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 57-year-old gentleman, admitted on with a five day history of intermittent chest pain and shortness of breath. electrocardiogram at an outside hospital showed anterior st elevations and q waves. the patient was transferred to for cardiac catheterization. physical examination: this is a pleasant, 57-year-old gentleman, in no apparent distress. vital signs: t-max of 99.8, pulse 77, sinus rhythm, blood pressure 130/81, oxygen saturation on nasal cannula 94%. laboratory data: white blood cell count 16, hematocrit 40.5, platelet count 337. pt 12.9, ptt 32.9. sodium 13,4 potassium 5.4, chloride 100, bicarbonate 28, bun 11, creatinine 0.8, glucose 239. arterial blood gas: ph 7.41, pco2 40, po2 90, total co2 26. chest x-ray showed mild congestive heart failure, no other significant findings. past medical history: 1. noninsulin dependent diabetes mellitus 2. status post umbilical hernia repair 3. hypertension 4. current smoker with an 80 pack year history preoperative medications: 1. glucophage 2. glyburide allergies: no known drug allergies. hospital course: the patient was taken to the cardiac catheterization laboratory on the evening of admission, . in the cardiac catheterization laboratory, it was shown that he had a 60% left main lesion, 80% left circumflex lesion, 90% left anterior descending lesion, and 80% right coronary artery lesion. echocardiogram the following day showed an ejection fraction of 35%, with a hypokinetic anterior wall and septum, consistent with an extensive anterolateral septal myocardial infarction. on , hospital day number two, the patient continued to have chest pain on intravenous nitroglycerin and integrilin and beta blockers. cardiac surgery was consulted for evaluation. on hospital day number five, the patient was taken to the operating room with dr. for a coronary artery bypass graft x 5, left internal mammary artery to left anterior descending, saphenous vein graft to ramus and obtuse marginal, saphenous vein graft to posterior descending artery and pl. the patient was weaned from bypass and placed on a milrinone infusion at 0.5 mcg/kg/minute. please see operative note for further details. the patient was transferred to the intensive care unit in stable condition on the first postoperative evening. the patient required volume resuscitation for labile blood pressure. the patient was weaned and extubated from mechanical ventilation on postoperative day number one. milrinone was weaned to off, and the patient was transitioned to captopril for afterload reduction. on postoperative day number two, it was noted that the patient had st elevation on his electrocardiogram tracing, which coincided with hypotension and bradycardia. the patient was taken to the cardiac catheterization laboratory for evaluation of his grafts. in the cardiac catheterization laboratory, the patient was noted to have elevated left and right-sided filling pressures, but all of his grafts were patent. the patient was transferred to the intensive care unit again in stable condition. on postoperative day number three, the patient was out of bed, in a chair, when it was noted that the patient was in ventricular tachycardia on the monitor. the patient was transferred back to bed. anesthesia was called. the patient was intubated, and underwent multiple defibrillations, placed on a lidocaine infusion, converted into sinus rhythm and subsequently paced, and the patient was transferred to the cardiac catheterization laboratory again. in the cardiac catheterization laboratory, an intra-aortic balloon pump was placed. all grafts were noted to be patent. the patient was noted to have a large left ventricular thrombus and, at the end of the procedure, the patient had two episodes of ventricular tachycardia. the patient was started on amiodarone and milrinone infusion was again started for low cardiac index. the patient was started on a heparin infusion for the left ventricular thrombus and, while the patient was still in the cardiac catheterization laboratory, a coronary sinus wire was placed for pacing. the patient was transferred to the intensive care unit from the catheterization laboratory. the patient was noted to have a low cardiac index, but subsequently was stabilized over the evening, however, the patient continued to have an irritable ventricular rhythm with multiple episodes of ventricular tachycardia. the patient required overdrive pacing to maintain normal rhythm. the patient remained intubated and a follow-up echocardiogram showed an ejection fraction of 20 to 25%, with global hypokinesis. on , it was noted that the patient had foul-smelling drainage coming from his mouth. the patient was started on levofloxacin empirically for presumed sinusitis. again the patient had several more episodes of ventricular tachycardia, requiring cardioversion. ep service, which had been consulted initially, recommended the addition of lidocaine infusion in addition to the amiodarone. the milrinone infusion was decreased, and the patient continued to be sedated on propofol infusion. on postoperative day number seven, the patient's white blood cell count climbed to 18. the patient was pancultured, and on the postoperative day number