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: sulfasalazine / percocet attending: chief complaint: difficulty breathing major surgical or invasive procedure: intubation history of present illness: this is a 83 year old man with cad and dm presented from nursing home with fevers and desaturations. per his wife, he has been fighting a uri for the past 6 weeks, which he caught from another nursing home resident. it seems like he was on a 3 day course of levofloxacin and a 10 day course of augmentin without improvement. he was also being treated for a left ear infection with antibiotic ear drops, which was diagnosed in the va last week. his cough was not improving and he developed a fever last night with desaturations and was subsequently transferred to for evaluation. . in the ed, his vitals were: 101.0, 126, 62/39, 32, 84% on 6lnc. he was given 3l ns and his bp improved to 120/60. he was put on a nrb and his abg was 7.19, 63, 79. he was then put on bipap and maintained his o2 sats in the 90%'s. his cxr showed bilateral ll opacities with small bilateral pleural effusions. ua was positive for a ua. lactate was 1.5. he was given vanco/levo/flagyl. ekg showed new afib with rvr to 130's. metoprolol 2.5mg iv x 1 was given and he eventually spontaneously converted to sinus. he was transferred to the micu for further care. past medical history: 1. dm 2 2. uc s/p ileostomy and colectomy 3. htn 4. cad s/p stent (90's) 5. s/p cvax3 (94, 95, 96) 6. prostate ca s/p xrt on hormone therapy 7. paget's disease 8. gerd 9. esophageal ulcer and stricture 10. venous stasis 11. anxiety 12. bladder cancer secondary to prostate ca therapy 13. macular degeneration 14. pulmonary embolism 15. anemia 16. hyperlipidemia 17. hearing loss 18. melanoma social history: patient lives at nursing home. no smoking, etoh or ivdu. family history: nc physical exam: vitals: 96.9 ax, 114/45, 56, 100% on bipap 12/5, 100% gen: a+ox2, somewhat fatigued and somnelent but arousable and interactive heent: right ptosis, poor vision, bipap mask neck: obese neck, jpv estimated to be 12mm cv: distant heart sounds, s1+s2, no m/g/r, no precordial impulses pulm: upper airway noses, poor air movement, especially on left, right base crackles, scattered rhonchi, no wheezes abd: soft, nt, nd, +bs, ostomy, midline scar ext: trace to 1+ pedal edema up to ankles pertinent results: 09:37pm type-art temp-37.5 peep-5 o2-50 po2-97 pco2-65* ph-7.21* total co2-27 base xs--3 intubated-not intuba 07:53pm type-art temp-37.5 o2 flow-15 po2-170* pco2-77* ph-7.15* total co2-28 base xs--3 intubated-not intuba 07:28pm ck(cpk)-19* 07:28pm ck-mb-notdone ctropnt-0.04* 06:19pm type-art temp-38.3 rates-/12 po2-204* pco2-84* ph-7.11* total co2-28 base xs--5 vent-spontaneou 03:55pm type-art temp-38.2 rates-/17 tidal vol-700 peep-8 o2-60 po2-121* pco2-57* ph-7.23* total co2-25 base xs--4 vent-spontaneou comments-cpap 01:05pm ck(cpk)-18* 01:05pm ck-mb-notdone ctropnt-0.04* 10:48am type-art po2-82* pco2-62* ph-7.20* total co2-25 base xs--4 10:48am lactate-1.0 06:05am urine color-yellow appear-clear sp -1.013 06:05am urine blood-sm nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-sm 06:05am urine rbc-0-2 wbc-* bacteria-mod yeast-none epi-0-2 06:05am urine mucous-few 04:15am comments-green top 04:15am glucose-245* lactate-1.6 04:00am glucose-262* urea n-44* creat-1.6* sodium-143 potassium-5.1 chloride-109* total co2-24 anion gap-15 04:00am estgfr-using this 04:00am alt(sgpt)-29 ast(sgot)-25 ck(cpk)-21* alk phos-414* amylase-51 tot bili-0.2 04:00am alt(sgpt)-29 ast(sgot)-25 ck(cpk)-21* alk phos-414* amylase-51 tot bili-0.2 04:00am lipase-16 04:00am wbc-19.8*# rbc-3.67* hgb-10.2* hct-32.1* mcv-87 mch-27.7 mchc-31.6 rdw-16.3* 04:00am neuts-95.1* bands-0 lymphs-2.9* monos-1.6* eos-0.2 basos-0.1 04:00am plt count-388 04:00am pt-12.5 ptt-26.4 inr(pt)-1.1 . cxr : interval progression of now complete opacification of the left hemithorax likely represents a combination of a left-sided pleural effusion with collapse/consolidation of the left lung. moderate/large pleural effusion has been present since the most remote chest radiograph available dated . if indicated, further evaluation with a ct could be considered. . cxr : single bedside ap examination labeled "erect at 3 a.m." is compared with the study obtained some 10.5 hours earlier; allowing for differences in technique, the overall appearance is unchanged. there are persistent bilateral pleural effusions, left greater than right with dense left retrocardiac opacity, and pneumonic consolidation in this region cannot be excluded. there is right basilar subsegmental atelectasis. heart remains enlarged with some pulmonary vascular congestion. note that in comparison to the previous study, at 0400 h, the overall appearance is significantly improved, with the support tubes removed and the left subclavian central venous catheter, unchanged in position. . swallow study : video oropharyngeal swallow. mild oropharyngeal dysphagia. evidence of silent aspiration and penetration. please refer to the speech pathologist note for details and recommendations. brief hospital course: 83 year old man with cad and dm presented from nursing home with fevers, hypotension and respiratory failure. . # respiratory failure: chronic left pleural effusion and rll pna on top of that which may explain his decompensation. he probably also has some chronic obstructive disease from his tobacco