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: the patient is a 67 year-old man transfer from an outside hospital with a presentation of mental status changes and sepsis. he has a history of hypertension, cerebrovascular accidents, diabetes and a left hip surgery for end stage osteoporosis who at the end of had been taking large amounts of percocet for left hip pain. at home on the patient became combative and the wife called ems and he was taken to hospital. there he became hemodynamically unstable and was intubated and started on pressors for circulatory support. he was found to have mssa positive blood cultures and a transesophageal echocardiogram there was bacterial vegetation. over the next several days he continued to require pressor support, ventilatory support and developed acute renal failure and increasing abdominal distention. he was transferred to for further evaluation and workup and critical care support. past medical history: 1. mitral regurgitation. 2. hypercholesterolemia. 3. cerebrovascular accident six or seven years ago. 4. diabetes mellitus. 5. hypertension. 6. end stage osteoporosis. past surgical history: left hip surgery, which is not specified. medications at home: 1. vioxx. 2. lipitor. 3. zestril. 4. metformin. 5. spironolactone. 6. aspirin. 7. zantac. 8. vitamins. allergies: dicloxacillin and sulfa based medications. social history: the patient lives with wife. physical examination: the patient is hypotensive with a blood pressure of 90/50, tachycardic to 120, breathing at 23 with a sat of 98%. the patient does not follow commands, intubated, grimaces to stimulation. pupils are equal, round and reactive to light. he had bilateral wheezing on end expiration with rales at the bases. heart was regular. no murmur noted on examination. abdomen was distended, firm and tender. rectal was guaiac positive. the right third digit had purulent drainage and the right foot plantar surface had an open wound, which was clean. the patient had 2+ edema in the bilateral lower extremities. laboratories on admission: white blood cell count of 28 with 81% neutrophils, 9% bands, hematocrit 40, inr 1.5, bun 42, creatinine 1.9 alt 84, ast 52 and alkaline phosphatase of 378 and a total bilirubin was 0.7. initial blood gas was 7.37, 34, 134, 20, -4. the patient had a kub, which demonstrated distention of the right and transverse colon with some dilated loops of small bowel. the cecum was 16 cm. a cat scan performed demonstrated bilateral pleural effusions, thickening of the descending colon with adjacent fat stranding and small amount of free fluid. head ct demonstrated a 1.5 cm cerebellar lesion thought to be subacute versus infectious. of note, the cat scan demonstrated a right common femoral vein thrombus. hospital course: the patient presented critically ill. he was immediately placed in the intensive care unit. he required pressor support to maintain his hemodynamics and this was managed via a pa catheter. his initial presenting problems included sepsis from presumed mssa endocarditis, a cerebellar lesion question an embolic phenomenon, a right third finger necrosis with purulent drainage thought to be embolic phenomenon, a right common femoral vein deep venous thrombosis and descending colon colitis thought to be ischemic in nature and acute renal failure. the patient received aggressive hemodynamic support, ventilatory support. he was placed on broad spectrum antibiotics. in his initial hospital course he continued to spike temperatures and had a persistent leukocytosis. the source for the endocarditis was thought to be secondary to the pain associated with his left hip and a possible osteomyelitis or joint infection. he was evaluated by the orthopedic team and underwent an ultrasound guided tap, which demonstrated gram positive rods of rare growth. he was continued on antibiotics and was weaned off pressor support with improving hemodynamics. over the next several days his leukocytosis persisted though and the patient did not show signs of improvement and the patient was taken to the operating room on to undergo a left hip incision and drainage and a girdlestone procedure, which involves removing of the femur head and proximal shaft. this procedure was significant for 10 cc of pus. the patient tolerated this procedure well and was transferred back to the intensive care unit after the surgery. the patient continued to have intermittent temperature spikes and an intermittent need for pressor support to maintain hemodynamics. the patient had numerous line changes blood cultures without any clear indication of the source of his sepsis. the patient had the right common femoral vein thrombosis evaluated by vascular surgery and he underwent filter placement