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: penicillins attending: chief complaint: nausea, vomiting, diarrhea major surgical or invasive procedure: endotracheal intubation central venous line placement history of present illness: 68yom, nursing home resident, w/ pmh sig for alzheimer's dementia and hydrocephalus s/p shunt who was sent to the ed from the nh today because of five days of diarrhea, one day of vomitting, and increased confusion/agitation. found to have partial sbo, aspiration pneumonia, now with blood cultures positive for gpc. on ctx/azithro/vanco/flagyl there have been no recent fevers or chills, sob. he has had a dry cough today. per so, a stool sample was sent for c diff at the nursing home. son states that at baseline pt can be combative and agitated but is also more verbal. there has been no blood in diarrhea or melena. . ros: no suggestion of back pain, headache, visual changes, dysuria, hematuria. . in the ed he had a ct of the head, abd, as well as a cxr. neurosurg evaluated pt and noted milf increase in ventricular size, but felt that shunt malfuntion or infection was unlikely. in addition, the surgical team evaluated the patient out of concern for partial sbo given vomitting and ct abd with ? of sbo. per surgical note, pt has likely partial sbo or ileus. an ng tube was placed and the team recommended no surgery, but ng tube, npo. . in the ed patient had a fever to 103, leukocytosis, no other abnl vital signs, lactate > 2. a femoral line was placed and pt was given ctx, azithromycin, flagyl. past medical history: alzheimer's dementia, bipolar disorder, pvd, dm2, hydrocephalus s/p vp shunt (son says it was placed 3-5 years ago at with no revisions, unknown cause of hydrocephalus), h/o subdural hemorrhages (unknown if before or after shunt placed), hearing loss with hearing aids, cataracts, hypertension, hypercholesterolemia, siadh with fluid restriction of 1l per day. social history: used to work as an accountant, 100 pack year smoking history, supportive family family history: nc physical exam: vitals: tm 102.6 hr 88 rr 18 bp 186/72 98% general: was asleep but easily arousable for exam. screaming in italian and throwing arms around. ng in place with bilious output. heent: no conjunctivitis or discharge, mucous membranes moist and pink, neck supple, no lad. burr hole on the right with shunt traveling down behind ear to neck. resevoir depressable with refilling immediately. cv: normal s1 and s2, no murmurs pulm: mild wheeze, decreased bs b/l, transmitted upper airway sounds. abdomen: soft, distended, nontender. extremities: warm and well perfused mental status: following some commands, awake and alert during the examination. neuro: mae, nl tone throughout pertinent results: 06:39pm lactate-2.3* 02:55pm lactate-2.4* 02:45pm glucose-173* urea n-8 creat-0.4* sodium-132* potassium-4.0 chloride-91* total co2-31 anion gap-14 02:45pm estgfr-using this 02:45pm alt(sgpt)-16 ast(sgot)-14 alk phos-83 amylase-49 tot bili-0.2 02:45pm lipase-11 02:45pm calcium-9.2 phosphate-3.7 magnesium-1.4* 02:45pm wbc-16.1*# rbc-5.23 hgb-14.1 hct-42.2 mcv-81* mch-26.9* mchc-33.4 rdw-13.9 02:45pm neuts-86.6* lymphs-8.2* monos-4.7 eos-0.3 basos-0.2 02:45pm microcyt-1+ 02:45pm plt count-356 02:10pm urine hours-random 02:10pm urine gr hold-hold 02:10pm urine color-straw appear-clear sp -1.017 02:10pm urine blood-tr nitrite-neg protein-500 glucose-1000 ketone-15 bilirubin-neg urobilngn-neg ph-8.0 leuk-neg 02:10pm urine rbc-0-2 wbc-0-2 bacteria-none yeast-none epi-0 . pcxr: 1. nasogastric tube seen within the body of the stomach and coursing off the imaged field of view. 2. bilateral airspace disease reflecting evolving pneumonia or asymmetric pulmonary edema. . cxr: interval removal of nasogastric tube. patchy airspace opacities, unchanged. diagnostic considerations again include pneumonia and asymmetric pulmonary edema. . ct abd/pelvis: 1. air-filled dilated loops of small bowel, with collapsed distal loops, suggesting partial small bowel obstruction. no free air or free intraabdominal fluid is identified. 2. confluent consolidative opacities in the right middle and lower lobes. differential includes pneumonia versus aspiration. . ct head: 1. compared to previous study dated , the ventricles appear slightly more dilated and therefore recommend evaluation to rule out shunt malfunction . 2. interval resolution of right subdural collection. . video swallow: fluoroscopic assistance was provided for the speech/language pathology service with the radiologist present. the patient swallowed barium of varying consistencies (thin liquid, nectar-thick liquid, and pureed consistency barium). no aspiration was seen throughout this examination. bolus formation with swallow initiation were appropriate with no premature spillover or retention. no penetration or aspiration occurred. the patient was able to cough throughout the examination and expectorated thick clear sputum. no aspiration was noted prior to and during the patient's coughing episodes. . ct head: stable prominence of lateral ventricles compared to . no acute intracranial abnormality including no sign of hemorrhage. . ct abd: 1. resolved partial obstruction of small bowel. no free air or free intra- abdominal fluid is noted. 