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: penicillins / norvasc / nifedipine / atenolol / codeine attending: chief complaint: presented with cervical spondylosis and disc degeneration who presented for an elective anterior cervical diskectomy c4-c5, c5-c6 and c6-c7 and fusion c4-c7 . major surgical or invasive procedure: anterior cervical diskectomy c4-c5, c5-c6 and c6-c7 fusion c4-c7 . history of present illness: 68 yo male with cervical spondylosis and disc degeneration for elective anterior cervical diskectomy c4-c5, c5-c6 and c6-c7 and fusion c4-c7 . . pt increasingly agitated and placed on ciwa scale as there was concern for etoh withdrawal. ciwa >20 early am. he received total 8 mg ativan since midnight and 17 mg haldol. pt gradually more stridorous, sat 96-98% on rebreather. ent at bedside 2pm and examined pt airway (significant obstruction of airway by posterior pharyngeal wall and notable edema). code blue called, anesthesia fiberoptically intubated pt orally. pt sats maintained and hd stable. pt subsequently transferred to sicu for further care. . in the sicu: the patient was started on a ciwa scale, and intermittant ativan, in addition to decadron. over the following days, the decadron was tapered as was his sedation. a cta of his neck demonstrated no acute changes and resolving pharygeal edema. he was extubated on , taken off the steroids. despite discontinuing the steroids, the patient continues to have a significant leukocytosis, was febrile and, as a result, was placed on vanc/cipro with cultures taken of blood, urine and wound. cipro and vanc were started on the 19th. past medical history: pmh: - cervical spondylosis and diskdegeneration. - osa not on cpap. - h/o partial empty sella syndrome. - htn - dyslipidemia - seasonal asthma - left sided cva years ago (right sided arm weakness) - migraines - back pain - l5-s1 disc disease - hypothyroidism - colitis (hospitalized with ischemic colitis), - h/o liver biopsy related to h/o - hemochromatosis - h/o feeling cold "chattering" teeth, muscle/joint aches x 30 years (he has been followed by dr. - retinal detachment . psh: - carpal tunnel repair 20 yr ago - liver bx - left shoulder arthroscopic subacromial decompression. - arthroscopic rotator cuff repair. - anterior cervical diskectomy c4-c5, c5-c6 and c6-c7. fusion c4-c7. anterior instrumentation c4-c7. structural allograft. social history: social history: the patient is married, a nonsmoker. drinks one 6-pack of beer per week. has 2 cups of coffee a day. currently works part time. family history: family history: his mother died from complications from a cerebrovascular accident. his father died from "old age." he has a sister with diabetes, another sister with ms, and a 62- year-old brother who died from a myocardial infarction. physical exam: vs: 99.5//88/20/97%ra general: this is a male nad. on exam, he was nontoxic appearing. neuro: patient's speech is intermitantly garbled, and nonsensical, but resolves when he makes a point of speaking more slowlly. heent: eomi, perrl with 1mm difference in pupil diameter. nc/at sclera anicteric. clear op, trachea midline. neck supple, with surgical scar sutured and c/d/i. pulmonary: symmetric, good expansion. breath sounds ctab. no rales/ wheezes/rhonchi. cardiac: rrr, normal s1, s2. no r/g, systolic ejection murmur heard at the apex, harsh in character. abd: + bs, soft, nt/nd ext: rue area of cellulitis, and area of drainage form right anticubital fossa wound, with mild induration. skin: no rash/petechiae/ecchymoses. pertinent results: 09:10am blood wbc-6.9 rbc-3.27* hgb-10.1* hct-30.0* mcv-92 mch-31.0 mchc-33.7 rdw-14.0 plt ct-335 12:15pm blood hct-32.3* 06:20am blood wbc-8.2 rbc-3.12* hgb-10.0* hct-29.0* mcv-93 mch-32.2* mchc-34.6 rdw-13.8 plt ct-348 09:30am blood wbc-10.1 rbc-3.58* hgb-11.3* hct-33.2* mcv-93 mch-31.4 mchc-34.0 rdw-14.1 plt ct-377 05:50am blood wbc-11.2* rbc-3.82* hgb-11.9* hct-34.8* mcv-91 mch-31.1 mchc-34.1 rdw-14.0 plt ct-375 . 09:30am blood neuts-79.0* lymphs-16.2* monos-3.4 eos-1.1 baso-0.2 07:30am blood neuts-83.2* lymphs-10.4* monos-4.8 eos-1.5 baso-0.1 01:36am blood neuts-85.4* lymphs-7.3* monos-5.4 eos-1.7 baso-0.1 04:20am blood neuts-92.9* lymphs-4.9* monos-2.0 eos-0.1 baso-0 11:20am blood neuts-89.1* lymphs-7.1* monos-3.6 eos-0 baso-0.1 . 