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: sepsis, endocarditis, pneumonia, breast mass major surgical or invasive procedure: none history of present illness: 74 y/o f w/ pmh: cad, chf, copd, pna, presented to osh on w/ fevers, chills, dysuria, flank back pain x 3 days. diagnosed with pyelonephritis, received ampicillin/gentimicin + ciprofloxacin + rocephin. blood cx were positive for gpc (later identified as mrsa), pt was switched to vacomycin + gentamicin. fever went to 105.3, pt became hypotensive 80/20, had st elevations on ecg. inr was 3.8, pt received 5 mg vitamin k. sent to for further management. past medical history: cad (anterior-inferior defects noted on previous stress tests), s/p stemi on . plans for cardiac intervention during recent hospitalization were deferred due to sepsis, hypotension, and the discovery of high grade mrsa bacteremia. echo disclosed ef 40-45%, and possible rv free wall depression. peak ck=580, trop 1.55. patient is followed by dr. . staph aureus bacteremia, , complicated by mitral valve endocarditis. patient started on vancomycin . source of mrsa bacteremia not identified, although may have been secondary to mrsa pneumonia (see below). rul multifocal pneumonia, associated with parapneumonic right pleural effusion, noted on ct chest on . attempts to sample this fluid collection were unsuccessful due to its relatively small size. right hilar lymphadenopathy (2.3 x 2.3 cm right hilar lymph node) noted on ct chest. 1.6 cm left breast mass left upper lip basal cell carcinoma chf (ef=40-45%, 1+ mr ), copd venous thromboembolism- pe. patient takes coumadin daily. hyperthyroidism hyperlipidemia obesity diverticulosis (noted on ct abdomen in ) social history: the patient lives alone, but was discharged from on to house rehabilatation facility. the patient has two children. the patient has a 20 pack year history of tobacco use. she has a history of occasional etoh use. no history of illicit drugs. family history: non-contributory physical exam: at admission: t=102.7, bp=112/39, p=117, rr=35, o2sat=97% 2l? gen: obese female in nad, axox3 heent: mmdry, eomi, perrl, jvp~6, crusty scaly plaque above left lip (1cm diameter) cv: regular tachycardic, 2/6 sem @ sternal border non-radiating, no rubs, gallops pulmo: diminished breath sounds b/l @bases, fine anterior wheezes abd: slightly distended, soft, nt, bs+, no rebound, no guarding ext: venous stasis, warm, dp bilaterally neuro: axox3 on the floor: t=101-101.3, bp=117-130/48-51, hr=110-111, rr=20, o2sat=97% 2l gen: lying in bed in nad cv: regular tachycardic, 2/6 sem throughout pericardium, non-radiating, no rubs/gallops, no elevated jvp, no jvd pulmo: crackles at bases b/l, no wheezes/ronchi abd: obese, soft, nt, nd, bs+, no rebound, no guarding ext: warm, 2+ radial/pt/dp, no c/c, trace edema pertinent results: 10:57pm d-dimer-3161* 10:57pm pt-24.4* ptt-43.2* inr(pt)-3.7 10:57pm wbc-9.1 rbc-4.43 hgb-12.5 hct-36.6 mcv-83 rdw-13.9 plt count-125* 10:57pm calcium-8.7 phosphate-2.5* magnesium-1.8 10:57pm ck-mb-29* mb indx-5.0 ctropnt-1.55* 10:57pm ck(cpk)-580* 10:57pm gluc-118* bun-27* cr-1.0 na-137 k-3.8 cl-101 co2-24 a-gap-16 10:59pm urine rbc-66* wbc-11* bacteria-few yeast-many epi-0 10:59pm urine blood-lg nit-neg prot-30 gluc-neg ket-50 bili-neg urobil-neg ph-5.0 leuk-tr 10:59pm urine color-amber appear-slcldy sp -1.025 10:59pm urine hyaline-2* 10:59pm urine amorph-rare tte: the left atrium is moderately dilated. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. lv systolic function appears depressed with distal septal, distal anterior and apical hypokinesis but views are technically suboptimal (estimated ejection fraction ?45%). right ventricular free wall motion appears depressed (but the free wall was not fully visualized). there is a moderate resting left ventricular outflow tract obstruction without significant change with valsalva maneuver. the aortic valve leaflets are moderately thickened. there is mild aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen (may be underestimated due to acoustic shadowing). the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. 