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: i have pain in my back and it goes to my neck major surgical or invasive procedure: drainage of epidural abcess in cervical spine x 2 incision and drainage of abscess to left anterior chast wall upper endoscopy placement of filter history of present illness: this 45 y/o white male presents to er at transferred from er for mri. pt states he has lbp radiating to neck x 2-3 weeks with progressive weakness. he went to pcp about week ago for this pain/ although not as weak at that time/ and was given antibiotics for a soft tissue mass at left clavicular region. he is not sure what kind of abx. he states the last two days have been the worst with regards to pain and weakness. presented to outside er via ambulance. pt states able to void and move bowels / difficulty ambulating and moving around his home. he admits to fever, ivda of coccaine that started 6months ago and he stopped two weeks ago ("heavy use"). he admits to 6pack beer per day. denies trauma, sob, chest pain, incontinence. pt received antibiotics in er past medical history: pmhx:denies social history: social hx: ivda, etoh family history: family hx:noncontrib physical exam: physical exam: on arrival o: t: 101.3, 153/84, 84, 24 sat 99% o2sat gen: wd/wn, appears stressed and uncomfortable heent: pupils: errl eoms intact neck: supple. lungs: scattered inspiratory wheeze and lll decreased bs. cardiac: rrr. s1/s2. abd: soft, + tender to rlq - ? bladder distention bs+ extrem: warm and well-perfused. no c/c/e. + track marks noted to b/l ue neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. motor: exam limited pain. best effort elicits full strength to lle, rle with 4+/5 throughout, rue and lue grip strength 3/5, biceps 9internally rotates upper extremeties during bicep testing), triceps , shoulder adduction , abduction 4-/5. sensation: intact to light touch throughout however there is a sensory level at the level of the umbilicus, distal to proximal he perceives decreased sensation to legs compared with upper torso. reflexes: slightly hyper-reflexive throughout, with 2 beat clonus toes upgoing bilaterally rectal exam normal sphincter control for this examiner pertinent results: date: signed by , md on affiliation: gi staff egd note uregent egd showed severe ulcerative esophagitis which was friable, but not actively bleeding. in the antrum there was a ~1 cm ulcer with stigmata of recent hemorrhage (black spots) and several tiny erosions (non bleeding). there were several small to 5 mm erosions in the fundus (non bleeding). duodenum was normal. we applied cautery to the antral ulcer in an attempt to reduce his chances of rebleeding. suggest: transufse to keep hct above 30%. continue with ng suction, iv ppi, sicu hospitalization. call us for repeat egd if he rebleeds or becomes hemodynamically unstable despite transfusion. mr l spine w/o contrast 1:21 am mr l spine w/o contrast reason: please check progression contrast: magnevist medical condition: 46 year old man with l5s1 discitis/osteo reason for this examination: please check progression exam: mri of the lumbar spine. clinical information: patient with l5-s1 discitis and osteomyelitis, for further evaluation and followup. technique: t1, t2 and inversion recovery sagittal and t1 and t2 axial images were obtained before gadolinium. t1 sagittal and axial images were obtained following gadolinium. comparison was made with the previous mri of . findings: again at l5-s1 level, abnormal signal is seen within the left side of the disc with mild paraspinal soft tissue changes. soft tissue changes extend to the left neural foramen with indentation and deformity of the exiting left l5 nerve root. since the previous study, the extent of t2 signal within the disc has slightly decreased. in addition, the paraspinal soft tissue changes also appear to be slightly less prominent. a small focus of low signal within the enhancing soft tissues indicates a tiny 5-mm paraspinal abscess which is also smaller than before. again noted are small areas of t2 hyperintensities within the posterior soft tissues bilaterally adjacent to the l4-5 facet joints which are slightly decreased from previous mri examination but are still identified. there is no evidence of significant epidural enhancement identified or evidence of epidural abscess seen. mild multilevel degenerative changes are identified in the lumbar region with mild bulging of disc at l4-5 level. there is no evidence of high-grade spinal stenosis seen. note is made of significantly distended urinary bladder which is a new finding since previous study. impression: since the previous mri examination, slight decrease in degree of signal changes and enhancement is identified at l5-s1 level. in