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: no known allergies / adverse drug reactions attending: chief complaint: hypoglycemia, hypotension major surgical or invasive procedure: ; 1. pancreatic necrosectomy. 2. pseudocyst-gastrostomy. history of present illness: mr. is a 54m with history of necrotizing pancreatitis c/b pseudocyst formation who presents with weakness. patient was seen in clinic regarding operative planning for a cyst gastrostomy. during this visit, he felt lightheaded and was found to have a glucose of 30 and sbp in 80s. he was given juice and felt some improvement, though not baseline. on admission patient was tpn dependent due to gastric obstruction from his pseudocyst. , his current tpn bag has the incorrect dose of insulin (too high). patient reports feeling well until this episode. his weight has been stable. he has been drinking fluids regularly with normal urine output. he denies nausea, vomiting, and diarrhea. his abdominal pain is at his baseline. his blood sugars at home have ranged from 40 to 200. since coming to the ed, he feels signifantly better, though he reports a headache. past medical history: 1. necrotizing pancreatitis complicated by acute fluid collection and a small pseudocyst in the tail which gradually disappeared over time. all this occurred in approximately and his care has been at hospital, , and most recently . 2. prior celiac plexus block for pain control attempted by dr. with no apparent benefit. 3. status post ercp in or by dr. , apparently notable only for mild biliary dilation and no sludge- complicated by post ercp pancreatitis according to patient 4. status post cholecystectomy. 5. hypertriglyceridemia. 6. hypertension. 7. multiple shoulder surgeries. 8. fatty liver. 9. schatzki's ring. 10. gastritis. social history: currently on disability but former restaurant manager prior to onset of pancreatitis in . lives with his sister and mother now since his wife passed away last year. formerly very active and has completed the marathon 4 times. has remote history of smoking, denies any alcohol use at this moment, finished rehab program. family history: he has a familial history of hypertriglyceridemia. his sister has ms. there is no family history of pancreatitis or pancreatic cancers as far as he knows. no other family history of gi or liver disease as far as he knows. physical exam: on admission: vs: 97.8 56 91/93 18 100% gen: appears well, nad cv: rrr resp: ctab abd: soft, tender in epigastrium, mildly distended, ecchymosis in rlq and at umbilicus (at sites of insulin injections per patient), no rebound or guarding ext: bilateral lower extremity edema on discharge: vs: 98.2, 72, 116/70, 12, 100% ra gen: nad cv: rrr, no m/r/g resp: ctab abd: midline abdominal incision open to air with steri strips and c/d/i. old rlq jp site with occlusive dressing and c/d/i. soft, nt/nd. extr: warm, no c/c/e pertinent results: 05:12am blood wbc-4.4 rbc-3.26* hgb-9.3* hct-27.4* mcv-84 mch-28.6 mchc-34.0 rdw-14.3 plt ct-217 04:00am blood hct-29.5* 05:12am blood glucose-118* urean-8 creat-0.7 na-135 k-3.7 cl-99 hco3-29 angap-11 05:12am blood calcium-8.5 phos-4.3 mg-1.6 06:18pm ascites amylase-9 3:50 pm blood culture #2. **final report ** blood culture, routine (final ): viridans streptococci. final sensitivities. sensitivity testing performed by sensititre. clindamycin >= 4 mcg/ml. viridans streptococci. second morphology. isolated from only one set in the previous five days. sensitivities: mic expressed in mcg/ml _________________________________________________________ viridans streptococci | clindamycin----------- r erythromycin---------- =>8 r penicillin g----------<=0.06 s vancomycin------------ <=1 s 3:30 pm blood culture 1 of 2. **final report ** blood culture, routine (final ): viridans streptococci. sensitivities performed on culture # 340-0091m . staphylococcus, coagulase negative. isolated from only one set in the previous five days. susceptibility testing requested by dr. , pager . final sensitivities. staphylococcus species may develop resistance during prolonged therapy with quinolones. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. testing of repeat isolates may be warranted. sensitivities: mic expressed in mcg/ml _________________________________________________________ staphylococcus, coagulase negative | clindamycin-----------<=0.25 s erythromycin----------<=0.25 s gentamicin------------ <=0.5 s levofloxacin----------<=0.12 s oxacillin-------------<=0.25 s tetracycline---------- =>16 r vancomycin------------ 1 s 7:50 pm blood culture **final report ** blood culture, routine (final ): no growth. 