nine, all of the patient's lines were changed due to white blood cell count increased to 24. on , the lidocaine infusion was weaned to off, and the milrinone infusion was weaned to off. the patient, that evening, had recurrent ventricular tachycardia, again requiring dc cardioversion. the lidocaine drip was restarted. the patient was also noted to have low-grade fevers at that time, in addition to an elevated white blood cell count. the patient had an elevated creatinine, which had risen to 2.1 by postoperative day number nine. on postoperative day number ten, the patient's white blood cell count was up to 31. the intra-aortic balloon pump was discontinued. the coronary sinus wire was discontinued. a temporary transcutaneous pacer was placed by the electrophysiology team. the patient was pancultured. his liver function tests were noted to be mildly elevated. infectious disease was consulted. the patient was started on vancomycin and zosyn empirically. the renal service was consulted. it was thought that the patient was in acute tubular necrosis due to the patient's rising creatinine. on , the patient's creatinine rose to 3.0. white blood cell count rose to 38. a right upper quadrant ultrasound was obtained due to the elevated liver function tests, and elevated white blood cell count. the right upper quadrant ultrasound showed a large dilated gallbladder with pericolic fluid and a gallbladder wall which measured 6 to 7 mm. these findings were consistent with acalculus cholecystitis. general surgery was consulted, and it was decided that interventional radiology would place a percutaneous cholecystostomy tube at the bedside. that afternoon, the patient spiked a temperature to 102, became hypotensive, and was taken to the operating room by general surgery for an exploratory laparotomy, with question of possible ischemic bowel. findings from the exploratory laparotomy were mild resolving mesenteric ischemia, mild acalculus cholecystitis, and patchy areas of splenic necrosis. it was felt that there were no findings that would explain the patient's septic picture, and no surgical interventions were made at the time. the cultures from the patient's bile were subsequently negative. at this date, the patient's blood line tips and urine cultures were also negative. postoperatively the patient's creatinine had risen to 4.0. on , a transesophageal echocardiogram was obtained and showed a depressed ejection fraction and a large left ventricular thrombus. the patient's white blood cell count rose to 33. the patient was requiring neo-synephrine infusion to maintain blood pressure. the patient had adequate cardiac index by swan numbers, and the patient was started on a lasix infusion for maintenance of urine output. on the 21st, the patient's white blood cell count had decreased to 19. urine output had increased, and it was thought that the patient was in the diuretic phase of acute tubular necrosis per the renal team. interrogation of the pacemaker by the electrophysiology team showed that the patient had an underlying heart rate sinus rhythm in the 70s to 80s. it was decided, due to the patient's elevated white blood cell count, that the pacemaker would be discontinued, which was done at the patient's bedside under fluoroscopy without complications. the patient continued on amiodarone infusion and a heparin infusion was restarted once the pacemaker lead was discontinued. on , the patient's white blood cell count was decreasing, and it was noted that the patient had an increasing level of consciousness and increased responsiveness to family. on the , it was noted that the patient's hematocrit had decreased from 26 to 21, with moderate amounts of bloody drainage from the orogastric tube. the orogastric tube was lavaged, and continued to drain burgundy fluid. the heparin infusion was discontinued. the patient was transfused packed red blood cells, and aggressive stress ulcer prophylaxis was started. the patient continued to have bloody drainage from his orogastric tube. on the , a gastroenterology consult was obtained. an esophagogastroduodenoscopy was done, which showed an ulcer in the lower one-third of the esophagus, a short segment of barrett's esophagus, and diffuse gastritis. it was felt that these findings were not sufficient to explain the moderate amount of bleeding and decrease in hematocrit. on , it was noted that again the patient's creatinine was rising. white blood cell count was rising. the patient was again pancultured. sputum showed budding yeast. urine culture showed yeast. the foley was changed repeatedly over several days. urine culture continued to show yeast. diflucan was started. the patient continued on zosyn for empiric coverage. vancomycin was discontinued and, due to the patient having a moderate amount of loose stools, the patient was empirically started on flagyl in spite of negative clostridium difficile cultures. on the , the patient underwent a percutaneous tracheostomy by interventional pulmonary team. bronchoscopy at that time showed moderate secretions from both lungs. also on the 28th, the patient went into atrial flutter, and the amiodarone infusion which had been changed to oral dosing was again restarted. the patient's blood pressure