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: codeine / enalapril attending: chief complaint: cc: major surgical or invasive procedure: temp r hd cath history of present illness: 48 yo m with sarcoidosis with esrd s/p failed transplant, h/o hep b/c/?d, h/o paf on coumadin, h/o pulmonary aspergillosis, presented from nh to osh with neck stiffness, was found to be hypotensive to the 80s, was started on vancomycin and transferred to the . in the field t101.8 108 111/66, in ed bp 79/53. was given ceftazidine, gentamicin, transplant was consulted for possible line removal, and renal were consulted. in addition his inr was 5 and was given ffp. he was given 250cc ns and transferred to the icu. . in the icu, he states he's had an aching neck pain and stiffness for the past day, he denies trauma, or headache, light sensitivity or rash, this pain is new onset. he otherwise denied f/c, cough/sob, cp, diarrhea, n/v, no urine output on baseline. no recent travel. past medical history: esrd secondary to amyloidosis -failed lrrt in now on hd- l groin line ivc stent sarcoidosis pulmonary aspergillosis dm chronic hcv hypertension sinusitis, paroxysmal atrial fibrillation, c. difficile mrsa line sepsis renal osteodystrophy adrenal insufficiency upper extremity dvt () pancreatitis bilateral bka right index finger amputation social history: patient currently living at rehab facility. smoked 1 ppd x 30 years but quit one year ago. no alcohol. previous drug use (ivdu). girlfriend is involved in his care. family history: mother, brother with diabetes. physical exam: pe: vs 96.3 93/59 106 20 94% 2l gen: lethargic, aaox3, speaking in full sentences heent: eomi, perrla, neck unable to touch chin to chest, op dry, chest: crackles at the bases bilaterally cv: rrr nl s1 s2 no mrg appreciated abd: soft, nt, nd +bs no guarding or rebound ext: r bka, l bk (dark skin around sutures, otherwise clean, dry) r index finger amputation, wound cdi, no erythema fluctuance neuro: moves all 4, aaox3 pertinent results: 12:40pm blood wbc-20.6*# rbc-4.05* hgb-11.9* hct-38.7* mcv-96 mch-29.5 mchc-30.9* rdw-16.8* plt ct-385 12:40pm blood neuts-71* bands-0 lymphs-13* monos-16* eos-0 baso-0 atyps-0 metas-0 myelos-0 nrbc-2* 12:40pm blood hypochr-1+ anisocy-1+ poiklo-normal macrocy-1+ microcy-normal polychr-normal 12:40pm blood pt-61.9* ptt-68.8* inr(pt)-7.7* 12:40pm blood glucose-64* urean-84* creat-11.3*# na-130* k-5.2* cl-93* hco3-13* angap-29* 02:14am blood calcium-8.4 phos-5.0*# mg-2.2 02:14am blood vanco-14.8 . ekg sr 106bpm na, peak p waves. no st-t changed, no change from previous. . cxr: suspicion of diffuse process in lungs possibly reoccurrence of aspergillosis. as translation of findings on plain chest examination into findings observed on previous ct may be difficult, consider the possibility to ascertain these new findings by renewed ct examination of this patient known to have rather advanced sarcoidosis. stat report delivered to emergency room board. brief hospital course: assessment/plan: 48m with sarocoidosis, amyloidosis-->esrd on hd with hx mult line infections, who p/w mrsa bacteremia, endocarditis, pre-vertebral cervical abscess. . # mrsa bacteremia/pre-vertebral abscess/endocarditis: pt presented with neck pain/stiffness. found to have prevertebral (c3-4) abscess with associated discitis/osteomyelitis on ct & mri. source likely mrsa bacteremia from infected hd catheter (in l groin). blood cx's from grew mrsa in bottles; cx's from grew mrsa in bottles. surveillance cultures, following initiation of antibiotics, from thru were no growth. tte showed moderate-sized mobile vegetation on mitral valve, which will be treated with antibiotics only. pt was treated with both vancomycin and gentamicin. gentamicin was discontinued on , and the patient was continued on vancomycin. he went for a washout of cervical abscess w/ neurosurgery on . abscess grew mrsa as well. he is to continue on vancomycin 8wks from , which was the date of his prevertebral abscess washout. pt defervesced following initiation of antibiotics. a tunnelled catheter was replaced in the groin on . neurosurgery does not feel that there is a need for follow up imaging and he will follow up with dr. . . # esrd: thought to be due to amyloidosis. he is status post failed renal transplant. he is maintained on chronic hd on a tues-thurs-sat schedule. . # right index finger pain: likely due to progressive dry gangrene. he is status post amputation of distal portion on by plastic surgery and given progression of gangrene, the rest of the digit to the mcp was removed with flap revision on . . # anemia: likely multi-factorial--related to ckd/anemia of chronic disease & operative loses. he receives epo at hd, was stable during this admission. . # h/o asperg infxn: itraconazole was continued for prophylaxis. . # h/o adrenal insufficiency: related to chronic steroid use (for possible renal transplant or amyloid). he