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: sulfa (sulfonamides) / oxacillin / heparin agents attending: chief complaint: hypotension major surgical or invasive procedure: . history of present illness: 70 yo m with history of esrd on hd, multiple mrsa line infections, atrial fibrillation, and cad who is admitted to the micu for respiratory distress. . the patient was noted at dialysis on the day prior to admission to have a fever to 102 with altered mental status and was sent to the ed. he was admitted to the general medicine service on with fever and lethargy. on the floor, the patient was continued on vancomycin for likely hd line infection. an lp was not performed given that the pt's lethargy had improved and he was thought to be at his baseline mental status. he was started on levofloxacin this morning for gnr in his blood. . the patient had been doing well until today. 35 minutes after initiating dialysis (with 500cc fluid removal), the pt began having rigors with shortness of breath. his temperature increased to 101.7, bp was 203/126 with hr 122. his oxygen saturation decreased to 88% ra. he was given a nebulizer with slight improvement in his subjective complaints of dyspnea. he was initially placed on 5l nc which was titrated up to 15l nrb mask. the micu was called for evaluation. past medical history: 1. esrd (unclear etiology) on hd m/w/f s/p r cadaveric tx ' at , failed ', removed 2. staph aureus (sensitive to ox, resistant to pcn) sepsis, recent line infections; micro data 3. htn 4. afib 5. ddd pcm 6. cad - mild 40% prox lad on cath ' 7. lue dvt 8. l tkr ' 9. hypothyroidism 10. hx of tuberculosis as child, ppd neg social history: retired dentist living in with wife, kids, and , denies etoh/tob. family history: both parents died in 90's, healthy. physical exam: vitals: t 102.7 bp 108/40 hr 90 rr 26 99% on 100% nrb gen: ill-appearing man in respiratory distress, answers questions yes and no, diaphoretic heent: dry mucous membranes, perrl, eomi neck: supple, jvp ~ lungs: diffuse crackles with decreased breath sounds and dullness to percussion in bilateral lower lobes cor: rrr, nml s1s2 abd: nabs, soft ntnd ext: warm, no edema, previous fistula rue brief hospital course: 1. hypoxic respiratory failure: etiology of respiratory distress/failure not entirely clear. cxr reveals slightly increased vascular markings and new cuffing, concerning for possible volume overload though compared to last several months the cxr is not that different. this cxr was after the patient was acutely hypertensive to 203/126 with hr 122, which could point to possible flash pulmonary edema. given hx of dvt, can also consider pe, especially with large a-a gradient. pt also has element of hypoventilation with poor oxygenation by abg. gave pt trial of bipap to see if pt appeared more comfortable, pt's respiratory status did not improve and pt appeared uncomfortable. pt intubated, received cta to r/o pe. pt tolerated intubation but attempts to wean from ventilator unsuccessful. pt developed opacity on cxr suggestive of pna and abx treatment initiated once mrsa pneumonia identified; however, pt's respiratory distress did not resolve c vancomycin x 19 days. trach placed and pt weaned on ventilator. pulmonary edema noted on cxr and pt diuresed gently because prone to hypotension particularly c hemodialysis. required assist control but eventually weaned to pressure support. currently, limiting factor largely pt's respiratory muscle weakness 2/2 prolonged hospitalization. pt has tolerated ps x 7 days and nights. yesterday also tolerated trial sprint of although became tachypneic. partly anxiety--> will try ativan during sprints. -in effort to improve resp muscle weakness continue sprints of lower pressure for 45 mins until pt sob/tachpneic c return to higher pressure afterwards to allow pt to rest -placed passe valve . 2. sepsis: pt with elevated lactate, fevers and hypotension (after intubation) pointing to sepsis. likely line infection from femoral dialysis catheter. blood cultures growing gnr and gpc. will discontinue dialysis line. continue levofloxacin for gnr (which are sensitive) and vanco given hx of staph aureus line infections. after abx course pt continued to have intermitent feverss and multiple episodes fo map dropping into 30-40s. initially treated c multiple ivf boluses. however, pt eventually required levophed to maintain map>60. etiology of hypot likely sepsis and hypovolemia as pt had cvps<10 and hypotension worse after hemodialysis. pt eventually grew serratia out of his blood cultures and was treated c a 21 day course of ceftaz. in addition, his dialysis cath was pulled and a new one placed. afterwards, he continued to have low grade fevers and developed the aforementioned lll pna. also, his r femoral line was pulled and grew coag- staph. therefore he was started on a 7 day course of meropenem and vancomycin. on this regimen his lll opacity has resolved and his fever curve has turned downward. he has since had no positive blood cultures. pt currently no wbc, no tachyc and today hypertensive c maps>75. bld cx ngtd. stool neg for c diff. tte no signs of ie. 3. esrd: received hemodialysis initially and then was transitioned to cvvh. once his bp tolerated he was transitioned back to hd. followed by renal service throughout. the pt did not make any urine throughout his stay. with hd his bp initially dropped. therefore, his hd was spaced out and less fluid was withdrawn during each session. attempts were made to keep the pt net fluid negative during the week. pt c temporary dialysis cath in place and will require more permanent line eventually. pt required supplementation of his phosphate c neutraphos regularly and briefly reqrd recalcitrol. pt currently tolerating removal of 2kg of fluid via hd three times a week. holding beta blocker on dialysis days to prevent instigation of hypotension. -per renal pt will eventually require more permanent access. 