addition, small posterior soft tissue abscesses seen on the previous study have also slightly decreased in size. these findings indicate overall improvement. a distended urinary bladder is seen on the current study for which clinical correlation is recommended. no significant new findings are identified. dr. chest (portable ap) 7:38 am chest (portable ap) reason: r/o pneumonia medical condition: 45 year old man with cervial epidural abscess, s/p hardware placement, now with fevers reason for this examination: r/o pneumonia reason for examination: fever. portable ap chest radiograph compared to . the patient is after cervical orthopedic surgery. the left picc line catheter terminates at the cavoatrial junction. the heart size is normal. mediastinum width, contour and position are unremarkable. the lungs are clear. the pleural surfaces are smooth with no pleural effusion. impression: no evidence of cardiopulmonary process. ct chest w/contrast 5:47 pm ct chest w/contrast; ct abdomen w/contrast reason: please evaluate infectious process contrast: optiray medical condition: 45 year old man with hx of ivda, s/p epidural abscess drainange. now with neck abscess. reason for this examination: please evaluate infectious process contraindications for iv contrast: none. indication: history of iv drug abuse status post epidural abscess drainage. now with neck abscess. comparison: ct neck dated and ct abdomen and pelvis dated , and ct chest dated . technique: mdct acquired images of the chest, abdomen and pelvis were obtained after the administration of iv and oral contrast. ct of the chest with iv contrast: there is interval improvement in the previously demonstrated left pleural/upper chest fluid collection. stranding in the anterior neck soft tissues with multiple foci of air is demonstrated, consistent with the patient's neck infection, that was more fully imaged on the neck ct of one day prior. there is a picc catheter that terminates in the svc. there are coronary artery calcifications. there is a trace right-sided pleural effusion, new compared to the previous exam. the previously demonstrated left-sided effusion has resolved. there are small areas of atelectasis in both lower lobes. note is made of a prominent left paratracheal node measuring 9 mm. there are multiple other small mediastinal nodes that do not meet ct criteria for pathologic enlargement. the airways appear patent to the level of segmental bronchi bilaterally. there is no pneumothorax. ct of the abdomen with iv contrast: the previously demonstrated region of hypoenhancement in the posterior portion of the spleen is now less prominent, with two small residual round hypodense foci. splenomegaly is again noted. there are no focal liver lesions. gallbladder is decompressed. the adrenal glands and kidneys are unremarkable. an infrarenal ivc filter is again seen. loops of small and large bowel are unremarkable. appendix is normal. there is trace ascites tracking along the right pericolic gutter into the pelvis. ct of the pelvis with iv contrast: there is a foley catheter within the bladder. air within the bladder is presumably secondary to the foley catheter placement. the rectum and sigmoid colon are unremarkable. there is small free fluid. bone windows demonstrate degenerative endplate changes at multiple levels. impression: 1. interval decrease in size and extent of previously demonstrated left anterior chest wall fluid collection. 2. soft tissue stranding and air in the anterior and right neck is consistent with infection, incompletely imaged. 3. previously demonstrated hypoenhancing peripheral focus in the posterior spleen is now less prevalent compared to the previous exam. 4. emphysema. 5. small ascites, predominantly located within the pelvis. reason: evaluate status of abscess contrast: magnevist medical condition: 45 year old man with epidural abscess s/p acd c4-c5 and evacuation of abscess. reason for this examination: evaluate status of abscess exam: mri of the cervical spine. clinical information: patient with cervical abscess, for further evaluation. technique: t1, t2 and inversion recovery sagittal and t1 and t2 axial images of the cervical spine were obtained before gadolinium. t1 sagittal and axial images were obtained following gadolinium. comparison was made with the previous studies of and . findings: there is evidence of increased signal seen within the c4, c5, and c6 vertebral bodies. in addition, increased signal is seen on inversion recovery and t2 images within the c4-5 and c5-6 discs. following gadolinium, enhancement is seen in the epidural soft tissues with an area of which does not enhance, extending on the posterior margin of c4 and c5 vertebral bodies indicative of an epidural abscess. in addition, there is also