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: the patient is a 78 year old white male with history of hypertension, diabetes mellitus, status post right lobectomy 14 years ago, who presents to the emergency room with complaints of shortness of breath for the past several days. the patient reports that he is short of breath while walking to the bathroom from his bed at night. he also has had mild diaphoresis. he denies any chest pain, nausea, vomiting, fevers, cough, orthopnea or paroxysmal nocturnal dyspnea. he denies any palpitations. the shortness of breath is worsened with minimal activity over the past two days. the patient was taken to the emergency room by ambulance service. in the ambulance, the patient was found to be in atrial flutter with heart rate 150s, blood pressure 140/70. he was treated with diltiazem with improvement in heart rate to 120s. chest x-ray with mild congestive heart failure. he was given 20 mg of intravenous lasix. he was weaned from 100% non-rebreather to nasal cannula with good oxygen saturation. past history of atrial fibrillation unknown. the patient reports that he has had an irregular heart beat for years. no known prior work-up. past medical history: 1. hypertension. 2. diabetes mellitus. 3. hypercholesterolemia. 4. lung cancer status post resection of the right lobe. medications at home: 1. glyburide 15 mg p.o. q. day. 2. adalat 30 mg p.o. q. day. 3. aspirin 81 mg p.o. q. day. 4. lipitor 10 mg p.o. q. day. social history: he is retired. he lives with his daughter. his wife died of cancer recently. he denies any tobacco use. has occasional alcohol use. physical examination: on arrival in the emergency room, heart rate 150 and regular; blood pressure 145/75; respiratory rate 26; 98% on 100% non-rebreather. in general, elderly white male in mild distress. heent: pupils equal and reactive to light. extraocular movements are intact. neck: no jugular venous distention. lungs: decreased breath sounds in the right lung field with occasional crackles in the left base. no wheezes. cardiac: irregularly irregular with s1, s2 normal. abdomen soft, nontender, nondistended, with positive bowel sounds. extremities: trace pitting edema bilaterally. back: positive surgical scar over right upper back. no costovertebral angle tenderness. neurologic: alert and oriented times three. rectal: guaiac negative stool. good rectal tone. laboratory: white blood cell count 17.4, hematocrit 41.4, platelets 83. sodium 136, potassium 4.3, chloride 95, bicarbonate 26, bun 16, creatinine 1.0, glucose 292, troponin 8.1. acetone large. total cholesterol 273. alkaline phosphatase 155, ck 175, albumin 4.4, calcium 9.9, phosphate 4.4, magnesium 1.7. chest x-ray: near opacification of the right lung field. mild congestive heart failure. impression: 78 year old white male with a history of hypertension and diabetes mellitus, who presents with shortness of breath and found to be in atrial flutter with a heart rate of 150. he is now rate controlled with intravenous diltiazem but his first troponin was positive at 8.1. hospital course by systems: 1. cardiac: initially the patient was in atrial flutter and he responded to the intravenous diltiazem. he was continued on his adalat 30 mg p.o. q. day and metoprolol was added, 12.5 mg p.o. twice a day. the patient was initially heparinized both for his rhythm and because of an elevated troponin. possible acute coronary syndrome. for his possible ischemia his cks were cycled and he was continued on his aspirin. he was also started on a beta blocker and continued on his lipitor. he was also started on heparin for acute coronary syndrome. because of his poor respiratory status, the patient was intubated. on the first night of admission, he became hypotensive and required to be started on dopamine and norepinephrine. he had a cardioversion on the second day of admission. he converted to sinus rhythm with cardioversion. however, that evening, he then reconverted back to atrial flutter. he had an echocardiogram done the second day of admission which showed left atrial moderate dilatation, severely depressed left ventricular function, right ventricle dilated, severe low rate ventricular free wall hypokinesis. mildly dilated aortic root, one plus mitral regurgitation. increased diastolic pa pressure. small pericardial effusion but no evidence of tamponade. ejection fraction was reported to be 20%. his ck went from 195 to 214 to 576, but this is status post cardioversion. his mb was 13.3, 11.7, and 12.2. his troponin increased from 8.1 to 21.1 in the setting of cardioversion. on the second day of admission, the patient was started on amiodarone load. he was started on an amiodarone drip of 0.5 mg per minute. he was felt to be in congestive heart failure. his urine output had decreased and he was given increasing amounts of lasix. he has received 10 mg intravenous for which his urine output did improve. his oxygen saturation was improved. he had another episode of rapid ventricular rate in the 120s with decreased blood pressure on the third day of admission. he had a cardioversion attempt again, but without success. his amiodarone was continued. his oxygen saturations were also decreasing. it was decided that he still required diuresis for his congestive heart failure. there was some discussion whether the patient would need a swan-ganz catheter in the setting of infection, however, he was still felt to be fluid overloaded and he had continued goal of diuresis. if the patient had another rapid ventricular response, he would have been further cardioverted, however, he did not have occasion for that. 2. pulmonary: the patient's pulmonary status deteriorated to the point where he needed intubation upon admission. his initial ventilator settings were assist control with total volume of 400, peep of 10 and fio2 of 70%. he had a respiratory rate of 24. his first arterial blood gas was ph of 7.34, pco2 of 39, po2 of 78. besides his right pneumonectomy, he had congestive heart failure. consequently, he had a very compromised pulmonary status. there was some concern that he may be developing a pneumonia. his subsequent ventilator settings were adjusted to decrease his fio2. his fio2 decreased to 0.60 on the third day. on the fourth day, his ventilator settings still required fio2 of 60%. his arterial blood gas on that day was 7.43 ph, pco2 of 37, po2 of 61. 