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: amoxicillin / tegretol / dilantin attending: chief complaint: respiratory distress major surgical or invasive procedure: endotracheal intubation x 2 tracheostomy peg tube placement history of present illness: 82 yo m with with tracheomalacia secondary to t-tube placement in the setting of stroke, now with chronic tracheostomy since presented to osh on with resp failure, cough and fever. pt initially intubated on after a stroke. he had difficulty weaning from the vent and underwent a tracheostomy. pt was then weaned from the vent and a t-tube was placed for tracheomalacia. pt followed here by ip. pt continued to do well over 2.5 years and t-tube removed, pt allowed to decannulate. pt then presented to ed on with a 2 day hx of sob, cough and fever. pt was seen in outpatient clinic with complaint of difficultly clearing secretions and was treated with abx and pulm toilet without improvement. there was also a question of aspiration per pts wife as he has had choking episodes while eating. pt was admitted to osh micu and intubated for resp failure. cxr noted r-sided atelectasis which resolved after intubation. pt was started on vanc and levo for suspected aspiration pna. pt was able to breathe spontaneously for a few hours on am of but failed extubation due to increased secreations and poor gag. pt then self extubated on and required reintubation. pt was afebrile during this admission, he had one episode of transient hypotension, cosyntropin test negative. resolved with ivf. . pt transfered to because he gets his pulmonary care here. on arrival, pt intubated but responding to questions. denies pain and currently comfortable breathing. past medical history: 1) tracheomalacia, status post stent x 2 with failure secondary to stent migration. status post trach revision . status post t-tube removal on . 2) status post stroke in with tia; right upper extremity weakness resulting. 3) hypertension. 4) seizure disorder. 5) history of mrsa. 6) hemorrhoids. 7) arthritis. 8) depression. 9) history of chf. 10) cri social history: married and lives at home with wife with nursing care. remote hx of smoking, duration unknown. rare etoh. family history: nc physical exam: vs t: 98.1 p:77 bp: 138/68 rr:15-17 o2sat: 94% vent: ac 600x12, fio2 0.40, peep 5. general: intubated, light sedation, responding to commands, agitation. heent: pupile equal, eomi, no icterus, non-injected. neck: supple, no jvd appreciated. cardiovascular: rrr no murmur appreciated. lungs: ant and lat fields with coarse breath sounds. abdomen: obese, ndnt, nabs, soft. extremities: no edema, warm and well perfused. neuro: r ue with weakness, lue strong, able to move toes bilaterally. alert, unable to assess orientation. pertinent results: 10:29pm type-art po2-80* pco2-40 ph-7.42 total co2-27 base xs-0 10:29pm lactate-1.0 06:38pm glucose-112* urea n-26* creat-1.5* sodium-145 potassium-3.6 chloride-109* total co2-25 anion gap-15 06:38pm ck(cpk)-134 06:38pm ck-mb-3 ctropnt-0.03* 06:38pm calcium-8.1* phosphate-2.2* magnesium-2.1 06:38pm phenobarb-23.6 06:38pm wbc-7.0 rbc-4.56* hgb-14.3 hct-42.1 mcv-92 mch-31.3 mchc-34.0 rdw-14.8 06:38pm neuts-74.4* lymphs-19.5 monos-4.9 eos-1.0 basos-0.2 06:38pm plt count-121* 06:38pm pt-12.3 ptt-32.6 inr(pt)-1.1 . chest (portable ap) 7:14 am reason: interval change impression: ap chest compared to through 29: endotracheal tube ends in the tracheobronchial stent, tip between 3 and 4 cm from the carina. lungs are low in volume and mild left lower lobe atelectasis is stable. mild pulmonary edema unchanged. heart size normal. no appreciable pleural effusion. nasogastric passes below the diaphragm and out of view. right jugular line can be traced as far as the upper right atrium but the tip is indistinct. no pneumothorax. . cardiology report ecg study date of 9:05:06 am sinus rhythm. leftward axis. compared to the previous tracing of no change. . brief hospital course: 1) resp failure: possible etiologies included aspiration vs bacterial pna vs bronchitis. likely combination of increased secretions with tracheomalacia making pt unable to clear secretions requiring intubation. initial extubation was not tolerated by the