a fluid collection indicative of epidural abscess seen in the prevertebral region extending from c4 to c6. the prevertebral soft tissue thickness is also prominent indicating inflammatory changes extending from c3 to c7. these findings indicate reaccumulation of the epidural abscess with a new prevertebral abscess. in addition, compared to the prior study, the signal changes within the intervertebral disc and enhancement have also increased. in addition, there is moderate- to-severe compression of the spinal cord seen at c4 and c5 level with increased signal within the spinal cord. this finding is more prominent since the previous study of . a small fluid collection at the anterolateral right nect could be post-operative fluid collection. impression: since the previous mri of , there is now a new epidural abscess identified at c4-5 level and a prevertebral abscess seen from c4 to c6 with increased epidural and prevertebral enhancement. there is also slight increase in spinal cord compression and increased signal in the spinal cord identified. findings were discussed with the physician taking care of the patient at the time of interpretation of the study on . patient/test information: indication: endocarditis. height: (in) 68 weight (lb): 180 bsa (m2): 1.96 m2 bp (mm hg): 111/71 hr (bpm): 70 status: inpatient date/time: at 15:24 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2006w000-0:00 test location: west cath/ep lab technical quality: adequate referring doctor: dr. interpretation: findings: left atrium: normal la size. right atrium/interatrial septum: normal ra size. right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending, transverse and descending thoracic aorta with no atherosclerotic plaque. aortic valve: normal aortic valve leaflets (3). no as. no ar. no masses or vegetations on aortic valve. mitral valve: normal mitral valve leaflets with trivial mr. mass or vegetation on mitral valve. tricuspid valve: normal tricuspid valve leaflets with trivial tr. no mass or vegetation on tricuspid valve. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. no vegetation/mass on pulmonic valve. pericardium: no pericardial effusion. general comments: the patient was monitored by a nurse e throughout the procedure. the posterior pharynx was anesthetized with 2% viscous lidocaine. no tee related complications. 0.2 mg of iv glycopyrrolate was given as an antisialogogue prior to tee probe insertion. conclusions: the left atrium is normal in size. right ventricular chamber size and free wall motion are normal. the ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. no masses or vegetations are seen on the aortic valve. the mitral valve appears structurally normal with trivial mitral regurgitation. no mass or vegetation is seen on the mitral valve. no vegetation/mass is seen on the pulmonic valve. there is no pericardial effusion. impression: no valvular vegetation or intracardiac mass seen. electronically signed by , md on 16:27. physician: , bilat lower ext veins port 3:39 pm bilat lower ext veins port reason: eval for ivc filter placement medical condition: 45 year old man s/p anterior cervical discectomy for epidural abscess with gi bleed reason for this examination: eval for ivc filter placement limited bilateral lower extremity venous doppler ultrasound. clinical history: 45-year-old man status post anterior cervical discectomy for epidural abscess, with gi bleed. evaluate for ivc filter placement. no prior studies available for comparison. findings: limited doppler ultrasound of the bilateral common femoral veins was performed, as requested by the ordering physician. bilateral common femoral veins are widely patent and demonstrate normal compressibility, augmentation and phasic flow. no evidence of intraluminal thrombus. impression: no evidence of deep venous thrombosis of bilateral common femoral veins. the study and the report were reviewed by the staff radiologist. dr. dr. approved: tue 9:33 am brief hospital course: pt was admitted through the ed for c/o low back pain that radiates to neck. pt taken to the or emergently for drainage of cervical epidural abscess. postopereatively the pts exam was worse with diffuse weakness. he remained intubated for 2 days post op. his cultures were positive for gram pos cocci in pairs and clusters. antibiotics were started broad spectrum in or. he was seen and evaluated by id and placed on nafcillin to reach a total course of 6weeks time. a picc line was placed. he had an episode of ugi bleeding and was scoped with cauterization of a gastric ulcer. he recieved 2 units of packed cells. he had ct's of chest abd pelvis to eval for further abscess formation. there was note of ?splenic infarct vs. abscess. this was followed by repeat ct and