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: a 43-year-old man, with a significant past medical history for iv drug use, who has had fever and shortness of breath for 1-2 weeks. he received a course of zithromax at an outside hospital for presumed pneumonia with no relief. chest x-ray done by primary care showed with ?evidence of emboli. ct of the chest with evidence of bilateral pulmonary lesions. admitted to outside hospital and noted to have a diastolic murmur. an echo at that time revealed 4+ aortic insufficiency with a 2 cm vegetation on his tricuspid valve, and a 1 cm vegetation on the aortic valve. systolic pa pressure was 70 mmhg. he was transferred to for further evaluation and treatment. past medical history: 1. degenerative joint disease. 2. hypercholesterolemia. 3. iv drug use. meds at home: methadone 37 mg q am. meds on transfer: 1. vancomycin 1 gm iv bid. 2. gentamicin 100 mg iv x 1 dose. 3. methadone 37 mg qd. 4. tylenol 1 gm po q 6 h prn. social history: iv drug use, heroin. the patient reports his last use was up to 2 years ago. family unaware of his history of abuse. he was started on methadone in . positive etoh--6 beers per day. positive tobacco--25 pack years. he is currently married and lives at home with his wife. family history: noncontributory. physical exam at admission: temperature 99.6, heart rate 90-100, blood pressure 112/60, respiratory rate 24, o2 sat 95% on room air. general: the patient is diaphoretic and tachypneic. heent: anicteric. no conjunctival petechiae. pupils are equally round and reactive to light. neck: no jvd with 3+ carotid pulses. cardiovascular: tachycardic with a diastolic murmur. lungs: diminished breath sounds at the bases bilaterally. coarse rhonchi throughout. abdomen: rigid but nontender. liver 4 cm below the costal margin. extremities: positive lesions. no ulcer or splinter hemorrhages. neurologic: alert and oriented x 3, but somewhat confused and unable to fully answer all questions. hospital course: the patient was admitted to the medical service. the cardiology service and infectious disease services were consulted upon admission. the patient underwent a full medical work-up, including a ct of his chest, his head, and his abdomen. additionally, the patient was seen by the cardiology service, the infectious disease service, the ophthalmology service, and the dental service, as well as cardiac surgery, and the orthopedic service for an effusion of the knee. his blood cultures showed staph aureus, and his antibiotics were adjusted accordingly. on the , the patient underwent cardiac catheterization, as recommended by ct surgery, to evaluate any coronary disease. please see cath report for full details. in summary, the cath showed that he had minimal plaquing and mild luminal irregularities with no flow-limiting stenoses. the patient also had a transesophageal echocardiogram which showed a tricuspid valve vegetation of 2.3 x 1 cm attached to the septal leaflet, at least mild tr, and aortic valve vegetation 1.4 x 0.4 cm, with severe ar, and a question of flail segment with no abscesses. no vegetations on the mitral valve and multiple jets of mitral regurgitation. no pulmonic valve vegetations, and normal lv. ct of his head at that time showed multiple embolic brain infarcts, and the neurology service was also consulted at that time. the patient was accepted for aortic valve replacement, and on , he was brought to the operating room where he underwent an aortic valve replacement. please see the or report for full details. in summary, the patient had an aortic valve replacement with a #23 ce pericardial valve, and resection of the tricuspid valve vegetation. his bypass time was 118 minutes with a crossclamp time of 80 minutes. he tolerated the operation well and was transferred from the operating room to the cardiothoracic intensive care unit. at the time of transfer, the patient's mean arterial pressure was 70 with a cvp of 11. he was in a sinus rhythm at 95 beats per minute. he had levophed at 0.13 mcg/kg/min, and propofol at 10 mcg/kg/min. the patient did well in the immediate postoperative period. his anesthesia was reversed. he was weaned from the ventilator and successfully extubated. on postoperative day #1, he remained hemodynamically stable with nitroglycerin infusion to control his blood pressure. he was continued on his antibiotic courses which, at that time, included clindamycin, gentamicin, oxacillin and vancomycin. during the