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: diaphoresis with ventilator alarms. major surgical or invasive procedure: none history of present illness: 51 yo spanish speaking quadraplegic male with als on a ventilator from rehab who was taken to the ed for ventilator alarms. he was noted to be diaphoretic. the patient reports that his shortness of breath started around the evening of the day before admission. he reports that he felt very air hungry and diaphoretic. he denies any increased secretion or a cough. he denies any fevers, chills or nightsweats. he also denies any cp, abdominal pain or dysuria. the patient answeres questions with yes or no by blinking with his eyes and further information is difficult to obtain. . in the ed, his vs: t 100.6 bp 123/70 hr 105 rr 14 98% he tolerated the ventilator in the ed without any problems on ac 600 x 14 with fio2 0.6, 5 peep. prelim cxr showed ventilator-associated pneumonia. ekg showed sinus tachycardia. he was given ivfs, zosyn and levofloxacin for vap. he received a total of 2l of ns. . currently, he continues to feel more uncomfortable on the ventilator and air hungry but it is already improved from prior. . ros: negative for cp, abdominal pain, diarrhea, constipation, f/c/ns, weight loss, changes in the color of the urine or stool. past medical history: *als. dx . home o2 requirement. *quadraplegic. *respiratory failure (fvc 40% predicted). *hx l common femoral vein dvt . *hypertension. *migraines. *arthritis. *actinic keratosis. social history: no tobacco, etoh, drugs. lives with family. has 2 kids ages 5 and 10. former custodian. spanish is preferred language. family history: *mother: dm. *father: mi at 70. physical exam: t 100.6 bp 123/70 hr 105 rr 14 98% general: nad but reports respiratory discomfort heent: unable to open mouth due to spasm, pt unable to tolerate testing for pupillary reflex neck: jvp low, trach collar in place, neck spastic cardiac: s1s2, no murmur/rub or gallop, regular rate rhythm lung: decreased and bronchial breath sounds in the l base abdomen: tense (according to family at baseline), non tender, +bs ext: +dp, no edema neuro: quadriplegic, following commands, cn 2-7 intact, negative kernig and brudzinkis sign skin: no open wounds pertinent results: **labs** 05:03pm blood wbc-33.6*# rbc-4.76# hgb-14.1# hct-43.4# mcv-91 mch-29.5 mchc-32.4 rdw-13.5 plt ct-268# 05:03pm blood neuts-74* bands-8* lymphs-8* monos-8 eos-0 baso-0 atyps-2* metas-0 myelos-0 05:03pm blood hypochr-normal anisocy-normal poiklo-normal macrocy-normal microcy-normal polychr-normal 05:03pm blood plt smr-normal plt ct-268# 05:03pm blood glucose-275* urean-27* creat-0.5 na-139 k-3.9 cl-100 hco3-25 angap-18 04:04am blood calcium-9.3 phos-2.4* mg-2.0 09:36pm blood cortsol-31.4* 09:47pm blood type-art temp-38.0 po2-183* pco2-36 ph-7.46* caltco2-26 base xs-2 05:06pm blood lactate-3.4* . **imaging** cxr : left lower lobe collapse and associated small pleural effusion. brief hospital course: # sepsis: most likely secondary to ventilator associated pneumonia seen on cxr. elevated wbc with bandemia. ua negative. treated initially with broad spectrum antibiotics: vancomycin, ceftazidime and levofloxacin. subsequently blood cultures positive for staph coag negative. antibiotic coverage reduced to vancomycin alone for 2 week course. subsequent blood cultures negative. tte negative for vegetations. pt initially required fluid resuscitation but never required vasopressors. no more fluid resuscitation needed after 2l in ed and subsequent 2l on the floor. dfa and urine legionella and urine culture negative. sputum culture with oropharyngeal flora. blood cultures negative to date, final results still pending. lactate initially elevated at 3.4, subsequently improved. stim test adequate. . # respiratory failure: due to to ventilator associated pneumonia and associated left lower lobe collapse. on baseline settings, absolute ventilator dependent due to als. treatment of pna and bactermia with vancomycin as above. dfa and urine legionella negative. . # als: continued on baclofen and lorazepam . # psychiatric: continued on