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: dyspnea, tachypnea, somnolence major surgical or invasive procedure: left picc placement history of present illness: pt is a 39 y/o male with a pmh significant for dm2, prader willi, cri who presented to the ed w/ subjective sob, tachypnea, and somnolence. pt dicharged from 1 month pta after extended treatment for r leg cellulitis. shortly after arrival at , maintained on vanc / zosyn and developed c.diff colitis (toxin positive ), treated with 7d of flagyl. on day of admit, found to desaturate to 85% at and become tachypneic. the patient became less responsive and was sent to for further evaluation. in er, tm=104, hypotensive although this corrected with fluids. he was given nebs, solumedrol, levaquin, and flagyl. his cbc demonstrated a left shift and his cxr was concerning for a lul pna. at his osh, he had not had any cough or any fever. in the the pt was treated for cdiff colitis with po flagyl, with plan to continue for 3 week course. osh picc line (placed ) was removed due to mssa bacteremia, new picc placed . past medical history: morbid obesity mental retardation thought secondary to possible prader-willi insulin dependent diabetes mellitus renal insufficiency obstructive sleep apnea requiring cpap social history: patient lived in group home, came from rehab this time. patient denies any smoking, ethanol or drug use. intermittently sexually active with a female partner. family history: positive family history for diabetes. physical exam: pe: tm 104 rectal; 100.2 ax; 115/51; 80; 97% on cpap (18cm) gen: morbidly obese aam lying flat in no distress heent: mmm cv: distant heart sounds; rrr lungs: cta anteriorly abd: obese; + bs ext: massive le edema with venous stasis changes and scaling over r shin neuro: slow speech; answers simple questions; follows commands; non focal exam pertinent results: 10:00pm blood wbc-7.9 rbc-4.37*# hgb-10.4*# hct-36.3*# mcv-83 mch-23.9* mchc-28.7* rdw-20.9* plt ct-177 06:03am blood wbc-9.0 rbc-4.04* hgb-9.8* hct-34.3* mcv-85 mch-24.4* mchc-28.6* rdw-21.5* plt ct-174 05:28am blood wbc-10.5 rbc-4.07* hgb-9.6* hct-33.9* mcv-83 mch-23.5* mchc-28.2* rdw-21.0* plt ct-232 10:00pm blood neuts-37* bands-38* lymphs-11* monos-6 eos-4 baso-0 atyps-1* metas-1* myelos-2* nrbc-2* 06:03am blood neuts-53 bands-38* lymphs-4* monos-4 eos-0 baso-0 atyps-0 metas-1* myelos-0 nrbc-2* 06:03am blood hypochr-2+ anisocy-2+ poiklo-1+ macrocy-2+ microcy-occasional polychr-1+ ovalocy-occasional stipple-1+ tear dr 10:00pm blood pt-16.0* ptt-28.0 inr(pt)-1.5* 10:00pm blood plt ct-177 05:28am blood plt ct-232 10:00pm blood glucose-148* urean-66* creat-1.8* na-145 k-5.6* cl-109* hco3-29 angap-13 05:28am blood glucose-165* urean-53* creat-1.1 na-145 k-4.8 cl-112* hco3-30 angap-8 10:00pm blood calcium-8.3* phos-3.4 mg-1.5* 05:28am blood calcium-7.5* phos-2.6* mg-1.6 06:55pm blood vanco-24.0* 04:05am blood vanco-28.4* 08:18am blood vanco-32.0 06:55am blood vanco-25.8* 04:35am blood vanco-18.1* 09:53am blood type-mix temp-36.7 po2-29* pco2-65* ph-7.23* calhco3-29 base xs--2 intubat-not intuba 09:49am blood lactate-1.4 09:49am blood freeca-1.16 ================= studies: cxr impression: interval worsening of bilateral airspace opacities as described. pneumonia is not excluded. . abdomen x-ray findings: two portable abdominal radiographs were obtained. these radiographs are extremely limited due to poor penetration and are thus nondiagnostic. repeat radiographic examination is suggested. . cxr impression: 1. resolution of left upper lobe opacity. 2. bilateral perihilar haziness suggestive of perihilar edema likely due to fluid overload . echo conclusions: the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size, and systolic function are normal (lvef 60%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. there is abnormal septal motion/position. 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. there is no mitral valve prolapse. no mass or vegetation is seen on the mitral valve. there is mild pulmonary artery systolic hypertension. no vegetation/mass is seen on the pulmonic valve. chest port. line placement impression: suboptimal assessment. doubt overt chf or pneumonia right picc line placement impression: successful placement of a 55 cm 5- french double- lumen picc via the right brachial vein with tip in the superior vena cava. a total of approximately 51 cm of the picc is within the patient. the picc can be used immediately. ultrasound right lower extremity impression: limited exam but no evidence for dvt. brief hospital course: the pt is a 39 yo male with prader willi, diabetes, and cri, who recently developed c. diff after antibiotic treatment for cellulitis. the patient presented with hypoxia which resolved, but was noted to have possible radiographic findings significant for pneumonia. mr. was also noted to have mrsa bacteremia and was treated with vancomycin. l picc was likely source of mrsa bacteremia, and pna may be due to different organism. id service recommended 2 week course of vancomycin. once his treatment is completed, he should have surveillance cultures to verify resolution of bacteremia. the pt was also empirically treated with oral flagyl for the c.diff colitis, however 