course of postoperative day #1, the patient was begun on diuretics, as well as beta blockers, and his chest tubes were discontinued. the patient remained hemodynamically stable, and on postoperative day #2, he was weaned from his iv nitroglycerin and begun on norvasc for blood pressure control. additionally, the patient had a picc line placed, and was seen by the orthopedic team for evaluation of his left knee effusion that had grown staph aureus from an aspiration done earlier prior to his surgery. the knee was again aspirated and sent for gram stain and culture. on postoperative day #3, the patient remained hemodynamically stable. he was begun on ace inhibitors and transferred to the floor for continuing postoperative care and cardiac rehabilitation. throughout this period, the patient continued to be followed by the infectious disease service. on postoperative day #4, the patient remained stable. his temporary pacing wires were removed, and he was scheduled for a left knee arthroscopy by the orthopedic department. on day #5, the patient underwent an arthroscopy and a washout. he continued to progress from inactivity and a cardiac surgery standpoint. however, he did continue to have low-grade fevers with a mildly elevated white blood cell count throughout this period. over the next week, the patient's white blood cell count continued to normalize. he continued to have low-grade fevers which were felt to be a result of splenic, pulmonary and cerebral infarcts. he continued on his clindamycin and oxacillin as recommended by the id team. his activity level was increased with the assistance of the nursing staff and the physical therapy staff. he had a repeat head ct which showed no change from his previous head ct. on postoperative day #12, it was decided that the following day the patient would be stable and ready for discharge to home. on postoperative day #13, arrangements were made for the patient to be followed for outpatient services to maintain antibiotic course throughout , and on postoperative day #14, the patient was discharged to home. discharge physical exam - vital signs: temperature 99.8, heart rate 79, sinus rhythm, blood pressure 118/69, respiratory rate 18, o2 sat 99% on room air, weight preoperatively 152 pounds and at discharge 142 pounds. neurological: alert and oriented x 3. moves all extremities. follows commands. motor strength 5/5 bilaterally. sensation intact. respiratory: clear to auscultation bilaterally. cardiac: regular rate and rhythm, s1, s2. sternum stable. incision with steri-strips, opened to air, clean and dry. abdomen: soft, nontender, nondistended with active bowel sounds. extremities: warm and well-perfused with no edema. lab data: white count 7.2, hematocrit 24.2, platelets 528, sodium 135, potassium 4.3, chloride 101, co2 28, bun 17, creatinine 1.2, glucose 92, pt 13.9, ptt 27.5, inr 1.3. discharge medications: 1. aspirin 325 mg qd. 2. colace 100 mg . 3. oxacillin 2 gm q 4 h through . 4. clindamycin 150 mg q 6 h until dental issues resolved. 5. metoprolol 25 mg q 12 h. 6. percocet 5/325, 1-2 tabs q 4-6 h prn pain. 7. methadone 37 mg qd. discharge diagnoses: 1. status post aortic valve replacement with a #23 - pericardial valve and status post tricuspid valve vegetation resection. 2. hypercholesterolemia. 3. degenerative joint disease. 4. status post arthroscopy of the knee. condition at discharge: good. follow-up: he is to be discharged home with vna and healthcare services. he is to have follow-up in the clinic in 2 weeks, follow-up in the clinic on with dr. , and follow-up with dr. in 6 weeks. he is also to have follow-up with his primary care provider, . , in 3 weeks. additionally, the patient can have follow-up with the clinic as needed. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters left heart cardiac catheterization diagnostic ultrasound of heart open and other replacement of aortic valve with tissue graft arthrocentesis arthrocentesis open heart valvuloplasty of tricuspid valve without replacement division of joint capsule, ligament, or cartilage, knee diagnoses: anemia, unspecified pure hypercholesterolemia congestive heart failure, unspecified methicillin susceptible staphylococcus aureus septicemia intracerebral hemorrhage methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site acute and subacute bacterial endocarditis embolism and thrombosis of other specified artery pyogenic arthritis, lower leg 

Answer: The patient is high likely exposed to