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: chest pain, empyema major surgical or invasive procedure: : transfer to micu and intubation : vats procedure with placement of three chest tubes 07-: placement of right ij line : extubation and removal of three chest tubes : removal of right ij line history of present illness: 34yr old female with hx of substance abuse, hepatitis c who developed back pain 5 days prior to admission. over the next 2 days, the pain became pleuritic and she developed increasing shortness of breath and a productive cough. she noted fevers to 102. pt used cocaine to numb her pain but any movement made the pain worse. she denied chest pain, orthopnea, pnd, edema, weight loss and night sweats. pt called ems and was brought to . there, pt was found to have an effusion and pna on cxr. given that the effusion was loculated, it was tapped using ct guidance. the thoracentesis revealed 20 cc of turbid fluid with gelatinous appearance. based on lab results (see below), effusion consistent with a parapneumonic effusion vs empyema. pt was then started on clinda/flagyl/ceftriaxone transferred to for vats procedure. . on arrival to , pt was evaluated by surgery and scheduled for vats on . on the day following admission, pt was doing well, satting in the low 90s on ra. however, during the evening, pt's pain increased, she began splinting, breathing at 30-40 and her room air sats dropped to 70%. she was placed on a nrb and her sats improved to 90s. she was then transferred to the micu for elective intubation and pain control prior to vats. . allergies: nkda past medical history: 1. polysubstance abuse - currently on methadone, recent cocaine use 2. hepatitis c 3. spontaneous abortion () with persistent spotting, inc b-hcg 4. asthma 5. nephrolithiasis 6. s/p appendectomy social history: pt lives with a friend. she has a three year old daughter who is currently in the custody of the dss. pt has a mother but did not want her involved regarding the details of her care. pt used heroin in the past but reported only iv cocaine use prior to admission. denies etoh. current tobacco use. - current psa: on needle exchange, current cocaine use, prior heroin use, on methadone - has been in jail multiple times - denied tuberculosis exposure family history: father with lung cancer physical exam: exam: temp 100.3, bp 114/79, hr 90, rr 36, o2 71% ra --> 94% on nrb gen: sleepy but arousable to voice, answers questions appropriately; tachypneic heent: perrl, eomi, mm dry, scabbed ulcer on upper left lip cv: rrr, no murmurs chest: short insp breaths pain, crackles heard throughout, decreased on right side way up chest abd: +bs, soft, ntnd, obese back: tender over right lower back ext: no edema, 2+ dp skin: multiple track marks on both hands; no splinter hemorrhages or spots pertinent results: osh labs: ** pleural fluid: yellow cloudy fluid wbc 560, 95% neuts, 4% lymphs rbc 1110 tp 5.3 ldh 942 glucose 2 culture: no growth . . labs: admission labs: 02:30am blood wbc-15.6* rbc-3.76* hgb-10.3* hct-30.4* mcv-81* mch-27.2 mchc-33.8 rdw-11.9 plt ct-289 02:30am blood neuts-84.9* lymphs-10.0* monos-3.9 eos-0.8 baso-0.3 02:30am blood pt-12.9 ptt-26.1 inr(pt)-1.1 02:30am blood glucose-122* urean-10 creat-0.5 na-141 k-3.7 cl-107 hco3-25 angap-13 02:30am blood calcium-8.3* phos-3.8 mg-1.8 02:30am blood hcg-22 08:40am blood hiv ab-negative microbiology: blood cultures: - no growth - no growth - no growth - no growth - no growth . hiv ()- negative . pleural tissue: - gram stain with 2+ pmns and no organisms- cultures pending. - sparse oxacillin resistant coag + staph aureus. . . radiology: : cxr: similar to prior though with worse inspiration: findings most likely consistent with pneumonia. loculated pleural effusion to suggest empyema. : the heart size and mediastinal contours are unchanged. there has been interval removal of the right-sided chest tubes. interval increase in size of a right pneumothorax. stable right pleural effusion layering within the fissure and stable bibasilar atelectasis. the osseous structures appear unchanged. : since the previous examination of , the right subclavian venous access catheter appears in unchanged position. there is stable enlargement of the cardiac silhouette. no pulmonary edema. bilateral pleural effusions, more prominent on the right and bibasilar atelectasis appear similar. no pneumothorax. . chest ct: 1. multifocal pulmonary and parenchymal consolidation, most prominent within the right lower lobe, consistent with pneumonia. 2. bilateral pleural effusions. the right pleural effusion is loculated with suggestion of peripheral enhancement, indicating the possibility of infected effusion/empyema. 