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: versed / codeine / haldol / benzodiazepines attending: chief complaint: cc: fever, ams major surgical or invasive procedure: picc placement and removal ngt placement x 2 and removal history of present illness: history of present illness: 76yo m with af, lb dementia, h/o gib and recent right tib/fib fracture s/p orif who presented to ed with fever, respiratory distress and altered mental status. pt intubated apon arrival to ed for protection of airway given ams. per wife; pt has had several days of worsening ms in setting of not returning to baseline after recent orthopaedic procedure. during this time has had low grade fevers without possible source of infection. this am was found to be febrile to 104 for which he recieved a dose of ctx prior to transferring to ed. per report wound has looked good and dressing changes without alarm. no diarrhea. no n/v. pt with h/o gib but no reported melena/brbpr/hematemesis. . ed course: initial vs-> 105, 100, 104/65, 15 96% nrm. intubated for ams and inability to protect airway. recieved vanc/levo/flagyl. given fever, was triaged as per code sepsis. past medical history: 1. atrial fibrillation: not anticoag falls 2. body dementia: h/o hallucinations resulting in severe agitation with h/o combative behavior, on quetiapine tid + prn at rehab 3. h/o gi bleed: esophageal erosions, on ppi 4. cva: pfo 5. recent tib/fib fx s/p orif r ankle bimalleolar fx and im nail tibia fracture social history: married, retired general surgeon, lives at nursing home, was ambulating independently; h/o tobacco- 3ppd, quit 40y ago; occ etoh, no drugs family history: nc physical exam: physical exam: vitals- t 99.2, 103, 115/70, 19 100% . general- intubated and sedated heent- perrl, anicteric, noninjected, ett in place, mmm, right nasal packing pulm- diffuse rhonchi cv- irregularly irregular, 2/6 systolic murmur heard best at the llsb/apex abd- soft, nd, no hsm, + bowel sounds x 4 quad. ext- rle cast with anterior scar/staples. incision c/d/i. no obvious effusion but right medial knee warmer to touch than left. toes wwp b/l. lle with no edema but venous stasis changes, 2+ l dp pulse neuro- sedated, not following commands or opening eyes to voice/tactile stimuls, moving all 4 extremities pertinent results: labs: 10:20am blood wbc-11.3* rbc-4.87 hgb-11.9* hct-35.5* mcv-73* mch-24.3* mchc-33.4 rdw-19.3* plt ct-341# 03:42am blood wbc-4.8 rbc-4.04* hgb-9.9* hct-31.4* mcv-78* mch-24.6* mchc-31.6 rdw-21.7* plt ct-387 10:20am blood neuts-75.9* lymphs-18.0 monos-5.8 eos-0.1 baso-0.3 10:20am blood hypochr-1+ anisocy-2+ microcy-3+ 10:20am blood pt-13.8* ptt-25.3 inr(pt)-1.2* 10:20am blood plt ct-341# 06:10am blood pt-14.7* ptt-32.2 inr(pt)-1.3* 03:42am blood plt ct-387 04:19pm blood esr-10 06:00am blood lmwh-0.31 11:51pm blood lmwh-pnd 10:20am blood glucose-105 urean-27* creat-1.2 na-133 k-4.5 cl-98 hco3-22 angap-18 03:42am blood glucose-104 urean-15 creat-0.7 na-140 k-3.9 cl-108 hco3-26 angap-10 10:20am blood alt-40 ast-54* ld(ldh)-362* ck(cpk)-268* alkphos-95 amylase-75 totbili-0.6 10:20am blood lipase-51 10:20am blood ck-mb-1 10:20am blood ctropnt-<0.01 10:20am blood calcium-8.0* phos-3.0 mg-2.1 05:40am blood albumin-2.5* calcium-7.7* phos-2.5* mg-1.9 06:15am blood calcium-7.6* phos-3.3 mg-2.1 06:00am blood triglyc-43 06:15am blood triglyc-38 03:35am blood tsh-0.90 10:20am blood cortsol-23.8* 04:19pm blood crp-12.3* 11:05am blood po2-287* pco2-31* ph-7.48* calhco3-24 base xs-1 03:19pm blood type-art rates-16/ tidal v-600 peep-5 fio2-50 po2-101 pco2-31* ph-7.43 calhco3-21 base xs--2 10:13am blood type-art temp-38.1 rates-/21 o2 flow-3 po2-114* pco2-33* ph-7.42 calhco3-22 base xs--1 intubat-not intuba comment-nasal 10:48am blood lactate-2.2* 03:19pm blood lactate-1.2 . micro: bl cx - no growth; x 2 - ngtd u cx , - no growth 6:34 pm stool consistency: soft **final report ** fecal culture (final ): no salmonella or shigella found. campylobacter culture (final ): no campylobacter found. clostridium difficile toxin assay (final ): clostridium difficile. feces positive for c. difficile toxin by eia. reference range: negative. a positive result in a recently treated patient is of uncertain significance unless the patient is currently symptomatic (relapse). . reported by phone to k. eldrekin 1455 . 