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: altered mental status, dyspnea major surgical or invasive procedure: none history of present illness: briefly, this is a 60 yom with esrd on peritoneal dialysis, dm2, htn, diastolic chf, anemia, wheelchair-bound state who presented from home with agitation and dyspnea after his wife was unable to successfully complete his pd sessions at home. the catheter had been flipped up into his abdomen and was not successfully pulling back. he also became dyspneic at home - likely from volume overload with inability to remove the dwelling fluid. the catheter has since been fixed and he has had successful dialysis while here. importantly, the patient also had a recent admission for c.diff diarrhea (+ by pcr) and is to complete a po vanc course until . on initial presentation the patient was extremely agitated, k was 6.9, lactate 0.8. cxr was performed and pneumonia could not be excluded, thus patient was given 750 mg iv levofloxacin, also got doses of vanco and flagyl. kayexelate, insulin were given and k improved to 4.7 today. . currently, the patient's vs are 99.8 80 138/67 18 99% on ra. he is conversant and appropriate. he states that he feels well and wants to go home. he denies sob though his lungs have diffused rhonchi and crackles. he abdomen is non-tender. he reports that he was having bowel movements at home. he currently has a flexiseal in place. past medical history: 1. esrd: anti-gbm disease, on hd since , then pd since 2. htn 3. chronic low back pain herniated discs 4. diastiolic chf- tte ef 75%, lvh 5. peripheral neuropathy 6. anemia 7. h/o nephrolithiasis 8. s/p cervical laminectomy; ?osteo in past 9. h/o depression 10. h/o mssa bacteremia (-infected hd catheter), e. coli bacteremia 11. s/p l av graft: 12. h/o of l4-5 diskitis, osteo, epidural abscess 13. mrsa cath tip infection 14. mssa peritonitis 15. thyroid nodule on u/s , recommended f/u 1 yr 16. wheelchair bound due to knee/muscle contraction since had a pna and icu admission in 17. h/o ij clot 18. right third digit abscess through the entire finger including flexor sheath s/p amputation 9/. social history: lives in with wife, who takes care of him at home, she also takes care of his peritoneal dialysis. he uses a wheel chair to move around at home which has been more difficult for him and wife has had difficulties with transfers. has two sons. one of his sons lives in and the other lives in . tobacco: 1-2 packs per day for the past 40 years. etoh: last drinking 8 years ago illicits: denies family history: no family history of high blood pressure or heart attack. two of his grandparents, his aunt, and his father had diabetes, but he is not sure which type. both his father and mother passed away from lung cancer. no fam hx of renal disease. physical exam: on admission: vs: 99.8 80 138/67 18 99% on ra gen: alert and oriented, appropriate, lying on back in nad heent: perrl, eomi, red eyes and mildly icteric sclerae neck: supple, no lad, distended neck vein pulm: bilateral rhonchi and expiratory wheezing, patient with abdominally augmented expiration, crackles heard throughout card: rr, 2/6 systolic murmur at rusb, nl s2, no r/g abd: bs+, soft, nt, nd, pd catheter site without tenderness or erythema, no exudates ext: wwp, diminished peripheral pulses neuro: sensation intact; cnii-xii intact, full strength in bil ue/le, able to lift both legs off bed . on discharge: pulmonary exam had improved with only scattered crackles heard and with transmitted upper airway noises pertinent results: labs/studies: . cbc: 03:00am blood wbc-10.4# rbc-2.57* hgb-7.5* hct-24.2* mcv-94 mch-29.2 mchc-31.0 rdw-21.3* plt ct-429 05:37am blood wbc-8.0 rbc-2.93* hgb-8.8* hct-27.5* mcv-94 mch-29.9 mchc-31.8 rdw-20.0* plt ct-383 . 03:00am blood glucose-77 urean-46* creat-9.9*# na-135 k-6.9* cl-106 hco3-20* angap-16 05:37am blood glucose-102* urean-36* creat-9.9* na-142 k-3.8 cl-104 hco3-25 angap-17 10:54am blood alt-53* ast-40 ld(ldh)-291* ck(cpk)-374* alkphos-111 totbili-0.1 . 05:02pm blood ck-mb-15* mb indx-4.6 ctropnt-0.73* 12:43am blood ck-mb-11* mb indx-4.0 ctropnt-0.81* 04:40am blood ck-mb-11* mb indx-3.8 . cxr: cardiomediastinal silhouette is unchanged, slightly shifted towards the left side. bibasilar consolidations have improved on the right side due to improvement of the component of atelectasis. vascular congestion has markedly improved. there is pneumothorax or large pleural effusions. spinal hardware is present. . abxrays: initially showed peritoneal dialysis catheter flipped into upper quadrant (wrong location) and then showed resolution with catheter coiled in rlq . 11/5 blood and peritoneal fluid cultures: ngtd brief hospital course: 60 yo m with esrd on peritoneal dialysis, presented from home with altered mental status and dyspnea in setting of receiving no peritoneal dialysis since recent discharge from on . in ed, was combative and refusing treatment, had hyperkalemia on laboratory evaluation. . #. altered mental status: patient with single day of confusion and agitation. ams most likely secondary to metabolic derangements (hyperkalemia) given recent limitations in dialysis. pt was alert and oriented x 3 at the time of discharge. blood cultures were negative at the time of discharge. restarted home mirtazapine and paroxetine at home doses. . #. esrd / hyperkalemia: likely due to insufficient peritoneal dialysis in last 4 days due to shift in location of dialysis catheter and in setting of patient being discharged from hospital newly on lisinopril and with instructions to take 20 meq supplemental potassium daily. (patient was recently started on potassium supplements and lisinopril because of chronically low k). the catheter shifted back into proper location and multiple rounds of successful peritoneal dialysis were performed. the patient was discharged to have labs drawn the following week in case his potassium again became low. continued calcitriol and nephrocaps. . #. dyspnea: likely due to volume overload from ineffective dialysis. he was