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: hypotension, s/p fall, respiratory failure major surgical or invasive procedure: none history of present illness: 72 yom w/ h/o cad, chf (ef 35-40%), recently dx c. diff and rle dvt presents from nh following an unwitnessed fall. per nh records, patient had t 103.4 today and reported he was lighhteaded prior to fall. he denied chest pain, n/v, adominal pain. no loc or head trauma. he was transported to the ed where t 102 (rectal), hr 96, bp 130/80, 86% ra -> 93% 4l nc. he received 2l ns and vancomycin 1 g iv x 1 given erythema noted at right picc site and levofloxacin 500 mg iv x 1 given possible rll infiltrate. his blood pressure dropped to 80/50 and he became progressively tachypnic. abg 7.43/43/55 and patient was intubated and sedated. left sc central line was placed, he received an additional 1l fluid bolus. levophed gtt was started to keep map >6 and he was admitted to the micu for further management. . recently admitted s/p fall with dehydration and uti, treated with 10 days of ceftriaxone. he was readmitted - with fever, n/v, diarrhea, and abdominal pain, and diagnosed with c. diff (abd ct showed pan-colitis). he was discharged on 14 day course of iv flagyl (due to difficulty swallowing) and po vancomycin. he was also noted to have a non-occlusive right internal iliac dvt, for which he was discharged on lovenox bridge to coumadin. he was also diagnosed with possible aspiration pneumonia, and received a 7 day course of levoquin. a right arm picc was inserted for tpn. past medical history: 1. cad s/p mi 2. ischemic cardiomyopathy - tee : anterior septum, distal anterior wall and inferior wall moderately hypokinetic. 2+ mr, ef 35-40% - ett mibi 7 min modified protocol mild reversible defect of the apical portion of the inferior wall and in the apex. regional hypokinesia in the apex. ef 48% 3. copd 3. borderline hypertension 4. eczematous eruption on his trunk and proximal extremities 5. depression and anxiety, treated with celexa. 6. l mca with mild residual r sided hemiplegia 7. s/p spinal fusion and revision 8. urinary retention 9. c. diff: diagnosed - abd ct: no significant change in extensive pancolitis. no evidence of pneumatosis or perforation. no focal abscess or fluid collection. increasing bibasilar consolidations may represent compressive atelectasis or infectious process social history: quit tobacco . no current etoh or other drug use. his wife and 3 children live in . the patient's sister is his hcp and is very supportive. pt is speaking only. since his cva one year ago, pt is speaking only, although he understands some english. he has also had difficulty swallowing solid foods and difficulty with coordination required to use an inhaler since his stroke. family history: positive for alzheimer's disease in paternal grandfather, negative otherwise. physical exam: pe: t 98.9, hr 87, bp 135/77, resp 19, 97% simv tv 600 rr 16, ps 5, fio2 0.5, peep 5 gen: elderly, chronically-ill appearing male, intubated and sedated heent: nc/at, perrl, anicteric, nl conjunctiva, omm dry, intubated, neck supple, no lad, jvp 8 cm cardiac: rrr, ii/vi sm at apex pulm: decreased ls at bases bilaterally, coarse ronchi throughout abd: moderately distended, soft, mild diffuse tenderness without rebound/guarding, hypoactive bowel sounds. ext: 2+ le edema to mid calf bilaterally, le cool with 1+ dp bilaterally . right arm picc site with surrounding erythema/induration. neuro: moves all 4 extremities in response to noxious stimuli. 1+ dtr left and le, 2+ dtr right , 1+ dtr left . toes downgoing bilaterally gu: very edematous scrotum (diameter ~6inches), foley catheter in place with yellow urine in bag pertinent results: labs on admission: glucose-110* urea n-17 creat-0.4* sodium-134 potassium-3.3 chloride-104 total co2-26 wbc-19.3* rbc-3.50* hgb-9.9* hct-30.4* plt count-381 mcv-87 mch-28.3 mchc-32.7 rdw-17.1* albumin-1.9* calcium-6.7* phosphate-3.0 magnesium-1.6 stim test - c/w adrenal insufficiency 11:25pm cortisol-16.3 10:55pm cortisol-14.5 08:10pm cortisol-14.4 08:40pm fibrinoge-388# d-dimer-3372* cxr: bilateral pleural effusions. ct: pancolitis. brief hospital course: 1. sepsis: in the micu, the pt was found to be in septic shock, with blood cultures and picc line culture positive for mrsa on . on admission, pt was hypoxic and in respiratory failure. he was intubated on in the icu and was subsequently extubated on . tte showed no evidence of vegetations. sputum cx also grew mrsa and cxr showed rml pneumonia. picc line was removed and a l sc line was placed. the pt was started on iv vancomycin 1g . negative blood cultures on . he was found to be adrenally insufficient by stim testing and was given 7 days of fludrocort/hydrocort per our sepsis protocol. although he initally required pressors and large amounts of fluid for his hypotension, the pt was quickly weaned off levophed in the micu and was able to maintain adequate blood pressure throughout the remainder of his stay. on transfer to the floor, the pt's vancomycin was stopped as he was also being covered with linezolid, which has bacteriostatic activity against mrsa. subsequent blood culture has been negative. linezolid will be continued for a total of 14 days (today is day 6). 