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 / sulfa (sulfonamides) / aspirin / heparin agents attending: chief complaint: transfer from for infectious disease and neurosurgical evaluation of epidural abscess with mrsa major surgical or invasive procedure: multiple vac dressing changes in the operating /204: "incision and drainage of postoperative wound which was treated elsewhere." :"incision and drainage of the osteomyelitis, incision and drainage of the postoperative wound, and exchange nailing using synthes, subtrochanteric nail." : closure of wound with irrigation and drainage history of present illness: this is an 87 y.o. female s/p right hip orif in who presented to on after her daughter tripped on her and she fell, sustaining a left hip fracture. she underwent a left hip orif on . (she was anticoagulated with coumadin given a heparin allergy). her hospital course was complicated by a temp spike to 101 on with 2/4 bottles + for mrsa. (per her family she had been febrile for several weeks prior). a tee on was (-) for sbe and a picc line was placed for 6 weeks of vancomycin. surveillance cx on grew mrsa and the picc line was d/c'd. on surveillance cultures were (-) and another picc line was placed. on the same day the patient complained of back pain and a ct t-l spine demonstrated multiple compression fractures and an mri on demonstrated l2-3 diskitis and a small epidural abscess (w/o evidence of cord compression). she was transferred to on for neurosurgical and infectious disease evaluation. past medical history: 1) hypertension 2) gerd 3) cva (residual short-term memory loss and diminished vision b/l) 4) right hip fracture s/p orif by dr. in 5) hypothyroidism 6) asthma social history: no tob/etoh. independent prior to 1st hip fracture. close with daughters (healthcare proxy) and . family history: non-contributory physical exam: t:99.3, bp:140/70, hr:102, rr:22, o2:99% 2l gen: nad. a/o x 3 heent: small ulcer on hard palate. no lad, supple neck cv: ii/vi sm at rusb pulm: cta b/l. abd: s/nt/nd ext:swollen left le with ttp. trace pt. erythematous papules in diaper area, under breasts, eythema at right picc line site. neuro: cn ii-xii gi. maew. sensation gi pertinent results: wbc:12.3 hct:31.5 plt:636 na:132 k:3.4 cl:91 hco3:31.6 bun:9 cr:0.7 gluc:91 ca:8.2 cxr: picc line well positioned w/o chf/infiltrates mri: l2-3 diskitis, possible small epidural abscess, no cord compression brief hospital course: the patient had a long and complicated hospital course as follows by issue: 1) id:(id service-- --following) (also see ortho below) she spiked a temp to 101 on and blood cx drew mrsa and vancomycin was started. - repeat cx no growth - no growth, picc line placed. tte negative spiked temp and cultures at that time grew mrsa continued to be febrile -- picc line d/c'd (picc tip cx grew staph coag negative not mrsa), gent added for synergy (duration 4 days) abdominal ct negative for abscess tee negative for evidence of endocarditis surveillence cultures negative lost iv access therefore no iv abx for 2 days -- spiked temp, surviellence cx negative picc placed, then cx from mrsa pt c/o back pain, plain films negative, rifampin added, esr 66 underwent mri l2-l3 diskitis, small epidural abcess, no cord compression when initially evaluated by id the following recommendations were made: -dose of vanco (begun on ) was changed to with trough checks q72 hours -rifampin (begun on ) was continued with lft checks qweek. and : left knee was tapped with no growth : repeat mri with l2-3 epidural abscess without cord compression : vanco changed to q8 hours : ortho hardware removal with deep tissue (from hip) culture + for enterobacter resistant to all organisms save meropenem, bactrim and cefepime. given possibility of inducible resistance, meropenem begun after desensitization in the micu (given h/o cefepime allergy) : spiked to 102.4 on . cxr with ? lll infiltrate : left hip hardware exchange performed with i+d. : given persistent low-grade fevers and +yeast in tissue cx and urine, started fluconazole on . d/c antibiotic plan as follows: -vanco/rifampin until for treatment of epidural abscess and left hip, then po doxycycline 100 po bid indefinitely (given sensitivity of mrsa and enterobacter to doxycycline) -meropenem for enterobacter soft issue infectionuntil -fluconazole until -lfts, cbc and chem-7 followed at rehab -f/u with in clinic in 2) epidural abcess dr (neurology) consulted. he advised medical management, neurologically intact. : incontinence of stool, ? decreased rectal tone therefore repeated mri ---> stable epidural abcess, no cord compression 3) ortho: intertrochanteric fx of left hip s/p orif ortho following (dr. . : knee tap negative for septic joint : ct guided aspiration of left hip -- cx ngtd : ortho took to or and removed hardware, took cx from hip tissue and placed new hardware as joint unstable ++ enterobacter : increased pain in left knee, lenis negative (except could not visualize popliteal), ortho retapped knee, cx ntd. leni (repeated given lle edema) (-). to or to replace hardware. gross drainage of pus. ***post-op with sbp in 80s w/o tachycardia, bolused with 1l ns with normalization of pressure. o2 sat remained>92% on ra. urine output was minimal but slowly picked up (to ~20-25cc/hour) with boluses and lasix (thought to be atn) >>to or for sterile vac dsg change >>to or for sterile vac dsg change >>to or for sterile vac dsg change >> wound closed with 2 jp drains placed on with plans for aggressive rehab with pwb on lle. >>jp drain #2 pulled after no output x 24 hours. >>per ortho recs, the remaining jp drain should be pulled (one suture in place) after no output for 24 hours. patient will follow-up with dr. in 3 weeks. 