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: transfer from osh for sepsis. major surgical or invasive procedure: intubation. icu procedures including central venous line placement, arterial line placement, hemodialysis. history of present illness: 61 y/o m with pmh dm, obesity, pmr on chronic prednisone, ?paroxysmal afib who initially presented to at 01:45 this am with shortness of breath. wife states that the pt began feeling sick yesterday with chief complaint of "chest congestion" with chills, increasing weakness, and increased productive sputum with cough, no fevers. the pt's wife states that he had been experiencing ?increasing myalgias over the last several days which he attributed to worsening pmr and had been increasing his usual doses of prednisone. the pt normally takes 50 mg of prednisone and the wife counted his pills this morning and believes he has taken approximately 360 mg of prednisone over the last 2 days(she states that he often increases his prednisone by himself to alleviate his pain). she reported that he was weaker over the last 2 days and fell 3 times yesterday with increasing disorientation. last night, the pt's breathing became more labored and the wife states that she "couldn't get him out of bed" and called ems. . in , pt presented with worsening dyspnea. vs according to records (very scant) show t 101.7, bp 70/34, p140, r 26, sat 94% nrb. pt was given ceftriaxone 2 g iv, tylenol, azithromycin as well as 3 l ns. the pt stated he was dni at the osh and refused intubation. despite low bp, pt was not put on pressors secondary to episode of rapid afib. ekgs at show sinus tach at 140 bpm with no st changes and also separate ekg with afib with hr 174 bpm. abg on 100% nrb was 7.25/64/76. labs were remarkable for wbc of 2.5 with 40% bands, hct 34.2, plt 258, bun creat 19/1.2, bnp 259, trop i 0.08(indeterminate), ck 43. . on arrival to , arrived as eu critical, pt had o2 sats of 80% nrb, sbp 60-70 systolic. code status was reversed by pt to full code after discussion with ed staff that condition may be reversible. pt was quickly placed on peripheral dopamine while being intubated and received ativan for sedation. received vancomycin and levaquin as well and ivf wide open. femoral tlc was placed urgently. initially placed on levophed but hr increased to 190 in afib, sbp dropped to 50s -->pt received 2 shocks at 300, 360--> sbp improved to 70 and hr improved to 110. pressors changed to neo briefly but given persistent hypotension, now on both neo +levophed. cxr with opacifiedl upper and lower lobes, small l effusion; lactate 2.1. pt admitted to for further management. . on arrival to , has gotten a total of 8 liters of ns, urine output has been 100cc. patient weaned from neo, now on levophed. past medical history: 1) dm 2) obesity 3) polymyalgia rheumatica - wife states that this was diagnosed 2 yrs ago and he has been on prednisone since then with steadily escalating doses, now on 50 mg daily alhtough taper has been attempted in the past; she states that she thinks pt is "addicted" to prednisone 4) ?paroxysmal afib - "racing heart rate" treated with sotalol 5) has been hospitalized 4x in the past year, once for dm, and another for "blood clot" in leg (was on blood thinner for some time but no longer on med) social history: he lives with his wife at home; prev tob use 1ppd x 22 yrs, quit 18 yrs ago, no etoh, no ivda. wife , . family history: not contributory. physical exam: afebrile bp 113/60 hr 110 on levophed at 0.2 mcg/kg/min vent ac 100% fio2/peep 10/tv 600/rate 20 gen: sedated, intubated heent: pupils equal, round, sluggish but equally reactive neck: supple, no lad, jvp could not be assessed secondary to body habitus cv: reg rhythm, tachy, no m/r/g pulm: coarse bs anteriorly, decreased on left abd: s/obese/nt/nd +bs ext: 3+ pitting edema l>r, cool skin: multiple excoriations on chest, bilateral forearms echymoses on lower extremities pertinent results: labs: wbc-2.6* rbc-2.94* hgb-10.3* hct-29.5* mcv-100* mch-34.9* mchc-34.8 rdw-16.7* glucose-219* urea n-22* creat-1.5* sodium-136 potassium-4.4 chloride-101 total co2-26 lactate-2.1* microbiology: blood culture: negative. urine culture: negative. sputum culture: >25 pmns and <10 epithelial cells/100x field. 4+ gram positive cocci in pairs and clusters. 1+ gram positive rod(s). coag positive staph aureus resistant to penicillin, sensitive to other antibiotics. viral screen: negative for influenza a, b, adenovirus, rsv, and parainfluenza 1,2,3. urinary legionella antigen: negative. imaging: cxr: 1. multifocal airspace opacities, most pronounced in the left mid lung. . echo: the left atrium is normal in size. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is probably severely depressed (probably globally) but views are technically suboptimal (estimated ejection fraction ?35-50%). the right ventricular cavity is dilated. there is severe global right ventricular free wall hypokinesis. the aortic valve leaflets are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened with no significant mitral regurgitation detected in suboptimal views. the tricuspid valve leaflets are mildly thickened. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. . le u/s: findings consistent with chronic left popliteal thrombosis. lumen remains partially patent. acute thrombosis is less likely but cannot be completely excluded. . cta: 1. extensive consolidation of the left upper and lower lobes. multifocal opacities in both left lobes and right upper, middle, and lower lobes. small left pleural effusion and smaller right pleural effusion. 2. no pulmonary embolism. 3. coronary vascular calcifications. . ct abdomen/pelvis: 1. narrowing of the celiac axis with soft tissue stranding. no atherosclerotic plaque seen in this region. these findings are more indicative of vasculitis than of atherosclerotic narrowing. 2. lack of opacification of renal collecting system indicating renal failure. 3. no evidence of acute bowel pathology. 4. large consolidation of left upper and lower lobes, with multifocal airspace opacities in both lungs. brief hospital course: 61 y/o m with history of dm, pmr on high dose prednisone, paroxysmal a-fib admitted with likely sepsis secondary to pneumonia as well as rapid atrial fibrillation possible pulmonary embolus, now intubated, on max doses of neo and levophed s/p cardioversion. . # respiratory failure: this was thought to be secondary to a multifocal pneumonia seen on cxr. there was initial concern for pcp given his history of high dose steroids but his initial cxr was thought most consistent with a community acquired pneumonia. there was also concern for a pe given his history of blood clots and the fairly acute onset of symptoms but this was ruled out by a chest cta on admission. cultures were negative except for coag negative staph in his sputum. he was treated initially with broad spectrum antibiotics including vancomycin, levofloxacin, and ceftriaxone and this was transitioned to oxacillin alone on . he was covered empirically for pcp with bactrim given his steroid abuse at home. he required ventilatory support until when he was extubated. he tired quickly and required re-intubation later that night and post-intubation films were suspicious for an aspiration event so zosyn was added. his cultures remained negative and he remained afebrile, however, and empiric antibiotics were stopped and he was given a surgical tracheostomy. he tolerated this well and was able to be weaned to trach collar quickly. he continued to have copious secretions but remained afebrile w/ a normal wbc count until d/c. . # hypotension/sepsis: this was also thought to be due to his pneumonia although atrial fibrillation leading to poor cardiac function was also considered. the fact that he was able to tolerate a significant amount of fluid pointed more toward pneumonia as a cause. he was supported with aggressive if fluid resuscitation and required pressor support until . he was also treated with antibiotics as above and with stress dose steroids given his history of heavy steroid use. by the time of his tracheostomy, he was approximately 35l positive and his bp was relatively stable. diuresis with a lasix gtt was begun while monitoring his bp. he responded well to the lasix drip and maintained his bp w/out need for further pressors. by the time of d/c he was thought to be only mildly fluid overloaded and lasix was changed to intermittant iv boluses. . # atrial fibrillation: he has a history of paroxysmal atrial fibrillation and was noted be in afib on arrival to the ed, likely precipitated by his pneumonia. he was cardioverted in the ed and transiently remained in nsr but was intermittently in a-fib during his time in the micu. once his blood pressure could tolerate it, he was rate controlled with metoprolol. he was anticoagulated with a heparin drip but was changed to coumadin as soon as he had a working gtube. his afib spontaneously converted during his diuresis suggesting atrial stretch was at least