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 / ceftriaxone attending: chief complaint: tachycardia major surgical or invasive procedure: hemodialysis history of present illness: ms. is a 63yo f living at with multiple medical problems including dm, htn, diastolic chf, hyperlipidemia, pulm htn, esrd on hd, h/o av graft infections, morbid obesity, lower extremity dvt, b/l ij vein thromboses on coumadin, and osa. she has recently been admitted several times to for tachycardia most recently on to the service which she was found to be in atrial tachycardia. today, she presents directly from hd. she has been needing more hd sessions for fluid removal in the past week. today, she had 2kg fluid removed and was hypotensive at hd and metoprolol was held. shortly afterwards, she began to notice palpitations with hr 120-130's. she was sent in directly from hd to . in our ed, initial vitals were 96.9 128 133/112 20 100%ra. one hour in ed, her bp then decreased to 64/60, which improved to 110's after receiving 1500 cc ns. she was mentating throughout and stated that bps normally run 80-90's. she then received lopressor 5mg iv x 3 with no change in hr. she had a low grade t 100.4, cxr negative, blood and urine cx drawn, but no antibiotics started. she was admitted to the icu, where she reported feeling well. she is still noticing some fluttering sensation in chest, but denies cp. she did note a left shoulder twinge during hd which prompted her to ask rn at hd to check her hr. since then, she has not had any more twinges. she attributes increased need for hd to eating more fruit at nh (watermelon and grapes). she has been to hd last tues, wed, , and today. also, she is recently s/p 7d levoquin for pneumonia. she denies fever, chills, n/v/d, no pnd/orthopnea/le swelling past medical history: past medical history: - hemorrhagic pericardial effusion - bilateral internal jugular thromboses, restarted on coumadin - h/o bilateral lower extremity dvt's - esrd on hd t, th, sat - iddm - diastolic heart failure - pulmonary hypertension - hypercholesterolemia - osa, noncompliant with cpap as outpatient - oa - h/o c. diff - gerd - depression - morbid obesity - fibroid uterus; vaginal bleeding - h/o osteomyelitis at the t9 vertebrae ; tx with vanc - h/o multiple line infections **: providencia, treated with 4 wk course of aztreonam **: staph coag positive, sensitive to both vancomycin and gentamicin **: staph bacteremia tx with vanc x 6 weeks **: proteius mirabilis and mssa, treated with ceftaz and vanc . past surgical history: - l forearm radial-basilic av graft, s/p infection, thrombosis and abandonment () - multiple lines in l upper arm with av graft - 1/07 l femoral permacath placed - l upper arm thrombectomy, revision, of lue av graft () - excision of left upper arm infected av graft; associated mrsa bacteremia treated with 6 weeks vancomycin. - right upper extremity av fistula creation s/p revision - right av fistula repair, right ij permacath rewiring and ivc filter removed social history: patient denies tobacco, alcohol or illicit drug use. she lives in a nursing home. she is separated from her husband. she has 5 children in area. family history: not obtained. physical exam: general: pleasant woman in no acute distress, obese; left hd line in place neck: no jvd appreciated lungs: wheezes clearing with cough, otherwise clear cardio: distant soft hs, rrr, no m/r/g appreciated abd: + bs, soft, obese, no hsm extremities: no edema neuro: aa, ox3, cn ii - xii intact, moving all limbs pertinent results: discharge labs: 08:50am blood wbc-5.0 rbc-3.09* hgb-10.0* hct-32.2* mcv-104* mch-32.4* mchc-31.2 rdw-14.4 plt ct-273 08:50am blood pt-22.9* ptt-35.1* inr(pt)-2.2* 08:50am blood glucose-107* urean-29* creat-4.9*# na-136 k-4.1 cl-97 hco3-29 angap-14 04:19am blood ck-mb-notdone ctropnt-0.06* 01:20pm blood ctropnt-0.06* 04:19am blood ck(cpk)-38 01:20pm blood ck(cpk)-90 08:50am blood calcium-9.4 phos-3.9 mg-2.2 imaging: echo the left atrium is dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the right ventricular free wall is hypertrophied. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. the mitral valve leaflets are mildly thickened. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. diastolic dysfunction. no significant valvular abnormality seen. compared with the prior study (images reviewed) of , findings are similar. microbiology: 1:20 pm blood culture blood culture, routine (preliminary): staphylococcus, coagulase negative. isolated from one set only. sensitivities performed on request. brief hospital course: 63 yo f with esrd and atrial tachycardia admitted initially to micu for hypotension/tachycardia. 