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: this is a 45-year-old previously healthy male who was in his usual state of health until two weeks prior to admission when he had left upper quadrant abdominal pain, fevers, and constipation. he went to his primary care physician and was given milk of magnesia laxative which worked well. blood drawn from that admission showed an increased white blood cell count, and the patient was sent to the emergency department with a question gastrointestinal infection. he was given levofloxacin and flagyl times five days. after five days of the levofloxacin and flagyl he began vomiting. his antibiotics were then changed again, and he had an abdominal ct which showed a duodenal mass, and the patient was admitted. the patient has had a increase in hiccups and a 20-pound weight loss for the past two weeks. he had no change in his appetite. no night sweats, no lightheadedness, no changes in bruising or bleeding, no lymph nodes, no melena, no hematemesis or hematochezia, frequency, urgency, hematuria, cough, shortness of breath, or chest pain. past medical history: his only past medical history is left knee surgery (meniscal repair). medications on admission: his medications on admission were levaquin 500 p.o. q.d. and flagyl 500 mg p.o. t.i.d. (but both were discontinued after five days), and he was also started on avalox two days prior to admission. allergies: no known drug allergies. social history: social history revealed that he quit alcohol one year ago. he denies prior heavy drinking. he did smoke one pack per week of cigarettes times five years. he denies intravenous drug use. he is a professional basketball player in and now a teacher. family history: he has a family history of diabetes mellitus. review of systems: his review of systems was as above. last bowel movement was three days prior to admission. physical examination on presentation: physical examination revealed a blood pressure of 105/81, pulse was 91, respiratory rate was 14, oxygen saturation of 99% on room air. in general, he was a tall, thin, african-american male who was talkative and pleasant, in no acute distress. head, eyes, ears, nose, and throat revealed extraocular movements were intact. pupils were equal, round, and reactive to light and accommodation. no icterus. a benign oropharynx. the neck was without lymphadenopathy and jugular venous distention. the chest was clear to auscultation bilaterally. cardiovascular examination revealed a regular rate and rhythm, first heart sound and second heart sound. no murmurs, gallops or rubs. the abdomen was normoactive, nontender, and mildly distended. there was visible aortic pulsations. no bruits. extremities revealed no edema or cyanosis. lymph node examination showed no cervical, axillary, epitrochlea, inguinal nodes. his skin was without rash or ecchymoses. pertinent laboratory data on presentation: laboratories revealed sodium was 137, potassium was 3.3, chloride was 93, bicarbonate was 27, blood urea nitrogen was 21, creatinine was 1.3, blood glucose was 161. calcium was 9.5. his white blood cell count was 12 (down from 19 prior to admission). his hematocrit was 39 and platelets were 499. pt was 12.3, inr was 1.1, ptt was 22.7. total protein was 7.3, albumin was 4.3, bilirubin was 0.3, ast was 16, alt was 13, amylase was 33, lipase was 5. he had pending blood cultures. radiology/imaging: a ct of the abdomen showed a duodenal mass abutting the aorta. there was filling defect in the superior mesenteric vein. there was no lymphadenopathy. there was a small low attenuation lesion on the liver. hospital course: the patient was admitted to the medicine service for evaluation of his abdominal mass. 1. abdominal mass: the patient received an esophagogastroduodenoscopy to try to obtain a biopsy specimen; however, he was too tall for the colonoscope that they used, and no adequate specimen was obtained. on hospital day two, he did receive a percutaneous biopsy of his abdominal mass. the results of this biopsy were initially sent to because of a question of lymphoma as a differential diagnosis, and when it was realized that this was not a lymphoma, the biopsy specimen was sent back to . it was there that the diagnosis of duodenal adenocarcinoma was made. oncology and surgery were both consulted on this patient, and it was felt that treatment of the mass and cancer most likely could not be offered except for palliative care and relief of the partial small-bowel obstruction caused by the mass. the lesion on the liver was further evaluated by a magnetic resonance imaging which showed the lesions, but it did not clarify whether they were metastatic in nature. the lesions did appear cystic in nature, and it was recommended that he receive ct and magnetic resonance imaging followup after surgery for these lesions. the patient also had ggt and cea levels drawn; both of which were elevated with a ggt of 265 and a cea of 12. these possibilities of liver metastases will be followed up after palliative relief of his partial small-bowel obstruction. 2. partial small-bowel obstruction: the duodenal adenocarcinoma was causing a partial small-bowel obstruction of his duodenum. the patient was admitted and initially given a clear diet that he could not tolerate and reacted to with bilious vomiting. he was then started on total parenteral nutrition therapy after a peripherally inserted central catheter line was inserted. however, the peripherally inserted central catheter line became a source of a methicillin-resistant staphylococcus aureus bacteremia and had to be removed. after removal of the peripherally inserted central catheter line, the patient was maintained on intravenous fluid hydration. he will be transferred to surgery for surgical relief of his partial small-bowel obstruction. 