease, peripheral vascular disease, diastolic congestive heart failure, and diabetes mellitus who was admitted from a nursing home with change in mental status times seven days. a head computed tomography was negative. the working diagnosis was congestive heart failure. the patient was initially admitted to the floor; however, the floor team asked the medical intensive care unit to evaluate for hypoxia and/or respiratory distress. on evaluation, the patient was agonally breathing and unresponsive. arterial blood gas revealed a ph of 7.28, pco2 was 87, po2 was 70% on 100% nonrebreather. the code team was called for emergency intubation. a left subclavian line was placed. dopamine was started for hypotension in the 60s/palpation. dark mucous plugs were suctioned after endotracheal tube placement. a chest x-ray revealed new left lung whiteout. an emergent bronchoscopy was performed and successfully suctioned copious amounts of mucous plugs from the left airway. a repeat chest x-ray showed significant re-expansion. past medical history: 1. coronary artery disease; status post left anterior descending artery stent in . catheterization in revealing 2-vessel disease. 2. peripheral vascular disease; status post aortobifemoral bypass, status post femoral-femoral bypass. 3. ischemic colitis in . 4. hypertension. 5. left renal artery stenosis of 100%. 6. hyperlipidemia. 7. congestive heart failure; diastolic function with an ejection fraction 50% to 55%. 8. nephrolithiasis. 9. diabetes mellitus. 10. atrial fibrillation. 11. adjustment disorder. medications on admission: 1. digoxin 0.125 mg p.o. q.h.s. 2. coumadin 2 mg p.o. every tuesday and friday. 3. lasix 20 mg p.o. q.d. 4. lopressor 12.5 mg p.o. b.i.d. 5. loperamide as needed. 6. regular insulin sliding-scale. 7. aspirin 81 mg p.o. q.d. 8. protonix 40 mg p.o. q.d. 9. flagyl 500 mg p.o. t.i.d. 10. levaquin 500 mg p.o. q.d. allergies: no known drug allergies. physical examination on presentation: physical examination on admission revealed temperature was 99.5, blood pressure was 101/70, heart rate was 100, oxygen saturation was 100%. in general, intubated and sedated elderly male, frail and cachectic. head, eyes, ears, nose, and throat examination revealed pupils were equal, round, and reactive to light, edematous. cardiovascular examination revealed was irregularly irregular second heart sound and second heart sound. no murmurs. pulmonary examination was clear to auscultation anteriorly. no wheezes. the abdomen was soft and nondistended. extremity examination revealed 2+ pitting edema bilaterally. neurologic examination revealed intubated and sedated. pertinent laboratory values on presentation: laboratories on admission revealed white blood cell count was 19.3 (with 85 neutrophils, 11 bands, and 3 lymphocytes), hematocrit was 29.4, and platelets were 263. inr was 4.2 and partial thromboplastin time was 32.5. chemistry-7 revealed sodium was 140, potassium was 4.9, chloride was 100, bicarbonate was 33, blood urea nitrogen was 57, creatinine was 1.5, and blood glucose was 160. alt was 15, ast was 29, alkaline phosphatase was 155, and total bilirubin was 0.4. creatine kinase was 58. troponin was 1.1. urinalysis revealed positive nitrites, greater than 50 red blood cells, 11 to 20 white blood cells, many bacteria. calcium was 7.3, magnesium was 2.1, and phosphate was 7.3. radiology/imaging: electrocardiogram revealed atrial fibrillation at 91, normal axis, and normal intervals. q wave in v3 and v6. 1-mm st elevations in v1 and v2. st depressions in v5 and v6. t wave inversions in ii, iii, and avf. a chest x-ray #1 initially revealed pulmonary edema with bilateral effusions. chest x-ray #2 revealed left lung whiteout/collapse, left mediastinal shift. chest x-ray #3 revealed left lung re-expansion, endotracheal tube and subclavian lines in satisfactory position. a head computed tomography revealed no acute bleeding. hospital course by issue/system: 1. pulmonary system: the patient was seen with copious secretions and episodes of mucous plugs which were effectively suctioned. also with bilateral pleural effusions. a diagnostic tap was performed of transudative effusion. flexible bronchoscopies were performed and secretions were suctioned. the patient was initially extubated on . the patient was reintubated on for ventilatory failure with respiratory distress, acidosis, hypercapnia. on , a thoracentesis was performed and 1400 cc were removed with 132 glucose, 1.1 protein, ldh 97, albumin 0.4. transudative and negative for malignant cells or organisms. due to pulmonary effusions with secretions, the patient was unable to be re-extubated. a tracheostomy tube was placed on , and the patient tolerated pressure support which was weaned as tolerated according to oxygen saturations. on , .................... was placed. at the time of discharge, the patient required pressure support of 10 with a positive end-expiratory pressure of 5 during the day, and at night pressure support of 15 with a positive end-expiratory pressure of 5. he was discharged to pulmonary rehabilitation to continue to be weaned. 2. gastrointestinal issues: the patient has a history of ischemic colitis. beginning on the first week of admission, he began to bleed bright red/melanotic stool and was transfused as needed for maintaining a hematocrit above 30. gastroenterology was consulted, and an upper endoscopy was negative for a source of bleeding. a red blood cell bleeding scan was done which was negative. vascular surgery was consulted as was general surgery. ultimately, his bleeding slowed down on . then on , he had a colonoscopy performed for diagnostic purposes which revealed ischemic colitis up to the level of the splenic flexure; however, the colonoscope could not be further advanced. he continued without bleeding, and a percutaneous endoscopic gastrostomy tube was placed on , and tube feeds were initiated on , and he began with more bright red blood per rectum. he received a total 23 units of packed red blood cells to maintain a hematocrit of greater than 30. surgery was consulted again initially wanted to take him to the operating room for a subtotal colectomy. however, heparin-induced thrombocytopenia antibodies were sent and returned positive. hematology was consulted. at this time, platelets were 87, and hematology recommended delaying the surgery until his platelets began to rise. all heparin products were discontinued at this time. on , his bleeding ceased, and his platelets rose. surgery (dr. opted that given that he was no longer bleeding, they would not take him to the operating room. he was started again on tube feeds and tolerated then well without any gross bleeding. his hematocrit remained stable. he continued with guaiac-positive stools, but no active copious bleeding. he was also continued on lansoprazole per percutaneous endoscopic gastrostomy tube b.i.d. the plan was to continue supportive management unless he begins to bleed copiously again; at which time, surgery should be consulted again to consider performing a subtotal colectomy. 