10:59 am fluid,other **final report ** gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. fluid culture (final ): no growth. anaerobic culture (final ): no growth. abd ct: impression: 1. stable peripancreatic fluid collections. 2. possible splenic vein occlusion with mesenteric collaterals. 3. fatty liver. 4. splenomegaly. cxr: impression: no acute cardiothoracic process tte/tee: conclusions: the left atrium is elongated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). 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) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. 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. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. ekg: sinus bradycardia. low limb lead voltage. q-t interval prolongation. delayed precordial r wave transition. compared to the previous tracing of no diagnostic interim change. pathology examination name birthdate age sex pathology # , 54 male report to: dr. description by: dr. /rate specimen submitted: necrotic pancreatic tissues, pseudocyst wall. procedure date tissue received report date diagnosed by dr. /ttl previous biopsies: gi bx's (3 jars) diagnosis: i. necrotic pancreatic tissue, necrosectomy (a-b): diffusely necrotic tissue/debris; no viable pancreatic parenchyma identified. ii. "pseudocyst wall", gastrostomy (c-e): gastric corpus segment with no intrinsic mucosal abnormalities and scant adherent cauterized fibrous tissue. brief hospital course: patient with history of necrotizing pancreatitis and pancreatic pseudocyst was seen in clinic for follow up. during exam, patient was found to have sbp in 80s and blood sugar 30. patient was admitted to general surgery service for further work up. blood cultures were sent on admission and was positive for staph coag negative and viridans strep. patient's picc line was removed and he was started on iv vancomycin, id was consulted. id recommended 14 days course of iv vancomycin. picc line tip and follow up blood cultures were negative, patient remained afebrile with wbc within normal limits. on , the patient underwent pancreatic necrosectomy and pseudocyst-gastrostomy, which went well without complication (reader referred to the operative note for details). after a brief, uneventful stay in the pacu, the patient arrived on the floor npo, on iv fluids and antibiotics, with a foley catheter, and dilaudid pca for pain control. the patient was hemodynamically stable. cv: patient was found to have asymptomatic sinus bradycardia on admission ecg. his atenolol was held and he was placed on telemetry for hr monitoring. he underwent echocardiography on which revealed normal lvef and was grossly normal. patient had another episode of sinus bradycardia on and repeat ecg revealed prolonged d q-t interval, patient's quetiapine was discontinued at this time. pre-op ecg on was stable and post operatively patient remained stable from a cardiovascular standpoint. telemetry was discontinued on pod # 7, patient's hr returned to sinus regular without any ectopy and home dose of atenolol was restarted. quetiapine was not restarted on discharge and patient was advised to discuss with his pcp possible discontinue of this medication s/t causing q-t prolongation. pulmonary: the patient remained stable from a pulmonary standpoint; vital signs were routinely monitored. good pulmonary toilet, early ambulation and incentive spirrometry were encouraged throughout hospitalization. gi/gu/fen: patient's tpn was discontinued on admission ,and on hd # 3 patient was started on full liquids diet with supplements. post-operatively, the patient was made npo with iv fluids. diet was advanced when appropriate, which was well tolerated. patient's intake and output were closely monitored, and iv fluid was adjusted when necessary. electrolytes were routinely followed, and repleted when necessary. id: the patient completed 14 days course of iv vancomycin for blood infection. tte and tee was nagative for any vegetations. follow up blood cultures were negative for any growth. patient underwent empirical treatment post operatively with cipro and flagyl for infected pseudocyst. final pseudocyst cultures were negative and antibiotics were discontinued. the patient's white blood count and fever curves were closely watched during hospitalization and remained within normal limits prior discharge. endocrine: the patient's blood sugar was monitored