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: trauma after high speed major surgical or invasive procedure: r acetabular repair intra-arterial tpa peg tube placement picc placement history of present illness: the pt is a 58 year-old man with pmh of htn and alcoholism who was admitted to the trauma sicu after a high speed (pt inebriated) on . the patient's icu course was complicated by delirium tremens and a ck/troponin leak that was attributed to cardiac contusion or demand ischemia. he had repair of a right acetabular fracture in the or in . he left the or at 12:30. he slept until 4pm when he was noted to have left facial droop, left sided weakness and difficulty producing speech. found to have r mca infarction. underwent intraarterial tpa and readmitted to icu. there, developed mssa infection of r lateral knee pin site as well as mssa bilateral pneumonia. icu course also marked by delirium. was transferred to floor for further care on for further care. past medical history: htn etoh abuse hyperlipidemia oral cancer s/p resection known lung nodules awaiting further work-up social history: etoh use - had positive alcohol level on admission. 135. tobacco - per pacu nurse pt quit smoking 3 years ago. family history: na physical exam: vitals: t:100.3 p:85 r:15 bp:120/55 sao2:100% on 3 l. general: awake, cooperative, nad. neurologic: - status: alert, dysarthric, follows commands to open eyes and close hands. -cranial nerves: fixed right gaze deviation. left visual field cut. patient keeps eyes closed most of the time. facial droop on the left is subtle at rest. smiling brings out the left facial droop. forehead wrinkling equal bilaterally. hearing intact to commands. -motor: right arm is normal (raises for 10 seconds). right leg post surgical. left arm is 0/5. left leg is . -sensory: patient was unable to detect noxious stimuli on the left arm and leg. -coordination: patient able to touch hand without dysmetria or ataxia with the right hand. -dtrs: not tested. plantar response not tested. -gait: not tested. pertinent results: pertinent labs: (admission) wbc-14.0* rbc-3.41* hgb-10.9* hct-30.2* mcv-89 mch-32.0 mchc-36.2* rdw-13.3 plt ct-533* . glucose-160* urean-7 creat-0.8 na-123* k-3.4 cl-87* hco3-21* angap-18 calcium-7.6* phos-2.4* mg-1.2* amylase-116* . pt-13.2 ptt-29.1 inr(pt)-1.1 . ck(cpk)-816* ck-mb-26* mb indx-3.2 ctropnt-0.30* . serum tox: positive for etoh (serum level 135) . urine toxicology: bnzodzp neg barbitr neg opiates pos cocaine neg amphetm neg mthdone neg . wbc-10.4 rbc-3.38* hgb-10.9* hct-31.4* mcv-93 mch-32.3* mchc-34.8 rdw-13.0 plt ct-541* . ck(cpk)-3994* ck-mb-43* mb indx-1.1 ctropnt-0.08* . wbc-7.4 rbc-3.25* hgb-10.4* hct-30.0* mcv-92 mch-32.0 mchc-34.7 rdw-13.6 plt ct-462* . pt-14.7* ptt-26.5 inr(pt)-1.3* . ck-mb-22* mb indx-1.9 ctropnt-0.02* . wbc-9.7 rbc-2.89* hgb-9.2* hct-26.6* mcv-92 mch-32.0 mchc-34.7 rdw-15.2 plt ct-404 . %hba1c-5.3 . triglyc-127 hdl-32 chol/hd-3.1 ldlcalc-42 . glucose-94 urean-12 creat-0.6 na-140 k-3.0* cl-102 hco3-25 angap-16 calcium-7.8* phos-2.8 mg-2.0 iron-21* . alt-34 ast-54* ld(ldh)-281* ck(cpk)-400* alkphos-66 totbili-0.6 . ctropnt-<0.01 . caltibc-135* vitb12-1465* ferritn-800* trf-104* . tsh-8.1* t3-66* free t4-0.79* . t3-89 free t4-1.0 . lipase-394* . lipase-265* . ck(cpk)-116 ck-mb-3 ctropnt-0.03* amylase-61 . lipase-203* . wbc-8.2 rbc-3.19* hgb-9.5* hct-30.6* mcv-96 mch-29.6 mchc-30.9* rdw-14.7 plt ct-1442* . glucose-111* urean-11 creat-0.8 na-135 k-4.5 cl-96 hco3-29 angap-15 calcium-9.3 phos-3.9 mg-2.1 . alt-15 ast-24 ld(ldh)-246 alkphos-228* amylase-70 totbili-0.3 albumin-3.4 lipase-294* . 1:02 pm swab right thigh abscess. **final report ** gram stain (final ): 2+ (1-5 per 1000x field): polymorphonuclear leukocytes. 3+ (5-10 per 1000x field): gram positive cocci. in pairs and clusters. wound culture (final ): staph aureus coag +. heavy growth . 10:06 am sputum source: induced. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gram positive cocci. in pairs and clusters. respiratory culture (final ): oropharyngeal flora absent. staph aureus coag +. moderate growth. . ct chest/abd/pelv impression: 1. right posterior-lateral acetabular fracture as described above with associated posterior dislocation of the right femoral head. intramuscular and intra-articular hematoma at the right hip. 2. multiple left minimally displaced left anterior rib fractures. 3. two 4 mm nodules within the right upper lobe. according to the society guidance in a low risk patient, no further followup is necessary. 4. focal ground-glass opacity within the right middle lobe may represent lung contusion. 5. extensive atherosclerotic changes of the aorta without evidence of aneurysm. . ct c-spine w/o contrast impression: no acute fracture or malalignment. degenerative changes as described above. . ct head w/o contrast impression: no acute intracranial pathology . cta head w&w/o c & recons; cta neck w&w/oc & recons impression: 1. ct head demonstrates early infarct in the right middle cerebral artery territory. 2. perfusion ct demonstrates delayed transit time in the right middle cerebral artery region with a slightly smaller blood volume defect indicating infarct with ischemic penumbra. 3. cta of the head demonstrates high-grade stenosis/occlusion at the right middle cerebral artery bifurcation with diminished sylvian branches. a small 3-mm aneurysm is also suspected at the anterior communicating artery. correlation with angiography is recommended. 4. calcification at both carotid bifurcations without high-grade stenosis. normal appearance of the vertebral arteries. . intraarterial tpa impression: underwent cerebral arteriography and mechanical and iv tpa thrombolysis of the right m1 segment with recanalization of all divisions except one m2 branch, corresponding to the superior division of the right middle cerebral artery. he tolerated the procedure well and there were no complications. . tte: no pfo/asd seen. mild symmetric left ventricular hypetrophy with preserved global and regional biventricular systolic function. mild pulmonary hypertension. head ct: evolution of right mca infarct, which is now better visualized. a small hyperdensity which appears to be due to petechial hemorrhage is also visualized. no large hematoma or midline shift. . carotid series complete impression: less than 40% stenosis, right ica and 40-59% stenosis left ica. . pelvis (ap only) findings: extensive metallic fixation devices are seen about the previous fracture of the right acetabulum. no evidence of hardware-related complication. of incidental note are extensive calcifications in the aorta and iliofemoral regions. brief hospital course: after his high speed motor vehicle accident, mr. was initially admitted to the trauma service. he was found to have a r posterior column posterior wall acetabular fracture with associated hip dislocation. a closed reduction was attempted but the reduction was unable to be maintained. he was therefore placed in skeletal traction. on he was transfered to the icu for agitation felt to be secondary to dt's. the traction failed to reduce the fracture. hence, he underwent orif of the posterior wall/posterior colummn on , which was successful. . in the pacu, several hours after his orif, he was noted to have left sided facial droop, left arm > leg weakness, and dysarthria. was out of window for iv tpa. taken for stat cta/ct-perfusion that demonstrated occlusion of the right mca at the end of m1. he was then taken to neurointerventional angiography urgently for merci thrombus retrieval w/ ia tpa. transferred to neuro icu for closer monitoring. . on , he was transferred back to the floor for further care. a stroke workup (for embolic source), including carotid dopplers and an echocardiogram, was negative. on he was transferred back to t-sicu for increasing respiratory distress, tachypnea, and fever to 101.2. a sputum cx grew mssa. cxr with new consolidation bilaterally in lower lungs. he was started on vancomycin on . on he developed purulence from lateral traction pin site, a culture of which also grew mssa. vancomycin was continued pending culture results. his status was waxing and throughout, c/w