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: demerol attending: chief complaint: chest pain major surgical or invasive procedure: none history of present illness: pt is a 65 yo male, dm2, cri, copd, h/o cad s/p cabg x 3 (), multiple stents (last in to previously grafted rca/ last viz catheterization ), open abdominal wound healing by secondary intention p/w left sided chest pain since last night. presented to osh with chest pain on left side, shooting down arm, and hip. pt says it was a . associated with nbnb vomitting after drinking water. no pain at abd wound site, states it has been "looking better than ever." no change in chronic cough, no change in sob. at baseline doe. no urinary frequency/urgency/dysuria. started on hep/int/dopa transferred here. * pt was transferred to . ekg in ed: sinus at 88. nl axis. nl intervals. lvh by voltage criteria. st horizontal depressions 2 mm in lateral leads (v4-v6) morphine 4 mg x 3, metoprolol 5 mg x 1 with decrease in bp to sbp 70s. temp 103, wbc elevated - started on sepsis must protocol and sent to unit. seen by cards, felt ekg changes demand ischemia, enzymes remained negative, chest pain abated. hep/integrillin/dopa off. micu course: 1) cv: as listed as above. was continued on aspirin. once hd stable, restarted on lipitor, lisinopril 20 daily, metoprolol 50 . bp stable w/ bp 130s-150s/60s-80s p 90s. complained of episode of chest pain similar to prior mi on . rr 40s o2 100% on nrbm , associated with left hip pain. received 2 sl nitro w/ improveoment in sob but no change in chest pain. started on nitro gtt @ 6/hrt. received 40 iv lasix and total 4mg iv morphine and chest pain decreased to and additional improvement in sob. ekg, sinus tachy 117, concave st elevateion in v2 (old), st depression v3-v6 w/ twi v5-6 (all old). asses to becardiogenic wheezing/chf exacerbated by albuterol nebs and tachycardia with resultant pulmonary edema. cxr w/ rul infiltrate (nbew) but no chf/pulm edema. ce negative. ekg @ 4:30 pm on no ischemic ahges. @5pm still with 3/10 chest pain on 150 mcg/kg/hr ntg, but vss (bp 137/75 p 80 o2 96% comfortable). likely cp to pna or sternal wound 2> leukocytosis: eivdence of rul on last cxr explaining fever/cp. started on levaquin 5-- daily (10 day course). vanco and flagyl started initially for empiric coverage for concern of open rectal flap wound v. pneumonia (ct with new focal ground glass opacity) v. bladder infection, open abdominal wound as source. plastics do not suspect open abd wound as source. on , assessed rul as most likely source of leukocytosis 3. respiratory: initial concerning of pulm edema. xray no signs of edema on . most likley pleurisy from pneumonia +/_ anxiety disorder+/_ sternal arthritis. pt was continued on albuterol/atrovent nebs q6 prncautiously 4.> chf: history of chf history but no formal tte. no signs of chf on cxr on . restarted on lasix 40 daily, continued on lsiiniopril 20, maintained on 2gm na diet 5. htn-stable on lopressor and acei 6. dm- stable cont on lantus 65 + ssi 7. chronic dvt: onocumadin for possible dvt (per pt). inr =3.4 at last. restart coumadin at 2.5 today 8. arf- imrpoved with excellent uop. restarted on lasix. 9. access: tlc changed to piv. past medical history: 1. left circumflex stent in 3/. 2. catheterization in with three vessel disease. 3. status post coronary artery bypass graft x 3. 4. s/p catheterization - with stent to native right coronary artery with an occluded saphenous vein graft. 5. insulin dependent diabetes mellitus. 6. cri with a baseline creatinine of 1.1 to 1.3. 7. hypothyroidism 8. copd 9. ? pe in 10. history of etoh. 11. pancreatitis. 12. s/p cabg complicated by osteomyelitis of the sternum. the patient had a left hemisternectomy in due to infection. sternal debridement rectus flap and bilateral pectoralis flaps. still open wound. 