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: back pain major surgical or invasive procedure: none history of present illness: hpi: 61m trauma surgeon and acting-chief of surgery at s/p recent posterior lumbar interbody fusion revision l4-l5 and l5-s1 () c/b superficial wound infection (or cultures w/ mssa)and s/p wound debridement with left l5 s1 discectomy ()for discitis and l5 radiculopathy re-presents w/ increasing lower back pain and spasms refractory to medication regimen of robaxin 750''', oxycontin 20'' and vicodin prn breakthrough pain.recently came to ed for eval and had mri of spine on that showed "post-surgical changes, fusion from l4/l5 and l5/s1,pattern of abnormal enhancement in intervertebral disc spaces at l4/l5 and l5/s1 worrisome for early discitis, fluid collection at these levels posteriorly worrisome for seroma vs abscess, diffuse enhancement in surgical bed likely c/w granulation tissue.posterior to the s1 vertebral body evidence of still rounded low-signal intensity areas w/ contrast, slightly hyperintense on t2, worrisome for abscess formation or collections." no fevers, chills, nausea, vomit, fecal incontinence. has foley. past medical history: pmh/psh: - posterior lumbar interbody fusion revision l4-l5 and l5-s1. - wound debridement with left l5 s1 discectomy -hypertension, in good control -hypercholesterolemia, on statin -bph, on flomax -appendectomy in -right inguinal hernia repair in -lumbar surgery between and with disk resections of the l5-s1, l4-l5 and repeats of both the l5-s1 and l4-l5 -basal cell carcinomas skin -pattern of elevated psa undergoing several transrectal biopsies of the prostate, all showing only chronic inflammation; followed here by dr. with plan for updated prostate biopsy. -repeat repair of a right inguinal hernia in with umbilical hernia repaired at the time. - meningitis with heart block in ; this resolved uneventfully. social history: social hx: acting chief of surgery, trauma surgeon here at the . he is married with a single child. no tobacco use. no significant ethanol. family history: family hx: notable for htn and mi in several relatives. the patient's father died at age 86 with complications of an mi. he has a sibling several years his in good health. his father did have prostate cancer, but this did not result in his death. physical exam: on arrival : physical exam: o: t: 98.9 bp: 130/66 hr: 94 rr: 21 o2sats: 98% ra gen: in noticeable pain, uncomfortable heent: at/nc, pupils: perrl, eoms intact neck: supple. lungs: cta bilaterally. cardiac: rrr. s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. motor: exam limited by pain. strength 4+ r ankle dorsiflexion, 5+ l ankle dorsiflexion. . sensation to gross touch intact except for r great toe. labs: wbc 7.8 hct 27.5 plt 375 pt 12.9 ptt 20.5 inr 1.1 na 142 k 4.0 cl 102 hco3 27 bun 23 cr 1.2 glu 112 calcium 8.8 phos 3.7 mg 1.9 on discharge: motor: except 4-/5 intact to lt wound sutures out, well healed on discharge: a&o x 3 lower extremity exam: ip q h gas at r 5 5 5 5 0 l 5 5 5 5 5 pertinent results: mr w & w/o contrast: there is l4 through s1 laminectomy with fusion with rods and screws. there are stable fluid collections surrounding the spinous process of l3 that is unchanged when compared to the prior exam. there is enhancement of the soft tissues within the surgical bed consistent with granulation tissue. posterior to the l5 and s1 vertebral body, there are fluid collections which are stable to slightly larger in size. this extends posteriorly and superior to the superior endplate of the l4 vertebral body and is unchanged. there is increased soft tissue enhancement anterior to the s1 vertebral body that is slightly increased when compared to the prior exam. there is increased compression on the right side of the thecal sac at l5-s1. the increased soft tissue induration on stir sequence anterior to the l5-s1 vertebral body is consistent with progression of infection. the remainder of the paraspinal soft tissues remains unchanged. cxr mon :tip of the new left subclavian line projects over the junction of the brachiocephalic veins, following removal of the right internal jugular line.right pic line tip projects over the mid svc. no pneumothorax, mediastinal widening or pleural effusion. lungs clear. heart size normal. echocardiography report findings this study was compared to the prior study of . left atrium: normal la size. right atrium/interatrial septum: normal ra size. left ventricle: normal lv wall thickness, cavity size and regional/global systolic function (lvef >55%). no resting lvot gradient. right ventricle: normal rv chamber size. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. aortic valve: normal aortic valve leaflets (3). no as. no ar. no masses or vegetations on aortic valve. mitral valve: mildly thickened mitral valve leaflets. no mvp. no mass or vegetation on mitral valve. no mr. tricuspid valve: normal tricuspid valve leaflets. no mass or vegetation on tricuspid valve. physiologic tr. borderline pa systolic hypertension. pulmonic valve/pulmonary artery: pulmonic valve not well seen. no ps. physiologic (normal) pr. pericardium: trivial/physiologic pericardial effusion. general comments: resting tachycardia (hr>100bpm). conclusions the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size is normal. 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 leaflets are mildly thickened. there is no mitral valve prolapse. no mass or vegetation is seen on the mitral valve. no mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. impression: no echocardiographic evidence of valvular vegetations. normal global and regional biventricular systolic function. borderline pulmonary hypertension. compared with the prior study (images reviewed) of , no mitral regurgitation is seen. the estimated pulmonary artery pressures are higher. the resting heart rate is faster. knee (ap, lat & oblique) left impresion: subchondral cyst along anterior aspect of (right or left) femoral condyle. otherwise, left knee xray examination within normal limits. abd and pelvis ct with contrast impression: 1. no intra-abdominal fluid collection. 