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: mr. is a 69-year-old male with a history of cad, hypertension and diverticulosis as well as diverticulitis who was brought to the emergency room by ambulance for diarrhea, nausea and vomiting. he was found history of chest pain, shortness of breath or abdominal pain. he does admit to mild headache. other past medical history is abbreviated due to the fact that the patient presented acutely ill. on emergency room arrival his temperature was 99.3, blood pressure 82/42, heart rate 133, breathing 96% on room air and overall he was sluggish. he was given several liters of normal saline and begun on peripheral dopamine. he incident in the emergency room. the patient was complaining of headache and of neck pain. he, however, denied chest pain, abdominal pain, pelvic pain as well as any nausea. in the emergency room he had a total of 8 liters of normal saline and dopamine drip was started at 5 mg. he was treated with levaquin and gentamycin. he spiked to 104.2 and initial abg was done and was 7.29/39/132 on a non rebreather. about 90 minutes later on 4 liters, the patient's abg was 7.32/28/66. past medical history: significant for cad, status post ptca in and again in . last catheterization in revealed two vessel disease. ejection fraction was normal per patient's pcp with history of hypertension, spinal fusion in the past, no history of diabetes, history of a chronic muscle wasting disease, extensive work-up negative, history of depression, history of diverticulosis and history of diverticulitis, most recent recurrence . surgery was recommended but the patient refused the procedure. medications: per the patient's pcp include diltiazem 240 mg q d, atenolol 25 mg q d, effexor 150 mg , trazodone 300 mg q h.s., risperdal 2 mg q d, zocor and aspirin. allergies: no known drug allergies. social history: he lives alone in . he is a retired taxi driver. he is originally from . his mother is currently living in . pcp is . . physical examination: he was moaning but alert, interactive and oriented. temperature 103.4, heart rate 131, blood pressure 79/49. heent: extraocular movements intact. sclera anicteric. pupils equal, round and reactive to light. mucus membranes dry. neck supple. cardiovascular, regular rhythm, tachycardic with distant heart sounds. pulmonary exam, anterolaterally clear. abdomen obese, soft, nontender, non distended, normoactive bowel sounds, no surgical scars. rectal exam, heme positive per emergency room staff. extremities without edema. ekg tachycardic, likely sinus tachycardia at 133, normal axis, right bundle branch block. old report also shows right bundle branch block. chest x-ray with bibasilar infiltrate vs atelectasis. laboratory data: initial laboratory data, white count 3.3, hematocrit 44.7, platelet count 258,000, differential 41% polys, 22% bands, 10% monos, 1% basophils, 2 metas. urinalysis was greater than 300 protein, trace ketones, otherwise negative. chemistries, sodium 143, potassium 5.6, hemolyzed repeat 3.5, chloride 105, co2 18, bun 31, creatinine 2.6, glucose 150, anion gap 21. first ck 331, troponin negative. serum tox and urine tox negative. hospital course: the patient initially presented therefore a 69-year-old gentleman with past medical history of cad and diverticulitis with septic shock without a clear source on the background of past medical history previously mentioned. the patient was admitted to the medical icu. his respiratory status worsened and he was intubated on and abdominal ct was obtained that revealed an sbo, right middle lobe, right lower lobe and left lower lobe consolidation. in intensive care unit he required four pressors to maintain his blood pressure including neo, levo, dopa and vasopressin. he was also given stress dose steroids for a question of addison's. he required approximately 16 liters of fluid resuscitation. he had an exploratory laparotomy on after serial ct showed evidence of an sbo. no bowel was excised during the procedure, however, and the patient was decompressed with an og tube in the or. perioperatively the patient had a troponin leak with a ck bump thought to be related to demand ischemia in the setting of overwhelming sepsis and causing him to have an mi. postoperatively he was afebrile for a few days and then he spiked a temperature again. his mental status was slow to return to baseline postoperatively. his lines were changed and coag negative staph grew from his right ij line on . he was then started on vancomycin. he had, at that point, completed a 10 day course of levo and flagyl and had completed a course of vancomycin as well. within 24 hours of starting the vancomycin, his temperature stopped. however, they returned a couple of days later and a line was pulled on and sent for culture as a potential source of his persistent fevers. the patient's mental status continued to improve starting on and when his mental status had started to clear he was complaining of back pain which is a chronic problem for him. an mri of the spine was done and was normal. repeat abdominal ct was negative. he was started to wean off the ventilator on and was extubated on . on he was transferred to the medicine floor and he was communicating with much improved mental status and in retrospect, at the time of transfer to the floor, it was felt that his initial septic shock was due to severe likely aspiration pneumonia in the right middle, right lower and left lower lobes and his subsequent fevers postoperatively were likely due to line sepsis. his medications on transfer to the medical floor included aspirin 325 mg q d, protonix 40 mg q d, lopressor 25 mg , ramipril 2.5 mg q d as well as prn tylenol, nystatin cream, ambien 5 mg q h.s. hospital course on the floor is as follows: 1. pulmonary: he was extubated as mentioned on and he was able to be weaned to room air by with oxygen saturations in the high 90's. an abdominal ct showed moderate right and small left pleural effusions with collapse of the left lower lobe. the patient had completed a 10 day course of levo and flagyl for presumed aspiration pneumonia on admission. his pleural effusions were found to be too small to tap per ultrasound and interventional radiology. his respiratory status was stable throughout the remainder of his hospitalization. 