09:10am blood glucose-160* urean-19 creat-1.6* na-134 k-4.3 cl-103 hco3-25 angap-10 06:20am blood glucose-90 urean-23* creat-1.8* na-139 k-3.8 cl-104 hco3-23 angap-16 03:10pm blood glucose-115* urean-29* creat-2.3* na-137 k-4.3 cl-105 hco3-24 angap-12 09:30am blood glucose-118* urean-26* creat-2.3* na-138 k-4.4 cl-105 hco3-22 angap-15 12:15pm blood glucose-107* urean-22* creat-2.0* na-136 k-3.8 cl-101 hco3-24 angap-15 05:50am blood glucose-110* urean-19 creat-1.4* na-136 k-3.7 cl-100 hco3-27 angap-13 06:45am blood glucose-98 urean-12 creat-0.9 na-134 k-3.2* cl-97 hco3-26 angap-14 06:30am blood glucose-100 urean-12 creat-0.9 na-136 k-3.4 cl-100 hco3-26 angap-13 07:30am blood glucose-100 urean-16 creat-0.9 na-137 k-3.4 cl-100 hco3-26 angap-14 . 04:20am blood ck(cpk)-315* 02:26pm blood alt-26 ast-45* ck(cpk)-696* 11:20am blood ck(cpk)-689* 04:20am blood ck-mb-4 ctropnt-<0.01 09:10am blood calcium-8.4 phos-3.2 mg-1.9 06:20am blood calcium-8.4 phos-3.4 mg-2.0 03:10pm blood calcium-8.5 phos-3.5 mg-2.2 09:30am blood calcium-8.3* phos-3.7 mg-2.2 12:15pm blood calcium-8.8 phos-4.4# mg-2.2 . wound culture (final ): staph aureus coag +. moderate growth. staphylococcus species may develop resistance during prolonged therapy with quinolones. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. testing of repeat isolates may be warranted. beta streptococcus group b. moderate growth. . sensitivities: mic expressed in mcg/ml . _________________________________________________________ staph aureus coag + | clindamycin-----------<=0.25 s erythromycin----------<=0.25 s gentamicin------------ <=0.5 s levofloxacin---------- 0.25 s oxacillin------------- 0.5 s trimethoprim/sulfa---- <=0.5 s . anaerobic culture (final ): no anaerobes isolated. . 9:03 am urine source: catheter. . **final report ** . urine culture (final ): escherichia coli. >100,000 organisms/ml.. presumptive identification. . sensitivities: mic expressed in mcg/ml . _________________________________________________________ escherichia coli | ampicillin------------ <=2 s ampicillin/sulbactam-- <=2 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 4 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s nitrofurantoin-------- <=16 s piperacillin---------- <=4 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s . 09:03am urine rbc->50 wbc->50 bacteri-many yeast-none epi-0 08:24am urine blood-mod nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-7.0 leuks-neg 09:03am urine blood-lg nitrite-neg protein-30 glucose-neg ketone-tr bilirub-neg urobiln-1 ph-5.0 leuks-sm 06:39am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg brief hospital course: 68 yo male with cervical spondylosis and disc degeneration for elective anterior cervical diskectomy c4-c5, c5-c6 and c6-c7 and fusion c4-c7 . the immediate post-op course was complicated by pharygeal edema and respiratory distress, for which the patient was intubated and sent to the surgical icu. in the sicu: the patient was started on a ciwa scale, and intermittant ativan, in addition to decadron. over the following days, the decadron was tapered as was his sedation. a cta of his neck demonstrated no acute changes and resolving pharygeal edema. he was extubated on , taken off the steroids. despite discontinuing the steroids, the patient continues to have a significant leukocytosis, was febrile and, as a result, was placed on vanc/cipro with cultures taken of blood, urine and wound. cipro and vanc were started on the 19th. . on the floor the patient had the following problems and plans: . # fall in the contect of recent laminectomy: the patient had had fluctuating mental status, exacerbated at night and had a fall with head strike and no loss of consciousness. the subsequent head ct without contrast and xr of the neck demonstrated no ich/midline shift or broken or displaced bones. his infections were treated and a bedalarm was placed to better monitor his movements. we attempted to provide patient with a soft collar, which he refused. pt/ot screened the patient for rehab and worked with him while an inpatient. . # ams: the patient has a difficult time speaking clearly, and is intermittantly confused her his wife's report - these symptoms are resolving. the ams/difficulty speaking may be due to resolving pharygeal edema, infection or may be associated with previous sedation. the primary team re-oriented him each morning, and followed his neuro exam. in addition, we treated his uti and soft tissue infections. his mental status has greatly improved and he is currently a+ox3 at all times. . #arf: the