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: the patient has no known drug allergies. medications: 1. regular sliding scale insulin. 2. lipitor. 3. diltiazem. 4. ceftazidime. 5. lopressor. 6. protonix. 7. morphine. laboratory results on admission: white blood cell count 21.6, hematocrit 29.6, platelets 730,000. sodium 139, potassium 2.0, chloride 108, c02 12, bun 40, creatinine 1.2, glucose 104. ck mb was found to be 90, troponin 12, and then ultimately 8.7. radiology: ct scan on showed evidence of a hiatal hernia and bilateral effusions. however, there was no small bowel obstruction; however, no other possible sources for infection. on , a ct scan of the head was performed. this was negative. on , another ct scan showed a large left chest pleural effusion; however, this was not thought to be tappable. examination on presentation: upon this presentation to the intensive care unit, the temperature was 98.9, pulse 83, blood pressure 118/62, respirations 30, saturating 100 percent on room air. he was at that time intubated and on a ventilator with an simv setting of 500 cc tidal volume, rate 24. in general, the patient is described as sedated and intubated. examination showed the pupils to be equal and reactive bilaterally. the sclerae were nonicteric. the lungs had clear sounds in the apices; however, decreased breath sounds at the bases. the cardiac examination revealed a regular rate and rhythm. no evidence of any murmurs, rubs, or gallops. the abdomen was soft, nontender, with a healing midline incision. the ileostomy was pink, healthy appearing, with an appliance placed. lower extremities were somewhat edematous but otherwise unremarkable. hospital course: soon after his arrival to the , the patient had a thoracic surgery consult. based on the recommendations of these, it was felt that the patient's findings were consistent with a known pneumonia and a loculated left pleural effusion. long-term, it was felt that the patient would likely need that but might consider chest tube placement in the interim. this plan was acknowledged by the primary team; however, no chest tubes were placed at that time. the patient was maintained on empiric treatment with vancomycin and zosyn for a known mrsa infection and presumption of a possible other infection source. on hospital day number two, after further evaluation of the radiographic findings, the attending thoracic surgeon felt that what had been presumed to be a left collection in the chest rather than being an empyema or other collection was most likely a hiatal hernia. nevertheless, there was recognized the presence of the two rather smaller pleural effusions. the cardiology workup consult recommended that the patient be continued on lopressor and be anticoagulated when possible. with regards to the positive cardiac enzymes, their feeling was that this was most likely a demand ischemia and not associated with a plaque rupture. recommendations were to continue aspirin and a beta blocker and possibly after the patient recovers from the acute phase of his illness can consider an ischemic workup as an outpatient with a p mibi versus a possible catheterization. on hospital day number two through three, the patient gradually stabilized. starting on hospital day number three, his ventilator was gradually weaned and on the evening of hospital day number three he was ultimately weaned from the ventilator. on hospital day number four, he was started on tube feeds and these were gradually increased until goal was met. attention then turned to the treatment of the patient's atrial fibrillation. he was started on heparin for anticoagulation. per cardiology recommendations, he was started on amiodarone 200 mg q.d. on . the plan was after one week of b.i.d. dosing the patient could be switched to 200 mg p.o. q.d. lopressor was continued. the patient was maintained on anticoagulation with heparin to a goal ptt of 60-80. on , the patient underwent a cardiac echocardiogram to assess any changes in his cardiac function. this showed that the left ventricular wall thickness, cavity size, and systolic function were normal with an lv ejection fraction of greater than 55 percent. the only notable change was a moderate to severe 3+ mitral regurgitation. the patient was started on enalapril which could be titrated upwards as tolerated for the mitral regurgitation. on , it became increasingly clear that the patient had some residual neurological deficits. while his examination was never focal and there could not be any specific deficits found, he remained unresponsive and persistently confused. a neurology consult was sought and thorough workup including all relevant blood tests were sent. these were all shown to be negative. the patient went on to have an mr scan which other than some nonspecific atrophy and old lacunar infarcts did not show any specific etiologies that would explain his change in mental status. the diagnosis of exclusion of post intensive care unit psychosis was assigned with the hope that the patient's mental status would gradually improved as he spent more time outside the intensive care unit. indeed, over the next 72 hours, as the patient's day and night schedule has continued to normalize, he has become more alert and oriented and is now conversant with some effort. on , there became increasing concern about the patient's ostomy output which was reaching as high as 2 liters per day. he was subsequently bolused with an appropriate amount of iv fluids to maintain his fluid balance. a small amount of tincture of morphine was also added to his tube feeds. this subsequently resolved over the next 48-72 hours. on , there was again concern that there might be an underlying infection or fluid collection which might explain the slow return to mental function. plans were made for an ultrasound-guided pleurocentesis. following informed consent provided by the patient's wife, he was evaluated for this. after several views with the attending radiologist, it was felt that none of the collections were substantial enough for a tap. the patient was subsequently returned to his room. on , after final evaluation by dr. and the rest of the surgical team, it was felt that the patient could be returned to the . this had been an issue that had been voiced on several occasions by the family, in particular his wife who has a very difficult time visiting him at the campus. at the time of discharge, there were no major medical or surgical issues that needed to be resolved and it appeared that the hospital course at this time was a watch and wait process as his mental status continued to improve. follow up: 1. ostomy care as directed. 2. physical therapy as directed. 3. the patient should be considered for a neuropsychiatric evaluation to be able to establish progression of his mental status resolution. 4. wound care as directed by dr. . medications on discharge: 1. aspirin 325 mg p.o. q.d. 2. regular sliding scale insulin per schedule attached. 3. amiodarone 200 mg one p.o. q.d. 4. lansoprazole 30 mg p.o. q.d. 5. opium 10 percent tincture 15 drops via tube feeds q. four to six hours as needed to limit tube feed output. 6. zosyn 4.5 grams every eight hours. 7. morphine 1-2 mg iv q. 1-2 hours p.r.n. pain. 8. vancomycin 1 gram iv q. 12 hours. 9. hydralazine 10 mg iv q. six hours. it should be noted that the patient was not transferred on enalapril, although this was part of cardiology recommendations. it was felt that this could be adjusted as an outpatient. diagnosis on discharge: troponin leak/mi mrsa/pseudomonas pneumonia. intermittent atrial fibrillation. congestive heart failure. chronic renal insufficiency. alcoholism. ulcerative colitis. delirium hypertension. tia/prior stroke/cerebrovascular accident. intensive care unit psychosis. mild dementia. nutrition: the patient's diet has been maintained on impact with fiber full-strength 60 milliliters an hour, residuals checked every six hours. , dictated by: medquist36 d: 16:54:35 t: 18:13:36 job#: procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances diagnoses: subendocardial infarction, initial episode of care unspecified pleural effusion congestive heart failure, unspecified unspecified septicemia cardiac complications, not elsewhere classified atrial fibrillation pneumonia due to pseudomonas methicillin susceptible pneumonia due to staphylococcus aureus 

Answer: The patient is high likely exposed to