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: macrobid / sulfa (sulfonamide antibiotics) / vancomycin attending: chief complaint: left hip wound dehisence major surgical or invasive procedure: ultrasound-guided drainage of left hip fluid collection history of present illness: ms. is a 73yo female with history of htn, copd, anxiety, and bilateral hip replacement s/p left tha in c/b poor healing, wound dehiscence and possible infection, who is transferred to from osh for further evaluation of possible infection. . patient underwent l tha at in , and has had a complicated post-op course including prolonged rehab stay, poor wound healing and wound dehiscence, but per report multiple work-ups (including cultures) for l hip infection have been negative. however, was some concern for infection, and patient has been on empiric antibiotics with penicillin vk for approximately 2 months. two days ago, patient states she lost her balance while going up stairs, but denies falling or hitting her hip. was caught by her husband. she later noted a feeling of warmth at her incision site, and found the wound had opened and was draining blood and whitish material. denies any odor to the drainage. has had intermittent fevers at home, but she cannot state how often these occur or how high her temp has been. did have temp of 100.3 last evening. also reports she has had some drainage of the wound before, but she cannot clarify details. given worsening pain in left hip and difficulty ambulating pain, presented to osh ed and was then transferred to for further evaluation. . in the ed, initial vs were 97.7 78 106/56 16 95%. exam notable for 1 cm wound dehiscence with serosanguinous drainage, surrounding induration and warmth, but no fluctuance or erythema. she had limited flexion, internal and external rotation of left hip secondary to pain. labs notable for esr 80, crp 54. no leukocytosis, and chem7 wnl. hct 28.5 with mcv 81. imaging notable for 11x16x9-mm subcutaneous heterogeneous fluid collection communicating with skin, which does not appear to communicate with bone per ortho resident who spoke with radiologist. patient seen by ortho consult resident, who will staff patient with attending in morning. recommended admission to medicine, and will discuss need for possible l hip aspiration. . given concern for infection, patient started on empiric abx in ed with vancomycin 1gm. however, she developed acute onset of dyspnea concerning for anaphylatic reaction, with desat to low 80s. rr increased to 20s-30s, and patient appeared cyanotic per report. cxr did not show any evidence of flash pulm edema. had already received albuterol nebs. was placed on nrb, and received pepcid 20mg iv, diphenhydramine 50mg iv, and solumedrol 125mg iv with improvement in symptoms. was quickly weaned to 2l nc, with sats in high 90s. was observed in ed, given dose of linezolid, and then admitted to floor. . on arrival to floor, patient appears comfortable and states dyspnea has resolved. she has ongoing left hip pain. . ros: has dyspnea at baseline, currently improved from acute worsening in ed. chest tightness that improves with symbicort. denies frank cp. reports occasional palpitations and non-productive cough. intermittent fever/chills/diaphoresis at home. has chronic ha for which she takes fioricet. ha not associated with vision changes. patient does have left eye blindness s/p injury several years ago. had nausea in ed during reaction to vanco, but no nausea. denies abdominal pain, diarrhea, constipation, melena, or hematochezia. has lost weight, unclear amount. no dysuria, but has had urinary incontinence since her surgery. no sore throat or nasal congestion. no myalgias or arthralgias other than left hip/leg pain as above. past medical history: medical history: htn copd anxiety h/o utis urinary incontinence . surgical history: s/p bilateral hip replacement, left tha was in s/p cholecystectomy s/p appendectomy s/p hysterectomy social history: patient retired. lives with husband and has daily for wound care. denies any tobacco, alcohol, or illicit drug use at present. former smoker for ~20 years, quit >12 years ago. using walker to ambulate. family history: father had heart disease. physical exam: vs: 100.8 151/73 101 22 97% 2l, weight 130 pounds admission physical exam: general: elderly female, resting in bed, nad heent: nc/at, right pupil reactive, patient blind in left eye to prior accident, eomi, sclera anicteric, mmm, op clear neck: supple, no cervical lad, no jvd heart: borderline tachycardic, regular, no r/m/g lungs: ctab, no wheezes/crackles/rhonchi, good air movement, respirations unlabored abdomen: bowel sounds present, soft, non-distended, mild tenderness to palpation in ruq with minimal guarding but no rebound, no organomegaly extremities: warm, well-perfused, dp/pts 2+ bilaterally, no edema, left lateral thigh incision with 1cm wound dehiscence with serosanguinous drainage, surrounding induration and warmth, possible 1cm area of fluctuance, no surrounding erythema, no purulent drainage noted msk: patient able to flex and extend left hip, does report pain with active rom, has only mild pain on passive flexion, internal/external rotation neuro: alert, oriented to person, date, hospital/ (thought she was at ), patient with blindness left eye otherwise cn grossly intact, strength 5/5 throughout, sensation intact to light touch, patellar reflexes 2+ bilaterally . discharge physical exam: gen: nad ab: soft, non-distended lle: left lateral thigh incision with 