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 / erythromycin base / demerol attending: chief complaint: femur fracture major surgical or invasive procedure: joint aspiration () right femoral head resection, irrigation, debridement, arthrotomy () placement of tobramycin/vancomycin cement spacer () history of present illness: history of present illness: the patient is a 67 y/o woman with a pmh of mrsa bsi with l2-l3 discitis/osteomyelitis and pelvic abscess, treated with 4 months of iv vancomycin, with recurrence of bsi and osteomyelitis after discontinuation of therapy, requiring l2/l3 debridment and allograft presenting with non-traumatic femur fracture. the patient was treated with vancomycin - after improvement in her inflammatory markers. the patient reported onset of r hip pain starting . r hip and l-spine x-rays were obtained on which did not show evidence of a new fracture or hardware loosening. she was started on 300 mg t.i.d. gabapentin by her pcp without improvement. she reports receiving an epidural injection on monday without relief of symptoms. ap pelvis/right hip was done which demonstrated a displaced femoral neck fracture and she was referred to the ed. . on arrival to the ed, initial vitals: t 98.8 hr 51 bp 174/80 rr 16 o2 100% on ra. she was evaluated by and ct pelvis performed demonstrating a acute mildly-comminuted r femoral subcapital fracture. no lesion to suggest underlying pathologic fracture. she was given a total of 12mg iv morphine for pain control. she is being admitted to the medical service for evaluation prior to surgical intervention of fracture. . on arrival to the medical floor, the patient complains of r hip pain. states she is otherwise feeling well overall. past medical history: - multiple admissions for partial sbo - mrsa bloodstream infection () --- bcx + --- tte neg (no tee) - l2-l3 discitis/osteomyelitis, suspected mrsa --- mri = l2-l3 discitis/osteomyelitis, w/ psoas abscess --- intra-pelvic abscesses, suspected mrsa --- vancomycin --- tmp/smx - ? - mrsa bloodstream infection, infected rue dvt () - l5-s1 lumbar spine fusion with hardware () - thrush - lue dvt - ovarian cancer --- dx ; stage iv, metastatic to liver only --- tah-bso, --- tx chemo (adriamycin) and xrt - chemotherapy-associated dilated cardiomyopathy - small bowel obstruction; radiation enteritis; chronic abd pain multiple admissions, with surgical mgmt - iron deficiency anemia - hyperlipidemia - chronic kidney disease - hyperthyroidism ablation - tonsillectomy, adenoidectomy - appendectomy - xerophthalmia, lagophthalmos, thyroid orbitopathy - depression, fibromyalgia social history: used to work as outpatient rn 3 days/week no significant tobacco, etoh, illicit drug use family history: cancer, heart disease in several family members physical exam: admission exam: vitals: t 97.3, hr 50, bp 179/84, rr 18, o2 92% on ra. gen: pleasant elderly female in nad heent: mmm, op clear cv: rrr, nl s1/s2, no mrg pulm: ctab, no wrr abd: soft, nt/nd, nabs back: well-healed lumbar surgical scar, no ttp msk: r hip no discoloration, no warmth, unable to test strength and rom secondary to pain neuro: no gross motor or sensory deficits discharge exam: gen: caucasian female laying down in bed in nard. cv: s1, s2, no murmurs, gallops or rubs, rrr pul: cta bilaterally abd: mildly tenderness to palpation in lower quadrants, soft, normoactive bs x 4. ext: rt hip wound shows staples with good approximation and no purulent drainage. no edema noted. pertinent results: 09:58am blood wbc-10.0 rbc-2.99* hgb-8.7* hct-26.7* mcv-89 mch-29.1 mchc-32.6 rdw-15.8* plt ct-391 06:00am blood wbc-15.1* rbc-3.28* hgb-9.4* hct-27.6* mcv-84 mch-28.6 mchc-34.0 rdw-16.4* plt ct-347 10:45am blood wbc-15.8* rbc-3.27* hgb-9.3* hct-27.9* mcv-85 mch-28.3 mchc-33.2 rdw-16.4* plt ct-320 09:06am blood wbc-19.7* rbc-3.47* hgb-9.9* hct-29.8* mcv-86 mch-28.7 mchc-33.4 rdw-16.0* plt ct-360 06:13am blood wbc-26.9* rbc-3.27* hgb-9.3* hct-28.1* mcv-86 mch-28.6 mchc-33.2 rdw-16.0* plt