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: icd infection major surgical or invasive procedure: icd removal, icd lead removal history of present illness: mr. is a 69m with h/o cabg, htn, hl, ischemic cardiomyopathy, paf, bioprosthetic avr, s/p icd in changed to biv in presenting with worsening icd infection. he notes that he has had chronic swelling/hematoma and occasional redness over the past 4 years but does not recall being treated for any infection in the past. dr. evacuated the hematoma on ; culture of the pocket grew coag negative staph and the patient was placed on keflex tid x 6 wks per id recs. over the past 1.5-2 wks the patient notes that the swelling over his icd has worsened and has become more erythematous and tender despite taking his keflex regularly. he denies any recorded fevers, but notes he has been feeling 'warm' at home occasionally over the past wks. he also notes a sharp pain that radiates down from his icd site along the left side of his chest on occasion during the same time period. this pain is not exertional and is not associated with sob or diaphoresis; he notes that it is not like the angina he has had in the past. he was admitted from home per dr. for iv abx management and closer monitoring. . on review of systems, he denies any prior history of deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. he denies recent documented fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, paroxysmal nocturnal dyspnea, orthopnea, palpitations, syncope or presyncope. past medical history: past medical history: 1. cardiac risk factors: dyslipidemia, hypertension 2. cardiac history: paroxysmal afib, cad s/p nstemi, infarct-related cardiomyopathy, lateral hypokinesis (lvef 43%) -cabg: w/bioavr in -percutaneous coronary interventions: -pacing/icd: w/ upgrade in lead fracture and recurrent shocks. 3. other past medical history: - cva in without residual deficits. - pad: ct angio in r internal iliac artery occlusion and 80% left internal iliac artery stenosis that was stented and 95% l superficial femoral artery treated with atherecotomy. - chronic lower back pain - osa - emphysema - restless leg syndrome social history: -tobacco history: 60 yrs x 1ppd, quit wks ago -etoh: social -illicit drugs: occ marijuana family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: vs: tm 99.3, tc 97.7, hr 63 (57-69), bp 111/54 (107-124/54-71), rr 18, sao2 94% ra i/o: 440/ nr (500), bm x 1 general: wdwn in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple neck, no bruits, difficult to assess jvp 2/2 body habitus cardiac: rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs/chest: prior icd site minimally tender, serosang drainage, penrose drain in place, incision c/d/i. evidence of prior sternotomy, no scoliosis or kyphosis. resp were unlabored, no accessory muscle use. minimal end expiratory wheezes bilaterally, no crackles, rhonchi. abdomen: soft, obese, ntnd. no hsm or tenderness. extremities: no c/c. 1+ edema on le bilaterally. skin: hemostatic changes in le bilaterally. pulses: right: carotid 1+ radial 1+ dp 1+ pt 1+ left: carotid 1+ radial 1+ dp 1+ pt 1+ . telemetry: sb/sr 50s-60s, 1st degree avb, bbb, rare pvcs, v couplets, v trigeminy pertinent results: cxr: as compared to the previous radiograph, the left pacemaker has been removed. the leads have also been removed. . newly placed picc line over the right upper extremity. the tip of the line projects over the mid svc. there is no evidence of complication, notably no pneumothorax. unchanged minimal retrocardiac atelectasis. no evidence of focal parenchymal opacity suggesting pneumonia. normal size of the cardiac silhouette. moderate tortuosity of the thoracic aorta. brief hospital course: 69m with h/o cabg, htn, hl, ischemic cardiomyopathy, paf, bioprosthetic avr, s/p icd in changed to biv in presenting with worsening icd infection s/p icd and lead extraction on . . # icd infection: longstanding icd infection after placement in ; s/p hematoma evacuation 5 wks ago, pocket tissue noted to be friable. swelling and erythema worsened over the past 2 weeks prior to presentation, evidence of cellulitis. s/p icd and lead extraction on , pt has remained hemodynamically stable, afebrile, no signs of systemic infection. will treat with vancomycin 1000mg q12h, ciprofloxacin 500mg , flagyl 500mg tid for a total of 2 wks per id (day 1 = . of note, patient developed red man syndrome after 1st dose of vancomycin; please administer at 1/2 rate (100mg/hr) and administer diphenhydramine and zofran as needed. has been tolerating vanc at reduced rate without issues after 1st dose. no evidence of valvular vegetations on tee prior to surgery. unfortunately, no deep tissue cultures taken at time of icd removal, will be treating empirically for gnr found on tissue swab 5 weeks ago. picc line placement confirmed by cxr: rue, tip of line over the mid svc. penrose drain placed during surgery was pulled prior to discharge; stitches will be removed in 1 wk during cardiology follow-up. . # coronaries: known cad, s/p nstemi, cabg. denied cp, sob throughout entire admission. patient was bradycardic and hypotensive s/p icd removal, which was expected as the patient was pacer dependent prior to the icd extraction. continue asa 81mg daily, continue reduced doses of toprol xl 25mg . . # pump: lvef of 30-35% on recent echo and mild aortic stenosis. evidence of minimal fluid overload on exam. continue home regimen at reduced doses as pt relatively bradycardic and hypotensive s/p icd and lead