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: penicillins attending: chief complaint: chest pain major surgical or invasive procedure: - off pump cabg x1 (lima to lad) - cardiac catheterization history of present illness: 66 yo m referred for cardiac cath which showed 80% lm. known 3vd managed medically since , and rca stent in . past medical history: cad mi rca stent dm l bka r toe amps htn bka ble fem- bypass c/n infection (mrsa) tonsillectomy trach/peg placement social history: 9 beers/day tob quit 15 years ago retired family history: brother with cabg in 50's. physical exam: on admission nad hr 68, rr 14, bp 162/61 neuro grossly intact no carotid bruit lungs ctab cv rrr no m/r/g l bka r toe amps bilat svg harvests pertinent results: 05:50am blood wbc-5.8 06:15am blood hct-32.1* 07:05am blood plt ct-184 05:50am blood urean-14 creat-1.5* k-4.4 06:15am blood urean-12 creat-1.5* k-4.1 07:05am blood glucose-125* urean-10 creat-1.4* na-134 k-4.2 cl-96 hco3-29 angap-13 02:48am blood urean-9 creat-1.5* na-134 k-4.4 cl-103 hco3-23 angap-12 cxr there has been interval placement of a left-sided picc, which terminates in the distal svc. the left-sided pleural effusion with associated mild atelectatic changes is unchanged in appearance. the lungs are otherwise clear. cardiac and mediastinal contours are stable. position of the picc was communicated to the iv nurse at the completion of the examination. echo pre-bypass: 1. a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen at rest. 2. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). 3. right ventricular chamber size and free wall motion are normal. 4. the descending thoracic aorta is mildly dilated. there are complex (>4mm) atheroma in the descending thoracic aorta. 5. there are three aortic valve leaflets. there is no aortic valve stenosis. no aortic regurgitation is seen. 6. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. 7. there is a trivial/physiologic pericardial effusion. post off pump cabg: 1. findings are unchanged from before. bi ventricular systolic function is preserved. cardiac catheterization 1. selective coronary angiography of this right dominant system revealed evidence of left main coronary artery disease. the left main coronary artery was heavily calcified and had an 80% eccentric distal left main lesion that extended into the ostium of the left anterior descending coronary artery. the left anterior descending artery had an ostial plaque (that extended from the left main) but had no other evidence of obstructive coronary artery disease. the left circumflex artery was diffusely diseased in the proximal, mid, and distal segements. the om1 branch had a long 90% stenosis and was diffusely diseased. om2 was occluded and fills via collaterals from the rca. the right coronary artery was the dominant vessel. there was no angiographic evidence of obstructive coronary artery disease in the right coronary artery. the previously placed rca stent was widely patent. 2. peripheral angiography revealed diffuse peripheral artery disease of the right iliac and femoral artery. carotid duplex ultrasound 1. there is a 100% occlusion in the right internal carotid artery. 2. hemodynamically insignificant stenosis of less than 40% was demonstrated in the left internal carotid artery. venous ultrasound 1. patent left greater saphenous vein from left saphenofemoral junction to upper calf. left below-knee amputation. 2. patent right greater saphenous vein from saphenofemoral junction to mid to low thigh. brief hospital course: mr. was transferred from hospital on for further management of his chest pain. a cardiac catheterization was performed which showed an 80% stenosed left main coronary artery. given the severity of his disease, the cardiac surgery service was consulted for surgical revascularization and he was worked-up in the usual preoperative manner. a carotid duplex ultrasound was performed which showed an occluded right internal carotid artery and a less then 40% stenosed left internal carotid artery. on , mr. was taken to the operating room where he underwent off-pump coronary artery bypass grafting with the left internal mammary to the left anterior descending artery. postoperatively he was transferred to the csru in stable condition for monitoring. on postoperative day one, he awoke neurologically intact and was extubated. he was then transferred to the step down floor for further recovery. mr. was gently diuresed towards his preoperative weight. the physical therapy service was consulted for assistance with his postoperative strength and mobility. beta blockade, aspirin and a statin were removed. on post operative day three he developed a small amount of sternal drainage for which he was placed on vancomycin and levofloxacin. a wound culture was negative for any organisms. a picc line was placed for intravenous antibiotics. his wound continued to improve and his intravenous antibiotics were stopped. mr. continued to make steady progress and was discharged home on postoperative day 17. a two week course of levaquin was started for coverage of his wound upon discharge. mr. will follow-up with dr. , his cardiologist and his primary care physician as an outpatient. on discharge, he was breathing comfortably on room air with saturations of 96%, afebrile with a stable heart rate and blood pressure. medications on admission: , , lopressor, diovan, nitro paste, lipitor, protonix, librium, ambien, riss discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. disp:*60 capsule(s)* refills:*0* 4. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 6. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 7. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 8. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 2 weeks. disp:*14 tablet(s)* refills:*0* 9. nystatin 100,000 unit/ml suspension sig: five (5) ml po tid (3 times a day) for 2 weeks. disp:*210 ml(s)* refills:*0* 10. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: home health care discharge diagnosis: cad dm htn hypercholesterolemia pvd s/p l bka s/p right iliac/femoral stent carotid disease prior mrsa discharge condition: good. discharge instructions: shower, no baths, no lotions, creams or powders to incision. no lifting more than 10 pounds for 10 weeks. no driving until follow up with surgeon. call with fever, redness or darinage from incision or weight gain more than 2 pounds in one day or five in one week. followup instructions: dr. 2 weeks dr. 2 weeks dr. every week for 4 weeks - please call to set up appts. procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified single internal mammary-coronary artery bypass coronary arteriography using two catheters injection or infusion of platelet inhibitor left heart cardiac catheterization diagnostic ultrasound of heart arteriography of femoral and other lower extremity arteries injection of antibiotic transfusion of packed cells diagnostic ultrasound of head and neck diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux intermediate coronary syndrome pure hypercholesterolemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atherosclerosis of aorta personal history of tobacco use percutaneous transluminal coronary angioplasty status occlusion and stenosis of carotid artery without mention of cerebral infarction displacement of cervical intervertebral disc without myelopathy ostium secundum type atrial septal defect old myocardial infarction family history of ischemic heart disease atherosclerosis of native arteries of the extremities, unspecified below knee amputation status other toe(s) amputation status 

Answer: The patient is high likely exposed to