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 attending: chief complaint: malaise, change mental status, hypotension major surgical or invasive procedure: none history of present illness: 68m w/ ms, bladder, foley catheter, uti in , mrsa+ presents with increasing malaise, change in mental status similar to prior uti per wife. was treated for uti w/ linezolid in . recently, had similar symptoms (decreased responsiveness, alertness and less verbal than baseline with utis) and was treated with 7 days of macrobid without improvement. this was changed to oral linezolid for past 4 days and he has not improved. becoming difficult to care for, and has had decreased po intake, malaise and is less responsive. in ed was afebrile and normotensive on arrival, but repeat bp 84/55. he received a 1.5l bolus (total 3l in ed) and sbp back up to 120-140s. by 1420p when i spoke with ed physician about his case, he had not yet been given any antibiotics (because patient not tolerating the linezolid pill that was ordered). the ed staff reportedly spoke with id fellow who had suggested to continue linezolid for the present. i requested that they cover for gram negative organisms prior to transfer to medical given his risks, his clinical failure on linezolid and lack of adequate gram negative coverage with linezolid. he then developed hypothermia in the ed who communicated that he might need a bear-hugger, and he was only getting linezolid. i paged the er attending. i paged the ed resident and again requested immediate gram negative coverage since he now meets sirs/sepsis criteria with presumptive urosepsis, and concern for icu needs. ros: otherwise negative in 13 point detail review past medical history: - multiple sclerosis - h/o mdr utis - seizure disorder - foley catheter, changed monthly - hyperlipidemia social history: he is a retired computer programmer who lives at home with his wife. is wheelchair bound at baseline. he had smoked very briefly from age 13 with a 10-pack-year smoking history. he has not had any environmental or occupational exposures. family history: his mother with breast cancer. father with stomach cancer. physical exam: admission physical exam: t32.6c p57 94/64 12 99%1l general: alert, oriented, very few words heent: sclera anicteric, dry mucus membranes, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: cold, well perfused skin: no impairments . discharge physical exam 95.1-97, 115/60, 70, 18, 100ra general: alert, oriented x 3, slow, but coherent speech heent: sclera anicteric, dry mucus membranes, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well-perfused, no edema pertinent results: admission labs: 10:52am urine color-straw appear-hazy sp -1.009 10:52am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-mod 10:52am urine rbc-2 wbc-9* bacteria-few yeast-none epi-<1 10:52am urine hyaline-2* 10:52am urine amorph-rare 09:35am glucose-63* urea n-22* creat-0.7 sodium-141 potassium-5.4* chloride-108 total co2-28 anion gap-10 09:35am estgfr-using this 09:35am wbc-6.6# rbc-3.50* hgb-11.8* hct-32.1* mcv-92 mch-33.8* mchc-36.8* rdw-19.3* 09:35am neuts-86.2* lymphs-10.2* monos-2.7 eos-0.7 basos-0.2 09:35am plt smr-low plt count-92* . 9:35 am blood culture blood culture, routine (pending): x two sets **final report ** urine culture (final ): yeast. 10,000-100,000 organisms/ml.. . ecg (): sinus bradycardia with first degree atrio-ventricular conduction delay. compared to the previous tracing of there is no significant change. . cxr (): impression: near-complete improvement of previous left lower lobe pneumonia. . historical studies: called pcp, , spoke with dr. --> most recent ucx s to linezolid/macrodantin, started on macrodantin , switched to linezolid . 06:05am blood wbc-3.5* rbc-2.90* hgb-9.3* hct-26.8* mcv-92 mch-32.1* mchc-34.7 rdw-18.4* plt ct-88* 07:00am blood wbc-2.7* rbc-2.80* hgb-9.0* hct-26.3* mcv-94 mch-32.0 mchc-34.2 rdw-18.3* plt ct-95* 07:00am blood neuts-58.4 lymphs-30.1 monos-5.9 eos-5.6* baso-0 07:00am blood plt ct-95* 06:05am blood glucose-67* urean-15 creat-0.7 na-142 k-4.3 cl-109* hco3-28 angap-9 07:00am blood glucose-71 urean-16 creat-0.7 na-144 k-4.6 cl-109* hco3-31 angap-9 05:31am blood alt-26 ast-29 alkphos-117 totbili-0.2 06:05am blood alt-24 ast-29 alkphos-112 totbili-0.2 03:44am blood calcium-7.7* phos-2.1* mg-1.7 04:32pm blood cortsol-12.5 05:07pm blood cortsol-25.7* 09:35am blood free t4-0.77* brief hospital course: 68 yo m with ms bladder frequently admitted with resistant utis admitted to micu for hypotension & profound hypothermia secondary to a uti for which he had already started po therapy as an outpatient. subsequent hospital course was complicated by metabolic encephalopathy which largely cleared prior to discharge. . # uti / bladder / sepsis / hypothermia: pcp??????s office confirmed on urine culture from , sensitive to macrobid and linezolid. initially he was treated with macrobid and worsened significantly. he transiently responded to linezolid, but eventually