delirium. . on he was transferred to the medicine floors for further care. he was afebrile and vitals were stable but he was delirious and required restraints and a 1:1 sitter. he self-d/c'ed his ngt on multiple occasions. he was started on qhs low dose antipsychotics (initially olazapine, changes to seroquel by discharge). since both his pneumonia and surgical wound had grown mssa, he was switched from vancomycin to nafcillin on . over the next few days his status slowly began to clear. in the meantime he remained afebrile and without clinical signs of infection. . since he was npo and had no ngt, he was maintained on iv fluids and gi was consulted for peg placement to maintain nutrition in post-stroke setting. a peg was placed on and tube feeds were started on peg day 2. there were no problems with feedings and he was easily titrated up to goal of 65cc/hr per nutrition recs. . continued to follow and felt no need to return him to the or for wound i+d. rather, since the wound infection was improving, it was recommended to continue packing and dressing changes, tapering the length of packing by 1 inch per week. surveillence pelvic films were taken on and again on after a minor fall, and showed the hardware to be in correct position with no complications. physical and occupational therapy continued to work with the patient and recommended rehab. . mr. status continued to improve daily, and he was off restraints for the last 5 days of his admission. he did not require a sitter after . he did not attempt to d/c any of his lines. at discharge he was a+o x 3, pleasant, and interactive, although still moderately dysarthric due to his stroke. . in anticipation of rehab placement, a right upper extremity picc line was placed on , again without complication. his iv antibiotic course lasts until . . although he was clinically asymptomatic, mr. ' lipase was chronically elevated and seemed to be exacerbated by tube feeding. the gastroenterology service consulted and recommended imaging (ct or mrcp) as outpatient to better evaluate and rule out any pseudocysts or ductal obstruction. . mr. also had mildly elevated blood glucose levels. he did not carry a diagnosis of diabetes upon admission to the hospital. it is hard to judge his true fasting glucose level due to his tube feeds. this may be impaired glucose tolerance vs. diabetes. he may have some pancreatic insufficiency from his chronic etoh abuse. we checked fingerstick glucose values qid and covered mr. with an insulin sliding scale. his fingersticks were very rarely above 150, and generally in the 120-140 range. we recommend outpatient followup with his pcp for formal diabetic testing. . another outpatient issue concerns mr. function. in the icu his tsh was elevated and he was briefly started on levothyroxine, however in the icu setting the tsh is notoriously unreliable, and a free horome level the subsequent day was normal. this most likely represented sick euthyroid syndrome. as an outpatient, his provider can repeat at a later date to better assess for true disfunction. . mr. is discharged on lovenox for post-hip fracture dvt prophylaxis, which he should receive until . he is strictly npo, with all feeds and pills via g tube, until cleared by speech and swallow to advance his diet. he has orthopedic and neurological followup scheduled. he was full code throughout his hospitalization. medications on admission: colestipol, 3gm lisinopril 40/day, hctz 25/day, amolodipine 10mg/day, asa 81 mg/day discharge medications: 1. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day). 2. metoprolol tartrate 25 mg tablet : one (1) tablet po bid (2 times a day). 3. hexavitamin tablet : one (1) cap po daily (daily). 4. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed. 5. ipratropium bromide 0.02 % solution : one (1) inhalation q8h (every 8 hours) as needed. 6. thiamine hcl 100 mg tablet : one (1) tablet po daily (daily). 7. folic acid 1 mg tablet : one (1) tablet po daily (daily). 8. ferrous sulfate 325 (65) mg tablet : one (1) tablet po daily (daily). 