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, pulmonary edema major surgical or invasive procedure: cvvhd, hemodialysis history of present illness: pt is a 67 male well known to me, with h/o cad s/p cabg, chf (ef 30%) esrd on hd, copd, chronic afib who was transferred nh with pulmonary edema and hypotension; also found to be in atrial fibrillation with rapid ventricular rate. mr. was noted to be dyspneic on the afternoon of admission. o2 sats were found to be 76% on ra and 80% on a nrb. on arrival to , he was noted to be in afib in rvr to 140-160 and bp was in mid 70s/20s. cxr was consistant with pulmonary edema. he was given diltiazem, lasix 100iv in the ed. he was then attempted on bipap, however he was unable to tolerate it. he was then admitted to the icu for cvvh. additionally, he required pressor support of levophed and dopamine which were weaned off. pt had intermittent episodes of rapid a fib which were controlled with iv beta blockers. while in the icu in the am of , pt had an episode of coffee-ground emesis. ng lavage was negative. inr was noted to be 10.8. his inr was reversed with ffp and vitamin k was given. gi consulted and said that scoping at this point was not recommended as pt had recent hypotension, a stable hct, and no frank blood on lavage. additionally, pt with rising wbc to 31.5 on from an initial wbc of 14. ? of infiltrate on cxr. initially started on vanc/levo/flagyl () for possible pneumonia. cvvh and dopamine d/cd . pt was on transferred to the floor and had signs and symptoms consistant with stroke. mri revealed a small ischemic stroke in the corona radiata on the left. pressures were kept ~100 as there was a tight balance between rate control and pressure control. on pt went to hd. pressures were in the 80s systolic and he did not tolerate it and was not stable to uf. his pulse went to the 130s and it came down to ~100 with 5 iv metoprolol. cardiology was consulted and we loaded pt with digoxin (1 gram). pt was transferred to the micu for possible cvvh with pressor support. he was stable overnight in the unit, received no intervention, and was transferred back to the medicine team now. past medical history: 1. dm2 2. htn 3. copd- on home copd though pt unaware how much 4. pvd s/p l bka and r tma 5. cad s/p cabg 6. chf (ef %30) 7. esrd on hd mwf at 8. chronic afib social history: pt is a former bartender. he lives alone in nh. usual care is at . he is a former bartender, has never been married and has no children. quit smoking 15 years ago, with 30 year pack history. no etoh. family history: non-contributory physical exam: on admission to medical service vs: t: 95.1; bp: 113/41; p: 71; rr: 26; o2: 94% on 2l gen: slightly tachypneic, able to speak for words and then getting short of breath. in nad neck: elevated jvd to jaw line. cv: irregularly irregular. s1s2. lungs: crackles at bases b/l. decent airflow. abd: soft, nt, nd. ext: right above foot amputation; right bandage on (pt deferred me looking until next dressing change). left leg: bka. no edema. neuro: a&o x 3. pertinent results: labs on admission: 05:35pm blood wbc-18.0*# rbc-4.73 hgb-14.0# hct-45.5# mcv-96 mch-29.6 mchc-30.8* rdw-17.1* plt ct-316 05:35pm blood neuts-91* bands-0 lymphs-6* monos-3 eos-0 baso-0 atyps-0 metas-0 myelos-0 nrbc-2* 05:35pm blood plt smr-normal plt ct-316 lplt-2+ 06:10pm blood glucose-413* urean-18 creat-2.9* na-139 k-3.5 cl-96 hco3-24 angap-23* 11:30pm blood alt-15 ast-15 ld(ldh)-308* ck(cpk)-35* alkphos-106 totbili-1.2 11:30pm blood albumin-3.2* calcium-7.9* phos-4.1 mg-1.4* 10:08pm blood type-art po2-63* pco2-40 ph-7.39 calhco3-25 base xs-0 01:45pm blood lactate-2.1* _________________________________ other labs: 11:30pm blood alt-15 ast-15 ld(ldh)-308* ck(cpk)-35* alkphos-106 totbili-1.2 11:30pm blood ck-mb-notdone ctropnt-0.08* 05:05am blood triglyc-72 hdl-52 chol/hd-2.3 ldlcalc-54 11:30pm blood cortsol-51.3* 11:46pm blood cortsol-57.9* 05:31am blood cortsol-79.1* 01:45pm blood lactate-2.1* _________________________________ radiology: chest ap -impression: mild worsening of congestive heart failure with small bilateral pleural effusions. no definite underlying consolidation is identified; however, if pneumonia is suspected, followup films may be helpful. mr head -findings: on diffusion images, a small area of hyperintense signal is seen within the left corona radiata, which could represent an acute subcortical infarct. moderate to severe brain atrophy is noted. increased signal is seen in the periventricular white matter due to small vessel disease. impression: somewhat limited study secondary to motion. small area of hyperintense signal seen on diffusion images in the left corona radiata could represent a small acute infarct. moderate to severe changes of small vessel disease and brain atrophy. echo -the left atrium is elongated. left ventricular wall thicknesses and cavity size are normal. there is severe global left ventricular hypokinesis. no definite left ventricular thrombus is seen (images suboptimal). the right ventricular cavity is mildly dilated with severe global free wall hypokinesis. the aortic valve leaflets are moderately thickened. there is minimal aortic stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. brief hospital course: 67m dm2, htn, copd, pvd, cad s/p cabg, chf, esrd on hd admitted for hypoxia, and a. fib in rapid ventricular response with resultant hypotension. also found to have ? pneumonia and with episode of hematemesis in micu. pt has chf in the setting of esrd and and likely rapid a. fib as well. /05- pt with 18 s (49 beat run vt), asx. pt febrile, tachypnic without hypoxia. tachypnea was likely fever. he did have a resp alkalosis with increase of aa gradient. received tylenol pr and mg 2 g. fever from likely line infection (started on zosyn and vanc) with cultures. 