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: right hip pain, unable to walk major surgical or invasive procedure: partial hip replacement history of present illness: 85 yo m with superficial bladder ca (dx ) - stage iv, mets to bone - r femur and s/p excision of r sided lung cancer who presents with acute on chronic worsening of r hip pain felt to be secondary to r femur metastatic lesion. he has actually been unable to walk for the last 3 days and has been mostly sitting in a chair at home. he had been evaluated for hospice services, though recently doses not qualify as he is using aranesp (successfully) for anemia. he has tried advil 600mg prn leg pain as well as tylenol #3 (taken infrequently) at home. he is also using a lidocaine patch. his pain in minimal while lying in bed, though he likens standing and walking to "giving birth" because the pain is so bad. he otherwise feels well. nephrostomy tubes are functioning well without bleeding. no sob or chest pain. no fevers. past medical history: oncologic history: mr. is an 84-year-old male with a history of superficial bladder cancer originally diagnosed in and treated with local resection and intravesicular bcg/ifn in and . in , turbt revealed papillary urothelial carcinoma, largely low grade with focal high grade features and lamina propria invasion in his prostatic urethra. he received intravesicular bcg and ifn, completed in 3/. restaging turbt on revealed two small recurrences of papillary urothelial carcinoma, low-grade, with a focus of invasion into the lamina propria but muscularis was free of tumor. retrograde pyelograms demonstrated severe bilateral hydronephrosis and he was in acute renal failure with cr of 2.2, up from 1.3. ureteral obstruction was thought to be due to locally advanced bladder cancer. bilateral percutaneous nephrostomy tubes were placed and he underwent 6660cgy of radiation to the pelvis in . the left nephrostomy tube was removed on . the right nephrostomy tube was removed on but on , he developed bilateral hydronephrosis again and a left nephrostomy tube was placed. he has had multiple complications, including ureteral obstruction, hydronephrosis, renal failure (cr of 2.8 in ) and hematuria felt to be due to radiation cystitis. cystoscopy in showed one tumor on the right bladder wall which was fulgurated. follow-up cystoscopy in was normal, but in he had several areas of infiltrative papillary urothelial carcinoma. in pelvic imaging disclosed stage iv bladder cancer and a destructive bone lesion of the right lesser trochanter, for which he received radiation, completed on . . past medical history: # superficial bladder cancer (see omr for details) # squamous cell cancer rll s/p excision # adenocarcinoma in rml s/p excision # lingular nodule, ? bronchoalveolar carcinoma # cad # s/p pacemaker # hypercholesterolemia # s/p bilateral inguinal hernia repairs # chronic renal insufficiency, baseline cr ~2.0 (stage iii ckd) social history: lives with his wife. difficult caring for him at home even prior to this leg pain given severity of illnesses. considering hospice care. family history: nc physical exam: vitals: t 98.2 bp 168/64 hr 96 rr 18 o2 99% ra general: wdwn older male in bed, awake and alert heent: sclerae anicteric. perrl, eomi. conjunctiva injected and pale, lower lids are lax op: mmm. oropharynx is clear. no thrush. neck supple. lymph: no cervical, supraclavicular, infraclavicular or axillary lad. heart: distant heart sounds, regular, with normal s1 and s2, no murmurs. lungs: clear to auscultation and percussion bilaterally. no crackles, wheezes or rhonchi. abdomen: soft, ntnd. + quiet bs. no hepatosplenomegaly., pressure ulcers b/l ischial tub. extremities: 2+ pitting edema to his mid calves bilaterally. skin is flaky, warm neuro: pain with abduction of r leg, no tenderness to palpation. unable to lift leg off bed due to pain. pertinent results: 02:50pm urine blood-lg nitrite-neg protein-25 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-mod 02:50pm urine rbc->50 wbc->50 bacteria-mod yeast-none epi-0 12:00pm wbc-11.7* rbc-3.73* hgb-10.1* hct-33.4* mcv-90 mch-27.1 mchc-30.2* rdw-16.0* . xray: there is no evidence of a new fracture. patient has known osteolytic lesion in the proximal shaft of the femur and large osteolytic lesion in the lesser trochanter; this is unchanged from prior as does degenerative changes in the right hip joint. . ct pelvis 1. destructive mass involving the right lesser trochanter and lateral subtrochanteric femur has progressed. there is high risk for pathologic fracture if this has not already occurred. dedicated femur radiographs are recommended as this lesion is only partially visualized. 2. new lesions within the left pubic symphysis and right sacrum. the right sacral lesion abuts the s3 nerve root. 3. slight progression of disease within the pelvis. . ct spine: 1. new right sacral lesion with soft tissue component, most likely lytic metastasis of rapid progression. these findings were not appreciated on prior exam of . 2. l3 left pedicle blastic lesion , overall unchanged since . 