3. mild cardiomegaly and possible mild congestive heart failure. . . discharge labs: 05:26am blood wbc-9.7 rbc-3.93* hgb-10.4* hct-31.1* mcv-79* mch-26.5* mchc-33.4 rdw-12.3 plt ct-625* 05:26am blood neuts-61.9 lymphs-25.6 monos-5.9 eos-6.0* baso-0.6 05:26am blood plt ct-625* 06:33am blood glucose-88 urean-6 creat-0.5 na-140 k-4.1 cl-102 hco3-30 angap-12 04:12pm blood alt-13 ast-15 ld(ldh)-173 alkphos-63 amylase-40 totbili-0.3 brief hospital course: 1. empyema: patient was admitted to on with known diagnosis of empyema from osh. she was admitted for planned vats and drainage of infected fluid.on the day of admission. upon admission she was receiving ceftriaxone, flagyl, and clindamycin which was continued upon admission. the patient was evaluated by thoracic surgery with planned right thoracotomy and vats procedure for loculated right pleural effusion. however, the patient became increasingly tachypnic on the floor with decreasing o2 saturation requiring intubation and transfer to the micu and flagyl was discontinued. on the patient underwent vats with decortication and placement of three chest tubes. patient failed original weaining trials secondary to sedation. additionally, as the patient continued to spike despite abx coverage, the patient was changed from ceftiaxone and clindamycin to zosyn and vancomycin for broadened coverage. the patient was successfully extubated on and the patient's chest tubes were removed without complication. the patient was transferred back to the medical service after successful extubation, afebrile with a resolving leukocytosis and all blood cultures with no growth. however, pathology from pleural tissue removed from the vats demonstrated oxacillin resistant staph aureus. the patient was continued on zosyn and vancomycin and remained afebrile while on the floor. the patient was found additionally to have a small pneumothorax s/p removal of chest tubes which remained stable with some resolution while patient was on medicine service. the patient remained afebrile and clinically stable with good os sats without o2 support. the patient was discharged to home with linezolid 600mg for 1 week for coverage of her known mrsa infection. the patient was discharged with plans to follow up with her pcp . for blood work and follow up. . 2. back/chest pain: the patient was in significant pain upon admission and was thought to be splinting which contributed to her respiratory distress. the patient was electively intubated as described above and given adequate pain control while intubated. after extubation, the patient was given her usual methadone dose of 60mg po daily as well os percocet 1-2 tabs every 4 to 6 hours with adequate control. . 3. substance abuse: prior to admission the patient was planned to undergo a methadone taper. she was continued on a maintenance dose of 60mg po qd while in house, but contact was made with her methadone clinic to make them aware of her dosing as well as her recent cocaine use. . 4. pneumothorax: s/p extubation and chest tube withdrawal on the patient was noted to have a small pneumothorax. this was followed daily and assessed to be stable with some resolution. the patient was instructed to follow up with her pcp and ensure full resolution. . 5. gyn: patient was known to have recent miscarriage and ongoing spotty bleeding. the patient' b-hcg was 25, down from 970 in . gyn was consulted and advised that the b-hcg was consistent with resolving from previous miscarriag rather than an ongoing ectopic and signed off with advise that a follow up hcg be performed in a week. the patient upon discharge was advised to have a repeat b-hcg performed when she went to see her pcp. medications on admission: 1. docusate 100 mg 2. methadone 60 mg daily 3. metoclopramide 10 mg iv q6h 4. pantoprazole 40 mg daily 5. zosyn 4.5 mg iv q8h 6. vancomycin 1000 mg q12h 7. sc heparin tid discharge medications: 1. linezolid 600 mg tablet sig: one (1) tablet po twice a day for 1 weeks: please complete entrie course of antibiotics,even if feeling better. thank you. disp:*14 tablet(s)* refills:*0* 2. methadone 10 mg tablet sig: six (6) tablet po daily (daily): you will need to obtain this through your methadone treatment center. 3. docusate sodium 100 mg capsule sig: one (1) capsule po twice a day. disp:*60 capsule(s)* refills:*0* 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for 1 weeks. disp:*25 tablet(s)* refills:*0* 5. outpatient lab work please check a cbc on . thanks. discharge disposition: home discharge diagnosis: primary diagnosis: right sided empyema and paraneumonic effusion secondary diagnosis: drug abuse- iv cocaine hepatitis c asthma discharge condition: stable. patient's oxygen saturation mid to high 90's on room air. patient afebrile. patient with small stable right pneumothorax s/p removal of three chest tubes on . discharge instructions: 1. please keep all follow up appointments. 2. please take all medications as prescribed. 3. seek medical attention for fevers, chills, chest pain, shortness of breath, bleeding from the chest tube sites, or any other concerning symptoms. 4. you must follow up at community health center on . it is very important that you have lab tests while on the linezolid. you will have a lab draw and a physician's appointment on . 5. it is extremely important that you avoid all drugs and alcohol. you have been very sick and these could slow your recovery. followup instructions: 1. please follow up with dr. at community health center on thurs at 9:45. if you have any questions or need to change this appointment time, please call . 2. it is very important that you follow up in cardiothoracic surgery clinic. i have called and they will be contacting you with an appointment within the next two weeks. if you do not hear from them with an appointment time within two days, please call . procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances decortication of lung diagnoses: anemia, unspecified chronic hepatitis c without mention of hepatic coma acute respiratory failure iatrogenic pneumothorax methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site empyema without mention of fistula laparoscopic surgical procedure converted to open procedure cocaine dependence, in remission 

Answer: The patient is high likely exposed to