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: fever and chills major surgical or invasive procedure: central venous line placement history of present illness: this is an 86 year old male with a history of multiple urethral strictures secondary to childhood bladder infections with recent foley placement presenting with fevers and rigors. mr was most recently seen on by urology for nocturia and decreased force of urine stream. this was thought to be secondary to an old residual urethral stricture from turp for bph performed nearly 30 years ago. he has required dilations of his urethra periodically over the past several decades but had not had any dilations in the past five years. cystoscopy in the urology clinic for evaluation of his nocturia and decreased urine stream on revealed an impassable stricture which was dilated and subsequently a foley was placed. he was initiated on finasteride in addition to his usual hytrin dose. he was instructed to remove his foley on following the procedure however he failed to deflate the balloon, resulting in hematuria, with clots, penile pain, and difficulty with urination. he was seen in the ed for the above; urology was consulted who replaced a foley with improvement in bleeding - he was discharged home with foley in place. he was seen in urology clinic 1 day prior to admission (on ) when foley was removed without incident. on afternoon of admission, patient complained of fevers and chills with dysuria and blood noted in urine. he presented to the ed with these complaints. vitals in the ed showed tmax of 103, hr of 110, bp 80/40. two 18 gauge ivs were placed and 3 ls of fluids were given with bp remaining in 80s. he was started on peripheral norepinephrine for pressor support. a right-sided ij was placed. initial chest x-ray revealed that central line was too high in position. urine analysis revealed pyuria with urine cultures pending. he received vancomycin and zosyn. he also received an abdominal ct to look for source of infection. given his hypotension, he was transferred to the micu for observation. in the icu he was noted to have bps in the 90s systolic on norepinehrine, with heart rates in the 60s, and was afebrile. he had no complaints. past medical history: htn bradycardia - with primary av block s/p aicd and pacer placement recurrent urethral strictures childhood infection mild systolic dysfunction - ef of 40-45% on echo in social history: denies smoking, alcohol use, recreational drug use. lives at home with wife. family history: father died of cva; sister has . physical exam: bp 93/49, hr 70, afebrile, rr 12, spo2 98% ra gen: caucasian male, pleasant, in no apparent distress heent: anicteric, eomi, perrl, oropharynx clear cardiac: nl s1/s2, rrr pulm: lungs clear bilaterally, no wheezes or rales appreciated abd: soft, nontender, no suprapubic tenderness ext: no edema noted prostate exam: per ed - nontender pertinent results: admission labs: 02:00pm blood wbc-6.4 rbc-3.56* hgb-11.8* hct-33.8* mcv-95 mch-33.2* mchc-34.9 rdw-13.6 plt ct-161 02:00pm blood neuts-91.8* lymphs-5.4* monos-0.5* eos-1.9 baso-0.4 02:00pm blood glucose-97 urean-28* creat-1.5* na-138 k-4.4 cl-102 hco3-23 angap-17 02:00pm blood alt-23 ast-38 alkphos-50 totbili-0.5 02:00pm blood lipase-43 09:04pm blood phos-2.2* mg-2.0 09:23pm blood type-central ve ph-7.34* comment-green-top 02:44pm blood lactate-1.2 . micro: 02:00pm urine color-yellow appear-hazy sp -1.008 02:00pm urine blood-lg nitrite-neg protein-25 glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-mod 02:00pm urine rbc->50 wbc-* bacteri-few yeast-none epi- . urine culture (final ): staphylococcus, coagulase negative. >100,000 organisms/ml.. escherichia coli. 10,000-100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ staphylococcus, coagulase negative | escherichia coli | | ampicillin------------ =>32 r ampicillin/sulbactam-- 4 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin--------- =>4 r gentamicin------------ <=0.5 s <=1 s levofloxacin---------- =>8 r meropenem------------- <=0.25 s nitrofurantoin-------- 32 s <=16 s oxacillin-------------<=0.25 s piperacillin/tazo----- <=4 s tetracycline---------- <=1 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s vancomycin------------ 1 s . discharge labs: 07:15am blood wbc-9.5 rbc-3.40* hgb-11.5* hct-33.6* mcv-99* mch-33.7* mchc-34.1 rdw-13.7 plt ct-232 07:15am blood glucose-100 urean-12 creat-1.0 na-137 k-4.1 cl-104 hco3-25 angap-12 07:15am blood calcium-9.4 phos-2.9 mg-2.0 brief hospital course: 86yo m with urethral stricture and urinary retention presented to the ed with sepsis secondary to uti, requiring pressors for 2 days in the micu. when off pressors and hemodynamically stable, transferred to general medical floor. . # hypotension: resolved. patient recieved a total of 7-8l ivf during micu stay. he had been off pressors for over 24 hours before being transfered to the floor. when he arrived on the general medicine floor, his pressures were 140s systolic. his home terasozina and anti-hypertensives were re-started one at a time as tolerated. his lasix was not re-inititaed this admission. pt did not show any signs of volume overload. volume status should be re-evaluated, and lasix can be re-started at the discression of pcp. . #uti: urine growing e. coli and cons. abx initially