8:32 pm sputum site: endotracheal **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 1+ (<1 per 1000x field): gram positive cocci. in pairs. 1+ (<1 per 1000x field): budding yeast with pseudohyphae. 1+ (<1 per 1000x field): gram negative rod(s). respiratory culture (final ): rare growth oropharyngeal flora. yeast. sparse growth. staph aureus coag +. sparse growth. oxacillin resistant staphylococci must be reported as also resistant to other penicillins, cephalosporins, carbacephems, carbapenems, and beta-lactamase inhibitor combinations rifampin should not be used alone for therapy. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin----------- =>8 r erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- =>8 r oxacillin------------- =>4 r penicillin------------ =>0.5 r rifampin-------------- <=0.5 s tetracycline---------- <=1 s vancomycin------------ <=1 s . imaging: dvt : no evidence of dvt. examination of popliteal veins was suboptimal see comments above. . cta chest : impression: 1. pulmonary emboli within right lower lobe segmental and subsegmental arteries. 2. bibasilar airspace opacities, right greater than left, which are nonspecific and may represent atelectasis or aspiration. developing infarction in the right lower lobe cannot be fully excluded. 3. feeding tube with tip positioned in a large axial hiatal hernia, directed cephalad. 4. small right pleural effusion. . ekg atrial fibrillation with a moderate ventricular response. left axis deviation with left anterior fascicular block. probable old lateral myocardial infarction. compared to the previous tracing of no significant diagnostic change. . tib/fib (ap & lat) right port 10:19 am intact hardware spanning anatomically aligned tib/fib fractures with no plain film evidence of osteomyelitis. popliteal atherosclerosis. . picc line placment sch 1:48 pm successful placement of right basilic vein 44 cm double-lumen picc line with the tip in the svc. the line is ready for use. . unilat up ext veins us right 9:24 am right upper extremity ultrasound: grayscale, color, and doppler son of the right internal jugular, subclavian, axillary, and brachial veins were performed. the cephalic and basilic veins were not visualized. heterogeneous material is seen in the proximal axillary vein which did not compress. there was limited blood flow demonstrated. the internal jugular, subclavian, and brachial veins demonstrated normal color flow and compressibility. 1. partially occlusive thrombus in the right axillary vein. these findings were discussed with dr. following the examination. . chest (portable ap) 7:26 am findings: the previously visualized ng tube is not seen on the current film. again noted is a hiatal hernia. there is patchy volume loss in the left lower lung. the right lateral lung is off the film. the right subclavian line is unchanged. this finding was called to the floor at time of dictating this report. brief hospital course: dr. is a 76 yo gentleman with atrial fibrillation, lb dementia, h/o gib and recent right tib/fib fracture s/p orif who presents with fever and ams. hospital course by problem is summarized below. . # fever/sepsis: sirs/sepsis criteria met by tachycardia/fever/tachypnea and suspected source. no definitive source at presentation but at risk for septic arthritis or infected hardware especially given physical examination. patient triaged as per code sepsis and transferred to . cta performed and showed rll subsegmental pe. ortho eval felt sepsis not related to leg. patient started on heparin gtt and continued on broad spectrum antibiotics. patient then noted to have a rash, ?drug fever/rash, tm 105, flagyl d/ced. stool then came back + for c.diff, flagyl restarted. patient extubated and sating on 3l nc. ngt fell out and replaced as well. levo also d/ced for ?drug rash. patient changed to po vanco for ongoing fevers thought to be c.diff. patient's ms slightly improved, following commands. patient transferred to medical floor in stable condition. on the floor, patient continued to improve initially slowly. he pulled out his ngt on and it was not replaced. due to his improved mental status, swallowing pills with thickened liquids was attempted by nursing and he seemed to do well. he continued to fail his speech and swallow evaluations however. after discussions with all teams involved, it was felt that the patient would likely continue to aspirate and he would be better off without an ngt or tpn