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: vancomycin / norvasc / iodine-iodine containing / tums plus / compazine / thymoglobulin / dilaudid / cefazolin attending: chief complaint: fevers major surgical or invasive procedure: ir catheter removal history of present illness: 35m s/p renal and pancreas transplant on m/th dialysis through temporary left sc line presents with fevers to 103.4 and hypotension with lethargy during dialysis today. initially transferred to where he was given 700 mg vanc and 2 gm ceftazidine as well as ivf bolus with sbp response to 100's mmhg. had ct head performed given complaint of lethargy which showed no acute abnormality. transferred to for further evaluation. . in the ed, initial vitals t was 100.8, hr 95 bp79/46 rr14 100% 2l nc. received 3 l ns at 250 cc's an hour with bp response to 100/60 mmhg. ua was negative for evidence of uti. noted to be hypokalemic at 2.9, and creatinine of 5.0. white count was 10.4 with 91% pmn's and 5% bands. lactate 1.4. cxr showed low lung volumes, with crowding of the pulmonary vascular structures, and suggestion of mild pulmonary vascular engorgement. given tylenol as well as stress dose hydrocortisone 100 mg in the ed. transplant surgery and renal notified in the ed. prior to transfer vitals were t92 bp100/60 rr16 o2 sat 100 2-3l nc. . on the floor, pateint aox3 without complaints besides fatigue. blood pressures in the high 70's systolic. bolused last 250 cc's of 3rd liter ns ivf with bp response to 110's systolic with map's in the 70's. denies any recent travel or sick contacts. . of note, has a left temporary hd line placed about 6 months ago after his right hd line had become infected. past medical history: history of dmi s/p pancreas transplant kidney transpant htn secondary hyperparthyroidism esrd s/p living related renal transplant history of recurrent utis (enterococcus) blind in left eye d/t toxoplasmosis infection hx of occlusion of radial/ulnar arteries s/p eye laser surgery/cataract surgery r eye diabetic retinopathy neuropathy fistula right arm left bka r toe amputation right tunneled ij placement removed for infection left subclavian hd line placement recently broken right calcaneus social history: lives with his parents; previously worked in a warehouse. 4 children, two stepchildren, quit smoking, smoked 1 pack per week many years ago, no etoh, no drugs. . family history: noncontributory. no history of diabetes physical exam: on admission: vitals: 99.2| bp83/45 hr 55 rr16 96% on ra gen: cushingoid. nad. aox3. heent: no scleral icterus, mucus membranes moist. left eye with poor reactivity. no oral lesions or ulcers. neck: supple, from cv: rrr, no m/g/r chest: left subclavian hd line in place. nontender/non erythematous. pulm: clear to auscultation b/l in upper lung fields. faint crackles in basilar fields bilaterally. abd: central midline scar. nbs. nondistended, nontender, no rebound or guarding. no fluid way. no tenderness over transplatns. ext: left bka,right toe amputation. pain with manipulation of right foot. scattered old ecchymoses on shins. neuro: aox3. mae. on discharge: vitals: 98.3 97.1 135/87 132/87 132-160/78-95 72-84 18 97%ra 24h , bmx1 gen: pleasant gentleman, lying down in bed, nad heent: eomi, no scleral icterus, mmm neck: supple, unable to appreciate jvp cv: rrr, 2/6 systolic murmur heard best at lusb without apparent radiation pulm: no use of access mm, clear b/l without wheezes or crackles abd: central midline scar. nabs. nondistended, nontender, no rebound or guarding. ext: left bka, right toe amputation. pain with manipulation of right foot. scattered old ecchymoses on shins. skin: tattoo over left chest, removed subclavian line, no rashes or skin breakdown neuro: awake, alert, appropriate, aox3. moving all extremities, no gross deficits pertinent results: admission labs: 05:10pm blood wbc-10.4 rbc-3.62* hgb-10.9* hct-32.3* mcv-89 mch-30.2 mchc-33.9 rdw-15.7* plt ct-278 05:10pm blood neuts-91* bands-5 lymphs-2* monos-2 eos-0 baso-0 atyps-0 metas-0 myelos-0 05:10pm blood pt-13.0 ptt-24.2 inr(pt)-1.1 05:10pm blood glucose-104* urean-34* creat-5.0* na-142 