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: falls major surgical or invasive procedure: ppm placement history of present illness: 89 yo m with recent etoh abuse, htn, likely vascular dementia and episodes of arm and leg shaking with decreased responsiveness over the past 1.5 years presenting after several similar episodes within the past several days. per his family, he had 3 episodes on and 6th and 1-2 episodes of the 7th. he has had no episodes since that time. the patient's daughter and wife describe his past episodes as: eyes are dilated, he flails his arms out and he taps either foot, he is intermittently responsive throughout the episode. at other times he will cling to his chair, with his eyes dilated, and when his wife or daughter asks him what the matter is, he says "nothing." his family also notes that he is getting increasingly confused, falling about 3 times within the past month (without fractures). he denies any symptoms during the episodes and actually does not remember them at all. he does endorse one fall. . upon presentation to the ed, his vs were initially notable for bradycardia to the 50s which dropped down to 30s with a stable bp and without symptoms. his labs were notable for hyponatremia to 129 and a negative trop. multiple ekgs reportedly looked like aflut with variable slow conduction. ep and cards were called due to c/f complete hb. per the ed resident's report, ep and cards did not think the ekgs were c/f chb. exam was otherwise notable for confusion, orientation times which his family reported was at his baseline. his neuro exam was reportedly non-focal. given his mental status and episodes of syncope, neurology was also called and felt these episodes were unlikely to be seizures. a ct head was done and showed small vessel disease which neurology felt was c/w with his poor mental status. since the patient is on atenolol at home, he was given ca gluconate although without effect. he was also given aspirin. atropine was pulled but not given. per report, his bps remained stable. vs prior to tx : 97.3 50 152/82 16 100% on 2l. . upon arrival to the floor, he reports feeling well. he states that he stopped drinking 5-6 months ago because his wife stopped buying alcohol and not because he wasn't feeling well. he reports feeling himself and has no complaints. . review of sytems: unable to reliably provide but specifically denies chest pain, shortness of breath, palpitations. past medical history: severe arthritis particularly involving his feet. he has had bilateral bunionectomies, has hammertoes, has had a total knee replacement on his right and he had a previous hip fracture. htn alcohol dependence bph with urinary obstructive symptoms elevated psa hearing loss falls largely associated with alcohol use dementia chronic constipation snores at night ?osa(not formally diagnosed) b/l cataract surgeries social history: both (patient's wife) and the patient are originally from . they have 4 adult children. he is a non-smoker. he has drunk 7 beers and several shots of whisky all of his adult life, apart from the past 10 days. he worked as a custodian in a school. he does not use recreational drugs family history: not known, his mother lived until she was aged 106, and the patient's wife stated that she had her "marbles" until she died. physical exam: vitals: 97.7 165/79 60 20 100ra general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: alert and oriented to self, hospital, and year. poor memory. on discharge: pacemaker in place, slightly bruised and tender, but no drainage, edema. pertinent results: 09:30am blood wbc-8.6 rbc-4.79 hgb-14.5 hct-42.1 mcv-88 mch-30.2 mchc-34.4 rdw-13.1 plt ct-373 09:30am blood neuts-65.4 lymphs-23.5 monos-5.4 eos-5.3* baso-0.5 09:30am blood pt-12.3 ptt-24.8 inr(pt)-1.0 09:30am blood glucose-107* urean-9 creat-0.9 na-129* k-4.0 cl-93* hco3-30 angap-10 09:30am blood alt-13 ast-20 alkphos-68 totbili-0.5 09:30am blood ctropnt-<0.01 09:30am blood albumin-3.9 calcium-8.4 phos-3.5 mg-2.1 09:30am blood vitb12-466 folate-9.1 03:12am blood osmolal-265* 05:58pm blood ammonia-30 09:30am blood tsh-1.9 06:25am blood crp-30.5* 06:25am blood vanco-20.3* 06:20am blood wbc-7.4 rbc-3.63* hgb-11.2* hct-32.4* mcv-89 mch-30.8 mchc-34.5 rdw-13.8 plt ct-308 06:20am blood glucose-157* urean-14 creat-1.1 na-133 k-4.3 cl-95* hco3-26 angap-16 06:20am blood calcium-7.9* phos-4.2 mg-2.1 ct head: 1. no acute intracranial hemorrhage. 2. small vessel ischemic disease and bilateral basal ganglia lacunes. 3. ethmoid sinus disease and fluid in the bilateral mastoid air cells, with extension of fluid in the left middle ear cavity. findings may represent an ongoing inflammatory process, but clinical correlation is recommended. 4. gas in the cavernous sinus and the subcutaneous tissues, likely venous and secondary to injection/iv placement. 5. enlarged ventricles disproportionate to the degree of sulcal atrophy, possibly due to central atrophy, but nph is not excluded. cxr: trace right pleural effusion. cxr: pacemaker tip in right ventricle tee attempted and unsuccessful. panorex - read pending brief hospital course: 89 year old man with a history of high alcohol intake until 10 days prior, htn, and several months of episodes of altered mental status and falls now presenting s/p fall with bradycardia and pauses. # bradycardia with history of atrial fibrillation and 5 second pauses. patient was thought to be asymptomatic, but on observation in the icu he was more confused during these episodes. ep was consulted and pacemaker was placed on . he was also started on asa 325mg of atrial fibrillation. coumadin was not started due to recent falls and etoh abuse. several hours after pacemaker was placed blood cultures drawn on admission returned positive. blood cultures were obtained to complete workup for altered mental status though infection was not the leading diagnosis. pt was started on vancomycin on after cultures returned positive. id team was consulted who recommended tee to rule out endocarditis. tee was attempted