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: opioid analgesics attending: chief complaint: malaise major surgical or invasive procedure: debridement of r toe ulcer . picc line placement history of present illness: 82 y/o m with h/o dmii, cad, non healing foot ulcer, s/p right hallux amputation () and wound closure (), mssa infection, who presents to ed with chief complaint of lethargy and fatigue, feels "week as a kitten", found to have fever to 102, tachycardia to 120's, hypotension (sbp in 80's-90's). . in er, given 4 l ivf with rise in sbp to 110's. also given clinda/vanco iv abx. subsequently remained hd stable. piv in place. wbc 13.8. . recent admit with mssa bacteremia. source was foot ulcer which also grew mssa. initially treated with nafcillin, ctx, flagyl. upon discharge ( and rehab), he completed a 2 week course of dicloxacillin, with last dose 10 days ago. . also on that admit, noted to have acute blood loss from bleeding peptic ulcer. egd revealed gastic ulcerations (fundus and antrum). he was transfused 2u prbc prior to discharge (hct 28.5) and started on ferrous sulfate 325mg po qd. he was also instructed to hold coumadin . past medical history: 1. cad s/p cabg in for 80% distal lmca, 90% mid lad, 90% prox d2, 80% prox om1 and 80% mid rca disease 2. chf ef of 25% 3. pvd (dr ) s/p right fem-af op bpg 4. af on anti-coagulation 5. s/p l foot debridement in (dr 6. hyperlipidemia 7. dm2 8. diabetic neuropathy (multiple foot ulcers followed with dr in podiatry) 9. mssa bacteremia- source r foot ulcer social history: lives with wife. stopped smoking 40 years ago. no etoh or drugs. family history: no hx of dm or htn physical exam: vitals- t 96.1, hr 77 irreg, bp 101/60, rr 16, 100% on 2l 02 gen- non-toxic, mentating, a&o x 3 heent- eomi. op clear neck-non-distended jvp pulm- cta b/l cv- irreg, no murmurs, rubs, gallops abd- soft, nt/nd. nabs ext- cool dist ext on left. rle warm w/ erythema around r distal hallux. r hallux s/p amputation, dressed w/ gauze w/o purulent drainage. non-palpable dist pulses b/l (dopplerable); neuro- cnii- xii intact, language fluent. pertinent results: r ankle/foot x-ray 1. prominent soft tissue swelling at the first toe amputation site with a probable small ulceration of the distal soft tissues. the appearance of the remaining aspect of the first metatarsal is unchanged, although radiographs have limited sensitivity for detection of osteomyelitis. 2. additional postoperative changes of the right foot are unchanged. . micro data: ========= **final report ** aerobic bottle (final ): staph aureus coag +. final sensitivities. sensitivities: mic expressed in mcg/ml staph aureus coag + | clindamycin-----------<=0.25 s erythromycin----------<=0.25 s gentamicin------------ <=0.5 s levofloxacin---------- 4 r oxacillin-------------<=0.25 s penicillin------------ =>0.5 r anaerobic bottle (final ): staph aureus coag +. sensitivities performed from aerobic bottle . 6:00 am swab rt. hallux. gram stain (final ): 2+ (1-5 per 1000x field): polymorphonuclear leukocytes. 4+ (>10 per 1000x field): gram positive cocci. in pairs and clusters. brief hospital course: 82 y/o m w/ h/o cad, dmii, r foot ulcer, s/p recent amputation, mssa bacteremia, who presents with fever/hypotension . # mssa bacteremia: initially presented with hypotension and sirs criteria including fever, tachycardia, leukocytosis, was admitted to the medical icu. hypotension was fluid responsive after 2.5l ns and he had no evidence of end organ damage. he did not require pressor support. given his recent mssa bacteremia (s to oxacillin, clinda) and preliminary r hallux wound culture with gp cocci, he was treated empirically with vanco/clinda iv. blood culture data returned 4/4 bottles positive for methicillin sensitive staph aureus, and antibiotics were tapered to iv nafcillin. suspected source was his r hallux ulcer which also grew mssa. this ulcer was debrided by the podiatry service. surveilence blood cultures remained negative to date and he has remained hemodynamically stable; his last positive blood culture was on . oral dicloxacillin was discussed as an alternative antibiotic, but he will be discharged on a two week course of nafcillin iv because of his high grade bacteremia and diabetes (to be continued through ). he got a transesophageal echo as an inpatient to rule out endocarditis given his risk factors, which was negative. . # dm type 2: controlled with sliding scale insulin while inpatient. resumed metformin and glyburide. with rising creatine, will monitor for hypoglycemia in the setting of being on glyburide as well as problems with metformin. please consider changing to glipizide if this becomes a problem. . # cad/chf: s/p cabg in ; no signs of active ischemia or volume overload. continued on simvastatin, asa. metoprolol, lasix held until