3. infectious disease: mr. a fever on hospital day twelve. blood cultures grew back tubes with methicillin-resistant staphylococcus aureus. his peripherally inserted central catheter line was pulled, and the culture tip also grew out methicillin-resistant staphylococcus aureus. the patient was started on vancomycin after initial treatment with broad spectrum antibiotics before his cultures came back. he was continued on vancomycin throughout his hospital stay, and the dose was increased from 1 to 1250 g q.12h. after a trough level came back at less than 5. he will need a total of six weeks of vancomycin therapy. he had initial surveillance cultures drawn three days after spiking the temperatures, and these also grew back positive staphylococcus. he then had next surveillance cultures drawn two days after this (on ), and those have not grown back staphylococcus to date (on ) mr. began having diarrhea a few days after starting on the vancomycin intravenous therapy for his methicillin-resistant staphylococcus aureus. this diarrhea was positive for clostridium difficile toxin, and he was started on intravenous flagyl because of his likely inability to have effective p.o. flagyl therapy with his partial small-bowel obstruction. 4. superior mesenteric vein clot: this clot was most likely secondary to mass effect of his duodenal adenocarcinoma impinging on the superior mesenteric vein. the patient received a vascular surgery consultation, and they recommended that he be anticoagulated because of his superior mesenteric vein clot. he was started on a heparin drip with the intention of putting him on coumadin anticoagulation postoperatively, after his likely gastrojejunostomy for relief of his partial small-bowel obstruction. the patient also had a superficial thrombophlebitis of his left antecubital vein where his peripherally inserted central catheter line had been. this was treated with warm compresses and did not bother the patient; he was completely asymptomatic. he had no evidence of deep venous thrombosis of his left arm with no edema or swelling, and he was already on heparin anticoagulation for his superior mesenteric vein clot. 5. hematology: the patient had occult blood in both his emesis and stool. this was likely thought due to his duodenal adenocarcinoma oozing blood. a workup of this anemia showed a very low reticulocyte index which was inappropriately low for his degree of anemia. he most likely has some bone marrow suppression from his staphylococcus bacteremia as well as possible anemia of chronic disease from his duodenal adenocarcinoma. he was also most likely oozing blood through his adenocarcinoma, given him a contribution of iron deficiency anemia. iron studies have been ordered including total iron-binding capacity, ferritin, and iron levels; and these were currently pending. mr. received a blood transfusion on of one unit. mr. ' inr has also been increasing during this admission. it was thought that this was most likely due to malnutrition because he has not eaten and had to be taken off his total parenteral nutrition because of his peripherally inserted central catheter line infection. his ptt was also supratherapeutic while his inr was 1.6, and this may also have been contributing to this increased inr. his magnetic resonance imaging did not show any large findings in his liver, and it was unlikely that liver failure is an etiology of this increased inr. the patient likely has adequate iron storage and is currently blood which will also give him more iron. 6. fluids/electrolytes/nutrition: the patient received a brief therapy with total parenteral nutrition before his peripherally inserted central catheter line became a source of methicillin-resistant staphylococcus aureus bacteremia. he was then maintained on aggressive intravenous fluid maintenance with d-5 half normal saline and 20 meq of potassium added. however, he likely has some degree of malnutrition because of his long nothing by mouth state during this entire admission. hopefully, he will be able to resume good oral intake after his partial small-bowel obstruction surgery. 7. cardiovascular: mr. had an electrocardiogram done to evaluate for question of endocarditis when he initially was found to have staphylococcus aureus bacteremia. this electrocardiogram showed q waves in ii, iii, and avf; which were likely related to a possible old inferior myocardial infarction. he had no signs or symptoms of chest pain, and an echocardiogram that was ordered to evaluate the possibility for endocarditis was also negative for any wall motion abnormalities or other signs of ischemia. the echocardiogram was also negative for vegetations, and it was thought very unlikely that mr. had any endocarditis because of a lack of clinical findings and echocardiogram findings. discharge disposition: the patient will likely be transfused to the surgery service (after his surveillance blood cultures grow back negative) for a likely gastrojejunostomy surgery to relieve his partial small-bowel obstruction. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances exploratory laparotomy other gastroenterostomy without gastrectomy esophagogastroduodenoscopy [egd] with closed biopsy closed [endoscopic] biopsy of small intestine diagnoses: acute posthemorrhagic anemia unspecified protein-calorie malnutrition bacteremia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site intestinal infection due to clostridium difficile infection and inflammatory reaction due to other vascular device, implant, and graft chronic vascular insufficiency of intestine malignant neoplasm of duodenum secondary malignant neoplasm of retroperitoneum and peritoneum 

Answer: The patient is high likely exposed to