4. heparin allergy -consulted allergy --> no heparin products. 5. svt/ a tach -- occasional burst of svt in 160s w/o sx, evaluated by ep on and recommended metoprolol. underwent cta (given not adequately anticoagulated -- use of coumadin and possible surgery) but negative for pe. 6. atn (by muddy brown cast on ) and oliguria s/p surgeries on and in the setting of transient hypotension. -- at dischargee resolved with crcl >80. 7. ?cad see svt above. ef by echo on was 75%. 8. anticoag: given heparin allergy, she was placed on coumadin with inr goal of 1.5-2.0. 9. code status/goals of care: discussed with daughter (hcp) on . . changed to dnr/dni status on . she would, however, want pressors and all other aggressive measures short of defibrillation and intubation. she provided us with the health care proxy form indicating that her daughter will make all decisions for her should she not be able to make decisions for herself. she values her function and would want all measures that would allow a reasonable chance of retaining her physical and mental function. she found comfort in prayer. medications on admission: (medications on transfer from to ) vanco 1.5 qd, rifampin 300 , lumigan eye gtts, advair, lexapro, protonix, norvasc 2.5, fosamax qweek, coumadin 3, tylenol, oxycodone prn discharge medications: 1. doxycycline hyclate 100 mg capsule sig: one (1) capsule po twice a day: start on . 2. outpatient lab work lfts, cbc, chem-7 qweek 3. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. escitalopram oxalate 10 mg tablet sig: one (1) tablet po qd (once a day). 5. fluticasone propionate 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 6. bimatoprost 0.03 % drops sig: one (1) drop ophthalmic qd (). 7. rifampin 300 mg capsule sig: one (1) capsule po q12h (every 12 hours) for 2 weeks: last dose on please follow lfts qweek. 8. alendronate sodium 70 mg tablet sig: one (1) tablet po qwed (every wednesday). 9. folic acid 1 mg tablet sig: one (1) tablet po qd (once a day). 10. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po tid (3 times a day). 11. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). 12. oxycodone hcl 5 mg tablet sig: one (1) tablet po q6h (every 6 hours). 13. ipratropium bromide 0.02 % solution sig: one (1) nebulizer treatment inhalation q6h (every 6 hours) as needed. 14. albuterol sulfate 0.083 % solution sig: one (1) nebulizer treatment inhalation q6h (every 6 hours) as needed. 15. levothyroxine sodium 175 mcg tablet sig: one (1) tablet po qd (once a day). 16. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 17. hydralazine hcl 10 mg tablet sig: one (1) tablet po q6h (every 6 hours). 18. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 19. fluconazole 200 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 1 days: last dose on . 20. furosemide 20 mg tablet sig: one (1) tablet po qd (once a day). 21. multivitamin capsule sig: one (1) cap po qd (once a day). 22. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed. 23. potassium & sodium phosphates mg packet sig: one (1) packet po bid (2 times a day). 24. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed. 25. magnesium oxide 400 mg tablet sig: one (1) tablet po qd (once a day). 26. warfarin sodium 2 mg tablet sig: two (2) tablet po hs (at bedtime): titrate to inr 1.5-2.0 for dvt prophylaxis given heparin allergy. 27. morphine sulfate 1-3 mg iv q4h:prn hold for sedation, or rr <12 28. meropenem 1 g recon soln sig: one (1) gram intravenous three times a day for 2 weeks: last dose on . 29. vancomycin hcl 1,000 mg recon soln sig: one (1) gram intravenous once a day for 2 weeks: last dose on . discharge disposition: extended care facility: rehab unit at - discharge diagnosis: congestive heart failure right hip fracture s/p orif left hip fracture s/p orif and hardware exchanges hypertension hypothyroidism discharge condition: stable discharge instructions: please notify your or doctors of chest , shortness of breath, palpitations, swelling, weakness, numbness, fevers, chills, dysuria, constipation, diarrhea, rashes or any other symptoms of concern. you will take meropenem until and then begin taking doxycycline. please follow-up (see below) with dr. . notify your doctors of weight gain (>3 pounds). limit fluid intake to less than 1.5 l per day and salt intake to less than 2g/day. followup instructions: provider: , md where: lm disease phone: date/time: 11:30 please call , md (orthopedics) to be seen in 2 weeks phone: md procedure: venous catheterization, not elsewhere classified closure of skin and subcutaneous tissue of other sites transfusion of packed cells other irrigation of wound other irrigation of wound other immobilization, pressure, and attention to wound other immobilization, pressure, and attention to wound other immobilization, pressure, and attention to wound other immobilization, pressure, and attention to wound other arthrotomy, hip other arthrotomy, hip other arthrotomy, hip revision of hip replacement, not otherwise specified revision of hip replacement, not otherwise specified diagnoses: acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified acute posthemorrhagic anemia hyposmolality and/or hyponatremia other specified conduction disorders bacteremia intraspinal abscess infection and inflammatory reaction due to internal joint prosthesis 

Answer: The patient is high likely exposed to