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: levofloxacin attending: chief complaint: ha, diff swallowing major surgical or invasive procedure: s/p colectomy history of present illness: this is a yo male with myasthenia with dysphagia, copd, prostate cancer, cva in , s/p colectomy for bowel perforation c.diff colitis transfered from . per osh discharge summary, pt was admitted to on with abdominal pain, found to have bowel perforation, underwent partial colectomy now with ostomy in place, operative findings notable for fecal contamination of peritoneal space, peritoneal fluid growing vre, now on multiple antibiotics. hospital course complicated by isolated episode of atrial fibrillation, as well as several episodes of chest pain without diagnostic ekg/enzyme abnormalities. failed speech and swallow evaluation at osh. pt also recently d/c'ed from w/diagnosis of pna on cefpodoxine. pt now complaining of "burning" in his head, headache for several days. pt also concerned about difficulty swallowing and inablity to tolerate po intake. pt states that abd pain at inscision is minimal and intermittent. past medical history: myasthenia with dysphagia and ptosis cervical disc disease copd prostate cancer rectal bleeding urinary frequency hx cva in , with mri showing a small left temporal lesion and small vascular ischemic disease hyperlipidemia hx bilateral cataract removal social history: the patient gives a 20 pack year history of smoking, smokes pipes and quit in . he lives at home with his wife. is a retired physics professor. he was born in and went to a greek school there and then moved to and eventually to the united states in . family history: noncontributory physical exam: general: elderly male, awake, alert, nad. heent:perrl, eomi without nystagmus, slight ptosis of rt eyelid, mmm, no lesions noted in op neck:</strong> supple, no jvd or carotid bruits appreciated pulmonary: mild wheezing in lt lung fields, good air movement throughout cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, hypoactive bowel sounds, no masses or organomegaly noted, midline abdominal dressing in place w/1 drain w/ minimal serosanguinous fluid, superficial abd brusing extremities: no edema, 2+ radial, dp and pt pulses b/l, strength , picc in rt arm lymphatics: no cervical, supraclavicular, axillary or inguinal lymphadenopathy noted. skin: no rashes or lesions noted. gu: slightly swollen, erythematous scrotum with white lesions neurologic: -mental status: alert, oriented x 3. able to relate history without difficulty. -cranial nerves: ii-viii and -xii grossly intact, soft voice and difficulty swallowing -motor: normal strength throughout, decreased bulk in interosseus muscles.nno abnormal movements noted. -sensory: no deficits to light touch throughout. -dtrs: 2+ biceps, patellar and 1+ ankle jerks bilaterally. plantar response was flexor bilaterally. pertinent results: 04:13am blood wbc-8.4 rbc-2.75* hgb-8.7* hct-27.4* mcv-99*# mch-31.7 mchc-31.9 rdw-20.8* plt ct-321 05:12am blood wbc-8.4 rbc-2.22* hgb-7.2* hct-24.3* mcv-110* mch-32.6* mchc-29.7* rdw-21.3* plt ct-383 04:10am blood wbc-16.8* rbc-2.38* hgb-8.0* hct-23.8* mcv-100* mch-33.8* mchc-33.8 rdw-21.3* plt ct-359 03:03am blood wbc-8.5 rbc-2.75* hgb-9.1* hct-26.6* mcv-97 mch-33.2* mchc-34.2 rdw-20.8* plt ct-434 04:05am blood wbc-4.6 rbc-3.02* hgb-9.8* hct-29.8* mcv-99* mch-32.4* mchc-32.8 rdw-20.2* plt ct-518* 04:13am blood glucose-76 urean-25* creat-0.3* na-142 k-4.0 cl-109* hco3-29 angap-8 03:36am blood ck-mb-notdone ctropnt-0.13* 04:13am blood calcium-7.5* phos-1.9* mg-2.2 04:57am blood albumin-1.6* calcium-7.7* phos-2.6*# mg-2.1 03:04pm blood vitb12-1625* folate-12.5 hapto-150 04:12am blood type-mix temp-37.1 03:40am blood type-art peep-5 po2-148* pco2-37 ph-7.50* caltco2-30 base xs-5 intubat-intubated 04:28am blood type-art temp-36.3 tidal v-550 peep-5 fio2-50 po2-130* pco2-40 ph-7.48* caltco2-31* base xs-6 -assist/con intubat-intubated 05:33am blood lactate-1.2 k-3.2* 11:35am blood glucose-136* lactate-1.6 k-2.9* 04:12am blood o2 sat-72 brief hospital course: is a y/o male with myasthenia , copd, prostate cancer, cva, s/p colostomy for bowel perforation c-diff colitis. he was transferred here for further management of his intrabdominal infection and his myasthenia . the night of admission on , he was noted to have grown progressively more weak and there was concern for myasthenic crisis. of note the patient was being tapered off prednisone to promote wound healing at this abdominal incision. the patients weakness progressed such that he had difficulty moving the legs. given concern for respiratory depression, peak flow was attempted and was 100. it was decided he would need closer monitoring for myasthenic crisis in an icu setting. abg prior to transfer ph 7.48 pco2 38 po2 82 hco3 29. . the patient was admitted to the micu on for weakness and monitoring for myasthenic crisis. he failed a swallow eval on and was also seen by surgery for evaluation of his ostomy and remaining stay sutures. the neuromuscular team also evaluated him and followed him throughout his hospital course- he had a 5 day course of ivig from . on the morning of he was intubated for respiratory failure. he finished a course of broad spectrum antibiotics for his intraabdominal infection. his respiratory status improved and he was able to be extubated on . he was able to clear secretions and was out of bed to chair and had a stable respiratory status until when he required bipap for increased work of breathing. on he was reintubated. during this time , he became febrile and found to have gnrs in his blood and sputum and developed vap/pneumosepsis. he was found to have resistant pseudomonas