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: tracheoesophageal fistula, esophageal stricture major surgical or invasive procedure: flexible bronchoscopy with bronchoalveolar lavage left 14-french pigtail catheter placement repair of tracheoesophageal fistula; tracheal resection and reconstruction; flexible bronchoscopy with bronchoalveolar lavage and esophagogastroduodenoscopy with central compartment neck dissection, left hemithyroidectomy and left recurrent nerve sacrifice. repair of tracheoesophageal fistula with interposition flap. pectoralis major myofascial flap right side. split-thickness skin graft 1 inch x 10 cm to right neck. history of present illness: mr. is a 66 year-old african american male who was previously followed by dr. at the 14 years prior. he has a history of esophageal carcinoma status-post radiation with 3-hole esohagectomy in at . he was recently hospitalized at for pna and found to have stricture near the cricopharyngeus, with evidence of tracheoesophageal fistulation. an egd showed no cancer recurrence however. a j-tube was placed in , but since that time has had issues with dehydration and instances of clogged j-tube, thus he has been on supplemental tpn. recently, he reported no fever, no chills, and decreased po intake. he still is on tube feeds, reports no abdominal pain. the daughter, , reports occasionnal diarrhea, which she thinks is due to his lactose intolerance. his voice has been hoarse for the last 2 days. he complains of mild dyspnea and reports an occasional productive cough characterized by white sputum. he was admitted to the night before surgery on and on underwent repair of tracheoesophageal fistula; tracheal resection and reconstruction; flexible bronchoscopy with bronchoalveolar lavage and esophagogastroduodenoscopy with central compartment neck dissection, left hemithyroidectomy and left recurrent nerve sacrifice; with repair of tracheoesophageal fistula with interposition flap and pectoralis major myofascial flap on the right side, with a split-thickness skin graft 1 inch x 10 cm to right neck. on , he required placement of a 14-french left pigtail catheter for pleural effusion. past medical history: -hypertension -hypothyroidism -prostate cancer s/p xrt -h/o esophageal ca s/p xrt with 3-hole esohagectomy in at . recently hospitalized at for pna and found to have stricture near cricopharyngeus, with evidence of tef. egd showed no cancer recurrence. j-tube placed -small bowel obstruction -cognitive deficit nos vs limited safety awareness -orthostatic hypotension - hospitalization after fall -dvt of the l subclavian and l axillary vein -r hip fracture s/p orif by dr. @ -rll pna , treated with levofloxacin -multiple stab wounds to the abdomen in the -right sided ptx after bronchoscopy s/p ct placement -tonsillectomy and adenoidectomy -r wrist and hand surgery social history: originally from . he has three daughters. one daughter lives in , another is in , and who is very involved. visits on tues/thurs/friday and weekends. he lives with a roommate. daughter comes over 3-4 times a week. reports he recently stopped smoking. although he has a history of binge drinking, he reports he hasn't drank since of . retired construction worker and plumber. family history: mother died of a blood clot. doesn't know what his father died of. sister died of obesity and "fat around her heart" physical exam: afebrile vitals wnl aaox3 nad rrr ctab trach intact soft nt/nd wounds c/d/i no edema, extrem warm pertinent results: g/gj/gi tube check (): 1. no evidence of j-tube leak. 2. ngt in neoesophagus. 3. right lung base fibrosis and loculated effusions. 4. diffuse skeletal demineralization and degenerative changes tracheal tissue/tef pathology (): membranous wall portion of tracheo-esophageal fistula: squamous mucosa with erosion and fibrosis. no evidence of malignancy noted. chest ct (): 1. right middle and bilateral lower lobe collapse, absent bronchial obstruction, accompanied by small-to-moderate pleural effusions is probably relaxation atelectasis. left basal pleural drain may not be in communication with the left effusion. small pericardial effusion is new, postoperatively, but probably not clinically significant. 