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: no known allergies / adverse drug reactions attending: chief complaint: pt. found in car with altered mental status and taken to osh where he was intubated major surgical or invasive procedure: tracheostomy peg history of present illness: 74m transferred from osh, no family story obtained from er physician. . found in car with altered mental status and taken to osh where he was intubated. this happened around 6pm. he had a ct scan that showed right parietal hemorhage with small amount of intraventricular extension and 5mm shift. past medical history: unable to obtain social history: unable to obtain family history: nc physical exam: on admit: o: t:98 bp:133/71 hr:68 r 18 o2sats 98% on cmv gen: intubated heent: pupils: 3mm reactive eoms unable to assess neck: supple. lungs: cta bilaterally. cardiac: rrr. s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: intubated, sedated cranial nerves: corneal reflex present gag reflex present moving all extremities when propofol turned off. withdrawing from painful stimuli. unable to test iii - xii because patient is intubated and sedated motor: normal bulk and tone bilaterally. sensation: withdrawing to pain toes downgoing bilaterally on discharge: exam: general trach/vent pulm: lungs sound clear compared to yesterday, minor ronchi at left frontal field cv: distant sounds. rrr abd: soft, positive bowel sounds neuro: eyes are open not tracking or following objects. right pupil 2mm left pupil 3mm reactive. moving all four extremities but the left side more then right side. not following commands. upgoing toes. paratonia. pertinent results: ct:right parietal bleed. small extension into ventricles. 5mm shift ammonia: 24 145 105 49 174 agap=10 5.3 35 1.1 ca: 10.2 mg: 2.4 p: 4.5 7.1>11.9<335 --> 8.8>12.3<387 9:06 am bronchoalveolar lavage **final report ** gram stain (final ): 4+ (>10 per 1000x field): polymorphonuclear leukocytes. 1+ (<1 per 1000x field): gram negative rod(s). respiratory culture (final ): commensal respiratory flora absent. klebsiella oxytoca. >100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ klebsiella oxytoca | ampicillin/sulbactam-- 16 i cefazolin------------- 8 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s **final report ** gram stain (final ): 2+ (1-5 per 1000x field): polymorphonuclear leukocytes. 2+ (1-5 per 1000x field): multiple organisms consistent with oropharyngeal flora. smear reviewed; results confirmed. respiratory culture (final ): commensal respiratory flora absent. moraxella catarrhalis. >100,000 organisms/ml.. streptococcus pneumoniae. >100,000 organisms/ml.. note: for treatment of meningitis, penicillin g mic breakpoints are <=0.06 ug/ml (s) and >=0.12 ug/ml (r). note: for treatment of meningitis, ceftriaxone mic breakpoints are <=0.5 ug/ml (s), 1.0 ug/ml (i), and >=2.0 ug/ml (r). for treatment with oral penicillin, the mic break points are <=0.06 ug/ml (s), 0.12-1.0 (i) and >=2 ug/ml (r). penicillin 1.0mcg/ml sensitive. penicillin sensitivity testing performed by etest. haemophilus influenzae, beta-lactamase negative. >100,000 organisms/ml.. beta-lactamse negative: presumptively sensitive to ampicillin. confirmation should be requested in cases of treatment failure in life-threatening infections.. sensitivities: mic expressed in mcg/ml _________________________________________________________ streptococcus pneumoniae | ceftriaxone----------- 0.5 s erythromycin----------<=0.25 s levofloxacin---------- <=0.5 s penicillin g---------- s tetracycline---------- <=1 s trimethoprim/sulfa---- <=0.5 s vancomycin------------ <=1 s mrsa screen (final ): no mrsa isolated. brief hospital course: mr was admitted after sustaining an mva and having a ct head demonstrate a right temp/parietal hemorrhage. he was admitted to the icu and intubated. he failed extubation and received a tracheostomy and peg. his course was complicated by a vap which was treated by broad spectrum abx. his neurologic status did not improve and is characterized by periods of agitation and being unable to follow even simple commands. there is no evidence that he is responding in any meaningful way and required klonopin and zyprexa for agitation. an eeg was performed which demonstrated encephalopathy but no evidence for seizures. his blood pressure was controlled after multiple agents were added. neurologic: patients bleed was stable by serial ct exams. an mri of the brain was not completed. he shows no signs of understanding and an eeg was performed which demonstrated encephalopathy. it is not known why his structural deficits by ct head have resulted in his current neurological presentation. cv: his blood pressure was initially difficult to control. his current regiment had him well within range. his beta blocker (labetalol) was titrated down and may be switched to low dose longer acting medication like metoprolol pulm: he was a failed extubation x1. was emergently re intubated with some difficulty. he received a tracheostomy and was able to tolerate trach mask for a few hours. his lungs by cxr are still infiltrated. he is on ciprofloxacin for pneumonia (culture and sensitivities were performed). he still has a problem with secretions. gu: he has irritation at the penile head/meatus. gi: tolerating peg tube feeding riss: not to goal blood sugars. riss has been adjusted. nephro: no active issues. bun and cr still needs to be monitored. medications on admission: unable to obtain. discharge medications: 1. hydralazine 10 mg iv q6h:prn sbp > 160 2. sodium chloride 0.9% flush 3 ml iv q8h:prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. 3. bacitracin zinc 500 unit/g ointment sig: one (1) appl topical tid (3 times a day). 4. miconazole nitrate 2 % cream sig: one (1) appl topical (2 times a day). 5. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 6. clonazepam 0.5 mg tablet sig: one (1) tablet po tid (3 times a day). 7. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 8. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q2h (every 2 hours) as needed for wheeze. 10. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 11. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 12. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 13. chlorhexidine gluconate 0.12 % mouthwash sig: one (1) ml mucous membrane (2 times a day). 14. famotidine 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). 15. clonidine 0.2 mg tablet sig: one (1) tablet po tid (3 times a day). 16. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 17. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: four (4) puff inhalation q4h (every 4 hours) as needed for wheezing. 18. glucagon (human recombinant) 1 mg recon soln sig: one (1) recon soln injection q15min () as needed for hypoglycemia protocol. 19. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po tid (3 times a day) as needed for agitation. 20. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed for thrush. 21. dextrose 50% 12.5 gm iv prn hypoglycemia protocol 22. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 5 days. 23. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). 24. insulin glargine subcutaneous 25. labetalol 100 mg tablet sig: one (1) tablet po tid (3 times a day). 26. fentanyl citrate 25-100 mcg iv q2h:prn pain discharge disposition: extended care facility: center- discharge diagnosis: new - iph - respiratory failure s/p trach - peg tube - vap discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: bedbound. discharge instructions: you were admitted after suffering from a intracranial bleed. your course was complicated by pneumonia and being unable to come off a ventilator. you are still on a ventilator. you had a tracheostomy and a peg tube placed. your neurological examination did not improve much. you had an eeg which did not provide evidence for seizures. you were discharged to an ltac for further care. followup instructions: neurology: dr . date/time. at 5:30pm. call ( two weeks prior to ensure date and time. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus diagnoses: obstructive sleep apnea (adult)(pediatric) friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified glaucoma intracerebral hemorrhage other persistent mental disorders due to conditions classified elsewhere acute respiratory failure cerebral edema encephalopathy, unspecified ventilator associated pneumonia streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, unspecified other specified bacterial infections in conditions classified elsewhere and of unspecified site, other gram-negative organisms other amyloidosis unspecified cerebrovascular disease other inflammatory disorders of penis 

Answer: The patient is high likely exposed to