had stabilized. neo-synephrine had weaned to off, and the patient was started on lopressor for control of his atrial fibrillation. the patient gradually became more alert and communicative, underwent aggressive diuresis with subsequent decrease in creatinine, however, the patient had significant hypernatremia to 153, requiring supplemental free water boluses. the patient continued on flagyl and zosyn, weaning on the ventilator. on , the zosyn was discontinued and the patient's white blood cell count again was noted to increase. the patient was pancultured. sputum from showed coag-positive staphylococcus and gram-negative rods. the patient was empirically started on levaquin, but the cultures subsequently grew resistant enterobacter and, per recommendations of infectious disease, the patient was started on meropenem for a two week course, as well as vancomycin to cover the staphylococcus aureus, which was subsequently found to be resistant to methicillin. the patient established a pattern of work and rest on the ventilator, and continued on his heparin infusion. the team was consulted for treatment of his hyperglycemia, and was started on nph insulin as well as tube feeds. on , the patient had a left chest tube placed for a persistent left pleural effusion. chest tube drained one liter of serosanguinous drainage. on , the patient had an mri of his chest and abdomen to assess for sources of leukocytosis. the mri showed multiple wedge-shaped non-enhancing lesions in the right kidney, indicating hemorrhagic infarcts, small infarct at the lower pole of the left kidney, large heterogeneous splenic lesion consistent with hemorrhagic infarct, no definite enhancement characteristics of infection, bilateral moderate pleural effusions with associated bibasilar atelectasis and collapse, no defined subxiphoid collection was noted. the patient began working with physical therapy to increase mobility on . the patient's white blood cell count had decreased to 11, creatinine decreased to 1.4. on , the patient had a percutaneous endoscopic gastrostomy tube placed by the thoracic service, as well as a tracheostomy changed to a #8 portex. the patient began trach mask trials as well as working with speech therapy for ___________ valve trials. on the 20th, the patient's picc line was discontinued, and the patient's antibiotics were discontinued. on , the patient underwent transthoracic echocardiogram which showed normal left ventricular wall thickness and cavity size, left ventricular ejection fraction of greater than 40%, right ventricular chamber size and free wall motion normal, paradoxic septal motion, mild to moderate mitral regurgitation, no pericardial effusion. on , the patient was taken to the electrophysiology laboratory for assessment of his ventricular tachycardia. the patient had no inducible ventricular tachycardia, and it was decided, as the patient's ejection fraction was increased to 40%, the patient did not currently need an aicd. as the patient is currently stable, it was decided that the patient is cleared for discharge to a rehabilitation facility. condition at discharge: t-max 98.4, pulse 64 in sinus rhythm, blood pressure 106/54, respiratory rate 20, ventilator settings cpap 40%, pressure support 10, peep 5, saturation 99%. laboratory data: chemistry from : sodium 137, potassium 5.1, chloride 97, bicarbonate 33, bun 42, creatinine 1.3. cbc from : 9.3 white blood cell count, hematocrit 28.3, platelet count 424. the patient is on a heparin infusion at 1000 units/hour for anticoagulation of his left ventricular thrombus. discharge diagnosis: 1. status post myocardial infarction 2. status post coronary artery bypass graft 3. postoperative ventricular tachycardia 4. postoperative atrial fibrillation 5. hypertension 6. diabetes mellitus 7. resolved postoperative acute tubular necrosis 8. acalculus cholecystitis status post cholecystostomy tube 9. enterobacter and methicillin resistant staphylococcus aureus pneumonia, now resolved 10. left ventricular thrombus 11. status post percutaneous tracheostomy 12. status post percutaneous endoscopic gastrostomy 13. postoperative respiratory failure with ventilator dependence the patient is cleared for discharge to a rehabilitation facility. the patient's medications and follow ups are to be dictated at a future date. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified 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 angiocardiography of left heart structures left heart cardiac catheterization (aorto)coronary bypass of four or more coronary arteries catheter based invasive electrophysiologic testing exploratory laparotomy percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy combined right and left heart angiocardiography implant of pulsation balloon diagnoses: coronary atherosclerosis of native coronary artery mitral valve disorders acute kidney failure with lesion of tubular necrosis atrial flutter acute myocardial infarction of anterolateral wall, initial episode of care paroxysmal ventricular tachycardia infection and inflammatory reaction due to other vascular device, implant, and graft hemorrhage of gastrointestinal tract, unspecified acute cholecystitis 

Answer: The patient is high likely exposed to