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: shortness of breath major surgical or invasive procedure: right ij central line placement right heart catheterization history of present illness: 75 year old male with cad stent to lad ', known 3vd plan for eventual cabg, dm, pvd recently admitted from for foot cellulitis and gangrene, s/p angiogram and r profunda angioplasty, on antibiotics presented to osh on with shortness of breath for a couple days and tachypnea. he and his wife were travelling to when he began to feel sob. they stopped for clam chowder, and his symptoms worsened. due to his sxs, he presented to the osh. there, he was hypoxic with a ph of 7.2 and was found to be in chf exacerbation/pulmonary edema. the patient was treated with bipap and diuresed well. the patient ruled in for mi with peak mb 16, tropi 10.7. given his diuresis, the patient was switched to facemask when he decompensated. he went into vf requiring 2 shocks. his rhythm returned to sinus. he was also intubated for airway protection, transfer abg 7.37/37/62. he was transferred to for further management. . on arrival to , the patient was intubated and sedated. ekg and cxr were performed. the patient was on dopa, amio, heparin gtt. the dopamine was weaned with poor effect. the patient dropped his sbp to the 60s. rij cvl was placed. . of note, he recently had cardiac cath performed at on showing diffuse 3vd (left main with ostial 50-60% lesion, lad with patent stent and mid 60-70 lesion, distal rca with 80% lesion - full report below). he was referred to for possible cabg, however, given gangrenous right toe, he was empirically treated with vanc, cipro switched to linezolid, cipro, flagyl (nasal swab w/ mrsa +) and developed post-cath atn with creatinine increase to 2.3 which resolved to baseline. cabg was postponed. pt was then admitted to vascular service for rle angioplasty of profunda, with unsuccessful sfa angioplasty. pt was to f/u for further rle evaluation . on review of symptoms, patient intubated, however, no known history pf cva, blood clots. all of the other review of systems were negative. . cardiac review of systems is now limited patient intubated and sedated. past medical history: cad s/p cypher stent to lad , known 3vd s/p cardiac cath : l main 50% ostial lesion as well as 3 vessel disease with a preserved ef of 55-60% htn hypercholesterolemia: lipid panel chol 104, trig 50, hdl 34, ldl 60 dm ii c neuropathy, retinopathy pvd sleep apnea s/p l tkr s/p l femur fracture c surgical repair s/p bilateral cataract surgery, legally blind . social history: the patient is married. he is a retired designer. he did smoke 1.5 packs per day for 20 years. he does not drink alcohol. family history: father died at age 80 due to cirrhosis and dm ii. mother died at age due to cva. physical exam: vs: t , bp 138/72, hr 75, rr 25, o2 100 % on ac gen: obese, intubated male, sedated. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: unable to appreciate jvp du to habitus cv: distant hs due to habitus. no appreciable m/r/g chest: diffuse rales throughout with scattered wheezes abd: obese, soft, nt/nd, no hsm or tenderness. no abdominial bruits. ext: 2+ pitting edema with venouse stasis changes, dopplerable pulses bilat skin: bilat ankle dressing with venous stasis changes pulses: right: carotid 2+ without bruit; femoral 2+ without bruits left: carotid 2+ without bruit; femoral 2+ without bruits pertinent results: wbc-10.6# rbc-4.06* hgb-10.9* hct-32.1* mcv-79* mch-26.8* mchc-33.9 rdw-16.1* plt ct-196 wbc-5.7 rbc-3.42* hgb-9.2* hct-27.3* mcv-80* mch-26.9* mchc-33.8 rdw-16.4* plt ct-134* wbc-8.9 rbc-3.95* hgb-10.6* hct-32.5* mcv-82 mch-26.8* mchc-32.5 rdw-16.5* plt ct-227 wbc-8.2 rbc-4.12* hgb-11.0* hct-33.2* mcv-81* mch-26.7* mchc-33.1 rdw-16.3* plt ct-252 pt-14.9* ptt-77.7* inr(pt)-1.3* pt-15.4* ptt-63.8* inr(pt)-1.4* pt-14.2* ptt-37.8* inr(pt)-1.3* glucose-159* urean-41* creat-2.0*# na-139 k-4.6 cl-102 hco3-23 glucose-335* urean-49* creat-1.6* na-136 k-3.8 cl-99 hco3-29 glucose-244* urean-60* creat-1.5* na-140 k-3.9 cl-97 hco3-32 glucose-235* urean-63* creat-1.4* na-138 k-3.7 cl-96 hco3-34* alt-15 ast-26 ld(ldh)-299* alkphos-90 totbili-0.4 06:58am blood alt-2 ast-17 ld(ldh)-55* alkphos-19* totbili-0.4 06:40pm blood ck(cpk)-141ck-mb-8 ctropnt-1.20* 04:55am blood ck(cpk)-91 ck-mb-notdone ctropnt-1.18* 04:13am blood ck(cpk)-24* ck-mb-notdone ctropnt-0.75* tsh-3.0 caltibc-155* vitb12-1495* folate-10.3 ferritn-147 trf-119* . cr 1.8, k 4.3 echo: the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal with moderate global hypokinesis (lvef 30%). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). the aortic valve leaflets (3) are moderately thickened. there is mild aortic valve stenosis (area 1.6cm2). trace aortic regurgitation may be present. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: moderate global left ventricular hypokinesis c/w diffuse process (toxin, metabolic, cannot fully exclude multivessel cad, but less likely). mild aortic valve stenosis. increased lvedp. cxr: a single portable radiograph of the chest demonstrates an endotracheal tube present with its tip located 3 cm above the level of the carina. there is a nasogastric tube present with its tip in the stomach. there are bilateral pleural effusions, worse on the left than the right. increased airspace opacity involving both lungs is present. no pneumothorax. trachea is midline. aorta is calcified. cxr: the endotracheal tube tip is 2.4 cm above the carina. the left ij line tip is in the superior vena cava. the ng tube tip cannot be adequately visualized. there is a large left greater than right pleural effusion that is increased in size compared to prior. there is bilateral hazy vasculature consistent with fluid overload. the overall impression is that of worsening chf and worsening effusions compared to the prior study. cxr: no evidence of intubation. tip of left jugular cv line overlies proximal svc. no pneumothorax. there is opacity at the left base consistent with atelectasis, with the previously noted bibasilar opacities on the study of improved. no pneumothorax. brief hospital course: 75 year old male with cad, known 3vd, planned for cabg presented to osh in chf, where he had a questionable vfib arrest requringing 2 shocks into nsr and loaded on amiodarone. he was intubated at osh for hypoxia and acidosis. he was then transferred to , diuresed 15l and then extubated on . . nstemi/cad. prior to hospital admission, patient was being planned for cabg as he was found to have diffuse 3vd by a cardiac cath at on . the cath showed left main osteal 50-60% lesion, lad with patent stent and mid 60-70% mid lesion, and distal rca with 80% lesion). an ekg on admission to osh showed with persistent st depressions. cardiac enzymes trending up at osh (troponin i 10.7 on ). the elevated troponins were thought to be due to demand ischemia rather than acs. he was treated with aspirin and statin. due to hypotension requiring pressors, he was not initially treated with acei or bb. once pressors were stopped, he was started on . he was evaluated by ct surgery prior to discharge who will perform cabg after a few weeks of rehab. he will see his cardiac surgeon in two weeks. . pump: an ef on an lv gram in (prior to admission) was 55-60%. an echo on showed ef of 30% with global lv hypokinesis c/w diffuse proccess (toxin, metabolic) but cannot fully exclude multivessel cad. prior to diuresis, cxr showed pulmonary edema which resolved with aggressive diuresis. he was diuresed 15.7 l on lasix drip with diuril. he will be sent home on po lasix 40 mg q day with a goal of ins equal to outs. . respiratory failure. initially, the etiology of respiratory failure was unclear if it was due to sepsis or pulmonary edema. there was improvement of oxygenation with diuresis so the respiratory failure was thought to be due to decompensated chf with pulmonary edema. also, no source of infection was found to suggest sepsis. he was extubated on . . questionable ventricular fibrillation arrest at osh. it it unclear if this was true vf, but he was given two shocks and reportedly converted to nsr. he was loaded on amio. he was treated initially with amiodarone 400 mg and then switched to amiodarone 400 qday on . he should stay on amiodarone until after his cabg. . type 2 diabetes. his hga1c was 7.1% on . he was treated with insulin sliding scale and nph during hospitalization. finger sticks were elvated into 300s and so was put on insulin drip for a few days. he was seen by for elevated fingersticks who made adjustments to his iss and nph doses, with improvement of finger sicks. he is currently on nph with regular insulin sliding scale at doses that are lower than his home doses as he is not