initially covered with antibiotics, however these were stopped when the patient's dyspnea improved with successful dialysis. he did have crackles on pulmonary exam at the time of discharge, however, cxr was improved and he did not have fevers. he did have uri symptoms but broad-spectrum antibiotics were not continued as the patient was breathing comfortably on room air. . #. diarrhea: presumably related to c diff colitis as evidenced by +pcr during prior admission. continued oral vancomycin for until as previously planned. restarted loperamide and diphenoxylate-atropine and uptitrated medications to help slow the diarrhea. the patient was to have gi follow-up the following week. he had no tenderness on abdominal exam. . #. troponin elevation: likely slightly elevated in setting of ineffective dialysis. ck-mb values were flat. continued aspirin and simvastatin. . #. hypertension: bp elevated to 170s systolic at presentation, no periods of relative hypotension in . continued home metoprolol and nifedipine. held lisinopril though this may need restarted as an outpatient if potassium again becomes low. . #anemia: hct stable but low at 23; likely renal disease. transfused 1 unit prbcs with adequate response. . access: the patient had a r femoral line during admission. . # dvt prophylaxis was with subq heparin. the patient remained full code during this admission. communication was with (wife and hcp) - (h) , (c). medications on admission: 1) omeprazole 20 mg po daily 2) paroxetine hcl 20 mg po daily 3) mirtazapine 30 mg po hs 4) nifedipine 60 mg po daily 5) simvastatin 20 mg po daily 6) aspirin 325 mg po daily 7) calcitriol 0.25 mcg po daily 8) metoprolol tartrate 12.5 mg po bid 9) gabapentin 600 mg po hs 10) gabapentin 300 mg po am 11) epoetin alfa 10,000 unit/ml mwf 12) potassium chloride 20 meq po once a day 13) oxycodone 5 mg po q6h:prn pain 14) nephrocaps 1 mg daily 15) loperamide 4 mg po tid 16) diphenoxylate-atropine 2.5-0.025 mg po bid:prn loose stools 17) vancomycin 125 mg po q6h until 18) lisinopril 5 mg po hs discharge medications: 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 2. paroxetine hcl 20 mg tablet sig: one (1) tablet po daily (daily). 3. mirtazapine 15 mg tablet sig: two (2) tablet po hs (at bedtime). 4. nifedipine 30 mg tablet sustained release sig: two (2) tablet sustained release po daily (daily). 5. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 6. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 7. calcitriol 0.25 mcg capsule sig: one (1) capsule po daily (daily). 8. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 9. gabapentin 300 mg capsule sig: two (2) capsule po at bedtime. 10. gabapentin 300 mg capsule sig: one (1) capsule po once a day. 11. epogen 10,000 unit/ml solution sig: one (1) injection injection qmon,wed,fri. 12. oxycodone 5 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. 13. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 14. vancomycin 125 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 7 days. 15. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) puff inhalation every six (6) hours as needed for dyspnea or wheezing. 16. diphenoxylate-atropine 2.5-0.025 mg tablet sig: two (2) tablet po bid (2 times a day) as needed for diarrhea. 17. loperamide 2 mg capsule sig: two (2) capsule po tid (3 times a day) as needed for diarrhea. 18. outpatient lab work please have bloodwork checked next tuesday . check chem10 panel. please fax results to dr. at . 19. outpatient lab work please have bloodwork checked on friday, . check chem10 panel. please fax results to dr. at . discharge disposition: home with service facility: vna discharge diagnosis: primary: hyperkalemia c. difficile diarrhea pulmonary edema anemia of chronic disease . secondary: esrd on peritoneal dialysis hypertension chronic lower back pain diastolic chf discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear mr. , you were admitted to the hospital because you were short of breath and you were agitated. these symptoms were from inadequate dialysis at home as your dialysis catheter was in the wrong location - your potassium was very high as a result. this problem resolved on its own and you have had successful dialysis during this admission. you have also had problems with diarrhea - you will need to complete a course of vancomycin and you should continue to take loperamide and lomotil to help slow down the diarrhea. you will see a gi physician next tuesday who will address your diarrhea if it has not slowed down. your shortness of breath improved your chest x-ray looked much better before discharge. we believe that the mass on your l hip is a lipoma -this is not a concerning finding but can be surgically excised if you have pain or discomfort at the site. . we made the following changes to your medications: we stopped potassium supplemention we stopped lisinopril we stopped these agents because they can increase your potassium. depending on your values next week. they may be restarted if your potassium again becomes low. you should continue dialysis per your home regimen. . your follow-up appointments are listed below. followup instructions: department: when: friday at 2:00 pm with: , md building: campus: east best parking: garage department: div. of gastroenterology when: tuesday at 2:30 pm with: , md building: ra (/ complex) campus: east best parking: main garage md procedure: peritoneal dialysis diagnoses: hyperpotassemia anemia in chronic kidney disease end stage renal disease congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease intestinal infection due to clostridium difficile hypoxemia kidney dialysis as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure altered mental status lumbago unspecified hereditary and idiopathic peripheral neuropathy chronic diastolic heart failure chronic glomerulonephritis with lesion of membranous glomerulonephritis personal history of methicillin resistant staphylococcus aureus other fluid overload wheelchair dependence 

Answer: The patient is high likely exposed to