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: fevers, seizure. major surgical or invasive procedure: central line placement. history of present illness: mr. is a 62 year old gentleman with ms, chronic foley, multiple uti's, and seizure disorder. taken from nursing home to ed for fever spike to 102 and subsequent tonic clonic seizure. in , pt somnolent, sbp in mid 80's. sepsis catheter placed. pt given several l of crystalloid (normal saline) with improvement of bp and ms. , levofloxacin, and flagyl in ed. in micu dilantin loaded, mental status reportedly improved but with low blood pressures (range 85-95), urine output low normal. on review of history, pt apparently had narrowing of anti-epileptic medication to only carbamazepine with discontinuation of dilantin in --review of medical records reveal his is still on phenytoin 200 daily. on admission, patient complained of 'stuffy nose.' past medical history: 1) secondary progressive ms: first symptoms in ; received courses of steroids in the past; diagnosed at ; now with dementia, decreased vision, paraplegia and decreased function ue l>r, unable to ambulate for the past 6 yrs; foley; 2) seizure disorder: no seizures since , has been on pht and tegretol 3) frequent utis (klebsiella esbl in past) 4) retention 5) trigeminal neuralgia 6) gerd 7) decub ulcers back and feet 8) decreased vision (20/400) 9) temporomandibular joint pain social history: the patient had lived in an elder apartment and has a live-in health aide. sister very involved in care. came from nursing home this admission. family history: non-contributory physical exam: on admission: t 98.8 bp 96/45 (sbp range 74-102) hr 92 (72-95) r 18 o2sat 96 on 3l u/o 891 cc since mn gen: thin caucasian male in nad difficulty speaking due to pain heent: mm dry, heart: nl rate, s1s2, no gmr lungs: cta ant abd: flat, soft, nt, nd +bs ext: heels wrapped in bandages foley: dark urine, brownish material in bag. neurol: follows commands, oriented to person and place ("") --not to time (). toes down going bilaterally. pertinent results: wbc 29.5 n:91.2 band:0 l:3.6 m:5.1 e:0 bas:0.1 at 7 pm had 23 bands. . hgb 10.9/hct 31.6 mcv 94 plts 270 . na 137 cl 109 bun 11 glu 141 ag=4 k 3.7 hco3 24 cr 0.5 . ca: 7.0 mg: 1.9 p: 2.3 alt: 52 ap: 54 tbili: 0.2 alb: pnd ast: 46 ldh: dbili: tprot: : 101 lip: 45 tsh:2 vitb12-729 folate-15.6 valproate: <3.0 carbamaz: 5.5 . lactate:2.1 from 6.2 . %hba1c-5.2 . blood cultures: no growth (not final at time of summary) . : urinalyisis: many bacteria, > 50 wbc, nitrate neg , le moderate. urine culture: contamination. . head ct negative. brief hospital course: mr. is a 62 year old gentleman with multiple sclerosis, seizure disorder, dementia, with chronic indwelling foley foley and multiple uti's who presents with fever, seizure, bandemia, and hypotension. . 1) sepsis: in micu, bp and urine output were low-normal but responsive to fluids. initial assessment was that the patient septic secondary to uti and developed febrile seizures. urine culture was unrevealing due to contaminant and previous antibiotics administered at nursing home. given his history of esbl klebsiella uti and long-term residence at a skilled nursing facility, he was treated with with meropenem and . his foley was replaced. he became afebrile, and his bandemia resolved and he had no further seizure activity. presumably his presentation was secondary to tract infection in the setting of chronic foley. patient hemodynamically normalized on hd 2. mental status returned to baseline at that point, and urine output improved. on , he was transferred from the icu to the medical service. his historical micro data was reviewed, and given no prior history of mrsa in urine cultures, was discontinued. he was discharged with a plan to complete a 14-day course of meropenem (day 1=, day 14 ). . 