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: thoracic wound drainage and hyponatremia major surgical or invasive procedure: - debridement and evacuation of wound infection - latissimus and trapezius flap - removal of porticath history of present illness: 55 y/o m with pmh of renal cell ca metastatic to t-spine s/p recent t1-t12 fusion on on decadron taper presented from rehab with increased serosanguinous drainage from wound per rehab team and low grade temp of 100.1. per the patient, he has been feeling well and denies fever, chills, increased back pain. he does have bilateral tingling/numbness in his lower extremities, but able to move his feet/legs. he was found to have renal cell ca in s/p nephrectomy, then found to have extradural mass at t5 in with kyphotic collapse at t10 when presented with leg weakness with numbness/difficulty walking. he is s/p recent admission between for thoracic instrumented fusion t1-12 on by dr. and was only at his rehab for 2 days when the staff noted increased serosanguinous drainage from site, without purulence, odor, but increased wbc. in the ed, his initial vitals were: t98.1, bp 120/67, hr 107, rr 20, 98% on ra. he was given ativan 1mg iv x 1, dilaudid 4mg po x 1. neurosurgery was consulted in the ed and did not suspect wound infection so did not recommend any antibiotics but recommended ct imaging of t-spine. labs drawn significant for hyponatremia with na 126, hyperkalemia k 5.5, and wbc 19.2 (around his recent baseline) with 9 bands. ulytes showed fena<1 and una 102. he was given iv decadron 10mg x 1 and admitted to medicine for workup of hyponatremia, tachycardia with neurosurgery following. on the floor, the patient denies any back pain, increased numbness or tingling of his legs, or subjective fever, chills, dysuria, or diarrhea. he notes increased urination recently and currently is thirsty. past medical history: rheumatoid arthritis x 20 years renal ca s/p nephrectomy metastatic spine disease s/p thoracic instrumented fusion t1-12 on for extradural mass at t5 and kyphotic collapse at t10 h/o ivda social history: lives with a friend and his wife; tobacco 2 ppd x 30-40 years but notes has not smoked for the last 2 weeks; recovering alcoholic but no etoh recently; history of drug abuse, but none for last two years, on methadone. family history: family history: father deceased at 63 yo of heart disease. physical exam: vs - t97.9, bp 114/72, hr 108, rr 20, 96% on ra general: lying in bed, in nad heent: ncat, dry mucous membranes neck: supple, no carotid bruits, no lad pulmonary: cta bilaterally, no w/c/r cardiac: tachycardia, regular rate and rhythm, with no m/r/g abdomen: +bs soft, nontender, mildly distended, extremities: radial deviation of mcp joints of both hands, slight tremor. back: + flowing serosanguinous drainage from wound draining 4 wound covers and chucks in 4 hours. no tenderness to palpation to paraspinal area. staples intact. neuro - awake, a&ox3, able to name hospital, spell his last name forwards and backwards. mildly inattentive. eyelids heavy. cns ii-xii grossly intact, slight weakness of right orbicularis. strength of right le, 5/5 strength of lle. sensation to light touch intact. reflexes 1+ pertinent results: ct spine 1. post-operative changes in the thoracic region with improvement in thoracic kyphosis since the following surgery and stabilization. at t5 level, no evidence of compression of the thecal sac is visualized on the current study with persistent lytic abnormality in the left pedicle of l5 and involving the articular processes. 2. fluid collection at the upper end of the laminectomy at c7-t1 level with small air bubbles without enhancement in the surrounding soft tissues could be a post-operative fluid collection. however, clinical correlation recommended as infection cannot be excluded entirely on the ct appearances. brief hospital course: 55 yo m with metastatic renal ca to t spine s/p t1-t12 fusion, with non-healing wound complicated by mssa, s/p latissimus and trapezius flap on . . pt presented with fever, elevated wbc, esr and crp, increasing drainage from surcial wound and signs of infection in c7-t1 area on ct. thoracic wound was debrided on and . wound cx showed mssa and pt was started on nafcillin. blood cultures remained negative, and echo showed no vegetations on tte. pt had portacath removed to ensure not nidus of infection. on wound was repaired with latissimus and trapezius flap and pt transfered to plastic surgery. pt followed usual post-op course with adequate healing of spinal wound. nafcillin to be continued for 6 weeks at 2 gm q4hr. . #. hyponatremia - pt with previous history of hyponatremia, and is at risk of siadh given cancer and ssri use. improved with fluid restriction. nephrology followed throught pt stay . # hap - pt febrile with rll infiltrate on cxr on . pt started on levofloxacin to treat hap continued for 10 days. id was consulted and followed throughout stay. . # thrombocytopenia - platelet drop greater than 50% with current nadir of 58. hit positive, but od equivocal, 0.7. serotonin release assay negative. therefore negative for hit. platelets subsequently improved through hospitalization . #. altered mental status - aaox3. no change in mental status. no masses/mets/bleed on ct head. medications on admission: bacitracin ointment celexa 20 mg po daily cyclobenzaprine 10mg po bid dexamethasone 1mg q12h (down from po q8h x 2 days) docusate 100mg sc heparin riss methadone 30 mg po qhs, 60 mg po q 6 am and q 6 pm metoprolol tartrate 12.5 mg po bid mvi senna 2tabs tylenol 1000mg q6hr prn dulcolax 10mg pr qd prn dilaudid 2-4mg po q3h prn pain sorbitol discharge medications: 1. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. methadone 10 mg tablet sig: three (3) tablet po qhs (once a day (at bedtime)). 4. bacitracin zinc 500 unit/g ointment sig: one (1) appl topical daily (daily). 5. sorbitol 70 % solution sig: thirty (30) ml miscellaneous daily (daily) as needed for constipation. 6. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day) as needed. 7. modafinil 100 mg tablet sig: two (2) tablet po qam (). 8. hydromorphone 4 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. 9. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours). 10. tizanidine 2 mg tablet sig: two (2) tablet po tid (3 times a day). 11. senna 8.6 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)). 12. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 13. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day). 14. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). 15. enoxaparin 40 mg/0.4 ml syringe sig: one (1) subcutaneous daily (daily). 16. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 17. aluminum-magnesium hydroxide 225-200 mg/5 ml suspension sig: 15-30 mls po qid (4 times a day) as needed. 18. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 5 days. 19. methadone 10 mg tablet sig: four (4) tablet po qam (once a day (in the morning)) as needed for pain. 20. methadone 40 mg tablet, soluble sig: one (1) tablet, soluble po noon (at noon) as needed for pain. 21. methadone 40 mg tablet, soluble sig: one (1) tablet, soluble po daily16 (once daily at 16) as needed for pain. 22. ondansetron 4 mg iv q8h:prn 23. nafcillin 2 gm iv q4h please administer in ns discharge disposition: extended care facility: hospital - discharge diagnosis: primary: - post-operative wound dehiscense c/b mssa infection. - mssa bacteremia - aortic valve lambl's excresences vs. vegetation - thrombocytopenia nos (not hit). - anemia of inflammation - hyponatremia secondary to siadh secondary: - transpedicular resection of the t5 renal cell metastasis. - t9 vertebrectomy for pathologic fracture. - posterior instrumentation segmental t1-t12 - right lower extremity weakness secondary to cord compression - metastatic renal cell carcinoma s/p left nephrectomy, xrt. - hepatitis c - prior ivda - etoh abuse discharge condition: good discharge instructions: please return to the hospital if - you experience fevers greater then 101.4, chills, or other signs of infection. - you experience chest pain, shortness of breath, redness, swelling, or purulent discharge from the incision site. - you experience worsening pain or any other concerning symptoms. certain pain medications may have side effects such as drowsiness. do not operate heavy machinery while on these medications. certain pain medications such as percocet or codeine can cause constipation. if needed you can take a stool softner such as colace (one capsule) or gentle laxative (such as milk of magnesia) once per day. restart taking all your regular medications. continue to take your antibiotics as prescribed -please do not shower until your follow-up visit. . please keep track of jp drain output for your follow-up visit followup instructions: please have lft's, cbc with diff, bun and creatine drawn weekly and esr and crp drawn ever other week. please fax weekly results to at (. follow up with dr. in clinic on at 11:30 am follow up with plastic surgery - dr. next tuesday. please call to make an appointment. follow up with dr. from neurosurgery in 2 weeks. please call to make an appointment procedure: venous catheterization, not elsewhere classified graft of muscle or fascia incision with removal of foreign body or device from skin and subcutaneous tissue closure of skin and subcutaneous tissue of other sites reopening of laminectomy site other myectomy diagnoses: pneumonia, organism unspecified hyperpotassemia thrombocytopenia, unspecified other postoperative infection chronic hepatitis c without mention of hepatic coma disruption of internal operation (surgical) wound bacteremia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation rheumatoid arthritis acute osteomyelitis, other specified sites other disorders of neurohypophysis personal history of malignant neoplasm of kidney secondary malignant neoplasm of bone and bone marrow disruption of external operation (surgical) wound anemia in neoplastic disease myelopathy in other diseases classified elsewhere 

Answer: The patient is high likely exposed to