history. initially admitted to icu with intubation. he has been steadily improving since his extubation, and is now saturating well on 3.5 lnc. he has completed 5 days of azithromycin, and finished 8day of vanco / zosyn. central line dc'd and tip sent for culture on . repeat cxr shows stable lll effusion and decreased rll opacity. patient needs to be maintained with aspiration precautions. . # hypotension: sbp improved since admission- range nearly normal. initially held home antihypertensives medications. restarted lisopril after renal functions improved to baseline. patient tolerated lisinopril well. f/u blood cultures were negative . # cad: cath in shows 2vd (lcx and rca) and s/p stent to lcx. subsequently no further symptoms or workup, although patient became more debilitated and rarely exerts himself. he has new rbbb since but ruled out with cardiac enzymes. patient was not placed on asa per urology recs in the past and was continued on plavix. . # pump: wife does not remember any hx of chf but remembers the patient taking lasix for peripheral edema at one point. he does not appear volume overloaded and was not continued on lasix. tte on showed nl lvef. . # afib: no prior history of afib before this admission. was in rvr to 130's in ed during acute respiratory distress when hypotensive. metoprolol 2.5mg iv x 1 was given and he spontaneously converted back to sinus rhythm. he has remained in sinus ever since. patient was continued on plavix while coumadin was not started per prior urology recs given history of hematuria. . # uti: by ua in ed. no dysuria. patient was already started on antibiotics as mentioned above for pna which would have covered his uti. . # chronic ear infection: patient was placed on out patient antimicrobial drops. he was advised to make an out patient appointment with his pcp to follow up his ear infection. . # arf: baseline creatinine 1.1 to 1.5. patient was discharged with baseline creatinine. . # anemia: baseline hct of 30. currently at baseline. patient was continued on out patinet epo schedule and was given units on . . # s/p cva's: he was on coumadin and then aspirin at one time. these were discontinued for hematuria, with discussions with urology. currently he is only on plavix. . # dm: held his home glipizide and was placed on sliding scale insulin. . # fen: -- thin, soft diet per nutrition recs . # ppx: -- prevacid -- sq heparin medications on admission: # lisinopril 5 mg daily # epogen 10,000 unit/ml sq q 2wk # multivitamin # norvasc 5mg daily # omeprazole 30 daily # glipizide 10mg qam, 5mg qpm # cortisporin 2gtt l ear qid x 1 week # ditropan xl 10mg daily # iron 325mg daily # zocor 20mg qhs # claritin 10mg qhs # augmentin 875mg q12h x 10 days, first day # levoquin 250mg dailt x 3 days, first day discharge medications: 1. hexavitamin tablet sig: one (1) cap po daily (daily). 2. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 3. neomycin-polymyxin-hc 3.5-10,000-1 mg-unit/ml-% drops, suspension sig: four (4) drop otic tid (3 times a day). 4. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 5. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 8. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 9. ditropan xl 10 mg tab,sust rel osmotic push 24hr sig: one (1) tab,sust rel osmotic push 24hr po once a day. 10. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 11. neomycin-polymyxin-hc 3.5-10,000-1 mg-unit/ml-% drops, suspension sig: four (4) drop otic tid (3 times a day). 12. albuterol 90 mcg/actuation aerosol sig: six (6) puff inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 13. ferrous sulfate 300 mg/5 ml liquid sig: one (1) po daily (daily). discharge disposition: extended care facility: nursing home - discharge diagnosis: primary: 1. pneumonia 2. urinary tract infection secondary: 1. diabetes mellitus type 2 2. otitis media 3. cerebrovascular accidents in the past 4. hypertension discharge condition: afebrile and hemodynamically stable. discharge instructions: you were evaluated and treated in the hospital for pneumonia. you were in the icu for respiratory failure and went to the hospital floor once your condition improved. your lung functions has improved to your baseline and you have no signs of active pneumonia. you need to follow up with your primary care doctor for your left ear infection. please take all your medications as written to you. please keep all your follow up appointments. please call your regular doctor or return to the emergency department for any difficulty breathing, fevers greater than 101.5, chest pain, or any other concern. followup instructions: please call your regular doctor to arrange follow up in the next week. please continue your follow up with your urologist as recommended by him/her in the past. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery esophageal reflux unspecified pleural effusion urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia severe sepsis chronic airway obstruction, not elsewhere classified personal history of malignant neoplasm of prostate atrial flutter percutaneous transluminal coronary angioplasty status acute respiratory failure personal history of other diseases of circulatory system septic shock personal history of malignant neoplasm of bladder ulcerative colitis, unspecified ileostomy status personal history of malignant melanoma of skin unspecified otitis media 

Answer: The patient is high likely exposed to