2. rind of soft tissue anterior to l5-s1 with stranding, compatible with infection as seen on mri of . 3. tiny (9 x 7 mm) focus of fluid at the surgical site posterior to the spinous process of l3, at the interface of subcutaneous tissues and paraspinal muscles. 4. numerous findings are unchanged, including enhancing liver lesions and left adrenal nodule, each of which are indeterminate and for which mri is recommended once the patient's clinical condition permits. brief hospital course: pt was admitted to the hospital through the emergency department for worsening back pain and spasm after lumbar wound washout days #21 and #14. pt admitted for pain control and then during the initial days was complaining of left knee pain which was tapped for about 30+ cc of fluid by ortho. the lab results were no microrganisms. wbc count elevated from 9->13 and then came down to 8. he was also re-seen by id and they followed his esr, crp and abx coverage. repeat imaging via ct and mri of the abdomen and spine were obatined and the results showed bladder distention and stool and stable fluid appearance in surgical area. a po pain medication regimen was ultimately acquired with good control. the sutures were removed from the wound on which was clean, dry and well healed without erythema. he had enemas with good results. he was voiding spontaneously in good amounts. he is being discharged home on with continued home abs therapy and home physical therapy. he will follow up with infectious disease on an outpatient basis for monitoring, the following has been recommended: laboratory monitoring required: -weekly cbc/diff, bun/cr, ast/alt all laboratory results should be faxed to infectious disease r.ns. at ( all questions regarding outpatient antibiotics should be directed to the infectious disease r.ns. at ( or to on md in when clinic is closed medications on admission: robaxin 750''', oxycontin 20'',vicodin prn breakthrough pain, valsartan 80', simvastatin 20',rifampin 300'', kefzol 2gm iv q8 discharge medications: 1. rifampin 300 mg capsule sig: one (1) capsule po q12h (every 12 hours). disp:*60 capsule(s)* refills:*2* 2. docusate sodium 100 mg capsule sig: capsules po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. gabapentin 300 mg capsule sig: two (2) capsule po q8h (every 8 hours). disp:*150 capsule(s)* refills:*2* 4. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po daily (daily). disp:*30 capsule, sust. release 24 hr(s)* refills:*2* 5. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*90 tablet(s)* refills:*0* 6. oxycodone 20 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po q12h (every 12 hours). disp:*60 tablet sustained release 12 hr(s)* refills:*2* 7. atenolol 25 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. baclofen 10 mg tablet sig: 1.5 tablets po tid (3 times a day). disp:*135 tablet(s)* refills:*2* 9. baclofen 10 mg tablet sig: 0.5 tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 10. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: adhesive patch, medicateds topical asdir (as directed). disp:*80 adhesive patch, medicated(s)* refills:*2* 11. cefazolin 1 gram recon soln sig: two (2) intravenous every eight (8) hours for last dosing to bbe on days. disp:*102 * refills:*1* 12. physical therapy sig: one (1) once a day: ongoing physical therapy as recommended by visiting clinician. disp:*1 1* refills:*1* discharge disposition: home with service facility: critical care systems discharge diagnosis: intractable spasm and low back pain urinary retention constipation discharge condition: neurologically stable discharge instructions: ?????? do not smoke. ?????? keep your wound clean / no tub baths or pool swimming for two weeks from your date of surgery ?????? no pulling up, lifting more than 10 lbs., or excessive bending or twisting for 2 weeks. ?????? limit your use of stairs to 2-3 times per day. ?????? check your incision daily for signs of infection. ?????? take your pain medication as instructed; you may find it best if taken in the morning when you wake-up for morning stiffness, and before bed for sleeping discomfort. ?????? do not take any anti-inflammatory medications such as motrin, advil, aspirin, and ibuprofen etc. for 3 months. ?????? increase your intake of fluids and fiber, as pain medicine (narcotics) can cause constipation. we recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. call your surgeon immediately if you experience any of the following: ?????? pain that is continually increasing or not relieved by pain medicine. ?????? any weakness, numbness, tingling in your extremities. ?????? any signs of infection at the wound site: redness, swelling, tenderness, and drainage. ?????? fever greater than or equal to 101?????? f. ?????? any change in your bowel or bladder habits (such as loss of bowl or urine control). followup instructions: follow up instructions/appointments ??????please call ( to schedule an appointment with dr. to be seen in 3 weeks if you do not recieve a phone call from him this week. ??????you will need x-rays prior to your appointment. provider: , md phone: date/time: 11:00 provider: , md phone: date/time: 12:00 procedure: arthrocentesis diagnoses: other chronic pain anemia, unspecified pure hypercholesterolemia unspecified essential hypertension hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) constipation, unspecified bacteremia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site pain in joint, lower leg retention of urine, unspecified fever, unspecified lumbago other symptoms referable to back swelling of limb other acute postoperative pain postprocedural fever 

Answer: The patient is high likely exposed to