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: briefly, the patient is an 83 year old gentleman who came in with shortness of breath and chest discomfort times two months. a catheterization at an outside hospital showed coronary artery disease and he was transferred here for a coronary artery bypass graft. past medical history: 1. deafness since age five. 2. past tonsillitis. 3. hypertension. 4. reflux esophagitis. 5. esophageal stricture status post multiple dilatations. 6. osteoarthritis. 7. hyperlipidemia. 8. erosive duodenitis. 9. diverticulitis. 10. status post right knee surgery. 11. vein stripping. 12. polypectomy. 13. bilateral cataract surgery. allergies: he is allergic to morphine and codeine causing constipation and other gi upsets. question of intravenous dye allergy history. home medications: 1. toprol xl 25 mg once a day. 2. aspirin 81 mg once a day. 3. zantac 150 mg twice a day. 4. hydrochlorothiazide 25 mg p.o. twice a day. social history: prior to this admission he was living with his handicapped wife. has no ethanol abuse history or smoking history. physical examination: physical examination was unremarkable on admission. hospital course: he was started on heparin upon arrival to the hospital and was taken to the operating room on , for a coronary artery bypass graft times three, left internal mammary artery to left anterior descending; radial obtuse marginal and left saphenous vein graft to the pda. indication was unstable angina; surgeon was dr. . first assistants were dr. , dr. , and temporau, nurse practitioner. bypass time was 103 minutes; cross clamp time was 63 minutes. the patient was transferred to the intensive care unit postoperatively where he had a complicated course. by system: 1. neurological: the patient was tolerating pain, had some complaints. mainly suffering from deafness. his pain was adequately controlled. he was sedated and we were avoiding over medication and over sedation. however, we achieved good pain control at all times. the patient did not have any focal symptoms of a stroke, did not have any symptoms of any transient ischemic attacks or any neurological signs during the course of his stay. 2. cardiovascular: the patient did not show any ischemia of his grafts during his admission. he came down with atrial fibrillation for which the patient was started on heparin. coumadin was not started until the first week of after perm-a-cath had been placed; see details below. the patient remained anti-coagulated after he had 48 hours of postoperative atrial fibrillation. lopressor was started low-dose to initial beta blockade and his pressors were slowly weaned off. the patient was also started on amiodarone to help control and to convert his atrial fibrillation. 3. respiratory: the patient was weaned off the ventilator and was extubated early during his stay. unfortunately, he was in respiratory failure and required prolonged intubation, therefore, a tracheostomy percutaneous was done on by dr. and dr. , along with a peg procedure, see details below. the patient has slowly been attempted to wean off the tracheostomy. the patient requires some resting at night, otherwise, a combination of c-pap and pressure support of varying degrees is obtained. the hope is that in rehabilitation he can be weaned off. 4. chest: the wound had healed adequately and there are no signs of infection. his leg wound similarly has healed. 5. gastrointestinal: the patient failed several speech and swallow evaluations. he received a peg endoscopically assisted on , when he was given his percutaneous tracheostomy, also by dr. and dr. . he has been on tube feeds, nepro at 35 cc an hour, which is his goal rate. 6. genitourinary: the patient has a foley catheter placed. he went into acute renal failure postoperatively. please see details below under fluids, electrolytes and nutrition. 7. hematologic: the patient's hematocrit is stable. he received several blood transfusions during the course of his stay in the intensive care unit. he is being anti-coagulated. he was on a heparin drip after perm-a-cath placement. we were able to start him on coumadin, for which a goal inr of 2.0 to 2.5 should be achieved. 8. renal: the patient is in acute renal failure which started three days postoperatively or so. dialysis was held off on until the first week of after the perm-a-cath placement. it was hoped that he would resolve. his tube feeds and fluids were maximally concentrated from the span from his operation until the first week of , however, it became evident that he required hemodialysis and in accordance with that, a right ij perm-a-cath was placed by dr. on . dialysis had been started the day prior using a left subclavian quinton line. after this, he is to receive chronic hemodialysis. 9. fluids, electrolytes and nutrition: for his electrolytes, he is on hemodialysis. for fluids, he should receive minimal fluids. he is getting tube feeds at goal of nepro at 35 cc an hour. 10. infectious disease: the patient had a febrile spike and an increase in his white blood cell count between and , showing signs of infection. his picc line which had been previously placed was cultured and grew out gram negative rods and his blood cultures grew out gram negative rods as well. these later proved to be serratia. the chest wound grew out treponema. infectious disease was consulted for this and it was felt that the sternal treponema was actually a colonization and that was not treated. the serratia was a true infection for which he was started on ceftriaxone which should continue for a therapy length of two weeks, after which time his blood should be recultured and made sure that he is cleared. his picc line was removed and after that, his white count which had increased to 18.0, was consistently coming down and as of , his white count had decreased to 7.5. 11. tubes, lines and drains: upon discharge, the patient has a tracheostomy, has a peg, has a right internal jugular perm-a-cath catheter and has a foley catheter. discharge instructions: 1. the patient will follow-up with dr. . the patient as of now is afebrile. his vital signs are stable. he is not requiring any hemodynamic support whatsoever. he is on a combination of c-pap pressure support, able to breathe on his own with varying degrees of pulmonary support, requiring rest at night. the patient's antibiotics will continue for two weeks. the patient has no cardiac issues at this time. a final addendum for his medications will be dictated just prior to discharge. , m.d. dictated by: medquist36 procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy diagnoses: coronary atherosclerosis of native coronary artery intermediate coronary syndrome unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation acute respiratory failure unspecified hearing loss other septicemia due to gram-negative organisms infection and inflammatory reaction due to other vascular device, implant, and graft 

Answer: The patient is high likely exposed to