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: lidocaine attending: chief complaint: weakness and nausea/vomiting major surgical or invasive procedure: cardiac cath history of present illness: 83 year old male with htn, dm, hx cva, pvd s/p bilateral bka's, was transferred from after presenting with 1 week weakness and 24 hours of n/v/d. w/u at osh revealed new arf with cr 2.4, ck 1720, tn 6 with ekg revealing inferior q's. bp on admission 80's/40's. given aspirin, plavix, heparin and dopamine gtt. at ed, noted to be febrile to 101.2 with uti. pt then admitted to micu. past medical history: htn niddm hx cva ' bilateral bka's social history: 30 pack year tob, now quit. no etoh or ivdu. lives alone. family history: non-contributory physical exam: 98.1 141/65 80-95 20 gen: nad, a& o x 3, comfortable, heent: eomi, perrl, mmm, few excoriations on face neck: no jvd or lad heart: tachy. irregular. cresendo systolic murmur at base radiating to carotids. also holosystolic murmur at apex with no radiation. lungs: few crackles left lower lung field. abd: soft, nt/nd. +bs. ext: bilateral bka's. no sacral edema. pertinent results: 06:15am blood wbc-8.1 rbc-4.12* hgb-12.2* hct-35.4* mcv-86 mch-29.6 mchc-34.4 rdw-14.4 plt ct-248 08:26pm blood wbc-16.0* rbc-2.98* hgb-8.9* hct-26.7* mcv-89 mch-30.0 mchc-33.5 rdw-14.8 plt ct-56* 09:30pm blood wbc-12.9* rbc-3.84* hgb-11.7* hct-34.9* mcv-91 mch-30.5 mchc-33.5 rdw-14.1 plt ct-90* 06:15am blood plt ct-248 05:24am blood pt-12.5 ptt-26.2 inr(pt)-1.0 04:05am blood plt ct-52* 09:30pm blood plt smr-low plt ct-90* 04:49am blood fibrino-442* 06:15am blood glucose-191* urean-26* creat-0.9 na-138 k-4.0 cl-100 hco3-30* angap-12 02:01am blood glucose-163* urean-53* creat-1.8* na-143 k-4.1 cl-117* hco3-17* angap-13 05:24am blood alt-93* ast-46* alkphos-164* totbili-0.8 04:49am blood alt-348* ast-295* ld(ldh)-392* ck(cpk)-1679* alkphos-101 totbili-0.9 02:01am blood ck(cpk)-4156* 10:47am blood ggt-96* 06:07am blood lipase-28 05:30pm blood ck-mb-79* mb indx-6.7* ctropnt-1.44* 06:15am blood calcium-7.7* phos-2.9 mg-2.1 04:49am blood albumin-2.8* calcium-7.8* phos-3.1 mg-2.3 10:47am blood tsh-2.4 10:47am blood free t4-1.3 04:26am blood cortsol-46.9* 03:55am blood cortsol-40.9* 03:16am blood cortsol-33.8* 10:47am blood digoxin-1.3 09:57pm blood lactate-2.3* tte: the left atrium is mildly dilated. left ventricular wall thicknesses and cavity size are normal. there is moderate regional left ventricular systolic dysfunction with akinesis of the basal 2/3rds of the inferolateral and basal inferior walls. the distal septum is also hypokinetic. the remaining segments contract well. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are moderately thickened. there is a minimally increased gradient consistent with minimal aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: regional left ventricular systolic dysfunction c/w cad. minimal aortic valve stenosis. mild mitral regurgitation. cath: 1. three vessel coronary artery disease. 2. moderate diastolic dysfunction. 3. successful pci of the lad. comments: 1. selective coronary angiography revealed a right-dominant system. the lmca had no angiographic disease. the lad had 70% ostial and sequential 80% proximal lesions with diffuse moderate disease. the lcx had on occluded om2 with diffuse severe proximal disease and an 80% mid-vessel lesion. the rca had an 80% proximal lesion with a total occlusion after a high-rising pda which had proximal disease to 70%. the rca filled via lca collaterals. 2. left ventriculography was deferred. 3. resting hemodynamics revealed moderately elevated left-sided filling pressures (pcwp 21 mmhg mean). the right sided filling pressures were mildly elevated (ra mean 6mmhg, pa mean 30mmhg). the calculated cardiac index was 2.1 l/min/m2. 4. successful pci of the lad with rotational atherectomy with a 1.5 mm burr and ptca/stenting using a 2.5 x 28 mm cypher des (overlapping, covering both ostial and proximal lad lesions). a 7 french iabp was placed in the rfa prophylactically during the case and removed at the end of the case. brief hospital course: 83 year old male with pvd, hx cva, htn, dm with pna and early sepsis, precipitating demand ischemia then unstable angina then myocardial damage and cardiogenic hemodynamic embarassament. 1. cad: pt's peak ck 4156. initially attributed to demand event in setting of comorbidities (see below), but then developed run of symptatic monomorphic vt, which was attributed to coronary disease, so mr. was then taken to the cath lab. found to have 3vd with probable culprit lesion mid-lad. after extensive discussion with family, the decision to defer cabg was made based on high risk of peri-operative mortality. after overlap stenting of lad, the pt remains pain free and stable. pt was started on aspirin and plavix, and will be on plavix for at least 9 months. beta-blocker was carefully started, given hx of hypotension. will be d/c'd on toprol xl 50 qd. also on lisinopril 10 mg po qd. high-dose statin for life. mr. could very well continue to have angina that may be secondary to his non-revascularized lcx, rca, om2 or pda lesions. 