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: aspirin attending: chief complaint: fever, chills, cough, sob major surgical or invasive procedure: avr (mech),root abcess debridment and mv patch repair history of present illness: 22 yo m with h/o ivdu (heroin) presented to osh with presumed uri. blood cultures positive and patient asked to return to ed where repeat blood cultures were positive for mrsa. he was admitted to osh and started on vanco and gentamicin. echo showed aortic valve vegetation, repeat echo showed new pericardial effusion and systollic right atrial invagination and he was transferred for further care. past medical history: hep c hiv-negative testing, asthma as a child, r-lobectomy at ~5 years ago social history: +ivdu +tobacco works in boatyard family history: nc physical exam: 126/41 114 95% pulsus 14 mmhg ill appearing male, diaphoretic in mild-moderate distress no splinter hemorrhages coarse crackles bilaterally well healed surgical scar right flank abdomen soft, nt, nd no edema pertinent results: 12:52am pt-16.4* ptt-38.6* inr(pt)-1.5* 12:52am wbc-16.0* rbc-2.96* hgb-9.2* hct-26.7* mcv-90 mch-31.2 mchc-34.6 rdw-13.5 12:52am alt(sgpt)-19 ast(sgot)-20 ld(ldh)-209 ck(cpk)-44 alk phos-63 tot bili-0.3 07:00am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 05:10pm wbc-33.7*# rbc-2.64* hgb-8.0* hct-24.7* mcv-93 mch-30.3 mchc-32.4 rdw-13.6 echo the left ventricle is not well seen. there is a moderate-sized vegetation on the leftr coronary cusp of the aortic valve. the non-coronary cusp of the aortic valve appears to be disrupted and its attachment may have separated from the aortic annulus. there is an abscess cavity that appears to extend from the non coronary cusp through the aortic-mitral fibrous continuity and into the middle anterior scallop of the mitral valve. the anterior and posterior scallops do not appear involved in this abscess. the aortic annulus is thickened near the non and left coronary cusps. severe (4+) aortic regurgitation is seen. there is an abscess cavity seen adjacent to the mitral valve (in continuity with the non coronary cusp of the aortic valve.) an eccentric, posteriorly directed jet of moderate to severe (3+) mitral regurgitation is seen. no vegetation/mass is seen on the pulmonic valve. there is a moderate sized pericardial effusion. the effusion appears circumferential. there is brief right atrial diastolic collapse. echocardiographic signs of tamponade may be absent in the presence of elevated right sided pressures. impression: aortic annular abscess that is probably extending from the non coronary cusp into the middle scallop of the mitral valve. there does not appear to be a vegetation or perforation of the mitral valve leaflets. there is also a vegetation on the left coronary cusp of the aortic valve. severe aortic regurgitation and moderate to severe mitral regurgitation are seen. small to moderate pericardial effusion that appears to track with gravity. most of the effusion is thus posterior to the heart. there is right atrial diastolic collapse but no frank tamponade (elevated right sided pressures may mask echocardiographic signs of tamponade.) echo prebypass 1. no atrial septal defect is seen by 2d or color doppler. 2. there is mild symmetric left ventricular hypertrophy. 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. there is a moderate-sized vegetation on the aortic valve- left coronary cusp. an aortic annular abscess is seen extending to the anterior leaflet of the mitral valve. there is a moderate to severe (3+) aortic regurgitation is seen. there is a communication between the aortic root and the left atrium. 5.there is a moderate-sized vegetation on the mitral valve. moderate (2+) mitral regurgitation is seen. 6. there is a large pericardial effusion. 7. dr. was notified in person of the results on at 1430. post bypass 1. biventricular systolic function is slightly depressed. lvef= 45% 2. mechanical valve seen in the aortic position. leaflets move well and the valve appears well seated. ( 21mm ). mean gradient across the valve is 20 mm hg. dr aware. 3. moderate to severe mitral regurgitation with a posteriorly directly jet present. 4. post surgical changes with pledgets and sutures seen on the left atrial side near the anterior leaflet of the mitral valve. ( dr informed) 5. aorta intact post decannulation ct scan 1. small postoperative substernal fluid collection as well as moderate pericardial effusion, both of which demonstrate peripheral rim enhancement. although these findings may be seen in the setting of recent postoperative state, a superimposed infection cannot be excluded. 2. small bilateral pleural effusions with associated atelectasis (right greater than left). 3. prior right lower lobe lobectomy. 