2. infectious disease: the patient was continued on vancomycin intravenously for a 7 day course which started on . this was treating an a line tip which grew out gram positive bacteria. there were mixed morphologies that were not speciated, however, since the patient demonstrated persistent fevers (despite antibiotics) with this line in place which resolved promptly after its removal, there was reasonable suspicion to suggest a true line infection. it was therefore felt prudent to continue the patient on a 7 day course of vancomycin. echocardiogram done on was negative for any evidence of endocarditis. in summary then, the only cultures of his that were positive included a catheter tip on that was coag negative staph treated with a course of vancomycin. sputum gram stain grew out gram positive cocci in pairs and a line tip grew out gram positive bacteria, not speciated. all other urine cultures and blood cultures are negative at the time of this dictation. 3. neuro/psychiatric: the patient's mental status continued to improve and he was awake, alert and conversational, able to provide a history and an explanation for the reason he came to the hospital initially. the patient had been on haldol for agitation but that was discontinued when he was transferred to the floor. he was not agitated for the remainder of his hospital stay on the medical floor. he had a head ct that was negative for any acute process. an mr of his spine was negative for any epidural abscess. based on his own effexor, trazodone and risperdal for depression, none of those psychiatric medications were started while the patient was in the hospital. 4. cardiovascular: patient with a history of cad, status post ptca times three on lopressor and aspirin at baseline. he was hemodynamically stable for his stay on the medical floor. as mentioned, his echocardiogram was negative except for mild lvh. ejection fraction of 55%. his troponin leak represented likely demand ischemia leading to an mi in the setting of severe sepsis and a known reversible ischemic lesion from outpatient ett performed prior to his admission. his cks were elevated but then were trending down. he will need to have an ett done in approximately 4-6 weeks following his discharge from the hospital. this will be arranged via his primary care physician and will be done to follow-up this mi that he had based on elevated troponin in the perioperative setting. 5. fluids, electrolytes & nutrition: the patient was tolerating po well and his electrolytes remained within normal limits. 6. gi: patient with a history of diverticulosis and diverticulitis, has been on protonix while in the hospital. exploratory laparotomy was negative. he developed diarrhea approximately on . stool cultures were sent for c. diff, those results are not back at the time of this dictation. at this time there is a question of whether the diarrhea is due to vancomycin or c. diff. those culture results are as mentioned, still pending. the patient had a swallowing study evaluation due to concern over future aspiration risk. that study was interpreted as normal and the patient was determined to be able to tolerate a regular diet including clears. 7. prophylaxis: the patient was maintained on subcutaneous heparin 5,000 units . 8. pain: the patient continued to complain of back pain and neck pain which is a chronic problem for him. he was treated with tylenol and percocet for the pain. in terms of disposition, pt and ot consults were done and the patient was screened for rehabilitation. at the time of this dictation it is not known what rehabilitation facility he will go to. discharge condition: stable. discharge status: discharged to a rehabilitation facility. discharge diagnosis: 1. septic shock. 2. aspiration pneumonia. 3. bacteremia. 4. coronary artery disease, status post ptca times three. 5. hypertension. 6. diverticulosis. 7. status post spinal fusion l5,s1. 8. chronic muscle wasting disease of unknown etiology. 9. depression. 10. status post compound fracture of his left wrist and skull fracture as a child due to an accident. discharge medications: aspirin 325 mg po q day, protonix 40 mg po q day, lopressor 25 mg po bid, ramipril 2.5 mg po q d, tylenol 650 mg q 4-6 hours prn, nystatin cream, miconazole powder, ambien 5 mg po q h.s. and vancomycin 1 gm q 12 hours times 7 day course. the course started on . , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube exploratory laparotomy diagnoses: unspecified essential hypertension unspecified septicemia pneumonitis due to inhalation of food or vomitus other shock without mention of trauma infection and inflammatory reaction due to other vascular device, implant, and graft acute myocardial infarction of unspecified site, initial episode of care other specified bacterial infections in conditions classified elsewhere and of unspecified site, other specified bacteria 

Answer: The patient is high likely exposed to