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: codeine / enalapril attending: chief complaint: lethargy major surgical or invasive procedure: central line placement (l ij) - now removed r femoral tunnelled line insertion history of present illness: 50m with dm (diet controlled), esrd on hd after failed lrrt, hcv, paf on coumadin, htn, h/o pulm aspergillosis and sarcoidosis and recent vertebral abscess with mrsa was admitted to after girlfriend noticed that he was more lethargic than usual and 'acting funny'. he was feeling ill over last few days with decreased po intake. girlfriend called ems that found fs to be 59. oral glucose was given and patient was brought to ed. in the ed vs 101.1, hr 115, bp 89/58, rr 22-26, o2 sat 93%. fs 26, d50 was given with 2l open fluid. his bps remained low and he was started on levophed after a l ij was placed. abg/vbg confirmed venous access, but cxr showed likely placement in branch of ij. he was started on levophed and covered with broad abx (vanco/levo/flagyl). he was also given 1u ffp for inr 5.4. his labs were notable for wbc of 16k, lactate 2.2, na 130 (baseline mid-130s), crea 6.4, tnt 0.12(baseline 0.08-0.12), ck14. abg 7.35/48/236. . ros: denies n/v/cp/sob/abd pain/diarrhea/rash past medical history: esrd secondary to amyloidosis -failed lrrt in now on hd- r groin line ivc stent sarcoidosis pulmonary aspergillosis dm (diet controlled) chronic hcv hypertension sinusitis, paroxysmal atrial fibrillation, c. difficile mrsa line sepsis renal osteodystrophy adrenal insufficiency upper extremity dvt () pancreatitis bilateral bka right index and fifth finger amputations social history: patient currently living home. discharged from rehab 1-2 months ago. smoked 1 ppd x 30 years but quit one year ago. no alcohol. previous drug use (ivdu). girlfriend is involved in his care. family history: mother, brother with diabetes. physical exam: vs t 100.2, hr 93, bp 119/72 (on 0.341 levophed), hr 84, o2 sat 100% on 100% non-reb, cvp 19 gen: looks fatigued, awake, responsive heent: injected conjunctiva r>l, mask on face, anicteric, jvd, l ij in place chest: bibasal crackles on anterior exam, no wheezing, no rales cv: rrr, no r/m/g abd: hyperactive bs, s/nt/nd ext: s/p bka b/l, r groin line in place neuro: aox3, knows president skin: dry, no visible rashes or petechiae pertinent results: wbc-10.0 hgb-12.2*# hct-42.8# mcv-80*# rdw-19.9* plt-344 neuts-71.9* lymphs-15.4* monos-7.2 eos-4.1* basos-1.5 pt-46.3* ptt-50.7* inr(pt)-5.4* glucose-419* urea n-20 creat-6.4* sodium-130* potassium-3.5 chloride-92* total co2-25 anion gap-17 albumin-2.9* calcium-9.4 phosphate-3.5 magnesium-1.6 alt-15 ast-30 ck(cpk)-14* alk phos-226* amylase-37 tot bili-1.0 lipase-15 asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg lactate-2.9* ctropnt-0.12* (c/w baseline) . ecg: sinus tachy, otherwise no change to prior . cxr: cardiac and mediastinal contours are within normal limits. evaluation of the lung is limited due to positioning, however, again note is made of biapical pleural thickening with faint opacities in the upper lobes with volume loss as noted previously, representing sarcoidosis, as noted on the prior ct scan. no evidence of pneumothorax is noted. left internal jugular vein terminating in the left upper chest, of unknown location. possibilities include insertion to the mediastinal venous branches such as thymic or internal mammary vein,extravascular location in the mediastinum, or arterial insertion. please correlate linically by drawing blood from the line (blood confirmed venous). brief hospital course: a/p 50m with dm, esrd on hd after failed lrrt, hcv, paf on coumadin, pvd, htn, h/o pulm aspergillosis and sarcoidosis and recent vertebral abscess with mrsa a/w fever, hypotension. . #) mrsa septicemia: source of infection initially unclear. however, 4/4 bottles from day of admission turned positive for mrsa. likely line infectionother infectious workup included cxr (w/o pna); no urine for u/a. on pe no other focal source. previous vertebral abscess appeared unchanged on neck ct and previous mitral valve vegetation/endocarditis also appeared similar. vancomycin was started with gentamicin for synergy for the first two weeks of treatment (given history of endocarditis). his r femoral dialysis catheter was also pulled. attempts to place an hd line in his l groin were unsuccessful, so another r tunnelled hd catheter was placed. hypotension associated with his sepsis managed as below. he will receive a total of 6 weeks vancomycin plus 2 weeks gentamicin with hemodialysis. . #) hypotension. in setting of mrsa septicemia. as per hpi, initally required levophed in the micu. he also received 2 l ns in the ed. his infection was managed as above. he is also on chronic steroids. he had a very poor response to stim testing and was given stress dose steroids. pt also on stress dose steroids for poor response to stim. he was weaned off pressors and transferred to the floor with stable bp and resumption of his anti-hypertensive meds began. . #) hypoglycemia/diabetes: had low glucose at home prior to presentation; likely in setting of sepsis. patient denies taking insulin at home. was later hyperglycemic after receiving exogenous glucose. has h/o dm, but