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: betadine / chlorhexidine attending: chief complaint: chills major surgical or invasive procedure: removal of hd line right ij line placement right ij line removal tunneled hd catheter placement transesophageal echocardiogram history of present illness: 65 y.o male with pmhx of dm type 2, copd on 2l home o2, and ckd (recently started on hd in ), who presents with fevers, hypotension.the patient was at dialysis, and reported fever up to 100.0 with chills.approx. 75 % of the dialysis was completed per ems and he recieved total of 1.5g of vanco at the dialysis center. the patient does make a small amount of urine at baseline and denies dysuria. he endorses a nonproductive cough for a couple days, but denies chest pain, nausea, vomiting,abdominal pain, confusion, headaches, sick contacts or recent travel. . of note in the patient started dialysis which was complicated by mrsa bactremia, and hypotension. he was admitted and had his dialysis line removed, tte at the time negative for endocarditis, he was discharged with new hd line and 6 weeks of vancomycin. he has been followed by outpatient clinic for this and completed therapy in 6/. . in the ed initial vitals were: 101.4 75 130/44 16 100% 2l nasal cannula and the patient recieved 500mg meropenem and 500mg p.o tylenol. he became tachypnic to 40s and o2 sats down to low 90s on 4l nc after 1 liter of ns and so put on bipap and went to 100% oxygen sat. he was weaned off of bipap after less than 1 hour and now resp status stable on 4l nc once again. he was given 0.5 mg iv ativan for comfort.for hypotension with sbp 70's, a right ij central catheter was placed and low dose levophed started with sbp's in the 90's.the patient was transferred for further care to the icu. . on arrival to the micu, the patient is off bipap and breathing well. he is mentating well and the above hpi was obtained. he says his breathing is "better." the below review of systems was obtained including no chest pain, nausea, productive cough. he has felt "crummy for few days" but will not elaborate. review of systems: obtained from patient (+) per hpi (-) denies recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: -diabetes mellitus type ii -htn -dchf/right heart failure (ef>55%), -s/p open chest surgery for "dot" on lung at -rheumatoid arthritis -copd on 2l home o2 -depression -bipolar disorder -schizoaffective disorder -glaucoma -stage 5 chronic kidney disease -peripheral vascular disease s/p rle bypass -history of pulmonary embolism on coumadin -obesity hypoventilation syndrome -osa on bipap/cpap -chronically elevated left hemidiaphragm social history: lives in , uses electric wheelchair at baseline. -tobacco history: smoked 1ppd for 43 years quit several years ago -etoh: quit drinking 4-5 years ago, used to drink socially -illicit drugs: denies family history: mother: (unknown type) father: disease physical exam: admission exam vitals: t:99.1 bp: 90/46 p: 96 r: 18 18 o2: 96% 4l nc general: alert, oriented x 3, no acute distress. speaking in full sentences but pursing lips when breathing heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad.r-ij in place . has left dialysis line with erythema 1-2cm around it, nontender with no drainage. cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: decreased breath sounds on the left side, mild exp wheezing in the right lower lung field, no significant rales and some mild diffuse ronchi abdomen: soft, non-tender, distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 1+ pulses dp b/l, no clubbing, cyanosis or edema , bruising on shins b/l neuro: cnii-xii intact, 4/5 strength upper/lower extremities, grossly normal sensation, gait deferred. discharge exam vs - t 97.8, hr88, bp 134/76, rr 01, o2sat 98% 2lnc general - awake, alert, nad heent - nc/at, sclerae anicteric, op clear lungs - poor air movement bilaterally, no crackles, no wheezes heart - rrr, nl s1-s2, no m/r/g neuro - awake, cns ii-xii grossly intact pertinent results: admission labs 08:40pm blood wbc-16.6*# rbc-3.91*# hgb-11.7*# hct-38.7*# mcv-99* mch-29.8 mchc-30.1* rdw-16.2* plt ct-180 08:40pm blood neuts-87* bands-2 lymphs-3* monos-3 eos-0 baso-0 atyps-0 metas-2* myelos-3* nrbc-2* 04:43am blood pt-13.4* ptt-37.2* inr(pt)-1.2* 08:40pm blood glucose-103* urean-22* creat-2.9*# na-138 k-3.9 cl-100 hco3-28 angap-14 08:40pm blood alt-11 ast-16 ld(ldh)-289* ck(cpk)-108 alkphos-66 totbili-0.1 08:40pm blood albumin-3.6 calcium-8.9 phos-1.1*# mg-1.6 09:00am blood vanco-7.4* 01:04am blood type- po2-48* pco2-67* ph-7.25* caltco2-31* base xs-0 09:05pm blood lactate-1.8 other pertinent labs: 07:20am blood vanco-19.2 08:20am blood crp-122.8* 08:40pm blood ck-mb-2 ctropnt-0.07* 04:43am blood ck-mb-2 ctropnt-0.07* 08:40pm blood alt-11 ast-16 ld(ldh)-289* ck(cpk)-108 alkphos-66 totbili-0.1 08:20am blood esr-30* 04:34am blood pt-11.1 ptt-32.9 discharge labs: 07:10am blood wbc-6.7 rbc-3.43* hgb-10.1* hct-34.0* mcv-99* mch-29.6 mchc-29.8* rdw-16.3* plt ct-193 07:10am blood glucose-96 urean-33* creat-2.7* na-134 k-3.9 cl-97 hco3-29 angap-12 07:10am blood calcium-8.6 phos-3.8 mg-1.9 cxr (): no evidence of acute disease. cxr (): new right internal jugular central venous