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: penicillins / vancomycin attending: chief complaint: altered mental status major surgical or invasive procedure: paracentesis history of present illness: mr. is a 42 year old male with a history of alcoholic cirrhosis who presents with somnolence and left leg discomfort. patient was scheduled to re-establish care with dr. in the liver center today. upon arriving to the clinic, there was concern about the patient's mental status and his left leg infection. the patient was instructed to go the ed for evaluation. in the ed, he was a and o x 3, but somnolent. his initial vs were 97.5 bp 96/36, hr 59, 99% ra. given concern for evolving sepsis, he received ns 2.5 liters. leni was (-) for dvt in left leg. ruq was also obtained without dopplers, and was equivocal, with possible non-occlusive portal vein thrombosis. blood and urine cultures were obtained, and the patient was given vancomycin. he apparently had a reaction to vanc, unclear if it was red man's syndrome, but received solumedrol 125 mg iv x 1 and benadryl 25 mg iv x 1. he then received clindamycin iv. he was then transferred to the unit for management of presumed sepsis in the setting of altered mental status. . upon arrival to the unit, the patient was somnolent but easily arousable. he endorsed abdmoninal pain, denied n/v/d. he also denied melena, brbpr, or hematochezia. he denied chest pain of shortness of breath. remainder of ros as noted below. he does state that the swelling in his legs is new over the past few days. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. past medical history: - etoh cirrhosis c/b grade i varices with h/o ugib, hemorrhoids, ascites, and hepatic encephalopathy - h/o alcoholic hepatitis - not treated with steroids given ugib. - alcohol dependence - hypertension - cholelithiasis - gout - obesity - depression social history: lives alone, divorced x2, has three children. denies tobacco or other iv drug use. last drink was . family history: nc physical exam: on admission: vs: 113/60, 54, 16, 96% ra ga: aox3, nad, somnolent, arousable heent: perrla. mild scleral icterus. mmm. no lad. no jvd. neck supple. cards: pmi palpable at 5/6th ic space. no rvh. rrr s1/s2 heard. no murmurs/gallops/rubs. pulm: ctab no crackles or wheezes abd: soft, nt, +bs. no g/rt. neg hsm. neg sign. extremities: wwp, no edema. dps, pts 2+. skin: mildly icteric, lle erythema, warmth on anterior shin with serosanguinous drainage neuro/psych: cns ii-xii intact. 5/5 strength in u/l extremities. dtrs 3+ bl (biceps, achilles, patellar). sensation intact to lt, pain, temperature, vibration, proprioception. cerebellar fxn intact (ftn, hts). gait not assessed. (+) asterixis. . on discharge: vs: 97.4, 120/73, 79, 18, 99% on ra general: wd/wn, pleasant, comfortable heent: nc/at, mild scleral icterus, mmm neck: no lad, no jvd, neck supple heart: rrr, nml s1/s2, 3/6 sem, no rubs or pulm: ctab abd: soft, obese, nt, no fluid palpated, liver and spleen not palpated extremities: wwp, 2+ radial/dp pulses, 2+ edema bilaterally to the knees skin: lle warm with erythematous rash demarcated by marker, decreasead in size from yesterday, small amount of serosanguinous drainaga neuro: a&ox3, no asterixis, cns ii-xii intact, motor and sensory function grossly intact pertinent results: admission labs (): wbc-5.6 rbc-2.31* hgb-9.6* hct-28.2* mcv-122* mch-41.8* mchc-34.2 rdw-16.8* plt ct-55* neuts-91* bands-0 lymphs-4* monos-3 eos-2 baso-0 atyps-0 metas-0 myelos-0 hypochr-occasional anisocy-normal poiklo-occasional macrocy-3+ microcy-normal polychr-occasional schisto-occasional 28.9* ptt-46.6* inr(pt)-2.8* fibrino-147* glucose-105* urean-44* creat-1.8* na-125* k-6.0* cl-95* hco3-25 angap-11 alt-38 ast-149* alkphos-177* totbili-10.3* lipase-34 albumin-2.4* calcium-8.9 phos-3.0 mg-2.4 vitb12-1892* folate-greater th hapto-<5* ammonia-184* --> 110* ctropnt-<0.01 probnp-264* blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg . urine: 02:15pm: color-amber appear-clear sp -1.012 blood-mod nitrite-neg protein-25 glucose-neg ketone-15 bilirub-sm urobiln-1 ph-5.0 leuks-neg rbc-0-2 wbc-0-2 bacteri-few yeast-none epi-0-2 casthy-* . 06:28pm: color-yellow appear-clear sp -1.009 blood-sm nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.5 leuks-neg rbc-1 wbc-4 bacteri-few yeast-none epi-0 casthy-5* hours-random urean-536 creat-93 na-<10 k-14 cl-<10 osmolal-297 bnzodzp-neg barbitr-neg opiates-neg cocaine-neg amphetm-neg mthdone-neg . discharge labs (): wbc-2.4* rbc-2.13* hgb-8.9* hct-26.3* mcv-124* mch-41.8* mchc-33.9 rdw-17.2* plt ct-27* pt-31.4* ptt-46.3* inr(pt)-3.1* glucose-77 urean-24* creat-0.8 na-134 k-3.7 cl-102 hco3-25 angap-11 alt-31 ast-69* ld(ldh)-229 alkphos-166* totbili-5.2* calcium-9.2 phos-2.9 mg-1.7 . micro: blood cx: pending urine cx: no growth wound cx (left leg): s. aureus coag + rare growth periotoneal cx: no growth . imaging: lle doppler us: no evidence of left lower extremity dvt . portable cxr: there is interval development of left retrocardiac opacity that is worrisome for interval development of infectious process. lung volumes remain low, but the lungs are otherwise clear. there is no appreciable pleural effusion. there is no pneumothorax. cardiomediastinal silhouette is stable. . ruq u/s: 1. focal, apparently nonocclusive filling defect in the main portal vein at the porta hepatis, with hepatopetal flow just proximal, with a velocity of 40 cm/sec. this could represent nonocclusive thrombus, or could be artifact. recommend dedicated liver doppler evaluation. 