13. history of lens transplant in right eye secondary to cataract. last cath in : lmca normal. lad occluded . the lcx was widely patent and the stented sites were open. at the origin of the om3, there was 50% restenosis. the rca stents were widely patent. lima-lad patent. cath () the lad had a proximal 60% lesion, a mid 80% lesion, and distal competitive flow from the lima-lad. the lcx stents were widely patent with normal flow. the rca had a proximal 60% lesion at a crook, with diffuse mid disease up to a sub-total occlusion in the mid vessel. the distal vessel supplied a lower am/pda and a rpl branch. 2. successful stenting of the rca was performed with overlapping 2.5 x 28 mm and 3.0 x 13 mm cypher (drug-eluting) stents, post-dilated using 2.5 and 3.25 mm nc balloons respectively. there was <10% residual stenosis, no angiographically-apparent dissection, and normal flow (see ptca comments). social history: social history: 2 ppd x 50 years (still smoking). former etoh abuser-vodka. quit with relapses per wife. history of drug use. family history: f: died at 63 of mi physical exam: in general,no acute distress with no accessory muscle use. heent:right surgical pupil. nc/at, op clear chest: small erythematous patch at right medial and above right nipple, incisional scar, well healed c/d/i, palpable movable bone. resp: clear to auscultation bilaterally with no rales, wheezes or rhonchi. cv: rrr, s1 and s2, no m/r/g abd: open wound with minimal sero-sanguinous dressing, mildly obese, soft, nontender, nondistended with normoactive bowel sounds. no hepatosplenomegaly palpated. ext: no c/c/e neuro:cranial nerves ii through xii are intact. strength is 5 out 5 and symmetric. toes are downgoing. skin: clean, dry and intact with no lesions noted. pertinent results: ct of the chest without contrast: marked coronary artery calcifications are seen. small mediastinal lymph nodes, not meeting size criteria with pathologic enlargement are present. lung windows demonstrate changes of mild centrilobular emphysema at the apices, as well as mild paraseptal emphysema, particularly along the right major fissure. in addition, right lateral dependent change of atelectasis are seen. a subpleural 2 cm region of ground-glass opacity within the right upper lobe anteriorly, was not seen on the prior examination, and could represent an atypical infectious focus. the patient is status post sternal debridement, and there is soft tissue density and mild stranding between the two sides of the sternum. ct of the abdomen without contrast: there is a small hiatal hernia. the upper-pole of the left kidney is quite atrophic in appearance. parenchymal calcifications along the pancreas are consistent with chronic pancreatitis. ct of the pelvis without contrast: several foci of air are seen within the bladder, possibly between folds of the thickened bladder wall. note that the bladder seems more distended than we would expect given the fact that the bladder is empty.there is no pelvic lymphadenopathy or free fluid. examination of the osseous structures show no suspicious lytic or blastic lesions. impression: 1. no definite infectious source is identified. 2. ground-glass opacity along the anterior subpleural aspect of the right upper lobe may represent an early or atypical infectious process, although no definite consolidation is seen. 3. there is soft tissue density in the region of sternal debridement. given the lack of iv contrast, it is difficult to assess for small abscess collections, although no dominant or obvious fluid collection is seen. given the history of sternotomy, ultrasound may be useful for further evaluation of the soft tissues for fluid collections. 4. the bladder wall also seems quite thickened considering that it appears not distended with urine on this examination. there are foci of air, probably trapped between folds of the bladder. as the patient cannot currently receive iv contrast, gu ultrasound, with retrograde filling of the bladder through the foley catheter may be performed for further characterization of the bladder wall. 5. atrophy of the left upper renal pole. mild to moderate calcifications of the infrarenal aorta. 