throughout his stay; insulin dosing was adjusted accordingly. center follow the patient daily and patient will continue to follow up with endocrinology as outpatient. hematology/gi bleed: on pod # 4 patient was noticed hematemesis x 2 and melena, his hct had 10 points drop. the patient was transferred in icu for observation. patient was transfused with 3 units of prbc and 1 unit of ffp, his hct improved after transfusion (19.8->23.9). on pod # 5, patient continued to have melena, no bloody emesis. he was transfused with 1 unit of prbc and transferred to the floor. patient's hct remains stable prior discharge, no further transfusion were required. prophylaxis: the patient received subcutaneous heparin and venodyne boots were used during this stay; was encouraged to get up and ambulate as early as possible. at the time of discharge, the patient was doing well, afebrile with stable vital signs. the patient was tolerating a regular diabetic diet, ambulating, voiding without assistance, and pain was well controlled. the patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. medications on admission: citalopram 20, lisinopril 10', omeprazole 20', quetiapine 100', aspirin 81', atenolol 25', docusate sodium 100', senna 8.6'', acetaminophen 325 q6h prn, oxycontin 20 mg q8h. discharge medications: 1. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 2. quetiapine 25 mg tablet sig: four (4) tablet po daily (daily). 3. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). 4. colace 100 mg capsule sig: one (1) capsule po twice a day. disp:*60 capsule(s)* refills:*2* 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for headache. 6. oxycodone 5 mg tablet sig: 1-2 tablets po every four (4) hours as needed for pain. disp:*120 tablet(s)* refills:*0* 7. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* 8. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 9. glipizide 5 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*0* 10. oxycodone 20 mg tablet extended release 12 hr sig: one (1) tablet extended release 12 hr po every eight (8) hours for 2 weeks: to refill this medication, please contact you pcp or specialist. disp:*42 tablet extended release 12 hr(s)* refills:*0* 11. insulin sliding scale and lantus insulin sc fixed dose orders bedtime glargine 6 units insulin sc sliding scale breakfast lunch dinner bedtime humalog humalog humalog humalog glucose insulin dose insulin dose insulin dose insulin dose 0-70 mg/dl with hypoglycemia protocol with hypoglycemia protocol with hypoglycemia protocol with hypoglycemia protocol 71-200 mg/dl 0 units 0 units 0 units 0 units 201-250 mg/dl 3 units 3 units 3 units 2 units 251-300 mg/dl 4 units 4 units 4 units 3 units 301-350 mg/dl 6 units 5 units 6 units 4 units 351-400 mg/dl 7 units 6 units 7 units 5 units discharge disposition: home discharge diagnosis: 1. necrotizing pancreatitis 2. pancreatic psuedocyst 3. gi bleed discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. avoid driving or operating heavy machinery while taking pain medications. please follow-up with your surgeon and primary care provider (pcp) as advised. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. *if you have staples, they will be removed at your follow-up appointment. *if you have steri-strips, they will fall off on their own. please remove any remaining strips 7-10 days after surgery. followup instructions: department: surgical specialties when: friday at 11:00 am with: , md building: sc clinical ctr campus: east best parking: garage . please follow up with in weeks after discharge. please call to make your appointment or if you have any questions. . please follow up with dr. (pcp) in weeks after discharge. procedure: diagnostic ultrasound of heart anastomosis of pancreas other excision or destruction of lesion or tissue of pancreas or pancreatic duct diagnoses: anemia, unspecified unspecified essential hypertension pure hyperglyceridemia hemorrhage complicating a procedure other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure bacteremia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled long-term (current) use of insulin insulins and antidiabetic agents causing adverse effects in therapeutic use blood in stool hematemesis dehydration chronic pancreatitis cyst and pseudocyst of pancreas stricture and stenosis of esophagus alcohol abuse, in remission acquired hypertrophic pyloric stenosis alcoholic fatty liver bloodstream infection due to central venous catheter 

Answer: The patient is high likely exposed to