2. diarrhea - given his recent history of severe c diff, the patient was continued on iv flagyl and po vanco started during his last admission throughout this admission as well (today is d22/28 total). all c diff toxin a studies this admission have come back negative. currently, c diff toxin b is pending. an abd/pelvis ct on demostrated an evolving diffuse colitis with interval increase in pericolonic inflammatory stranding and free fluid. this was believed to be lagging behind the patient's clinical picture, which was generally improving over time. a rectal tube was placed in the micu for decompression and was removed upon transfer to the floor. on the day prior to discharge, rifaximin was added to the patient's antibiotic regimen for further coverage of c diff given our high suspicion regardless of negative toxin screens. (today d2/10) the pt's abdominal pain and tenderness have resolved. the pt's diarrhea markedly decreased over the course of his stay on the floor. he tolerated a liquid diet without problem. gi was formally consulted and they agreed that the patient was improving with a negative abdominal exam and therefore required no further workup. antibiotics should be continued as an outpatient, as listed above, and the patient's diet can be advanced as tolerated. when he is taking good po, his tpn can be stopped as it is only for supplementation. please follow cdiff toxin a and b as an outpatient. if negative, pt may stop his antibiotics as planned above. 3. uti: urine cultures on grew vre and the pt was started on linezolid. subsequent cultures have been negative. linezolid will be used to cover both his vre and his mrsa - requires 14 day course given bacteremia (today day 6). 4. r iliac thrombus - pt has been anticoagulated throughout his stay with a heparin drip and goal ptt 60-100. given hypoxia, cta in the micu was negative for pe. on the day prior to admission the patient's heparin was d/c-ed and he was started on a loading dose of coumadin 5mg x 1 to be followed by coumadin 2mg qhs as an outpt. he was also started on lovenox which can be discontinued when the patient is at goal inr on coumadin (inr 2-2.5). please note that flagyl amplifies the effect of coumadin, thus the pt's inr should be watched closely and if supratherapeutic, coumadin may be held for 1-2 days and then restarted. . 5. hypoxia - given his initial hypoxia, he was intubated and sedated in the micu. his respiratory status improved during his stay, and he was eventually weaned off the vent, satting well by nasal cannula. on the day of discharge he was satt-ing well on ra (93-97%). the pt has baseline copd and likely baseline sats are 93-94%. there is likely also a chf component. pt received large amounts of fluid in the micu for hypotension and has been making good urine, but is notably anasarcic. he uses nebulizers for sob as he lacks the coordination to use inhalers since his cva one year ago. he should continue these as an outpt. . 6. anasarca - secondary to large amount of fluid given in micu when septic. pt also has very low albumin with poor nutritional status. pt is third spacing, especially noted in scrotum, with severe swelling. pt is making good urine without lasix, but may require this in the future, as he had during his last admission. we are elevating his scrotum and legs to assist in drainage. please continue to elevate as an outpt. 7. s/p spinal fusion and fall at rehab - likely orthostatic in setting of high grade fever. head ct negative for intracranial process or bleed. pt should only be oob with assist. note that whenever pt is oob (even to chair) he must wear his back brace. 8. picc access- the patient was discharged from his last admission with a picc line, which was subsequently infected with mrsa. the picc was pulled upon admission and was replaced with a l subclavian line. on the day of discharge, a new picc line was placed for outpt use for tpn and abx. the pt should only require iv abx for one more week. his po intake is improving. please be extremely cautious with the use of his picc line. we recommend that tpn be discontinued as soon as the pt is taking adequate po, and that sterility and caution be used when manipulating the patient's picc line as an outpt. 9. poor po intake - the patient's diet was slowly advanced as tolerated to full liquids. he has difficulty swallowing solids and is likely a chronic aspirator. his intake was supplemented by tpn given through a central line daily throughout his stay. the pt can swallow pills, although he has some difficulty with large pills. his diet should be advanced as tolerated as an outpt. tpn has been used to supplement his nutrition and should be stopped when he is taking adequate po. 10. h/o cad: the pt was ruled out for mi with cardiac enzymes x 3 when he initially present s/p fall. he was continued on his usual dose of asa, plavix, statin. as an outpt he may be restarted on his beta blocker, which was held on admission given hemodynamics and sepsis. . 