secondary to the contraindication to anticoagulation due to his cerebellar lesions. the patient remained critically ill and was maintained on appropriate therapy for his bacteremia and began to show signs of improvement. he after several weeks of antibiotic therapy the blood cultures have remained negative. the patient's acute renal failure on admission improved and his current creatinine is 0.4. serial echocardiography of his heart demonstrated a stabilized vegetation. at the end of the patient developed a lower gastrointestinal bleed. this required a transfusion of packed red blood cells and the patient underwent a colonoscopy, which demonstrated ischemia of the transverse and proximal descending colon. the patient continued to require resuscitation for the gastrointestinal bleed and on , underwent an exploratory laparotomy. the findings in the operating room included a colospleno arterial fistula, which appeared to be chronically bleeding. also a colojejunel fistula at a separate location. the patient underwent a subtotal abdominal colectomy, control of the splenic hilar erosion bleed, a hartmann's procedure and ileostomy placement of a feeding jejunostomy tube and a tracheotomy tube placement. the patient tolerated this procedure well and his postoperative course has led to improvement. his hemodynamics have remained stable. he is currently off of pressors. his ventilatory status was improved and the patient is currently on a pressor support of 5 and a peep of 5 and undergoing trach mask spontaneous breathing trials. the patient's mental status has cleared and he is awake following commands. the patient remained afebrile and recent cultures have been negative for bacteremia. the patient has been continued on his antibiotic course under the guidance of the infectious disease team. after the surgery the patient did have a trend of a increasing white count and the central line was removed. postoperative day one the patient was started on tube feeds and this has been advanced to a goal of full strength at 90 cc per hour. the patient is receiving physical therapy and occupational therapy. seeing as the patient appears to have recovered from his acute illness and demonstrates no bacteremia or septic physiology and improvement in all organ systems the patient is stable for discharge to rehabilitation facility where he will undergo continued therapy. discharge diagnoses: 1. endocarditis with multiple embolic phenomenon. 2. acute renal failure. 3. ischemic colitis status post total abdominal colectomy hartmann's procedure with end ileostomy. 4. respiratory failure status post tracheotomy tube placement. 5. right common femoral vein thrombosis status post filter placement. 6. septic joint status post girdlestone procedure. 7. sepsis/bacteremia with mssa. 8. pseudomonas urinary tract infection. medications on discharge: 1. lopressor 50 mg po b.i.d. 2. heparin 5000 units subq q 8 hours. 3. nystatin swish and swallow 5 ml q.i.d. 4. dilaudid 1 mg intravenous q 3 to 4 hours prn. 5. zosyn 4.5 grams intravenous q 8 hours times seven days. 6. desonide 0.5% cream topical b.i.d. as needed. 7. albuterol one to two puffs inhaler q 6 hours prn. 8. protonix 40 mg po q.d. 9. nph insulin 16 units q.a.m. and q.p.m. 10. haldol 1 to 2 mg intravenous prn. discharge condition: the patient is in stable condition tolerating tube feeds at goal, which is impact with fiber at 90 cc an hour. the patient is following commands and can undergo physical therapy. the patient's abdominal wound has two small open areas, which can be dressed with a wet to dry dressing change. the patient's ileostomy is functioning well. the patient's follow up will be with dr. in two weeks following discharge. the patient will follow up with dr. in the orthopedics clinic three weeks after discharge. the patient is to follow up with plastics for the finger lesion three weeks after discharge. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other enterostomy insertion of endotracheal tube interruption of the vena cava enteral infusion of concentrated nutritional substances other and unspecified partial excision of large intestine arterial catheterization temporary tracheostomy pulmonary artery wedge monitoring other partial ostectomy, femur closure of fistula of small intestine, except duodenum other permanent ileostomy other local excision or destruction of lesion of joint, hip diagnoses: mitral valve disorders acute kidney failure, unspecified acute respiratory failure acute and subacute bacterial endocarditis fistula of intestine, excluding rectum and anus other diseases of spleen pyogenic arthritis, pelvic region and thigh unspecified vascular insufficiency of intestine 

Answer: The patient is high likely exposed to