ct-367 07:35am blood wbc-20.6* rbc-2.68* hgb-7.7* hct-23.1* mcv-86 mch-28.8 mchc-33.4 rdw-16.3* plt ct-450* 11:30pm blood wbc-25.5* rbc-3.05* hgb-8.9* hct-25.8* mcv-85 mch-29.1 mchc-34.4 rdw-16.3* plt ct-434 10:50am blood wbc-31.2*# rbc-3.35* hgb-9.3* hct-28.9* mcv-86 mch-27.7 mchc-32.1 rdw-16.1* plt ct-450* 09:29pm blood wbc-16.4* rbc-3.33* hgb-9.2* hct-28.7* mcv-86 mch-27.6 mchc-32.0 rdw-16.3* plt ct-434 10:50am blood wbc-31.2*# rbc-3.35* hgb-9.3* hct-28.9* mcv-86 mch-27.7 mchc-32.1 rdw-16.1* plt ct-450* 09:29pm blood wbc-16.4* rbc-3.33* hgb-9.2* hct-28.7* mcv-86 mch-27.6 mchc-32.0 rdw-16.3* plt ct-434 05:40am blood wbc-21.4* rbc-4.24 hgb-12.2 hct-36.2 mcv-85 mch-28.8 mchc-33.8 rdw-16.3* plt ct-503* 06:50am blood wbc-16.5* rbc-3.55* hgb-10.3* hct-30.4* mcv-86 mch-28.9 mchc-33.8 rdw-16.0* plt ct-443* 06:15am blood wbc-18.5* rbc-3.54* hgb-10.2* hct-29.7* mcv-84 mch-28.8 mchc-34.3 rdw-16.3* plt ct-531* 05:35am blood wbc-16.9* rbc-3.58* hgb-10.4* hct-30.8* mcv-86 mch-29.2 mchc-34.0 rdw-16.2* plt ct-493* 06:54pm blood wbc-18.4*# rbc-4.09* hgb-11.2* hct-34.8* mcv-85 mch-27.3 mchc-32.1 rdw-16.2* plt ct-529* 10:45am blood neuts-89.5* lymphs-7.2* monos-2.6 eos-0.5 baso-0.2 06:13am blood neuts-90.9* lymphs-4.0* monos-4.9 eos-0.2 baso-0 09:00am blood glucose-91 urean-23* creat-1.3* na-136 k-4.0 cl-108 hco3-20* angap-12 09:58am blood glucose-93 urean-22* creat-1.2* na-137 k-3.6 cl-110* hco3-18* angap-13 06:00am blood glucose-87 urean-29* creat-1.3* na-136 k-3.9 cl-106 hco3-18* angap-16 10:45am blood glucose-104* urean-30* creat-1.4* na-134 k-3.6 cl-106 hco3-17* angap-15 09:06am blood glucose-86 urean-27* creat-1.4* na-130* k-3.7 cl-101 hco3-17* angap-16 06:13am blood glucose-92 urean-38* creat-1.6* na-133 k-3.8 cl-105 hco3-18* angap-14 07:35am blood glucose-86 urean-39* creat-1.9* na-132* k-4.3 cl-100 hco3-18* angap-18 11:30pm blood glucose-101* urean-32* creat-1.6* na-131* k-3.9 cl-100 hco3-18* angap-17 10:50am blood glucose-104* urean-36* creat-1.8* na-132* k-5.0 cl-102 hco3-19* angap-16 05:40am blood glucose-94 urean-28* creat-1.5* na-131* k-4.7 cl-96 hco3-21* angap-19 06:50am blood glucose-79 urean-31* creat-1.3* na-133 k-4.8 cl-104 hco3-19* angap-15 06:15am blood glucose-98 urean-33* creat-1.6* na-129* k-4.1 cl-101 hco3-21* angap-11 05:35am blood glucose-101* urean-36* creat-1.6* na-133 k-4.6 cl-103 hco3-17* angap-18 06:54pm blood glucose-80 urean-36* creat-1.7* na-134 k-4.8 cl-103 hco3-19* angap-17 09:00am blood calcium-8.4 phos-2.4* mg-1.5* 09:58am blood calcium-7.5* phos-2.4* mg-1.4* 06:00am blood calcium-8.3* phos-2.3* mg-2.6 12:42pm urine color-yellow appear-clear sp -1.012 12:42pm urine blood-neg nitrite-neg protein-tr glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.5 leuks-neg 12:42pm urine rbc-5* wbc-3 bacteri-mod yeast-many epi-<1 transe-<1 brief hospital course: 67 y/o woman w10ith a pmh of mrsa bsi with l2-l3 discitis/osteomyelitis and pelvic abscess, treated with 4 months of iv vancomycin, with recurrence of bsi and osteomyelitis after discontinuation of therapy, requiring l2/l3 debridement and allograft presenting with non-traumatic femur fracture. ##. right femoral subcapital frature: ms. was referred on from her pcp's office after a complaint of right hip pain and and x-ray showing a displaced femoral neck fracture. in the ed she underwent a ct scan of her pelvis which showed mildly-comminuted r femoral subcapital fracture. she was evaluated by the orthopaedic service and admitted to the medicine service with infectious disease and orthopaedic consulting. she was initially started on vancomycin given her mrsa history and her joint was aspirated and notable for 36k wbc and 96% polys with rare growth of mssa. on she had a cement vancomycin/tobramycin spacer placed in her right hip and femoral head resection. she developed diarrhea and was found to have +c. diff on . per id recommendations her antibiotics were changed from vancomycin iv to daptomycin iv. she will need to continue this antibiotic 330mg intravenous every 