for nutrition. he continues to tolerate his pills crushed with thickened liquids. the hope is that his diet will be advanced as he continues to improve. he has been afebrile for several days and is discharged on a course of po flagyl/vanco to be continued for a 2 week course up to . of note, he was started of iv vanco on due to persistent fevers and +mrsa in his sputum which seems to improve his overall clinical course. . # ams: exacerbated by infection with underlying dementia. as pt became afebrile on antibiotics, ms cleared to baseline. seroquel held for depressed ms during this hospital stay. . # hypotension: transient in setting of sedation and intubation. received ivf upon admission. maintained stable sbp 100's and adequate cvp. no need for pressors. currently stable. . # afib. well rate controlled off meds, transiently tachy to 160 however has been well rate controlled majority of time. lopressor prn for rvr. . # mechanical ventilation: patient intubated for airway protection. no difficulty with ventilation or oxygenation. patient self extubated while being weaned on pressure support. of note, patient is now confirmed dnr/dni and do not hospitalize. . # pe/rue dvt: patient developed rll segmental pe found on cta despite prophylaxis lovenox. then developed a partial thrombus in the r axillary vein in the setting of picc placement. factor xa determined to be 0.3 (therapeutic range 0.6-1.0) while on 80 mg lovenox . patient to be discharged on 100 mg lovenox with repeat factor xa pending. patient was transiently on a heparin gtt however will be maintained on lovenox. . # h/o gib: esophageal erosions; at risk given anticoagulation. hct has remained stable despite guaiac positive stools. pt maintained on ppi. . # pd/dementia: c/w seroquel . # fen: transiently on tube feeds then tpn, currently without access for feeds, will take pos as tolerated despite aspiration risk. diet: ground, honey thickened asp precautions, s+s eval. . # ppx: hob>30 deg, ppi, lovenox -->f/up factor xa repeat level . code status: dnr, dni, dnh medications on admission: acetaminophen 325-650 mg po q4-6h:prn bisacodyl prn docusate prn heparin iv ss vit d vancomycin oral liquid 250 mg po q6h quetiapine fumarate 25 mg po bid miconazole powder 2% 1 appl tp metronidazole 500 mg po tid levothyroxine sodium 37.5 lansoprazole oral suspension 30 mg ng discharge medications: 1. lansoprazole 30 mg susp,delayed release for recon sig: one (1) po bid (2 times a day). 2. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 3. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po q 8h (every 8 hours). 4. levothyroxine 75 mcg tablet sig: 0.5 tablet po daily (daily). 5. docusate sodium 100 mg tablet sig: one (1) tablet po bid (2 times a day). 6. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day). 7. quetiapine 25 mg tablet sig: 0.5 tablet po qhs (once a day (at bedtime)) as needed for agitation. 8. colace 100 mg capsule sig: one (1) capsule po twice a day. 9. lovenox 100 mg/ml solution sig: one (1) subcutaneous twice a day. 10. tylenol extra strength 500 mg tablet sig: two (2) tablet po every eight (8) hours for 14 days. 11. outpatient lab work please check bmp and cbc on 12. flagyl 500 mg tablet sig: one (1) tablet po three times a day for 11 days. 13. vancomycin 250 mg capsule sig: one (1) capsule po four times a day for 11 days. discharge disposition: extended care facility: of discharge diagnosis: c.diff colitis pulmonary embolus r axillary vein thrombus dementia a.fib chronic aspiration ?mrsa pneumonia discharge condition: fair - stable discharge instructions: continue medications as listed. followup instructions: please schedule followup with pcp: , . . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances diagnoses: unspecified septicemia atrial fibrillation sepsis pneumonitis due to inhalation of food or vomitus ostium secundum type atrial septal defect intestinal infection due to clostridium difficile other complications due to other vascular device, implant, and graft methicillin susceptible pneumonia due to staphylococcus aureus dermatitis due to drugs and medicines taken internally dementia in conditions classified elsewhere without behavioral disturbance other specified antibiotics causing adverse effects in therapeutic use other pulmonary embolism and infarction dementia with lewy bodies 

Answer: The patient is high likely exposed to