4. pt's hct repeatedly dropped over last three weeks requiring multiple transfusions. etiology unknown. possibly gi bleed as pt c h/o melanic stools, guiac positive regularly, and on significant anticoagulation c argatroban/coumadin. rbc scan negative for gi bleed. alternatively, maybe esrd. pt given epo . also, maybe fe deficiency and so pt given iron supplements. currently hct stable x 5ds off anticoagulation. following hcts and remained in low 30s. will restart anticoagulation. transfuse for hct<25. pt will require colonoscopy/egd as outpt to further eval guiac positive stools. . . 5. atrial fibrillation: intermittently v-paced. pt c one episode of tachycardia c rate controlled c diltiazem. otherwise no incidents. pt's anti-coagulation held for one week while hct unstable. currently hct stable and restarted coumadin. goal inr 2- 6. pt c h/o hit and also upper extremity clots so not started on heparin. anti-coagulated in hospital c argatroban and then transitioned to coumadin. anticoagulation held while pt's hct unstable. . 7. fen: pt tolerating tube feeds via peg tube. requires intermitent supplementation of phosphate c neutraphos based on low serum phosphate. . 8. access: right ij in place c 3 ports, 2 of which are dedicated for use only c cvvh. r femoral removed and grew coag negative staph. ir reluctant to place on r as stent from ij to svc. on left pt has braciocephalic clot preventing pic placement. pt now c 1 peripheral ivs. 9. ppx: pneumoboots. ppi, coumadin . 10. full code . 10. communication: wife and daughter medications on admission: 325 qd folate vitamin b12 ranitidine amiodarone 200 qd timolol 1 gtt lopressors 25mg tid coumadin 2g qd discharge medications: 1. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 2. cyanocobalamin 100 mcg tablet sig: 0.5 tablet po daily (daily). tablet(s) 3. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for fever. 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 5. docusate sodium 150 mg/15 ml liquid sig: one (1) po bid (2 times a day). 6. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q4h (every 4 hours) as needed. 7. albuterol sulfate 0.083 % solution sig: inhalation q4h (every 4 hours) as needed. 8. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day): hold if sbp<120. 10. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 11. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day): continue until no longer see thrush in mouth. 12. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 13. miconazole nitrate 2 % powder sig: one (1) appl topical prn (as needed). 14. lorazepam 1 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed: for anxiety when pt's resp rate increases significantly. 15. lansoprazole 30 mg susp,delayed release for recon sig: one (1) po bid (2 times a day). 16. warfarin sodium 2 mg tablet sig: 1.5 tablets po daily (daily): check inr daily for goal inr of . 17. outpatient lab work please check inr daily while pt on coumadin. goal inr of . adjust dose accordingly. discharge disposition: extended care facility: hospital - discharge diagnosis: end stage renal disease, sepsis, pneumonia, line infection, anemia, gastrointestinal bleed discharge condition: stable discharge instructions: please return to the ed or call your doctor if you have shortness of breath, chest pain or any concerns at all. followup instructions: follow-up with your primary care doctor this week. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more diagnostic ultrasound of heart insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis non-invasive mechanical ventilation percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy transfusion of packed cells transfusion of other serum phlebography of other specified sites using contrast material infusion of vasopressor agent diagnoses: congestive heart failure, unspecified iron deficiency anemia secondary to blood loss (chronic) severe sepsis unspecified acquired hypothyroidism atrial fibrillation infection with microorganisms resistant to penicillins methicillin susceptible staphylococcus aureus septicemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure blood in stool septic shock long-term (current) use of anticoagulants methicillin susceptible pneumonia due to staphylococcus aureus cardiac pacemaker in situ infection and inflammatory reaction due to other vascular device, implant, and graft knee joint replacement septicemia due to serratia 

Answer: The patient is high likely exposed to