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: service: acove-medicine history of present illness: the patient is an 86 year old gentleman presenting from the facility for altered mental status described as "lethargy" times approximately four days, as well as question of worsening anemia. the patient is speaking and upon arrival in was minimally responsive to even noxious stimuli. the eye position was midposition. the pupils were felt to be minimally reactive. the patient was not following commands, even commands in russian. the patient in the emergency department became increasingly awake and alert, status post dosing of narcan although it emergency department was negative for narcotics. on repeat examination at the time the patient arrived at the floor, through an interpreter, the patient was awake and alert and not sure why he was at the or really the name of the facility. even he denied fever, chills, chest pain, shortness of breath, headache, abdominal pain, change in vision, change in strength, change in sensation. he stated he had been somewhat short of breath approximately seven days ago but had not experienced the symptoms since that time. the patient is reported to have had an episode of decrease in blood pressure on , at the center. he does have a recent history of discharge from the on , for anemia and transient renal insufficiency. additionally, please note that the patient had a recent admission to the between , and , for atrial fibrillation with hospital course complicated by an exaggerated response to lopressor producing unresponsiveness and hypotension, noting that the patient's vital signs in the emergency department at this admission were stable at a heart rate of 75, blood pressure 122/90, respiratory rate 20, and pulse oximetry 97% on four liters. past medical history: 1. recent discharge , for anemia. 2. parkinson's disease. 3. depression with psychotic features with a history of a suicide attempt. 4. colon cancer, status post hemicolectomy in . 5. benign prostatic hypertrophy. 6. gastroesophageal reflux disease. 7. history of atrial fibrillation. 8. history of c. difficile. 9. history of loculated pericardial effusion with pericarditis. 10. alert and oriented times two at baseline. allergies: no known drug allergies. medications on admission: 1. lasix 40 mg p.o. b.i.d. 2. neurontin 500 mg p.o. t.i.d. 3. atenolol 25 mg p.o. q.d. 4. aspirin 81 mg p.o. q.d. 5. sinemet 25/100 two tablets p.o. q.i.d. and one tablet p.o. q.h.s. 6. ibuprofen 600 mg p.o. t.i.d. 7. prevacid 30 mg p.o. q.d. 8. flomax 0.4 mg p.o. q.d. 9. seroquil 100 mg p.o. b.i.d. (noting that had been recently decreased from 150 mg p.o. b.i.d. physical examination: in the emergency department, afebrile at 98.4, pulse 74, blood pressure 144/63, respiratory rate 12, 97% in room air and 100% on four liters. general - somnolent, opening eyes to verbal commands, not following commands, normocephalic and atraumatic. the pupils are equal, round, and reactive to light and accommodation. the neck was supple. chest was clear. cardiac - regular rate and rhythm. the abdomen was benign. rectal examination was negative for occult blood. there was 1+ edema bilaterally. the skin was warm and dry. the patient as noted was somnolent and unable to follow commands. the examination when the patient arrived on the floor the night of , the patient was afebrile, blood pressure 148/100, pulse 53, respiratory rate 18, pulse oximetry 93% in room air. in general, the patient is awake, alert in no apparent distress. there was a question of jugular venous distention but the pulsus was 4 to 5 (not elevated). the oropharynx was exceptionally dry. there was noted to be poor dentition. there were upper dentures in place with white exudate versus dry mucus in the posterior aspect of the oropharynx. the patient was oriented to and the year , with the month being , on repeated questioning. he could pick the type of building as hospital from a list but could not generate this on his own. the pupils are equal, round, and reactive to light and accommodation. extraocular movements are intact. the strength was full and symmetrical to limited examination in the upper and lower extremity flexors and extensors. cardiac examination was unremarkable with regular rate and rhythm, no murmurs were noted. there were dry crackles at the bases, right greater than the left, and otherwise the patient was clear to auscultation bilaterally. the abdomen demonstrated a well healed midline scar, soft, nontender abdomen with normal abdominal sounds. there is no edema noted. the patient was awake and alert in no apparent distress. laboratory data: white blood cell count at the time of admission was 5.3, hematocrit 28.8, with normal