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: history of present illness: this is a 46-year-old white male with a history of hypertension, and hepatitis c, and distant intravenous drug use who was in his usual state of good health until he developed upper abdominal pain on . he had an acute episode of this upper abdominal pain which lasted for several hours and then passed. the abdominal pain returned on with nausea, vomiting, and loose stools. the patient did experience chills, but he did not take his temperature. the patient presented to the emergency department at in on where a right upper quadrant ultrasound revealed a dilated common bile duct and 10.5-mm thickened gallbladder. a computed tomography scan at this institution revealed a nonenhancing head of the pancreas consistent with necrosis, free fluid around the pancreas and gallbladder consistent with necrotizing pancreatitis. notable laboratories from the outside hospital included an amylase of 801, lipase was 276, ast was 198, and alt was 310. hematocrit was 53, glucose was 162, and white blood cell count was 14.7. creatinine was 1.4. the patient was admitted and treated with intravenous fluids, calcium repletion, and imipenem for his necrotizing pancreatitis. gastrointestinal and general surgery were consulted, and an endoscopic retrograde cholangiopancreatography was deferred at that institution because the patient's liver function tests were declining. the hospital course was complicated by low urine output, an increasing creatinine, declining calcium, and moderate-to-severe pain. the patient was given mannitol and dopamine for his low urine output and then transferred to for further evaluation and management. past medical history: 1. hypertension. 2. hepatitis c. 3. history of intravenous drug and alcohol abuse (very distant); the patient denies any use in the past 10 years. medications on transfer: 1. atenolol 50 mg p.o. q.d. 2. imipenem 250 mg p.o. q.6h. 3. morphine sulfate patient-controlled analgesia. 4. ativan as needed. 5. dopamine as needed allergies: the patient has an allergy to penicillin. social history: the patient is married with four children. he quit tobacco four years ago. he has a distant history of intravenous drug use and alcohol use, but he has not used these in 10 years. family history: family history is notable for hypertension and cerebrovascular disease. physical examination on presentation: admission physical examination revealed temperature current of 100.9, heart rate was 104, blood pressure was 118/64, respiratory rate was 24 to 28 times, oxygen saturation was 95% on 4 liters nasal cannula. generally, an obese white male in moderate distress. head, eyes, ears, nose, and throat examination revealed pupils were equal, round, and reactive to light and accommodation. extraocular muscles were intact. mucous membranes were dry and without lesions. carotid pulses were 2+ bilaterally. the neck was supple. cardiovascular examination revealed tachycardic. normal first heart sound and second heart sound. no murmurs, gallops, or rubs. lungs revealed a few inspiratory wheezes and decreased lung volumes bilaterally. the abdomen was distended and tympanitic. decreased bowel sounds. moderate epigastric tenderness and increased in the right upper quadrant. extremities revealed no cyanosis, clubbing, or edema. distal pulses were 2+ in the upper extremities and lower extremities bilaterally. neurologic examination revealed alert and oriented times four. cranial nerves ii through xii were tested and were grossly intact; nonfocal. pertinent laboratory values on presentation: laboratory data revealed white blood cell count was 11.9, hematocrit was 38.2, and platelets were 228. sodium was 138, potassium was 5.1, chloride was 107, bicarbonate was 16, blood urea nitrogen was 95, creatinine was 2.6, and blood glucose was 88. inr was 1.3, prothrombin time was 13.9, and partial thromboplastin time was 27.2. ast was 69, alt was 56, total bilirubin was 0.8, alkaline phosphatase was 81, albumin was 3. creatine kinase was 2103; although, mb and troponin i fractions were unremarkable. amylase was 239 and lipase was 144. radiology/imaging: a chest x-ray revealed a double lumen peripherally inserted central catheter in place and tube in good position. low lung volumes. no acute process. an electrocardiogram revealed a normal sinus rhythm at 99, normal axis and normal intervals, a q wave in lead iii, early r wave progression. no acute st-t wave changes. hospital course by issue/system: (summary of the hospital course up to this time revealed) 1. pulmonary system: several hours after admission, the patient's respiratory status decompensated because he was tachypneic and began to desaturate. the patient was intubated. the patient was alternatively managed throughout his stay on assist-controlled and pressure-controlled ventilation. initially, during his hospitalization ventilation began difficult given his very high peak and plateau pressures. however, given the patient's large body habitus and marked abdominal distention, an esophageal balloon was performed to determine a potential contribution of his high ventilator pressures to his chest wall and abdomen versus his lungs. his transpulmonary pressure was calculated to be approximately 10 cm, and his intragastric pressures were found to be 30. this was felt to be most consistent with marked compression of his thoracic cavity by his abdominal distention and body habitus. the patient was felt to have significant room to move on his ventilatory status. at the time of this dictation, the patient is currently being gradually weaned off ac ventilator settings. also with regard to pulmonary issues, the patient developed a large left pleural effusion early in his stay. this was felt most likely to be secondary to his acute pancreatitis. however, given his very high fevers, several attempts were made by the interventional pulmonology service and interventional radiology service to tap this effusion by ultrasound-guidance. however, because of the patient's body habitus, high positive pressure ventilation, and diffuse skin rash on his back this was not feasible and felt to be too high or a risk. 2. cardiovascular system: throughout his stay in the intensive care unit, the patient remained hemodynamically stable. because of his markedly high fevers. his heart rate and his blood pressure were actually elevated. given his massive fluid resuscitation, an echocardiogram was performed. he was found to have to have hyperdynamic ventricle with an ejection fraction of greater than 70%. at the time of this dictation, the patient has remained hemodynamically stable. a swan-ganz catheter was placed on and revealed low systemic vascular resistance and high cardiac output; most likely consistent with septic shock. the patient's wedge pressures were markedly elevated to the 30s and 40s. given the fact that there was no problems oxygenating, and the patient had normal left ventricular function, this was felt likely to be falsely elevated secondary to his abdominal compartment syndrome compressing his thoracic cavity. 