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: tachypnea major surgical or invasive procedure: r ij placement history of present illness: mr. is a 89 year-old man with a history of cad s/p cabg, chf (ef 25%) and paf who initially p/w respiratory distress, transferred to the icu on day of admission for continued borderline hypoxia and tachypnea, dnr/i, briefly on dopa gtt for hypotension, then called out to floor on at night, now re-transferred to micu for recurrent sob. . of note, two recent admission: first admission ( - ) was for an enterococcal uti; he was treated with ampicillin and discharged to home. second admission ( to ) was for chf in the setting of afib with rvr; he was treated with rate controlling agents (amiodarone was added to metoprolol); valsartan was also added to his regimen. at rehab the day before admission, he developed labored breathing and inability to urinate. . in the ed, initial vitals were hr 124 bp 80s-90s/30s-40s rr:20-30 o2sat 97% on 2l nc. bnp , down from on last admission . a cxr showed bilateral effusions, atelectasis, and appearance concerning for left lower lobe pneumonia. he was given 500 mg levofloxacin given and 2 liters of ns. also recieved nebs given. . on the floor, his labored breathing -> iv lasix, foley placed -> 350cc of cola-colored urine. abg 7.40/38/64. on arrival to the micu, pt with sbps in 80's then drifting into ?60's-70's. he was transiently on dopa gtt, weaned off and started on empiric vanc and zosyn for possible pna although afebrile and normal wbc but productive cough. lactate was initially 3.0, then trended down to 1.4. pt had reportedly his flu shot. legionella ag was negative. a repeat echo did not show worsening ef or tamponade but worsened mr. elevated cardiac enzymes were felt to be due to past event or demand ischemia. also in acute on chronic renal failure with cr of 3.3. inr supratherapeutic, thus coumadin was held. once off the dopa, he was called out to the floor in am on . however, developed af/rvr and was kept in the icu until 9pm. he received 5mg iv lopressor with rate control. he also received 40 iv lasix since it was felt that he was now fluid overloaded. once stable, he came to the floor on 9pm on . . on the floor, he triggered overnight for tachypnea and af/rvr. he received 10 iv dilt with rate control. he also received 2x250cc ivf boluses for sbp in 90s. a foley was placed and 1l dark urine came back. ua without infection. in the morning, he was restarted on abx (vanc/ctx this time). he was found to be tachypneic again. abg was 7.38/41/77. cxr was ordered. he was given 40 iv lasix, o2 was uptitrated on nc, then switched to fm. nebs were given. it was felt that he was tiring out and would benefit from retransfer to micu, also for possible lasix gtt since bp dropped to low 90s after iv lasix bolus. . on arrival to the icu on , he was less tachypneic, satting 100% on 3l nc but still using accessory muscles. he denied any cp, palpitations, but has productive cough (whitish sputum x2 weeks). no f/c/n. . ros: negative for abdominal pain, n/v/d, urinary sxs. last bm few days ago. past medical history: 1. systolic congestive heart failure: infarct-related. ef ~20% on echocardiogram 2. coronary artery disease: s/p cabg w/ lima-lad, svg-om1-om2, svg-rca-pl. last p-mibi w/ large fixed defect involving the entire inferior wall and the basal inferoseptum and the basal inferolateral (pda region). history of small nonq wave infarct. 3. paroxysmal atrial fibrillation - on coumadin 4. type ii diabetes (non-insulin dependent) controlled 5. peripheral vascular disease w/ aaa and common iliac aneurysm 6. cva in 7. gerd 8. lbbb on ekg 9. nsvt - has declined icd in the past 10. hypertension 11. hyperlipidemia social history: wife currently has cancer, lives with her in apartment. he denies ever smoking, etoh or other illicits. family history: family history of hypertension and coronary artery disease physical exam: vitals: t 96.7, bp 107/34, hr 76 sr, rr 22, 100% on 3l, cvp 10 gen - elderly male in mild respiratory distress. able to complete full sentences but uses accessory muscles to breathe. skin - bruises over l arm and back, no rash heent - perrl, eomi, dry mm, jvp up to jaw (but with known 2+tr), no hjr, r ij in place cv - rr, nl s1, s2, no obvious murmur appreciated. pulm - dull at bases, crackles half-way up, diffuse wheezes. abd - soft and non-tender. nondistended, sparse bs, no hepatomegaly appreciately, no hepatic tenderness suggesting congestion. ext - warm. no peripheral edema. no clubbing or cyanosis. neuro - a&o x 3, responds appropriately to all questions. moves all extremities. pertinent results: 10:35am wbc-9.9# rbc-3.45* hgb-10.3* hct-30.2* mcv-88 mch-29.7 mchc-34.0 rdw-14.7 10:35am neuts-86.3* bands-0 lymphs-8.7* monos-4.7 eos-0.1 basos-0.1 10:35am plt smr-normal plt count-175 10:35am probnp-* 10:35am glucose-101 urea n-93* creat-3.2* sodium-136 potassium-4.3 chloride-94* total co2-28 anion gap-18 