will be followed as an outpt by id> it is not thought at this time to be an abscess. he had a bedside i and d of the left anterior chest wall abcess x 2 by the surgical team. his hct dropped again from 28 to 25. he has remained stable - currently at 27. he had le dopplers on the 13th which were negative mri showed worsening discitis with increased fluid in epidural space at c45 and new pre-vertebral abscess at c4-6. he was transfused one unit pre-op and was taken back to the or for 2 level corpectomy and discectomy / fusion as well as evacutation of recurrent abscess. he also had filter placed that day. his na level has been fluctuatin between 128 and 132 this hospitalization - he was on a fluid restriction of 2000ml / day for a few days. his na is stable at 132 as of . he maintains a regular diet. pneumovax was given . lumbar mri has decreased abscesses and crp now2.2 and esr 57. ppd negative this hospitalization and he did receive pneumococcal vaccine. cdiff from is negative his foley was d/c'd and he is being straight cath'd q 6 hours. he was seen and evaluated by pt and ot. they are working with him daily as his motor strength improves daily (le strength >ue strength). medications on admission: none discharge medications: 1. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 3. hexavitamin tablet sig: one (1) cap po daily (daily). 4. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed. 5. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 8. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed. 9. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed. 10. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 11. lorazepam 0.5 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 12. fluoxetine 20 mg capsule sig: one (1) capsule po daily (daily). 13. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed) as needed for dry eyes. 14. zolpidem 5 mg tablet sig: two (2) tablet po hs (at bedtime) as needed. 15. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po hs (at bedtime) as needed. 16. fentanyl 100 mcg/hr patch 72hr sig: one (1) patch 72hr transdermal q72h (every 72 hours). 17. gabapentin 300 mg capsule sig: one (1) capsule po tid (3 times a day). 18. nortriptyline 10 mg capsule sig: one (1) capsule po hs (at bedtime). 19. dolasetron 12.5 mg/0.625 ml solution sig: one (1) intravenous q8h (every 8 hours) as needed for nausea. 20. heparin lock flush (porcine) 100 unit/ml syringe sig: one (1) ml intravenous daily (daily) as needed. 21. nafcillin 2 g piggyback sig: one (1) intravenous every four (4) hours: for a total of 8 weeks - as of pt is day #23 . discharge disposition: extended care facility: medical center - discharge diagnosis: epidural abcess discharge condition: stable/improved discharge instructions: return to ed asap if any new weakness, numbness/ fever / wound drainage please check blood test weekly for cbc,diff, bun/cr, lft while on antibiotics. and fax to followup instructions: dr in 6 weeks at with ap and lateral xrays of c-spine. you will need to follow up with the gastroenterology department in weeks with dr. - please call for an appointment infectious disease clinic follow up 12/19 11am: check weekly, cbc,diff, bun/cr, lft. no specific follow up with thoracic surgery necessary per thoracic team, please ocntinue dressing changes for left anterior chest wall incision site and call procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified diagnostic ultrasound of heart interruption of the vena cava incision of chest wall incision of chest wall endoscopic control of gastric or duodenal bleeding other excision of joint, other specified sites other cervical fusion of the anterior column, anterior technique excision of intervertebral disc transfusion of packed cells other irrigation of (naso-)gastric tube excision of bone for graft, tibia and fibula aspiration of other soft tissue fusion or refusion of 2-3 vertebrae diagnoses: acute gastric ulcer with hemorrhage, without mention of obstruction tobacco use disorder cellulitis and abscess of trunk unspecified pleural effusion hyposmolality and/or hyponatremia methicillin susceptible staphylococcus aureus septicemia cocaine abuse, unspecified intraspinal abscess acute osteomyelitis, other specified sites other and unspecified alcohol dependence, unspecified viral hepatitis b without mention of hepatic coma, acute or unspecified, without mention of hepatitis delta other and unspecified disc disorder, thoracic region acute esophagitis alcohol withdrawal other disorders of muscle, ligament, and fascia other diseases of spleen vascular myelopathies intervertebral disc disorder with myelopathy, lumbar region intervertebral disc disorder with myelopathy, cervical region 

Answer: The patient is high likely exposed to