3. infectious disease: the patient did not have any evidence of infection upon admission. however, he did have a temperature spike of 101.6 f., on the second day of admission. he was started on levofloxacin and metronidazole. there was some concern that he may have a pneumonia. however, on the fourth day of admission, the patient was found to have two out of four blood culture bottles positive for gram positive cocci in pairs and clusters. consequently, he was started on vancomycin and the levofloxacin and the flagyl were still continued. he was additionally further pan-cultured. 4. renal: the patient's creatinine on admission was 1.0. the second day of admission it was 0.5. his urine output was muddy and had many brown casts consistent with acute tubular necrosis. his rise in creatinine was consistent with this also. his acute renal failure was thought to be due to acute tubular necrosis secondary to hypotension that now required dopamine and norepinephrine. however, because he was fluid overloaded, he still required diuresis with lasix. his urine output had decreased and he required increasing amounts of lasix. he also had decreased oxygen saturation which was thought to be due to, in part, the initial heart failure. creatinine then was stable at 1.4 to 1.5. further hospital course is as follows: because of the patient's fever, it was decided that his right internal jugular line needed to be switched, particularly because the culture was growing gram positive cocci, the possible source was the line. it was decided that he would have stick and then the right internal jugular could be replaced. initially a right subclavian line was attempted but the wire could not be threaded through the needle. the right subclavian vein was thought to have been found fairly easily but the wire would not progress through the vessel and the right femoral vein was attempted to be cannulated, however, again, the wire had difficultly being passed through it. consent was obtained from the son. at that point, because it was unsuccessful, no further attempts were made at changing the line. he continued to have the right internal jugular line. later in the evening, the patient's blood pressure decreased to systolic of 70 with a heart rate in the 70s. previously his heart rate had been 90 to 110. dopamine was increased to 20 mg per kg per minute and norepinephrine was restarted. arterial blood gas was sent which revealed a hematocrit of 27, decreased from 39. his arterial blood gas was 7.33, with a pco2 of 47 and po2 of 172 and a bicarbonate of 26. it was thought that from the attempts of cannulating his subclavian vein and his right femoral vein, it was possible that his artery had been injured in the process, particularly in the subclavian area. no hematoma was observed at either site. the patient was given 1.5 liters of normal saline and a unit of blood. his blood pressure responded to the pressors, fluid and blood with a systolic blood pressure of 110 to 120 and heart rate of 120 to 140, which was thought to be appropriate. his heparin was discontinued. a repeat hematocrit was 35. the unit of blood had already been started. however, it was thought that the 27 was more consistent. a chest x-ray was obtained and did not reveal any evidence of blood, but it could not exclude bleeding. the family of the patient was notified of the change in the patient's clinical situation. they were informed that a possible option was to have ct scan with possible intervention. however, they were told that treating the bleeding would not change the overall prognosis of the patient. because the patient had a very poor prognosis, the family decided that he should be "do not resuscitate" and "do not intubate" which they felt would be consistent with what the patient would have wanted. they also that the patient would have wanted to have pressure support withdrawn. at this time, pressor support was withdrawn and the patient's blood pressures decreased. cardiology fellow and attending were notified of the change in clinical situation. later in the evening, the patient was found to have no auscultatory heart sounds, was unresponsive, and had fixed and dilated pupils. the patient was pronounced dead at 12:35 a.m. the patient's family was at the patient's bedside. they did not want to have an autopsy. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances atrial cardioversion diagnoses: pneumonia, organism unspecified subendocardial infarction, initial episode of care acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified atrial fibrillation personal history of malignant neoplasm of bronchus and lung atrial flutter other shock without mention of trauma cardiogenic shock 

Answer: The patient is high likely exposed to