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: patient recorded as having no known allergies to drugs attending: chief complaint: chills. major surgical or invasive procedure: intubation in the medical intensive care unit. history of present illness: mr. is an 81 yo male with pmh of cad and alzheimers dz who presents from rehab with fever and hypoxia. he was empirically started on doxycycline 100 mg po bid for uti one day prior to admission. this evening he developed shaking chills and ??????looks sick?????? according to rn. temperature 99.8. bp 140/70. hr 100, rr 28, o2 sat was 86% on ra-->94% on 3l. patient was put on nrb and o2 sat improved to 97%. wbc yesterday 13.4. urine c&s was obtained yesterday and pending. . in the emergency department, initial vital signs were: t 99.7 hr 96 bp 93/44 rr 16 95% on 3l. labs were notable for a lactate of 3.7, bicarb of 21, ag of 15, a ua with 21-50 wbcs, arf with cr 1.5 (bl 0.9), and trop of 0.04 with nl ck/ckmb. he received 2l of ivf, vancomycin, zosyn and cefepime, and a right ij cvl was placed. of note the patient had a chronic foley in place. this was removed in the ed. upon removal, there was quite a bit of bleeding at the meatus. urology was called, and placed a new foley. vitals prior to transfer bp 94/50 hr 104 rr 25 99% on nrb. cvp was 9. patient was intubated prior to transfer. he received fentanyl and versed, and was subsequently started on low dose levophed. . on the floor, patient is intubated and sedated. past medical history: -alzheimers dementia: dx , chair bound, disinhibited -hypertension -diastolic chf with reported ef 65% (no echo in our system) -cva: in -cad s/p mi in -cri: since -penile cancer: dx with 2 areas of ulceration at end of penis -normal pressure hydrocephalus (with ataxia, dementia, incontinence) -upper back cyst resection -c. diff: resolved in on vanc taper -prostate cancer: ~, treated with radiation and ? surgery. social history: at baseline, he lives in rehab where he has been for the past 4 years. his is wheelchair bound but can move his own wheel chair. dines with a group but sometimes forgets that he is eating. occasionally sexually inappropriate. in the past, he dranks very rarely and never heavily. he smoked one pack of cigarettes a day for many years. family history: his mother died at 77 allegedly of a heart attack. his father died at 78 of unknown causes. allegedly, they had normal memories at the end, but the patient did not keep up with his parents who lived in . he has a brother age 80 in good health. he has a sister age 67 also in good health. we don't know details about their memory. he has three daughters, 42, 38 and 34, all in good health. he has ten grandchildren, all well. physical exam: vitals: t: bp: 108/64 p:90 r: 18 o2: 97% on ac fio2 100%, tv 500, rr 16, peep 5 general: intubated and sedated heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally on anterior exam, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: penis wrapped. foley present. ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: complete blood count: 10:10pm blood wbc-7.9 rbc-4.75 hgb-14.2 hct-41.4 mcv-87 mch-29.8 mchc-34.2 rdw-13.8 plt ct-135*# 02:53am blood wbc-24.3*# rbc-4.01* hgb-11.7* hct-35.0* mcv-87 mch-29.1 mchc-33.4 rdw-14.1 plt ct-161 02:51am blood wbc-16.3* rbc-3.91* hgb-11.2* hct-33.9* mcv-87 mch-28.7 mchc-33.1 rdw-14.3 plt ct-144* 06:09am blood wbc-11.2* rbc-3.98* hgb-11.4* hct-34.5* mcv-87 mch-28.7 mchc-33.1 rdw-14.2 plt ct-158 07:25am blood wbc-11.5* rbc-4.20* hgb-11.7* hct-35.3* mcv-84 mch-27.9 mchc-33.2 rdw-13.8 plt ct-150 . coagulation profile: 10:10pm blood pt-14.2* ptt-30.3 inr(pt)-1.2* 02:53am blood pt-14.6* inr(pt)-1.3* 02:51am blood pt-12.9 ptt-34.7 inr(pt)-1.1 10:10pm blood glucose-118* urean-48* creat-1.5* na-141 k-3.9 cl-105 hco3-21* angap-19 02:53am blood glucose-155* urean-43* creat-1.4* na-142 k-3.5 cl-111* hco3-20* angap-15 02:51am blood glucose-139* urean-28* creat-1.1 na-143 k-4.1 cl-114* hco3-21* angap-12 06:09am blood glucose-90 urean-15 creat-0.9 na-142 k-3.4 cl-107 hco3-25 angap-13 07:25am blood glucose-77 urean-14 creat-0.9 na-140 k-3.5 cl-105 hco3-23 angap-16 02:53am blood calcium-7.6* phos-2.9 mg-1.5* 02:51am blood calcium-7.6* phos-2.2* mg-2.2 06:09am blood calcium-8.3* phos-2.9 mg-1.9 07:25am blood calcium-8.3* phos-3.3 mg-1.9 . cardiac