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: patient recorded as having no known allergies to drugs attending: chief complaint: sepsis major surgical or invasive procedure: none history of present illness: 45m h/o remote mrsa abscess transferred here with sepsis after suffering complications of perforated appy. initially presented to presented to on with perforated appendicitis where he underwent lap appendectomy complicated by abscess which was later drained by ir on at . he was also treated with antibiotics. . two weeks ago, he was rescanned with evidence of a 6 x 3.3 cm abscess in the rlq. a residual collection was identified and drained again. he was admitted for sepsis and treated with another course of antibiotics, discharged on 2 weeks of augmentin. he had been feeling well, tolerating pos, and without nausea, vomiting, or abdominal pain. . yesterday at 1pm, he was scheduled for a repeat interval ct scan which was apparently reassuring but was not officially read. he returned home, however, and began having chills, mild transient chest pain, nausea and anxiety for which he returned to hospital. . at the outside hospital, he was found to be hypotensive to sbp of 70s and tachycardic to 160s. he was started on a norepinephrine drip with improvement in sbp to 110s. transported by helicopter to ed. . in the ed, vitals tm/tc 104/101 rectally, 115/68, 88, 12, 95% ra. labs notable for wbc 24.7 with 23% bands, lactate 1.8, hco3 19, normal lfts, inr 1.4, ck 133, ckmb 13 (index 9.8), tnt 0.29. u/a negative, blood and urine cultures sent. ecg with twf ii, twi iii. ct abd/pelvis with inflammation about appy site but no drainable fluid collection and no free air. central venous line placed, continued on levophed. given vanco, levoflox, ceftriaxone, flagyl. surgery consulted and based on imaging and benign abdomen, recommended non-surgical management at present. cardiology was called and thought this was demand ischemia. he was admitted to micu for sepsis. . ros: denies pain. he denies fever, and has had diarrhea (2-3x/day) which he relates to being on antibiotics. while he was off antibiotics, his diarrhea resolved. denies dyspnea, orthopnea, pnd. able to walk independently. past medical history: h/o mrsa abscess on arm () s/p appy c/b abscess, s/p ir drainage x 2 social history: works for furniture warehouse. ppd smoker from age 18-present. denies etoh. family history: father died of a "blood clot" after a traumatic injury, mother healthy, 3 sibs healthy, 3 children healthy. no family history of ibd. physical exam: on admission to the micu, exam: t 98.4 hr 88 bp 129/67 rr 21 sao2 98% ra general: ill appearing, speaks in full sentences, tearful at times, breathing comfortably on ra heent: perrl, eomi, anicteric sclera, conjunctivae pink, very dry mucous membranes neck: supple, trachea midline, no thyromegaly or masses, no lad, right ij in place c/d/i cardiac: rrr, s1s2 normal, no m/r/g, no jvd pulmonary: ctab anterior back: patient declines back exam abdomen: +bs, soft, nontender, nondistended, no hsm, well-healed laproscopic scars extremities: warm, 1+ dp pulses bilaterally, no edema neuro: a&ox3, speech clear and logical, cnii-xii intact, moves all extremities rectal: guaiac negative in the ed . on discharge: vs t 98.3, bp 128/76, hr 84, rr 20, 94% ra pt was well-appearing, mmm, abdomen benign, otherwise unchanged. pertinent results: labs : 10:20pm blood wbc-24.7* rbc-4.21* hgb-11.5* hct-33.9* mcv-81* mch-27.4 mchc-34.0 rdw-16.4* plt ct-644* 10:20pm blood neuts-70 bands-23* lymphs-2* monos-3 eos-0 baso-0 atyps-0 metas-2* myelos-0 10:20pm blood pt-16.0* ptt-33.5 inr(pt)-1.4* 10:20pm blood glucose-193* urean-9 creat-1.2 na-135 k-4.2 cl-108 hco3-19* angap-12 10:20pm blood alt-11 ast-14 ck(cpk)-133 alkphos-61 totbili-0.5 10:20pm blood lipase-20 10:20pm blood ck-mb-13* mb indx-9.8* 10:20pm blood ctropnt-0.29* 10:20pm blood cortsol-27.9* 11:01pm blood lactate-1.8 10:20pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg 10:20pm urine color-yellow appear-clear sp -1.036* . labs : 05:45am blood wbc-22.6* rbc-4.18* hgb-11.2* hct-34.4* mcv-82 mch-26.7* mchc-32.4 rdw-15.4 plt ct-596* 05:45am blood ck-mb-14* mb indx-13.3* ctropnt-0.27* 11:41am blood ck-mb-notdone ctropnt-0.18* 05:45am blood albumin-2.1* calcium-7.0* phos-2.6* mg-2.6 cholest-73 05:45am blood triglyc-93 hdl-11 chol/hd-6.6 ldlcalc-43 12:14am blood lactate-1.8 11:41am blood crp-120.1* . labs : 04:10am blood wbc-11.5* rbc-4.03* hgb-10.8* hct-32.5* mcv-81* mch-26.8* mchc-33.2 rdw-15.0 plt ct-391 04:10am blood neuts-51 bands-3 lymphs-8* monos-5 eos-32* baso-1 atyps-0 metas-0 myelos-0 04:10am blood glucose-84 urean-5* creat-1.0 na-139 k-4.1 cl-109* hco3-24 angap-10 . labs : 05:31am blood wbc-11.3* rbc-4.15* hgb-10.9* hct-34.0* mcv-82 mch-26.3* mchc-32.1 rdw-15.3 plt ct-409 05:31am blood neuts-31* bands-1 lymphs-26 monos-4 eos-38* baso-0 atyps-0 metas-0 myelos-0 07:50am blood wbc-11.8* rbc-4.39* hgb-11.5* hct-35.6* mcv-81* mch-26.2* mchc-32.3 rdw-15.4 plt ct-428 07:50am blood neuts-44.6* bands-0 lymphs-17.1* monos-2.1 eos-36.0* baso-0.2 . cultures: blood cultures: no growth to date urine cultures: final no growth stool: c. diff negative stool: c. diff negative stool: c. diff negative ct abdomen and pelvis (iv contrast): there are small bilateral pleural effusions with associated atelectasis. atelectasis within the lingula is additionally noted. an amorphous area low