removal. cont spironolactone 12.5mg, metoprolol 25mg , lisinopril 10mg daily. continue home lasix 20mg . . # rhythm: history of paf, s/p biv icd placement and icd extraction icd pocket infection. pt in sinus rhythm on day of discharge, rates in 50s-60s with first degree avb and bbb, rare pvcs. continue digoxin 0.125mg daily. continue to hold anti-coagulation as pt is not in a-fib, will re-eval for need for anticoagulation at follow-up cards appt. . # htn: bp 111/54 on am of discharge. cont home regimen at reduced doses as stated above (lisinopril, spironolactone, toprol xl). . # acute renal insufficiency: cr 1.3 on day of discharge, 1.1 on admission. likely poor po fluid intake, recent npo status for surgery; will have obtain follow-up blood work to monitor. we encouraged increasing po fluid intake on day of discharge. . #shoulder pain: resolving, likely vaccination given in l deltoid; rom has improved, minimal concern for icd infection spreading to joint. . # hl: recent lipid panel - chol 165, tg 158, hdl 42, ldl 91. continued atorvastatin. . # copd: pt notes that breathing has improved since quitting smoking. continued singulair, advair and albuterol prn. . # chronic back pain: continue home regimen lexapro, gabapentin. meloxican held during admission. . # restless leg syndrome: continued pramipexole. . # osa: please continue patient on cpap (home machine to be brought to ecf, please use home setting of 25cm h2) medications on admission: metoprolol succ 200mg daily warfarin 2.5-7mg daily lipitor 40mg daily lisinopril 10mg daily spirinolactone 12.5mg daily lasix 40mg (*not currently taking) meloxican 15mg daily pramipexole 25mg daily lexapro 20mg daily digoxin 125mcg daily zonasamide 100mg qhs gabapentin 300mg qhs singulair 10mg daily discharge medications: 1. vancomycin 1,000 mg recon soln sig: one (1) g intravenous twice a day for 2 weeks: please give at 100cc/hr, administer diphenhydramine, zofran prn. disp:*qs 2 wks* refills:*0* 2. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. toprol xl 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*30 tablet sustained release 24 hr(s)* refills:*2* 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 5. zonisamide 100 mg capsule sig: one (1) capsule po hs (at bedtime). 6. spironolactone 25 mg tablet sig: 0.5 tablet po daily (daily). 7. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). 8. gabapentin 300 mg capsule sig: one (1) capsule po hs (at bedtime). 9. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 10. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 11. meloxicam 15 mg tablet sig: one (1) tablet po once a day as needed for pain. 12. pramipexole 0.25 mg tablet sig: one (1) tablet po daily (). 13. lexapro 20 mg tablet sig: one (1) tablet po once a day. 14. digoxin 125 mcg tablet sig: one (1) tablet po once a day. 15. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 2 weeks. disp:*28 tablet(s)* refills:*0* 16. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 2 weeks. disp:*42 tablet(s)* refills:*0* 17. antihistamine 25 mg capsule sig: one (1) capsule po twice a day as needed for itching for 2 weeks. disp:*28 capsule(s)* refills:*0* 18. zofran 4 mg tablet sig: 1-2 tablets po twice a day as needed for nausea for 2 weeks. disp:*28 tablet(s)* refills:*0* 19. outpatient lab work please have your chem 10 panel checked on monday, . discharge disposition: extended care facility: nursing home - discharge diagnosis: primary diagnosis: icd infection . secondary diagnosis: dyslipidemia, hypertension, paroxysmal afib, cad s/p nstemi, infarct-related cardiomyopathy, emphysema, restless leg syndrome discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: it was a pleasure taking care of you during your admission to the cardiology service. you were found to have a worsening icd infection, and your icd and leads were removed on without complications. . please make the following changes with your medications: -change metoprolol succinate to 50mg daily -change lasix to 20mg twice daily . -start vancomycin 1g iv twice daily -start ciprofloxacin 500mg by mouth twice daily -start flagyl 500mg by mouth three times daily . -stop coumadin . please continue all other medications as prescribed. . please follow-up with dr. within 1 week; you will have your staples removed at that time. you will be called by dr. office with an appointment time. also, please have your blood drawn on monday, to monitor your electrolytes and kidney function. . weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: name: ,, md address: ,ste 8a, , phone: appointment: monday, at 3:15pm **we are working on a follow up appointment with dr. in days. you will be called at home with the appointment. if you have not heard from the office or have questions, please call .** procedure: venous catheterization, not elsewhere classified removal of lead(s) [electrode] without replacement revision or relocation of cardiac device pocket diagnoses: obstructive sleep apnea (adult)(pediatric) cellulitis and abscess of trunk congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status unspecified disorder of kidney and ureter other emphysema chronic systolic heart failure personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation heart valve replaced by transplant staphylococcus infection in conditions classified elsewhere and of unspecified site, other staphylococcus restless legs syndrome (rls) infection and inflammatory reaction due to cardiac device, implant, and graft 

Answer: The patient is high likely exposed to