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 a 78-year-old gentleman with coronary artery disease, diabetes mellitus, and chronic renal insufficiency who presented with a chief complaint of shortness of breath. the patient presented to the emergency department and was found to be bradycardia to the 20s. per the patient's family, the patient had complained of shortness of breath for the past two days prior to admission. he was becoming dyspneic with walking across the room. on the day of admission, the patient had decreased oral intake and one episode of vomiting. his wife his finger blood sugar level to be 400 and called his primary care physician (dr. ) who advised the patient to go to the emergency department. in the emergency department, the patient's heart rate was in the 20s with a stable blood pressure. electrocardiogram showed complete heart block. according to his wife, the patient does not have any recent history of chest pain, orthopnea, or paroxysmal nocturnal dyspnea. the patient did complain of some lightheadedness earlier on the day of presentation. he denies any recent history of fevers or chills. past medical history: 1. coronary artery disease; status post coronary artery bypass graft in with stents times five in . 2. diabetes mellitus. 3. hypercholesterolemia. 4. hypertension. 5. benign prostatic hypertrophy. 6. congestive heart failure with left ventricular systolic dysfunction. 7. chronic renal insufficiency. medications on admission: 1. aspirin 325 mg by mouth once per day. 2. lasix 80 mg by mouth once per day. 3. hydralazine 25 mg by mouth four times per day. 4. isordil 20 mg by mouth three times per day 5. toprol-xl 100 mg by mouth once per day. 6. zantac 150 mg by mouth twice per day. 7. zestril 40 mg by mouth once per day. 8. zocor 80 mg by mouth once per day. 9. flomax 0.4 mg by mouth once per day. 10. proscar 5 mg by mouth once per day. 11. insulin (70/30) 40 units subcutaneously in the morning and 35 units subcutaneously in the evening. 12. procrit 7500 units subcutaneously every other week. allergies: an allergy to penicillin. social history: the patient is married. he denies any history of alcohol, tobacco, or drug use. family history: family history was noncontributory. physical examination on presentation: physical examination on admission revealed the patient was afebrile, his blood pressure was 164/58, his heart rate was in the 70s (following temporary pacemaker placement), his respiratory rate was 20, -level positive airway pressure with an fio2 of 60%, and saturating 100%. the physical examination was notable for an irregular rhythm with normal first heart sounds and second heart sounds. no murmurs, rubs, or gallops were appreciated. extremity examination revealed no lower extremity edema was present on examination. chest examination revealed crackles in the lungs bilaterally. pertinent radiology/imaging: electrocardiogram on admission revealed complete heart block with a rate of 30 and possible anterior fascicular block. pertinent laboratory values on presentation: laboratories were notable for a creatinine of 4 and a potassium of 6.2. concise summary of hospital course by issue/system: the patient was admitted to the coronary care unit. in the emergency department, prior to transfer to the coronary care unit, a temporary pacemaker was placed. the patient was also placed on -level positive airway pressure to assist with ventilation. the following morning, the patient was taken for pacemaker placement. the patient received a sdr 303b dual-chamber rate-responsive pacemaker. the patient tolerated the procedure well. following the procedure, the patient was sent back to the coronary care unit for further monitoring. following pacemaker placement his heart rate remained stable in the 60s with a systolic blood pressure ranging from the 120s to the 140s. due to his congestive heart failure and mild left ventricular systolic dysfunction, the patient was diuresed with lasix. the patient required multiple blood pressure medications to control his hypertension. he was also continued on aspirin, statin, and beta blocker due to his history of coronary artery disease. the patient was not placed on an ace inhibitor due to his elevated creatinine over his baseline. his creatinine remained stable between 3.7 and 4 throughout his hospitalization. however, his creatinine was elevated from his previous known baseline of 3. following the pacemaker placement procedure, the patient was restarted on his home insulin scheduled of 70/30. it was found to cause excessive nocturnal hypoglycemia. his evening insulin dose was decreased, and he had no further problems with his blood sugars. on hospital day four, the patient was found to have an episode of shaking chills. he was afebrile, and his white blood cell count was elevated. blood cultures and urine cultures were obtained but did not grow anything. due to concern for possible pacemaker pocket infection, the patient was started on intravenous vancomycin; however, there were no signs of infection at pacemaker site. prior to discharge, the patient was switched to a by mouth antibiotic. prior to discharge, the patient was given an injection of epogen 7500 units for anemia of chronic disease and chronic renal insufficiency. condition at discharge: condition on discharge was stable. discharge status: the patient's discharge status was to home with home physical therapy. discharge diagnoses: 1. complete heart block. 2. status post pacemaker placement. 3. congestive heart failure. 4. systolic dysfunction. 5. coronary artery disease; status post coronary artery bypass graft and stent from prior hospitalization. 6. hypertension. 7. insulin-dependent diabetes mellitus. 8. chronic renal insufficiency. 9. benign prostatic hypertrophy. medications on discharge: 1. aspirin 325 mg by mouth once per day. 2. zantac 150 mg by mouth twice per day 3. toprol-xl sustained release 100 mg by mouth once per day. 4. hydralazine 50 mg by mouth q.6h. 5. amlodipine 5 mg by mouth once per day. 6. isosorbide dinitrate 20 mg by mouth three times per day. 7. furosemide 80 mg by mouth twice per day. 8. docusate 100 mg by mouth twice per day as needed (for constipation). 9. insulin (70/30) 40 units subcutaneously in the morning and 25 units subcutaneously in the evening. 10. tamsulosin sustained release 0.4 mg by mouth at hour of sleep. 11. finasteride 5 mg by mouth once per day. 12. zocor 80 mg by mouth once per day. 13. clindamycin 150 mg by mouth q.6h. (times five days). discharge instructions/followup: (the patient's was scheduled to follow up as follows) 1. the patient was instructed to follow up with the cardiology device clinic on . 2. the patient was instructed to follow up with his primary cardiologist (dr. ) at the cardiovascular division. 3. the patient was instructed to follow up with his primary nephrologist (dr. ) at the . 4. the patient was instructed to follow up with his primary care physician (dr. ) on . , m.d. dictated by: medquist36 procedure: initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle non-invasive mechanical ventilation insertion of temporary transvenous pacemaker system diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia mitral valve disorders unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) atrioventricular block, complete unspecified disorder of kidney and ureter chronic systolic heart failure 

Answer: The patient is high likely exposed to