eating as much as he did at home. . right second necrotic toe. evaluated by id and vascular surgery on prior admission. it was recommended that he complete a 3 week course of flagyl/vanco/cipro starting on . during this admssion, he was seen by id who recommended adding cefepime (instead of cipro) for broader gram negative coverage. antibiotics were stopped on . on prior admission, he was seen by vascular surgery who recommended rle angioplasty in the near future. prior to discharge, vascular surgery recommended follow up with dr. two weeks following cabg to schedule vascular surgery. . arf. patient has a baseline cr of .2 secondary to type 2 diabetes. he developed acute renal failure in setting of decompensated chf and intravascular volume depletion. he was aggressvily diuresed with significant improvement in renal function. on day of discharge, his creatinine was 1.8. . fen: he was evaluated by speech and swallow who saw signs of aspiration with thin liquids. he was put on nectar thickened liquids with regular solids for two day. on re-evaluation by speech and swallow, his diet was changed to soft solids and thin liquids. . full code medications on admission: home meds: asa 325 mg daily valsartan 80 mg po daily gabapentin 300 mg po daily simvastatin 40 mg po daily sl ntg prn clopidogrel 75 mg po daily hydrochlorothiazide 12.5mg po daily oxybutynin chloride 5 mg po tid ciprofloxacin 250 mg po q24hours nph 36 units sc qam, 40 units sc qpm regular insulin sliding scale . . meds on transfer: dopamine 4mcg/kg/min heparin gtt 1600 units/hr amiodarone gtt 0.5 mg/min (loaded with 150mg bolus, 360mg over 6hrs) fentanyl 50mcg/hr asa 81mg daily insulin ss cipro 400mg iv daily flagyl 500mg iv q8 lasix prn versed prn for sedation . discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. tablet(s) 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed. 4. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 5. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day). 6. amiodarone 200 mg tablet sig: two (2) tablet po daily (daily). 7. valsartan 80 mg tablet sig: one (1) tablet po daily (daily). 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. gabapentin 300 mg tablet sig: one (1) tablet po once a day. tablet(s) 10. simvastatin 40 mg tablet sig: one (1) tablet po once a day. 11. furosemide 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 12. insulin sliding scale nph 38 units at breakfast and nph 38 units at bedtime. regular insulin sliding scale between 8-23 units. please see attached scale. discharge disposition: extended care facility: & rehab center - discharge diagnosis: primary: congestive heart failure cardiogenic shock coronary artery disease secondary: peripheral vascular disease dry gangrene of right second toe diabetes mellitus type ii dyslipidemia acute renal failure discharge condition: stable discharge instructions: you have been treated for cardiogenic shock as a result of decompensated congestive heart failure. prior to transfer to , your heart went into a ventricular arrhythmia requiring cardiopulmonary rescucitation with two electrical shocks. you were mechanially ventilated while excess fluid was being removed from your lungs. once you were able to breath again on your own, the mechanical ventilation was removed. currently you are awaiting cardiac bypass surgery after you regain your strength at a rehab facility. please return to the hospital if you have any new chest pain, worsening sob, lightheadedness, or fevers. followup instructions: please see dr. on tuesday at 1:45. his clinic is located on . ph . . please set up an appointment with dr. from vascular surgery two weeks after getting bypass surgery. phone number(. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances pulmonary artery wedge monitoring monitoring of cardiac output by other technique transfusion of packed cells diagnoses: anemia of other chronic disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled personal history of tobacco use acute respiratory failure cardiogenic shock unspecified sleep apnea ventricular fibrillation family history of ischemic heart disease atherosclerosis of native arteries of the extremities with gangrene knee joint replacement diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled legal blindness, as defined in u.s.a. diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to