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: azulfidine / remicade / sulfa (sulfonamide antibiotics) / methotrexate / azathioprine attending: chief complaint: hypotension major surgical or invasive procedure: none history of present illness: 66 year old male with history of crohn's disease c/b fistulas s/p multiple surgeries, esrd on hd qmwf, who originally presented to osh with sudden onset of neck pain and blurry vision. patient reports that he woke up this morning, and when he stood up, suddenly felt acute onset of neck pain in the back of his neck. the pain was both at the midline and sides, described to be pressure like. no trauma to neck. also felt lightheaded, vision blurry, and felt like he might pass out. sitting down relieved his symptom somewhat. patient went to ed where he was noted to be hypotensive in the 70s. he received a 1 l bolus with some improvement of his symptoms. noncontrast head ct and cxr at osh reported to be normal. he was transferred to for neurological evaluation for concerns for vertebral artery dissection. by the time patient arrived at ed, his neck pain had resolved, and his blurry vision had improved. his tmax at home was 100.0. denies any chills or headaches. . in the ed, initial vs were: 98.6, 116, 115/55, 18, 100% ra. neurology evaluated the patient, recommended cta head and neck which is preliminarily read as no evidence of dissection. his labs were notable for a k of 6.6 on admission, for which he received kayexalate, as well as insulin/d50, which improved his k to 5.2. patient then began to become hypotensive again, down to the 70s. he was started on levophed, given a total of <1 l of fluids, with recovery of his pressure to the 100s. tmax in the ed was 103, for which he got 1 gram of tylenol. also noticed to have thick yellow urine. per patient, says he produces about half a cup of urine a day. patient received vancomycin, zosyn, cipro, and 4 g of mg. vitals on transfer were: 102/52, 108, 20, 99%2l. . in the micu, patient is feeling comfortable, neck pain resolved, blurry vision resolved, no longer feeling dizzy. no complaints. . past medical history: crohns disease s/p multiple surgeries esrd on hd nephrolithiasis h/o utis social history: lives alone, never married, denies tobacco, alcohol, illicit drug use family history: father - dm, htn physical exam: vitals: t: bp: p: r: 18 o2: general: aaox3, nad, pleasant heent: perrla, eomi, neck supple, no lad, no jvd cv: s1s2, tachycardic, ii/vi sem chest: cta b/l, no w/r/r, left hd catheter clean and dressed abd: several healed surgical scars, ostomy x2 clean and dressed, soft, nd, nt, +bs ext: rue av fistula, lue picc line clean and dressed, no e/c/c, 2+ peripheral pulses pertinent results: cxr () impression: right base atelectasis due to low lung volumes. no definite focal consolidation or superimposed edema. . cta head/neck () - prelim prominent left vertebral artery likely related to tortuosity. no definite dissection. no aneurysm or thrombosis. final read pending neuroradiology fellow input. . echocardiography report , (complete) done at 3:25:23 pm final referring physician information , c , 311 , status: inpatient dob: age (years): 66 m hgt (in): 66 bp (mm hg): 144/65 wgt (lb): 145 hr (bpm): 85 bsa (m2): 1.75 m2 indication: ?endocarditis. icd-9 codes: 424.90, 424.1, 424.0 test information date/time: at 15:25 interpret md: , md test type: tee (complete) son: cardiology fellow doppler: full doppler and color doppler test location: west echo lab contrast: none tech quality: adequate tape #: 2011w000-0:00 machine: vivid i-3 sedation: versed: 1.5 mg fentanyl: 75 mcg patient was monitored by a nurse throughout the procedure echocardiographic measurements results measurements normal range tr gradient (+ ra = pasp): *26 mm hg <= 25 mm hg findings right atrium/interatrial septum: normal interatrial septum. no asd by 2d or color doppler. left ventricle: overall normal lvef (>55%). right ventricle: normal rv systolic function. aorta: normal ascending, transverse and descending thoracic aorta with no atherosclerotic plaque. aortic valve: mildly thickened aortic valve leaflets (3). no masses or vegetations on aortic valve. mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. no mass or vegetation on mitral valve. moderate (2+) mr. tricuspid valve: normal tricuspid valve leaflets. no mass or vegetation on tricuspid valve. mild tr. borderline pa systolic hypertension. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. no vegetation/mass on pulmonic valve. physiologic (normal) pr. pericardium: no pericardial effusion. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was monitored by a nurse throughout the procedure. the patient was monitored by a nurse in throughout the procedure. local anesthesia was provided by benzocaine topical spray. the patient was sedated for the tee. medications and dosages are listed above (see test information section). the posterior pharynx was anesthetized with 2% viscous lidocaine. 0.1 mg of iv glycopyrrolate was given as an antisialogogue prior to tee probe insertion. no tee related complications. echocardiographic results were reviewed by telephone with the houseofficer caring for the patient. conclusions no atrial septal defect is seen by 2d or color doppler. overall left ventricular systolic function is normal (lvef>55%). with normal free wall contractility. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque to 40 cm from the incisors. the aortic valve leaflets (3) are mildly thickened. no masses or vegetations are seen on the aortic valve. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. no mass or vegetation is seen on the mitral valve. moderate (2+) mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. no vegetation/mass is seen on the pulmonic valve. there is no pericardial effusion. impression: no echocardiographic evidence of endocarditis. moderate mitral regurgitation. mild aortic regurgitation. globally normal biventricular systolic function. dr. was notified by telephone on at 1 pm. . . echocardiography report , tte (complete) done at 9:00:00 am final referring physician information , c , 311 , status: inpatient dob: age (years): 66 m hgt (in): 66 bp (mm hg): 126/73 wgt (lb): 135 hr (bpm): 90 bsa (m2): 1.69 m2 indication: endocarditis. icd-9 codes: 424.1, 424.0, 424.2, 424.90, test information date/time: at 09:00 interpret md: , md test type: tte (complete) 3d imaging. son: , rdcs doppler: full doppler and color doppler test location: west echo lab contrast: none tech quality: adequate tape #: 2011w000-: machine: vivid echocardiographic measurements results measurements normal range left atrium - long axis dimension: *4.2 cm <= 4.0 cm left atrium - four chamber length: *6.5 cm <= 5.2 cm left atrium - peak pulm vein s: 0.8 m/s left atrium - peak pulm vein d: 0.5 m/s left atrium - peak pulm vein a: 0.3 m/s < 0.4 m/s right atrium - four chamber length: *5.6 cm <= 5.0 cm left ventricle - septal wall thickness: 1.1 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.2 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 5.0 cm <= 5.6 cm left ventricle - ejection fraction: 56% >= 55% left ventricle - stroke volume: 88 ml/beat left ventricle - cardiac output: 7.92 l/min left ventricle - cardiac index: 4.68 >= 2.0 l/min/m2 left ventricle - lateral peak e': 0.12 m/s > 0.08 m/s left ventricle - septal peak e': *0.07 m/s > 0.08 m/s left ventricle - ratio e/e': 11 < 15 aorta - sinus level: *4.3 cm <= 3.6 cm aorta - ascending: *3.9 cm <= 3.4 cm aorta - arch: *3.5 cm <= 3.0 cm aortic valve - peak velocity: 1.9 m/sec <= 2.0 m/sec aortic valve - lvot vti: 28 aortic valve - lvot diam: 2.0 cm mitral valve - e wave: 1.0 m/sec mitral valve - a wave: 1.0 m/sec mitral valve - e/a ratio: 1.00 mitral valve - e wave deceleration time: 169 ms 140-250 ms tr gradient (+ ra = pasp): *42 mm hg <= 25 mm hg findings multiplanar reconstructions were generated and confirmed on an independent workstation. left atrium: mild la enlargement. right atrium/interatrial septum: mildly dilated ra. left ventricle: mild symmetric lvh with normal cavity size and regional/global systolic function (lvef>55%). no resting lvot gradient. no vsd. right ventricle: normal rv chamber size and free wall motion. aorta: mildy dilated aortic root. mildly dilated ascending aorta. mildly dilated aortic arch. aortic valve: mildly thickened aortic valve leaflets (3). no as. mild (1+) ar. mitral valve: no mass or vegetation on mitral valve. moderate (2+) mr. tricuspid valve: mildly thickened tricuspid valve leaflets. no mass or vegetation on tricuspid valve. moderate tr. moderate pa systolic hypertension. pulmonic valve/pulmonary artery: pulmonic valve not visualized. no ps. physiologic pr. pericardium: no pericardial effusion. conclusions the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function. quantitative (3d) lvef = 56%. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. the aortic arch is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. no mass or vegetation is seen on the mitral valve. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: no vegetations seen (adequate-quality study). mild aortic regurgitation. moderate mitral and tricuspid regurgitation. normal global and regional biventricular systolic function. in presence of high clinical suspicion, absence of vegetations on transthoracic echocardiogram does not exclude endocarditis. brief hospital course: 66 m with h/o crohn's disease, esrd on hd presents with hypotension, possibly due to urosepsis . # hypotension - possibly due to urosepsis. he has a history of utis. he is also on chronic steroids for crohn's disease. patient admitted with fever, tachycardia, white count of 16.1, and a dirty ua. there were no other sources of infection to explain white count and septic physiology. cxr shows atelectasis, no evidence of pneumonia. initially started on levophed in ed, able to wean and d/c by . covered with vanc and zosyn. blood culture showed staph species from picc line which was discontinued. his hd line was discontinued and he had a line holiday. he was continued on vancomycin dosed ad hd. tte and tee both showed no evidence of vegetations. he was afebrile and hd stable with negative surveilence cultures for three days and a new hd line was placed. he was discharged home hemodynamically stable. . # dizziness/blurry vision - likely hypotension. symptoms improved at osh with iv fluid bolus and with initiation of pressors here. symptoms resolved with stablization of blood pressure. ct showed no evidence of dissection. he was asymptomatic for the remainder of his stay. . # esrd on hd - admitted with k of 6.6, improved to 5.2 with iv fluids, kayexalate, and d50/insulin. continued hd as an inpatient. nephrocaps were started. he was discharged with instructions to continue hd on his outpatient shcedule. . # neck pain - unclear what etiology of his neck pain is, but it had resolved by the time he got to the micu. cta head and neck without evidence of dissection on prelim read. he had no more neck pain during his admission. . # crohn's disease - complicated by fistulas s/p multiple surgeries. prednisone continued. otherwise stable. he will follow up with his gastroenterologist as an outpatient. medications on admission: omeprazole 20 mg metoprolol 50 mg allopurinol 100 mg daily ropinirole 4 mg qhs prednisone 10 mg daily alprazolam 0.5 mg daily prn anxiety discharge medications: 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 2. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 3. ropinirole 1 mg tablet sig: four (4) tablet po hs (at bedtime). 4. prednisone 10 mg tablet sig: one (1) tablet po once a day. 5. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). disp:*28 cap(s)* refills:*2* 6. alprazolam 0.5 mg tablet sig: one (1) tablet po once a day as needed for anxiety. 7. vancomycin in d5w 1 gram/200 ml piggyback sig: as directed intravenous hd protocol (hd protochol) for 24 days. discharge disposition: home discharge diagnosis: mrsa bacteremia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were amditted to because you had a blood stream infection caused by mrsa that caused you to go into shock. you were managed in the icu overnight with medications to help maintain your blood pressures. the next morning you were able to maintain your blood pressure on your own and were transferred from the icu to the floor. you have been treated with iv antibiotics and will continue with them until . you will receive these at dialysis. we changed your hd line. . while you were here we made the following changes to your medication: #) we stopped your metoprolol. you should discuss the need to restart this medication with your pcp at your next visit . #) we started you on nephrocaps. you should take this once a day . #) we started you on vancomycin. this antibiotic should be given to you at each dialysis appointment until . you shoudl continue to take your other medications as prescribed followup instructions: thursday at 530pm with dr. for a follow up appointment. please call them at if you need to reschedule for any reason. . you should also call your vascular surgeons to follow up with them regarding your dialysis graft. . procedure: diagnostic ultrasound of heart hemodialysis venous catheterization for renal dialysis diagnoses: hyperpotassemia anemia in chronic kidney disease end stage renal disease renal dialysis status esophageal reflux urinary tract infection, site not specified anxiety state, unspecified regional enteritis of unspecified site bacteremia right bundle branch block osteoporosis, unspecified other postprocedural status infection and inflammatory reaction due to other vascular device, implant, and graft streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] kidney dialysis as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site ileostomy status restless legs syndrome (rls) cervicalgia 

Answer: The patient is high likely exposed to