1cm wound dehiscence with serosanguinous drainage, silt s/s/t/dp/sp, gs/ta/, 2+ dp/pt pertinent results: admission exam: --------------- 04:50pm sed rate-80* 04:50pm plt count-356 04:50pm neuts-67.0 lymphs-22.3 monos-7.7 eos-2.6 basos-0.3 04:50pm wbc-6.1 rbc-3.51* hgb-9.8* hct-28.5* mcv-81* mch-28.0 mchc-34.6 rdw-14.8 04:50pm crp-54.0* 04:50pm probnp-745* 04:50pm alt(sgpt)-13 ast(sgot)-21 alk phos-92 tot bili-0.2 04:50pm estgfr-using this 04:50pm glucose-96 urea n-17 creat-0.8 sodium-137 potassium-4.5 chloride-102 total co2-22 anion gap-18 05:01pm glucose-107* lactate-1.1 na+-136 k+-4.2 cl--101 tco2-25 05:01pm comments-green top 07:40pm pt-12.8 ptt-18.8* inr(pt)-1.1 . imaging: inj/asp major jt w/fluoro impression: 1. left hip aspiration procedure with approximately 0.5 ml of serosanguineous aspirate sent for gram stain and culture, which were carried directly to the laboratory after completion of examination. not enough aspirate was obtained for cell count and crystals. 2. radiopaque contrast material in the left hip joint space courses at the lateral aspect of the left total hip arthroplasty hardware in the proximal aspect of the left femur and into the subcutaneous soft tissues of the proximal left lateral thigh and into the skin through soft tissue defect. findings indicate communication of external skin defect in left lateral thigh with left hip joint space consistent with a left hip articular-cutaneous fistula. 3. small amount of contrast material is seen between metal hardware and bone interface at medial aspect of proximal left thigh hardware at level of second cerclage wire (1:7), indicative of hardware loosening. -------- microbiology: joint fluid left hip joint: gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. fluid culture (preliminary): no growth. acid fast smear (final ): no acid fast bacilli seen on direct smear. acid fast culture (preliminary): fungal culture (preliminary): ------------- brief hospital course: please see above hpi for more details. ms. had adequate pain management and worked with physical therapy while in the hospital. the remainder of her hospital course was uneventful and she is being discharged to home with services on in stable condition in time to make her pat appointment at . she will return for surgery with dr. on . medications on admission: metoprolol 25mg po bid naproxen 250 mg po bid penicillin vk 250mg symbicort 160mcg/4.5mcg 1 puff vicodin 5/500 mg prn pain fioricet 50/325/40 1 tab prn headache discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*60 tablet(s)* refills:*0* 3. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 4. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. disp:*56 tablet(s)* refills:*0* 5. butalbital-acetaminophen-caff 50-325-40 mg tablet sig: tablets po q8h (every 8 hours) as needed for headache. 6. symbicort 160-4.5 mcg/actuation hfa aerosol inhaler sig: one (1) puff inhalation twice a day. 7. enoxaparin 40 mg/0.4 ml syringe sig: one (1) subcutaneous hs (at bedtime) for 4 days. disp:*4 * refills:*0* discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis: left hip articular-cutaneous fistula. . secondary diagnosis: htn copd anxiety urinary incontience discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear ms. , it was a pleasure taking care of you during your hospitalization at . you were hospitalized after a fall associated with increasing leg pain. through the hospital course you had no fevers. during this admission, you were found to have a fluid collection in your left hip that was drained under ultrasound guidance. this fluid was sent for culture, which are still pending. imaging showed a connection between your skin and your hip-replacement hardware, known as an articular-cutaneous fistula. orthopedics was consulted during this admission, and they have recommended follow-up with dr. for further management of your left hip articular-cutaneous fistula. . please take your medications as directed. please note the following medication changes: **new: enoxaparin 1 injection sq daily in pm **changed: none. **stop: penicillin vk 250mg please keep all follow-up appointments as scheduled. please make a hospital follow-up appointment within 2 weeks of discharge with your primary care doctor regarding this hospital admission. followup instructions: department: pat-preadmission testing when: thursday at 10:40 am with: pat-preadmission testing building: cc resection arthroplasty / removal of thr implants left campus: west best parking: garage procedure: arthrotomy for removal of prosthesis without replacement, hip arthrocentesis other partial ostectomy, femur insertion or replacement of (cement) spacer diagnoses: other iatrogenic hypotension urinary tract infection, site not specified unspecified essential hypertension acute posthemorrhagic anemia chronic airway obstruction, not elsewhere classified anxiety state, unspecified surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] other specified antibiotics causing adverse effects in therapeutic use knee joint replacement nonunion of fracture urinary incontinence, unspecified hip joint replacement persistent postoperative fistula acute osteomyelitis, pelvic region and thigh major osseous defects other anaphylactic reaction infection and inflammatory reaction due to internal joint prosthesis unspecified infective arthritis, pelvic region and thigh other specified disorders of joint, pelvic region and thigh abdominal tenderness, right upper quadrant 

Answer: The patient is high likely exposed to