3 sets of stool were negative for c. difficile toxin. two sets of pt's blood cultures showed mrsa and the rest of the cultures were pending at the time of discharge and will need to be followed by the pt's primary care physician. id: the pt was noted to have interval worsening of bilateral airspace opacities which could have represented an underlying pneumonia (however he did not have an elevated white cell count). he was also noted to have mrsa bacteremia, with his left side picc as likely source. the left sided picc was removed and a new right sided picc was placed. the pt was treated with vancomycin (to complete a total 14 day course on ) for the mrsa bacteremia (trough goal 15-20, current adjusted dose is 1 gram q48h). once treatment with vancomycin is completed, the pt will need to have surveillance cultures to ensure clearance of bacteremia. the pt was also noted to have diarrhea in the setting of antibiotic use. the pt had 3 stool samples sent that were negative for c. difficile toxin. the pt's diarrhea gradually resolved. rectal tube fell out on the day prior to discharge, but the pt remained continent. respiratory: the pt was noted to have an interval worsening of airspaces which could have represented an underlying pneumonia. the pt remained afebrile on the floor and his white count was not elevated. the pt was maintained on cpap (18 cm qhs) at night for his obstructive sleep apnea. fen: diarrhea resolved with treatment during the hospitalization. his electrolytes were repleted. renal: patient has chronic renal insufficiency (baseline creatinine 1.3-1.5) and he was noted to have a creatinine of 1.8 on admission. after hydration, cr=1.1 at discharge. anemia: the pt has a history of anemia of chronic disease, likely secondary to chronic renal disease. the pt was continued on erythropoietin and iron. diabetes mellitus: the pt was noted to have elevated blood glucose level (in 200 range) for which his standing morning 70/30 dose of insulin was increased. it is likely that the pt will need uptitration of his insulin if the blood glucose levels continue to remain elevated. hypothyroidism: the pt was maintained on his outpatient thyroxine dose. prophylaxis: the pt was maintained on subcutaneous heparin and pantoprazole for prophylaxis. after 10 days, patient feeling well and with no changing medical issues. the patient was very particular in choosing the specific rehabilitation institution for discharge, noting that he has had numerous negative experiences with various rehab sites in the past. the patient was accepted to , and was pleased to be transferred there on . maintained full code throughout hospital stay. medications on admission: meds (on admit:) 1. aspirin 81 mg qd 2. levothyroxine 75 mcg qd 3. hydrochlorothiazide 25 mg qd 4. ferrous sulfate 325 mg qd 5. epoetin tiw 6. tamsulosin 0.4 mg hs 7. calcium acetate 2668 mg tid 8. insulin 70/30; 40u qam, 15u qpm 9. morphine 15 mg prn allergies: nkda discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. epoetin alfa 10,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-friday). 3. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 4. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day) as needed for rash. 8. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 9. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 10. insulin- as directed per attached sliding scale sig: see instructions as directed: please referto fixed insulin dose and insulin sliding scale. . 11. heparin flush picc (100 units/ml) 2 ml iv daily:prn 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. 12. vancomycin in dextrose 1 g/200 ml piggyback sig: one (1) gram intravenous q48h (every 48 hours) for 7 days: last day to complete 14 day course : . discharge disposition: extended care facility: - discharge diagnosis: primary: pneumonia . secondary: prader willi syndrome morbid obesity dm ii cri w/ baseline creatinine 1.8-2 osa on home cpap mental retardation discharge condition: stable discharge instructions: please report to the nearest emergency department if you have fever, chills, nausea, vomiting, diarrhea or increasing pain in your right leg. . there has been a change in your medications. . you have been scheduled for some follow-up appointments. followup instructions: *** the rehab will need to arrange for patient to be transported to his appointments in a bls ambulance ***** . provider: , md phone: date/time: 2:40 . provider: , .d. phone: date/time: 4:30 . provider: , m.d. date/time: 4:30 procedure: venous catheterization, not elsewhere classified diagnoses: pneumonia, organism unspecified anemia in chronic kidney disease diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism infection with microorganisms resistant to penicillins chronic kidney disease, unspecified bacteremia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site long-term (current) use of insulin unspecified sleep apnea intestinal infection due to clostridium difficile pressure ulcer, lower back infection and inflammatory reaction due to other vascular device, implant, and graft unspecified intellectual disabilities prader-willi syndrome pressure ulcer, upper back pressure ulcer, hip 

Answer: The patient is high likely exposed to