received stress dose steroids for surgery and by the time of discharge had been tapered down to his outpatient regimen of prednisone 5mg alternating with 2.5mg daily. . # delirium: ct head w/ contrast unremarkable. altered mental status attributed to infection exacerbated by pain medication. by the time of discharge, patient was back to baseline. . # dm: well controlled on insulin sliding scale. . # afib: the patient was in nsr throughout the admission. his metoprolol was continued, but given his multiple procedures and also given that his inr was supratherapeutic on admission, his coumadin was held. it was restarted on the day of discharge, with a goal of which will have to be monitored upon discharge. . # psych: celexa was continued. . # fen: please maintain patient on a renal, diabetic, fluid restricted (to 1.5l/day) diet. . # ppx: subcut heparin, ppi . # comm: hcp (girlfriend) . # code: full (discussed with pt & hcp). medications on admission: prednisone 5mg qd, 2.5mg qd provigil 100mg qd nephrocaps qd sensipar 60mg qd itraconazole 200mg fosrenol 50mg tid renagel 2400mg tid citalopram 30mg qd folic acid 1mg qd metoprolol 12.5mg qd vicodin es tid mom 30ml prn tramadol 50mg prn tylenol prn dulcolax 10mg prn coumadin 1mg qhs discharge medications: 1. outpatient lab work please check cbc/diff, esr, crp every week and fax to dr. of infectious diseases (. 2. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 3. cinacalcet 30 mg tablet sig: two (2) tablet po daily (daily). 4. itraconazole 100 mg capsule sig: two (2) capsule po bid (2 times a day). 5. citalopram 20 mg tablet sig: 1.5 tablets po daily (daily). 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 9. lanthanum 500 mg tablet, chewable sig: one (1) tablet, chewable po tid w/meals (3 times a day with meals). 10. metoprolol tartrate 25 mg tablet sig: three (3) tablet po bid (2 times a day). 11. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 12. sevelamer 800 mg tablet sig: one (1) tablet po tid (3 times a day). 13. lactulose 10 g/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed. 14. prednisone 5 mg tablet sig: one (1) tablet po every other day (every other day). 15. prednisone 2.5 mg tablet sig: one (1) tablet po every other day (every other day). 16. insulin lispro (human) 100 unit/ml solution sig: one (1) subcutaneous asdir (as directed). 17. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 18. vancomycin 1000 mg iv hd protocol 19. sodium chloride 0.9% flush 3 ml iv daily:prn peripheral iv - inspect site every shift 20. coumadin 1 mg tablet sig: one (1) tablet po at bedtime: please check inr, goal . 21. outpatient lab work please check inr daily, patient just being restarted on coumadin on after tunnelled line placement. goal inr is . discharge disposition: extended care facility: discharge diagnosis: primary: mrsa bacteremia endocarditis pre-vertebral cervical abscess gangrene of right index finger . secondary: esrd on hd likely secondary to amyloidosis anemia history of aspergillus infection diabetes mellitus atrial fibrillation on coumadin discharge condition: stable, afebrile discharge instructions: you were admitted for infection of the heart valves and the space around your spinal cord. you have been on intravenous antibiotics during this admission and will continue on these antibiotics for a total of 8 weeks. you also had further amputation of the right index finger secondary to progressive gangrene. . if you experience fevers or chills, nausea/vomiting, chest pain or shortness of breath, please seek medical attention. followup instructions: with dr in infectious diseases (id) clinic on at 9:30am. md, procedure: hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis venous catheterization for renal dialysis other exploration and decompression of spinal canal incision with removal of foreign body or device from skin and subcutaneous tissue transfusion of other serum amputation and disarticulation of finger attachment of pedicle or flap graft to hand diagnoses: anemia in chronic kidney disease end stage renal disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere tobacco use disorder congestive heart failure, unspecified long-term (current) use of steroids diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled severe sepsis unspecified viral hepatitis c without hepatic coma atrial fibrillation sarcoidosis methicillin susceptible staphylococcus aureus septicemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site acute and subacute bacterial endocarditis infection and inflammatory reaction due to other vascular device, implant, and graft delirium due to conditions classified elsewhere below knee amputation status aspergillosis kidney replaced by transplant infection (chronic) of amputation stump other and unspecified disc disorder, cervical region acute osteomyelitis, hand other amyloidosis 

Answer: The patient is high likely exposed to