catheter terminates at the expected junction of the superior vena cava and right atrium, with no evidence of pneumothorax. there is otherwise no relevant change in the appearance of the chest since the recent study performed a few hours earlier. blood culture blood culture, routine-pending inpatient catheter tip-iv wound culture-pending inpatient urine urine culture-final inpatient blood culture blood culture, routine-pending inpatient mrsa screen mrsa screen-final {positive for methicillin resistant staph aureus} inpatient blood culture blood culture, routine-preliminary {staph aureus coag +}; anaerobic bottle gram stain-final; aerobic bottle gram stain-final emergency blood culture blood culture, routine-preliminary {staph aureus coag +}; anaerobic bottle gram stain-final; aerobic bottle gram stain-final emergency blood culture blood culture, routine-preliminary {staph aureus coag +}; anaerobic bottle gram stain-final; aerobic bottle gram stain-final tee (): no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. overall left ventricular systolic function is normal (lvef>55%). the right ventricular cavity is dilated the aortic valve leaflets (3) are mildly thickened. no masses or vegetations are seen on the aortic valve. no aortic valve abscess is seen. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. no mass or vegetation is seen on the mitral valve. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. no vegetation/mass is seen on the pulmonic valve. there is no pericardial effusion. impression: no echocardiographic evidence of endocarditis. preserved left ventricular function. dilated right ventricle. mild-to-moderate tricuspid regurgitation. unilat up ext veins us (): impression: no evidence of dvt in left upper extremity veins. brief hospital course: 65 year old male with type 2 dm, lung disease on 2l home o2, and esrd (recently started on hd in ) who presents with fever and chills at dialysis complicated by hypotension. # hd line associated gpc septicemia. he was admitted to the micu with norepinephrine gtt requirement which was weaned off within 24 hours on . he was empirically covered with vancomycin and meropenem which was narrowed to vancomycin once blood cultures grew gpc. hd line was removed on . right ij line which was placed on was also removed on . he underwent placement of a new right-sided tunneled ij hd catheter on . he underwent tte for evaluation of the presence of endocarditis, which was non-diagnostic. subsequently, he underwent tee, which did not show any evidence of vavular vegitations or abscesses. blood cultures speciated to mrsa, and he was treated with vancomycin for a total course of 4 weeks (through ). as an outpatient, this will be dosed via hd protocol, and will be managed by his nephrologist. while on antibiotics, should have weekly cbc, lft's, and blood chemistries for the next 3 weeks, or until instructed to stop by pcp or renal doctors. # htn/dchf/right heart failure (ef>55%): held metoprolol while hypotensive, but continued aspirin 81 mg daily. restarted metoprolol at 25 mg on . blood pressures were well controlled after restarting this medication. # rheumatoid arthritis: no active issues on this admisison. hydroxychroloquine was continued. # hx pulmonary embolism on coumadin: emailed dr. and told her we aren't bridging coumadin and ask if she objects for any reason - she does not know pmh and could not get records. pt says only had pe once many years ago. pcp ok with discontinuing coumadin. # esrd: recieved most of dialysis session prior to micu transfer. electrolytes remained stable. following the removal of his infected hd line, he was given an hd holiday. with placement of a new hd line, hd was reinitiated. upon discharge he was restarted on his normal hd schedule on m/w/f. next session will be . # copd: goal sao2 is 90-92%. continued on home fluticasone, albuterol standing and tiotropium. he was maintained on his home oxygen requirement and bipap at night. # ekg changes: has baseline right bundle branch block, but did have deeper st segments in anterolateral distribution in the setting of hypotension and tachycardia. likely rate related changes vs lead placement. patient denied any current chest pain, pressure, nausea/vomiting. ekg similar to priors upon lead change. ce stable. no further action necessary. # contact dermatitis: noted following exposure to chloraprep and/or betadine. these medications were added as allergies on his record. follow-up with allergy as an outpatient to further explore this issue is being arranged by care connections. # hypophosphatemia: resolved. stopped sevelamer on this admission. phosphate management per renal as outpatient. # bipolar disorder/schizoaffective disorder: no signs or symptoms of psychosis. continued his home divalproex, oxcarbazepine, and risperdone and clinically trend mental status. # diabetes mellitus ii: sugars were well controlled on this admission. he was maintained on a humalog sliding scale. he was discharged on the same. # obesity hypoventilation syndrome and osa: maintained on bipap at night. transitional issues: -please resume hd on monday/wednesday/friday schedule. next session . -needs vancomycin, dosed via hd protocol, through . -please check weekly cbc, lft's, and blood chemistries for the next 3 weeks, or until instructed to stop by pcp or renal doctors. -please only use hypoallergenic occlusive dressings with iv therapy, and please avoid the use of chloraprep and betadyne. -needs evaluation by allergy to determine if he is allergic to betadine and/or chlorhexidine. medications on admission: . information was obtained from . 