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: colace attending: chief complaint: transfer from osh for staph bacteremia, r hand abscess/cellulitis major surgical or invasive procedure: r hand abscess debridement history of present illness: 56 yo m with h/o "diet controlled dm" s/p right aka, admitted on to hospital with purulent drainage from his right thumb and progressive erythema up his arm to his elbow over the days just prior to admission. the patient reports that the initial injury occurred 5 days ago when he tried to open a can of cat food. given the progression of the wound as above, his brother called an ambulance on so that the patient would undergo further evaluation. ct of the arm from osh revealed gas in the soft tissue. additionally thumb swab from osh is now growing staph aureus and rare gnrs and blood cultures are growing gram positive cocci. he was initially started on cefazolin, but was transitioned to aztreonam/clindamycin late on the . vancomycin was added on . also of note, his hct at osh was reportedly 23 (baseline not known) on presentation for which he received 2 units prbcs with post transfusion hct 29. his wbc count at that time was 26k. additionally, he was noted to be jaundiced with scleral icterus with t.bili 10 prior to transfer. gallstones were reportedly visualized on abd ct without clear e/o obstruction. hepatitis a ab was negative, hep b surface ag negative (no surface ab), hep c ab negative. also on ct abdomen (with oral not iv contrast), marked jejunal thickening to as much as 1cm was noted. given his hct and jaundice, hematology was consulted out of concern for hemolysis. direct coombs was negative. as he was thought to have anemia of chronic disease based on iron studies at osh, possible renal contribution so he received erythropoeitin. he was transferred from osh on initially to the medicine service and for urgent orthopedic evaluation. initial vitals on the floor were t 101.2 bp 139/62 hr 100 o2 96%. plastics evaluated him upon presentation to the floor and he was taken emergently to the or for debridement. intraoperatively, his sbps dropped to 70s requiring initiation of phenylephrine. of note, he had been started on propofol for sedation. he received approximately 3l ivfs intraoperatively with estimated 10cc blood loss. gross purulence was drained in the or. in the pacu, sbps dipped to 70s again when titration of neosynephrine was attempted and he was noted to have made only approximately 200cc uop including or and pacu course (prior to that not well documented). he received 4.5g iv zosyn and vanco 1g iv. ros: unable to obtain given intubated/sedated however osh documents report pt. denied abdominal pain, nausea, vomiting, blood in stool/black stool. past medical history: diet controlled dm2 s/p right leg amputation abscess right middle finger s/p amputation s/p cataract surgery social history: lives with two brothers, "occasional" etoh although reports past heavy use in college. no tobacco. family history: non-contributory physical exam: vitals: t: 101 bp: 142/60 hr: 85 rr: 16 o2sat: 100% vent settings: ac 550/14 peep 5.0 fio2 0.40; neosynephrine at 0.50 mcg/kg/min general: middle aged male lying in bed, intubated and sedated skin: jaundiced, left anterior shin with large area of erythema, warmth, no fluctuance, no purulent drainage heent: left pupil 3mm->2.5mm, right pupil 3.5mm->3mm, icteric sclerae. dry mucous membranes. neck: supple chest: slightly less air movement on left laterally, however sounds clear anteriorly and laterally cardiac: soft early systolic murmur lusb, rrr abdomen: soft, normoactive bowel sounds, does not appear to grimace with palpation of abdomen extremities: right hand with multiple lesions over the fingers, half amputated right middle finger. right thumb dressed, right arm suspended. left le with multiple excoriations anterior shin. also has an area of erythema over the midshin with increased warmth (as above). 1+ lle edema. left toes with ?ischemic emboli. s/p aka on right. pertinent results: labs on admission: 12:00am wbc-18.9* rbc-3.06* hgb-10.2* hct-28.3* mcv-92 mch-33.2* mchc-35.9* rdw-16.7* 12:00am neuts-96.0* bands-0 lymphs-2.0* monos-1.5* eos-0.5 basos-0.1 12:00am plt count-270 12:00am pt-18.0* ptt-34.6 inr(pt)-1.6* 12:00am albumin-2.4* calcium-7.7* phosphate-2.8 magnesium-1.8 12:00am lipase-26 12:00am alt(sgpt)-39 ast(sgot)-85* ld(ldh)-194 alk phos-208* amylase-17 tot bili-16.0* 12:00am glucose-185* urea n-51* creat-1.6* sodium-126* potassium-5.0 chloride-94* total co2-21* anion gap-16 osh blood cultures 4/4 bottles mssa bacteremia ekg in micu: nsr rate 88, nml axis, twi v2, twi v3 now resolved. radiologic data from osh: cxr: no acute cardiopulmonary process. ct abdomen w/o iv contrast, oral contrast only : 1. diffuse thickening of jejunum measuring up to 1cm. etiology is unknown. infiltrative disease or edema cannot be ruled out. there is no bowel obstruction. 2. the liver is enlarged with fatty infiltration. 3. one cm stone int he left kidney that is nonobstructing. 4. layering stones in the gallbladder. ct right upper extremity: gas within soft tissue planes right arm from level of thumb and index finger to just above the elbow. ruq us - 1. stones and sludge seen within the gallbladder, with wall thickening and edema although no pericholecystic fluid. differential diagnosis includes hypoalbuminemia, chf, hepatitis and acute cholecystitis. if acute cholecystitis remains a consideration, hida scan could be helpful for further evaluation. 