10:35am alt(sgpt)-17 ast(sgot)-41* alk phos-66 tot bili-0.5 08:07pm lactate-3.0* . ecg #1: nsr with lbbb. ecg #2: afib with rvr (rate 129) ecg : lad, lbbb, no acute st changes . cxr (read pending): prelim read by micu with no significant change to yesterday, retrocardiac opacity visible, b/l effusions, minimal pulmonary edema. . cxr : as compared to the previous radiograph, there is no major change. extensive cardiomegaly with retrocardiac opacities. small bilateral pleural effusions. unchanged position of the central venous access right. . echo : severe regional left ventricular systolic dysfunction with akinesis of the inferior and inferolateral walls, hypokinesis of the setpum, anterior and lateral walls. the basal to mid septum contracts best. (lvef= 20 %). (3+)mr, 2+ tr. moderate pulmonary artery systolic hypertension. impression: moderately dilated left ventricular cavity with severe regional dysfunction consistent with multivessel coronary disease. moderate to severe mitral regurgitation. at least moderate pulmonary hypertension. c/w , the severity of mitral regurgitation has increased. estimated pulmonary pressures are higher. . cxr (): bilateral effusions, atelectasis, and appearance concerning for left lower lobe pneumonia. . pfts (): normal spirometry and lung volumes. the reduced dlco suggests a perfusion limitation. there are no prior studies available for comparison. . tte (): ef 20%, inferior/inferolateral akinesis/dyskinesis and hypokinesis elsewhere. mild to moderate (+) mitral regurgitation is seen. biatrial enlargement. . micro data: sputum gram stain-good sample, 2+ gpc in pairs and clusters. cx-pending ucx-pending ucx-pending urine legionella urinary antigen -negative ucx negative bcx pending x2 brief hospital course: 89m w/ cad s/p cabg, chf (ef 25%), paf p/w tachypnea, cough, course c/b hypotension in micu (briefly on dopa gtt), vanc/zosyn for pna, af/rvr, a/crf, on floor again tachypneic, re-transferred to micu for possible noninvasive ventilation, instead pt remained stable on nc, was treated for 7 days with vanc/ctx for pna, remained labile with regards to bp and uop, was initially started on ntg gtt and lasix gtt, then switched to milrinone gtt and continue on lasix gtt with moderate increase in uop. his cr continued to increase and the patient stated that he would not want hemodialysis if this became necessary. decision was made to transition to comfort care, and pt. was d/c'd of all noncomfort medications. he was transferred to floor and expired 5pm . autopsy declined. . medications on admission: medications (rehab): 1. aspirin 81 mg daily 2. coumadin 2 mg po qd 3. lasix 40 mg po once a day-recent increase to , but says was not taking prior 4. valsartan 80 mg 5. amiodarone 200 mg qd 6. isosorbide mononitrate 30 mg 7. metoprolol 50 mg sustained release po daily 8. simvastatin 20 mg po daily 9. glipizide 5 mg daily 10. calcitriol 0.25 mcg po daily 11. docusate sodium 100 mg po bid 12. ampicillin 500 mg po twice a day for 14 days twice a day starting . 13. riss - miconazole powder 85 gm topical tid . medications (on first transfer to micu on ): - levofloxacin 250 mg q48 day 1 - zosyn 2.25g q8h day 1 - vanco 1 g x1 today - isosorbide mononitrate 30 mg daily - metoprolol 50 mg - calcitriol 0.25 mcg po daily - aspirin 81 mg tablet, po daily - coumadin 2 mg po qd - lasix 40 mg po bid - amiodarone 400 mg qd - riss - miconazole powder 85 gm topical tid - albuterol nebs q3h; ipratropium neb q4h . medications (on re-transfer to micu on ): - guaifenesin-dextromethorphan 5 ml po q6h:prn - insulin sc (per insulin flowsheet) - ipratropium bromide neb 1 neb ih q4h - lidocaine jelly 2% (urojet) 1 appl tp prn - metoprolol tartrate 12.5 mg po bid - acetylcysteine 20% 6-10 ml neb q6h:prn congestion - miconazole powder 2% 1 appl tp tid - amiodarone 200 mg po daily - senna 1 tab po bid:prn - aspirin 325 mg po daily - simvastatin 20 mg po daily - bisacodyl 10 mg po daily:prn - calcitriol 0.25 mcg po daily - cepacol (menthol) 1 loz po prn - ceftriaxone 1 gm iv q24h - valsartan 80 mg po daily - docusate sodium 100 mg po bid - zolpidem tartrate 5 mg po hs:prn - vancomycin 1000 mg iv once discharge medications: none discharge disposition: expired discharge diagnosis: chronic chf diabetes atrial fibrillation hypertension discharge condition: expired followup instructions: none md procedure: venous catheterization, not elsewhere classified arterial catheterization diagnoses: pneumonia, organism unspecified acidosis coronary atherosclerosis of native coronary artery esophageal reflux mitral valve disorders unspecified pleural effusion congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation other chronic pulmonary heart diseases peripheral vascular disease, unspecified other and unspecified hyperlipidemia other shock without mention of trauma other left bundle branch block dehydration acute on chronic systolic heart failure 

Answer: The patient is high likely exposed to