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: 84 year old male with multiple medical problems including diabetes, cad, chf, cri who is admitted with cholangitis. major surgical or invasive procedure: and stent placement percutaneous cholecystostomy tube placement tracheostomy history of present illness: patient came to the er with three days of right upper quadrant pain. in er was found to be afebrile but a ct of the abdomen was suggestive of gall bladder pathology. he was admitted and started on broad spectrum antibiotics with vancomycin/levo/flagyl administered in the er. he had a percutaneous cholecystostomy tube placed on after elective intubation for respiratory distress. he underwent an which revealed a compacted ampullary stone, likely cholangitis and possible cbd stone; a biliary stent was placed. past medical history: 1. cad, cath 5 years ago at nebh (cardiologist ) 2. chf, tte w/depressed ef 3. hypertension, per daughter pt's bp usually 90s-100s on meds 4. severe lumbar spinal stenosis, mild cervical stenosis 5. sleep apnea, on 2l home o2 at night 6. afib, s/p dccv which failed, now rate controlled 7. arthritis 8. gout 9. copd 10. niddm 11. e-coli-sepsis (admission - ) 12. bph 13. parkinson's disease social history: patient uses a cane for assistance at baseline. he lives with his daughter . formerly worked at sears. widowed. no tobacco or etoh use. family history: notable for cad, htn, and stroke. physical exam: t: 100.4 p: 64 r: 16-20 bp: 96/62 general: resp distress, acute pain, alert and oriented times three heent: mucous membranes moist neck: supple without lad cardiovascular: irregular s1 s2 respiratory: diffuse wheezes throughout; decreased breath sounds at right base gastrointestinal: soft, nt, nd bowel sounds normal and active musculoskeletal: knees swollen and warm bilaterally with effusion l>r,left elbow warm and swollen skin: multiple eccymoses pertinent results: abdominal ct - thickened gallbladder wall with stranding, without evidence of gallstones, however, concerning for acute cholecystitis. this was posted to the ed dashboard on the afternoon of the study. abdominal ultrasound - there is a small area of increased echogenicity in the gallbladder, which is not shadowing and may represent sludge, polyp, or much less likely gallstone. the gallbladder wall is 4 mm but not striated. there was no tenderness when scanning over the gallbladder. the common bile duct was normal measuring 3.2 mm. there is normal hepatopetal flow in the portal vein. labs - 10:06pm glucose-132* urea n-19 creat-1.4* sodium-134 potassium-3.7 chloride-97 total co2-25 anion gap-16 10:06pm alt(sgpt)-204* ast(sgot)-236* ld(ldh)-360* alk phos-267* amylase-148* tot bili-3.4* 10:06pm wbc-15.0* rbc-3.75* hgb-11.9* hct-36.3* mcv-97 mch-31.6 mchc-32.6 rdw-16.3* - successful ultrasound-guided placement of a percutaneous cholecystostomy tube. central line placement - in comparison with the study of , there has been placement of a left subclavian line that extends to the mid portion of the svc. no evidence of pneumothorax. there appears to be some increasing prominence of the pulmonary markings, suggesting elevated pulmonary venous pressure. hemodialysis catheter placed. 02:11am blood glucose-127* urean-85* creat-2.5* na-133 k-4.2 cl-99 hco3-21* angap-17 01:30am blood wbc-35.5* rbc-3.31* hgb-10.0* hct-30.7* mcv-93 mch-30.2 mchc-32.5 rdw-16.7* plt ct-504* 1. no evidence of colonic wall thickening or megacolon to suggest c. difficile. 2. bilateral pleural effusions with some adjacent consolidation and atelectasis, right greater than left. 3. anasarca. 4. interval removal of cholecystostomy tube. 05:14am blood wbc-6.6 rbc-2.93* hgb-9.0* hct-27.3* mcv-93 mch-30.8 mchc-33.0 rdw-17.5* plt ct-373 10:18am blood ptt-61.9* 05:14am blood pt-15.5* ptt-52.9* inr(pt)-1.4* 05:14am blood glucose-136* urean-56* creat-1.3* na-143 k-3.7 cl-107 hco3-26 angap-14 09:07am blood alt-10 ast-26 alkphos-71 amylase-35 totbili-0.2 09:07am blood lipase-12 microbiology: 5/16-8:c diff neg x 3 bal: staph aureus, coag +; yeast () sputum cx: coag mrsa ucx >100k e. coli () bal: coag + staph pleural fluid: mrsa bcx: neg ucx: neg, l elbow fluid: no wbcs, 97 polys, many monosodium urate crystals () cath tip: mrse () pancx: negative except, sputum: mrsa and yeast, joint aspirate: wbc 25k mod amount - monourate sodium crystals () bile cx: neg; bcx: neg, sputum cx: mrsa, ucx: neg; () sputum: mrsa; echo: la, ra dilated. mild symmetric lv hypertrophy. lvef>55%. ao root moderately dilated @sinus