enzymes: 10:10pm blood ck(cpk)-302 02:53am blood ck(cpk)-264 09:59am blood ck(cpk)-159 06:09am blood alt-25 ast-27 10:10pm blood ck-mb-4 10:10pm blood ctropnt-0.04* 02:53am blood ck-mb-4 ctropnt-0.07* 09:59am blood ck-mb-4 ctropnt-0.03* . blood gases: 03:13am blood type-mix temp-38.5 po2-205* pco2-47* ph-7.26* caltco2-22 base xs--5 comment-green top 04:08am blood type-art po2-398* pco2-38 ph-7.32* caltco2-20* base xs--5 06:56am blood type-art temp-37.2 rates-16/3 tidal v-500 peep-5 fio2-40 po2-139* pco2-37 ph-7.33* caltco2-20* base xs--5 -assist/con intubat-intubated 10:30am blood type-art temp-37.1 po2-120* pco2-39 ph-7.33* caltco2-21 base xs--4 -assist/con intubat-intubated 02:57am blood type-art po2-131* pco2-34* ph-7.42 caltco2-23 base xs--1 . 10:14pm blood lactate-3.7* 03:13am blood lactate-2.8* 10:30am blood lactate-1.8 . urine: 10:21pm urine color-red appear-cloudy sp -1.015 10:21pm urine blood-lg nitrite-pos protein-300 glucose-neg ketone-tr bilirub-sm urobiln-1 ph-8.5* leuks-lg 10:21pm urine rbc->50 wbc-21-50* bacteri-mod yeast-none epi-0-2 . blood culture: proteus mirabilis, enterococcus urine culture: probable enterococcus urine legionella antigen negative dfa influenza a and b negative blood culture x 2: no growth to date blood culture: pending . cxr: impression: left lower lobe opacity, atelectasis or consolidation. . cxr: impression: mild-to-moderate cardiomegaly is stable. right ij catheter tip is in the cavoatrial junction. the aorta is tortuous. bibasilar opacities are likely atelectasis and are unchanged. the lungs are hyperinflated. there is no pneumothorax or enlarging pleural effusion. . cxr: findings: interval removal of right internal jugular vascular catheter with no evidence of pneumothorax. unchanged cardiomegaly and tortuosity of the thoracic aorta. new patchy opacities have developed at the periphery of both lung bases and are nonspecific. their rapid development favors either atelectasis or aspiration over infectious pneumonia, but a followup radiograph may be helpful in this regard. there are probable small pleural effusions. . renal ultrasound: impression: 1. no evidence of obstruction. 2. unchanged right renal stone. 3. multiple bilateral renal cysts, not significantly changed from prior. . ecg: sinus tachycardia. left atrial abnormality. right bundle-branch block. left anterior fascicular block. consider left ventricular hypertrophy. consider prior anterior myocardial infarction, although it is non-diagnostic. anterolateral st-t wave abnormalities are primary and they are non-specific. since the previous tracing of the marked inferior and precordial lead t wave inversions are now absent, sinus tachycardia is now present and atrial ectopy is not seen. brief hospital course: this is a 81 year old with pmh significant for cad, multiple utis in the past, who was admitted with sepsis secondary to sepsis. status post 3 day course in the micu, called out to the general medicine floor. . #. sepsis: presented with altered mental status, leukocytosis, fever in the setting of positive urine analysis. in the ed, patient was started on vancomycin, zosyn, and cefepime and central line was placed. urology placed new foley. was initially intubated and placed on low dose levophed in the micu. blood cultures found to grow proteus and enterococcus, with presumed urinary source. was found to have positive u/a and growth of enterococcus in urine culture. levophed was successfully weaned without difficulty and extubated without issue. upon transfer to general medicine floor, hemodynamically stable with downtrending leukocytosis. will continue iv vancomycin and zosyn as an outpatient for 14 day course (day 1 on ). will complete course at macu of rehab. . #. hypoxia: unclear etiology, though chest radiograph on showed new patchy opacities at the periphery of both lung bases. their rapid development favored either atelectasis or aspiration over infectious pneumonia. also with history of diastolic chf as per omr notes, but appeared euvolemic on physical exam. urine legionella and influenza dfa were negative. will continue iv vancomycin and zosyn as above for full 14 day course. zosyn will provide appropriate anaerobic/gram negative coverage for aspiration. . #. acute renal failure: resolved with iv hydration. elevated on admission to 1.5. baseline