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: weakness major surgical or invasive procedure: none history of present illness: mr. is an 89 year-old man with a history of chf (ef 30%, nyha class iii), cad s/p cabg and recent pci, and atrial fibrillation, admitted with hypotension. he has had several recent extended admissions at this hospital. most recently, he was admitted - after a fall when he was found to have a bloody r effusion (hct 2%). this was tapped, but fluid immediately reaccumulated. he was then re-admitted - for chf and nstemi with pci. at that time part of his hypoxia was thought to be due to his reaccumulated effusion, and it was again tapped, removing 1.5 l of blood-tinged sputum. his symptoms improved, and he was discharged on increased dose of diuretics. he has remained quite frail with a poor functional status, using a walker but unable to get far due to shortness of breath. his wife (25 years younger) meticulously cares for him including 6 cup daily fluid restriction. he followed up with dr. on , and spironolactone was added to his regimen. his blood pressure at home has been mostly 110s but sometimes as low as 90. for this reason his wife seldom gives his valsartan. . because of recurrent r effusion, he underwent large volume (2600 cc) thoracentesis in clinic. the procedure was stopped due to low pressures, but the patient was asymptomatic. cxr showed a well-expanded lung and a small pneumothorax that was thought to be clinically insignificant. . mr. was feeling better after the procedure, less short of breath. however, this morning his wife found him very weak and unable to climb the stairs as he usually does. she took his blood pressure and it was >100. however, he seemed very weak and not himself so he brought her to the ed. . in the ed, initial vs: 96.8 92 86/42 24 100% 3l ra. cxr was concerning for pneumonia. he was given vancomycin and levofloxacin. ip wanted to keep him dry, but he was given 1 l ns for low urine output. sbp 100 lying, 80 sitting. ekg was similar to prior. vs prior to transfer: hr 63, bp 101/46, rr 16, o2 100% on 2l past medical history: chf ( lvef = 30 %, nyha class iii) - cad h/o mi s/p cabg s/p pci, most recently - r>l leg swelling (after cabg vein harvest) - dm, diet controlled - afib following cabg not anticoagulated - htn - colon cancer, s/p partial colectomy with colostomy - hyperlipidemia - anemia - oa - bph s/p turp - h/o scrotal hydrocele - spinal stenosis - carotid stenosis - diverticulosis - gerd - h/o hernia repair - h/o stroke - h/o colon polyps - labyrinthitis - s/p detatched retina - s/p tonsillectomy social history: non smoker. no etoh. married with 5 adult children. he is retired. prior to retiring he sold life insurance. family history: non-contributory physical exam: vs: t 97.4, bp 122/53, hr 62, rr 11, o2 100% gen: pleasant man lying in bed at ~20 degrees with eyes closed, easily arousable to voice heent: moist mucosa, jvp not elevated resp: crackles throughout the lower and middle right lung field, otherwise clear with distant breath sounds cv: 3/6 systolic murmur heard best at lusb abd: empty colostomy bad, soft, nontender ext: no edema neuro: oriented x3 pertinent results: admission labs 09:25am blood wbc-9.9# rbc-3.50* hgb-10.6* hct-30.8* mcv-88 mch-30.3 mchc-34.5 rdw-15.8* plt ct-290 09:25am blood neuts-77.4* lymphs-15.3* monos-5.4 eos-1.5 baso-0.5 09:25am blood pt-14.4* ptt-28.2 inr(pt)-1.2* 08:42pm blood glucose-145* urean-24* creat-0.9 na-138 k-3.3 cl-101 hco3-29 angap-11 09:25am blood alt-17 ast-55* alkphos-63 totbili-0.8 09:25am blood lipase-23 09:25am blood ctropnt-0.03* 04:35pm blood ctropnt-0.03* 06:16am blood ctropnt-0.03* 08:42pm blood calcium-8.5 phos-2.8 mg-2.1 09:13am blood glucose-127* lactate-1.3 na-138 k-3.3* cl-95* calhco3-33* discharge labs 06:00am blood wbc-6.4 rbc-3.51* hgb-10.7* hct-30.8* mcv-88 mch-30.5 mchc-34.8 rdw-15.2 plt ct-243 06:00am blood glucose-127* urean-30* creat-0.8 na-137 k-3.9 cl-100 hco3-31 angap-10 06:00am blood calcium-8.2* phos-3.1 mg-2.0 ekg 8:52am atrial fibrillation. left axis deviation. left ventricular hypertrophy with secondary repolarization abnormality. compared to the previous tracing of no diagnostic interim change. ekg 4:45pm underlying rhythm is probably sinus, although baseline artifact makes this difficult to determine. premature ventricular contractions and premature atrial contractions are probably present. possible prior septal myocardial infarction, age undetermined. cxr impression: 1. tiny right apical pneumothorax. 2. new right lower lung opacity concerning for asymmetric/reexpansion pulmonary edema vs pneumonia. 