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: peanut / latex attending: chief complaint: cellulitis major surgical or invasive procedure: 1. left above-the-knee amputation 2. debridement of left lower extremity wound and placement of a wound vac 3. revision of left aka with partial closure and placement of vac 100 cm2 and debridement of upper sacral wound and back decubitus with placement of wet-to-dry dressings 4. debridement of presacral ulcer, placement of v.a.c. on left amputation below-knee amputation stump, tracheostomy history of present illness: 31 year old male with spina bifida, s/p spinal fusion, hydrocephalus s/p shunt, bilaterally dislocated hips and clubbed feet presented to osh with chills/night sweats and a known likely infected left foot (has a history of many lower extremity infections in the past). at the osh, noted to be septic with hr in the 120s, hypotensive to the 70s responsive to ivf, afebrile with source likely cellulitis in his left leg; ua and cxr negative, blood cultures ngtd. initially was put on vanc/clinda however pt continued to be septic with wbc count trending upwards (17 on to 33 on , day of transfer) and with spreading of his cellulitis, so his abx were changed to vanc/zosyn. he was seen by surgery at the osh who felt that he likely did not have nec fasc and recommended adding iv diflucan. skin/wound cultures reportedly growing group g strep, blood cultures negative. he was transferred for further multidisciplinary workup; normally he is seen at for his lower extremity infections, it is unclear why he was not transferred there. his custom wheelchair recently broke and he has since been in one that is not well fitted to him. he developed lower extremity abrasions and sacral skin breakdown complicated by lower extremity and sacral cellulitis for the past few weeks. on the floor he appears tired and ill but not toxic, intermittently falling asleep. he is oriented to person and time but not place, and exhibits concentration. endorses chills, night sweats, mild shortness of breath. states that he can feel his lower extremities but does not feel pain in them currently. endorses dysuria. pt was initially admitted to hmed service. he became increasingly toxic overnight and was transferred to the micu for dropping pressures in the setting of afib with rvr. on arrival to the micu, pt was hypotensive to 70s systolic, still in rvr. past medical history: pmh: spina bifida, chronic lymphedema, hydrocephalus s/p shunt, lower extremity paralysis with bilateral clubbed foot deformities psh: s/p vp shunt placement, s/p spinal fusion social history: lives with parents who are caregivers. worked in the past at kiosk in the mall, but not currently employed. not married, no children. no tobacco, ethanol, drugs. family history: mother with chronic fatigue syndrome and allergies, dad unknown physical exam: 97.2 108/42 110 26 94%2l admission exam: gen alert, oriented to person/time, states he is at , no acute distress heent ncat dry mm, eomi sclera anicteric, op clear neck supple, no jvd, no lad pulm only able to auscultate anteriorly due to habitus, good aeration, ctab no wheezes, rales, ronchi cv regular tachycardia normal s1/s2, no mrg abd obese soft nt nd normoactive bowel sounds ext l: massive lymphedema with club foot deformity, capillary refill <2sec distally, over medial thigh and lateral club foot area of skin with cellulitic appearance with skin sloughing and weeping of serous fluid, dermis underneath appears beefy red, nontender to palpation, no area of fluctuance noted. no crepitus. some areas with dark purple discoloration. fungal appearing coat over some areas of skin. r: mild lymphedema with club foot deformity, no areas of skin breakdown noted. sacrum: erythematous non-necrotic ulcer noted without penetration to bone/muscle. non purulent. neuro cns2-12 intact, upper motor function grossly normal gu fungal appearing discharge from meatus pertinent results: admission labs: 01:55am blood wbc-41.7* rbc-4.42* hgb-11.8* hct-38.2* mcv-86 mch-26.7* mchc-30.9* rdw-18.5* plt ct-270 01:55am blood neuts-85* bands-1 lymphs-11* monos-1* eos-0 baso-0 atyps-0 metas-0 myelos-2* 01:55am blood pt-12.4 ptt-25.2 inr(pt)-1.1 01:55am blood glucose-118* urean-52* creat-1.6* na-130* k-4.3 cl-97 hco3-22 angap-15 01:55am blood alt-13 ast-37 alkphos-207* totbili-0.8 01:55am blood albumin-2.0* calcium-8.4 phos-4.2 mg-2.7* 07:01am blood lactate-1.7 09:58am blood lactate-1.3 07:01am blood type-art o2 flow-4 po2-137* pco2-73* ph-7.15* caltco2-27 base xs--5 intubat-not intuba 11:04am blood type-art temp-36.2 rates-21/ peep-5 fio2-100 po2-165* pco2-60* ph-7.14* caltco2-22 base xs--9 aado2-490 req o2-83 intubat-intubated abscess culture/wound swab staph , , bacteroides 12:39am blood wbc-4.6 rbc-2.78* hgb-8.2* hct-27.2* mcv-98 mch-29.4 mchc-30.1* rdw-19.5* plt ct-212 12:39am blood plt ct-212 12:39am blood glucose-89 urean-30* creat-1.4* na-141 k-4.4 cl-112* hco3-25 angap-8 01:00am blood alt-15 ast-18 alkphos-121 totbili-0.6 12:39am blood calcium-8.4 phos-3.0 mg-2.5 04:10am blood vanco-15.9 brief hospital course: mr. is a 31 yo m w/ pmh of spina bifida with paraplegia and is wheelchair bound at baseline who was transferred from an osh for concern re: his left leg cellulitis. upon admission, he was found to be hypotensive despite aggressive fluid resuscitation. he was transferred to the micu initially, and surgery was consulted for concern regarding necrotizing fasciitis in the face of elevated wbc and signs of sepsis. he was taken urgently to the or and did require aka for necrotizing fasciitis; he was transferred to the surgical service postoperatively. his course is summarized by systems below: n: he was initially mentating well. he was sedated while intubated, but remained responsive when sedation was weaned. after sedation was d/c'd, he was a&ox3. he worked with pt and was out of bed to chair and interacting appropriately. cv: at admission, his pressures did drop and upon transfer to the micu on he required three pressors to maintain his bp. his rhythm at this point was afib; he was started on an amiodarone