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: lorazepam attending: chief complaint: nsvt, pvcs major surgical or invasive procedure: multi-lumen picc placement history of present illness: 62 m with hx of htn, hl, pe x 2 s/p ivc filter and on heparin, morbid obesity, who was initially admitted to on with dyspnea and weakness. he was found to have a septic knee replacement and was sent to nebh for washout and hardware removal on . knee cultures showed coag negative staph. he was hypotensive and was sent to the icu, where he was treated with penicillin for his staph infection. he was also noted to have a gout flare for which he was started on colchicine. he developed arf which was felt to be pre-renal and responded to fluids. from the cardiac standpoint he was noted to have multiple runs of nsvt (3-5 beats) for which cardiology was consulted and recommended beta-blockade. he also had a tni of 0.34 for which it was recommended he undergo a mibi. however he was too heavy to undergo this test and had a fair amount of ectopy when his beta-blocker was discontinued in anticipation of a dobutamine echo. he was restarted on his beta blocker and it was felt that he did not need further workup as he had a negative stress last year. in regards to his surgery, he underwent resection arthroplasty of left knee with insertion of cement antibiotic spacers on . his ebl was 3.2 liters. extubated on . the patient had post-surgical non-oliguric with increase of bun/creatinine to 18/0.9 to 42/5.0. he also developed ileus on , and was not absorbing any po, subsequently ng decompressed. past medical history: osa refuses cpap hypertension hypercholesterolemia pulmonary embolus x2 s/p ivc filter benign prostatic hypertrophy glaucoma cataracts status post splenectomy in cholelithiasis gout esophageal varices fatty liver disease knee surgery in and and a left knee prosthesis (with h/o infection) cardiac risk factors include diabetes, dyslipidemia, hypertension, tobacco use and family history of cad. social history: lives at home with his wife, is a college professor of history. smoked cigars/day then quit after pe. one glass of alcohol daily. family history: non-contributory physical exam: vitals: bp 140/71, hr 70 (regular), rr 12, o2 98% 3l nasal cannula gen: pleasant, morbidly obese, caucasian gentleman in nad. aao x3. eyes: no conjunctival pallor or hemorrhage. no icterus. perrla. eomi. ent: mm dry. op clear. no op hyperemia or exudate cv: jvp difficult to assess given habitus. no carotid bruits. pmi in 5th intercostal space, mid clavicular line. irregularly irregular heart rate. normal s1, s2. no appreciable murmurs or rubs. full distal pulses bilaterally. lungs: ctab anteriorly. no wheezes, rales, or rhonchi. good inspiratory effort abd: obese. soft, nt, nd. no hsm. no rebound tenderness or guarding. no abdominal bruits or pulsatile masses. lymph: no cervical lymphadenopathy appreciated. skin: erythematous, scaly, hairless skin of anterior right shin. left leg obscured by surgical cast/dressing. mildly erythemtous patches over left neck, area surround right ij line/dressing, and llq of abdomen. also with ecchymoses over lower abdomen, potentially in distribution of subcutaneous heparin injections. neuro: a&ox3. cn 2-12 grossly intact. preserved sensation throughout. 5/5 strength throughout, although left lower extremity strength exam deferred. normal coordination. gait assessment deferred psych: mood and affect were appropriate. aao x3. speech fluent, thought process clear. pertinent results: admission laboratories: 08:02pm blood wbc-8.4 rbc-3.34* hgb-10.1* hct-29.7* mcv-89 mch-30.3 mchc-34.0 rdw-16.4* plt ct-215 08:02pm blood neuts-71.4* lymphs-13.8* monos-7.7 eos-6.4* baso-0.6 08:02pm blood pt-15.3* ptt-55.6* inr(pt)-1.3* 08:02pm blood glucose-95 urean-45* creat-5.2* na-128* k-4.5 cl-93* hco3-22 angap-18 08:02pm blood alt-16 ast-22 ck(cpk)-31* alkphos-107 totbili-0.4 . discharge laboratories: 04:56am blood wbc-14.1* rbc-3.24* hgb-9.2* hct-28.8* mcv-89 mch-28.3 mchc-31.9 rdw-16.5* plt ct-378 06:16am blood neuts-67 bands-3 lymphs-11* monos-6 eos-8* baso-0 atyps-0 metas-4* myelos-1* 04:56am blood pt-19.9* ptt-150* inr(pt)-1.8* 04:56am blood glucose-100 urean-47* creat-2.9*# na-139 k-3.7 cl-100 