10:57 pm blood fungal culture (pending), blood/afb culture (pending) 10:57 pm blood aerobic culture (pending), anaerobic bottle (pending) 10:59 pm urine catheter culture (pending) 11:11 pm blood aerobic culture (pending), anaerobic bottle (pending) clostridium difficile toxin assay, feces negative for c. difficile toxin by eia. reference range: negative. ct chest: 1. multifocal air space consolidation within the right upper lobe likely represents multifocal pneumonia. lymphadenopathy seen within the chest is likely reactive to this, with note made of a 2.3 cm right hilar node. 2. right-sided parapneumonic pleural effusion. 3. 1.6 cm left breast mass. this is concerning for breast cancer. further evaluation with mammography and ultrasound is recommended 4. cholelithiasis without cholecystitis. 5. diverticulosis without diverticulitis tte: the left atrium is dilated. no thrombus/mass is seen in the body of the left atrium. the right atrium is dilated. overall left ventricular systolic function is mildly depressed (lvef 40-45%) with septal hypokinesis. right ventricular systolic function appears mildly depressed. there are complex (>4mm, non-mobile) atheroma in the aortic arch and the descending thoracic aorta. the aortic valve leaflets are moderately thickened but mobile. no masses or vegetations are seen on the aortic valve. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is moderate to severe, focal mitral annular calcification of the posterior leaflet.there is no mitral valve prolapse. there is a small, slightly mobile mass (0.3mm x 0.5mm)) attached to the posterior mac consistent with a vegetation. there is no obvious paravalvular abcess cavity. mild (1+) mitral regurgitation is seen (mitral regurgitaion may be underestimated due to acoustic shadowing). no vegetation/mass is seen on the tricupsid or pulmonic valve. there is a trivial/physiologic pericardial effusion. impression: small mitral valve vegetation c/w endocarditis. moderate to severe focal mitral annular calcification. mild mitral regurgitation. no paravalvular abcess seen. mildly depressed lvef with regional hypokinesis c/w cad. ecg: normal sinus rhythm. left atrial abnormality. q waves in leads v1-v4 consistent with prior anterior myocardial infarction. non-specific st-t wave abnormalities. compared to the previous tracing of no diagnostic interval change brief hospital course: sepsis/endocarditis/pna: post antibiotic blood (bacterial and fungal) + urine cultures were all no growth to date at the time of discharge. tte demonstrated small mitral valve vegetation c/w endocarditis. moderate to severe focal mitral annular calcification. mild mitral regurgitation. no paravalvular abcess seen. mildly depressed lvef with regional hypokinesis c/w cad. ct of the chest showed 1. multifocal air space consolidation within the right upper lobe likely represents multifocal pneumonia. lymphadenopathy of a 2.3 cm right hilar node. 2. right-sided parapneumonic pleural effusion. 3. 1.6 cm left breast mass concerning for breast cancer. after identification of the organism as mrsa (2 days), the gentamicin was discontinued and vancomycin was maintained. the effusion was deemed to small to do a thoracentesis. stemi: elvated c-mb and trop-t, st elevations in v2-v4. maintained on metoprolol, atorvastatin, aspirin, clopidogrel, nitro prn. no catheterization, as septic. hyperthyroidism: controlled on methimazole 10 mg qd arf: cr=1.6 on arrival to , reduced to 1.0 by first day of hospitalization and remained at 0.7 throughout. copd: continued ipratropium neb q6h with 2 puffs q4-6h prn pe: pt w/ hx of pe maintained on coumadin which was held due to pending cath, however, given sepsis and relative cardiac stability cath postponed. coumadin will be reinitiated one day after discharge. basal cell carcinoma: dermatology was consulted and a biopsy was performed. pt to follow-up as outpt. yeast infection (groin): powder antifungal cream applied hyperlipidemia: continued on atorvastatin medications on admission: ###########home meds: toprol coumadin tapazole lasix lipitor asa ###########osh transfer meds: vancomycin 1 gm iv gentamicin 60 mg iv lopressor 1.5 mg q1h prn lopressor 12.5 mg q6h anzimet 12.5 mg iv prn tylenol prn discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po qd (once a day). 