1. cv a. pt was in frank overload upon admission to the icu. he was on cvvh in the icu as above. echo done showed an ef of 20% with rv and lv hypokinesis. pt's chf was handled by dialysis. he initially did not tolerate it secondary to fluctuation of pressures and hypotention. he improved when his rate improved (see below) and he handled dialysis until he decided that he not longer wished to have it (see below) b. pt with cad s/p cabg. we continued asa, beta blocker, and statin. his enzymes were negative here. c. pt came in in rapid a. fib with rapid ventricular response with possible flash. he remained in atrial fibrillation. mr. was initially on metoprolol 50 tid for rate control but bps were tenous and lead to hypotension. he was digoxin loaded iv but levels reached 3.4 on hd 9. he had a 49 beat run of vtach during that time but no evidence of ekg changes. his levels slowly drifted down. during the initial loading of digoxin, his rate slowed down to the 90s-100 and bp improved dramatically to 100-110 systolic. 2. fever/leukocytosis/fungemia- a. pt spiked 101.3 on hd #10 and had a leukocytosis. cxr was clear. pt was tender in suprapubic region, refusing straight cath, and ab ct. we started pt empirically on vanc (dosed by level <15) and zosyn with negative cultures. we d/cd the zosyn but were treating what we thought was a probably line infection. b. fungemia-blood culture from (surveillance) grew out . the plan was to treat pt for 2 weeks with flucanazole, however, given his refusal and ultimate cmo, he was unable to take the course. opthamology came by initially but pt refused dilated eye exam. 3. stroke- the day after admission to the medicine service, pt with slurred speech, altered mental status, and problems swallowing. ct showed areas of old stroke and large ventricles. mri showed acute left corona radiata ischemic stroke. we continued asa, and inr was therapeutic though pt not on coumadin at that time. we started a statin. neurology was initially following pt. 4. hypoxia- improved after pt went to medical floor. he was stable on 2 l -->ra. in the unit previously he had aspiration pna which was treated with levo/flagyl 11 day course. 5. hypotension- bps went to the 100s-110 systolic with digoxin. this was likely in the setting of better rate control, better filling, and atrial kick. 6. coffee ground emesis- pt had an episode coffee ground emesis in unit with inr 10.8. his inr was reversed and pt had no episodes after that. gi workup was not initiated given his state then and he was stable from that point of view afterwards. 7. esrd on pt started dialysis 8 weeks prior to admission. had a right quintin catheter in place. was getting cvvh in the micu and then tolerated dialysis once rate was under better control. 8.dm- tight glucose control post stroke. riss that was uptitrated 9.copd- we continued nebs (ipratropium and albuterol). pt was stable. 10. ppx- was on subcutaneous heparin and we continued pt's ppi. 11. access- had a right quintin catheter for hemodialysis. piv. would have needed access for dialysis to have changed given his fungemia but pt was made cmo (see below) 12. wound care- pt with left heel ulcer and left upper back duoderm in place. wound care nursing consultation saw pt and recommended dressing changes. 13. f/e/n- post stroke, pt failed his speech and swallow evaluation. he was advanced to ground solids. he was not eating and his nutritional status was quite poor; pt said that he has no appetite. we started megace but pt refused. a. hypernatremia- pt hypernatremic to 150s; we gave him free water through his iv as tolerated and at dialysis they did not use sodium filter. 14. code status- pt was dnr/dni. he made this clear throughout his stay. towards the end of his hospital stay, mr. would refuse medication and dialysis occasionally but then do it. ethics saw pt and agreed that he had capacity, though delirius at times, was clear in his overall goals. pt's refusal became more and more and the team initiated discussions with him regarding goals of care. it became clear to pt and team that what he wanted was comfort measures only. he was sick of being in his condition and knew that it was time for him to be comfortable. he was made cmo on . palliative care saw pt and facilitated transition back to nh with hospice. hcp was involved in discussions with pt regarding goals of care and agreed with pt and the team. medications on admission: n/a discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 4. morphine 10 mg/5 ml solution sig: po q2-3h (every hours) as needed for sob,pain. 5. morphine 2 mg/ml syringe sig: one (1) injection q3-4h () as needed for sob, pain. 6. lorazepam 0.5 mg tablet sig: 1-4 tablets po q2-3h (every hours) as needed for sob, pain: alternatively could have sc. discharge disposition: extended care facility: healthcare- discharge diagnosis: primary diagnosis: congestive heart failure hypotension atrial fibrillation fungemia stroke aspiration pneumonia secondary diagnosis: end stage renal disease diabetes mellitus chronic obstructive pulmonary disease discharge condition: pt has decided to be cmo. he is comfortable upon discharge. discharge instructions: plan of care per hospice facility. comfort measures only. followup instructions: plan of care per hospice facility. comfort measures only. procedure: hemodialysis diagnoses: congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status paroxysmal ventricular tachycardia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease pneumonitis due to inhalation of food or vomitus disseminated candidiasis infection and inflammatory reaction due to other vascular device, implant, and graft hemorrhage of gastrointestinal tract, unspecified hyperosmolality and/or hypernatremia cerebral artery occlusion, unspecified with cerebral infarction diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled below knee amputation status ulcer of heel and midfoot 

Answer: The patient is high likely exposed to