3. bilateral small-to-moderate pleural effusions with associated compressive atelectasis. brief hospital course: mr. is an 89y/o man with an extensive cardiac history including chronic systolic chf (last ef 30%), cad s/p cabg in , last pci in with to lima, afib not on coumadin and recurrent pleural effusions s/p recent large volume thoracentesis, who presented with hypotension and weakness in the setting of increased diuretic regimen. . active issues: . # hypotension: was likely related to large volume thoracentesis on , hypovolemia from being npo and poor po intake since last discharge, strict 6 cup fluid restriction, and recent change and titration up of diuretics and antihypertensive regimen. he would clearly benefit from spironolactone and valsartan but his bp does not tolerate these medications. he was discharged on a less aggressive bp/chf regimen: stopped valsartan, stopped spironolactone. i addition, tamsulosin was stopped (he had no trouble urinating). he will continue on his home dose of torsemide and sotalol. he has close follow-up with his pcp, will also follow up in heart failure clinic. . # chronic systolic chf: last ef 30% on tte, nyha class iii. no evidence of overload now. effusions most likely due to chf. patient would benefit from spironolactone but does not seem to tolerate. he will follow up in heart failure clinic. in addition, he has pulmonology follow-up to see if the effusions have resolved. . # atrial fibrillation: he was rate controlled (60-80). he declines coumadin at home. he was continued on sotalol. . # coronary artery disease: troponin was stable at .03 x3, most likely demand ischemia in the setting of hypotension, less likely atrial stretch given no evidence of overload. last cath with . he was continued on asa 325 and plavix 75. . inactive issues: . # hyperlipidemia: stable. he was continued on simvastatin. . # anemia: hct remained near 30, similar to baseline. . # bph s/p turp: holding tamsulosin due to low bp/lightheadedness, but hehad no trouble urinating. . #. gerd: stable. continue omeprazole. . transitional issues: . #. goals of care: unfortunately, the patient has been readmitted frequently to the hospital; this time it was because of asymptomatic low sbp readings. in discussions with mr. and mrs. , it was clear that they understand the prognosis of advanced heart failure, especially in the setting of needing to cut back on medications such as spironolactone that would benefit him in the long run. they declined a discussion about goals of care, but said they would consider this and will discuss it with the pcp. medications on admission: asa 325 mg daily clopidogrel 75 mg daily docusate 100 mg mvi nitroglycein .3 mg prn omeprazole 20 mg daily simvastatin 40 mg daily sotalol 20 mg tamsulosin .4 mg qhs torsemide 20 mg daily valsartan 80 mg daily discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. torsemide 20 mg tablet sig: one (1) tablet po daily (daily). 4. sotalol 80 mg tablet sig: 0.25 tablet po bid (2 times a day): equivalent of 20mg dose . 5. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet sublingual once as needed for chest pain: may repeat every 5 minutes for 3doses; please seek help if having chest pain. 7. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. multivitamin tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: homecare discharge diagnosis: primary diagnoses: -hypotension -chronic systolic congestive heart failure -fatigue discharge condition: mental status: clear and coherent. level of consciousness: lethargic but arousable. activity status: ambulatory - requires assistance or aid (walker or cane); has been using a wheelchair. discharge instructions: you came to the hospital because of low blood pressures. after changing the doses of your blood pressure and heart failure medications, your blood pressure has improved. you would likely benefit from some of these medications in the long term; please follow up with cardiology. . weigh yourself every morning, md if weight goes up more than 3 lbs. you have been set up with home telemonitoring. . you will follow up with your pcp, (for blood pressure, coronary artery disease, and heart failure management), and also pulmonology (to follow up your pulmonary effusion). . we made the following changes to your medications: -stop valsartan -stop spironolactone -stop tamsulosin followup instructions: primary care name: , location: comprehensive healthcare llc address: , , phone: when: friday, , 1:30 cardiology department: cardiac services when: wednesday at 11:00 am with: , np building: sc clinical ctr campus: east best parking: garage pulmonology department: west clinic when: tuesday at 10:45 am with: , md building: de building ( complex) campus: west best parking: garage procedure: thoracentesis diagnoses: anemia, unspecified esophageal reflux congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation aortocoronary bypass status percutaneous transluminal coronary angioplasty status chronic kidney disease, unspecified occlusion and stenosis of carotid artery without mention of cerebral infarction other and unspecified hyperlipidemia hypotension, unspecified old myocardial infarction chronic systolic heart failure osteoarthrosis, unspecified whether generalized or localized, site unspecified personal history of malignant neoplasm of large intestine personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits hypoxemia hypovolemia subendocardial infarction, subsequent episode of care diverticulosis of colon (without mention of hemorrhage) personal history of colonic polyps personal history, urinary (tract) infection acquired absence of intestine (large) (small) 

Answer: The patient is high likely exposed to