2. echogenic liver suggesting fatty infiltration. however, other forms of liver disease and more advanced liver disease including significant hepatic fibrosis/cirrhosis cannot be excluded. tte - the left atrium is mildly dilated. the right atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is smaller than usual. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). the estimated cardiac index is normal (>=2.5l/min/m2). tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). the right ventricular cavity is mildly dilated. right ventricular systolic function is normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. no masses or vegetations are seen on the aortic valve. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. no mass or vegetation is seen on the mitral valve. the pulmonary artery systolic pressure could not be determined. there is an anterior space which most likely represents a fat pad. impression: normal left ventricular systolic and diastolic function. the left ventricle appears somewhat underfilled. the right ventricle is mildly dilated with normal function. the mitral and aortic valves appear to function well with no vegetations identified. cxr - lines and tubes as described. prominent cardiomediastinal silhouette of indeterminate significance given low lung volumes. this should be further assessed on a film obtained with better inspiration when the patient can tolerate. left lower lobe collapse and/or consolidation. brief hospital course: 56 yo m with dm, mssa bacteremia due to a r hand abscess due to a cut, transfered here from osh for debridement in or. initially admitted to the medical floor from osh and taken emergently to the or by plastic/hand surgery for debridement of the r hand abscess. intraoperatively, the pt dropped his sbps, requiring neosynephrine gtt for bp support. as the pt remained intubated and on pressors in the pacu, he was tranferred to the micu for further care. neo was titrated off the following morning and the pt was given a total of 9ls ivf boluses for cvps < 12. he was extubated successfully on the day of admission to the micu. he briefly required levophed overnight after extubation for sbps in the 80s, maps < 65 after being aggressively fluid resuscitated, which was weaned off the following morning. the pt was placed on vancomycin and zosyn until further culture data was available. a wound swab from the r hand showed 4+ gpc and 2+ gnrs and eventually grew mssa. blood cultures from the osh were also with mssa while blood cultures here remain ngtd. given his persistent hyperbilirubinemia, the decision was to keep the pt on vancomycin (dosed by level) rather than switching to nafcillin. a tte was checked and was negative for vegetations. off of pressors since . most likely source of infection was infected hand wound. he then required a second icu stay for ugib and hypotension after and egd. his course is complicated by liver failure with underlying newly diagnosed liver cirrhosis secondary to ongoing etoh use, new renal failure requiring cvvh due to atn associated with hypotenation/atn, also with ugib with evidence of nonbleeding ge junction ulcer requiring blood transfusions. the patient was persistently hypotensive to the 70's (with good mentation) which was felt to be due to fluid shifts. he was doing well until 4am on the morning of , when the patient became bradycardic and had a pea arrest. he was successfully resuscitated after 1 atropine and 3 epinephrine doses and 10 minutes of cpr. the cardiac arrest was complicated by large witnessed aspiration, intubation, subsequent hypoxia x 5 minutes and dilated fixed pupils. it is unclear what precipitated this event, it was most likely secondary to acidemia. throughout the course of the next 12 hours, the patient needed increasing blood pressure support ending up on 3 pressors. his antibiotics were broadened to include meropenom, vancomycin and caspofungin. he was difficult to oxygenate even on high peep and 100% fio2. he remained acidemic despite our efforts to give him bicarb. it was felt that given his low blood pressure it was not possible to use cvvh. after a discussion with his brother (hcp), it was felt that given the grim prognosis, the patient would not want further life sustaining measures. the patient was made cmo. pressors were stopped and the patient expired within a few minutes. he expired at 9:02pm on . medications on admission: home medications: none medications on transfer: aztreonam clindamycin vancomycin discharge medications: the patient expired at 9:02pm on . discharge disposition: extended care discharge diagnosis: cardiac arrest hypoxic respiratory failure mssa sepsis r hand infection s/p i&d hyperbilirubinemia with jaundice acute on chronic renal failure discharge condition: the patient expired at 9:02pm on . discharge instructions: the patient expired at 9:02pm on . followup instructions: the patient expired at 9:02pm on . md procedure: venous catheterization, not elsewhere classified insertion of endotracheal tube hemodialysis venous catheterization for renal dialysis percutaneous abdominal drainage cardiopulmonary resuscitation, not otherwise specified exploration of tendon sheath of hand diagnoses: anemia, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled alcoholic cirrhosis of liver acute kidney failure, unspecified severe sepsis methicillin susceptible staphylococcus aureus septicemia chronic kidney disease, unspecified acute respiratory failure cardiac arrest septic shock hemorrhage of gastrointestinal tract, unspecified cellulitis and abscess of hand, except fingers and thumb 

Answer: The patient is high likely exposed to