k-2.9* cl-101 hco3-29 angap-15 01:12am blood alt-24 ast-28 ld(ldh)-204 alkphos-65 totbili-0.3 01:12am blood albumin-3.8 calcium-8.0* phos-4.2 mg-1.9 05:16pm blood glucose-105 lactate-1.4 na-143 k-3.0* cl-98* calhco3-30 . discharge labs: 06:00am blood wbc-4.3 rbc-3.07* hgb-9.4* hct-27.7* mcv-91 mch-30.7 mchc-34.0 rdw-15.0 plt ct-272 06:00am blood glucose-90 urean-63* creat-7.4* na-145 k-4.1 cl-109* hco3-26 angap-14 06:00am blood calcium-8.5 phos-4.1 mg-2.2 05:51am blood vanco-16.0 06:00am blood vanco-6.0* 06:00am blood rapmycn-5.0 06:00am blood tacrofk-6.3 . cxr : impression: low lung volumes, with crowding of the pulmonary vascular structures, and suggestion of mild pulmonary vascular engorgement. . transplant u/s : status post renal and pancreas transplants to assess for possible hydronephrosis or peri-transplant fluid collection. the renal transplant is identified in the right lower quadrant and measures 9.6 cm in length, similar in size to the prior scan of . there is no evidence of hydronephrosis and no peri-transplant fluid collections are seen. normal arterial waveforms and velocities are seen in the main renal artery and main renal vein. intrarenal doppler shows normal to nearly normal resistive indices ranging from 0.65 - 0.73. vascularity is uniform throughout the transplant. the bladder is empty, drained by a foley catheter. conclusion: normal-appearing right lower quadrant renal transplant. pancreas u/s : clinical indication: status post pancreas transplant, to assess for fluid accumulation or parenchymal damage. the pancreas transplant could be partially imaged and was seen in the right periumbilical region, but visualization was incomplete due to patient's body habitus and overlying bowel gas. there were no peritransplant fluid collections seen and the graft measures approximately 2 x 3 x 3 cm. venous flow was seen contiguous to the graft, possibly in the splenic or superior mesenteric vein, but arterial flow within the pancreas transplant could not be established. conclusion: limited views of the pancreas transplant in the right periumbilical region show no fluid collections. doppler assessment is inadequate, possibly for technical reasons cited above. . micro: urine culture (final ): no growth. blood cultures 5/30, , , : pending 5:23 pm catheter tip-iv source: hd line . wound culture (final ): no significant growth. brief hospital course: pt is a 35-year-old man with type i diabetes and esrd s/p renal / pancreatic transplant with esrd (on hd via indwelling line) following allograft failure admitted with severe sepsis presumptively from line infection. he was initially treated in the icu and was fluid responsive. on the medicine floors he remained stable. culture data from dialysis center grew out coagulase negative staph, susceptible to vanc. he was given a line holiday, with new tunneled catheter placed and dialysis done day of discharge. he will complete a 14 day course of vancomycin with hd dosing. #. line sepsis: patient emperically started on vancomycin/ceftazidime in the icu. per transplant recs, pulled line via ir guidance and tipe sent for culture. in the icu, he required several liter boluses and maintained maps >65. on transfer, he was hemodynamically stable. he also recieved hydrocortisone 100 mg for stress dose steroids as he is on steroids as an outpatient. on the medicine floor he remained afebrile and hd stable. blood cultures here negative and wound tip culture was negative. he had a 2 day line holiday. cultures from hd center on grew out gram positive cocci in clusters, speciated to coagulase negative staph, sensitive to vancomycin. he will complete a 14 day course of vancomycin with hd dosing. # hx of renal/pancreatic transplant: renal transplant failing but pancreatic transplant still working. currently on tacrolimus, rapamycin, and prednisone. he was continued on home dosing, as well as bactrim prohpylaxis. # normocytic anemia: hct stable, at baseline, most likely acd. # htn: bp meds initially held given sepsis. on the medicine floors he became hypertensive and his home doses of metoprolol and clonidine were