and put on a 14 day course of meropenem. he improved over the next week, with reassuring sbts, and was extubated on but then reintubated later that night for increased work of breathing. he had a tracheostomy performed on . during these weeks he received nutrition through a /oro-gastric tube, as a procedure for a percutanous gastric tube was thought to be technically difficult and risky given his anatomy and health status. briefly, the hospital/icu course by problem: # respiratory failure: pt had tracheostomy performed on after multiple re-intubations after failing extubation trials in the setting of infection, generalized weakness, and myasthenia. # infection: finished broad spectrum antibiotics, including vancomycin, linezolid, flagyl, and fluconazole for peritonitis. treated for disseminated pseudomonas infection with meropenem, s/p 14 day treatment. # sacral decubitus ulcer: plastic surgery and wound care nurses have followed him for a stage 4 sacral decub. pt is s/p bedside debridement on . continue to do wet-to-dry dressings and consult nutrition for maximization of nutrition for wound healing. # pain: chronic pain unchanged, comfortable on fentanyl patch plus morphine for breakthrough pain. # myasthenia : pt had course of ivig in the hospital. cellcept held per neuromuscular recommendations in the setting of disseminated infection. neuromuscular states no need to restart cellcept as inpatient, will re-evaluate when pt is out of the hospital. on prednisone 5mg daily. # hypotension: has required occasional fluid boluses, otherwise blood pressure has remained stable in the 90s-100s/50s-60s. # ostomy: output remained good; continue to monitor. surgery crimson team followed the patient. ostomy is prolapsed but reducible- good output. no concerns. suture removal perhaps soon by crimson service. please call crimson surgery service for further consult as necessary. # deconditioning: poor nutrition, neuromuscular pathology and generalized lack of mobilization make his current deconditioning severe. will continue to encourage to write as this forces patient to utilize his arm, which he has been able to maintain using all along. working well with pt/ot, please continue pt/ot as outpatient. nutrition consult as outpatient for maximizing nutrition. . # fen: ngt re-placed, secured, tube feeds continuing. please make sure tube is secure as patient has pulled his tube multiple times. # ppx- scds while patient is in the bed, ppi, and sc heparin for dvt prophylaxis. # access l picc- placed # communication: with pt and wife and daughter. # dispo: to rehab soon - # code: full code medications on admission: 1. prednisone 20mg po qd 2. nitroglycrin 0.4mg sublingual prn chest pain 3. asa 325mg q8 prn 4. lasix 40mg po qdaily 5. kcl 40meq po qdaily 6. mag oxide 400mg 7. mupirocin 2% to nares 8. albuterol 2.5 nebs q4 prn 9. guaifenesin syrup 5mg q8 by mouth 10. metoprolol 25mg q8 po 11. tylenol 650mg po q4 12. omperazole 20mg po 13. vancomycin 250mg po q6, started 14. flagyl 500mg q8 iv, started to , changed to po on 18th 15. dilaudid 0.5-1mg q4 prn 16. fluconazole 400mg q24 iv, started 17. linezolid 600mg q12 iv, started discharge medications: 1. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day). 2. albuterol 90 mcg/actuation aerosol sig: 2-4 puffs inhalation q4h (every 4 hours) as needed. 3. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed. 4. ipratropium bromide 0.02 % solution sig: 1-2 puffs inhalation q4h (every 4 hours) as needed. 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 6. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day). 7. docusate sodium 50 mg/5 ml liquid sig: tsp po bid (2 times a day): hold for loose stools. 8. fentanyl 25 mcg/hr patch 72 hr sig: one (1) patch 72 hr transdermal q72h (every 72 hours). patch 72 hr(s) 9. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 10. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. discharge disposition: extended care facility: - discharge diagnosis: 1. respiratory failure 2. myasthenia 3. pneumonia discharge condition: stable discharge instructions: you were evaluated and treated during an extended hospital stay for your infections, myasthenia and respiratory failure. please continue to work with physical therapy, occupational therapy, and nutrition counselors to regain your strength. take your medications as prescribed. please do not take the following home medications until you follow-up with your doctor as an outpatient: lasix 40mg po daily, kcl 40meq po daily, mag oxide 400mg , mupirocin, guaifenesin syrup, metoprolol. please call your primary care providers and other doctors to arrange follow-up. 1. , md 2. surgery (dr. ) 3. neuromuscular (neurology- will follow-up at rehab) please call your primary care doctor or return immediately to the emergency department for any difficulty breathing, high fevers > 102, or any other concern. followup instructions: please call your primary care providers and other doctors to arrange follow-up. 1. , md 2. surgery (dr. ) 3. neuromuscular (neurology- will follow-up at rehab) procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances temporary tracheostomy nonexcisional debridement of wound, infection or burn injection or infusion of oxazolidinone class of antibiotics diagnoses: thrombocytopenia, unspecified hyposmolality and/or hyponatremia severe sepsis chronic airway obstruction, not elsewhere classified atrial fibrillation acute respiratory failure pneumonia due to pseudomonas pressure ulcer, lower back other and unspecified coagulation defects unspecified peritonitis septicemia due to pseudomonas myasthenia gravis with (acute) exacerbation 

Answer: The patient is high likely exposed to