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: dilantin attending: chief complaint: cough, nausea, vomiting, respiratory failure major surgical or invasive procedure: endotracheal intbuation central line arterial line history of present illness: 79 yom with hx of sdh and dementia, cad s/p cabg, who presents with fever to 104, cough and hypoxia. he had a prolonged hospital course during which patient underwent craniotomy for subdural hematoma. patient also developed klebsiella pna s/p trach and peg. he has been in rehab since and now wheelchair bound wit poor functional status on/off tubefeeds. according to family, he received a feeding early sunday morning and was found approx one hour later flat in bed with tubefeed material in his mouth. since that time he had a cough and gargling breathing. he had overall fatigue and was essentially confined to bed, talking less and eating very little. on the evening prior to admission he spiked a fever to 103.8 and was noted to be hypoxic and in more respiratory distress. in the ed he received 2l ivfs, vanco/ctx/azithro as well as 5mg iv metoprolol for a sbp 220 and hr afib in 130s. he desatted <90% on 6l and required nrb and was transferred to the icu. past medical history: diabetes mellitus history of cad history of mitral regurgitation s/p cabg with lima graft in , mv repair. hypertension hypercholesterolemia chronic kidney disease 2 sigmoid resection/polypectomies social history: retired engineer denies tobacco etoh/day family history: non-contributory physical exam: at admission: vs: hr 111 bp 141/75 rr 34 o2 95% on nrb gen: awake but drowsy, apparent respiratory distress w/ shallow breaths and abdominal breathing. able to follow some commands, squeezes hand heent: mm dry neck: supple, no jvd, no lad heart: irregular, tachycardic, no murmurs lungs: rhonchi throughout, poor air movement abd: slightly distended, soft, nt, normoactive bs extrem: no edema neuro: pt is sleepy, answers questions appropriately pertinent results: at admission 11:57pm blood wbc-12.5* rbc-4.45*# hgb-14.5# hct-41.9# mcv-94 mch-32.5* mchc-34.5 rdw-14.5 plt ct-167 11:57pm blood neuts-93.6* lymphs-3.6* monos-2.4 eos-0.2 baso-0.2 11:57pm blood pt-11.3 ptt-22.9 inr(pt)-0.9 11:57pm blood plt ct-167 11:57pm blood glucose-155* urean-17 creat-1.0 na-139 k-3.0* cl-103 hco3-25 angap-14 07:44am blood calcium-6.9* phos-3.0 mg-1.5* 04:13am blood type-art po2-138* pco2-48* ph-7.26* caltco2-23 base xs--5 11:50pm blood lactate-3.2* 12:38pm blood freeca-1.14 at discharge 02:20am blood wbc-7.7 rbc-2.92* hgb-9.5* hct-28.1* mcv-96 mch-32.6* mchc-34.0 rdw-14.8 plt ct-230 02:20am blood pt-12.5 ptt-30.2 inr(pt)-1.1 02:20am blood plt ct-230 02:20am blood glucose-200* urean-22* creat-0.9 na-145 k-3.5 cl-110* hco3-27 angap-12 02:20am blood calcium-8.0* phos-2.5* mg-1.8 brief hospital course: a/p: 79 year old man with cad, dmii, past h/o sdh s/p craniotomy and klebsiella vap who presents with cough, fever, altered mental status, vomiting, found to have a likely pneumonia on cxr. # respiratory failure: patient intially presented as hypoxic and hypercarbic, with tachypnea and shallow breaths. abg at initial presentation was 7.26/48/138 on 100% nrb. he had a highly suspected aspiration event 4 days pta with retrocardiac opacity on cxr that was otherwise clear making aspiration pneumonia most likely etiology of respiratory failure. patient was thus intubated for hypoxic respiratory failure and was started on vancomycin and meropenum for broad spectrum coverage of underlying pnuemonia. antibiotics were continued for a 7 day course. patient initially had poor mental status, evaluated with head ct which was negative. his mental status gradually improved after sedation was turned off. patient was gradually weaned off ventilator and extubated on . # septic shock: patient was initially hypotensive after 5 liters of crystalloid in the setting of dropping urinary output and worsening mental status. patient was also febrile to 104 with aspriation pneumonia as likely underlying source. central venous access was obtained and leveophed was started to support map goals > 65. a-line was also placed for bp monitoring with a goal cvp > 10. broad spectrum antibiotics were also started as discussed above. # pneumonia: patient was covered broadly with history strongly suggestive of aspiration but also known risks for hospital acquired pneumonia. he also had a known history of mrsa + swabs. a kub was performed to rule out obstruction in the setting of possible aspiration from g-tube feeds which was negative. legionella urine antigen was negative and bal was possitive for moderate yeast growth and minimal growth of gnr. patient was treated with 7 days of antibiotics and sputum was sent prior to discharge with a negative gram stain. # oliguria: patient had a reduced urine output in the setting of sepsis concerning for poor forward flow vs. impending renal failure. he was initially given fluid boluses with some effect. the icu team felt there was a large component of respiratory failure do to fluid overload and the patient was started on lasix boluses to which he responded with excellent urine output. he was substantially diuresed with improved pulmonary function prior to extubation. # diabetes mellitus: patient was started on a sliding scale with modest management of sugars in the setting of sepsis. he may require home dose of insulin at rehab. medications on admission: tylenol 650 prn vit d 1000u iron sulfate 325 insulin 70/30 riss metoprolol tartrate 25 mg daily prilosec 20 daily senna visine opthalmic 1 drop to left eye nasal saline 1 spray daily to both nostrils valsartan 320 once daily mag hydroxide prn constipation sorbitol prn constipation miconazole discharge medications: 1. heparin (porcine) 5,000 unit/ml solution : one (1) syringe injection tid (3 times a day). syringe 2. chlorhexidine gluconate 0.12 % mouthwash : fifteen (15) ml mucous membrane (2 times a day). 3. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 4. metoprolol tartrate 25 mg tablet : 0.5 tablet po bid (2 times a day): please hold for bp < 110. 5. furosemide 10 mg/ml solution : 40 mg injection daily (daily). 6. insulin continue humalog sliding scale - see attached 7. colace 50 mg/5 ml liquid : 100 mg po twice a day. additional medications from his home list may be started at the discretion of the rehab facility. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: pneumonia discharge condition: good discharge instructions: you were admitted to the hospital for a pneumonia (lung infection). during the hospitalization, a machine helped you breath and you were given antibiotics. we also felt that part of your respiratory failure resulted from being fluid overloaded and we gave you some medicines which helped with this fluid balance. please call your doctor or return to the emergeny department for any of the following - documented fevers, shaking chills - nausea with vomiting - chestpain, increasing shortness of breath - any other new symptoms which concern you followup instructions: please follow up with your primary care doctor in weeks for further evaluation and a physical exam. md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances injection or infusion of other therapeutic or prophylactic substance arterial catheterization closed [endoscopic] biopsy of bronchus injection of antibiotic injection of insulin diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia intestinal bypass or anastomosis status acute kidney failure, unspecified unspecified septicemia severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation aortocoronary bypass status pulmonary collapse heart valve replaced by other means pneumonitis due to inhalation of food or vomitus long-term (current) use of insulin septic shock late effects of cerebrovascular disease, hemiplegia affecting unspecified side hypoxemia diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled gastrostomy status personal history of colonic polyps chronic kidney disease, stage ii (mild) personal history of methicillin resistant staphylococcus aureus personal history of allergy to other specified medicinal agents 

Answer: The patient is high likely exposed to