hd stable and subsequently re-started. will start lisinopril today prior to discharge for improved mortality benefit. will need a creatinine check 10 days after starting ace-i (on ) to ensure that cr not elevated. consider starting spironolactone if his creatinine remains stable over next few days. . # acute on chronic renal failure: initial creat 1.5, baseline creat 1.2-1.4. likely pre-renal component. volume repleted with ivf's and prbc and creatinine returned to baseline levels. on discharge, he was 1.5. he should have this checked in one week. . # insomnia/anxiety: the patient had an episode where he crawled out of bed after receiving ativan and ambien. we stopped both of these medications and gave him haldol for sleep (2mg) with good effect. as a result of this, he has an abrasion of his right elbow which is superficial in nature, not requiring stitches. he also required olanzapine for anxiety. he should follow up with his pcp for his chronic anxiety/insomnia problems. . # atrial fib: rate controlled, holding coumadin anti-coagulation in setting of recent gi bleed. follow-up with cardiology as outpatient to assess whether or not to restart coumadin given that patient is a fall risk. . # anemia: initial hematocrit 26. guaiac negative. transfused 1 unit prbc given h/o cad and pvd with appropriate increase to 29. his hematocrit has been stable since. . # r foot ulcer: as above, treated with antibiotics and debridement. podiatry and vascular surgery consulted. vanco given for mssa and levo/flagyl empirically at first, switched to nafcillin prior to discharge. he needs to follow up with vascular surgery as an outpatient given his non-healing ulcer and repeated infections as well as with dr. of podiatry for repacking/resuturing of foot. . # dispo: patient seen by pt/ot and it was felt that the best thing for him in terms of rehabilitation is to go to a rehab center. medications on admission: 1. folic acid 1 mg po daily 2. terazosin 2 mg po hs 3. cyanocobalamin 1000 mcg po daily 4. multivitamin po daily 5. aspirin 81 mg po daily 6. metoprolol tartrate 50 mg po bid 7. omeprazole 20 mg po once a day 8. ferrous sulfate 325 po daily 9. glyburide-metformin 5-500 mg po twice a day. 10. simvastatin 20 mg po qhs 11. lasix 20mg qod discharge medications: 1. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 2. cyanocobalamin 500 mcg tablet sig: two (2) tablet po daily (daily). 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 6. simvastatin 10 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)). 7. acetaminophen 500 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)). 8. furosemide 20 mg tablet sig: one (1) tablet po every other day (every other day). 9. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 10. ketoconazole 2 % cream sig: one (1) appl topical (2 times a day). 11. hydrocortisone valerate 0.2 % cream sig: one (1) appl topical (2 times a day). 12. glyburide-metformin 5-500 mg tablet sig: one (1) tablet po bid (2 times a day). 13. nafcillin in d2.4w 2 g/100 ml piggyback sig: one (1) 2g intravenous q6h (every 6 hours): started on , to continue through . 14. haloperidol 5 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. disp:*qs tablet(s)* refills:*0* 15. olanzapine 2.5 mg tablet sig: two (2) tablet po bid (2 times a day) as needed for anxiety. 16. metoprolol succinate 100 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). 17. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 18. terazosin 2 mg tablet sig: one (1) tablet po at bedtime. discharge disposition: extended care facility: - discharge diagnosis: staph aureus bacteremia (methicillin sensitive) secondary to foot ulcer discharge condition: good discharge instructions: please call if you have any fever/chills, worsening or uncontrolled foot pain, worsening malaise, fatigue. . you will need 2 weeks of treatment with iv naficllin (first day on to continue through ) . please check creatinine in 10 days to ensure stable (ace-i started on day of discharge). followup instructions: -provider: , dpm phone: date/time: 3:10 . -dr. of vascular surgery ( date/time: at 9:45 . -provider: , md phone: date/time: 3:30 . -provider: , m.d. phone: date/time: 10:00 procedure: venous catheterization, not elsewhere classified transfusion of packed cells local excision of lesion or tissue of bone, tarsals and metatarsals diagnoses: congestive heart failure, unspecified acute kidney failure, unspecified severe sepsis atrial fibrillation aortocoronary bypass status diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes peripheral vascular disease, unspecified methicillin susceptible staphylococcus aureus septicemia chronic kidney disease, unspecified ulcer of other part of foot other and unspecified hyperlipidemia septic shock hypovolemia 

Answer: The patient is high likely exposed to