1) atrial tachycardia: the patient was started on iv diltiazem and converted to po diltiazem and metoprolol after rule out of myocardial infarction. ep was consulted to advise and her diltiazem was stopped, replaced with amiodarone load to complete . at this time, metoprolol will be discontinued. the patient had an echo with no significant change from prior. 2) hypotension: the patient has chronic bp in the 80s-90s especially post-dialysis. the goal of therapy above is to remove her diltiazem & metoprolol to avoid the hypotensive side effects of her rate control medications. she was given fluid rescusitation but did not develop sepsis during this admission. although she had 1 bottle positive for coag negative staph and received 2 dose of vancomycin, therapy was discontinued as this is a likely contaminant. 3) chronic diastolic chf: the patient remained euvolemic on exam and on her baseline 1.5-2l oxygen by nasal cannula. echo confirmed no signficant change. 4) venous thromboembolism: the patient has a history of multiple dvts. she was maintained on warfarin 2.5mg intermittently during this admission as her inr often increased over 3.0. she will be discharged on 1mg daily given the addition of amiodarone and followed closely at . 5) esrd: the patient was continued on her renal vitamins and hd tuesday/thursday/saturday. 6) depression: continued paxil 7) dm: continued home nph with additional sliding scale coverage. medications on admission: aspirin 81 mg daily simvastatin 10 mg daily warfarin 2.5 mg daily diltiazem hcl 30 mg qid b complex-vitamin c-folic acid 1 mg daily zinc sulfate 220 mg daily sevelamer carbonate 1600 mg tid paroxetine hcl 40 mg daily folic acid 1 mg daily acetaminophen ascorbic acid 500 mg bisacodyl/senna metoprolol tartrate 25 mg tid nph 20 units qam discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. warfarin 1 mg tablet sig: one (1) tablet po once daily at 4 pm. 4. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 5. zinc sulfate 220 mg capsule sig: one (1) capsule po daily (daily). 6. sevelamer carbonate 800 mg tablet sig: two (2) tablet po tid w/meals (3 times a day with meals). 7. paroxetine hcl 20 mg tablet sig: two (2) tablet po daily (daily). 8. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 9. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 10. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 11. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 12. insulin nph human recomb 100 unit/ml cartridge sig: twenty (20) units subcutaneous qam. 13. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day) for 1 months: last dose . 14. amiodarone 200 mg tablet sig: two (2) tablet po bid (2 times a day) for 6 days: last 400mg dose 5/7 pm dose. 15. amiodarone 200 mg tablet sig: one (1) tablet po twice a day for 3 weeks: to begin until . 16. amiodarone 200 mg tablet sig: one (1) tablet po once a day: to begin . please stop metoprolol when starting this dose. discharge disposition: extended care facility: - discharge diagnosis: 1. atrial tachycardia 2. chronic kidney disease stage v, on hemodialysis 3. chronic diastolic heart failure discharge condition: hemodynamically stabile, afebrile, tolerating pos discharge instructions: you have been admitted to the hospital because of your fast heart rate/arrythmia. while you were here we had our electrophysiology (heart rhythm) doctors , and they recommended changing your medications. you also continued on dialysis while admitted. please note the following changes to your medications: amiodarone 400mg by mouth twice daily until tuesday afternoon dose. after that, your dose will change to 200mg by mouth twice daily for 3 weeks (until ). thereafter, continue on amiodarone 200mg by mouth every day. you may stop the metoprolol once you are the amiodarone 200mg every day. please stop your diltiazem. we have changed your warfarin dose to 1mg daily. please have follow your coumadin levels. please call your doctor or 911 if you experience fever >100, chest pain, difficulty breathing, confusion or any other concerning medical symptom. followup instructions: dr. will follow you at . dr. , your cardiologist, will contact you at to set up an appointment within one month. md procedure: hemodialysis diagnoses: end stage renal disease obstructive sleep apnea (adult)(pediatric) congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled depressive disorder, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified cardiac dysrhythmias primary pulmonary hypertension morbid obesity long-term (current) use of anticoagulants personal history of venous thrombosis and embolism chronic diastolic heart failure 

Answer: The patient is high likely exposed to