attenuation is identified within segment ivb of the liver. the liver is otherwise unremarkable. the gallbladder, spleen, pancreas, adrenal glands, and left kidney appear within normal limits. the kidneys enhance symmetrically and excrete contrast normally. a 3-cm low- attenuation lesion at the lower pole of the right kidney is consistent with a simple cyst. diffuse atherosclerotic disease of the infrarenal abdominal aorta is evident. there is thickening of the cecum and significant pericecal stranding of mesenteric fat. surgical clips at the site of appendectomy are noted. no evidence of abscess or loculated fluid. a small amount of free fluid in this area, which also tracks down into the pelvis is seen. although the distal ileum is not well distended with oral contrast, there is a suggestion of bowel wall thickening/edema and stranding of the surrounding mesenteric fat. no organized fluid collection is evident, however. there is no evidence of bowel obstruction as contrast has passed through to the rectum. there is no free air within the abdomen. although the colon is not distended, there is a suggestion of diffuse colonic wall thickening. . ct of the pelvis with iv contrast: the rectum, sigmoid colon, intrapelvic loops of small bowel are unremarkable. a foley balloon is present within a decompressed bladder. a small amount of free fluid is evident within the pelvis. small, bilateral fat-containing inguinal hernias are evident. osseous structures: there are no suspicious lytic or blastic lesions. impression: 1. inflammatory process appears to be centered in the ileocecal area at the site of recent appendectomy. no organized or drainable intra-abdominal fluid collection. assessment is somewhat limited by lack of distal ileal distention with oral contrast. a small amount of free fluid and scattered subjacent lymph nodes are additionally evident. 2. equivocal diffuse colonic wall thickening. this finding raises the possibility of colitis and and infectious process such as c. difficile should be considered. 3. small bilateral pleural effusions with associated atelectasis. . echocardiogram : the left atrium and right atrium are normal in cavity size. no atrial septal defect is seen by 2d or color doppler. the estimated right atrial pressure is 0-5 mmhg. left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with focal akinesis of the basal inferolateral wall and hypokinesis of the basal half of the inferior wall. there is minimal hypokinesis of the remaining segments (lvef = 45 %). the estimated cardiac index is normal (>=2.5l/min/m2). tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. the pulmonary artery systolic pressure could not be determined. there is a trivial/physiologic pericardial effusion. impression: mild regional left ventricular systolic dysfunction c/w ischemia. left pleural effusion. . ecg : normal sinus rhythm with t-wave inversions in leads iii, avf . pending studies at time of discharge: final blood cultures from (no growth to date) stool cultures, o&p from brief hospital course: 1. sepsis: mr. was transferred from an outside hospital with hypotension, on levophed with an elevated wbc count of 22.6 on admission. the source of infection was not clear on admission and differential included infection from recurrent abscesses at appendectomy site or c. diff colitis. other etiology considered was reaction to ct contrast. was started on vanocmycin, zosyn and flagyl in the micu. he remained hemodynamically stable and afebrile and levophed was stopped on the day of transfer for map>65, svo2 72, cvp 6 and good urine output. ct showed inflammation prior appendectomy site without fluid collection. surgery was consulted and did not recommend surgery. gastroenterology was consulted and recommended 48 hours of iv antibiotics for presumed gi infection, then 3 weeks of po antibiotics. cultures were obtained on from hospital and showed no growth to date of blood or urine cultures. blood and urine cultures collected at showed no growth to date. c. diff x 3 were negative. the patient continued to do well and was trasnferred to the general medical floor on . he was continued on iv antibiotics and then changed to po antibiotics on . he was put on ciprofloxacin 500mg po bid and metronidazole 500mg po tid and was discharged with 16 more days of antibiotics. he will follow-up with his pcp 1 week. another possible etiology for his symptoms that was considered was anaphylaxis from po contrast from the ct scan, although this was less likely given that he has had po contrast in the past without problems. we recommended that he see an allergist as an outpatient to assess the possibility of an allergic reaction to po contrast. . 2. nstemi the patient was found to have elevated cardiac enzymes with a ck of 133, ckmb 19, troponin t 0.29 and t-wave inversions in leads iii and avl. cardiology was called and thought this was likely rate-related demand ischemia in the setting of tachycardia due to sepsis physiology. cardiac enzymes trended down and follow-up ecgs showed no change. the patient's tachycardia improved with iv fluids and antibiotics. he was asymptomatic during his admission. he was put on telemetry and had no events or arrythmias. an echocardiogram showed global reduced function, ef 45% and focal akinesis of basal inferior wall. aspirin 325mg po qday and metoprolol 12.5mg po bid were started for nstemi. cardiology did not recommend heparin or anti-platelet agents. cardiology recommended a follow-up echo and cardiologist appointment within 4 weeks after his acute illness had resolved. the patient will have this scheduled with his primary care doctor. he remained asymptomatic with no chest pain or signs of clinical heart failure. . 