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: vancomycin attending: chief complaint: infected right hip major surgical or invasive procedure: none history of present illness: patient is a 41m s/p l thr for post traumatic oa complicated by infection. on he noticed redness and drainage from wound and then had fevers . presented to ed at that time. a hip aspirate revealed frank pus and he then ermergently underwent id with liner exchange and placement of an incisional vac by dr. on . intraoperative cultures eventually grew mrsa. he was continued on vancomycin postoperatively and followed by id. post operative course was complicated by arf secondary to atn, recurrent svt, and delirium. depsite antibiotics, he continued to have a leukocytosis and ongoing fevers. he underwent repeat ids with antibiotic spacer placement on and . intraoperative cultures from grew sparse staph aureus. no grow from culture. postoperatively he continued to spike temps despite vancomycin and repeated i/ds. serial blood cultures repeatedly were negative. cxr was normal. tee on was negative for vegatations. recurrent svt was managed by cardiology with po diltiazem. everyone was quite perplexed by his continued fevers. on patient left ama. however, he could not get into his car and decided to immediately return to the ed that same day. patient was then readmitted to our service for continued management. past medical history: -see hpi ex-lap with resection of his small bowel, orif r femur, t10-l3 fusion, transpedicular decompression, at t12, multiple laminotomies, right icbg, h/o polysubstance abuse, depression social history: disability. tobacco 1ppd. etoh, crack cocaine, opiate use in past but none recently. denies ivdu.nvc family history: nc physical exam: at the time of discharge: avss nad wound c/d/i without erythema /fhl/ta/gs intact silt distally pertinent results: labs on admission: 06:00am blood wbc-5.4 rbc-2.89* hgb-8.3* hct-26.0* mcv-90 mch-28.8 mchc-32.0 rdw-15.8* plt ct-269 06:20am blood neuts-77.5* lymphs-14.4* monos-5.2 eos-2.6 baso-0.3 06:00am blood plt ct-269 06:00am blood glucose-129* urean-20 creat-1.9* na-133 k-3.6 cl-98 hco3-22 angap-17 06:00am blood calcium-7.2* phos-3.7 mg-1.3* labs prior to dc: micro: , , blood cultures: no growth urine cxr: no growth stool cdiff: negative brief hospital course: patient readmitted shortly after leaving ama for continued fevers s/p infected left thr. hospital course summarized by systems below. neuro: patient maintained on seroquel prn, which he did not require during stay. he remained calm throughout stay. he was not suicidal. cv: patient was hd stable during stay. he continued to have intermittent svts responding to po diltiazem. po dilt regimen was increased for continued svts with good effect. rate of svts significantly reduced with resolution of fever. cardiology reconsulted, no new recs. when made npo for abdominal pain (see gi), av node suppression maintained with standing iv lopressor with good effect. cardiology saw patient several times in house. given a structurally normal heart, they are not recommending any additional diagnostic or therapeutic interventions besides po diltiazem at this time. he can follow up with cardiology as needed. resp: stable. ongoing fevers were concerning for pna. cxr was negative for infiltrate. renal: improved. patient renal function recovered to baseline following arf secondary to atn. u/o adequate during stay. gi: on patient developed severe diffuse abdominal pain with recurrent n/v in the setting of a grossly bloody bowel movement. kub showed dilate sb loops without free air. given prior history of ex lap with sbr in , we were worried about a high grade sbo. general surgery was immediately consulted. he was made npo, placed on mivfs, and a ngt was placed, which showed bilious return without bright red blood. he was placed on iv protonix. subsequent i+/o+ abd ct showed thickening of the duodenum and distal ileum. no sbo or signs of colitis. his abdominal labs were unremarkable. given grossly blood stool suggestive of a gib and abd ct findings, gi was immediately consulted. gi recommended both a colonoscopy and egd. patient refused proposed procedures. he was deemed in capacity. he is highly recommended to follow up at clinic with dr. . at ( to schedule a colonoscopy and egd. id: id service actively followed patient during stay. continued fevers while on vancomycin and clean incision was concerning. patient developed a significant full body rash concerning for a drug reaction. dermatology was consulted and agreed that vancomycin, the newest drug introduced to this pt, was the most likely culprit. a wbc scan showed likely osteomyelitis of the left hip, as expected, but was without other hot spots suggestive of a missed infections focus. given these findings, in addition to an unremarkable standard fever workup, we decided to stop the vancomycin and switch to daptomycin. within 2-3 days of switch, his fevers subsided and his rash improved. these findings confirmed our suspicion to a vancomycin-induced fever and skin rash. incidentally, we also believe he developed drug-induced thrombocytopenia (see hem). a new rash developed while on daptomycin on limited to bilateral feet and shins. id did not think this was related to daptomycin. rash was stable prior to discharge and should be monitored closely for progression. patient scheduled to continue daptomycin until follow up appointment with id, potential end date being . patient is scheduled to see dr. in clinic on . patient afebrile and wbc wnls prior to discharge. he will need weekly cbc/diff, ck, bun/cr drawn and faxed to clinic as instructed. hem: patient was chronically anemic during stay. he received 2 units prbc on for a hct of 22.8 in the setting of frequent svts. pt developed significant thrombocytopenia on . nadir of 50. hematology was consulted and believed thrombocytopenia was drug induced. hit was less likely, but was nevertheless ruled out with a negative hit antibody. dic and ttp/k??????ss were unlikely. there were no signs of active hemolysis. platelets slowly rose following discontinuation of vancomycin, as expected. unclear if low platelets contributed to gib. platelet count returned to by time of discharge. hct 24 prior to discharge, which again reinforced the importance of gi follow up with upper and lower endoscopy. patient again refused inpatient scopes, and reassured me that he will make a gi appointment in the near future. ortho: his hip incision was clean/dry/intact during stay. patient afebrile soon after vancomycin discontinued. no immediate plans for another i/d. on patient developed lle edema concerning for dvt. le??????o was negative. staples were removed on . medications on admission: fluoxetine, vancomycin, nicotine, docusate, senna, diltiazem, gabapentin, fentanyl patch, enoxaparin 40 daily, valium, omeprazole discharge medications: 1. fluoxetine 20 mg capsule sig: two (2) capsule po daily (daily). 