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: ceftriaxone / seroquel attending: chief complaint: altered mental status major surgical or invasive procedure: right hemiarthroplasty evacuation of hematoma lateral hip, placement of deep drain and superficial vacuum sponge history of present illness: this is a 70-year-old male with a history of mechanical aortic valve replacement in (#25 carbomedics valve) with an inr goal on warfarin of 2.5-3.5, parkinson's disease with dementia who was admitted for altered mental status and failure to thrive at home on and was noted to have a right subcapital femoral neck fracture. past medical history: -parkinson's disease with dementia -mechanical aortic valve replacement, on coumadin -hypertension -prostate ca s/p resection with dr. fistula (seeing ; applying bacitracin) social history: uses a walker intermittently. married, lives with wife who is primary caretaker. denies tobacco smoke. drinks coffee times per day. family history: brother died of mi age 56 physical exam: vs: 98 104/62 98 20 96ra general: frail man in nad, occasionally speaks, waxing and orientation heent: patient holds his neck in forward flexion (chin almost to chest), with effort can extend backward to neutral position, can rotate to left and right without difficulty, eomi, sclerae anicteric, oropharynx clear. heart: s1, s2, no murmurs auscultated, audible click appreciated lungs: cta bilaterally, good air movement, resp unlabored. abdomen: soft/nt/nd, no masses or hsm, no rebound/guarding. extremities: warm, well perfused. radial and pedal pulses 2+. ecchymosis over r hip and r flank improving. wound c/d/i lymph: no cervical lad. neuro: drowsy, not oriented (knows name but thinks it is and he is in ) pertinent results: 06:30am blood wbc-9.2 rbc-3.66* hgb-11.2* hct-32.4* mcv-88 mch-30.6 mchc-34.6 rdw-13.8 plt ct-426 06:15am blood wbc-9.1 rbc-3.74* hgb-11.6* hct-32.6* mcv-87 mch-31.0 mchc-35.6* rdw-14.1 plt ct-321 06:30am blood wbc-7.5 rbc-3.62* hgb-10.9* hct-32.0* mcv-89 mch-30.2 mchc-34.2 rdw-13.8 plt ct-265 04:55am blood neuts-84.1* lymphs-9.6* monos-4.7 eos-1.5 baso-0.2 06:30am blood pt-24.2* ptt-27.6 inr(pt)-2.3* 06:15am blood pt-25.6* ptt-28.9 inr(pt)-2.4* 06:30am blood glucose-100 urean-18 creat-0.7 na-139 k-4.0 cl-105 hco3-28 angap-10 06:15am blood glucose-110* urean-15 creat-0.6 na-136 k-4.0 cl-104 hco3-26 angap-10 06:30am blood glucose-112* urean-13 creat-0.7 na-137 k-4.0 cl-104 hco3-27 angap-10 06:15am blood calcium-8.3* phos-3.0 mg-1.9 brief hospital course: assessment & plan: the patient is a 70-year-old man with a history of parkinson disease and falls who is presenting with changes in behavior at home and a newly discovered right hip fracture. . 1. right subcapital femoral neck fracture: pt was not in pain prior to operation, fracture was found due to fall at home and inability to ambulate. his inr was reversed with po vit k and he was bridged to heparin prior to procedure. on he went to the or for a right hip hemiarthroplasty. postoperatively, he had difficulty with extubation and required a course in the ticu. during his post-op course, coumadin was restarted and the pt developed a large hematoma in the wound bed requiring prbcs and surgical evacuation on . cardiology was consulted at this point and recommended waiting 2 days prior to restarting coumadin. he was transferred to the medical service on after restarting coumadin. he worked with pt and was able to stand with assistance, although at his baseline he can ambulate on his own with a walker. he will need aggressive pt and will need follow-up with orthopedics. . 2. altered mental status: the patient's baseline is aox2. per the wife, he was altered at home the day after his fall (more confused, not taking pos). on admission to medicine originally, he was aox0-1, although he was quite alert. post-operatively, he was still aox0 but less alert, and as his course continued he became progressively more alert but still remained aox1. infectious workup was negative throughout his course; he remained afebrile, blood cx/ucx were negative, and he never developed a leukocytosis or penia. . 3. +sputum culture: during his ticu stay, he had a sputum culture from an ett that was positive for mrsa. it is unclear why this culture was performed, as he had no signs of infection throughout his course. 2 cxr after this sample was obtained were negative for infiltration; the pt never developed a fever or leukocytosis. he was not treated in the ticu and by the time he arrived on the medical floor, it was determined that he was ~5d after the culture was obtained and that in all likelihood he was not infected. he was not treated for this culture during this course. . 4. aortic valve replacement: anticoagulation started . after his hematoma evacuation, he was restarted on coumadin 2.5 by the ortho team. it is unclear why he did not resume his old dose. however, he was resumed on 2.5 qd on the medical floor with inrs in the low 2s (not consistently therapeutic above 2.5). he will be discharged on 3mg qd and will need follow-up inrs to ensure that he is within the therapeutic window of 2.5-3.5. it is important that he be above 2.5 for his valve, and be less than 3.5 as his risk of bleeding and hematoma development in the wound site would be quite high. . 