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: iodine / sulfa (sulfonamides) attending: chief complaint: hypoxic respiratory failure major surgical or invasive procedure: none history of present illness: mr. is an 81 year old male with a history of cad, diastolic chf, copd, and alzheimers who was transferred from an osh for further management of hypoxia secondary to pneumonia. of note, patient was recently admitted to from /08 for chest pain and sob. at that time he was transferred from and osh with chf on cxr and a question of st elevations on ecg. however, in the cath lab he was found to have nonobstructive cad. he was diuresed during the course of his admission. echo during that admission showed preserved systolic function. his medications were changed: amlodipine to diltiazem to improve diastolic chf and home dose lasix was increased. on the day of the present admission, the patient was noted to be in respiratory distress by his family when they came to visit at his nursing home. ems was called and upon evaluation his o2 sats were found to be in the 40s. he was described as pale, diaphoretic, gasping for air, with coarse rales and rhonchi in all lung fields. ems noted vomitus and suspected aspiration. he was placed on nrb, o2 sats improved to 90s and transferred to osh. there he had a cxr which suggested a r sided pneumonia. at that time abg with ph of 7.26/59/59. wbc was 36,000, 16%. tropi elevated at 0.13 but cks were negative. there he was also noted to be vomiting. he received levo and flagyl and was transferred to for further managment. . in ed, 97.1, 140/65, 107, 42, 76% nrb. o2 sats improved to 90s on bipap 20/5 with 100% fio2. lab showed leukocytosis of 21,500, bnp 1621. ces negative. electrolytes unremarkable. cxr confirmed r sided pneumonia. he received aspirin and 1 gram of vancomycin and was transferred to the icu. . upon arrival, patient remained on bipap. he was awake but not interactive and not following commands. unable to obtain ros. past medical history: 1. hypertension 2. hyperlipidemia 3. copd 4. anemia 5. thallasemia 6. alzheimer's dementia 7. severe diverticulosis 8. l inguinal hernia repair - 9. cataracts social history: rapid development of dementia within the last 2 years. lives in . family history: no family history of early mi. physical exam: general appearance: thin, tachypneic eyes / conjunctiva: perrl head, ears, nose, throat: normocephalic, bipap lymphatic: cervical wnl cardiovascular: (s1: normal), (s2: normal) peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (expansion: symmetric), (breath sounds: diminished: bases, rhonchorous: r middle) abdominal: soft, non-tender, bowel sounds present extremities: right: absent, left: absent, no(t) cyanosis skin: warm neurologic: responds to: noxious stimuli, movement: non -purposeful, tone: increased, unreponsive to verbal stimuli. cns grossly intact. cannot assess strength or sensation. cannot illicit dtrs pertinent results: admission labs: wbc-21.5*# rbc-4.57* hgb-10.4* hct-31.7* mcv-69* mch-22.7* mchc-32.7 rdw-18.7* plt ct-366# hypochr-1+ anisocy-2+ poiklo-2+ macrocy-normal microcy-2+ polychr-1+ ovalocy-1+ schisto-occasional stipple-1+ tear dr2+ glucose-367* urean-33* creat-1.0 na-139 k-4.4 cl-107 hco3-24 angap-12 ck(cpk)-50 ctropnt-0.16* probnp-1621* calcium-8.5 phos-4.4 mg-1.8 lactate-2.1* 11:27 am influenza a/b by dfa site: nasopharynx source: nasopharyngeal aspirate. **final report ** direct influenza a antigen test (final ): negative for influenza a viral antigen. direct influenza b antigen test (final ): negative for influenza b viral antigen. ekg - sinus tachycardia. otherwise, baseline artifact makes assessment difficult. suggest repeat tracing. since the previous tracing of baseline artifact makes comparison difficult. cxr - impression: findings most consistent with a right lower lobe pneumonia. recommend followup radiographs to document resolution after appropriate therapy. brief hospital course: mr. is a 81 year old male with a history of cad, diastolic chf, copd, and alzheimers dementia who was transferred from an outside hospital for hypoxic respiratory failure. # pneumonia / respiratory distress: the patient presented with hypoxic respiratory failure, secondary to a multifocal pneumonia seen on chest x-ray. he was placed on nippv in the ed which was continued initially in the icu. the patient was broadly covered for healthcare-associated pneumonia with vancomycin, levofloxacin, and ceftriaxone. dfa was sent for influenza virus testing which came back negative. on the morning of , the primary icu team, the patient's pcp, the patient's family met to discuss goals of care. given his underlying progressive dementia and low likelihood of meaningful recovery, he was taken off of nippv. antibiotics were continued in the case that he improved with supplemental oxygen. he was transferred from the micu to the general medical floor to continue antibiotics but with comfort as a goal should he get worse from a respiratory standpoint. on the medical floor ceftriaxone was stopped as it was felt that the two other antibiotics provided sufficient coverage. the patient continued to receive oxygen from a face tent with prn nebulized bronchodilators for comfort. the patient was also given morphine iv prn to ease respiratory distress and hyoscamine to decrease secretions to help make him more comfortable. the patient eventually stopped breathing and died on the morning of . # sepsis: the patient met sirs criteria on admission. he received antibiotics for pneumonia as above. # hypertension: antihypertensives held given tenuous blood pressures on admission. blood pressures were not checked on the general medicine floor as comfort was the primary goal of care. # tachycardia: the patient presented with sinus tachycardia on ekg. antihypertensives were held as above, including diltiazem. # copd: the patient was given albuterol and atrovent nebs. # cad: po medications were held given the likelihood of aspiration and goals of care. # anemia: the patient's anemia was at his baseline on admission. # alzheimer's dementia: the patient had a history of rapidly progressive alzheimer's dementia that likely contributed to aspiration and his pneumonia. medications on admission: b12 1000 mcg inj qmonth flomax 0.4 mg qam amlodipine 10 mg qam finasteride 5 mg daily furosemide 40 mg qam megace 625 mg daily aspirin 81 mg daily zyprexa 2.5 mg daily, 5 mg qhs colace 100 mg qam albuterol nebs aricept 5 mg qhs simvastatin 40 mg daily bisacodyl aranesp 100 mcg monthly (given ) lisinopril 20 mg daily (dc'ed ) diltiazem 60 mg qid lorazepam prn mom discharge medications: n/a discharge disposition: expired discharge diagnosis: primary diagnoses: 1. multifocal pneumonia 2. hypoxic respiratory failure secondary diagnoses: 1. hypertension 2. hyperlipidemia 3. chronic obstructive pulmonary disease 4. anemia 5. alzheimer's dementia discharge condition: expired discharge instructions: n/a patient expired. followup instructions: n/a patient expired. procedure: non-invasive mechanical ventilation diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis chronic airway obstruction, not elsewhere classified acute respiratory failure pneumonitis due to inhalation of food or vomitus alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance chronic diastolic heart failure 

Answer: The patient is high likely exposed to