drip. it was at this point that the patient was taken urgently to the or. he remained on pressors post-operatively, but they were able to be significantly weaned. after the initial operation, he was weaned down to a small dose of levophed, which he continued to require. he was weaned off the amiodarone drip on pod 1 and remained in sinus rhythm. he was weaned off pressors and remained in sinus rhythm. patient was stable from a cardiovascular standpoint at time of discharge pulm: he was initially intubated on after transfer to the micu due to worsening ventilation and combined respiratory and metabolic acidosis on abg. he was kept intubated postoperatively initially due to the need to return to the or for washout. however he did continue to require high peep, and attempts to wean off the ventilator were unsuccessful. he was taken to the or on for trach placement. at time of discharge patient with stable 02 saturations on trach collar at 40% fio2 gi: the patient was initially kept npo with ivf. on he was started on tube feeds via ngt. these were held as needed for a return trip to the or on for washout and partial closure, and then restarted postoperatively. they were titrated up to goal and he tolerated them with low residuals. patient was tolerating tube feeds at goal at time of discharge and was advanced to a soft solid diet with trach cuff inflated while taking po intake. gu: urine output was monitored with a foley catheter. his uop remained good however his creatinine did increase during the course of his icu stay. this was monitored daily. id: at initial presentation he was septic necrotizing fasciitis in his left lower extremity. his preop wbc was 59. he was started on vanc/zosyn/clinda/flagyl for broad spectrum coverage and id was consulted. id continued to follow throughout his course. after the initial operation his wbc dropped to 26 on pod1; his hemodynamic status stabilized. his antibiotics were narrowed to vanc/zosyn/clinda. the cultures of his leg returned mrsa. patient was continued on antibiotics until time of discharge and was discharged without antibiotics, afebrile with stable wbc. patient was discharged to rehabilitation facility with trach collar, tolerating tube feeds at goal with a soft diet and vac in place. vac will be changed every 3 days tube feeds will be managed by the rehab facility pending po intake requirements. abx were discontinued at time of discharge and patient will call to arrange a follow up appointement with clinic in 2 weeks time. medications on admission: medication on transfer from medical service: metrogel q12h to face tylenol prn albuterol nebs prn oxycodone 5-10mg q3h prn pain zosyn 3.375g q6 vancomycin 2g q12 diflucan 200 qd discharge medications: 1. acetaminophen (liquid) 650 mg po q6h:prn fever/pain 2. artificial tear ointment 1 appl both eyes prn redness/dry eyes 3. bisacodyl 10 mg po/pr daily 4. buspirone 10 mg po bid anxiety 5. collagenase ointment 1 appl tp daily apply to sacral decubitus ulcer daily 6. docusate sodium (liquid) 100 mg po bid 7. gabapentin 300 mg po daily 8. heparin 7500 unit sc tid 9. hydroxyzine 25-50 mg po q6h:prn anxiety/puritus 10. lactulose 30 ml po bid 11. oxycodone (immediate release) 5-10 mg po q4h:prn pain rx *oxycodone 5 mg tablet(s) by mouth every four (4) hours disp #*30 tablet refills:*0 12. sarna lotion 1 appl tp tid:prn itching 13. senna 1 tab po bid *ast approval required* 14. zolpidem tartrate 10 mg po hs 15. metronidazole topical 1 % gel 1 appl tp discharge disposition: extended care facility: hospital for continuing medical care - ( center) discharge diagnosis: rle necrotizing fasciitis discharge condition: stable discharge instructions: you were admitted to the general surgery service for necrotizing fasciitis of the right lower extremity. please call your doctor or go to the emergency department if: *you experience new chest pain, pressure, squeezing or tightness. *you develop new or worsening cough, shortness of breath, or wheeze. *you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience an unusual discharge. *your pain is not improving within 12 hours or is not under control within 24 hours. *your pain worsens or changes location. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *you develop any concerning symptoms. general discharge instructions: please resume all regular home medications, unless specifically advised not to take a particular medication. please take any new medications as prescribed. please take the prescribed analgesic medications as needed. you may not drive or heavy machinery while taking narcotic analgesic medications. you may also take acetaminophen (tylenol) as directed, but do not exceed 4000 mg in one day. please get plenty of rest, continue to walk several times per day, and drink adequate amounts of fluids. avoid strenuous physical activity and refrain from heavy lifting greater than 20 lbs., until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. please also follow-up with your primary care physician. the rehabilitation facility will be caring for your wound vac and your wound will be reevaluated at your follow up visit with acs general surgery followup instructions: please call the clinic to make a follow up appointment in 2 weeks. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances temporary tracheostomy excisional debridement of wound, infection, or burn excisional debridement of wound, infection, or burn amputation above knee repair of entropion or ectropion with wedge resection revision of amputation stump central venous catheter placement with guidance diagnoses: unspecified septicemia severe sepsis atrial fibrillation acute respiratory failure septic shock morbid obesity pressure ulcer, lower back methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site talipes, unspecified presence of cerebrospinal fluid drainage device arthrodesis status mixed acid-base balance disorder pressure ulcer, stage iii other lymphedema body mass index 50.0-59.9, adult necrotizing fasciitis wheelchair dependence congenital diplegia 

Answer: The patient is high likely exposed to