narrowed to vancomycin and ceftriaxone. sensativities showed e. coli sensative to tmp/smx and amoxacillin-clavulonate. cons were sensative to oxacillin and tetracyclines. he was transitioned to a po regimen of doxycycline and tmp/smx on day 4 of admission. will treat for a total of 14 days for complicated uti. . # hypoxia ?????? patient initially presented with new o2 requirement in setting of sepsis and atelectasis on cxr, now resolved. pt encouraged to use incentive spirometry and sit upright, oob to chair. albuterol prn was needed rarely. pt saturating well (mid-90s) on room air at the time of discharge. . # acute renal failure - resolved after agressive hydration. likely sepsis, prerenal disease, or a combination of these 2 factors given poor po intake at home. pt taking good po at the time of discharge. . # recurrent urethral strictures - per urology, keep foley in place for at least 2 weeks to allow bladder time to heal. pt will f/u with dr. as outpatient. . # anemia: baseline hgb appears to be 12s. likely hematuria/urethral trauma. h/h has been stable throughout hospital course. . # history of bradycardia/primary av block: has aicd/pacer in place. no bradycardia observed during hospital course. . # hyperlipidemia - home crestor was restarted on transfer to medicine floor. medications on admission: 1. furosemide 40 mg daily 2. hytrin 5 mg qpm 3. lisinopril 10 mg qam 4. toprol xl 25 mg daily 5. nasonex 50 mcg spray 6. kcl 20 meq tab daily 7. crestor 40 mg daily 8. sildenafil 50 mg prn 9. terazosin 5 mg daily 10. tramadol 50 mg daily prn 11. tramadol - acetaminophen 37.5 mg-325 mg tablet prn 12. aspirin 81 mg daily 13. multivitamin daily 14. naproxen 440 mg qpm discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation every four (4) hours as needed for shortness of breath or wheezing. disp:*1 inhaler* refills:*0* 3. terazosin 5 mg capsule sig: one (1) capsule po hs (at bedtime). 4. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 5. multivitamin tablet sig: one (1) tablet po daily (daily). 6. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 7. doxycycline hyclate 100 mg capsule sig: one (1) capsule po q12h (every 12 hours) for 15 doses: please take all of this medication unless told otherwise by dr. . disp:*15 capsule(s)* refills:*0* 8. sulfamethoxazole-trimethoprim 800-160 mg tablet sig: one (1) tablet po bid (2 times a day) for 15 doses: please take all of this medication unless told otherwise by dr. . disp:*15 tablet(s)* refills:*0* 9. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. 10. nasonex 50 mcg/actuation spray, non-aerosol sig: sprays in each nostril nasal once a day. 11. naproxen sodium 550 mg tablet sig: one (1) tablet po once a day. tablet(s) 12. crestor 40 mg tablet sig: one (1) tablet po once a day. 13. tramadol 50 mg tablet sig: one (1) tablet po once a day as needed for pain. 14. tramadol-acetaminophen 37.5-325 mg tablet sig: one (1) tablet po twice a day as needed for pain. discharge disposition: home with service facility: family & services discharge diagnosis: primary: urinary tract infection sepsis . secondary: hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: mr. , . thank you for coming to for your care. you initially went to the medical intensive care unit for low blood pressure due to an infection in your urine. you got a lot of iv fluids and medications to help raise your blood pressure. when your blood pressure was stable, you were transferred to the medical floor. you were initially started on iv antibiotics and transitioned to oral antibiotics that you should continue taking until , . . you will be leaving the hospital with the foley catheder in place. please do not remove this catheder on your own. it will be taken out at dr. office at your appointment next week. . start taking: - doxycycline 100mg by mouth twice a day - trimethoprim/sulfa double strength by mouth twice a day - we are also starting you on an albuterol inhaler to use as needed for shortness of breath and wheezing . stop taking: - lasix 40mg po daily. when you follow up with dr. , you should discuss with him whether you should restart this medication. . weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: department: surgical specialties when: wednesday at 8:00 am with: , m.d. building: campus: east best parking: garage . name: , location: group address: , , , phone: appt: we are working on a follow up appt for you for next week the office will call you at home with an appt. . department: surgical specialties when: thursday at 2:00 pm with: , m.d. building: campus: east best parking: garage . department: surgical specialties when: wednesday at 10:30 am with: , m.d. building: campus: east best parking: garage procedure: venous catheterization, not elsewhere classified diagnoses: congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified unspecified septicemia severe sepsis systolic heart failure, unspecified pulmonary collapse other and unspecified hyperlipidemia septic shock automatic implantable cardiac defibrillator in situ cardiac pacemaker in situ unspecified accident injury to bladder and urethra, without mention of open wound into cavity accidents occurring in unspecified place atrioventricular block, unspecified urethral stricture, unspecified 

Answer: The patient is high likely exposed to