48 hours for 6 weeks (her last dose will be ). she has an appointment to see her infectious specialist dr. on , during this appointment he will determine whether she will need a longer course of daptomycin. - recommend continuing daptomycin iv 330mg every 48hours for at least 6 weeks, last dose of the antibiotic will be - recommend following up with dr. appointment on at 1100 - recommend continuing methadone 2.5mg twice a day with dilaudid 2-4mg every 3 hours prn for breakthrough pain - recommend following up with orthopaedic appointment, physical therapy ##. c. diff associated diarrhea: pt during hospitalization ntoed to have numerous bowel movements and tested positive on c. diff toxin assay for c. diff, gastroenterology were consulted for regimen length. per gastroenterology recommendations ms. will need to be on vancomycin po every 6 hours, this will need to continued for 2 weeks after the daptomycin is stopped with no taper. if her last course of daptomycin remains scheduled on her vancoymcin po course will end . - recommend continuing po vancomycin 250mg every 6 hours until 2 weeks after her last daptomycin ##. urinary tract infection: during hospitalization pt was noted to have a urinary tract infection on and completed a course of ciprofloxacin. subsequent urine culture showed no bacterial growth. ##. renal insufficiency: pt has a history of renal insufficiency with a baseline creatine ranging from 1.3-1.5 since . during hospitalization pt did develop acute on chronic insufficiency from a combination of pre-renal and allergic interstitial nephritis (urine was positive for urine eosinophils). cause of ain not entirely clear though ciprofloxacin was suspected, however creatinine improved with intravenous fluid. ##. hypothyroidism: patient was continued on her home regimen of synthroid 150mcg daily ##. hyperlipidemia: pt was continued on home regimen of simvastatin 40mg at bedtime. ##. depression: pt was continued on her home regimen of sertraline. ##. nutrition: pt was continued on a regular diet with resource breeze supplementation every breakfast, lunch and dinner. anticipated length of stay less than 30 days medications on admission: amlodipine 2.5 mg tablet 1 tablet(s) by mouth daily (daily) butorphanol tartrate 10 mg/ml spray, non-aerosol sprays(s) intranasally q 4 hours as needed for prn one nare only. alternate nares every other dose. carvedilol 25 mg tablet one tablet(s) by mouth twice daily diphenoxylate-atropine 2.5 mg-0.025 mg tablet 1 tablet(s) by mouth four times a day gabapentin 100 mg capsule capsule(s) by mouth three times a day ( start with 100 qhs and increase slowly) hydrocodone-acetaminophen 5 mg-500 mg tablet tablet(s) by mouth qid prn (max 8/day) levothyroxine 150 mcg tablet 1 tablet(s) by mouth once a day lipase-protease-amylase 333 mg (18,000 unit-,500 unit-,500 unit) capsule, delayed release(e.c.) 3 capsule(s) by mouth three times a day lorazepam 0.5 mg tablet 1 tablet(s) by mouth every 6-8 hours as needed for anxiety omeprazole 40 mg capsule, delayed release(e.c.) 1 capsule(s) by mouth once a day sertraline 100 mg tablet 1 tablet(s) by mouth once a day simvastatin 40 mg tablet 1 tablet(s) by mouth once a day (not taking as prescribed: on hold in recovery) ergocalciferol (vitamin d2) 1,000 unit tablet 1 tablet(s) by mouth once a day discharge medications: 1. carvedilol 12.5 mg tablet sig: two (2) tablet po bid (2 times a day). 2. levothyroxine 75 mcg tablet sig: two (2) tablet po daily (daily). 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 4. sertraline 50 mg tablet sig: two (2) tablet po daily (daily). 5. simvastatin 40 mg tablet sig: one (1) tablet po at bedtime. 6. cholecalciferol (vitamin d3) 400 unit tablet sig: 2.5 tablets po daily (daily). 7. heparin (porcine) 5,000 unit/ml solution sig: 5,000 units injection tid (3 times a day). 8. lipase-protease-amylase 5,000-17,000 -27,000 unit capsule, delayed release(e.c.) sig: one (1) cap po tid w/meals (3 times a day with meals). 