2. small upper mediastinal retrotracheal hematoma, and larger soft tissue hematoma in the right neck and upper chest with a large intramuscular component in the right pectoralis flap. 3. small gas collections in the upper mediastinum may be residual rather than an indication of active leak. if leak is of active clinical concern, oral contrast would need to be administered. 4. et tube in standard placement. right pic line ends in the svc 5 cm above the superior cavoatrial junction. ct neck w/without contrast brief hospital course: neuro/pain: mr. pain post-operatively has remained controlled with fentanyl. his sedation was maintained with midazolam and propofol. sedation was discontinued pod#8 (). when gtt was turned off, the patient was easily aroused and interactive. sedation was on/off during periods of intubation followed by extubation. cardiovascular: post-op, mr. remained hemodynamically stable with systolic pressures in 120-140s and without an abnormal cardiac rhythm. he was maintained on lopressor iv and lasix was utilized intermittently to achieve euvolemia. the patient appeared slightly volume overloaded on pod#6, around 3l positive. he autodiuresed well and was euvolemic by the end of his hospitalization respiratory: patient remained intubated post-op on with a high tracheal anastamosis and history of difficult intubation. the patient was weaned on and required re-intubation when his oxygen saturations dropped and he became tachypneic. he was fiberoptically re-intubated given his airway surgery. on pod#2 a left pigtail catheter was placed by ip to drain a moderate left pleural effusion. it drained over 1800 cc of serous fluid. the patient has had copious secretions amenable to suction, mucolytics and nebulizers. he initially was extubated on pod# 2 and developed hypercarbia requiring re-intubation that same evening. the patient had a second, successful extubation trial pod#8 over a cook catheter (second extubation). right sided pleural effusion was noted on pod#7, but this was follow-ed without intervention. lasix was used intermittently for gentle diuresis. patient required reintubation for hypercarbic respiratory failure on pod#8 and although his mechanics of ventilation were adequate, bronchoscopy on pod#13 demonstrated questionable compromise of the tracheal anastamosis, and patient underwent tracheostomy on . he was weaned immediately to trach mask. he had a large amount of secretions that required frequent nebs and suctioning. fen/gi: the patient had an ngt placed in the operating room. this was maintained on low suction until it was displaced (by the patient) on pod#8. the patient was started on tube feeds @ 55 cc/hr (20 kcal/kg/day) on pod#3. a ppi was utilized for gi prophylaxis. the patient was npo throughout this period. on , patient self-removed nasogastric tube. tfs were continued through the j-tube site. genitourinary: the patient had a foley catheter placed in the operating room, and he maintained a urine output of 30-45 cc/hr. lasix was intermittenly used for grentle diuresis with good response noted. he was kept 1.5l negative on pod# to enhance volume loss, given he was 3l positive from the or. he mobilized fluid appropriately. his creatinine has remained at baseline (0.6). foley removed day of discharge. heme/id: post-op hematocrit was stable at 32.8 and no evidence of bleeding was noted. his wbc was 7.9. bronchoscopy and bal on showed pmns 3+ and 4+ gram positive cocci with gram positive rods that were established as commensal organisms. the patient was placed on ciprofloxacin and metronidazole on (for a 10 day course) post-op given the respiratory contaimination with tef, the extent of surgical intervention, and the need for re-exploration at the end of surgery for jp drain perforation of the neo-esophagus--which was subsequently repaired without issue. antibiotics were switched to vancomycin and cefepime on when a bronch/bal grew gram positive cocci and gram positive rods. on , a repeat bronchoscopy/bal revealed coagulase positive staphylococcus that was noted to be mrsa for which antibiotics were continued. he had a 10 day course of antibiotics and has had no current signs of infection. endocrine: sliding scale insulin was utilized to maintain blood sugars in the 80-120 mg/dl range. we maintained his home thyroid medication needs. synthroid 75 mcg iv daily was utilized. his tsh was elevated on admission. this