most recent a1c in was 5.1. he denies use of insulin or oral hypoglycemic agents at home. he should continue diet control at home. . # esrd: due to amyloidosis. he is status post failed renal transplant. he is maintained on chronic hd on a tues-thurs-sat schedule. dr is nephrologist. he was dialyzed daily and then per usual tu/th/sa schedule. new hd line as above. he continued his nephrocaps, lanthanum, sevelamer, cinacalcet. . # h/o asperg infxn: itraconazole was continued; no active issues. . # h/o adrenal insufficiency: related to chronic steroid use (for renal transplant and/or amyloid). failed stim as above and given stress dose steroids. . # afib: currently in nsr. coumadin initially held inr 5.4, then restarted. beta blocker was also initially held then restarted. . #) access: difficult access given multiple scars from prior dialysis lines. had r groin tunneled line (from ). hd line replacement as above. has chronic femoral line inability to maintain ue line. . . # code: full medications on admission: meds (partially per last d/c summary with adjustment per patient report) 2. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 3. cinacalcet 30 mg tablet sig: two (2) tablet po daily (daily). 4. itraconazole 100 mg capsule sig: two (2) capsule po bid (2 times a day). 5. citalopram 20 mg tablet sig: 1.5 tablets po daily (daily). 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 9. lanthanum 500 mg tablet, chewable sig: one (1) tablet, chewable po tid w/meals (3 times a day with meals). 10. metoprolol tartrate 25 mg tablet sig: three (3) tablet po bid (2 times a day). 12. sevelamer 800 mg tablet sig: one (1) tablet po tid (3 times a day). 13. lactulose 10 g/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed. 14. prednisone 5 mg tablet sig: one (1) tablet po every other day (every other day). 15. prednisone 2.5 mg tablet sig: one (1) tablet po every other day (every other day). 17. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 20. coumadin 1 mg tablet sig: one (1) tablet po at bedtime: please check inr, goal . discharge medications: 1. vancomycin 1,000 mg recon soln sig: 1000 (1000) mg intravenous at every hemodialysis for 6 weeks. disp:*18 grams* refills:*0* 2. gentamicin in normal saline 80 mg/100 ml piggyback sig: eighty (80) mg intravenous with every hemodialysis for 4 doses. disp:*320 mg* refills:*0* 3. sevelamer 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). 4. lanthanum 500 mg tablet, chewable sig: one (1) tablet, chewable po tid w/meals (3 times a day with meals). 5. itraconazole 100 mg capsule sig: two (2) capsule po bid (2 times a day). 6. prednisone 5 mg tablet sig: one (1) tablet po every other day (every other day). 7. prednisone 2.5 mg tablet sig: one (1) tablet po every other day. 8. cinacalcet 30 mg tablet sig: two (2) tablet po daily (daily). 9. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 10. citalopram 20 mg tablet sig: 1.5 tablets po daily (daily). 11. metoprolol tartrate 25 mg tablet sig: three (3) tablet po bid (2 times a day). 12. warfarin 1 mg tablet sig: one (1) tablet po hs (at bedtime). 13. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 14. lactulose 10 g/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed for constipation. 15. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 16. acetaminophen 500 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever or pain. 17. percocet 5-325 mg tablet sig: one (1) tablet po every hours as needed for pain. discharge disposition: home with service facility: vna discharge diagnosis: mrsa septicemia hypotension end stage renal disease hypertension discharge condition: stable discharge instructions: you were admitted with an infection in your blood. we had to remove your dialysis catheter and replace it with a new one. this new catheter is working well. we treated you with antibiotics and you will continue to get antibiotics at dialysis for 6 weeks. you briefly required treatment with medications to support your blood pressure because of this infection. . please keep all of your appointments with your doctors and take of your medications as prescribed. we have made the following changes in your medications: you will receive two antibiotics (gentamicin and vancomycin) at hemodialysis. we have made no changes to your home medications. . please return to the hospital if you are having recurrence of fever, pain at your dialysis catheter site, shortness of breath, or any new symptoms that you are concerned about. followup instructions: you have the following upcoming appointments: . - , md (primary care) phone: date/time: 2:00 - , md (infectious disease) phone: date/time: 8:30 . please go to dialysis as usual tomorrow, . md procedure: venous catheterization, not elsewhere classified hemodialysis venous catheterization for renal dialysis diagnoses: end stage renal disease chronic hepatitis c without mention of hepatic coma diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled severe sepsis atrial fibrillation sarcoidosis methicillin susceptible staphylococcus aureus septicemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hypotension, unspecified septic shock long-term (current) use of anticoagulants 

Answer: The patient is high likely exposed to