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: history of present illness: the patient is a 74-year-old male with multiple medical problems and recent hospitalization for left lower extremity ulcer infected with methicillin-resistant staphylococcus aureus. the patient was directly admitted from home for a decreasing ability to take p.o. secondary to throat pain when swallowing. the patient has a history of throat cancer and status post surgery and radiation therapy. the patient denies abdominal pain and nausea but does admit to lack of appetite. he says his clothes are fitting loosely and has apparently lost a lot of weight in the last month or two. the patient states that he was admitted "to get a feeding tube." of note, the patient has old pacemaker wires in his abdomen which may complicate percutaneous endoscopic gastrostomy tube placement. the patient is also on coumadin for atrial fibrillation and reportedly has not taken his coumadin in three days. however, his latest inr drawn on was 9.5. the patient undergoes hemodialysis on monday, wednesday and friday which should be continued while in the hospital. past medical history: 1. congestive heart failure with an ejection fraction of less than 15% by echocardiogram in . 2. end-stage renal disease (on hemodialysis three times per week). 3. coronary artery disease; status post myocardial infarction times two, with percutaneous transluminal coronary angioplasty to the circumflex. 4. chronic obstructive pulmonary disease. 5. paroxysmal atrial fibrillation (on coumadin). 6. history of ventricular tachycardia; status post implantable cardioverter-defibrillator placement. 7. pulmonary hypertension and pulmonary fibrosis secondary to amiodarone toxicity. 8. hypertension. 9. status post throat cancer for which he was treated with radiation therapy. 10. history of diabetes. 11. history of colon cancer, status post colectomy. 12. history of gout. 13. hypothyroidism. 14. peripheral vascular disease with chronic lower extremity ulcer. medications on admission: digoxin 0.125 mg p.o. q.d., colace 100 mg p.o. q.d., synthroid 50 mcg p.o. q.d., coumadin 4 mg p.o. q.h.s., tums 1 tablet p.o. t.i.d., nephrocaps 1 tablet p.o. b.i.d., xanax 0.25 mg p.o. q.h.s., pravastatin 20 mg p.o. q.h.s., trazodone 50 mg p.o. q.h.s., tylenol no. 3 p.r.n., levofloxacin 250 mg p.o. q.o.d., flagyl 500 mg p.o. b.i.d., vitamin c, and vancomycin (which is dosed at dialysis). allergies: social history: the patient lives with wife at home. he has a daughter who is a nurse and extremely involved in his care. he has no history of tobacco, and no current alcohol use. physical examination on presentation: temperature of 95.9, blood pressure of 86/63, heart rate of 88, respiratory rate of 20, satting 100% on room air. the patient was a pale, cachectic male lying in bed, and appeared sleepy. pupils were equal, round, and reactive to light. mucous membranes were dry. tongue was red and smooth. extraocular movements were intact. heart was irregular. no murmurs. the point of maximal impulse was laterally displaced. chest had bibasilar crackles, and a pacemaker was noted in the right upper chest wall. the abdomen was soft, normal active bowel sounds, wires were noted in the right abdominal wall. extremities revealed bilateral pitting edema. venous stasis changes bilaterally. the patient had a dressing over the left lower leg. his toes were cool with nonpalpable dorsalis pedis pulses. neurologic examination revealed cranial nerves were intact. the patient was weak but moved all four extremities. pertinent laboratory data on presentation: laboratories on admission revealed a white blood cell count of 10.9, hematocrit of 51, platelets of 189 (70 neutrophils, 4 bands, 12 lymphocytes). sodium of 142, potassium of 5.5, chloride of 104, bicarbonate of 22, blood urea nitrogen of 51, creatinine of 6.2, blood sugar of 131. albumin of 3.2, calcium of 9.6, phosphate of 4.6, magnesium of 2.1. iron of 100. inr of 5.1. digoxin level of 4.2. hospital course: the hospital course was quite complicated and marked by two trips to the intensive care unit. of note, on admission, the patient was noted to be digoxin toxic, and his digoxin was held throughout his hospitalization. there were no electrocardiogram changes concerning for digoxin toxicity, and the patient was asymptomatic. the patient's blood pressure on admission was notably low, in the 80s/50s. according to his family, his blood pressure did run on the low side. it was felt by the team that he was severely dehydrated due to poor oral intake over the past few weeks. he was gently hydrated due a known ejection fraction of 10%. on , status post dialysis, the patient became hypotensive to the 70s and was admitted to the intensive care unit briefly for further monitoring. he received more intravenous fluids at that point. the medical intensive care unit stay was short, and he was called back out to the floor on . a percutaneous endoscopic gastrostomy tube was placed on ; and, of note, the patient got 600 cc of lactated ringer's intraoperatively as well as fentanyl. overnight, following the procedure, the patient was persistently hypotensive in the 70s/30s and did not respond to fluid boluses. the patient was admitted back to the medical intensive care unit on for hypotension refractory to intravenous