but unsuccessful. he had a panorex on and was evaluated by dentistry who did not feel he had an acute infection. at time of discharge plan was to continue nafcillin for 4 weeks, and 2 weeks of levoquin and rifampin orally. midline should be pulled upon completion of nafcillin course. weekly cbc/diff/electrolytes and lfts should be checked and faxed to clinic. pt has follow up with device clinic and clinic as noted below. . # altered mental status. likely vascular dementia with possible contribution of hyponatremia and alcohol dependence. at risk for wernicke's. he was given thiamine, mvi, folic acid. he did not score on ciwa during hospital stay. blood cultures drawn to complete infectious workup and after 48 hrs grew three bottles of coag negative staphylococcus. neurology consulted and b12, folate, and tsh, along with cardiac enzymes, cbc, chem 7, lfts, ammonia returned within normal limits. #during his hospitalization pt was noted to have poor dentition. he will require follow up with the clinic at rehab for complete exam, cleaning and plan to extract mobile teeth which include 1,16, 32, and fractured 9. # hyponatremia. urine lytes suggested siadh possibly secondary to multiple strokes, history of etoh abuse, or reset osmostat. sodium corrected with fluid restriction. pt should maintain on a 1500cc fluid restriction. # shaking episodes at home. the etiology of this remains unclear. it may be related to pauses or episodes of profound bradycardia vs seizures. neuro did not feel eeg would be high yield. after pacer was placed, he had no further episodes during his hospitalization. # falls. be related to posterior column demyelinization vs etoh abuse vs bradycardia. pt was evaluated by pt who felt he was incredibly unsteady on his feet and would not be able to use a walker without placing excess weight on his left arm (pacemaker site). he was discharged to rehab. # code: full (discussed with wife) rehab to do: continue antibiotics as directed pull midline upon completion of nafcillin course f/u with device clinic and id daily physical therapy evaluation by clinic for tooth extraction once stable 1500 cc fluid restriction medications on admission: ketoconazole 2 % topical cream use at least once a day between buttocks once a day atenolol 50 mg tab 1 tablet(s) by mouth once a day colace 100 mg cap 2 capsule(s) by mouth once a day discharge medications: 1. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day): for constipation . 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily): to prevent stroke caused by irregular heart rate. 4. multivitamin tablet sig: one (1) tablet po daily (daily): (vitamin). 5. folic acid 1 mg tablet sig: one (1) tablet po daily (daily): (vitamin). 6. acetaminophen 325 mg tablet sig: two (2) tablet po tid (3 times a day) as needed for pain. 7. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 8. nafcillin in d2.4w 2 gram/100 ml piggyback sig: two (2) grams intravenous q6h (every 6 hours): day 1= , last day . 4 week course. 9. rifampin 300 mg capsule sig: two (2) capsule po q24h (every 24 hours): first day . last day is . two course following completion of 4 week course of nafcillin. . 10. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours): first day . last day is . two course following completion of 4 week course of nafcillin. . 11. outpatient lab work please draw weekly cbc with differential, basic metabolic panel including bun and cr, and liver function tests. please fax to to the infectious disease nurses. all questions regarding outpatient antibiotics should be directed to the infectious disease r.ns. at ( or to on md in when clinic is closed. 12. pull midline please pull midline upon completion of nafcillin course. 13. atenolol 50 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: primary: symptomatic bradycardia coagulase negative staph infection hypertension atrial fibrillation discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: mr. - you were admitted for recent falls. you were found to have a very slow heart rate requiring a pacemaker. pacemaker was placed. it was later discovered that you have had a blood stream infection that requires aggressive treatment. we tried to figure out where the infection came from but this was unclear. . also during your hospitalization a dentist evaluated your teeth. you should be evaluated at rehab by the dentist and likely will need extraction of several teeth. . you have a number of new medications. please stop taking atenolol. a number of medications were started. please see attached list. followup instructions: please make the following appointment: department: cardiac services when: friday at 10:30 am with: device clinic building: sc clinical ctr campus: east best parking: garage department: infectious disease when: tuesday at 10:50 am building: lm campus: west best parking: garage you may follow up with dr. when you finish your rehab stay. procedure: initial insertion of single-chamber device, rate responsive initial insertion of transvenous lead [electrode] into ventricle diagnoses: atrial fibrillation atrial flutter alcohol abuse, unspecified ulcer of other part of foot hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (luts) other specified cardiac dysrhythmias bacteremia unspecified hearing loss acute and subacute bacterial endocarditis unspecified accident personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits injury to bladder and urethra, without mention of open wound into cavity staphylococcus infection in conditions classified elsewhere and of unspecified site, other staphylococcus other disorders of neurohypophysis syncope and collapse knee joint replacement other and unspecified alcohol dependence, unspecified hematuria, unspecified dental caries, unspecified vascular dementia, uncomplicated hip joint replacement history of fall dermatophytosis of nail corns and callosities other hammer toe (acquired) chronic periodontitis, unspecified arthropathy, unspecified, ankle and foot 

Answer: The patient is high likely exposed to