11. anemia: iron studies consistent with anemia of chronic disease. 12. h/o depression: pt's citalopram was held on admission and may be restarted as an outpt. . 13. ppx: anticoagulated, please continue protonix 40 po daily as an outpt. . 9) code: dnr documented in chart per sister . please discuss this with her again, as this was a change from his previous admission. . 11) communication: sister (h , c ) --- medications on admission: 1) alb/atr nebs q6h 2) ecasa 325 mg po daily 3) calcitonin 200 iu daily 4) ca/vit d 500 mg po tid 5) citalopram 20 mg po daily 6) plavix 75 mg po daily 7) lovenox 80 mg sc q12h 8) lasix 40 mg po bid 9) riss 10) lactobacillus 1 tab po tid 11) lisinopril 10 mg po daily 12) toprol xl 12.5 mg po daily 13) metronidazole 500 mg iv q8h 14) mv1 15) pantoprazole 40 mg po daily 16) simvastatin 20 mg po qhs 17) vancomycin 12.5 mg po q6h 18) warfarin 19) tylenol prn discharge medications: 1. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. rifaximin 200 mg tablet sig: two (2) tablet po tid (3 times a day) for 8 days. 5. warfarin sodium 2 mg tablet sig: one (1) tablet po hs (at bedtime): please monitor inr for goal 2.0-2.5 and adjust coumadin dose accordingly. note concurrent use of flagyl amplifies coumadin effect and may hold coumadin 1-2d if needed for supratherapeutic inr. 6. metronidazole metronidazole 500mg iv q8hrs x 6 days 7. vancomycin vancomycin oral liquid 250mg q6hrs x 6 days. 8. albuterol sulfate 0.083 % solution sig: one (1) nebulization inhalation q6h (every 6 hours) as needed for sob. 9. ipratropium bromide 0.02 % solution sig: one (1) nebulization inhalation q6h (every 6 hours). 10. morphine sulfate morphine sulfate (oral solution) 5mg q4-6 hours prn pain. 11. linezolid linezolid 250 mg iv q12hrs x 8 days 12. lovenox lovenox 60 mg sc q12hrs. please monitor inr. please stop lovenox when inr is therapeutic (between 2.0 and 2.5) and then continue only coumadin. 13. heparin flush 10 ml ns followed by 2 ml of 100units/ml heparin (100 units heparin total) in each lumen daily and prn after each use. please inspect picc site three times daily. 14. insulin sliding scale please follow attached insulin slide scale. 15. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 16. citalopram hydrobromide 20 mg tablet sig: one (1) tablet po once a day. 17. calcitonin (salmon) 200 unit/actuation aerosol, spray sig: one (1) spray nasal once a day. 18. calcium 500 with vitamin d 500-125 mg-unit tablet sig: one (1) tablet po three times a day. 19. multivitamin tablet, chewable sig: one (1) tablet, chewable po once a day. discharge disposition: extended care facility: for the aged - acute rehab discharge diagnosis: c diff colitis mrsa sepsis likely picc line infection pneumonia urinary tract infection discharge condition: fair. discharge instructions: if you have fever, chills, increased sob, chest pain, back pain, increased diarrhea or abdominal pain, please call dr. or come to the emergency department. please always wear back brace when moving out of bed (including to chair). please continue vancomycin and flagyl for 6 days after discharge. please continue rifaximin for 8 days after discharge. please continue linezolid for 8 days after discharge. please continue to advance diet as tolerated. please stop tpn when pt is taking adequate po to minimize the amount of time picc line in place. please d/c picc line as soon as no longer needed for abx or tpn. followup instructions: please monitor inr with coumadin. adjust dose as needed for inr 2-2.5 goal. please note that simultaneous use of flagyl may amplify the effect of coumadin so use conservative management. coumadin may be stopped for 1-2 days if needed for supratherapeutic inr and then restarted. please check cdiff toxin a and b in four days. if negative, may stop flagyl, vanco and rifaximine at that time. if not, please continue antibiotics. please direct questions/concerns to dr. . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances insertion of endotracheal tube injection or infusion of oxazolidinone class of antibiotics diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery urinary tract infection, site not specified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis chronic airway obstruction, not elsewhere classified acute respiratory failure septic shock intestinal infection due to clostridium difficile old myocardial infarction infection and inflammatory reaction due to other vascular device, implant, and graft acute venous embolism and thrombosis of deep vessels of proximal lower extremity 

Answer: The patient is high likely exposed to