sertraline, mirtazapine and trazodone . # glucose intolerance: started on insulin sliding scale . # fen: restarted on tube feeds . # ppx: heparin sq, ppi, bowel regimen . # access: piv x2 . # code: full (reversed from dnr prior per wife) medications on admission: hydrocortisone cream 1% 1 appl tp albuterol-ipratropium 4 puff ih q6h levofloxacin 750 mg iv daily aspirin 325 mg po daily lorazepam 0.5 mg po q8h:prn baclofen 5 mg po tid mirtazapine 15 mg po hs ceftazidime 2 g iv q8h senna 1 tab po bid:prn sertraline 150 mg po daily desenex *nf* 2 % topical docusate sodium (liquid) 100 mg po bid trazodone 50 mg po hs tylenol elixir 1000mg qid lopressor 37.5mg q8h heparin sc tid nexium 40mg qdaily discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 2. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 3. cortisone 1 % cream sig: one (1) appl topical (2 times a day). 4. miconazole nitrate 2 % cream sig: one (1) topical (2 times a day). 5. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: four (4) puff inhalation q6h (every 6 hours). 6. sertraline 100 mg tablet sig: 1.5 tablets po daily (daily). 7. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 8. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 9. baclofen 10 mg tablet sig: 0.5 tablet po tid (3 times a day). 10. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 11. lorazepam 0.5 mg tablet sig: one (1) tablet po every eight (8) hours as needed. 12. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime). 13. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 14. vancomycin 1000 mg iv q 12h day 1 = for 14 days 15. heparin flush picc (100 units/ml) 2 ml iv daily:prn 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. 16. chlorhexidine gluconate 0.12 % mouthwash sig: one (1) ml mucous membrane (2 times a day). 17. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 18. insulin regular human 300 unit/3 ml insulin pen sig: asdir subcutaneous asdir: per sliding scale. discharge disposition: extended care facility: hospital discharge diagnosis: ventilator associated pneumonia left lower lobe collapse acute renal failure likely from ischemic atn discharge condition: conversant through eye blinking, quadriplegic discharge instructions: admitted for ventilator associated pneumonia. treated initially with broad spectrum antibiotics: vanco, ceftazidime and levofloxacin. subsequently blood cultures positive for staph coag negative. antibiotic coverage reduced to vancomycin alone for 2 week course. subsequent blood cultures negative. tte negative. pt also found to have rising creatinine, likely due to initial hypotension in the context of gpc sepsis. never on vasopressors, however initially needed fluid resuscitation. continue to hold metoprolol for now. restart once renal function recovered. respiratory settings unchanged from baseline. patient with copious secretions, will need frequent suctioning. patient will need: -ventilator treatment, mouthcare, chlorhexidine mouthwash -continue vancomycin for a 14 day course, first day -daily labs to monitor creatinine -cardiopulmonary assessment, restart metoprolol once map > 65 continously for 2days followup instructions: with physicians at rehab on daily basis md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances injection of antibiotic diagnoses: pneumonia, organism unspecified acute kidney failure with lesion of tubular necrosis unspecified essential hypertension severe sepsis constipation, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure amyotrophic lateral sclerosis acute and chronic respiratory failure personal history of venous thrombosis and embolism other and unspecified complications of medical care, not elsewhere classified migraine, unspecified, without mention of intractable migraine without mention of status migrainosus gastrostomy status quadriplegia, unspecified intestinal disaccharidase deficiencies and disaccharide malabsorption tracheostomy status dependence on respirator, status arthropathy, unspecified, site unspecified other staphylococcal septicemia actinic keratosis 

Answer: The patient is high likely exposed to