patient developed a rising creatine from 0.9 to 2.0 in the setting of starting bactrim. his cr. now 1.6 represents improvement in the setting of changing from bactrim to levoflox and ivf supportive therapy. . # infectious disease - uti and soft tissue infection: fever 102 with a leukocytosis of wbc 16 started vancomycin and cipro . urine culture now positive for ecoli (sensitive to cipro and bactrim) and his skin infections positive for mssa (sensitive to keflex and bactrim). we administered bactrim initially, which was then transitioned to levoflox for a 7 day course stated on . . # inability to swallow: likely due to pharyngeal edema, though may have had a hypoxic damage during initial intubation. follow speach and swallow recommendations: observed meals of pureed foods. . #htn: place on home medications (lisinopril, hctz, simvastatin, diltiazem, losartan). . # hypothyroid: cont. home dose of synthroid. medications on admission: medications at home: - cardizem - cozaar 100 mg daily - cymbalta - hctz - lisinopril 40 mg daily - oxycodone hydrochloride - synthroid - xanax prn - zocor 40 mg daily - other (testosterone daily) - mvi discharge medications: 1. testosterone 1 % (25 mg/2.5 g) gel in packet sig: one (1) appl transdermal daily (daily). 2. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 5 days. disp:*5 tablet(s)* refills:*0* 3. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. tablet(s) 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 5. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical tid (3 times a day) as needed. 6. polyethylene glycol 3350 100 % powder sig: one (1) po once a day as needed for constipation. 7. duloxetine 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 8. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 9. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 10. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal (2 times a day). 11. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 12. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 13. clonazepam 0.5 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for muscle spasm. 14. diltiazem hcl 90 mg tablet sig: one (1) tablet po qid (4 times a day). 15. insulin sliding scale please follow the attached protocol. discharge disposition: extended care facility: academy manor- discharge diagnosis: s/p laminectomy pharygeal edema respiratory distress uti soft tissue infection discharge condition: good discharge instructions: you presented to the hospital for an elective laminectomy, which was complicated by pharygeal edema and respiratory distress. you were intubated and treated with steroids, and recovered. while on the general floor you developed a urinary track infection and a soft tissue infection, for which you were treated with antibiotics. discharge instructions: if you experience any of the following, return to the emergency department. - fevers and chills - inability to use parts of your body. - worsening neck pain - weakness, dizziness or fainting - abdominal (belly) pain or vomiting - new or worsening weakness, numbness followup instructions: dr. office on with orthospine: - , at 11:30am - at 10:30am pcp: provider: , md phone: date/time: 10:30 md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube enteral infusion of concentrated nutritional substances other cervical fusion of the anterior column, anterior technique excision of intervertebral disc fusion or refusion of 2-3 vertebrae diagnoses: obstructive sleep apnea (adult)(pediatric) urinary tract infection, site not specified acute kidney failure, unspecified other pulmonary insufficiency, not elsewhere classified unspecified acquired hypothyroidism unspecified fall other and unspecified hyperlipidemia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site blood in stool other late effects of cerebrovascular disease cellulitis and abscess of upper arm and forearm infection and inflammatory reaction due to other vascular device, implant, and graft hypovolemia phlebitis and thrombophlebitis of superficial veins of upper extremities accidents occurring in residential institution sulfonamides causing adverse effects in therapeutic use alcohol withdrawal other disorders of muscle, ligament, and fascia cervical spondylosis without myelopathy edema of pharynx or nasopharynx benign essential hypertension degeneration of cervical intervertebral disc 

Answer: The patient is high likely exposed to