3. eosinophilia the patient's wbcs trended down from admission from 22.6 to 11.8. he had 23% bands on admission which resolved by discharge. his eosinophil count was 0 on admission, however on he had 32% eosinophils, on had 38% eosinophils, and on had 36% eosinophils. this corresponds to an absolute eosinophil count of 3680 on , 4294 on , and 4248 on . he had no signs of drug reaction, no fevers, skin rashes or other symptoms. his diarrhea had improved over the course of admission but was still having bowel movements per day. his stool was checked for c. diff and was negative x 3. ova and parasites and fecal stool cultures were pending at the time of discharge. it was recommended that he see an allergist for discussion and testing for reaction to po contrast from the ct scan. . 4. diarrhea most likely etiology is antibiotic-associated as the patient has been on antibiotics off and on for the past several weeks. his diarrhea was at times watery, but improved through admission and was described as loose stool at the time of discharge. clostridium difficile was checked x 3 and was negative. he was discharged with cipro and flagyl for his antibiotic regimen. he will follow-up with his pcp with any further problems. his final stool cultures are still pending at the time of discharge. . 5. anxiety the patient was anxious during his hospitalization regarding his medical condition and etiology of his sepsis. he was given ativan 0.5mg prn for anxiety symptoms. he was given trazodone 25mg po qhs to help with sleep. . 6. prophylaxis mr. was given sc heparin for dvt prophylaxis. he was able to tolerate a regular diet on . . his symptoms improved and he was discharged with close pcp and instructions to follow-up with cardiology as arranged by his pcp. was also recommended to see an allergist on discharge for follow-up of this episode as a potential reaction to po contrast from the ct scan. medications on admission: augmentin x 2 weeks (approx day 7) discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 2. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 16 days. disp:*48 tablet(s)* refills:*0* 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*0* 5. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 16 days. disp:*32 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: 1. sepsis secondary diagnosis: 2. non-st elevation mycardial infarction 3. eosinophilia discharge condition: afebrile, hemodynamically stable, good condition discharge instructions: you were admitted to the hospital with low blood pressure and septic shock after having a perforated appendicitis several weeks ago. all your blood cultures were negative. you were admitted to the intensive care unit and improved dramatically on antibiotics. you were initially put on intravenous antibiotics and these were changed to oral antibiotics after 72 hours. you experienced some chest pain and blood tests showed that was some damange to your heart which was likely from the low blood pressure. you had an echocardiogram which showed some reduced function of the heart. you should see a cardiologist as an outpatient as arranged by your primary care doctor and have another echocardiogram in 1 month to reassess your heart. you had a rise in your white blood cell count associated with the sepsis. your eosinophils, a type of white blood cell, was still elevated on discharge. you should have your blood checked in 1 week to assess your white blood count and differential. this will be arranged by your primary care doctor. you should continue to take the antibiotics ciprofloxacin and metronidazole as prescribed for the next 16 days, even if you are feeling well. you were started on metoprolol 12.5mg by mouth twice a day to help your heart. you should continue to take aspirin. you should follow-up with your primary care doctor next week. your primary care doctor will arrange for you to see a cardiologist and have a repeat echocardiogram within 1 month. you should call your doctor or come to the emergency room for any fevers > 100, chills, night sweats, cough, shortness of breath, chest pain or pressure, numbness in the arm or jaw, abdominal pain or bloating, nausea or vomiting, swelling in the legs, skin rashes, or any other symptoms that concern you. followup instructions: primary care doctor: dr. at , , ma appointment: wednesday, at 10:10 am please have your labs drawn at this visit to check your cbc and differential. please follow-up with a cardiologist and repeat echocardiogram in 1 month as arranged by your primary care doctor. procedure: venous catheterization, not elsewhere classified diagnoses: subendocardial infarction, initial episode of care tobacco use disorder unspecified pleural effusion severe sepsis pulmonary collapse anxiety state, unspecified septic shock diarrhea accidents occurring in residential institution methicillin resistant staphylococcus aureus septicemia inguinal hernia, without mention of obstruction or gangrene, unilateral or unspecified (not specified as recurrent) unspecified antibiotic causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to