differential. platelet count was 317,000. coagulation studies were essentially unremarkable. urine was negative for urinary tract infection. chem7 sent at the time of admission on , at 1:30 p.m. was sodium 139, potassium 3.8, chloride 98, bicarbonate 28, blood urea nitrogen 20, creatinine 1.5**a significant value. glucose 111. calcium 8.8, magnesium 1.6, phosphate 2.9. arterial blood gases in the emergency department on , at 3:40 p.m. had a ph 7.47, pco2 46, po2 77. urine culture is pending at the time of this dictation. head ct was performed on , with the following impression: "no acute intracranial pathology, brain atrophy". chest x-ray was performed on , with the following impression: "persistent pericardial and pleural effusions". hospital course: the patient was admitted with the above complaints with having received doses of narcan in the emergency department. although the toxicology screen was negative for narcotics, the patient's mental status improved markedly although there was no clear cause and effect relationship for this change. by the time the patient arrived at the medical floor, his mental status was apparently more or less at the baseline. his creatinine was noted to be elevated to 1.5 and the patient was gently hydrated with 750 ccs of normal saline overnight with a resultant decrease in the patient's creatinine to 0.9 the day following admission, noting that the patient's mouth had been quite dry at the time of admission and it was moist on the morning following admission. the etiology of the patient's mental status change observed in the emergency department with stable vital signs and unclear precipitant of resolution at this time is still unclear, but possibilities are felt to include dehydration which has now been corrected, the possibility of narcotic ingestion responding to narcan, the patient's psychiatric or neurologic problems including depression or disease although parkinson's disease the sinemet has not recently changed. the seroquil has recently been decreased and is currently being held though these possibilities appear less likely than others. head ct was performed as noted above to rule out acute intracranial pathology including bleeding. additionally, please note that the geriatric fellow raised the possibility of seizure although the patient is not reported to have had positive phenomenon including tonoclonic movements or eye movements consistent with seizure during the period of unresponsiveness. the possibility of occult seizure is still open to question and the patient will be observed for approximately 24 additional hours to insure that such an episode does not recur. at this time, the patient's mental status is approximately baseline and the patient is stable and will be observed for the forthcoming day with reassessment at that time and possible discharge back to center in the morning. medications on discharge: (at the time of this dictation) 1. lopressor 25 mg p.o. b.i.d. (to be changed to atenolol 25 mg p.o. q.d. prior to the time of the patient's discharge to ). 2. flomax 0.4 mg p.o. q.d. 3. prevacid 30 mg p.o. q.d. 4. sinemet 25/100 two tablets p.o. q.i.d. and one tablet p.o. q.p.m. 5. aspirin 81 mg p.o. q.d. 6. colace 100 mg p.o. b.i.d. discharge diagnoses: 1. dehydration. 2. altered mental status possibly secondary to dehydration or other factors yet to be determined. please note that additional diagnoses may be found in past medical history. condition at time of dictation: stable. discharge plan: the current plan is for discharge back to center. the patient should not have increased beta blocker without close supervision including frequent blood pressure monitoring and neurologic checks as he has a history of unresponsiveness and hypotension because of sensitivity to beta blockade although he is stable on his current dosing. sedating medications should be avoided. the patient should be closely monitored for signs of dehydration and creatinine should be checked q.d. to q.o.d. for one week versus signs for volume overload including pulse oxygenation measured b.i.d. and on examination as the patient may either need additional hydration or diuretic to insure that he does not begin to become dehydrated, nor does he have worsening of his pulmonary status. dr., dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis percutaneous [endoscopic] gastrostomy [peg] biopsy of blood vessel diagnoses: esophageal reflux hyposmolality and/or hyponatremia atrial fibrillation methicillin susceptible staphylococcus aureus septicemia pneumonitis due to inhalation of food or vomitus grand mal status coma major depressive affective disorder, single episode, severe, specified as with psychotic behavior 

Answer: The patient is high likely exposed to