restarted. he had improved blood pressure control subsequently thereafter. # depression: continued on escitalopram. # hld: continued on statin and asa. transitional care: 1. code: full 2. contact: mother (h); (c) 3. follow-up: - renal transplant - pcp 4. medical management: - no changes to medications 5. outstanding tasks: - blood cultures pending at time of discharge medications on admission: atorvastatin 40 mg tablet qpm clonidine 0.1 mg tablet qday escitalopram 10 mg tablet qday lorazepam 0.5 mg tablet tablet(s) prn metoprolol tartrate 25 mg tablet omeprazole 20 mg capsule, delayed release(e.c.) prednisone 5 mg tablet sirolimus 1 mg tablet daily sulfamethoxazole-trimethoprim 400 mg-80 mg tablet daily tacrolimus 1 mg capsule aspirin 81 mg tablet, daily calcium carbonate-vitamin d3 500 mg (1,250 mg)-200 unit ferrous sulfate 325mg discharge medications: 1. atorvastatin 40 mg tablet sig: one (1) tablet po hs (at bedtime). 2. clonidine 0.1 mg tablet sig: one (1) tablet po daily (daily). 3. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). 4. lorazepam 0.5 mg tablet sig: 1-2 tablets po twice a day as needed for anxiety: this medication may cause drowsiness, do not take it while driving or doing heavy activity. 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 6. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 7. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 8. sirolimus 1 mg tablet sig: one (1) tablet po daily (daily). 9. sulfamethoxazole-trimethoprim 400-80 mg tablet sig: one (1) tablet po daily (daily). 10. tacrolimus 1 mg capsule sig: one (1) capsule po q12h (every 12 hours). 11. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 12. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po twice a day. 13. calcium carbonate-vitamin d3 500 mg(1,250mg) -200 unit tablet sig: one (1) tablet po twice a day. 14. vancomycin 500 mg recon soln sig: 1500mg mg intravenous hd protocol (hd protochol) for 14 days: to be completed (one dose after hd, one dose after hd, and one dose after hd) . discharge disposition: home discharge diagnosis: primary: 1. line sepsis secondary: 1. renal/pancreatic transplant 2. hypertension 3. depression discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , it was a pleasure taking care of you during this admission. you were admitted with high fevers from dialysis. you had low blood pressure initially, and you were admitted to the icu where you received fluids and antibiotics. you were transferred to the medicine floors and had your hd line removed. a new line was placed and you had a session of dialysis. we found out that you were growing a bacteria from the first line and you will need to continue antibiotics when you leave. the following medications have been changed during this admission: - start vancomycin 1500mg intravenously at the end of hd for 14 days total to be completed (one dose after hd, one dose after hd, and one dose after hd) please continue all other medications you were taking prior to this admission. followup instructions: please follow-up with the following appointments: department: when: tuesday at 11:30 am with: , md building: campus: east best parking: garage department: transplant center when: tuesday at 3:40 pm with: , md building: lm campus: west best parking: garage md procedure: hemodialysis venous catheterization for renal dialysis diagnoses: anemia of other chronic disease end stage renal disease renal dialysis status severe sepsis depressive disorder, not elsewhere classified hypopotassemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure long-term (current) use of insulin secondary hyperparathyroidism (of renal origin) other and unspecified infection due to central venous catheter complications of transplanted kidney mononeuritis of unspecified site below knee amputation status background diabetic retinopathy staphylococcal septicemia, unspecified diabetes with ophthalmic manifestations, type i [juvenile type], not stated as uncontrolled pancreas replaced by transplant profound impairment, one eye, impairment level not further specified 

Answer: The patient is high likely exposed to