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: this is a 61-year-old male with a past medical history significant for diabetes mellitus type 2, chronic renal insufficiency on hemodialysis with a history of congestive heart failure, status post a-v fistula placement, history of diverticulosis, status post partial colectomy, hypertension, and abdominal hernia. medications prior to admission: 1. norvasc 20 mg p.o. q.d. 2. protonix 40 mg p.o. q.d. 3. metoprolol 50 mg p.o. b.i.d. 4. nephrocaps q.d. 5. quinine 325 mg p.o. q.d. 6. renagel 240 t.i.d. 7. lisinopril 10 mg p.o. q.d. 8. glipizide 5 mg p.o. b.i.d. 9. neurontin 300 mg p.o. b.i.d. 10. phoslo with meals. 11. aspirin 81 mg p.o. q.d. allergies: 1. demerol. 2. valium. 3. codeine. this 61-year-old male was admitted to on for increased shortness of breath. he was transferred from , where he was admitted for severe shortness of breath. he was diuresed with lasix with no change in symptoms at the outside hospital. also at the time of his admission to the outside hospital, patient had a two week history of a cough nonproductive with a current chest cold, however, denying any fevers, chills, nausea, vomiting, or chest pain. chest x-ray was done at the outside hospital, which revealed bilateral pleural effusions. ekg was performed, which revealed new t-wave inversions in leads i, avl, and cardiac enzymes were performed as well showing a small increase in troponin to 0.7 with a ck mb of 10. the patient was treated in the emergency room with heparin drip, beta blocker, and aspirin, and was transferred to for cardiac catheterization. cardiac catheterization was performed , which revealed left main coronary artery disease and two vessel coronary artery disease. patient underwent coronary artery bypass grafting x3 with the left internal mammary artery to the left anterior descending coronary artery. reverse saphenous vein graft to the right posterior descending coronary artery, and reverse saphenous vein graft to the obtuse marginal coronary artery. on , the patient was originally scheduled, however, to have surgery on the , but when the patient was brought to the holding area, the morning of the 10th, he was found to have an oxygen saturation of 85%, appearing short of breath, and was tachypneic. an ekg was performed at that time which showed slightly worse t-wave inversions laterally. abg revealed respiratory acidosis with a large aa gradient, and the patient was postponed for surgery and transferred to the ccu. the evening of , the patient had an intra-aortic balloon pump placed prophylactically. patient was transferred to the csru after surgery on milrinone 0.4 mcg, 0.1 mcg of levophed, 0.15 mcg of nitroglycerin, and 20 mcg of propofol. a renal consult was called on the patient the day of his surgery and their plan was for hemodialysis the following day, and to d/c the patient's intra-aortic balloon pump if the patient remained hemodynamically stable. postoperative day one, the patient still remained intubated on an insulin drip, a levophed drip, as well as propofol drip. with a t max of 101.8 and sinus rhythm with an intra-aortic balloon pump still in place at 1:1. patient was sedated due to his anxiety upon waking up at which time he would flail his arms causing his blood pressure to go up. patient also received small doses of versed as needed for his increased agitation upon waking. he had minimal urine output with a bun of 23 and a creatinine of 5.8, and he was given tylenol for his fever. his intra-aortic balloon pump was removed that same morning after which the patient received hemodialysis. a couple minutes into his hemodialysis, svts were noted on the monitor with a systolic blood pressure in the 90s. a crash cart was brought into the room for cardioversion. the patient rapidly deteriorated into v-tach and around 10:52 that morning, the patient was brought to the operating room. after several attempts to resuscitate the patient using closed chest resuscitative measures, the patient's chest was opened in the icu for open cardiac massage before being brought to the operating room. at that time, a left femoral and a left arterial sheath was also placed in the left groin in an anticipation that the patient would probably need extracorporal membrane oxygenation. the patient underwent placement of the extracorporeal membrane oxygenator as well as another intra-aortic balloon pump, and underwent coronary artery bypass grafting x1 with a free left internal mammary artery to the left anterior descending coronary artery the morning of . the patient was transferred to the csru on vasopressin, amiodarone, and levophed. patient had chest tube output of 200 cc q 15 minutes for which he received constant infusion of blood products with a brief attempt at cvvh, which had to be stopped due to the fact that the patient was extremely volume sensitive causing the patient's ecmo to chatter. the patient had episodes v-tach and v-fib which required multiple defibrillations with the internal paddles as well as an extra bolus of amiodarone. the patient was able to open his eyes for his family, however, was maintained sedated on propofol. postoperative day two status post the patient's original coronary artery bypass grafting, the patient was still on amiodarone drip as well as cisatracurium drip, fentanyl drip, insulin drip, levophed drip, pitressin drip and remained sedated on propofol with a t max of 101.3, and the intra-aortic balloon pump on 1:1 ecmo in place on full ventilatory support. multiple blood products were given for volume and a low hematocrit. the patient continued to have large amounts of chest tube drainage from one of his chest tubes. cvvh was restarted. the patient was started on bicarb drip, which was changed over to normal saline due to his increasing ph. on physical exam, the patient's right foot was cool, and his left foot and left calf were cold and slightly dusky. dp and pt pulses were present by doppler on the right foot, however, not present on the left. the patient was unresponsive to verbal and physical stimuli. an increased number of premature atrial contractions were noted for which patient received another amiodarone bolus and around 5 o'clock that afternoon, the patient had a 17 beat run of v-tach as well as multiple episodes of atrial fibrillation with