9. lorazepam 0.5 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for anxiety. 10. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 11. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. 12. methadone 5 mg tablet sig: 0.5 tablet po bid (2 times a day). 13. vancomycin 250 mg capsule sig: one (1) capsule po q6h (every 6 hours): please continue for 2 additional weeks after last daptomycin dose. 14. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 15. daptomycin 500 mg recon soln sig: three y (330) recon soln intravenous q48h (every 48 hours): last dose of antibiotic will be unless prolonged course is recommended by dr. during id appointment. discharge disposition: extended care facility: of discharge diagnosis: right subcapital femur fracture secondary to infection right septic hip (mssa on daptomycin) with spacer placement, femoral head resection clostridium difficile colitis uti (treated with ciprofloxacin) hypertension hypothyroidism hyperlipidemia 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: you were initially admitted to the hospital with a fracture of one of your bones that we think was due to an infection. whilst in the hospital you were seen by the orthopaedic and infectious disease team who followed you during your hospital stay. you were found to have an infection in your hip and were prescribed intravenous antibiotics, you were also went to the operating room to have a spacer placed in your right hip. prior to leaving the hospital you were diagnosed with having an intestinal infection called clostridium difficile and were started on oral antibiotics. we started several new medications: 1. please start taking daptomycin 330mg iv every 48hours for at least 6 weeks (). you will see dr. who will be able to clarify if you need a longer course of antibiotics. 2. please start taking vancomycin 250mg by mouth every 6 hours, you will stop this medication 2 weeks after you finish your daptomycin medication. 3. please start taking methadone 2.5mg by mouth twice a day 4. please start taking dilaudid 2-4mg by mouth as needed for pain every 3 hours 5. please take the lidocaine patch every day 6. please take pancrelipase 5,000units three times a day with meals we changed some of your old medications: 1. please start taking 5mg amlodipine daily instead of 2.5mg. we stopped some of your old medications: 1. please stop taking gabapentin 2. please stop taking hydrocodone-acetaminophen followup instructions: department: infectious disease when: friday at 11:00 am with: , md building: lm bldg () campus: west best parking: garage department: orthopedics when: thursday at 10:00 am with: xray (scc 2) building: sc clinical ctr campus: east best parking: garage department: spine center when: thursday at 10:20 am with: dr. building: campus: east best parking: garage md procedure: venous catheterization, not elsewhere classified arthrocentesis other partial ostectomy, femur local excision of lesion or tissue of bone, femur insertion or replacement of (cement) spacer diagnoses: anemia, unspecified urinary tract infection, site not specified congestive heart failure, unspecified friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site acute kidney failure, unspecified hyposmolality and/or hyponatremia unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified depressive disorder, not elsewhere classified chronic kidney disease, unspecified other and unspecified hyperlipidemia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site intestinal infection due to clostridium difficile personal history of venous thrombosis and embolism personal history of antineoplastic chemotherapy personal history of irradiation, presenting hazards to health chronic diastolic heart failure adult failure to thrive pyogenic arthritis, pelvic region and thigh other closed transcervical fracture of neck of femur personal history of methicillin resistant staphylococcus aureus personal history of malignant neoplasm of ovary 

Answer: The patient is high likely exposed to