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: obtunded at rehab major surgical or invasive procedure: none history of present illness: 79yom with h/o dementia, chf (ef 55% with regurg), s/p pacer, s/p mvr/avr, admitted to /06 with right hip pain and diagnosed with mrsa uti, lll pneumonia, and c.difficile infection, discharge to rehab where today he was found obtunded with agonal respirations and sent to ed. prior hospital course was complicated by acute renal failure due to prerenal azotemia, delirium, coagulopathy due to supratherapeutic warfarin, and hypothyroidism. he was discharged to on a continued course of azithromycin, vancomycin, ceftriaxone, and metronidazole. he completed all courses other than the metronidazole which was scheduled to continue for 14days after completion of other antibiotics. this had been changed to po vancomycin. he was also on pcn v ?infection. according to records from the patient was short of breath on the night prior to presentation, agitated, and refused all food and po medications. today his oxygen saturation dropped to low 80%s, and he was placed on a non-rebreather mask. lasix was administered, and saturation improved to 96%. per ems report patient was obtunded, moving extremities but not responding to voice or pain, with agonal respirations rr 10. however, transfer report from reports vs on transfer bp 107/63 hr 62 rr 22 100%on nrb. he was intubated in the field for airway protection and transferred to ed. on arrival to the ed vs t 96.0r hr 63 bp 83/31 rr 16 100%vent. he received 1l ns bolus, vancomycin, levofloxacin, and metronidazole. bp improved to 105/55 prior to transfer to the icu. abg in ed reported to be 7.16/63/46 on 100%fio2, although was likely venous. repeat abg unchanged. on presentation to the icu he is intubated and sedated but responding to pain and manipulation by swinging arms bilaterally. no response to commands. withdraws to pain in all four extremities. past medical history: dementia htn cad s/p cabg cri mechanical mvr and avr () s/p dual chamber pcm (for bradycardia, syncope in ) cardiomyopathy with ef 30% () pulm htn s/p left mca stroke () s/p hip fracture hypothyroidism gout . pshx: left inguinal herniorrhaphy in social history: heavy smoker for 50 years, quit 10 years ago, no current alcohol use. he lives at home and gets vna services. family history: noncontributory physical exam: pe: t 94.2r hr 65 bp 122/67 rr 25 100% wt 62kg ac tv 400 rr 20 fio2 40% peep 5 gen: initially agitated and hitting with hands, then sedated, kyphotic heent: per, sluggishly reactive, anicteric, conjunctiva pink, ett neck: supple, palpable but nonenlarged cervical lad, jvp nondistended cv: rrr, pmi lateral, ii/vi sem at lusb with mechanical click resp: cta posteriorly with decreased bs left base, coarse anteriorly abd: +bs but decreased, soft, nd, no masses ext: diffuse 3+ ble, bue edema skin: diffuse skin tears on bue/ble, bullous lesions on ble, erthema/scaling over sacrum neuro: , , withdraws to pain in all four extremities pertinent results: 05:30pm blood wbc-14.5* rbc-3.09* hgb-9.2* hct-30.9* mcv-100*# mch-29.6 mchc-29.6* rdw-24.1* plt ct-175 04:18am blood wbc-11.1* rbc-3.05* hgb-9.0* hct-28.8* mcv-94 mch-29.4 mchc-31.2 rdw-22.7* plt ct-170 05:30pm blood glucose-142* urean-28* creat-1.7* na-148* k-4.9 cl-119* hco3-20* angap-14 04:18am blood glucose-76 urean-25* creat-1.7* na-145 k-3.8 cl-114* hco3-20* angap-15 05:29am blood alt-25 ast-44* alkphos-128* totbili-1.0 05:30pm blood caltibc-204* vitb12-* folate-10.2 hapto-<20* ferritn-170 trf-157* 05:30pm blood tsh-14* 05:24am blood free t4-1.2 brief hospital course: 79yom with h/o vascular dementia, chf, cad s/p cabg, s/p mvr/avr, chronic kidney disease p/w hypothermia, acidemia, delirium. # respiratory failure: intubated for airway protection in field, hypercapneic and hypoxemic on admission. cxr concerning for untreated pna, community-acquired vs rehab-acquired vs aspiration. pt tolerated extubation well. satting fine on o2 by nc. nothing growing in cultures. initial presentation likely oversedation followed by aspiration pneumonitis/pneumonia. pt