a heart rate as high as 140. several doses of lopressor were given intravenously, and the patient converted back to normal sinus rhythm. ecmo flow was maintained at 2.6 to 2.9 liters per minute throughout the day with a hematocrit being checked hourly by the perfusionist with a treatment of heparin as needed. intra-aortic balloon pump remained 1:1 with good wave form. patient also underwent an infusion of platelets for a platelet count of 58,000. multiple blood products as well as potassium were administered to keep the hematocrit greater than 60 and a potassium at 5. patient had a v-fib arrest at 9:30 that evening of for which they were able to resuscitate to normal saline. however, the patient continued to be in rapid afib following the arrest. the following morning, postoperative day three, the patient was still continued on ecmo with the intra-aortic balloon pump at 1:1 on levophed and vasopressin as well as amiodarone. on physical exam, the patient still had a cyanotic appearing left lower extremity with absent pulses and dopplerable pulses on the right side. hematocrit of 31.5. the patient remained in stable condition with only an increase in the levophed drip for hypertension, and the patient's cvvh was stopped for transport to the cardiac cath laboratory. due to patient's refractory arrhythmias, cardiac catheterization revealed left main coronary artery disease as well as two vessel coronary artery disease with a patent lima to the left anterior descending artery, patent svg to the om, patent saphenous vein graft to the pda. patient was continued on his cvvh following his cardiac catheterization. on physical examination, there were noted to be two areas on the patient's abdomen overlying the patient's hernia, which had become dusky and mottled for which surgery consult was obtained. general surgery recommended providing the patient with antibiotic coverage, however, because of the patient's current condition, felt that the patient would not be able to tolerate any type of surgical procedure at that point. postoperative day four, patient remained sedated and paralyzed on propofol, fentanyl, cisatracurium, still on amiodarone, pitressin and levophed drip. heart rate ranged between 110 and 125 in rapid afib with his intra-aortic balloon pump continuing at 1:1. still on cvvh on full respiratory support. the patient went into v-fib and after multiple shocks returned to sinus rhythm. he was taken to the operating room that day for the removal of his ecmo, and the patient was transferred back to the csru in critical condition on levophed, pitressin, amiodarone, esmolol, and milrinone with his intra-aortic balloon pump at 1:1. a swan was floated in the operating room and pads were placed on the patient's chest with the patient's chest remaining opened secured with ioban dressing. patient continued to have self-limiting runs of v tach for which he was treated with amiodarone bolus. cvvh was restarted. patient had a bun of 27, creatinine of 4.1, hematocrit of 28.2, and a white count of 16.7. while in the operating room for his ecmo removal, patient also had his left femoral vein and right femoral artery catheters removed for his ischemic left leg as well as having a left femoral thrombectomy. postoperative day five, patient still on an insulin drip, propofol, milrinone, norepinephrine, vasopressin, fentanyl, cisatracurium, and amiodarone drips. afebrile with a white count of 17.5, hematocrit of 40, bun of 29, and creatinine 3.9. with a failure of the cvvh early that morning, which was then restarted still with a heart rate in the 120s svt and an intra-aortic balloon pump in place at 1:1. cardiac index ranging between 2.8-3. on physical exam, the patient's left lower leg was still cold and very firm from mid calf down to his foot with his left toes cyanotic. vascular was consulted, who felt that no intervention was necessary at this time. patient's esmolol and levo drip needed to be increased to maintain an adequate blood pressure. the intra-aortic balloon pump was later weaned to with stable hemodynamics, and the patient's swan was changed over wire. patient was transfused 2 units of red blood cells as well as 2 units of platelets for platelet count of 33,000 and 54,000. patient continued on cvvh for the rest of that day. on postoperative day six, the patient was febrile to 101, still on the following drips: insulin, propofol, milrinone, fentanyl, cisatracurium, amiodarone, esmolol, vasopressin, and levophed with a heart rate in the 110s to 130s in svt on full ventilatory support. white count of 18, hematocrit of 43, bun of 29, and creatinine of 3.8. cvvh was restarted that morning. neurology was consulted to evaluate the patient's neurological status. they recommended a possible eeg and/or head ct to assess for hypoxia and ischemia as well as encephalopathy. patient remained sedated that morning on propofol and nimbex with a labile blood pressure requiring increased doses of levophed. patient had runs of v-tach that morning, treated with magnesium and calcium as well as an amiodarone bolus. patient's mixed venous oxygen saturation dropping to the 50s with decreasing blood pressure. the patient's peep was increased as well as his fio2 and he had v tach arrest shortly after noon that day. several defibrillations were performed with the patient's rhythm varying between v tach and v fib and later bradycardia, and complete heart block. continued defibrillation attempts were made without a return of the patient's rhythm, and the patient was pronounced at 12:44 p.m. the patient's family was present during the resuscitation. , m.d. dictated by: medquist36 procedure: single internal mammary-coronary artery bypass single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries angiocardiography of left heart structures endarterectomy, lower limb arteries extracorporeal membrane oxygenation [ecmo] diagnoses: subendocardial infarction, initial episode of care congestive heart failure, unspecified cardiac complications, not elsewhere classified atrial fibrillation paroxysmal ventricular tachycardia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease cardiac arrest other complications due to other vascular device, implant, and graft arterial embolism and thrombosis of lower extremity 

Answer: The patient is high likely exposed to