fluids. the patient was maintained on a dopamine drip for several days for a blood pressure in the 90s. there was some confusion as to his volume status, not being clear whether he was dehydrated or volume overloaded, and with his low ejection fraction, he had been pushed off the starling curve. on , the patient was dialyzed off 2 liters of fluid which then enabled the dopamine to be weaned off. again, on , an additional 2 liters were dialyzed off. the patient was stable off dopamine for 24 hours with a blood pressure in the 90s, and he was transferred out to the floor on . the patient initially was stable on the floor but was noted to have increasing tachypnea over and . on , upon evaluation by the team, the patient was increasingly tachypneic, more somnolent, and was feeling very poorly to the point where he said, "i just want to die." an arterial blood gas was done and revealed an acidosis with a ph of 7.22, a pco2 of 50, and a po2 of 129 on 4 liters nasal cannula. a stat chest x-ray revealed a large right-sided pleural effusion, and when compared with previous x-rays was read as increasing bilateral effusions, right greater than left. the effusion was drained by ultrasound guidance by the radiology team, and approximately 1.2 liters were taken off. the patient had improved respiratory status after and appeared more comfortable. fluid studies were pending at the time of this dictation. other issues during this hospitalization included his nutritional status. the patient was originally treated with intravenous fluid hydration as noted above prior to percutaneous endoscopic gastrostomy tube placement. a gastrojejunostomy tube was placed by interventional radiology on without any complications. the patient tolerated the procedure well and was immediately started on .................... for tube feeds. this was changed to nepro on due to his renal failure. the patient continued to tolerate tube feeds well and will be sent home on nepro tube feeds with a goal of 50 cc per hour. the patient's renal status was basically stable throughout this hospitalization. he continued to be dialyzed on monday, wednesday and friday. there were no complications. infectious disease issues included continuation of flagyl, levofloxacin, and vancomycin for his left lower extremity ulcer. the vascular team did come by and see the patient and recommended continuing wet-to-dry dressing changes b.i.d. as well as to keep pressure off the leg. the patient was kept in multipoultice boots to prevent further skin breakdown. hematologic issues included the need for reversal of his supratherapeutic inr which was 9.2 on admission. on the first two days of his hospitalization the patient received several doses of p.o. vitamin k to help reverse his inr. the patient was kept off coumadin status post percutaneous endoscopic gastrostomy tube placement during his medical intensive care unit stays and was restarted on coumadin on . his inr will need to be followed closely. social and disposition issues during this hospitalization included the overall goals of care. initially, the patient and family were very adamant that he should be full code and wanted everything done. it became more clear to the family and the patient during this hospitalization that he was very sick and had multiple medical problems. on , after a thoracentesis, the patient and family had a discussion with the attending and the decision was made to change the patient to do not resuscitate/do not intubate. the plan was to send the patient home with services. further discussions about goals of care may be carried out with the attending at a future date. discharge diagnoses: 1. end-stage renal disease. 2. congestive heart failure with an ejection fraction of 15%. 3. peripheral vascular disease with chronic left leg ulcer infected with methicillin-resistant staphylococcus aureus. 4. bilateral pleural effusions. 5. chronic atrial fibrillation. 6. ventricular tachycardia/ventricular fibrillation with implantable cardioverter-defibrillator placement. 7. status post gastrojejunostomy tube for odynophagia. medications on discharge: 1. nepro tube feeds 50 cc per hour. 2. coumadin 2 mg p.o. q.h.s. 3. colace 100 mg p.o. b.i.d. 4. trazodone 50 mg p.o. q.h.s. 5. xanax 0.5 mg p.o. q.h.s. 6. metronidazole 500 mg p.o. b.i.d. 7. prevacid 30 mg p.o. q.d. 8. synthroid 50 mcg p.o. q.d. 9. nephrocaps 1 tablet p.o. q.d. 10. tums 1 tablet p.o. with meals. 11. vitamin c 1000 iu p.o. q.d. 12. levofloxacin 250 mg p.o. q.i.d. 13. senna 2 tablets p.o. q.d. 14. vancomycin intravenously (to be dosed at hemodialysis). discharge status: the patient will be discharged home with services. he will require for dressing changes of his leg. the patient will also require close monitoring of his inr and continued followup of his digoxin level. discharge followup: the patient was to follow up with dr. . , m.d. dictated by: medquist36 procedure: enteral infusion of concentrated nutritional substances hemodialysis thoracentesis arterial catheterization percutaneous [endoscopic] gastrojejunostomy diagnoses: unspecified pleural effusion congestive heart failure, unspecified unspecified protein-calorie malnutrition chronic airway obstruction, not elsewhere classified atrial fibrillation postinflammatory pulmonary fibrosis 

Answer: The patient is high likely exposed to