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: ivp dye, iodine containing / sulfa (sulfonamides) / bactrim attending: chief complaint: weakness, rash (?bactrim allergy), acute respiratory failure. major surgical or invasive procedure: none history of present illness: hpi: 67yo m with cad s/p cabg, dm, pvd, transferred from osh with ards. . he initially presented to osh w/ 3 days history of increasing weakness and unable to situp and ambulate w/ his walker. he had some dizziness and some neck pain but no photophobia. he also had bitemporal headache an anorexia. h ealso had a couple episode of vomiting but no diarrhea. he also had a non-productive cough. he noted a fascicular and papular rash on his bilateral hands, including his palms and trunk and extremities. . of note, he has chronic yeast infection in his groin. in the ed, he was hypotensive to the 80s w/ hr 62 but afebrile (on b-blocker). he was very ill appearing and dry looking. . about 1 wk prior, he was started on bactrim by dr. for ulcer on both feet. he took a few days of bactrim but developed severe diarrhea as a result of it. he stopped it. he was advised by dr. to resume bactrim b/c of concern of persistent infection. upon resuming bactrim, he developed a generalized rash started initially over his face and spreading to his abd, his upper and lower ext. the rash was not painful and no itchy. it then began to itch subsequently. . brief osh course : he was admitted on w/ profound weakness and worsening renal fx w/ bun 78 creat 2.5. baseline bun 30-40s. notable labs initially wbc 12k, hct 32.7 plt 203. 26% band, 2 % eos na 142 k 4.0 bun 78 and creat 2.5. gluc 159. ast 79, alt 55, alk phos 84. inr 1.1. ekg initially rbbb w/ non specific st t wave changes w/ nsr at 62. cxr showed some bilateral patchy infiltrate. an lp was attempted in the ed for concern of disseminated zoster. . he was sats 98 % on ra and bp 98/43 and afebrile. he had an extensive exfoliate rash on his upper and lower ext. of note, he was on bactrim for heel ulcer. he required hypotensive and required ivf. . he was started on diflucan and acyclovir and ctx. bld cx was drawn and these have remained negative. one of the exfoliateive lesion was unroofed and sent for culture. derm and di not believed that it was virla or herpetic and recommended stopping acyclovir. (of note, he had been given lasix as outpt meds.). he was noted to be in increasing respiratory distress 1-2 days and was given additional dosage of lasix. (total 3 dosages of 40 iv lasix given on ). he was also seen by id who recommended stopping diflucan, acyclovir, cta. prednisone was also started for presumed exfoliate dermatitis. renal was also consulted and felt that the rash is likely from bactrim and sulfa related allergy. and recommended ivf hydration. despite attempted diuresis, he developed bilateral infiltrate (diffuse) and increasing hypoxic respiratory failure. he was emergently intubated after midnite . he was sating low 90s w/ fio2 100 and peep of 7.5. central line was inserted and cvp was 16 w/ bnp 1020. frothy pinkish secretions were obtained from his ett tubes. cultures were sent. pt was started on ceftaz 1 q8 and cipro 400 iv and 1 dose of 1gm vanco given empirically. he was also started on hydrocort 100 q8 on am. . of note pt was recently admitted to the vascular service for l>r ulcer and was planned to have f/u surgery pending cardiac evaluation. past medical history: 1. cad- s/p cabg x 3 in at , last cath with 80% stenosis in svg to om1 s/p stent placement 2. aortic stenosis- moderate by tte 3. ckd- by report, baseline cr 1.2, h/o arf with iv contrast 4. dm- hga1c 6.4 in ; c/b nephropathy, neuropathy, retinopathy 5. pvd- b/l ischemic heel ulcers, s/p r foot partial amputation 6. hypertension 7. hypercholesterolemia 8. peripheral neuropathy 9. bilateral carotid stenosis, s/p r cea 10. osa- on home bipap 11. history of junctional tachycardia social history: he is married. he is a retired quality assurance engineer. nonsmoker and uses alcohol occasionally family history: (+) fhx cad: mother died at age 65 of an "enlarged heart". physical exam: physical exam on admission: vitals- p 109 bp 106/44 o2 90% rr 14 ac tv 450 fi o2 100% rr 14 peep 