3. extensive degenerative disease of the lumbar spine. brief hospital course: mr. is an 85-year-old male with invasive bladder cancer and lung cancer, who is not pursuing aggressive treatment who presents with severe, worsening leg pain secondary to lytic lesion in prox femur. . #. hip fracture: a hip x-ray was done that showed lytic lesion of femur and subsequent ct demonstrated extensive cortical destruction of right femur and of left pubic symphysis. patient evaluated by ortho and xrt. patient expressed he wanted to have surgery. ortho recommended partial hip replacement given the significant destruction seen on ct. preoperative risk assessment was done by anesthesiology and nephrology, as well as by obtaining an echocardiogram. echo showed mild symmetric left ventricular hypertrophy with hyperdynamic systolic function without lvot gradient as well as mild pulmonary artery systolic hypertension. patient was transfused with 3 units prbc prior to surgery. . the patient underwent r total hip hemiarthroplasy on . during the procedure he was hypotensive and had ebl of about 1000cc. he received 2 units of prbcs and was briefly on norepinephrine. postoperatively he was admitted to the for monitoring. on presentation to , pt. was a+o x 0. there was concern that the patient may have focal neurological deficits on right side, but those resolved quickly as the patient became more oriented. post-operatively, the patient was noted to have poor uop with hematuria that resolved. the patient also had leukocytosis to wbc of 30, likely post-procedural stress and trended downward. he was again trasnfused 1 additional unit of prbc with appropriate hct response. the patient remained alert, oriented, and hemodynamically stable and was transferred back to the floor. he was seen by orthopedic surgery who recommended lovenox for 4 weeks, outpatient follow-up with dr. and touch down weight bearing for activity. - touch down weight bearing on right leg - continue lovenox - f/u with dr. . # uti - urine cultures significant for mrsa infection sensitive to vanc and bactrim. patient initially started on bactrim but was switched to vanc as renal function deteriorated (see below). patient completed a course of vanc for his uti. . # acute on chronic rf - patient had an elevated cr and low uo through nephrostomy tube. patient's was evaluated by ir who saw that the nephrostomy was displaced and had to be changed. nephrology was consulted who felt that his arf was likely post-obstructive, but could not rule out an element of ain given pos eos seen on smear. patient was switched from bactrim to vanc and lasix was held. cr trended downward and patient maintained good urine output through replaced nephrostomy. post-operatively, patient was found to have hematuria (as stated above), that resolved. his cr elevated again, thought to be secondary to blood loss from surgery and atn. patient maintained good urine output and cr trended downward. cr on discharge was 1.9. lasix was restarted prior to discharge. . #. anemia: managed with blood transfusion as stated above. patient was not restarted on his home aranesp. - check weekly hematocrit; transfuse 1u prbc if hct <25 medications on admission: lipitor 40 aranesp q2 weeks proscar 5 lasix 20 daily metoprolol 25 mvi lidocaine patch advil 600mg prn tylenol #3 prn discharge disposition: extended care facility: center - discharge diagnosis: primary: metastatic bladder cancer to the bone discharge condition: stable discharge instructions: you were seen in the hospital because of your leg pain. we saw that you had bone destruction to your femur which was causing your leg pain. you agreed to have surgery for this problem. we made the following changes to your medications: 1. we are treating your pain with tylenol, lidocaine patch, and morphine. you do not need to take tylenol #3. 2. we started you on senna, colace, biscodyl, mylanta 3. we started you on omeprazole 4. we did not continue your aranesp, please talk to your physician before restarting this. if you experience fevers >101, worsening pain, nausea, vomiting, or any concerning symptoms please contact your pcp. followup instructions: please follow up with dr. on at 1:40pm. she is on the of the building . her number is (. md procedure: partial hip replacement replacement of nephrostomy tube diagnoses: hyperpotassemia anemia in chronic kidney disease coronary atherosclerosis of native coronary artery urinary tract infection, site not specified acute kidney failure, unspecified personal history of malignant neoplasm of bronchus and lung other and unspecified hyperlipidemia chronic kidney disease, stage iii (moderate) personal history of malignant neoplasm of bladder cardiac pacemaker in situ carrier or suspected carrier of methicillin resistant staphylococcus aureus methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site drug-induced delirium hematuria, unspecified attention to other artificial opening of urinary tract secondary malignant neoplasm of bone and bone marrow personal history of irradiation, presenting hazards to health ulcer of heel and midfoot neoplasm related pain (acute) (chronic) pathologic fracture of other specified part of femur pain in limb other and unspecified general anesthetics causing adverse effects in therapeutic use urinary obstruction, unspecified 

Answer: The patient is high likely exposed to