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: history of present illness: seventy-eight year old male with a history of type 2 diabetes, tachy-brady syndrome status post pacemaker, hypertension, cri, who presented with a one week history of worsening shortness of breath and cough. patient has also noted increasing lower extremity edema and a cough productive of grayish sputum over this time. he also noted fever to 100.2. patient has upper respiratory symptoms including postnasal drip. patient needs increasing pillowed needed five pillows on the night prior to admission for comfortable sleep. wife reported that the patient had increased amount of fluid intake over the past week. he reported no changes in urinary habits. no recent sick contacts. denied chest pain, lightheadedness, arm pain, nausea, vomiting, or abdominal pain. past medical history: 1. diabetes type 2 complicated by retinopathy. 2. tachy-brady syndrome status post pacemaker in . 3. pvd. 4. hypertension. 5. hypercholesterolemia. 6. chronic renal insufficiency. 7. anemia. 8. atrial fibrillation. 9. benign prostatic hypertrophy. allergies: patient has no known drug allergies. medications on admission: 1. coumadin 1 q.d. 2. amiodarone 200 q.d. 3. norvasc 5 q.d. 4. prinivil 10 q.d. 5. zocor 20 q.d. 6. humulin 70/30 24 q.a.m., 7 q.p.m. 7. lasix 20 q.d. 8. metoprolol 25 q.d. physical exam on admission: temperature 99.1, pulse 66, blood pressure 108/45, respirations 24, sating 91% on room air. in general, this is an elderly male coughing, but in no acute distress. examination was significant for jvd to the jaw, no lymphadenopathy. coarse upper airway sounds throughout the lung fields. dullness to percussion at the bases. patient had a regular, rate, and rhythm, no murmurs, rubs, or gallops, 2+ pitting edema was noted bilaterally. laboratory values on admission: significant for a white count of 8.4, hematocrit 28.9. also significant for an inr of 2.4, bun 66, creatinine 3.3, former baseline had been 1.9-2.5. on admission, the patient had a renal ultrasound which was unremarkable. no hydronephrosis. prostate mildly enlarged. chest x-ray showed evidence of chf, patchy right lower lobe opacities. summary of hospital course: patient was admitted to the medicine unit. on the 18th, the patient was transferred to the ccu for fluid monitoring and subsequently on the same day transferred to the micu for fluid monitoring as well as further care. the patient was discharged from the micu on to the general medical floors. 1. respiratory: patient with shortness of breath and hypoxia. patient was admitted with oxygen saturations 91% on room air, which declined to 95% on 2 liters. on the day after admission, the patient's oxygen requirement increased to 98% on 6 liters. patient was originally diuresed for presumed chf. patient was given lasix with worsening of his pulmonary status. an echocardiogram was performed at the time on which showed a normal ef, 1+ mr, and mild pulmonary hypertension. did not explain the patient's worsening pulmonary function. patient was treated for a pneumonia with levofloxacin and flagyl. the patient received a full 10 day course of both of these antibiotics. patient also was started on vancomycin during this hospital course for an increasing white count and worsening chest x-ray. patient received five days of vancomycin, however, the cultures remained negative and this was discontinued at the completion of the levofloxacin, flagyl combination. patient was diuresed with dialysis with improvement in his oxygen saturation confirming the component of congestive heart failure to the patient's respiratory status. in addition to being treated for pneumonia and congestive heart failure, it was also believed that the portion of the diffuse process in the patient's lungs may have been due to amiodarone toxicity. patient was not started on steroids, however, the patient's respiratory status improved and then remained constant during his micu stay. patient was not an optimal candidate for steroids given his multiple other comorbidities. it was believed if the amiodarone was stopped and the patient's respiratory status improved, this was not necessary. 2. acute renal failure: patient had a fena of less than 1%, which indicated the patient was dry, however, the patient also had muddy brown casts on urinalysis, was a mixed picture. renal ultrasound did not indicate any signs of obstruction. patient's renal function declined throughout his hospital stay, and the patient required dialysis. the patient's decline in renal function over his baseline chronic renal insufficiency may have been due to a hepatorenal type picture in the setting of hepatitis due to amiodarone toxicity. patient was dialyzed as needed, and the patient's urinary function was improving at the time of discharge from the micu. the patient began to have urine output again at this time. 3. liver: patient with increased lfts. patient's liver function tests were elevated on the . a right upper quadrant ultrasound showed cholelithiasis, no cholecystitis. a ct of the abdomen was performed on , which showed a hyperdense hepatic pattern which was consistent with amiodarone effect. patient's amiodarone was discontinued. the patient's lfts increased, where bilirubin rising to approximately 16, however, these then trended down and the patient's liver function tests and synthetic function via measurement of inr improved throughout his course. 4. cardiac: the patient's original echocardiogram showed a normal ejection fraction of greater than 55%, however, the echocardiogram was repeated approximately two weeks later, which showed an ejection fraction of 20-25%. there was global lv and rv hypokinesis consistent with a cardiomyopathy and not indicating ischemic event. troponins were monitored throughout the hospital course, and the highest that they noted was less than 0.2 in the setting of acute renal failure. at the time of discharge from the micu, the patient continued to be worked up with a p-mibi to rule out ischemic event, however, the decline in cardiac function may be more consistent with a cardiomyopathy possibly due a systemic inflammatory response type syndrome in the setting of amiodarone toxicity and pneumonia. patient was followed by cardiology throughout his hospital course. 5. atrial fibrillation: the patient did show signs of atrial fibrillation, however, the patient was in a rhythm paced at the ventricular level. patient was maintained on coumadin in his original hospital course, this was discontinued, and patient was started on heparin due to the procedure line placement needs. patient was maintained on low dose heparin with a ptt goal of 60-80 for his atrial fibrillation. 6. anemia: patient with baseline hematocrit on admission. patient required infrequent transfusions to maintain his hematocrit above 28. there was no evidence of acute bleed during his hospital course. 7. hyperthyroidism: patient had a low tsh and high t4. this may represent a sick euthyroid syndrome in the setting of an icu syndrome, however, this may also be consistent with amiodarone toxicity to the thyroid. this continues to be under investigation at this time. 8. fen: patient's fluid status was unclear at the time of admission, although he did have lower extremity edema and evidence of congestive heart failure on examination. on the 18th, the swan-ganz catheter was placed for better fluid monitoring. the patient had a high pulmonary capillary wedge pressure of 24 at the time of catheter placement. the patient was dialyzed on successive days to remove fluid. although initial dialysis attempts at removing 3 liters at a time did not effect the pulmonary capillary wedge pressure. on the subsequent dialysis session, the wedge pressure decreased to 14. after this, the catheter was pulled and replaced with a triple lumen right ij central line for access as well as cvp monitoring. subsequent to this, patient did require occasional fluid boluses to maintain urine output. he had good response to these fluid boluses. note: this discharge summary will be addended to reflect the remaining hospital course for this patient. dr 12.207 dictated by: medquist36 procedure: enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis pulmonary artery wedge monitoring right heart cardiac catheterization diagnoses: pneumonia, organism unspecified congestive heart failure, unspecified acute kidney failure, unspecified atrial fibrillation other diseases of lung, not elsewhere classified systemic inflammatory response syndrome due to noninfectious process with acute organ dysfunction hepatitis, unspecified cardiac rhythm regulators causing adverse effects in therapeutic use thyrotoxicosis of other specified origin without mention of thyrotoxic crisis or storm 

Answer: The patient is high likely exposed to