5. parkinson disease and dementia: continuing home regimen of selegiline, carbidopa-levidopa, exelon, and clozapine. on admission, his citalopram was held due to his ams and citalopram's interaction with his selegiline. it was felt prior to receiving general anesthesia that it would be best to d/c his citalopram (low dose, unlikely to cause withdrawal). it was not restarted afterwards, and should be left to his pcp to restart at some point in the future. . 6. hypotension: on midodrine since last admission. no episodes of hypotension during this admission. . 7. anal fistula: unclear etiology. continued bacitracin ointment . medications on admission: 1. selegiline hcl 5 mg capsule sig: one (1) capsule po qam (once a day (in the morning)). 2. selegiline hcl 5 mg capsule sig: one (1) capsule po noon (at noon). 3. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 4. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 5. warfarin 1 mg tablet sig: 3.5 tablets po qtuthsa (tu,th,sa). 6. warfarin 2 mg tablet sig: two (2) tablet po qmowefrsu. 7. carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po q3h (every 3 hours). 8. clozapine 25 mg tablet sig: 1.5 tablets po daily (daily). 9. exelon 9.5 mg/24 hour patch 24 hr sig: one (1) transdermal daily (). 10. bacitracin zinc 500 unit/g ointment sig: one (1) appl topical (2 times a day). 11. midodrine 5 mg tablet sig: one (1) tablet po tid (3 times a day): take during waking hours (not before bed). disp:*90 tablet(s)* refills:*2* discharge medications: 1. selegiline hcl 5 mg capsule sig: one (1) capsule po bid (2 times a day, once in am and once at noon). 2. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. bacitracin zinc 500 unit/g ointment sig: one (1) appl topical (2 times a day). 4. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 5. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 6. exelon 9.5 mg/24 hour patch 24 hr sig: one (1) transdermal q24h (every 24 hours). 7. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 8. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 9. midodrine 5 mg tablet sig: one (1) tablet po tid (3 times a day). 10. carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po q3h (every 3 hours). 11. clozapine 25 mg tablet sig: 1.5 tablets po daily (daily). 12. multivitamin tablet sig: one (1) cap po daily (daily). 13. calcium carbonate 500 mg calcium (1,250 mg) tablet sig: one (1) tablet po tid (3 times a day). 14. sodium chloride 0.9% flush 3 ml iv q8h:prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. 15. warfarin 3 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: - discharge diagnosis: right femoral neck fracture right hip wound hematoma post operative blood loss anemia post operative fluid volume deficit discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: mr , it was a pleasure taking care of you at . you were admitted for confusion and found during your workup to have a right hip fracture which was repaired by orthopedic surgery on . after the operation, you had bleeding into the surgical site, which required a return trip to the or for drainage. afterwards, you had a wound vacuum placed over the incision to help facilitate healing which was removed prior to discharge. you also had continued confusion during your hospital course that was originally due to your hip fracture, and afterwards was due to the anesthesia from your operations; this is common. please make the following changes to your medications: please stop citalopram. please stop your previous warfarin dosing. please start warfarin 3mg everyday. this will likely have to be changed in the future, but your dose was lowered due to the risk for further bleeding into your operation. wound care: -keep incision dry. -do not soak the incision in a bath or pool. -keep pin sites clean and dry. -sutures/staples will be removed at your first post-operative visit. activity: -continue to be _ weight bearing on your left/right arm/leg. -you should not lift anything greater than 5 pounds. -elevate right/left arm/leg to reduce swelling and pain. other instructions - resume your regular diet. - avoid nicotine products to optimize healing. followup instructions: name: , a. specialty: internal medicine address: ,2nd fl, , phone: **please discuss with the staff at the facility the need for a follow up appointment with your pcp when you are ready for discharge** department: orthopedics when: wednesday at 7:50 am with: ortho xray (scc 2) building: sc clinical ctr campus: east best parking: garage department: orthopedics when: wednesday at 8:10 am with: , np building: campus: east best parking: garage procedure: partial hip replacement other incision with drainage of skin and subcutaneous tissue diagnoses: unspecified essential hypertension acute posthemorrhagic anemia personal history of malignant neoplasm of prostate hematoma complicating a procedure unspecified fall heart valve replaced by other means long-term (current) use of anticoagulants surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation dementia in conditions classified elsewhere without behavioral disturbance accidents occurring in residential institution kyphosis (acquired) (postural) dementia with lewy bodies closed fracture of unspecified part of neck of femur anal fistula 

Answer: The patient is high likely exposed to