1. aspirin 81 mg po daily 2. calcitriol 0.25 mcg po daily 3. divalproex (delayed release) 250 mg po qam 4. divalproex (delayed release) 500 mg po qpm 5. docusate sodium 100 mg po bid 6. metoprolol tartrate 25 mg po bid 7. vitamin d 1000 unit po daily 8. calcium carbonate 1250 mg po tid 9. fluticasone propionate 110mcg 2 puff ih 10. tiotropium bromide 1 cap ih daily 11. hydroxychloroquine sulfate 400 mg po bid 12. risperidone 2.5 mg po hs 13. tamsulosin 0.4 mg po hs 14. oxcarbazepine 300 mg po bid 15. sevelamer carbonate 1600 mg po tid w/meals 16. warfarin 3 mg po daily16 17. albuterol inhaler 1 puff ih q6h:prn wheezing discharge medications: 1. aspirin 81 mg po daily 2. calcitriol 0.25 mcg po daily 3. divalproex (delayed release) 250 mg po qam 4. divalproex (delayed release) 500 mg po qpm 5. docusate sodium 100 mg po bid 6. fluticasone propionate 110mcg 2 puff ih 7. hydroxychloroquine sulfate 400 mg po bid 8. oxcarbazepine 300 mg po bid 9. tiotropium bromide 1 cap ih daily 10. calcium carbonate 1250 mg po tid 11. tamsulosin 0.4 mg po hs 12. vitamin d 1000 unit po daily 13. vancomycin 0 mg iv hd protocol 14. insulin sc sliding scale fingerstick qachs insulin sc sliding scale using hum insulin 15. metoprolol tartrate 25 mg po bid 16. risperidone 2 mg po hs 17. albuterol inhaler 2 puff ih :prn wheezing 18. ascorbic acid 500 mg po bid 19. lactulose 15 ml po bid:prn constipation 20. vitabee/c *nf* (b-complex with vitamin c) 1 tab oral daily 21. vitamin d 400 unit po daily discharge disposition: extended care facility: - discharge diagnosis: primary: methacillin resistant staph aureus septicemia hemodialysis catheter infection secondary: end stage renal disease chronic obstrictive pulmonary disease hypertension bipolar disorder diastolic congestive heart failure discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear mr. , you were recently admitted to for treatment of fevers and chills. while you were hospitalized, you were found to have bacteria in your blood, likely from your dialysis catheter. your infected dialysis catheter was removed, and you were treated with antibiotics. a new dialysis catheter was placed, and you were restarted on hemodialysis. during your hospitalization, you developed low blood pressure, requiring a brief stay in the medical icu. the cause of this low blood pressure was likely the infection in your blood. during your icu stay, you were on medications to treat your low blood pressure, and you improved. those medications were stopped, and you were transferred to the normal medical floor. when you leave the hospital, you will need to continue to have hemodialysis, per your normal routine. you will also need to continue to receive iv antibiotics through . this will be managed by your kidney doctors. also, while you were hospitalized, it was observed that you developed a rash following exposure to products used to clean your skin, including betadine and chloraprep. please consider this an allergic reaction, and avoid exposure to these cleaning agents in the future. weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: department: radiology when: wednesday at 11:00 am building: gz building (/ complex) campus: east best parking: main garage department: div of gi and endocrine when: wednesday at 1 pm with: , md building: ra (/ complex) campus: east best parking: main garage department: pulmonary function lab when: thursday at 4:10 pm with: pulmonary function lab building: campus: east best parking: garage we are working on a follow up appointment in allergy and inflammation. it is recommended you be seen within 2 weeks of discharge. the office will contact you at home with an appointment. if you have not heard within 2 business days please call the office at . procedure: diagnostic ultrasound of heart hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis diagnoses: anemia in chronic kidney disease end stage renal disease obstructive sleep apnea (adult)(pediatric) renal dialysis status congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease bacteremia disorders of phosphorus metabolism long-term (current) use of anticoagulants rheumatoid arthritis kidney dialysis as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site bipolar disorder, unspecified atherosclerosis of native arteries of the extremities, unspecified diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled chronic diastolic heart failure schizoaffective disorder, unspecified other dependence on machines, supplemental oxygen personal history of pulmonary embolism bloodstream infection due to central venous catheter obesity hypoventilation syndrome contact dermatitis and other eczema due to drugs and medicines in contact with skin local anti-infectives and anti-inflammatory drugs causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to