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: sulfonamides / heparin sodium,porcine attending: chief complaint: delirium major surgical or invasive procedure: picc line placement history of present illness: 79 yo male with hx of cad s/p mi with ef 35%, paf on coumadin and recent right mca stroke now presents from rehab with altered mental status. he was admitted to the neurology service for left sided weakness and altered mental status found on mri to have a right mca stroke. he has a history of paf, for which he was not anticoagulated; given allergy to heparin, he was bridged with argatroban to coumadin. that hospital course was also noted for atrial fibrillation with rvr requiring diltiazem gtt and eventual transition to po metoprolol. he failed a speach and swallow evaluation, therefore a peg tube was placed by gastroenterology. he also had a coagulase negative staphylococcus bacteremia for which he received vancomycin and his picc was pulled. he was discharged to complete a course of levofloxacin and metronidazole for an aspiration pneumonia. at the rehabilitation facility, he had a fever on with a erythema at the site of his midline. this was pulled and us was negative for dvt. on a neurology consult was obtained due to worsening mental status who recommended repeat ct head to assess for hemorrhagic tranformation or edema from his cva. he was evaluated by ct at hospital which showed edema without shift; given a possible new area of hemorrhage, he was transferred to the for further workup. in ed repeat ct head showed area of laminar necrosis in parietotemporal area but no hemorrhage or edema. eeg was negative for acute seizure activity and lp was deferred due to elevated inr but he was given 10u sc vit k. he also developed fever to 101.5 and afib with rvr and was given lopressor 5mg iv x2, 25mg of po lopressor, and empirically treated with 2g ceftriaxone, 1g vancomycin, and 800mg of acyclovir for possible meningitis. he was admitted to the icu for further management. past medical history: 1. s/p right mca stroke, discharged 2. paf now on anti-coagulation 3. cad s/p mi (posterolateral s/p lcx stent, imi s/p rca stent with subsequent mid lad 4. s/p r thr 5. idiopathic thrombus of l eye that spontaneous resolved () 6. bilateral cataract surgery 7. status post hernia repair 8. diffuse osteoarthritis 9. right renal fistula 10. bph 11. s/p vasectomy 12. cri (baseline around 1.3) social history: retired internist. former chief resident at in . widower for 6 yr. has 3 kids, 10 grandchildren and 1 great grandchild. past smoking hx (from age 16 to ~1 pack a day). has 2 shots of daily prior to last admission, none since discharge. family history: father died at age 78 of lung cancer. had two brothers who died of prostate cancer at the ages of 73 and 78. mother died of an mi at the age of 91. extensive colon cancer on mother??????s side. physical exam: physical exam on admission vitals: t 98.2 hr 130 bp 112/67 rr 6 o2 sat 96% 2l general: somnolent but arousable often falling asleep mid conversation with respirations heent: left pupil surgical rt reactive neck: no carotid bruit, no elevated jvp, supple when pt awake chest: crackles at left base hrt: irreg irreg, ns1s2 nor mrg abdomen: peg site w/o erythema, soft, nt, nd, no hsm extremity: 2+ rad and dp pulses, trace le edema bilat worse on left, rt antecub eruthema neuro: unable to comply with neuro exam, increase tone diffusely worse on lue and lle, hyperreflexia in bicep, brachiorad and patellar on left, distal sensation intact. could not assess strength due to somnolence although moves all 4 extremities. (+) left facial droop, tongue midline pertinent results: laboratory studies on admission: wbc-13.1 hgb-13.6 hct-39.4 mcv-89 rdw-13.7 plt count-308 neuts-75.4 lymphs-14.7 monos-6.5 eos-3.0 basos-0.4 pt-28.2 ptt-41.2 inr(pt)-2.9 ck-mb-notdone ctropnt-<0.01 alt(sgpt)-62 ast(sgot)-58 alk phos-88 amylase-82 tot bili-0.9 lipase-64 glucose-107 urea n-26 creat-1.0 sodium-133 potassium-4.5 chloride-94 total co2-33 u/a: blood-sm nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-neg rbc-18 wbc-0 bacteria-rare yeast-none epi-<1 alt-46 ast-35 ck(cpk)-84 alkphos-76 totbili-1.0 lipase-32 laboratory studies on discharge: wbc-9.7 hgb-11.0 hct-32.6 mcv-89 rdw-13.9 plt ct-295 glucose-130 urean-18 creat-1.1 na-136 k-3.9 cl-102 hco3-28 angap-10 ekg: sinus rhythm with atrial premature beats. left anterior fascicular block. poor r wave progression. consider anterior myocardial infarction, age indeterminate but could also be due to left anterior fascicular block. compared to the previous tracing of no significant change eeg: this is an abnormal eeg due to the presence of a slow and mildly disorganized background consistent with a mild to moderate encephalopathy of toxic, metabolic, or anoxic etiology. no evidence of ongoing or potential seizure activity was seen. head ct: a large area of hypodensity within the right middle cerebral artery territory is largely unchanged in terms of size compared to . there is new hyperdensity along the cortex of this area of infarction extending into the temporal lobe and insular area. this finding is consistent with laminar necrosis, a sign of a subacute infarct. there is no new edema or associated mass effect. no areas of acute hemorrhage are identified. no new areas of infarction are visualized. there is no hydrocephalus or shift of normally midline structures. the remainder of the density values of the brain parenchyma remain within normal