4. small bilateral patchy opacities in both lungs which may be infectious or inflammatory in origin or may represent atelectatic foci. 5. mild splenomegaly. brief hospital course: he was admitted to the ccu. tee confirmed vegetation on av and severe ai, moderate to severe mr. was taken urgently to the operating room on where he underwent an avr and mitral valve reconstruction with pericardial patch. he was transferred to the icu in stable condition. he was extubated post op. he was seen by infectious diseases and continued on vancomycin. he was seen by pain medicine and started on methadone, baclofen and clonidine with dilaudid for breakthrough. he was transferred to the floor on pod #2. he was started on coumadin for his mechanical valve. he was seen by addiction services. on a generalized erythematous, maculopapular rash developed. lasix was discontinued due to possible sulfa cross reactivity. the infectious disease and dermatology services were consulted. punch biopsies as well as viral specs were sent to pathology which were negative. it was suspected that the rash was related to either the lasix or vancomycin. bumex was thus used for diuresis and vancomycin was replaced with daptomycin for treatment of his mrsa aortic valve endocarditis. the remainder of his postoperative course remained uneventful. he continued anticoagulation for his mechanical aortic valve with a goal inr of 2.5-3.0. his coumadin dosing will be managed by the rehabilitation center while a resident there followed by dr. ( of system. social worker, , is working on obtaining a primary care physician for mr. . daptomycin will be continued until . he will need weekly cbc's with differentials, chemistry 7, liver function studies and cpk's while taking daptomycin. he will follow-up with the id service. mr. continued to make steady progress and was discharged to the rehabilitation facility on . he will follow-up with dr. in 1 month. medications on admission: albuterol mdi w spacer, q4-6h prn sob, moxifloxacin 4000 mg po daily discharge medications: 1. outpatient lab work weekly cpk,cbc with diff.,bmp,lfts ***last dose of daptomycin 2. daptomycin 500 mg recon soln sig: one (1) 550 intravenous q24h (every 24 hours): last dose . 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. warfarin 1 mg tablet sig: two (2) tablet po daily (daily): dose daily for goal inr of 2.5-3.0. 5. bumex 2 mg tablet sig: one (1) tablet po twice a day for 7 days. 6. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 7. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed for pruritis. 8. diphenhydramine hcl 12.5 mg/5 ml elixir sig: 12.5mg mg po q8h (every 8 hours) as needed for itching. 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 10. clobetasol 0.05 % cream sig: one (1) appl topical (2 times a day) for 2 weeks. 11. heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous prn (as needed) as needed for line flush: 2ml picc line flush. 12. xopenex hfa 45 mcg/actuation hfa aerosol inhaler sig: puffs inhalation four times a day as needed for shortness of breath or wheezing. 13. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day) for 1 months: then may discontinue after 1 month. 14. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed. discharge disposition: extended care facility: - discharge diagnosis: endocarditis now s/p hep c, asthma, r-lobectomy at ~5 years ago, ivdu discharge condition: stable. discharge instructions: 1) monitor wound for signs of infection. these included redness, drainage or increased pain. please call surgeon at ( for any wound issues. 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lifting more then 10 pounds for 10 weeks from date of surgery. 5) no driving for 1 month. 6) please shower daily. you may wash incision and gently pat dry. no lotions creams or powders to incision until it has healed. you should use sunscreen on incision after it has healed when out in sun. 7) coumadin for mechanical avr and patch repair of mitral valve. goal inr 2.5-3.0. please monitor daily inr and dose coumadin appropriately. pt will need coumadin follow-up on discharge from . dr. of may assume this role. social worker is currently working on finding a pcp for the patient. 8) daptomycin will be continued until . he will need weekly cbc's with differentials, chemistry 7, liver function studies and cpk's while taking daptomycin. he will follow-up with the id service. 9) bumex for 1 week then reassess. 10) hibiclens washes and clobetasol cream to lower extremities. 11) call with any questions or concerns. followup instructions: in 2 weeks - dr. in 2 weeks ( dr. in 4 weeks ( dr. / clinic in 8 weeks or as needed. procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart diagnostic ultrasound of heart open and other replacement of aortic valve open heart valvuloplasty of mitral valve without replacement closed biopsy of skin and subcutaneous tissue operations on other structures adjacent to valves of heart diagnoses: tobacco use disorder unspecified viral hepatitis c without hepatic coma infection with microorganisms resistant to penicillins asthma, unspecified type, unspecified other specified cardiac dysrhythmias bacteremia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site dermatitis due to drugs and medicines taken internally acute and subacute bacterial endocarditis other specified antibiotics causing adverse effects in therapeutic use opioid abuse, unspecified vascular disorders of kidney rupture of artery cardiac tamponade other diuretics causing adverse effects in therapeutic use other acute pericarditis allergic purpura sensorineural hearing loss, unilateral 

Answer: The patient is high likely exposed to