6. hiatal hernia. . cxr: lung volumes are low. the heart size and mediastinal contours are unremarkable. there are surgical clips overlying the left upper lobe and within the upper mediastinum bilaterally. the lungs are clear. there is no pleural effusion or pneumothorax. the osseous structures are unremarkable. . todays labs: 06:11am blood wbc-14.8* rbc-4.23* hgb-12.7* hct-36.9* mcv-87 mch-30.0 mchc-34.4 rdw-14.2 plt ct-325 06:48am blood wbc-23.0* rbc-3.76* hgb-11.2* hct-33.5* mcv-89 mch-29.7 mchc-33.3 rdw-14.4 plt ct-289 06:11am blood plt ct-325 06:11am blood pt-27.1* ptt-38.8* inr(pt)-4.6 06:48am blood pt-23.1* ptt-35.0 inr(pt)-3.4 06:11am blood glucose-pnd urean-pnd creat-pnd na-pnd k-pnd cl-pnd hco3-pnd 06:48am blood glucose-122* urean-27* creat-1.4* na-141 k-3.5 cl-106 hco3-29 angap-10 06:11am blood calcium-pnd phos-pnd mg-pnd brief hospital course: after he was transferred from the icu to the floor. he did fine. * 1. right upper lobe pneumonia- cough + xray findings. stable o2 on room air he was continued and discharged with 12 more days of levaquin 2. chest pain/coronary artery disease- he has been chest pain free since transfer. he was continued on aspirin, metoprolol, lisinopril, statin, lasix. he was discharged on these medications, except for toprol xl in place of metoprolol. . 3. hypertension- this issue was stable. he was continued on lisinopril, b-blocker and lasix * 4. diabetes- he was continued on galrgine 30 units at evening along with sliding scale insulin, * 5. hypercholesterolemia- he was continued on lipitor * 6. acute renal failure on pt with baseline of 1.1-1.3.1.4 on likely secondary to pre-renal state. monitor creatinine. * 7. hypothyroidism- continuing synthroid per outpt dose. * 8. chronic dvt-inr 3.4 on . he was asked to hold evening dose of coumadin and recheck his inr at his primary care doctor's clinic on for further instruction regarding coumadin dosage * medications on admission: medications at home: lantus 65 units qpm hiss tid 5-10 units protonix 40 qday asa 81 qday celexa 40 neurontin 600 cardura 4 qday lasix 40 qday toprol xl 100 qday lipitor 10 qday coumadin 5 qhs synthroid 175 mcg qday zestril 20 mg qday remeron 30 qday . medications on transfer from micu: levofloxacin 500 mg po q24h duration: 8 days acetaminophen 325-650 mg po q4-6h:prn lisinopril 20 mg po daily albuterol 0.083% neb soln 1 neb ih q6h:prn metoprolol 50 mg po bid aspirin ec 325 mg po daily mirtazapine 30 mg po hs atorvastatin 10 mg po daily morphine sulfate 1-2 mg iv q4h:prn citalopram hydrobromide 40 mg po bid nitroglycerin sl 0.4 mg sl furosemide 40 mg po daily pantoprazole 40 mg po q24h glargine 30 hs + ssi ipratropium bromide neb 1 neb ih q6h:prn warfarin 2.5 mg po hs levothyroxine sodium 175 mcg po daily discharge disposition: home discharge diagnosis: pneumonia coronary artery disease diabetes renal insuffiency discharge condition: stable discharge instructions: please take your medications, including your levoquin (antibiotics) for 12 more days for pneumonia. you should not take your coumadin for today. please go to your primary doctor , dr. to have your followup checkup and have your inr checked. he will let you know what to do about your coumadin. your inr today ( ) is 4.6 followup instructions: please see your primary doctor tomorrow. procedure: infusion of vasopressor agent diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia severe sepsis obstructive chronic bronchitis with (acute) exacerbation aortocoronary bypass status septic shock unspecified disorder of kidney and ureter long-term (current) use of anticoagulants 

Answer: The patient is high likely exposed to