partially to blame. he was continued on his metoprolol and he was started on coumadin with his with a goal inr of . his inr should be followed for coumadin dose adjustments. on discharge he has an inr of 1.6. . # oliguric renal failure: his creatinine climbed to as high as 3.8 and this was thought to be due to hypoperfusion from prolonged hypotension. the renal service was consulted and he was treated with several episodes of hemodialysis through a catheter placed in his right femoral line. his renal function eventually stabilized and normalized during his admission. . #dm: he was initially treated with an insulin drip but this was later changed to qd glargine with iss prn hyperglycemia. . #pmr: he was initially treated with high dose steroids secondary to his sepsis. per report, the patient was taking at least 50mg of prednisone qd and intermittantly taking as much as 350mg w/out md input. as he stabilized, his steroids were titrated downwards with an eventual goal of a more appropriate pmr dose of 20mg qd. . #fen: he had a peg placed during his tracheostomy and tube feeds were started at this time. he will eventually need a speech and swallowing evaluation to facilitate po nutrition. medications on admission: 1) zantac 150 mg daily 2) neurontin 2600 mg daily 3) prednisone 50 mg daily 4) trazadone 50 mg daily 5) metformin 500 mg daily 6) glyburide 2.5 mg daily 7) sotalol 80 mg daily 8) prozac discharge medications: 1. prednisone 20 mg tablet sig: one (1) tablet po daily (daily). 2. warfarin 5 mg tablet sig: one (1) tablet po hs (at bedtime). 3. lansoprazole 30 mg susp,delayed release for recon sig: thirty (30) mg po daily (daily). 4. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 5. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 6. docusate sodium 150 mg/15 ml liquid sig: one hundred (100) mg po bid (2 times a day). 7. lactulose 10 g/15 ml syrup sig: thirty (30) ml po q2-3h (every 2-3 hours). 8. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed. 9. trimethoprim-sulfamethoxazole 40-200 mg/5 ml suspension sig: one (1) tablet po qmwf (). 10. haloperidol 5 mg tablet sig: one (1) tablet po bid (2 times a day). 11. ipratropium bromide 17 mcg/actuation aerosol sig: two (2) puff inhalation q6h (every 6 hours). 12. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 13. fentanyl 75 mcg/hr patch 72hr sig: one (1) patch 72hr transdermal q72h (every 72 hours): please titrate down to 50mcg q72hr as tolerated by the patient. 14. nystatin 100,000 unit/g cream sig: one (1) appl topical (2 times a day). discharge disposition: extended care facility: - discharge diagnosis: primary: pneumonia sepsis . secondary: oliguric renal failure, acute liver failure, acute respiratory failure, paroxsysmal atrial fibrillation, diabetes mellitus ii, polymyalgia rheumatica discharge condition: stable. tolerating tube feeds and cooperating with pt. requiring frequent suctioning from his trach. discharge instructions: please take your medications as directed by the facility. please have your blood checked for pt/inr tomorrow and every day until your inr is at goal , then twice per week to have your coumadin adjusted accordingly. please pull pt's central line as soon as you no longer need it to prevent infection. be sure to apply pressure given the patient is anticoagulated. please suction trach tube as needed for thick secretions. if you have fever, persistent low blood pressure, chest pain or other concerning symptoms please call your doctor or come to the emergency room. followup instructions: please make an appointment to see your pcp (, ) within a week of discharge from your facility procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis other electric countershock of heart venous catheterization for renal dialysis percutaneous [endoscopic] gastrostomy [peg] arterial catheterization temporary tracheostomy infusion of vasopressor agent diagnoses: thrombocytopenia, unspecified polymyalgia rheumatica acute kidney failure with lesion of tubular necrosis long-term (current) use of steroids diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver acquired coagulation factor deficiency severe sepsis atrial fibrillation methicillin susceptible staphylococcus aureus septicemia acute respiratory failure pneumonitis due to inhalation of food or vomitus methicillin susceptible pneumonia due to staphylococcus aureus obesity, unspecified chronic ulcer of other specified sites history of fall ulcer of calf 

Answer: The patient is high likely exposed to