2. resolving right middle and lower lobe pneumonia or aspiration. 3. diffusely mild thickened bladder wall. this might be due to cystitis. . tte: the left atrium is moderately dilated. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is no pericardial effusion. compared with the report of the prior study (images unavailable for review) of , the pericardial effusion has resolved. brief hospital course: 1) htn: had severely elevated bp while in house even >200/100 at times. he also complained of chest pain and headache at times with this, so he was started on long acting medications due to him refusing meds at times. on toprol, hydralazine, and lisinopril his bp was much better controlled. 2) partial sbo: initially presented with n/v. ct showed partial sbo, surgery was consulted. resolved with bowel rest. ct abd showed resolved psbo. now toleating diet and passing stool. 3) diastolic chf: had slightly elevated cardiac enzymes, but no ecg changes. tnt peaked at 0.24, although mb fraction negative: likely demand ischemia in the setting of htn. tte showed preserved ef and no wall motion abnormalities. improved with aggressive bp control. cont. asa/toprol/lisinopril/statin. 4) h/o siadh: on salt tabs at home, but na stable off them in-house. cont. fluid restriction. 5) hypothyroidism: continued on levothyroxine 6) type ii dm: holding glyburide/metformin for now. continue pm nph; riss. can restart oral meds at nh as needed. 7) diarrhea: c. diff (-) x 3, no diarrhea. 8) aspiration pna: developed sudden respiratory arrest while eating dinner. thought to be aspiration. pt. was intubated and transferred to icu and started on levofloxacin and flagyl. patient passed video swallow. 9) gpc bactermia bcx cns; also w/ cns. surveillance cx negative. 10) candiduria: d/c foley 11) fe def anemia: spep hypogamma; check folate, low/nl vit b12, hold iron pending completion of levo course 12) full code 13) dispo: back to nh medications on admission: trileptal 300 mg glyburide 2.5 mg glucophage 1000 mg ursodiol 300 mg nacl 2 tabs tid 1l fluid restiction senna levothyroxine 25 mcg daily abilify 10 mg daily colace 100 mg prilosec 20 mg daily ativan 0.25 mg prn nph 40 units sc q4pm regular insulin sliding scale discharge medications: 1. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 7 days. disp:*7 tablet(s)* refills:*0* 2. levothyroxine 25 mcg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin 20 mg tablet sig: four (4) tablet po daily (daily) for 1 months. disp:*120 tablet(s)* refills:*0* 4. heparin (porcine) 5,000 unit/ml solution sig: 5,000 units injection tid (3 times a day). 5. oxcarbazepine 300 mg tablet sig: one (1) tablet po bid (2 times a day). 6. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation q4h (every 4 hours). 7. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 8. famotidine 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). 9. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day). 10. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 11. hydralazine 10 mg tablet sig: two (2) tablet po q6h (every 6 hours). 12. albuterol sulfate 0.083 % solution sig: one (1) neb inhalation q2h (every 2 hours) as needed. 13. codeine-guaifenesin 10-100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed. 14. metoprolol succinate 100 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). 15. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 16. aripiprazole 10 mg tablet sig: one (1) tablet po daily (daily). 17. lasix 40 mg tablet sig: one (1) tablet po once a day. 18. insulin nph human recomb 100 unit/ml suspension sig: thirty six (36) units subcutaneous qdinner. 19. insulin regular human 100 unit/ml solution sig: sliding scale sliding scale injection four times a day. discharge disposition: extended care facility: healthcare - discharge diagnosis: partial small bowel obstruction aspiration pneumonia severe hypertension diastolic chf cad alzheimer's dementia discharge condition: stable discharge instructions: please continue meds as listed. please follow up with your pcp in the next 2 weeks. followup instructions: 1. please follow up with your pcp in the next 2 weeks. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube cardiopulmonary resuscitation, not otherwise specified diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute respiratory failure pneumonitis due to inhalation of food or vomitus bacteremia malignant essential hypertension alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance other disorders of neurohypophysis atherosclerosis of native arteries of the extremities, unspecified diastolic heart failure, unspecified unspecified intestinal obstruction urinary incontinence, unspecified presence of cerebrospinal fluid drainage device 

Answer: The patient is high likely exposed to