5 pip 34 general- nad, intubated, sedated, generalized exfoliate dermatitis heent- perrl, op clear w/ dry mmm neck- supple, flat jvd pulm- diffuse crackles and rhonchi cv- rrr, s1 and s2, no m/r/g abd- soft, nt, nd +bs extrem- cool to touch, poor distal pulses neuro- sedated brief hospital course: pt admitted to on hemodynamically stable, but with ards for further management. pt was extubated on , but did poorly on cpap with trials of high flow ventilation. he elected to be dnr/dni on after extubation, and on goals of care where changed to comfort measures only. pt expired on from hypercarbic respiratory failure. . . # respiratory failure: the etiology of pt's ards unclear, but is presumably bactrim allergy which was being used to treat ?foot cellulitis. . pt did have bandemia at osh on arrival, but numerous cultures on presentation to and at osh negative including blood, sputum, bal, urine, and foot wounds (left and right) were negative. on presentation to osh pt noted to have rash of b le and it was thought that he had a bactrim allergy which he was started on for foot ulcers. . pt intubated at osh on ~. his respiratory mechanics gradually improved with gentle diuresis with lasix gtt + diamox, and pt was extubated , and transitioned to his home bipap with ps 14/8. after extubation, pt continued to have copious secretions which improved slowly. he also remained grossly volume overloaded, and was tolerating only gentle diuresis (~500-1000cc fluid removal daily), given his severe aortic stenosis and preload dependence. pt gradually improved, tolerating trial of high flow face mask ventilation, with o2 sats 95-100% on 8-15lpm. his secretions were improving on , and less copious. . blood and sputum cultures, though initially negative (pt previously on vanco/zosyn from osh for unclear indication, abx d/c'd ), subseqeuntly were positive for mrsa in blood and sputum on . pt was begun on vanco/zosysn, and switched to linezolid/meropenem for ?improved lung penetration. however pt continued to progress off of cpap, and on decision was made to change goals of care to cmo. pt expired on . . . # sepsis - on pt was noted to be hypothermic. central line and left a-line were removed earlier that day. source remained unclear, though ddx included versus aline/lij central line. blood cx subsequently +mrsa. sbps remained elevated, and pt was already being treated with a second course of vanco/zosyn, which was continued. lactate level was unremarkable. by , pt was afebrile for 48hrs, and without hypotension. his uop, however remained, low, and given his failure to improve from a respiratory standpoint, pt elected to change goals of care to cmo on and expired on . . . # cv: pt with h/o cad s/p cabg , last cath . this admission pt with cardiac enzymes x 3 w/ + trop but negative cks and these trended down. thought to be due to demand ischemia with hypotension. pt's plavix was d/c'd as pt is >1.5 yrs s/p cath and has had had guaic pos stools. aspirin dose decreased to 81 mg po qdaily, and held pending restarting oral feeding. on pt complained of cp, however no new ekg changes were noted, cardiac enzymes unremarkable compared to prior bump, and cp resolved within <5 min. on goals of care were changed to cmo. . b) pump-last echo showed decreased ef from w/ 1+ mr and as, now with ef 30-40% and mod-severe as-attempting diuresis with diamox and lasix although on this hospitlization, diureses was complicated by pt's preload dependence. he continued to remain volume overloaded on , and diuresis was also complicated by ?sepsis physiology. on , decision was made to change goals of care to cmo. . c) rhythmn: had episode of aflutter on admission, digoxin loaded but not continued. on pt developed intermittent aflutter with variable block. this was felt to be to his pulmonary processes, rather than ischemia. plan was to treat underlying pulmonary process (pna and pulmonary edema) with linezolid, meropenem and diuresis, however on decision was made to change goals of care to cmo. . . # dm2 with complications - pt initially treated with insulin gtt which was weaned and transitioned to sliding scale coverage with good fsbs. . # foot ulcers- vascular sugery was consulted regarding pt's