2. acetaminophen 325 mg tablet sig: two (2) tablet po q4-6h (every 4 to 6 hours) as needed for fever. 3. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed). 4. atorvastatin calcium 40 mg tablet sig: two (2) tablet po qd (once a day). 5. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 6. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po qd (once a day). 7. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation q4-6h (every 4 to 6 hours) as needed. 8. ipratropium bromide 0.02 % solution sig: one (1) inhalation every six (6) hours. 9. methimazole 10 mg tablet sig: one (1) tablet po once a day. 10. heparin sodium (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 11. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day). 12. promethazine hcl 25 mg/ml solution sig: one (1) injection q6h (every 6 hours) as needed for nausea. 13. lisinopril 5 mg tablet sig: one (1) tablet po at bedtime. 14. atenolol 50 mg tablet sig: one (1) tablet po qam. 15. vancomycin hcl 1,000 mg recon soln sig: one (1) intravenous every twelve (12) hours for 4 weeks. 16. warfarin sodium 1 mg tablet sig: one (1) tablet po at bedtime. discharge disposition: extended care facility: - discharge diagnosis: primary: 1. st elevation myocardial infarction. 2. staph aureus bactermia. 3. mitral valve endocarditis. 4. septicemia. 5. rul mutlifocal pneumonia. 6. parapneumonic right pleural effusion. 7. right hilar lymphadenopathy (2.3 x 2.3 cm right hilar lymph node) 8. 1.6 cm left breast mass. 9. left upper lip basal cell carcinoma. secondary: 1. hyperthyroidism. 2. venous thromboembolism - pe. 3. copd. 4. hypertension. 5. cad native vessel. 6. obesity. discharge condition: o2satting in 90s on ra. sbps in 120-130s. no fever, chest pain discharge instructions: 1) seek immediate medical attention if experiencing worsening fever, cough, chest pain, palpitations, nausea, decreased urine output. 2) take all medications as prescribed. 3) go to all follow-up appointments followup instructions: dr. (pulmonologist) saw patient while in hospital and recommended that she receive a follow-up ct scan of her chest to follow the 2.3 x 2.3 cm lymph node seen in hospital ct. , , md division of interventional cardiology-cath lab , 4 , phone: please make an appointment after being discharged from rehabilitation. pt needs further cardiac management status post stemi and endocarditis. she was also noted to have a breast mass on ct that needs follow-up mammography. please page dr. () for results of blood cultures at time of discharge or any other issues. provider: , md (dermatology) where: date/time: 9:00 for basal cell carcinoma above left lip, biopsy taken while in hospital. 1. will need bun/creatinine/electrolytes on monday the 18th and thursday the 21st, as recent initiation of ace-i.\ 2. vancomycin for 4 more weeks and then infectious disease evaluation - please follow troughs and interval sma-7's. 3. outpatient dental evaluation for evaluation of occult source of bactermia. 4. inr should be followed with goal of .25 procedure: venous catheterization, not elsewhere classified diagnostic ultrasound of heart diagnostic ultrasound of other sites of thorax diagnoses: pneumonia, organism unspecified subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery unspecified pleural effusion congestive heart failure, unspecified severe sepsis chronic airway obstruction, not elsewhere classified infection with microorganisms resistant to penicillins thyrotoxicosis without mention of goiter or other cause, and without mention of thyrotoxic crisis or storm methicillin susceptible staphylococcus aureus septicemia long-term (current) use of anticoagulants acute and subacute bacterial endocarditis personal history of venous thrombosis and embolism lump or mass in breast enlargement of lymph nodes malignant neoplasm of upper lip, vermilion border 

Answer: The patient is high likely exposed to