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: this is an 85 year-old male with multiple medical problems including diabetes, congestive heart failure with an ef of 25%, coronary artery disease with known reversible ischemia, chronic obstructive pulmonary disease and chronic renal failure who was sent from his nursing home with mental status changes, leukocytosis and increase in his creatinine and respiratory congestion. the patient had self discontinued his foley three days prior to admission. he had been recently hospitalized from to for a congestive heart failure exacerbation and acute renal failure requiring natrecor and dopamine. he was also found at that time to have reversible ischemia on a pmibi, but catheterization was deferred given his acute renal failure. in the emergency room on admission the patient was found to have a systolic blood pressure of 79/31, which initially improved to 129/31 with intravenous fluids, but then fell. his white blood cell count was found to be 28, creatinine 3.5. his urinalysis was suggestive of a urinary tract infection. he was entered into the sepsis protocol and started on pressors. the patient at that time was somnolent, but denies any complaints. specifically he denied chest pain, shortness of breath, nausea, vomiting, fevers or chills. he did not recall the events leading up to this presentation in the emergency room, but he did recall that he had been in his nursing home earlier that day. he was unable to provide any other history. per the family the patient had been delirious for two to three days starting around the time of pulling the foley with poor appetite and no po intake for the last two to three days. past medical history: 1. type 2 diabetes. 2. gout. 3. congestive heart failure with an ef of 25%. 4. coronary artery disease status post angioplasty. pmibi in showing severe partially reversible basilar inferior wall and inferior lateral wall defects. no catheterization given the acute renal failure. 5. chronic renal insufficiency. 6. hypothyroidism. 7. hyperlipidemia. 8. peripheral vascular disease. 9. mitral regurgitation. 10. benign prostatic hypertrophy status post transurethral resection of the prostate. 11. cataracts. 12. chronic obstructive pulmonary disease. 13. esophagitis. 14. chronic hiccups. 15. urinary incontinence. 16. anemia. 17. osteoarthritis. medications at home: 1. multivitamins. 2. aspirin 325 q.d. 3. calcium carbonate 500 t.i.d. 4. levothyroxine 75 q.d. 5. protonix 40 q.d. 6. colace 100 q.d. 7. maalox. 8. isosorbide mononitrate 30 sr. 9. plavix 75 q day. 10. carvedilol 12.5 b.i.d. 11. flomax 0.4 prn. 12. lasix 80 mg q.a.m. and 60 mg q.p.m. 13. 70/30 20 units q.a.m. and 10 units q.h.s. 14. sliding scale insulin. 15. detrol 2 mg b.i.d. 16. allopurinol 100 mg q.d. 17. albuterol inhaler prn. 18. heparin 5000 units b.i.d. allergies: no known drug allergies. family history: noncontributory. social history: he smoked 20 plus pack years. was unable to get any other history at that time. physical examination: on admission his temperature was 99.9. his blood pressure was 79/31, which improved to 100/43 prior to starting dopamine. his heart rate was 104 to 110. respiratory rate 30. sat 91% on room air. in general, he was a somnolent elderly man in no acute distress with mild tachypnea. heent his mucous membranes were dry. oropharynx was clear. he was anicteric. neck his jvp was about 10 cm, supple, no lymphadenopathy. thorax course bilateral breath sounds, diffuse expiratory wheezes. cardiovascular tachycardiac. no murmurs, rubs or gallops. abdomen soft, nontender, nondistended. extremities he had 2+ bilateral lower extremity edema. he had a 2+ sacral decube. neurological he was oriented to himself, and , but not to the place. he thought he was at the . he moved all four extremities to command. laboratories on admission: white blood cell count was 28.7 with 87 neutrophils, 12 bands, hematocrit 29.6, platelets 351. his chem 7 was within normal limits with the exception of a bun of 123 and a creatinine of 3.5. his liver function tests were within normal limits. his lactate was 3.7. urinalysis moderate leukocyte esterase, nitrate positive, 11 to 20 white blood cells, many bacteria. electrocardiogram was sinus tachycardia at 108. qtc was 456. there were no acute st or t wave changes. chest x-ray showed mild cardiomegaly, mild congestive heart failure, left lower lobe collapse versus consolidation. hospital course: the patient was admitted to the medical intensive care unit. 1. sepsis: the patient was initially started on levaquin given that they thought this was urosepsis. one out of four blood cultures were positive for gram positive cocci. vancomycin