level. mildly thickened ao & mitral valve leaflets. mild 1+ mr. a systolic htn. brief hospital course: the patient was admitted on and started on broad spectrum antibiotics with vancomycin/levo/flagyl administered in the er. he had a percutaneous cholecystostomy tube placed on after elective intubation for respiratory distress. he underwent an which revealed a compacted ampullary stone, likely cholangitis and possible cbd stone; a biliary stent was placed. he had post procedure hypotension and sirs with progressive low grade fever, elevated wbc and a pressor requirement and he remained intubated. he spiked to 101.5 and was pan cultured on . sputum from that date ultimately grew mrsa. neuro: the patient was initially sedated with fentanyl and propofol as needed. : aps consult, started ketamine infusion for acute gout flare. po dilaudid started and fentanyl patch started . fentanyl drip stopped . for pain control, the patient continued on a fentanyl patch, tylenol liquid and po dilaudid. cardiovascular: initially started on cardizem on arrival to icu but this was changed to levophed for hypotension. the levophed was titrated to a goal map >60. throughout his stay in the icu, his blood pressure and heart rate were treated intermittently with neo, levo, lopressor, and ivf boluses. midodrine started . he was eventually weaned off all pressors on . he continued on metoprolol digoxin 0.125mg po daily for rate control. a heparin drip was started on for anticoagulation for atrial fibrillation with a goal ptt of 60-80 until therapeutic on coumadin. coumadin was started on at low doses with an inr goal of . lovenox was started on day of discharge as a bridge to a therapeutic inr. pulmonary: the patient was intubated on for respiratory distress. he underwent a tracheostomy on . the patient continued on the ventilator and was weaned to a trach collar on . pulmonary toilet continued with intermittent ventilator support as needed. gi: dobbhoff feeding tube placed and enteral nutrition started. nutren renal full strength with beneprotein 40gm/day, banana flakes 3 packets per day tube feedings continued at goal rate of 40ml/hr. gu: foley catheter placed on admission. a sore on the meatus was noted. urology was consulted and recommended changing position of the foley daily, changing the foley every six weeks and appyling bacitracin ointment daily. : foley changed fen: the patient was initially started on iv lasix for fluid overload and was dosed prn. cvvh started on for fluid overload. it continued for a goal of 50-100ml/hr and eventually stopped . lasix continued as a drip for a goal of keeping the fluid balance even. the lasix drip was stopped on day of discharge and po lasix was started. rheumatology : consulted on for acute, painful flare of gout. colchicine and indocin were both used for treatment of gout. endocrine: insulin drip was used prn to control blood sugars followed by an insulin sliding scale. id: vanc/zosyn started on for mrsa pna and biliary tract coverage. changed to linezolid/zosyn on . zosyn discontinued and cipro and flagyl added. flagyl and cipro d/c. linezolid was discontinued on : started meropenem, urine cx positive for e.coli. meropenem was discontinued on . flagyl started on empirically for c diff colitis. medications on admission: celebrex 200', coumadin 2.5/5 alternating', wellbutrin er 100', protonix 40', lasix 160', potassium 20', crestor 5', carbidopa 25/100''', flomax 0.4', glipizide 5'', colchicine 10.6 q2d, trazadone 100', 180', sotalol 80'', digoxin 0.125 q2d, xalatan 1 drop l eye', lidoderm patch' discharge medications: 1. metronidazole 500 mg tablet : one (1) tablet po tid (3 times a day) for 7 days. disp:*21 tablet(s)* refills:*0* 2. colchicine 0.6 mg tablet : 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. coumadin 3 mg tablet : one (1) tablet po once a day: goal inr dose daily. disp:*30 tablet(s)* refills:*2* 4. carbidopa-levodopa 25-100 mg tablet : one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 5. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 6. docusate sodium 50 mg/5 ml liquid : ten (10) ml po bid (2 times a day). disp:*600 ml* refills:*2* 7. bacitracin zinc 500 unit/g ointment : one (1) appl topical (2 times a day). disp:*1 tube* refills:*2* 8. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. disp:*30 tablet(s)* refills:*0* 9. digoxin 125 mcg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. trazodone 50 mg tablet : 1.5 tablets po hs (at bedtime) as needed. disp:*60 tablet(s)* refills:*0* 11. indomethacin 25 mg capsule : two (2) capsule po tid (3 times a day). disp:*180 capsule(s)* refills:*2* 12. fentanyl 75 mcg/hr patch 72 hr : one (1) patch 72 hr transdermal q72h (every 72 hours). disp:*10 patch 72 hr(s)* refills:*2* 13. chlorhexidine gluconate 0.12 % mouthwash : fifteen (15) ml mucous membrane (2 times a day): use only if patient is on mechanical ventilation. disp:*400 ml(s)* refills:*0* 14. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). disp:*30 tablet,rapid dissolve, dr(s)* refills:*2* 15. latanoprost 0.005 % drops : one (1) drop ophthalmic hs (at bedtime). disp:*20 ml* refills:*2* 16. ipratropium bromide 17 mcg/actuation aerosol : two (2) puff inhalation qid (4 times a day). disp:*1 unit* refills:*2* 17. acetaminophen 160 mg/5 ml solution : six y (650) mg po q6h (every 6 hours). disp:*500 ml* refills:*2* 18. levothyroxine sodium 50 mcg iv daily 19. albuterol 90 mcg/actuation aerosol : 1-2 puffs inhalation q6h (every 6 hours). disp:*1 unit* refills:*2* 20. lidocaine 5 %(700 mg/patch) adhesive patch, medicated : one (1) adhesive patch, medicated topical q24h (every 24 hours) as needed for pain for 7 days. disp:*7 adhesive patch, medicated(s)* refills:*0* 21. lorazepam 0.5 mg tablet : 1-2 tablets po q6h (every 6 hours) as needed. disp:*30 tablet(s)* refills:*0* 22. bupropion 75 mg tablet : one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 23. erythromycin 5 mg/g ointment : 0.5 in ophthalmic qid (4 times a day). disp:*60 in* refills:*2* 24. metoprolol tartrate 5 mg iv q6h:prn afib / rvr 25. sodium chloride 0.9% flush 10 ml iv prn line flush temporary central access-icu: flush with 10ml normal saline daily and prn. 26. furosemide 40 mg tablet : three (3) tablet po bid (2 times a day). disp:*180 tablet(s)* refills:*2* 27. enoxaparin 100 mg/ml syringe : one hundred (100) mg subcutaneous q 12h (every 12 hours): until therapeutic on coumadin (inr ) then may d/c lovenox. disp:*25 syringes* refills:*2* discharge disposition: extended care facility: senior life discharge diagnosis: acute cholangitis gall stone pancreatitis respiratory failure- mrsa pneumoniae gout acute on chronic renal failure congestive heart failure (lvef > 55%) atrial fibrillation coronary artery disease parkinson's disease diverticulosis discharge condition: fair discharge instructions: please call your surgeon or return to the emergency room if you have a fever greater than 101.5, chills, nausea, vomiting, chest pain, shortness of breath, if your skin becomes yellow-tinged or any other symptom that should worry you. please take all medications as prescribed. continue to wean off the vent as tolerated. you are being discharged on blood thinners, you must have your pt, ptt checked daily and have your coumadin dosed daily for an inr goal of . the heparin drip may stop once your inr is at a therapeutic level. speech and swallow should assess for pmv placement and swallow evaluation. please change position of foley catheter qdaily to avoid further erosion; bacitracin to meatus tid for lubrication and topical antibiosis and we would recommend foley change every 6 weeks. you will need to stop the coumadin 5 days prior to your on . therefore, do not take your coumadin dose on , , , . followup instructions: please call the office of dr. to make a follow up appointment in weeks at please call your cardiologist dr. to make a follow up appointment in weeks. ( please call rheumatology to make a follow-up appointment in weeks with dr at previously scheduled appointments: provider: 2 (st-4) gi rooms date/time: 10:00 provider: , md phone: date/time: 10:00 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis thoracentesis temporary tracheostomy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus endoscopic insertion of stent (tube) into bile duct arthrocentesis arthrocentesis percutaneous aspiration of gallbladder injection or infusion of oxazolidinone class of antibiotics diagnoses: obstructive sleep apnea (adult)(pediatric) acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis chronic airway obstruction, not elsewhere classified atrial fibrillation infection with microorganisms resistant to penicillins chronic kidney disease, unspecified hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (luts) paralysis agitans acute respiratory failure methicillin susceptible pneumonia due to staphylococcus aureus cholangitis acute pancreatitis calculus of bile duct with acute cholecystitis, with obstruction 

Answer: The patient is high likely exposed to