3. gastrointestinal/biliary issues: following transfer with aggressive intravenous fluids resuscitation, the patient's pancreatic enzymes and liver function tests normalized. an ultrasound performed on the day following admission (on ) revealed a continually dilated common bile duct of 8 mm to 9 mm, but no evidence of stones or cholecystitis. the patient was evaluated by the endoscopic retrograde cholangiopancreatography service and felt not to require endoscopic retrograde cholangiopancreatography because the patient's pancreatitis was clinically improving. the patient was felt to need a cholecystectomy and endoscopic retrograde cholangiopancreatography with papillotomy eventually, but this was not emergent. a few days into his stay, the patient began to spike very high fevers to 103 to 104 degrees fahrenheit. given concerns for potentially infected pancreatic tissue, serial abdominal computed tomography scans were performed on and . these were notable for severe pancreatitis, nonenhancement of the head; consistent with necrosis, but no evidence of focal fluid collection or abscess were noted. the patient's small-bowel loops appeared normal. the patient was very closely followed by the hepatobiliary service and the general surgery service. consideration was given for a percutaneous pancreatic sampling; however, after extensive discussions with interventional radiology and general surgery, there was not felt to be a focal fluid collection that would be potentially drainable. on the day following his admission, a nasojejunal tube was placed by the biliary service for trophic tube feedings which the patient is currently receiving at this time. the patient's gastrointestinal course was also complicated by an marked ileus causing massive abdominal distention. this ileus, combined with his severe pancreatitis, resulted in marked abdominal distention which was believed to have caused an abdominal compartment syndrome, which compressed the patient's thoracic cavity. throughout his stay, bladder pressures were closely monitored. general surgery felt that there was no operative intervention at this time. 4. infectious disease issues: in the couple of days following his arrival to , the patient began to spike very high fevers to 103 to 104. however, he remained hemodynamically stable. all blood cultures including fungal and myolytic isolators remained negative to this date. the patient was transferred on imipenem which was continued for a few days of his admission. however, given a rash on his abdomen, this was later changed to vancomycin, levaquin, and fluconazole. the patient was very closely followed by the infectious disease service. at the time of this dictation, the fluconazole was discontinued on and consideration was being given to discontinuing the patient's remaining antibiotics given the evolution of the rash on his back and the fact that he has remained hemodynamically stable with very high fevers and negative blood cultures. 5. dermatologic issues: on approximately , the patient began to develop a diffuse erythematous macular rash on his back which appeared to worsen over the course of a few days. given its appearance, and the fact that the patient was on fluconazole, it was not felt to be fungal in nature. a dermatology consultation was obtained on , and they that this rash was most likely consistent with a drug eruption, with imipenem being the most likely culprit, but that any of his medications could potentially cause this. given the fact that the patient remained critically, was febrile, and did not appear to be suffering in terms of mucosal or - syndrome with his current antibiotics, these were recommended to be continued. however, at the time of this dictation, consideration is being given to discontinuing antibiotics. 5. renal system: the patient's blood urea nitrogen and creatinine declined over the first few days of admission with aggressive fluid resuscitation. however, there was a minor increase in his creatinine to 2.1 which was felt most likely to be compression of the renal vasculature with his abdominal compartment syndrome. a fractional secretion of sodium was checked, and this was found to be less than 1. this resolved with aggressive fluid resuscitation. 6. fluids/electrolytes/nutrition issues: the patient's ionized calcium was closely followed and repleted, as were all of his other electrolytes. the patient was continued on total parenteral nutrition, and is currently receiving jejunal feeds. 7. lines: the patient currently has a right internal jugular quad-lumen catheter which was placed on and a left radial arterial line was placed on . 8. communication issues: extensive discussions were held with the patient's family members including his wife and children. they were informed of the critical nature of the patient's illness and the potential for mortality and morbidity with a prolonged intensive care unit stay. all questions were answered. , m.d. dictated by: medquist36 d: 16:09 t: 07:43 job#: procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances diagnostic ultrasound of heart temporary tracheostomy diagnoses: unspecified pleural effusion acute and chronic respiratory failure alkalosis methicillin susceptible pneumonia due to staphylococcus aureus infection and inflammatory reaction due to other vascular device, implant, and graft acute pancreatitis calculus of gallbladder with acute cholecystitis, without mention of obstruction staphylococcal septicemia, unspecified 

Answer: The patient is high likely exposed to