per omr appears to be 0.9, though he has cri listed as a problem. likely secondary to poor forward flow in the setting of sepsis. renal ultrasound showed no obstruction. . #. renal cysts: pt was noted to have multiple hypoechoic kidney lesions involving both kidneys on renal us done , also present on repeat imaging during this admission. these were previously known to both dr. and family; they elected not to pursue further workup, given the patient's comorbidities. . #. tortuous aorta on cxr, question for aneurysm. will monitor as an outpatient. no aggressive intervention at this time. . #. anion gap metabolic acidosis: resolved. likely from lactic acidosis in the setting of poor end organ perfusion. repeat lactate resolved with fluids. . #. alzheimers dementia: stable. per family, close to baseline mental status, where he is usually able to recognize faces and family members. . #. htn: holding home atenelol and finasteride in the setting of resolving sepsis. will need to discuss reinitiation of these medications as an outpatient. . #. cad: stable, ecg shows twi that are non-specific and similar to previous ecg. enzymes flat. continued on asa 81mg and statin. beta blocker was held as above. medications on admission: 1.senna 8.6 mg po bid 2.aspirin 81 mg po daily 3.atenolol 50 mg po daily 4.calcium carbonate 500 mg po bid 5.cholecalciferol (vitamin d3) 1,000 unit po daily 6.finasteride 5 mg po daily 7.simvastatin 40 mg po daily discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 4. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid: prn as needed for thrush. 7. piperacillin-tazobactam-dextrs 4.5 gram/100 ml piggyback sig: one (1) intravenous q8h (every 8 hours) for 11 days. 8. vancomycin in dextrose 1 gram/200 ml piggyback sig: one (1) intravenous q 12h (every 12 hours) for 11 days. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: sepsis secondary to urinary tract infection hypoxia acute renal failure alzheimer's dementia hypertension coronary artery disease discharge condition: mental status:confused - sometimes level of consciousness:alert and interactive activity status:out of bed with assistance to chair or wheelchair discharge instructions: it was a pleasure taking care of you at . you were admitted to the hospital due to fever and low oxygen levels and found to have a urinary tract infection that spread to your bloodstream. you were placed temporarily on a breathing machine and required medications to keep your blood pressure within normal range. you were given iv fluids, starting on iv antibiotics and have improved. . we have made the following changes to your medications: - started vancomycin (last dose on ) - started zosyn (last dose on ) - hold atenolol until you see your primary care physician finasteride . please seek medical attention should you develop confusion, pain with urination, urinary frequency, cough, fever, chills, nausea, vomiting, or diarrhea. followup instructions: your primary care physician, . of rehab, will see you upon your return to the facility. md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube insertion of indwelling urinary catheter diagnoses: pneumonia, organism unspecified acidosis coronary atherosclerosis of native coronary artery urinary tract infection, site not specified congestive heart failure, unspecified acute kidney failure, unspecified severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified personal history of malignant neoplasm of prostate chronic kidney disease, unspecified pulmonary collapse other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure pneumonitis due to inhalation of food or vomitus septic shock old myocardial infarction other septicemia due to gram-negative organisms personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits injury to bladder and urethra, without mention of open wound into cavity alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance streptococcal septicemia hematuria, unspecified personal history of irradiation, presenting hazards to health chronic diastolic heart failure cyst of kidney, acquired personal history of methicillin resistant staphylococcus aureus personal history of malignant neoplasm of other male genital organs wheelchair dependence anomaly of aorta, unspecified 

Answer: The patient is high likely exposed to