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: mental status changes major surgical or invasive procedure: central venous line placement history of present illness: patient is a 73 year old male with a past medical history of avr/mvr for vre endocarditis and abscess , discharged with recurrent abscess and new mvr vegetation, now admitted with altered mental status. patient was admitted to micu for multisystem organ failure in setting of likely recurrent vre endocarditis on multiple valves breaking through therapy. micu course: initial lactate 8.9 with improvement to 6.6 on dobutamine. patient was placed on daptomycin/zosyn in micu. patient weaned off pressors. lacate improved to 3.7. patient noted to have liver dysfunction, acute on chronic renal failure, and worsening diastolic and valvular function. patient remained altered and oriented only to self. patient remains not a surgical candidate. after detailed discussion with family, decision was made to make patient dnr/dni, comfort measures, no dialysis. patient self discontinued his central line and family agreed with no further antibiotics. patient followed by palliative care team. patient started on scopolamine patch, hyoscyamine, ativan, dilaudid and haldol prn for comfort. patient originally from and unable to go home. patient transferred to floor for palliative care. past medical history: s/p aortic valve replacement hypertension chronic renal insufficiency abdominal aortic aneurysm sleep apnea benign prostatic hypertrophy hypercholesterolemia s/p bilateral cataract extractions cardiomyopathy sp/ redo sternotomy, redo aortic valve replacement, mitral valve replacement, closure aorto- social history: married, retired computer programmer, lives with wife in . no current tobacco use, etoh 2 drinks/week family history: non-contributory physical exam: vitals: t 95, bp 111/89, hr 69, rr 15, o2 100% 2l cvp 16 general: ill-appearing. confused heent: pupils 2mm symmetric neck: non-tender, full rom cv: no jvd, rrr, iii/vi systolic crescendo murmur, and rsb early diastolic murmur resp: ctab, no wrr breast: well-healing sternal wound; 3-4 cm inferior aspect with good granulation tissue, no purulent drainage gi: + bs nt/nd, nabs gu: foley, scant urine neuro: moving all 4 extremities, follows simple commands patient was discharged to death. above is physical exam on presentation. pertinent results: admission labs: 10:54pm lactate-7.4* 10:30pm glucose-53* urea n-94* creat-4.5* sodium-134 potassium-5.6* chloride-93* total co2-23 anion gap-24* 10:30pm wbc-17.9* rbc-3.22* hgb-8.7* hct-28.1* mcv-88 mch-27.1 mchc-31.0 rdw-19.7* 10:30pm neuts-89.9* lymphs-5.9* monos-4.0 eos-0 basos-0.1 10:30pm plt count-165 09:22pm lactate-7.9* 07:51pm lactate-6.6* 06:53pm glucose-61* urea n-94* creat-4.3* sodium-134 potassium-5.7* chloride-92* total co2-23 anion gap-25* 06:53pm tot prot-6.3* 06:53pm cortisol-42.8* 06:53pm crp-102.6* 06:51pm comments-green 06:51pm lactate-7.5* 06:50pm type-art po2-78* pco2-42 ph-7.33* total co2-23 base xs--3 06:10pm po2-42* pco2-49* ph-7.29* total co2-25 base xs--3 06:10pm o2 sat-68 05:15pm urine color-yellow appear-hazy sp -1.012 05:15pm urine blood-lg nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-mod 05:15pm urine rbc-* wbc-21-50* bacteria-mod yeast-none epi- 02:02pm pt-25.5* ptt-33.8 inr(pt)-2.5* 12:01pm comments-green top 12:01pm lactate-8.9* 11:40am glucose-100 urea n-93* creat-4.5* sodium-134 potassium-5.5* chloride-90* total co2-22 anion gap-28* 11:40am estgfr-using this 11:40am ast(sgot)-824* ck(cpk)-103 alk phos-203* tot bili-4.3* 11:40am lipase-58 11:40am ck-mb-4 ctropnt-0.16* 11:40am albumin-3.0* calcium-9.7 phosphate-7.5*# magnesium-2.5 11:40am wbc-19.8*# rbc-3.37* hgb-9.1* hct-29.7* mcv-88 mch-27.1 mchc-30.8* rdw-19.5* 11:40am neuts-93.2* lymphs-4.0* monos-2.7 eos-0.1 basos-0.1 11:40am plt count-212 12:55am blood neuts-90.6* lymphs-5.5* monos-3.8 eos-0.1 baso-0.1 06:53pm blood cortsol-42.8* 06:53pm blood crp-102.6* rule out mi 07:18am blood ck-mb-6 ctropnt-0.15* 11:40am blood ck-mb-4 ctropnt-0.16* labs prior to cmo: 03:25am blood pt-32.7* ptt-34.2 inr(pt)-3.4* 02:09pm blood glucose-85 urean-116* creat-5.7* na-139 k-5.3* cl-96 hco3-23 angap-25* 03:25am blood alt-665* ast-834* ld(ldh)-1116* alkphos-191* totbili-3.5* 02:09pm blood calcium-8.9 phos-7.8* mg-2.5 01:17am blood type-mix temp-36.6 o2 flow-3 po2-34* pco2-48* ph-7.33* caltco2-26 base xs--1 intubat-not intuba 03:02pm blood lactate-3.7* microbiological studies: 11:40 am blood culture labs off picc line. **final report ** blood culture, routine (final ): enterococcus faecium. dr called and requested daptomycin,linezolid,synercid,tetracycline and rifampin . daptomycin = 2ug/ml by e-test . synercid = sensitive <=0.25 ug/ml. sensitivities: mic expressed in mcg/ml _________________________________________________________ enterococcus faecium | ampicillin------------ =>32 r daptomycin------------ s linezolid------------- 2 s penicillin g---------- =>64 r rifampin-------------- r tetracycline---------- <=1 s vancomycin------------ <=1 s 5:15 pm urine site: catheter **final report ** urine culture (final ): pseudomonas