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: confusion major surgical or invasive procedure: none history of present illness: 65 yom w/ a h/o dmii, esrd on pd, cad, chf w/ an ef of 25% and lymphoplasmocytic lymphoma (waldenstrom's) presents with 5 days of nausea, vomiting and diarrhea- having missed peritoneal dialysis for 2 days he became confused and was brought to the er. since admission he was found to have an elevated wbc count in his peritoneal fluid and started on vanc / ceftriaxone for possible bacterial peritonitis which is thus far culture negative. since his admission his mental status has improved, abd pain and diarrhea has resolved, he is not nauseas but does lack an appetite. he denies any cp, sob, orthopnea or pnd. his main complaint is overall fatigue, no muscle aches. he had a cough and sore throat and these symptoms also remain. of note his wife had exactly the same constellation of symptoms beginning roughly 1 week prior to his onset of symptoms (which was 1 week ago). no fevers or chills. has noticed dry skin over the past few months. patient is on pd and does make urine (small amount), he lives at home with his wife and states he is fully independent. past medical history: -esrd on pd since -dm -cad s/p angioplasty in and -chf (ef 20-25%) -htn -hypercholesterolemia -sleep apnea, on cpap at home -gout -gerd -h/o gallstones -hypothyroid -h/o waldenstrom's macroglobulinemia --> lymphoplasmacytis lymphoma social history: the patient denies tobacco use. no etoh. he is married. ?h/o etoh use for him and ?his wife. is semi-retired. he used to be the director of human relations and vice president of hospital. the patient was also a lawyer and does a small amount of law practice on the side. he has 4 grown children who are healthy. family history: the patient's father died of colon cancer at age 55; mother is alive in her late 80s with hypertension, status post cabg for an mi, and with history of stroke. physical exam: vs: 96.3 bp 108/76 hr 77 rr 20 o2 96% ra gen: nad, aox3 heent: perrl, eomi, sclera anicteric, slight posterior op erythemia, jvp is 14 without a kussmauls sign card: rrr, no m/r/g, soft heart sounds pulm: ctab abd: soft, nt, nd, no masses or organomegaly ext: wwp, no c/c/e neuro: cn2-12 intact, aox3, appropriate affect, able to hold conversation, stregnth in all 4 extremities pertinent results: 01:08pm blood wbc-17.2*# rbc-3.02* hgb-9.4* hct-28.0* mcv-93 mch-31.0 mchc-33.5 rdw-14.8 plt ct-379 06:45am blood wbc-7.5 rbc-2.71* hgb-8.2* hct-24.6* mcv-91 mch-30.1 mchc-33.1 rdw-16.7* plt ct-249 01:08pm blood neuts-91.5* bands-0 lymphs-5.8* monos-2.1 eos-0.2 baso-0.4 03:12am blood neuts-90.8* lymphs-5.0* monos-2.7 eos-1.1 baso-0.3 01:08pm blood glucose-515* urean-125* creat-13.7*# na-136 k-6.3* cl-89* hco3-17* angap-36* 06:45am blood glucose-131* urean-74* creat-9.0* na-135 k-3.9 cl-94* hco3-31 angap-14 06:45am blood calcium-8.4 phos-6.5* mg-1.8 iron-19* 06:45am blood caltibc-142* ferritn-1043* trf-109* 06:45am blood %hba1c-13.3* 06:45am blood tsh-6.1* 06:45am blood pth-158* 06:45am blood vanco-17.5 03:34am blood lactate-2.6* 03:47pm blood lactate-5.2* cxr: resolved left pleural effusion. suspect persistent right pleural effusion in predominantly subpulmonic distribution. decubitus views may be of benefit if useful for clinical management. no consolidation or edema. cxr: portable ap chest radiograph compared to , obtained at 6:50. the left internal jugular line tip terminates in left brachiocephalic vein. the cardiomegaly is stable. mediastinal contours are unremarkable. the patient is still in mild volume overload/failure. new opacity overlying the right lung most likely is due to layering pleural effusion which was predominantly concentrated at the right base on previous study. there is no significant change in bibasilar atelectasis. impression: 1. mild volume overload/failure. 2. bilateral pleural effusions, right more than left. foot x rays: bilateral history: diabetes. foot ulcers. rule out osteomyelitis. six radiographs of the bilateral feet are submitted. mineralization is normal. the joint spaces are maintained without periarticular erosion. no fracture. atherosclerotic calcifications are present. no localizing history is provided. no discrete soft tissue loss is evident. no subcutaneous emphysema is seen. no cortical fragmentation is identified. no change compared with . impression: unremarkable bilateral feet. 2:02 pm swab source: right hallux. gram stain (final ): 3+ (5-10 per 1000x field): polymorphonuclear leukocytes. 4+ (>10 per 1000x field): gram positive cocci. in pairs and clusters. wound culture (final ): staph aureus coag +. heavy growth. staphylococcus species may develop resistance during prolonged therapy with quinolones. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. testing of repeat isolates may be warranted. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin-----------<=0.25 s erythromycin----------<=0.25 s gentamicin------------ <=0.5 s levofloxacin----------<=0.12 s oxacillin------------- 0.5 s penicillin------------ =>0.5 r trimethoprim/sulfa---- <=0.5 s anaerobic culture (preliminary): no anaerobes isolated. 2:02 pm swab source: left 2nd digit. gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. 1+ (<1 per 1000x field): gram positive cocci. in pairs and clusters. wound culture (final ): staph aureus coag +. moderate growth. staphylococcus species may develop resistance during prolonged therapy with quinolones. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. testing of repeat isolates may be warranted. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin-----------<=0.25 s erythromycin----------<=0.25 s gentamicin------------ <=0.5 s levofloxacin----------<=0.12 s oxacillin------------- 0.5 s penicillin------------ =>0.5 r trimethoprim/sulfa---- <=0.5 s anaerobic culture (preliminary): no anaerobes isolated. urine culture negative blood cx no growth to date on brief hospital course: confusion: likely related to viral syndrome in addition to uremia, this may have been due in part to a few days of missed peritoneal dialysis due to weakness. patient's mental status cleared as he was treated for his infection, his electrolytes normalized and he was dialyzed (pd) for his uremia. bacterial peritonitis: initially started on antibiotics for bacterial peritonitis given initial wbc count of 300 on initial peritoneal fluid, however, this could have been due to no peritoneal dialysis for 2 days, 5 hours later her wbc count in his peritoneal fluid was in the 30s. his antibiotics for sbp were discontinued. hypotension: in setting of peritoneal dialysis. patient remained asymptomatic and was ambulatory with pt. diabetic foot infection: seen by podiatry, purulence drained from r hallux and l second toe. not deep, did not probe to bone, dressed w/ clean dry dressings. heel laceration due to dry skin and fissuring, given amlactin cream for this. mssa from wounds, started on levofloxacin for this (on vanc until sensitivities returned). levo 250mg po q48hrs renally dosed, coverage for infection starting on , should continue until or . insulin regimen adjusted, initially hyperglycemic; near date of discharge was hypoglycemic but after adjustment of insulin dosage had a normal glucose. patient should have non-invasive vascular studies to evaluate arterial blood flow, this has been ordered for outpatient. anemia: on epo, iron studies reveal ferritin > 1000, iron supplementation stopped. dmii: a1c 13.3%, patient should follow up with upon discharge. chronic systolic heart failure: medications were adjusted before discharge due to hypotension. patient will need to be re-assessed to re-start ace inhibitor. please see medication section for details. medications on admission: allopurinol 75 per day metoprolol tartrate levothyroxine 75 mcg daily nexium 40mg daily niaspan er 50mg daily icaps humulin r and n ?dose lipitor 20 mg daily lisinopril 20mg daily iron 65? aspirin 81mg daily effexor xr 150 daily lorazepam 1mg ?daily zolpidem 10 q.h.s. procrit 6000 every week fosrenol 1000 tid with meals discharge medications: 1. levofloxacin 250 mg tablet sig: one (1) tablet po q48h (every 48 hours) for 3 doses: next dose 2/26. disp:*3 tablet(s)* refills:*0* 2. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 3. allopurinol 100 mg tablet sig: one (1) tablet po once a day. 4. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 5. niaspan 500 mg tablet sustained release sig: one (1) tablet sustained release po once a day: 30 minutes after aspirin. 6. atorvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 7. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 8. venlafaxine 75 mg capsule, sust. release 24 hr sig: two (2) capsule, sust. release 24 hr po daily (daily). 9. insulin nph human recomb 100 unit/ml suspension sig: as directed subcutaneous as directed: nph 10 units at breakfast time and nph 8 units at bedtime. 10. insulin lispro 100 unit/ml solution sig: as directed subcutaneous as directed: lispro (humalog) insulin based on a sliding scale for breakfast, lunch, dinner and at bedtime. 11. icaps tablet sustained release sig: one (1) tablet sustained release po once a day. 12. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed. disp:*60 capsule(s)* refills:*2* 13. ativan 1 mg tablet sig: one (1) tablet po once a day as needed for anxiety. 14. ambien 10 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. 15. procrit 3,000 unit/ml solution sig: two (2) ml injection once a week. 16. fosrenol 1,000 mg tablet, chewable sig: one (1) tablet, chewable po three times a day. 17. ammonium lactate 12 % lotion sig: one (1) appl topical (2 times a day). disp:*1 bottle* refills:*2* 18. morphine 15 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. disp:*30 tablet(s)* refills:*0* 19. toprol xl 25 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* discharge disposition: home with service facility: discharge diagnosis: primary diagnosis: infected toe ulceration / abscess viral syndrome uremia discharge condition: stable discharge instructions: you were admitted for confusion and infection in your abdomen and of your toes. you have been treated with antibiotics and are improving. you will need outpatient "vascular studies" to look at the blood pressures in your arms compared to your legs. your primary care physician can help set this up for you, if you have narrowed vessels in your legs this may be the reason that you have ulcers and infections of your feet. please note, we have held the dose of lisinopril. please do not take this medication until you see dr . we have also decreased the amount of metoprolol you take; please discard the bottle you have at home and take the new toprol xl 25mg daily we have prescribed until you see dr . followup instructions: please follow up with your primary care physician . on friday, at 10:30 a.m., phone (. in addition please follow up with your podiatrist dr. on friday, 2:40 p.m. in the building , phone: ( please call your kidney doctor for an appointment within 2 weeks of your discharge. provider: , m.d. phone: date/time: 1:40 md, procedure: percutaneous abdominal drainage peritoneal dialysis diagnoses: acidosis hyperpotassemia anemia in chronic kidney disease end stage renal disease obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia congestive heart failure, unspecified acute kidney failure, unspecified unspecified acquired hypothyroidism gout, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease unspecified viral infection diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled chronic diastolic heart failure cellulitis and abscess of foot, except toes ulcer of heel and midfoot cellulitis and abscess of toe, unspecified other named variants of lymphosarcoma and reticulosarcoma, unspecified site, extranodal and solid organ sites 

Answer: The patient is high likely exposed to