came to the hospital minimally interactive and hypothermic. cefepime was added on in the micu and linezolid was continued. he was warmed artificially and improved significantly. all cultures from this admission returned negative: cefepime was discontinued on and linezolid was continued until to complete a two week course. he will follow-up with infectious disease to discuss further options to prevent utis. . # multiple sclerosis: per wife, has been worsening over the last few months with each recurrence of uti. palliative care and sw were consulted. hospice options were presented to the patient and his wife & daughter. the patient was receptive to the idea of comfort focused care and avoiding futuere hospitalizations, but states that at this time he is not ready for hospice. baclofen was continued. . # toxic-metabolic encephalopathy: cleared on the medical floor as the patient recovered. by the time of discharge, he was near his recent baseline. . # seizure disorder: continued phenytoin. . # mood disorder nos: recently started on sertraline as an outpatient. however, concurrent linezolid puts him at risk for serotonin syndrome. setraline was held throughout the admission and the patient was advised to continue holding this medication until at least a week after completing linezolid. consideration should be given to indefinite discontinuation of ssris as he may require linezolid again. . # moderate pancytopenia: likely secondary to linezolid. because of this, would favor daptomycin to cover utis in the future. . medications on admission: senna 8.6 mg 1 tablet po bid colace 100 mg dulcolax 10 mg suppository daily prn oxybutynin chloride 2.5 mg po tid baclofen 20 mg tablet po tid phenytoin sodium 200 mg po qhs cranberry, oral vit c 500 mg po bid. mvi po daily (daily). simvastatin 10 mg po qhs polyethylene glycol 3350 17 gram/dose po daily discharge medications: 1. baclofen 20 mg tablet sig: one (1) tablet po three times a day. 2. methenamine hippurate 1 gram tablet sig: one (1) tablet po twice a day. 3. oxybutynin chloride 5 mg tablet sig: 0.5 tablet po three times a day. 4. dilantin extended 100 mg capsule sig: two (2) capsule po at bedtime. 5. simvastatin 10 mg tablet sig: one (1) tablet po once a day. 6. ascorbic acid oral 7. cranberry oral 8. multivitamin oral 9. linezolid 600 mg tablet sig: one (1) tablet po twice a day for 1 days: last day . 10. miralax 17 gram powder in packet sig: one (1) packet packet packet po once a day as needed for constipation. 11. dulcolax 10 mg suppository sig: one (1) rectal once a day as needed for constipation. 12. senna 8.6 mg capsule oral discharge disposition: home with service facility: area vna discharge diagnosis: uti / bladder / sepsis toxic-metabolic encephalopathy multiple sclerosis pancytopenia, likely secondary to linezolid discharge condition: mental status: clear, slow but coherent speech. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear mr. , you were admitted with a severe infection which caused hypothermia and low blood pressure. we think that this was caused by another uti. you were treated with antibiotics, fluids, and medications which were necessary to maintain your blood pressure. you were seen by consultants from infectious disease and palliative care. you should continue to take linezolid for one more day after discharge, your last dose should be on . we are holding sertraline because it interacts wil linezolid. you should continue to hold sertraline for at least a week after finishing linezolid because these medications can cause a severe reaction when taken together. we have not changed any of your other previous medications. please continue to take them as you did previously. a full list has been attached. followup instructions: please call your pcp's office on monday to schedule an appointment within the next week. you will be contact by someone from the division of infectious disease regarding a follow-up apopointment. if you do not hear from them, please call (. previously scheduled appointments: department: otolaryngology-audiology when: thursday at 9:30 am with: , md building: lm bldg () campus: west best parking: garage department: adult specialties when: tuesday at 1 pm with: , md building: (, ma) campus: off campus best parking: free parking on site department: surgical specialties when: wednesday at 1 pm with: , md building: campus: east best parking: garage md procedure: injection or infusion of oxazolidinone class of antibiotics diagnoses: urinary tract infection, site not specified toxic encephalopathy unspecified septicemia severe sepsis other and unspecified hyperlipidemia infection with microorganisms without mention of resistance to multiple drugs epilepsy, unspecified, without mention of intractable epilepsy multiple sclerosis other specified antibiotics causing adverse effects in therapeutic use neurogenic bladder nos unspecified episodic mood disorder other drug-induced pancytopenia 

Answer: The patient is high likely exposed to