should be titrated long term. prophylaxis: heparin 5000 units sq tid was given for dvt prophylaxis. tld: a piv, right picc, foley catheter, j-tube, ett, and surgical drains: jp in neck x 2 (right) and drain x 1 were maintaned. no meds in j-tube. he had a pigtail placed in his left side that drained a moderate amount of straw colored fluid, pt self d/c'd this and had no problems with reaccumulation. medications on admission: lasix 20 mg daily via j-tube daily synthroid 25 mcg po daily magoxide 400 mg po twice daily simethicone 80 mg po q12h heparin 5000 units sq q12h albuterol neb twice daily tums 500 mg tid transderm-scopolamine patch q48hs 1.5 mg (last dose ) tpn @ 90 ml/hr via right picc prns: atrovent neb tylenol elixir 650 mg po q6h mucomyst 10% po q6h prn cepacol lozenges zofran 4 mg po q8h compazine 10 mg via j-tube q8h milk of magnesia discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 2. acetylcysteine 20 % (200 mg/ml) solution sig: three (3) ml miscellaneous q12h (every 12 hours) as needed for thick secretions: mix w/albuterol to prevent bronchospasm. 3. metoprolol tartrate 5 mg/5 ml solution sig: ten (10) mg intravenous q4h (every 4 hours): hold for hr < 60 sbp < 100. 4. heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous prn (as needed) as needed for line flush: picc line flushes. 5. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed for oral care. 6. oxycodone-acetaminophen 5-325 mg/5 ml solution sig: 5-10 mls po q4h (every 4 hours) as needed for pain. 7. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: three (3) ml inhalation every 4-6 hours as needed for shortness of breath or wheezing. 8. levothyroxine 200 mcg recon soln sig: 75 mcg recon solns injection daily (daily). 9. famotidine 20 mg iv q12h 10. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q12h (every 12 hours). 11. ipratropium bromide 17 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation qid (4 times a day). discharge disposition: extended care facility: hospital - discharge diagnosis: h/o esophageal ca s/p xrt with 3-hole transhiatal esophagectomy in at . recently hospitalized at for pna and found to have stricture near cricopharyngeus, with evidence of tef. egd showed no cancer recurrence. j-tube placed 3/. -hypertension -hypothyroidism -prostate cancer s/p xrt -small bowel obstruction -cognitive deficit nos vs limited safety awareness -orthostatic hypotension -dvt of the l subclavian and l axillary vein -r hip fracture s/p orif by dr. @ -multiple stab wounds to the abdomen in the psh: -3-hole transhiatal esophagectomy by dr. @ -j-tube -orif by dr. @ -tonsillectomy and adenoidectomy -r wrist and hand surgery -abdominal surgery for stab wounds discharge condition: trached, awake, alert discharge instructions: call dr. office if you have any questions or concerns. followup instructions: follow-up with dr. 2 weeks after discharge from rehab. please call for an appointment procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for 96 consecutive hours or more continuous invasive mechanical ventilation for 96 consecutive hours or more other endoscopy of small intestine insertion of endotracheal tube insertion of endotracheal tube fiber-optic bronchoscopy fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances temporary tracheostomy other skin graft to other sites closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus attachment of pedicle or flap graft to other sites other repair and plastic operations on trachea suture of laceration of esophagus local excision or destruction of lesion or tissue of trachea closure of other fistula of trachea other excision or avulsion of cranial and peripheral nerves unilateral thyroid lobectomy percutaneous angioplasty of intracranial vessel(s) diagnoses: unspecified pleural effusion unspecified essential hypertension unspecified acquired hypothyroidism personal history of malignant neoplasm of prostate accidental puncture or laceration during a procedure, not elsewhere classified acute respiratory failure methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation stricture and stenosis of esophagus tracheoesophageal fistula personal history of malignant neoplasm of esophagus status of other artificial opening of gastrointestinal tract 

Answer: The patient is high likely exposed to