2. pump: pt with ef 35-40% with regional wall motion abnormalities. cardiac output and index 3.5/2.1, pcwp 28, and svr 1600. iabp was used transiently during the pt's cath. he transiently required dopamine, which was switched to neosynephrine then vasopressin. this pressor requirement was attributed to combination cardiogenic shock and early sepsis. he currently has no pressor requirement. digoxin was added to mr. regimen to augment his inotropy. pt diuresed while in house but does not require any further diuresis as outpt. now that pt is partly revascularized, his ef may have improved slightly and he may need an echo in the future to better estimate his systolic function. 3. rhythm: mr. was noted to have a variety of arrhythmias while in house. his sinus rhythm has prolonged av nodal delay of 225 msec and inferior q's on surface ecg. prior to cath the pt had occasional 6-8 beat runs of nsvt. he also had a 40 beat run monomorphic vt 24 hours following recanulization, which was self-terminated. he did not have any further episodes of vt or nsvt. mr. was also noted to go in and out of a-fib/flutter. his ventricular response is controlled in the 70's - 90's. digoxin was started to further control his rate. he will be discharged with toprol xl 50 mg po qd for further rate control (please watch the pt's pr if deciding to titrate up the beta-blocker, or any other nodal blocker). the pt has been started on coumadin given his very high chads risk score of . 4. id: pt noted to have a dirty ua on admission and a left lower lobe infiltrate on cxr. his hypotension was initially attributed to infection/sepsis, but his hemodynamics were more consistent with cardiogenic shock (see above). he was started on levaquin and ceftriaxone for uti and pna. all urine and blood cultures have returned with no growth. max wbc 24.9 (with 30% bandemia) and temperature 101.9. these trended down and currently mr. has no fever and his wbc count is 8.1. his ceftriaxone was d/c'd on day #5. the patient will continue on levaquin for total of 14 days, will end on . 5. hypotension: transferred to on dopamine gtt and the pt continued to require blood pressure augmentation with neosynephrine, vasopressin and prn fluid boluses. initially attributed to sepsis, but hemodynamics during right heart cath were more consistent with cardiogenic shock (co/ci 3.42/2.08, pcwp 28, svr 1600). the pt's hypotension normalized after revascularization of lad. 6. arf: mr. was transferred with cr 0f 1.8 with fena 1.2%. this trended down with improved blood pressure augmentation. etiology likely non-oliguric atn in setting of persistent renal hypoperfusion. currently cr 0.8 and gfr estimate of 98 ml/min/meter^2 by mdrd equation (may be overestimate given lack of lower extremity musculature). 7. thrombocytopenia: pt admitted with plt nadir of 90k. currently 248k. most likely explanation is dic given coagulopathy at time of presentation also. however, although low pre-test prob, all heparin and heparin containing compounds were discontinued for worry of hit. mr. has no evidence of arterial/venous thrombosis seen in hit. he had one hit ab that returned negative and his seretonin release assay is still pending from . 8. transaminitis: ast 348 alt 295 and ldh 392. all trending down and thought to be secondary to hepatic congestion in setting of cardiogenic shock. current levels as above. medications on admission: atenolol 25 daily liinopril 40 daily actos 30 daily hctz 12.5 daily glipizide 10 aspirin 325 daily lipitor 40 daily discharge medications: 1. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. trazodone hcl 50 mg tablet sig: 0.5 tablet po hs (at bedtime) as needed for insomnia. disp:*30 tablet(s)* refills:*0* 5. pioglitazone hcl 30 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. digoxin 125 mcg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. atorvastatin calcium 40 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 8. metoprolol succinate 25 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). disp:*30 tablet sustained release 24hr(s)* refills:*2* 9. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. glipizide 10 mg tab, sust release osmotic push sig: one (1) tab, sust release osmotic push po daily (daily). disp:*30 tab, sust release osmotic push(s)* refills:*2* 11. levaquin 500 mg tablet sig: one (1) tablet po once a day for 6 days. disp:*6 tablet(s)* refills:*0* discharge disposition: extended care facility: life care center of discharge diagnosis: nstemi ventricular tachycardia cardiogenic shock left lower lobe pneumonia thrombocytopenia retroperitoneal hematoma discharge condition: good discharge instructions: if you have these symptoms, your doctor or go to the ed: - chest pain - shortness of breath - dizziness - visual changes - blood in stool - black stools - sudden weakness - fever, chills followup instructions: please your pcp and be seen within 10 days. please the general cardiology clinic, to arrange follow-up in 1 month. procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters implant of pulsation balloon transfusion of packed cells nonoperative removal of heart assist system insertion of drug-eluting coronary artery stent(s) infusion of vasopressor agent diagnoses: pneumonia, organism unspecified thrombocytopenia, unspecified subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery pure hypercholesterolemia acute kidney failure with lesion of tubular necrosis 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 hematoma complicating a procedure defibrination syndrome other specified cardiac dysrhythmias cardiogenic shock below knee amputation status chronic passive congestion of liver 

Answer: The patient is high likely exposed to