made dnr/dni during later part of admission, then soon made cmo and palliative care consulted. pt discharged to palliative care. # ckd: h/o ckd but creatinine 1.0 prior to last hospitalization during which he suffered acute prerenal azotemia. creatinine now 1.6. likely new baseline is 1.2-1.4. # acidemia: resolved after intubation. patient had combined non-gap metabolic and respiratory acidosis on admission that resolved on the ventilator. had elevated lactate and hypothermia on admission that was concerning for sepsis. respiratory component likely oversedation at rehab facility. head ct unchanged from prior. # chf: ef >55% on echo . no acute decompensation. initially held metoprolol given concern for sepsis. not on ace likely recent acute renal failure. volume status managaed with prn furosemide. # cad: s/p cabg. elevated troponin on admission with nml ck likely due to strain in setting of renal dysfuction. # s/p mvr/avr: inr supratherapeutic on admission; held warfarin given acute decompensation. discharged to palliative care. medications on admission: warfarin per inr level aspirin 81mg daily colace 100mg levothyroxine 50mcg daily metoprolol 25mg mvi olanzapine 5mg qam, 2.5mg qpm, 2.5mg prn protonix 40mg daily pcn v 500mg po q6hr kcl 20meq daily vancomycin 250mg po q8hr atrovent neb prn sob oxycodone 2.5mg q8hr prn pain tylenol q4hr prn pain, fever albterol neb q4hr prn sob dulcolax 10mg pr prn constipation discharge medications: 1. lorazepam lorazepam liquid 2 mg/ml 0.25-2 mg po q4-6hrs prn agitation/anxiety/shortness of breath dispense 10 ml 2. hospital bed please provide semi-electric bed with air mattress 3. oxygen please provide oxygen with liter flow via nasal canula 4. suction system please provide portable suction system and tubing 5. ativan/benadryl/haldol abh 1 mg/12 mg/2 mg td gel apply 1 ml transdermally q4-6hrs prn severe agitation dispense 6 ml 6. compazine compazine 50 mg/ml td gel 5-20 mg po/sl q2hrs prn pain/shortness of breath dispense 40 ml 7. haloperidol haloperidol 2 mg/ml oral solution 0.5-2 mg po/sl q4-6hrs prn agitation dispense 5 ml 8. hycosamine hycosamine 0.25 mg/ml oral solution 0.125-0.25 mg po/sl q4-6hrs prn secretions dispense 5 ml 9. acetaminophen 650 mg suppository sig: one (1) suppository rectal every 4-6 hours as needed for fever or pain. disp:*2 suppository* refills:*0* 10. scopolamine base 1.5 mg patch 72hr sig: patches transdermal every seventy-two (72) hours as needed for congestion. disp:*12 * refills:*0* 11. oxyfast 20 mg/ml concentrate sig: 5-20 mg po q2hrs as needed for pain or shortness of breath. disp:*40 ml* refills:*0* discharge disposition: home with service facility: hospice care, inc. discharge diagnosis: primary: respiratory failure secondary to aspiration secondary: vascular dementia hypertension cad s/p 1v cabg (svg-om ) s/p ddd pacer for recurrent syncope ; s/p dual chamber pacer for bradycardia, syncope chronic kidney disease s/p mechanical mvr and avr () h/o chf, cardiomyopathy (ef >55%) moderate pulmonary hypertension s/p left mca stroke () s/p pubic rami fracture hypothyroidism gout h/o c. difficile infection discharge condition: hemodynamically stable discharge instructions: please take all of your medications as prescribed. followup instructions: none procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more transfusion of packed cells diagnoses: other primary cardiomyopathies acidosis end stage renal disease congestive heart failure, unspecified acute kidney failure, unspecified unspecified acquired hypothyroidism gout, unspecified infection with microorganisms resistant to penicillins coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease heart valve replaced by other means acute respiratory failure pneumonitis due to inhalation of food or vomitus blood in stool cardiac pacemaker in situ abdominal aneurysm without mention of rupture vascular dementia, uncomplicated cerebral atherosclerosis unspecified deficiency anemia carrier or suspected carrier of other specified bacterial diseases other general symptoms 

Answer: The patient is high likely exposed to