aeruginosa. >100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ pseudomonas aeruginosa | cefepime-------------- 16 i ceftazidime----------- 4 s ciprofloxacin--------- =>4 r gentamicin------------ 4 s meropenem-------------<=0.25 s piperacillin---------- 8 s piperacillin/tazo----- 8 s tobramycin------------ <=1 s 10:30 pm catheter tip-iv picc line tip. **final report ** wound culture (final ): no significant growth. ------------------- blood cultures from and : no growth at time of patient death imaging studies: echo the left atrium is moderately dilated. the right atrium is moderately dilated. there is mild global left ventricular hypokinesis (lvef = 40-45 %). the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. there is abnormal systolic septal motion/position consistent with right ventricular pressure overload. a bioprosthetic aortic valve prosthesis is present. a paravalvular aortic valve leak is probably present. moderate (2+) aortic regurgitation is seen. there is a mass on the mitral valve. mild (1+) mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. compared with the prior study (images reviewed) of , the findings are similar. ct head findings: there is no acute intracranial hemorrhage, shift of normally midline structures, hydrocephalus, major or minor vascular territorial infarction. calcifications of the cavernous portion of the carotid arteries is noted. the density values of the brain parenchyma are maintained. mild low attenuation in the periventricular white matter is consistent with chronic small vessel ischemia. the visualized paranasal sinuses and mastoid air cells appear well aerated. soft tissues and osseous structures are unremarkable. brief hospital course: patient is a 73 year old male with a past medical history of avr/mvr for vre endocarditis and abscess , discharged with recurrent abscess and new mvr vegetation, who was admitted with altered mental status. patient was admitted to micu for multisystem organ failure in setting of likely recurrent vre endocarditis on multiple valves breaking through therapy. of note, cultures grew vancomycin sensitive enterococcus. micu course: initial lactate 8.9 with improvement to 6.6 on dobutamine. patient was placed on daptomycin/zosyn in micu. patient weaned off pressors. lacate improved to 3.7. patient noted to have liver dysfunction, acute on chronic renal failure, and worsening diastolic and valvular function. patient was also noted to have multidrug resistant pseudomonal urinary tract infection. despite aggressive treatment, patient remained altered and oriented only to self and clinically continued to deteriorate. patient was not considered a surgical candidate. after detailed discussion with family, decision was made to make patient dnr/dni, comfort measures, no dialysis. patient self discontinued his central line and family agreed with no further antibiotics. patient followed by palliative care team. patient started on scopolamine patch, hyoscyamine, ativan, dilaudid and haldol prn for comfort. patient originally from and unable to go home. patient transferred to floor for palliative care. patient was transferred to floor where he was provided with pain control as needed. he expired within one day of transfer to the floor with family at his bedside. medications on admission: medications: (rehab med list not available, taken from dc summary of daptomycin 900 mg recon soln sig: 500 mg recon solns intravenous q48h (every 48 hours). linazolid 600mg iv q12 hours simvastatin 80 mg tablet daily aspirin 81 mg tablet, daily metolazone 5 mg tablet potassium chloride 20 meq packet po q12h docusate sodium 100 mg p acetaminophen 325 mg tablet 2 po q4h heparin (porcine) 5,000 unit/ml tid polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed). bisacodyl 5 mg tablet, delayed release 2 tab po daily furosemide 10 mg/ml solution sig: 120mg injection q12h sodium chloride 0.45 % 0.45 % parenteral solution sig: ten (10) ml intravenous prn (as needed) as needed for line flush. tramadol 50 mg tablet sig: 1 tablet po q4h metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous prn (as needed) as needed for line flush. amiodarone 200 mg tablet sig: one (1) tablet po daily discharge medications: not applicable discharge disposition: expired discharge diagnosis: primary: enterococcus endocarditis acute on chronic renal failure valvular systolic cardiomyopathy pseudomonal urinary tract infection sepsis with multisystem organ failure discharge condition: discharged to death discharge instructions: not applicable followup instructions: not applicable procedure: venous catheterization, not elsewhere classified diagnoses: other primary cardiomyopathies obstructive sleep apnea (adult)(pediatric) urinary tract infection, site not specified acute kidney failure, unspecified severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, unspecified retention of urine, unspecified encounter for palliative care streptococcal septicemia pseudomonas infection in conditions classified elsewhere and of unspecified site infection and inflammatory reaction due to cardiac device, implant, and graft 

Answer: The patient is high likely exposed to