limits. a small area of isodensity within the right frontal bone is not changed compared to . the soft tissues and osseous structures as well as the visualized paranasal sinuses are unremarkable. impression: laminar necrosis in a subacute right middle cerebral artery territory infarct. cxr: minimal blunting of the left costophrenic angle could represent atelectasis or small effusion. brief hospital course: 79 yo male with hx of cad s/p mi with ef 35%, paf and recent right mca stroke presents with delirium. a head ct showed laminar necrosis in the right parietotemporal area but no hemorrhage or edema. he was initially covered empirically for meningitis (ctx/vanco/acyclovir); no lp was attempted given elevated inr. he was admitted to the icu, where his antibiotics were changed to zosyn/vancomycin to cover possible nursing home acquired pneumonia and possible line infection (erythematous midline removed ), given low suspicion for meningitis. his mental status improved and he was transferred to the general med floor . 1) altered mental status: most likely due to the pneumonia and possible line infection. head ct was without acute hemorrhage and eeg was consistent with encephalopathy without epileptiform activity. the patient's mental status gradually improved on zosyn and vancomycin, and, on discharge, was close to his baseline. the neurology service followed him throughout his hospital stay and recommended outpatient follow-up. additional toxic/metabolic work-up included vitamin b12 (normal), tsh (elevated at 5, but free t4 normal at 1.2 - repeat as an outpatient in weeks), and an infectious work-up (urine culture negative, blood cultures no growth to date). the patient's neurologic status remained stable (improved since admit) despite elevated inr on discharge; if mental status worsens, head ct should be obtained to rule out hemorrhage in the setting of inr 4.3. 2) pneumonia and possible line infection: although cxr was without clear infiltrate, the patient did have a cough and fever; he clinically improved on zosyn/vancomycin and will complete a 14 day course. at time of discharge, he was afebrile with a normal wbc count. 3) atrial fibrillation: the hospital course was complicated by atrial fibrillation with rapid ventricular rate to the 120s-140s. he was continued on metoprolol (titrated up to 100 mg pgt tid) and was started on diltiazem (titrated up to 60 mg four times a day). at time of discharge, his heart rate was stable in the 60s-80s. he was transitioned to coumadin on an argatroban drip (given heparin allergy). the day prior to discharge, his inr rose to 5 and his coumadin was held. at time of discharge, his inr was 4.3. his ptt was mildly elevated, which may be due to residual argatroban (lfts wnl, albumin 3.1, fibrinogen elevated, not consistent with dic). he should continue off coumadin and have an ptt and inr rechecked on monday and coumadin restarted as needed for a goal inr . 4) coronary artery disease: ekg was without acute changes and cardiac enzymes were cycled without evidence of acute ischemia. he was continued on aspirin, simvastatin, and metoprolol 5) anemia: at time of discharge, the patient's hematocrit was stable at 31.9. iron studies/vit b12/folate were not consistent with deficiency. as an outpatient, his hematocrit should be monitored closely, particularly given his anticoagulation. oupatient colonoscopy may be considered as an outpatient to evaluate for occult sources of gi bleeding. 6) fen: the patient ws continued on tube feeds. he is npo given risk of aspiration. full code medications on admission: asa 81mg po daily riss metoprolol 50mg po tid provigil 100mg po daily zocor 40mg po daily warfarin 5mg qhs discharge medications: 1. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 2. simvastatin 40 mg tablet : one (1) tablet po daily (daily). 3. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 4. diltiazem hcl 60 mg tablet : one (1) tablet po qid (4 times a day). 5. metoprolol tartrate 50 mg tablet : two (2) tablet po tid (3 times a day). 6. vancomycin 1,000 mg recon soln : one (1) gram intravenous twice a day for 8 days. 7. piperacillin-tazobactam 4.5 g recon soln : 4.5 grams intravenous q8h (every 8 hours) for 8 days. 8. acetaminophen 325 mg tablet : 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. discharge disposition: extended care facility: - discharge diagnosis: primary: change in mental status secondary: pneumonia, atrial fibrillation, coronary artery disease, anemia, right mca stroke. discharge condition: stable discharge instructions: please follow-up as indicated below. please come to the emergency room with worsening mental status, fevers, chills, bleeding, or other symptoms that concern you. followup instructions: 1) primary care: please follow-up with dr. () within 1-2 weeks after being discharged from the rehabilitation facility 2) neurology: provider: , md phone: date/time: 1:30 md procedure: venous catheterization, not elsewhere classified diagnoses: pneumonia, organism unspecified anemia, unspecified toxic encephalopathy atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft sepsis methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site infection and inflammatory reaction due to other vascular device, implant, and graft altered mental status dehydration cerebral artery occlusion, unspecified with cerebral infarction unspecified procedure as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure 

Answer: The patient is high likely exposed to