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: hematuria, chills major surgical or invasive procedure: none history of present illness: 79 yo m h/o htn, esrd to htn nephropathy, dementia, bph, lbp p/w hematuria, chills. pt was recently admitted for penile discharge. was consulted and placed a foley which revealed purulent discharge. pt was placed on daily irrigation with abx, though this was discontinued at the time of d/c with plans for out-pt f/u with . also during that admission, multiple cxs grew out e coli. pt was discharged with plans for tx with with hd x 4 weeks. initially the pt felt well after discharge and had no complaints. however, yesterday pt noted mild "chills and sweats." this am pt noted large amount of hematuria, but he and his wife decided to go to hd. pt with worse chills and sweats at hd. given persistent symptoms and worsening hematuria, pt's wife brought him to . . in ed, vitals: 96.1, hr 70, 110/50, rr 18, 96% ra. lactate 1.8. bun 23, cr 5.6. hct 35, baseline 41. cxr with patchy retrocardiac opacity, likely atelectasis. ekg: nsr@78 bpm, lad, rbbb, twf v2-3 (new). consulted and foley was palced. renal called for hd and elected to hold on dialysis today. lij placed for access (white port not flushing). pt given vanc 1 gram, gent 80 mg for ? endocarditis, flagyl 500 mg given for prior h/o b frag bacteremia (on admission ), given for prior e coli bacteremia, tylenol 325 mg. home bp meds held. pt started on labetalol gtt for elevated sbps to 270s, which were controlled. however, pt's sbps dropped to 70s. drip turned off and pt bolused with sbp to 120s. pt transferred to micu for further management. . ros: denies chest pain, abdominal pain, nausea, vomiting, or shortness of breath past medical history: -esrd related to htn nephropathy s/p av graft in both arms, r arm was functional until the past 24h -htn x >20 yrs -multivascular dementia -bph -chronic lbp with djd, spinal stenosis -macrocytic anemia, unclear etiology -bacteremia - - ecoli and b. fragilis; - ecoli -prostatitis - - ct of prostate with hypodense area and ecoli in penile discharge swab and . daily bladder irrigation through the foley with fluid containing neomycin-polymyxin was done. pt discharged on 4 weeks of as endocarditis not ruled out on tee. social history: lives w/ wife in . retired plumber; no tob, etoh or drugs; no recent sexual activity. family history: nc physical exam: vitals- 98.4, 158/p, 78, 20, 100% ra gen - alert, no acute distress, but appears confused. heent - perrl, extraocular motions intact, anicteric, mmm neck - no jvd, no cervical lymphadenopathy, central line left neck without erythema chest - clear to auscultation bilaterally cv - irregularly irregular, nml s1,s2. no murmurs noted. abd - soft, nontender, nondistended, with normoactive bowel sounds extr - 2+ dp, pt pulses bilaterally, no edema or cyanosis, warm and well perfused. skin - no rashes or petechiae noted. foley catheter in place. draining bright red . pertinent results: 02:10pm plt count-255 02:10pm hypochrom-2+ anisocyt-1+ macrocyt-3+ 02:10pm neuts-75.6* lymphs-16.1* monos-3.9 eos-2.9 basos-1.6 02:10pm wbc-6.6# rbc-3.49* hgb-11.4* hct-35.8* mcv-103* mch-32.7* mchc-31.9 rdw-17.2* 02:10pm calcium-9.2 phosphate-3.8# magnesium-2.0 02:10pm ck-mb-notdone ctropnt-0.28* 02:10pm ck(cpk)-94 02:10pm estgfr-using this 02:10pm glucose-136* urea n-23* creat-5.6*# sodium-142 potassium-3.8 chloride-94* total co2-36* anion gap-16 02:27pm lactate-1.8 02:27pm type- comments-not specif 12:00am hct-28.9* . chest (portable ap) 2:33 pm upright ap chest: heart size is normal, though there is a left ventricular configuration. mediastinal and hilar contours are unchanged. there is minimal patchy opacity in the retrocardiac area which likely reflects atelectasis. there is no definite consolidation. no evidence of failure. no pleural effusion or pneumothorax. flecks of dense material are seen within the bowel, likely reflecting bits of retained barium from recent ct. -minimal patchy opacity in the retrocardiac region likely reflects atelectasis. to better evaluate this area, a lateral view could be obtained. . ekg baseline artifact. sinus rhythm. atrial ectopy. left axis deviation with left anterior fascicular block. right bundle-branch block. compared to the previous tracing of no significant diagnostic change. . - tte the left atrium is dilated. the right atrium is moderately dilated. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. compared with the prior study (images reviewed) of , there is sginificant change. no vegetation is seen on either study. brief hospital course: 79 yo m h/o htn, esrd to htn nephropathy, dementia, bph, lbp p/w hematuria, chills. . in micu continued , flagyl and vanc dosed by levels. foley with numerous clots, periodically flushed. dialysis planned for tuesday as per renal, with 2 grams iv to be given during hemodialysis. stabilized bp on home meds. question of vegetation on tte admission. . #fever/chills: question of endocarditis (especially given previous echo) vs. prostatic infection, abscess. vanc and flagyl dc'd shortly after initiation. continued 2 gm per dialysis. tte with no evidence of vegetation. wife would not like tee at this time. e-coli bacteremia noted. frequent bouts of prostatis, but family not interested in turp at this time. ~6 week course of . . #hematuria: ddx includes prostatitis v abscess v prior trauma from foley placement. foley in place by . monitored crit which were stable. had replaced the 16f coude catheter placed in ed, numerous clots irrigated from the bladder. as patient did not produce much urine, it was difficult to tell whether foley was clotted vs. his baseline anuria. irrigated the foley regularly to clear out any residual clots. clear urine at the time of discharge. patient denied any pain. no white count or fever, hemodynamically stable. transfused prbc's last 2 units on . follow up. . esrd: on hd as an out-pt. dialysis as per renal during admission. electrolytes stable. continued sevelamer, nephrocaps, caco3, cinacalcet. . #htn urgency: transient htn, resolved with gtt and now stable on no meds. transient hypotension, likely related to labetolol drip. no evidence of sepsis. continue amlodipine and metoprolol . stable pressure on the floor up to discharge. . #elevated tpn: in setting of renal failure. minimal non-specific ekg changes. pt asymptomatic. pt was ruled out. . #fen: renal/hh diet, ivf as above #ppx: pneumo boots, po diet #full code medications on admission: amlodipine 7.5 mg daily metoprolol tartrate 25 mg levothyroxine 25 mcg daily cinacalcet 30 mg daily nephrocaps ceftazidime 2 gm qhd x 4 weeks (). sevelamer 800 mg tid calcium carbonate 500 mg tid . meds on transfer to the floor: levothyroxine sodium 25 mcg po daily amlodipine 7.5 mg po daily metoprolol 25 mg po bid calcium carbonate 500 mg po tid w/meals nephrocaps 1 cap po daily ceftazidime 2 gm iv qhd senna 1 tab po bid:prn cinacalcet hcl 30 mg po daily sevelamer 1600 mg po tid docusate sodium 100 mg po bid discharge medications: 1. cinacalcet 30 mg tablet sig: one (1) tablet po daily (daily). 2. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 3. levothyroxine 25 mcg tablet sig: one (1) tablet po daily (daily). 4. sevelamer 800 mg tablet sig: two (2) tablet po tid (3 times a day). tablet(s) 5. calcium carbonate 500 mg tablet, chewable sig: two (2) tablet, chewable po tid w/meals (3 times a day with meals). 6. amlodipine 5 mg tablet sig: 1.5 tablets po daily (daily). disp:*60 tablet(s)* refills:*0* 7. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 8. ceftazidime 2 gm iv qhd discharge disposition: home discharge diagnosis: primary: e-coli bacteremia prostatitis hematuria hypertension esrd secondary to hypertensive nephropathy . secondary: s/p av graft in both arms, r arm is functional multivascular dementia bph chronic lbp with djd, spinal stenosis macrocytic anemia discharge condition: stable discharge instructions: you were admitted with fever, chills, bleeding from urethra with clots. your pressure was also very elevated, and then dropped after being placed on a labetolol drip. you were given dialysis, foley catheter placed and flushed. you were continued on , antibiotic given to you at dialysis. a repeat tte demonstrated no vegetation concerning for endocarditis, and your wife would not like a tee at this time. -please continue 2 grams every dialysis until id follow up on . a decision will be made at that time to continue with or to have course of cipro or bactrim. -you will have a 6 week course of for your e-coli bacteremia, prostatis. -you will need your lft's and cbc checked weekly at dialysis. -please maintain all appointments, with your , and kidney doctors. -please return to the hospital if you are feverish, have bleeding through your urethra, altered mental status, severely elevated pressure, or any other symptoms concerning to you or your wife. . changes to your medications: -your metoprolol was increased to 50 mg twice daily -sevelamer was increased to 1600 three times a day followup instructions: provider: md. phone : date/time 3:00 pm -will follow up on pending culture results. . please follow up with dr. tomorrow at dialysis in . discussed with mrs. , and she will see dr. . provider: unit phone: date/time: 10:00 . provider: , md phone: date/time: 9:30 procedure: venous catheterization, not elsewhere classified hemodialysis diagnoses: end stage renal disease hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hypotension, unspecified bacteremia vascular dementia, uncomplicated unspecified deficiency anemia chronic prostatitis 

Answer: The patient is high likely exposed to