foot ulcer. the wound did not probe to bone. one wound was swabbed which did not grow anything, and the wound do not appear to be infected. b/l foot xrays could not r/o osteomyelitis. pt was afebrile without white count initially off abx. spoke with pt's vascular surgeon, who feels that if wound does not probe to bone, osteo is unlikely. as this is the case, will continue wound care, but will not workup further for osteomyelitis. . regarding bilateral lower extremity rash, this was largely resolved on . do not feel that this represents cellulitis, as it lacks erythema, no wbc, or fever (off abx, or tyelenol). plan was for f/u with vascular surgeon as outpatient ( ), however pt expired on . . . #arf- patients creatinine on admission was elevated to approx 2 and had returned to wnl despite continuing to diuresing with lasix to remove fluid exacerbating respiratory failure. on it had started trending upward again with diuresis. . . #anemia-chronic anemia. iron studies demonstrate acd likely dm, chf. pt breifly had guaic positive stool upon presentation, though hct stable after 1 u prbc. pt started on ppi for ?gib, however subsequent stool guaic were negative. nevertheless plavix was d/c'd. . #hypernatremia- pt initially hypernatremic, felt likely to hypovolemia and free water deficit. pt was treated with free water boluses in tf and d5w once ogt was removed, with subsequent resolution on . . # fen: s/p extubation pt, evaluation of pt's swallow was attempted, however he was requiring long periods of cpap which made this difficult. if pt does not tolerate face mask for significant periods of time, plan was to place ngt and use cpap on top, despite poor seal. s&s consulted placed, however they were unable to see pt until after he can tolerate being off of cpap for significant periods of time, pt was treated with tpn. . . # disposition - on decision was made to change goals of care to cmo after discussion with pt, and family. on pt expired due to hypercarbic respiratory failure. medications on admission: outpatient meds (per d/c summary ): hydrochlorothiazide 25 mg po qd acetazolamide 250 mg po qd lisinopril 10 mg po qd aspirin ec 325 mg po qd metoprolol 12.5 mg po bid citalopram hydrobromide 20 mg po qd nifedipine cr 30 mg po qd clopidogrel bisulfate 75 mg po qd papain-urea ointment 1 appl tp qd potassium chloride 20 meq po bid ezetimibe 10 mg po qpm simvastatin 40 mg po qpm furosemide 80 mg po bid . medications ( on addmission to osh): lopressor 25 plavix 75 daily fosamax 75 q sunday potassium 20 lisinopril 20 daily diamox 50 daily ecasa 325 daily celexa 20 daily lasix 680 hctz 25 daily vytorin 10/41 daily fish oil 1700 lantus 18 u qhs humalog ssi colace discharge disposition: expired discharge diagnosis: pt expired on . discharge condition: expired. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances non-invasive mechanical ventilation closed [endoscopic] biopsy of bronchus transfusion of packed cells injection or infusion of oxazolidinone class of antibiotics infusion of vasopressor agent diagnoses: anemia of other chronic disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere obstructive sleep apnea (adult)(pediatric) acute kidney failure, unspecified unspecified septicemia severe sepsis infection with microorganisms resistant to penicillins aortocoronary bypass status diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes atrial flutter methicillin susceptible staphylococcus aureus septicemia chronic kidney disease, unspecified rheumatic heart failure (congestive) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified forms of chronic ischemic heart disease acute and chronic respiratory failure long-term (current) use of insulin septic shock mitral valve insufficiency and aortic valve stenosis methicillin susceptible pneumonia due to staphylococcus aureus pressure ulcer, lower back dermatitis due to drugs and medicines taken internally nonspecific abnormal findings in stool contents hyperosmolality and/or hypernatremia diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled ulcer of heel and midfoot sulfonamides causing adverse effects in therapeutic use candidiasis of skin and nails 

Answer: The patient is high likely exposed to