2) seizures: seizure threshold likely was lowered in the setting of fevers, sepsis, hyponatremia. he was evaluated by neurology and loaded with dilantin following arrival to icu. he had no further seizure activity while inpatient. per neurology recommendations, dilantin and carbamazepine doses were modified according to following goal levels: dilantin (corrected) level: carbamazepine level: . 3) hyponatremia: serum sodium level was 129 on admisssion, likely a reflection of hypovolemia. this corrected with fluid resuscitation. . 4) skin breakdown: patient with stage i breakdown over dorsal surfaces of feet and isolated spots at bony prominences. a wound care consult was obtained, and recommendations were implemented as follows: support surface - atmos air mattress turn and reposition every 1-2 hours and prn heels off bed surface at all times waffle boots ble's if oob, limit sit time to one hour at a time and sit on a pressure relief cushion. moisturize b/l le's and feet . commercial wound cleanser or normal saline to irrigate/cleanse all open wounds. pat the tissue dry with dry gauze. apply moisture barrier ointment(criti-aid clear) to bilateral dorsum of feet . . 5) hyperglycemia: patient was noted to be hyperglycemic in the setting of sepsis and was maintained on a humalog sliding scale. question of diabetes was raised; however, a1c was 5.2. . 6) ms: no medications, no active issues. . 7) pain control: continued outpatient regimen of baclofen and oxycodone. . 8) ppx: hep sc, ppi, bowel regimen. . 9) access: right ij was placed per the sepsis protocol in the ed and later discontinued prior to transfer from micu. picc attempt unsuccessful at bedside, and interventional radiology was consulted for picc placement prior to discharge. medications on admission: 1) nystatin units tid 2) tramadol 25 mg prn 3) carbamezepine 300 mg qid 4) phenytoin 200 daily 5) baclofen 10 mg qid 6) oxycodone 5 mg q6h 7) bisacodyl 8) senna 17.2 qhs 9) vitamin c 500 mg 10) colace 100 daily discharge medications: 1. baclofen 10 mg tablet sig: one (1) tablet po qid (4 times a day). 2. carbamazepine 200 mg tablet sig: one (1) tablet po four times a day. 3. phenytoin sodium extended 200 mg capsule sig: one (1) capsule po once a day. 4. senna 8.6 mg tablet sig: two (2) tablet po hs (at bedtime). 5. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed. 7. oxycodone 5 mg tablet sig: 1-2 tablets po every 4-6 hours as needed. 8. bisacodyl 5 mg tablet, delayed release (e.c.) sig: tablet, delayed release (e.c.)s po daily (daily) as needed. 9. nystatin 500,000 unit tablet sig: one (1) tablet po three times a day. 10. heparin lock flush (porcine) 100 unit/ml syringe sig: two (2) ml intravenous daily (daily) as needed. 11. meropenem 500 mg recon soln sig: one (1) recon soln intravenous q6h (every 6 hours) for 14 days: day 1=. day 14=. discharge disposition: extended care facility: center discharge diagnosis: tract infection sepsis multiple sclerosis seizure disorder hyponatremia acute renal failure hyperglycemia stage i pressure ulcer discharge condition: afebrile, hemodynamically stable. discharge instructions: you were admitted with a tract infection. you are being discharged with instructions to complete a 14-day course of iv antibiotics. . you should return to the hospital if you are experiencing fevers, hypotension, chest pain, shortness of breath, changes in mental status, seizure activity, or other concerning symptoms. followup instructions: , clinic phone: date/time: 10:00 . , md opthalmology phone: date/time: 10:30 . visual field screening phone: date/time: 11:00 procedure: venous catheterization, not elsewhere classified diagnoses: esophageal reflux urinary tract infection, site not specified acute kidney failure, unspecified unspecified septicemia hyposmolality and/or hyponatremia severe sepsis pressure ulcer, other site epilepsy, unspecified, without mention of intractable epilepsy pressure ulcer, heel multiple sclerosis infection and inflammatory reaction due to indwelling urinary catheter 

Answer: The patient is high likely exposed to