hco3-34* angap-9 06:16am blood alt-14 ast-29 ck(cpk)-19* alkphos-93 totbili-0.3 04:56am blood calcium-9.0 phos-4.6* mg-1.9 transthoracic echocardiogram mabh: this is a technically difficult study. lv dimensions are normal. lv systolic function is at the lower limits of normal with an estimated ef of 55%. the right ventricle is mildly dilated with preserved rv systolic function. there is mild to moderate left atrial and mild right atrial enlargement. the aortic leaflets are minimally thickened with no ar. the mitral leaflets are minimally thickened with trace mr. there is trace tr. no pericardial effusion is seen. compared to a prior study dated , the right ventricle is now noted to be dilated. p-mibi : frequent apcs and pvcs were seen. patient had no symptoms of chest pain. there were no ekg changes seen. no evidence for jeopardized myocardium. findings consistent with the diaphragmatic attenuation or inferior wall scar. low normal ejection fraction (49%) and normal wall motion. . kub: technically limited study with poor penetration. non-obstructive bowel gas pattern with no dilated loops of small or large bowel. no evidence of pneumoperitoneum. lung bases are clear. no soft tissue calcification or radiopaque foreign bodies. visualized osseous structures demonstrate multilevel degenerative changes with extensive degenerative change seen within the right hip. impression: non-obstructive bowel gas pattern. . knee films: washout with hardware at outside hospital for septic knee. evaluate hardware and soft tissues. two views of the left knee are obtained without prior studies available for comparison. there is methyl methacrylate spacer at the knee joint with additional methyl methacrylate in the suprapatellar bursa. there is a moderate joint effusion. patient is status post osteotomy at the proximal tibia and distal femur. status post hardware removal. there is mild lucency about the methacrylate in the proximal tibia, but this may have been secondary to prior hardware. outside radiographs would be helpful for assessment. . renal ultrasound: despite repositioning attempts, the kidneys were unable to be visualized secondary to patient's large body habitus. impression: unable to visualize kidneys secondary to body habitus. brief hospital course: 63 y/o m with htn, hl, gout, morbid obesity, recurrent pe's s/p ivc filter, t2dm, s/p left knee arthroplasty for septic joint, complicated by and non-sustained ventricular tachycardia. . # acute kidney injury: creatinine reportedly increased to 5, from baseline of 0.8 at osh and trended up to a stable 6.6 while in the micu. osh renal ultrasound, urine eos unrevealing. renal ultrasound could not be repeated here given his body habitus and positioning issues. potentially atn, given patient's volume overloaded state. reportedly aggressively volume resuscitated at osh. renal was consulted and felt patient was continuing to third space. they recommended continuing lasix 40mg iv daily and monitoring bun/creatinine, urine output and electrolytes. did not feel hemodialysis was indicated at this time. the patient was able to produce urine. with lasix use, he was around negative 1 liter a day at the end of his hospitalization. he should continue lasix for three more days after hospitalization. his renal function continues to improve with a cr of 2.9 at discharge. the patient continues to have lower extremity and scrotal/penile edema. his legs and scrotum need to be elevated. . # s/p septic knee/left knee arthroplasty: pod 5 on admission from left knee resection with placement of antibiotic spacers at nebh. knee culture reportedly had coag negative staph infection. infectious disease was consulted and recommended continued daptomycin and ceftriaxone with planned week course. a multilumen picc was placed. id fellow, , would like to be paged when patient discharged to plan outpatient appointment with id and antibiotic course. patient responded well to pain control with analgesics per nebh pain consult recommendations (morphine). orthopedics was consulted and followed patient inhouse. recommended mainly outpatient followup at or where he had his surgery. the patient needs his sutures removed tomorrow. the patient will continue daptomycin and his course will be