9. nafcillin in d2.4w 2 gram/100 ml piggyback : two (2) grams intravenous q6h (every 6 hours) for 3 days: last day of nafcillin therapy = . 10. metoprolol tartrate 25 mg tablet : one (1) tablet po bid (2 times a day). 11. quetiapine 25 mg tablet : one (1) tablet po hs (at bedtime). 12. lisinopril 10 mg tablet : one (1) tablet po daily (daily). 13. folic acid 1 mg tablet : one (1) tablet po daily (daily). 14. aspirin 325 mg tablet : one (1) tablet po daily (daily). 15. thiamine hcl 100 mg tablet : one (1) tablet po daily (daily). 16. ipratropium bromide 0.02 % solution : one (1) neb inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing: use prn increased oral secretions. 17. oxycodone-acetaminophen 5-325 mg/5 ml solution : 5-10 mls po q6h (every 6 hours) as needed. 18. enoxaparin 30 mg/0.3 ml syringe : thirty (30) mg subcutaneous q12h (every 12 hours) for 11 days: last day of lovenox therapy = . 19. heparin lock flush (porcine) 100 unit/ml syringe : two (2) ml intravenous daily (daily) as needed: for picc line: 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. . 20. tylenol 325 mg tablet : 1-2 tablets po every six (6) hours as needed for pain. 21. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr once a day. discharge disposition: extended care facility: discharge diagnosis: primary: r acetabular fracture . secondary: stroke with l-sided deficit dt's staph pneumonia staph surgical wound infection anemia mild pancreatitis reactive thrombocytosis impaired glucose tolerance vs. diabetes discharge condition: stable, improved discharge instructions: you were admitted to the hospital after a high-speed car accident in which you suffered a badly broken right hip and thigh. after your surgery to repair these fractures, you suffered from alcohol withdrawal. you also suffered a stroke which impaired your ability to speak or swallow safely. in order to feed you while you recover from the stroke, we placed a feeding tube through your stomach to supply you with nutrition. finally, you suffered 2 hospital-acquired infections - one in your surgical wound site, and the other in your lungs. we treated you with antibiotics for these infections. . you are being discharged to rehab where you will continue to rehabilitate your surgically repaired right hip as well as the muscles which became weak after your stroke. you will also finish your course of antibiotics while you are there. . 1. please take all medications as prescribed 2. please call your doctor or come to the closest ed if you develop new symptoms that re concerning such as new weakness or numbness on one side of your body, worsened slurring of your speech, fevers/chills, or shortness of breath. followup instructions: you have neurology follow-up for your stroke as follows: provider: , .d. phone: date/time: 2:30 . you have orthopedics followup for your hip fracture as follows: provider: xray (scc 2) phone: date/time: 8:40 provider: , : date/time: 9:00 . please make an appointment to follow-up with your pcp in the next 2 weeks. procedure: venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances injection or infusion of thrombolytic agent percutaneous [endoscopic] gastrostomy [peg] removal of implanted devices from bone, other bones application of external fixator device, other bones open reduction of fracture with internal fixation, other specified bone open reduction of dislocation of hip diagnoses: pure hypercholesterolemia other postoperative infection unspecified essential hypertension hyposmolality and/or hyponatremia methicillin susceptible pneumonia due to staphylococcus aureus other motor vehicle traffic accident involving collision on the highway injuring driver of motor vehicle other than motorcycle contusion of lung without mention of open wound into thorax acute pancreatitis closed fracture of multiple ribs, unspecified iatrogenic cerebrovascular infarction or hemorrhage alcohol withdrawal delirium closed fracture of acetabulum acute alcoholic intoxication in alcoholism, continuous closed dislocation of hip, unspecified site 

Answer: The patient is high likely exposed to