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: the patient is a 56 year old gentleman with a history of end stage renal disease on hemodialysis since , coronary artery disease, hypertension and diabetes. he had been recently admitted in to an outside hospital with an mssa bacteremia thought to be caused by an infected permcath. at that time, the patient had the permcath removed, and he was treated with an antibiotic course of nafcillin and appeared to recover uneventfully. on , the patient presented at an outside hospital complaining of shortness of breath, lower extremity edema, and a "cold foot." during his extensive workup at the outside hospital, he was started on antibiotics. the complaint of back pain led to an mri which demonstrated no epidural abscess, and he underwent an echocardiogram which demonstrated a left ventricular ejection fraction of 60 percent and significant mitral regurgitation. he also underwent a cardiac catheterization, which demonstrated a left circumflex artery stenosis of 70 percent. he was transferred to the for consideration of surgery for mitral valve endocarditis, coronary artery disease, and evaluation for his cold left leg. past medical history: 1. end stage renal disease on hemodialysis since . 2. coronary artery disease status post myocardial infarction. 3. peripheral vascular disease. 4. hypertension. 5. diabetes. 6. mssa bacteremia, mitral valve endocarditis, severe mitral regurgitation. 7. diverticulitis. 8. congestive heart failure. 9. malnutrition with serum albumin 1.9. past surgical history: 1. eye surgery. 2. permcath placement. medications on admission: calcium carbonate 500 mg p.o. t.i.d. fentanyl patch 50 ug over 72 hours. colace. insulin sliding scale. nafcillin. gentamicin. aspirin 81 mg p.o. daily. protonix 40 mg p.o. daily. allergies: no known drug allergies. social history: the patient denies tobacco use or etoh use. he is an auto mechanic. vital signs on admission - temperature was 97.1, heart rate 101, blood pressure 88/58, with a mean of 64. breathing 10, 100 percent on room air. preoperative weight is 72 kg. the patient is in no acute distress. his chest was clear to auscultation bilaterally. his heart was regular, with a iii/vi holosystolic murmur at the apex. his abdomen was soft, nontender, nondistended. his left foot was cold and mottled, with a capillary refill greater than five seconds. he had two plus carotid pulses, two plus radial pulses, two plus femoral, and he had triphasic signals on the right popliteal, dorsalis pedis and posterior tibialis, and he had a monophasic popliteal on the left, with no signals over his dorsalis pedis and posterior tibialis. his left foot strength - his dorsiflexion and extension were on the left, and he had no sensation to the mid calf. on laboratories, his white count was 12.2, hematocrit 27.6, platelets 213. his sodium was 129, potassium 5.0, chloride 90, bicarbonate 26, bun 43, creatinine 6.5, glucose 145. the troponin was 3.52. albumin 1.9. on radiographic studies, he had an echocardiogram at the outside hospital which showed ejection fraction of 60 percent and plus mitral regurgitation. cardiac catheterization demonstrated a 70 percent lesion at the left circumflex, 36 percent lesion of the lm, and a 35 percent lesion of the rca. hospital course: the patient was admitted to the cardiac surgery service, and on the day of admission, the patient was taken to the operating room, where he underwent enbolectomy of the lower extremity by dr , followed later in the day by a mitral valve replacement with a 29 mm ce porcine valve, a coronary artery bypass graft x one, with svg to om, and a left lower extremity thrombectomy with patch closure and a lower extremity angiography. the patient tolerated the procedure well and was transferred to the cardiac surgery intensive care unit for his postoperative care. in the intensive care unit, the patient was weaned to extubation. his pressor support was weaned appropriately. he received transfusions for postoperative anemia, and at this point his hematocrit has remained stable. the nephrology team has been following him, and began initially continuous venous hemofiltration and dialysis, and as he improved and recovered from his surgery, this was replaced with typical hemodialysis. the transplant team has placed a new permcath, and his temporary dialysis line has been removed at this point. he was treated initially with a broad spectrum antibiotic course, and this has been tailored by the infectious disease team. his cultures have remained negative to date in the hospital, and his only positive cultures were the mssa, which grew out from an outside hospital. all tissue cultures, as well, have been negative. he underwent a bone scan to determine if there were any septic emboli, and there were none demonstrated on the scan. the patient was transferred to the floor and his recovery continued, and he has received physical therapy, nutritional consultation, and has been making good recovery strides. a picc line was placed for his five week course of antibiotics recommended to treat his bacterial endocarditis. all of his other lines and drains have been removed as appropriate. he does have a permanent permcath, which remains. he is now postoperative day twenty and two, and is ready for discharge to rehabilitation. discharge diagnoses: 1. bacterial endocarditis status post mitral valve replacement. 2. septic embolus to the left lower extremity. 3. mssa bacteremia. 4. end stage renal disease. 5. coronary artery disease. 6. peripheral vascular disease. 7. hypertension. 8. diabetes. 9. congestive heart failure 10. severe malnutrition. procedures performed: 1. status post mitral valve replacement with 29 mm porcine valve. 2. coronary artery bypass graft, svg to om. 3. left femoral thromboembolectomy with patch angioplasty. 4. placement of temporary dialysis catheter. medications on discharge: colace 100 mg p.o. b.i.d. zantac 150 mg p.o. daily. aspirin 81 mg p.o. daily. repaglinide 1 mg p.o. t.i.d. nephrocaps 1 p.o. daily. lopressor 25 mg p.o. b.i.d. oxacillin 2 grams iv q 4 hours x 5 weeks. instructions: the patient is to receive liver function tests once a week after discharge until antibiotics stop, a creatinine once a week after discharge until antibiotics stop, cbc once a week after discharge until antibiotics stop. these should be faxed to the primary medical doctor and the infectious disease team. he can call the infectious disease team for followup. follow up: the patient will follow up with dr. in two weeks. he should call for an appointment. the patient will also follow up with id and primary medical doctors. should call for an appointment. disposition: stable, and will go to rehab for further care. , procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart hemodialysis arteriography of femoral and other lower extremity arteries venous catheterization for renal dialysis non-invasive mechanical ventilation (aorto)coronary bypass of one coronary artery arterial catheterization incision of vessel, lower limb arteries pulmonary artery wedge monitoring open and other replacement of mitral valve with tissue graft monitoring of cardiac output by other technique transfusion of packed cells transfusion of other serum repair of blood vessel with tissue patch graft transfusion of platelets diagnoses: acidosis coronary atherosclerosis of native coronary artery congestive heart failure, unspecified acute posthemorrhagic anemia severe sepsis peripheral vascular disease, unspecified methicillin susceptible staphylococcus aureus septicemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site cardiogenic shock septic shock acute and subacute bacterial endocarditis hyperparathyroidism, unspecified diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled arterial embolism and thrombosis of lower extremity other protein-calorie malnutrition 

Answer: The patient is high likely exposed to