further clarified at his infectious disease outpatient appointment. while on daptomycin, the patient needs a weekly check cpk, cbc, diff, lfts, and bun/cr. . # non-sustained ventricular tachycardia: per discharge summary, patient had breakthrough arrhythmias despite amiodarone infusions and iv beta blockade. also had cardiac enzyme elevations with tni of 0.34; he did not undergo mibi given habitus, as well as increased ectopy when beta-blocker d/c'd in anticipation of dobutamine echo. he was restarted on his beta blocker and it was felt that he did not need further workup as he had a negative stress last year. seen by cards upon arrival to , who recommended continuing amiodarone infusion and iv beta blockade, as well as with diuresis, given contribution of volume overload to ongoing arrhythmias. amiodarone gtt was briefly discontinued but patient developed asymptomatic pvcs every 2-3 beats. amiodarone gtt was restarted with good effect and as patient diuresed and was further out from his surgery (less hyperadrenergic), the drip was discontinued. patient was kept on metoprolol 15mg iv q6 hours with good effect, with plans to transition to oral meds once tolerating po diet. electrolytes were repleted closely. the patient still continues to have nsvt on telemetry, though he remains asymptomatic and hemodynamically stable. cardiology recommended using metoprolol. he should have electrolytes checked 3 times a week while at rehab and repleted as needed. once at rehab, can consider switching metoprolol tartrate to metoprolol succinate. . # leukocytosis: the patient has a recent leukocytosis of 14.1 on the day of discharge (14.8 yesterday). the patient does not have any localizing infectious symptoms (no dysuria, cough). no fever. c. diff negative. according to derm, he does not have cellulitis. the leukocytosis is likely inflammatory. multiple negative u/as. if spikes a temperature, consider infectious sources, especially urine since he had a foley catheter in place. . # ileus: per osh records, kub confirmed ileus after significant ng tube output. non tender on exam, but endorsed nausea and occasional vomiting on admission. not absorbing po meds at osh. patient's ngt was clamped initially and patient did not tolerate it, with a mild episode of emesis. patient's diet was gently advanced which he also did not tolerate it. eventually, morphine dose was lowered and patient was re-trialed on ngt clamping and diet advancement with good results. the ng tube was pulled and the patient had multiple bowel movements. . # h/o pe s/p ivc filter: patient was continued on heparin gtt given possibilities of surgical/procedural interventions with a ptt goal 60-100. patient was eventually transitioned back to his home coumadin dose and on discharge he was continued on a heparin drip with coumadin 7.5 mg with inr=1.8. . # acute venous stasis ulcers: has dressings from osh around both feet for blistering wounds. reports history of cellulitis. confluent bright erythema on bottom of both lower legs, purpura and petechiae (non-blanching) present, occasional papules, very mild oozing. wound care and dermatology were consulted for monitoring and management. they recommended clobetasol ointment 0.05% to affected areas, then covering with abd/gauze wrap, and applying gentle compression of the legs with ace bandages, elevation, and mobilization with pt. with the clobetasol, the patient's erythema improved. . # anemia: was stable. guaiac negative, given known esophageal varices. . # glaucoma: continued with home eyedrops # osa refuses cpap: monitored oxygen saturation on nasal cannula and remained stable . # gout: taking colchicine at osh, which was held here in setting of acute renal insufficiency. indomethacin and nsaids were also avoided. patient remained asymptoamtic while here. . # esophageal varices: chronic & stable, per patient. no records @ . # hypertension: blood pressures normal on arrival and stable on metoprolol . # hypercholesterolemia: the patient was continued on his home statin. medications on admission: home medications propranolol 80 t.i.d. hctz 25 daily simvastatin 20 daily vesicare 10 daily medications at transfer: - amiodarone infusion - metoprolol 10 mg iv q2 hrs - heparin gtt - prednisolone 1% ophthalmic drops - protonix 40 mg iv bid - colchicine 0.6 iv bid - daptomycin spacer 1 g iv q24 hrs - lasix 40 mg iv daily allergies: ativan--paradoxical reaction of agitation discharge medications: 1. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. prednisolone acetate 1 % drops, suspension sig: one (1) drop ophthalmic (2 times a day). 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 5. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 8. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain: hold for sedation or rr<12. 9. daptomycin 500 mg recon soln sig: 1000 (1000) mg intravenous q24h (every 24 hours). 10. vesicare 10 mg tablet sig: ten (10) tablet po daily (). 11. furosemide 40 mg tablet sig: one (1) tablet po daily (daily) for 3 days. 12. clobetasol 0.05 % ointment sig: one (1) appl topical (2 times a day). 13. metoprolol tartrate 50 mg tablet sig: one (1) tablet po q6h (every 6 hours): hold for sbp<100 or hr<60. 14. warfarin 2.5 mg tablet sig: three (3) tablet po once daily at 4 pm. 15. heparin (porcine) in d5w 10,000 unit/100 ml parenteral solution sig: per weight based protocol intravenous once a day: see attached weight based protocol. continue until inr: . indication: pulmonary emboli. discharge disposition: extended care facility: hospital & rehab center - discharge diagnosis: primary: -left knee septic joint leading to sepsis -acute kidney injury -non-sustained ventricular tachycardia -post-operation ileus . secondary: -history of pulmonary emboli-on anticoagulation -obesity -type ii diabetes mellitus -hypercholesterolemia -venous stasis discharge condition: mental status:clear and coherent level of consciousness:alert and interactive activity status:out of bed with assistance to chair or wheelchair discharge instructions: it was a pleasure taking care of you at . you were transferred from after having an infection in your knee that spread to your blood. you're currently on an antibiotics called daptomycin for the infection. you also have antibiotics blocks in your left knee. you will need to be on iv antibiotics for weeks. . the infection in your blood caused your kidneys to go into acute renal failure causing swelling in your legs and scrotum. this swelling will decrease as your kidneys start functioning better. . you were taken off of your home coumadin for surgery and started on heparin another blood thinner. you will continue heparin until your inr (coumadin level) is . . you had an irregular heart rhythm called nsvt (non-sustained ventricular tachycardia). you were never symptomatic from it and your blood pressure was always normal. cardiology evaluatd you and recommended a beta blocker called metoprolol. followup instructions: appointment #1: doctor: infectious disease, date/time: 10:50a location: , ,lm , basement . appointment #2 md: dr specialty: orthopedics date/ time: at 11:30am location: , phone number: special instructions for patient: please come at 11:30 to register in the lobby for xrays and then you have an appt with dr at 12:30pm. must get xrays first. appointment #3 md: dr specialty: nephrology date/ time: at 1pm location: , phone number: special instructions for patient: . appointment #4 md: dr specialty: dermatology date/ time: at 10:l30am location: , bldg, phone number: special instructions for patient: procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified diagnoses: obstructive sleep apnea (adult)(pediatric) congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hyposmolality and/or hyponatremia severe sepsis gout, unspecified personal history of tobacco use unspecified glaucoma hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) paroxysmal ventricular tachycardia other and unspecified hyperlipidemia other specified septicemias morbid obesity paralytic ileus personal history of venous thrombosis and embolism surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation accidents occurring in residential institution other chronic nonalcoholic liver disease unspecified cataract ulcer of other part of lower limb venous (peripheral) insufficiency, unspecified esophageal varices without mention of bleeding infection and inflammatory reaction due to internal joint prosthesis 

Answer: The patient is high likely exposed to