3. infectious disease issues: the patient initially had a urinary tract infection with enterococcus and citrobacter which was treated with zosyn for 7/7 days. then, for ischemic colitis he was continued on zosyn; however, this was discontinued after a 2-week course. he was admitted with a large sacral decubitus ulcer. the plastic service was consulted and initially suggested wet-to-dry dressing changes; however, they were consulted again on and debrided it; revealing a stage iv ulcer. on , his sputum returned methicillin-resistant staphylococcus aureus positive, and precautions were initiated. then, on , he became septic with methicillin-resistant staphylococcus aureus in his blood, and his left subclavian line was discontinued and revealed methicillin-resistant staphylococcus aureus at the tip of the catheter. he was given vancomycin and improved. it was felt to be secondary to methicillin-resistant staphylococcus aureus line sepsis. surveillance cultures were pending at this time. 4. cardiovascular system: (a) coronary artery disease: the patient with a history of coronary artery disease who had chest pain in the setting of his gastrointestinal bleed. he was ruled out for a myocardial infarction with a slightly elevated troponin of 0.6. he was not started on heparin secondary to the bleed. he was continued on lopressor 12.5 mg p.o. b.i.d. which was discontinued secondary to hypotension. he was switched to lopressor 5 mg intravenously q.6h. which he tolerated well. then on , he was restarted on lopressor 12.5 mg p.o. b.i.d. which he tolerated well. (b) atrial fibrillation: the patient with rapid atrial fibrillation despite being on lopressor. his heart rate remained elevated in the 120s to 140s range. as his digoxin was initially discontinued, it was restarted on , and his heart rate improved minimally. he was not anticoagulated because of his ischemic colitis and gastrointestinal bleed. (c) congestive heart failure: the patient with diastolic dyspnea; per echocardiogram. he was continued on a beta blocker. an ace inhibitor was not added secondary to acute renal failure. 5. hematologic issues: the patient with heparin-induced thrombocytopenia antibody positive. all heparin was held as of . his platelets improved to the 140s, and the patient had no signs of thrombosis. prophylaxis with pneumatic boots only. he was transfused as needed for a hematocrit of less than 30. after his active gastrointestinal bleed, he was transfused 23 units of packed red blood cells during the length of his stay. 6. endocrine system: the patient received a regular insulin sliding-scale as well as insulin in his total parenteral nutrition for a goal blood sugar between 80 and 120 with good control. 7. fluids/electrolytes/nutrition issues: the patient failed a swallow study when he was extubated on . a percutaneous endoscopic gastrostomy tube was placed on . tube feeds were initially held due to bleed, and he was continued on total parenteral nutrition. then tube feeds were restarted on and were advanced as tolerated, per nutrition service recommendations. total parenteral nutrition was decreased as tolerated. 8. neurologic issues: the patient with a history of depression. initially, the family refused medications, but on agreed starting treatment. he was started on celexa on at 10 mg p.o. q.h.s. this was held on because he began to be lethargic; however, the etiology of the lethargy turned out to be the line sepsis, so his celexa was restarted on . 9. disposition/plan: the patient to be discharged to pulmonary rehabilitation. the plan was for the patient to return home once he is successfully weaned to trach mask. condition at discharge: condition on discharge was stable. discharge status: discharge to rehabilitation. discharge diagnoses: 1. ischemic colitis. 2. respiratory failure secondary to mucous plugs. 3. urinary tract infection. 4. decubitus ulcer; stage iv. 5. rapid atrial fibrillation. 6. sepsis; resolved (from methicillin-resistant staphylococcus aureus line infection). 7. heparin-induced thrombocytopenia antibody positive. 8. diabetes mellitus. 9. hypoalimentation with albumin of 1.4. 10. depression. medications on discharge: 1. regular insulin sliding-scale. 2. lansoprazole 30 mg p.o. b.i.d. 3. albuterol/ipratropium 1 to 2 puffs inhaled q.6h. 4. .................... one-half strength one application topically t.i.d. to coccyx and ankle. 5. vancomycin 1 g intravenously q.12h. 6. metoprolol 12.5 mg p.o. b.i.d. 7. digoxin 0.125 mg p.o. q.d. 8. fentanyl 25 mcg intravenously q.12h. as needed; premedicate with dressing changes. , m.d. dictated by: medquist36 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 parenteral infusion of concentrated nutritional substances other endoscopy of small intestine insertion of endotracheal tube insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis percutaneous [endoscopic] gastrostomy [peg] other intubation of respiratory tract temporary tracheostomy excisional debridement of wound, infection, or burn colonoscopy diagnoses: pneumonia, organism unspecified urinary tract infection, site not specified congestive heart failure, unspecified acute kidney failure, unspecified acute and chronic respiratory failure hemorrhage of gastrointestinal tract, unspecified acute vascular insufficiency of intestine 

Answer: The patient is high likely exposed to