2. nicotine 21 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal once a day. disp:*30 patch 24 hr(s)* refills:*0* 3. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for severe pain: do not drive or operate heavy machinery. disp:*90 tablet(s)* refills:*0* 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 6. gabapentin 300 mg capsule sig: one (1) capsule po tid (3 times a day). 7. fentanyl 50 mcg/hr patch 72 hr sig: one (1) patch 72 hr transdermal q72h (every 72 hours). disp:*10 patch 72 hr(s)* refills:*0* 8. triamcinolone acetonide 0.1 % cream sig: one (1) appl topical tid (3 times a day): apply to affected skin area. do not apply around hip incision. disp:*1 tube* refills:*0* 9. enoxaparin 40 mg/0.4 ml syringe sig: one (1) subcutaneous daily (daily): continue until instructed otherwise. disp:*21 syringes* refills:*0* 10. daptomycin 500 mg recon soln sig: seven hundred (700) mg intravenous once a day. disp:*30 bags* refills:*0* 11. valium 5 mg tablet sig: one (1) tablet po at bedtime as needed for muscle spasm. disp:*14 tablet(s)* refills:*0* 12. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 13. ferrous sulfate 325 mg (65 mg iron) capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). 14. diltiazem hcl 30 mg tablet sig: one (1) tablet po qid (4 times a day). discharge disposition: extended care facility: discharge diagnosis: infected left thr discharge condition: good discharge instructions: experience severe pain not relieved by medication, increased swelling, decreased sensation, difficulty with movement, fevers >101.5, shaking chills, redness or drainage from the incision site, chest pain, shortness of breath or any other concerns. 2. please follow up with your pcp regarding this admission and any new medications and refills. 3. resume your home medications unless otherwise instructed. 4. you have been given medications for pain control. please do not operate heavy machinery or drink alcohol when taking these medications. as your pain improves, please decrease the amount of pain medication. this medication can cause constipation, so you should drink plenty of water daily and take a stool softener (e.g., colace) as needed to prevent this side effect. 5. you may not drive a car until cleared to do so by your surgeon or your primary physician. 6. please keep your wounds clean. 7. please call your surgeon's office to schedule or confirm your follow-up appointment at 2 weeks. 8. please do not take any nsaids (i.e. celebrex, ibuprofen, advil, motrin, etc). 9. anticoagulation: please continue your lovenox until your follow up appointment to prevent deep vein thrombosis (blood clots). 10. wound care: please keep your incision clean and dry. please place a dry sterile dressing on the wound each day if there is drainage, otherwise leave it open to air. check wound regularly for signs of infection such as redness or thick yellow drainage. 11. vna (once at home): home pt/ot, dressing changes as instructed, wound checks. 12. activity: partial weight bearing as tolerated on the operative leg. no strenuous exercise or heavy lifting until follow up appointment. physical therapy: non-weight bearing lle. treatments frequency: wound checks, daily daptomycin infusions, lovenox injections. prescribed antibiotic information: daptomycin 700mg iv daily needs weekly cbc/diff, ck, bun/cr other medications of note for drug inteactions, other oral antibiotics taken in conjunction etc. access changes comments all laboratory results should be faxed to infectious disease r.ns. at ( all questions regarding outpatient antibiotics should be directed to the infectious disease r.ns. at ( followup instructions: please schedule a 2 week follow up appointment with dr. at (. please call dr. at the clinic to schedule an outpatient upper endoscopy and colonoscopy at (. provider: , md phone: date/time: 10:00 provider: , md phone: date/time: 9:30 provider: , md phone: date/time: 9:30 procedure: venous catheterization, not elsewhere classified arthrotomy for removal of prosthesis without replacement, hip arthrocentesis other local excision or destruction of lesion of joint, hip other local excision or destruction of lesion of joint, hip other local excision or destruction of lesion of joint, hip other local excision or destruction of lesion of joint, hip insertion or replacement of (cement) spacer insertion or replacement of (cement) spacer insertion or replacement of (cement) spacer revision of hip replacement, acetabular component synovectomy, hip diagnoses: thrombocytopenia, unspecified tobacco use disorder acute kidney failure with lesion of tubular necrosis acute kidney failure, unspecified depressive disorder, not elsewhere classified sepsis surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation accidents occurring in other specified places personal history of noncompliance with medical treatment, presenting hazards to health surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation sinoatrial node dysfunction cocaine dependence, continuous hip joint replacement paroxysmal supraventricular tachycardia methicillin resistant staphylococcus aureus septicemia pyogenic arthritis, pelvic region and thigh unspecified osteomyelitis, pelvic region and thigh infection and inflammatory reaction due to internal joint prosthesis opioid type dependence, episodic antisocial personality disorder 

Answer: The patient is high likely exposed to