patient with increased respiratory distress, requiring reintubation and eventual tracheostomy with prolonged weaning course likely. - continued vanc and levoquin on admission given hx of mrsa pna, and was switched to and completed a 10 day course of aztreonam and vanco. the patient spiked a temp to 101 several days after completing this course and given that there was a witnessed aspiration when he self d'c'd his ngt, he was restarted on vanc and aztreonam for a 7 day course. all cultures were negative. - was extubated and reintubated on given acute resp distress/stridor (fiberoptic intubation by ip). he was extubated again on and reintubated on for tachypnea and inability to clear secretions. it was d/w ip and family and patient underwent tracheostomy . . 2) tracheomalacia: pt followed by ip service. underwent rigid bronchoscopy on , which showed granulation tissue on the l lateral wall of the trachea causing tracheal stenosis and moderate to severe tracheobronchomalacia. the area of tracheal stenosis was balloon dilated and the granulation tissue was excised. he was transiently given heliox for tenuous respiratory status right after bronchoscopy. he was started on dexamethasone post-bronchoscopy for empiric treatment of tracheolaryngeal edema and continued on high dose guafenesin. . 3) htn: continued metoprolol once more clinically stable. pt has been hd stable since admission. initially underwent aggressive diuresis for management of his resp distress, but with reintubation on , patient's cvp's were 0-2 and map's were less than 60, requiring 2 days of levophed gtt. lasix was stopped and aggressive fluid repletion with a goal of cvp 8-10 and map's>60 was started with good response and levophed was able to be weaned . . 4) cri: baseline 1.2-1.5. after repleting fluids, patient remained in the lower range of his baseline for the rest of his admission. . 5) hx cva: continued aspirin. . 6) sz disorder: maintained on phenobarbital throughout admission, dosing by level secondary to renal insufficiency. medications on admission: lopressor 12.5 zantac 150 lasix 40 daily potassium 10 qd phenobarb 200 qd baclofen 2.5 aspinrin flomax 0.4 qd tums duoneb discharge medications: lopressor 12.5 zantac 150 lasix 40 daily potassium 10 qd phenobarb 240 qd baclofen 2.5 aspirin flomax 0.4 qd discharge disposition: extended care facility: - discharge diagnosis: respiratory distress secondary to aspiration pneumonia and tracheomalacia tracheostomy placement gastrostomy placement bacteremia acute renal failure shock diabetes discharge condition: stable discharge instructions: please return to the hospital for shortness of breath, fevers, chest pain, fainting. followup instructions: please follow up with your pulmonologist within 3 weeks of discharge from the hospital. md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube enteral infusion of concentrated nutritional substances other bronchoscopy other bronchoscopy other bronchoscopy other lavage of bronchus and trachea other lavage of bronchus and trachea percutaneous [endoscopic] gastrostomy [peg] arterial catheterization other intubation of respiratory tract temporary tracheostomy closed [endoscopic] biopsy of bronchus other operations on trachea endoscopic excision or destruction of lesion or tissue of bronchus replacement of laryngeal or tracheal stent infusion of vasopressor agent diagnoses: anemia of other chronic disease congestive heart failure, unspecified acute kidney failure, unspecified unspecified protein-calorie malnutrition hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified other convulsions chronic kidney disease, unspecified acute and chronic respiratory failure pneumonitis due to inhalation of food or vomitus bacteremia other late effects of cerebrovascular disease paralytic ileus mechanical complication due to other implant and internal device, not elsewhere classified hypoxemia hypovolemia other and unspecified complications of medical care, not elsewhere classified other specified hypotension bronchitis, not specified as acute or chronic other diseases of trachea and bronchus foreign body in main bronchus muscle weakness (generalized) 

Answer: The patient is high likely exposed to