was started. the urine culture began growing out coag positive staph aureus methicillin sensitive. the blood cultures subsequently grew out methicillin sensitive staph aureus so the patient's antibiotic regimen was changed to oxacillin. vancomycin had been discontinued. the patient during his hospital course on developed a pneumonia for which he was started on levaquin. he completed a short course of levaquin. the patient had a renal ultrasound done to exclude an abscess in his kidneys and there was no abscess. he had an echocardiogram done on , which showed no valvular abnormalities, however, there were 4 to 5 little regurgitant jets. they could not see these coursing through a perforation, but this could be suggestive of endocarditis so the patient will be continued on six weeks of intravenous antibiotics. 2. cardiovascular: the patient did have a troponin leak likely secondary to demand ischemia. he was continued on his aspirin, plavix, beta-blocker. no ace secondary to his creatinine and no statin secondary to his history of myositis. myocardium: initially the patient when he was admitted to the micu was volume repleted, however, during hospital course he developed worsening congestive heart failure so that the patient was diuresed in the intensive care unit on a lasix drip. when he was discharged to the floor he was euvolemic. the volume goal for him was to remain even. 3. pulmonary: chronic obstructive pulmonary disease, the patient was continued on his regular inhaler regimen. 4. renal: the patient had acute renal failure on admission, which was worsened after the lasix drip. however, the patient's creatinine has now improved to his baseline. 5. hematology: anemia, during his unit stay the patient did develop some hematuria around the foley site. his hematocrit drop to 24 to 25. the patient was transfused 3 units of packed red blood cells. stool guaiacs were negative. the patient's hematocrit remained stable after the 3 units of blood in the intensive care unit. coagulopathy, his inr was slightly elevated on admission. it was felt that this was likely secondary to a nutritional deficiency. the patient was given three days of oral vitamin k and his inr subsequently improved. 6. skin: the patient had a grade 2 sacral decube. he was seen by plastic surgery who recommended wet to dry dressings b.i.d. on the decube appeared to have a black appearance to it. plastics was called. they said that this was the eschar formation of the decube and it was normal so they recommended continuing duoderm or adaptic dressing b.i.d. and keeping the area clean. 7. electrolytes: the patient had persistent hypocalcemia during his hospital stay, which was repleted. 8. the patient had complained of leg pain during his hospital course. there was no localizing signs or symptoms. it was felt that this could likely be a neuropathic pain. the patient was started on neurontin 100 mg po q.h.s. this will be followed by his outpatient primary care physician. discharge status: the patient was discharged to the nursing home. discharge instructions: take all medications as prescribed. intravenous antibiotics for five more weeks. follow up with your primary care physician. final diagnoses: 1. congestive heart failure. 2. coronary artery disease. 3. chronic renal failure. 4. chronic obstructive pulmonary disease. 5. endocarditis. 6. staph aureus urinary tract infection. 7. bacteremia. recommended follow up: follow up with you primary care physician within the next two weeks. call to schedule an appointment. follow up with on at 10:00 a.m. major surgical/invasive procedures: central line placement and a transesophageal echocardiogram. discharge condition: stable. discharge medications: 1. aspirin 81 mg q.d. 2. levothyroxine 75 mg q.d. 3. protonix 40 mg q.d. 4. plavix 75 mg q.d. 5. allopurinol 100 mg po q.o.d. 6. albuterol nebulizers. 7. tylenol prn. 8. nitroglycerin 0.3 prn chest pain. 9. carvedilol 6.25 po b.i.d. 10. ipatropium nebulizers q six. 11. senna. 12. colace. 13. lasix 60 mg po b.i.d. 14. oxacillin 2 grams intravenously q 6 hours for the next five weeks. 15. insulin, nph 20 units q.a.m., 9 units q.p.m. and an insulin sliding scale. 16. neurontin 100 mg po q.h.s. 17. calcium 500 mg po q.i.d. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified diagnostic ultrasound of heart transfusion of packed cells diagnoses: pneumonia, organism unspecified urinary tract infection, site not specified congestive heart failure, unspecified acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified methicillin susceptible staphylococcus aureus septicemia sepsis acute and subacute bacterial endocarditis 

Answer: The patient is high likely exposed to