2. moderate ascites. . ct head: 1. no acute intracranial abnormality. 2. small locules of gas in the cavernous sinus bilaterally. this is most likely related to peripheral intravenous catheter. 3. paranasal sinus disease. . echo: the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the prior study (images reviewed) of , no major change. . ruq u/s with doppler: pending brief hospital course: 42 year old man with etoh cirrhosis admitted with altered mental status in the setting of cellulitis. brief hospital course by problem: . # altered mental status: ct head neg for acute process. no evidence of hypercarbia on vbg. no meningismus on exam to raise concern for encephalitis or meningitis. paracentesis negative for sbp. most likely secondary to hyponatremia and encephalopathy in the setting of infection. mental status improved with antibiotics, lactulose, and rifaximin. . # lle cellulitis: pt was initially treated with vancomycin, however he had a bad reaction to the vancomycin (possibly red man's syndrome), and received solumedrol and benadryl, and was switched to iv clindamycin. wound culture grew staph aureus. pt mrsa negative. the patient remained afebrile with stable vitals and improving , he was switched to po clindamycin to complete a 7-day course. . # : creatinine was 1.8 on admission. urine sodium <10, fractional excretion of urea 25%, c/w pre-renal physiology. patient was fluid overloaded, so he was diuresed with iv lasix and spironolactone, and creatinine normalized. pt was discharged on 60mg po lasix qd and 100mg spironolactone qd. . # hyponatremia: sodium was 125 on admission, likely secondary to cirrhosis. sodium normalized. . # etoh cirrhosis: ruq ultrasound without evidence of portal vein thrombosis. treated with diuretics, lactulose and rifaximin. . # painful left 2nd toe: pt states that he had a recent fall and has since had pain in the second toe on the left foot. foot x-ray was negative for fracture. . # code status: full code. . # outstanding issues: - f/u ruq ultrasound final read medications on admission: 1. atenolol 50 mg daily 2. furosemide 60 mg daily 3. mvi 4. magnesium oxide 400 mg 5. folic acid 1 mg daily 6. lactulose 30 grams 7. vicodin 5/500 1 tab daily prn discharge medications: 1. atenolol 50 mg tablet sig: one (1) tablet po once a day. 2. furosemide 20 mg tablet sig: three (3) tablet po once a day. 3. multivitamin capsule sig: one (1) capsule po once a day. 4. magnesium oxide 400 mg tablet sig: one (1) tablet po bid. 5. folic acid 1 mg tablet sig: one (1) tablet po once a day. 6. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po bid. 7. vicodin 5-500 mg tablet sig: one (1) tablet po once a day prn pain. 8. spironolactone 100 mg tablet sig: one (1) tablet po daily. disp:*30 tablet(s)* refills:*0* 9. clindamycin hcl 300 mg capsule sig: one (1) capsule po q6h. to be taken through . disp:*16 capsule(s)* refills:*0* 10. outpatient lab work: please have chem 7 drawn on and fax results to dr. : (. discharge disposition: home discharge diagnosis: primary: - cellulitis - acute kidney injury secondary: - etoh cirrhosis - hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: mr. , you were admitted with altered mental status and an infection on your left leg which is being treated with antibiotics. . please continue to take your home medications. we have made the following changes: - started spironolactone 100mg by mouth daily - started clindamycin 300mg by mouth every 6 hours through . . please see below for information regarding upcoming appointments. followup instructions: you have an appointment with dr. on at 11:40am. the clinic phone number is . . we are giving you a prescription to have some lab work done on monday, and the results will be faxed to dr. . md procedure: percutaneous abdominal drainage diagnoses: thrombocytopenia, unspecified unspecified essential hypertension alcoholic cirrhosis of liver acute kidney failure, unspecified hyposmolality and/or hyponatremia other and unspecified alcohol dependence, in remission gout, unspecified other chronic pulmonary heart diseases depressive disorder, not elsewhere classified cellulitis and abscess of leg, except foot methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site other acquired absence of organ dermatitis due to drugs and medicines taken internally other ascites obesity, unspecified hepatic encephalopathy esophageal varices in diseases classified elsewhere, without mention of bleeding other specified antibiotics causing adverse effects in therapeutic use unspecified deficiency anemia pain in limb 

Answer: The patient is high likely exposed to