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: hypotension major surgical or invasive procedure: central venous line (right ij) arterial line (left) history of present illness: mr. is a year old male with a history of atrial fibrillation, systolic heart failure, chronic kidney disease who presents from nh with altered mental status. per report, pt was noted by staff at nh yesterday to be difficult to arouse and having labored breathing. his vitals at the time included bp 112/57, and o2 sats and temperature were not obtainable due likely to hypothermia. he was sent to the ed for further revaluation. of note, per his daughter, he was recently hospitalized () from hospital with congestive heart failure. during this hospitalization he was noted to have deteriorating mental status and delirium, which is why he had been discharged to nh. in the ed, vs t 92.1 axillary, bp 100/50, hr 50, rr 21 88% 6l initially then placed 99% nrb. he received vancomycin, ceftriaxone, and flagyl for aspiration pneumonia. also received vitamin k iv 10 mg for coagulopathy with inr to 7.2. with ct head negative for acute intracranial process. also received 1 l ivf total in ed. on arrival to micu, he was noteedd to be bradycardic to hrs to 30s and hypotensive to sbp 80s with maps 50s. he was given 1 mg atropine with hr to 50s. he was given 500 cc fluid bolus x 2 and sbp came up to 90s. past medical history: systolic heart failure with ef 30% hypertension atrial fibrillation hypothyrodism chronic kidney disease, stage iii dysphagia dementia? social history: currently lives in a nursing home. has a daughter and son. to being in the nursing home, he lived with his daugther. family history: nc physical exam: vs: hr 46 96/49 rr 18 100% nrb gen: on nrb, difficult to arouse, non-verbal, opens eyes to painful stimuli, unable to follow commands heent: at, nc, eomi, no conjuctival injection, anicteric, mm dry, right pupil reactive 3 to 2 mm, left pupil unreactive cv: irreg irreg, nl s1 s2 pulm: diffuse crackles anteriorly abd: soft, mild distension, + bs, no hsm ext: cool, b/l lateral malleolus venous stasis ulcers neuro: unable to assess due to mental status pertinent results: 10:40pm blood wbc-4.8 rbc-3.30* hgb-10.5* hct-32.1* mcv-98 mch-32.0 mchc-32.8 rdw-17.6* plt ct-124* 05:10pm blood wbc-5.9 rbc-3.06* hgb-10.0* hct-30.5* mcv-100* mch-32.7* mchc-32.8 rdw-17.2* plt ct-100* 10:40pm blood neuts-85.0* bands-0 lymphs-9.2* monos-4.7 eos-0.6 baso-0.5 10:40pm blood pt-60.4* ptt-67.9* inr(pt)-7.2* 04:49am blood fibrino-405* d-dimer-686* 10:40pm blood glucose-61* urean-50* creat-2.0* na-137 k-4.8 cl-100 hco3-27 angap-15 10:40pm blood alt-23 ast-40 ck(cpk)-175* alkphos-164* totbili-0.8 10:40pm blood ck-mb-17* mb indx-9.7* ctropnt-0.12* probnp-5749* 03:32am blood albumin-2.8* calcium-7.5* phos-4.1 mg-1.9 03:32am blood tsh-20* 04:55pm blood t4-5.9 calctbg-0.82 tuptake-1.22 t4index-7.2 11:01pm blood lactate-1.4 relevant imaging: ct head findings: there is no intra- or extra-axial hemorrhage, mass effect, or shift of normally midline structures. extensive bilateral periventricular as well as subcortical white matter hypoattenuation related to chronic microangiopathic ischemic changes is evident. the ventricles and sulci are moderately prominent, appropriate for age- associated involutionary changes. bilateral basal ganglia calcification and extensive calcification along the tentorium and falx cerebri are evident. the osseous and soft tissue structures are unremarkable. a nonspecific focus of hyperdense focus is noted in the left pre-zygomatic soft tissue. clinical correlation is advised. impression: no acute intracranial process. a small hyperdense focus in the left pre-zygomatic soft tissue could represent calcification and clinical correlation is advised. echo the left atrium is moderately dilated. the right atrium is markedly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild regional left ventricular systolic dysfunction with severe hypokinesis of the basal half of the inferior and inferolateral walls. the remaining segments contract normally (lvef = 40 %). right ventricular chamber size and free wall motion are normal. the ascending aorta is dilated at the sinus level. the descending thoracic aorta is mildly dilated. the aortic valve leaflets are severely thickened/deformed. significant aortic stenosis is present (not quantified). no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with regional systolic dysfunction c/w cad. aortic stenosis. dilated ascending aorta. if clinically indicated, a follow-up study to assess aortic stenosis is suggested when the patient can be transported to the echo laboratory. brief hospital course: year old male with a history of systolic congestive heart failure, atrial fibrillation, who presented with hypoxia, hypotension, and hypothermia. upon admission to the micu, agressive therapy was initiated keeping a broad differential diagnosis. patient however continued to deteriorate and abruptly became profoundly bradycardic, unresponsive to atropine or increasing doses of pressors, culminating in asystole; patient was pronounced dead at 1:05am on . below are the details leading to these events, arranged by problem: 1)hypotension / hypothermia: on initial presentation on the floor sbp 80s, given 500cc fluid bolus x 2 with sbp to 90s. meets sirs criteria with hypothermia and tachpnea and hypotension concerning for sepsis, with pneumonia as the most likely source. also on differential was hypovolemic hypotension for occult blood loss, cardiogenic shock, adrenal insuffiency and myxedema coma. cooling blanket placed on patient upon arrival. patient was given fluid boluses and central access was obtained. echocardiogram was obtained and revealed mildly depressed ejection fraction (40%) with inferolateral wall hypokinesis and moderate tricuspid regurgitation. central venous pressure was measured and found to be elvated to 24mmhg, which even in the setting of tr was felt to rule out hypovolemia. patient was initiated on dopamine in hopes of supporting both blood pressure and heart rate. arterial line was placed for accurate assessment of arterial pressure. hematocrit remained stable and pressure responded to pressor support. patient started on stress dose steroids for possible adrenal insufficiency. 2)hypoxia: with bilateral infiltrates and likely superimposed fluid overlaod. given recent hospitalization and extent of o2 requirement, high suspicion for hospital acquired pneumonia (hap) with vancomycin and zosyn. this was later changed to vancomycin and cefepime. patients blood gas was concerning for hypercarbia, and after re-discussing goals of care with family and confirming patient did not want to be intubated, non invasive ventillation was initiated. patient tolerated nippv well and hypoxia / hypercarbia / respiratory acidosis improved until his sudden decompensation. 3)bradycardia: with baseline bradycardia per history, unclear etiology. on arrival to micu, bradycardic to hr in 30s, gave 1 mg atropine with hr to 50s. all nodal agents were stopped and heart rate improved with dopamine administration. 4)meningitis: given patients poor baseline mental status and findings of significant nuchal rigidity, concern for meningitis was raised. given patients decompensated status, lumbar puncture was not pursued and empiric coverage with ampicillin for listeria, vancomycin/cefepime for staph/strep were initiated. 5)hypothyroidism: tsh of 20, difficult to interpret in this setting as sick euthyroid may have impacted laboratory results. given decompensated state, endocrine consult was placed and thyroid hormone was supplemented intravenously at higher doses than per outpatient regimen. free t3, t4 and thyroid binding protein were ordered but were not available before patient decompensated. per endocrine team recommendations, t3 was not given due to concerns for arrythmia and cardiac side effects, and given very poor level of evidence for its efficacy. 6)coagulopathy: inr 7.2 on admission in setting of anticoagulation. given vitamin k and ffp. dic labs negative. 7)chronic kidney disease: with known baseline ckd stage iii, likely exacerbated in the setting of hypotension. medications on admission: acetaminophen 325 mg prn milk of magnesia prn dulcolax 10 mg rectal suppository prn fleet enema prn albuterol inh prn coumadin 2.5 mg daily flomax 0.4 mg daily ferrous sulfate 325 mg daily levothyroxine 125 mcg daily lasix 20 mg daily lisinopril 2.5 mg daily magnesium oxide 400 mg daily calcium 500 with vitamin d daily proscar 5 mg daily ranitidine 150 mg daily zyprexa 2.5 mg discharge disposition: expired discharge diagnosis: patient expired discharge condition: patient expired discharge instructions: patient expired followup instructions: patient expired procedure: venous catheterization, not elsewhere classified arterial catheterization diagnoses: abnormal coagulation profile congestive heart failure, unspecified unspecified septicemia severe sepsis unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, stage iii (moderate) acute respiratory failure pneumonitis due to inhalation of food or vomitus chronic systolic heart failure long-term (current) use of anticoagulants anticoagulants causing adverse effects in therapeutic use glucocorticoid deficiency meningitis, unspecified 

Answer: The patient is high likely exposed to