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: penicillins / oxycodone hcl/acetaminophen attending: chief complaint: feeling unwell, hypertensive urgency major surgical or invasive procedure: dialysis history of present illness: pt is a 22 yo female with lupus, end-stage renal disease on hd, htn, multiple other medical problems as below who presents with feeling unwell and found to be in hypertensive urgency. pt states that last thursday, five days ago, she started to feel unwell. states that she had chills, no fever, a "weird feeling in my stomach" with cramps, and no cough. no diarrhea. no dysuria. pt missed her dialysis session on saturday because she was feeling unwell (3 days ago). per patient she started to feel better that day, but today, started to feel unwell with the same symptoms. no sick contacts. . in the ed, vs on arrival were: hr: 73; bp: 222/128, 100% ra. she was given labetalol 20 mg iv, 40 mg iv, and then started on a labetaolol gtt.she was also calcium gluconate 1 am iv, kayexalate 30 mg po x 1, 10 units of insulin iv, and 1 amp of d50. . of note, pt was recently admitted to at the end of for left uveitis/endophthalmitis. she the developed endophthalmitis and had her l eye enucleation. she states that she went to her appt at 5 days ago. they said that her eye "looked good" and she was to continue on the same amount of prednisone that she is on. . her last admission she was also noted to have coag negative staph bacteremia. she was discharged on 14 day course of vancomycin but she somehow did not receive this at dialysis. she has now had 4 sets bld cx + for coag negative staph and was started on vancomycin. past medical history: 1. lupus - . diagnosed after she began to have swolen fingers, a rash and painful joints. 2. esrd secodary to sle - . was initially on cytoxan, 1 dose every 3 months for 2 years until began dialysis 3 times a week in (t, th, sat). awaiting living donor transplant from mother. 3. htn - . normal bps run 180's/120's. has had 1 hypertensive crisis that precipitated seizures in the past. 4. uveitis secondary to sle - 5. hocm - per echo in 6. vaginal bleeding 7. mulitple episodes of dialysis reactions 8. anemia 9. coag neg. staph bacteremia and hd line infection - 10. h/o ue clot, was on coumadin, but no longer social history: lives in with mother and 16 year old brother. graduated school and then got sick so currently is not working or attending school. denies any t/e/d. family history: no family history of sle. gf: htn. no clotting disorders in family. no history of autoimmune disease. physical exam: vs: t: 97.8; bp: 203/133; hr: 100; rr: 15; o2: 100 ra gen: speaking in full sentences in nad heent: left eye patch. refuses to let examine/look. right eye reactive. sclera anicteric. op clear. neck: no lad cv: rrr s1s2. no m/r/g lungs: cta b/l with good air entry and flow abd: soft, nt, nd. back: no spinal, paraspinal, or cva tenderness ext: no edema. dp 2+ neuro: a&o x 3, ms intact. pertinent results: ekg: sinus at 75. normal axis. normal intervals. early repolarization in anterior precordium. no acute changes. lvh. . radiology: cxr pa/lat - large-bore inferior approaching right-sided dialysis catheter is unchanged in position terminating within the right atrium. the lungs are clear and cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. no evidence of pneumothorax or pulmonary edema. . 06:20am wbc-7.4 rbc-3.85*# hgb-11.2*# hct-35.3*# mcv-92 mch-29.1 mchc-31.8 rdw-20.9* 06:20am neuts-91.1* lymphs-7.7* monos-1.1* eos-0.1 basos-0 06:20am plt count-202 . 06:20am glucose-100 urea n-40* creat-5.2* sodium-138 potassium-6.3* chloride-109* total co2-18* anion gap-17 . 04:10pm wbc-5.6 rbc-3.47* hgb-10.3* hct-31.4* mcv-91 mch-29.6 mchc-32.7 rdw-20.6* . 04:10pm calcium-9.1 phosphate-3.6# magnesium-2.3 04:10pm lipase-54 04:10pm alt(sgpt)-20 ast(sgot)-38 alk phos-74 amylase-267* tot bili-0.3 04:10pm glucose-89 urea n-40* creat-4.9* sodium-139 potassium-5.2* chloride-109* total co2-20* anion gap-15 . and with blood cultures 4/4 + coag negative staphylococcus. and bld cultures no growth to date. . ecchocardiogram: severe symmetric lvh. normal lv cavity size. normal regional lv systolic function. hyperdynamic lvef >75%. moderate resting lvot gradient. lvot gradient increases with valsalva. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. normal aortic arch diameter. no 2d or doppler evidence of distal arch coarctation. aortic valve: normal aortic valve leaflets (3). trace ar. mitral valve: normal mitral valve leaflets with trivial mr. no mvp. tricuspid valve: normal tricuspid valve leaflets. mild tr. indeterminate pa systolic pressure. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. pericardium: no pericardial effusion. general comments: echocardiographic results were reviewed with the houseofficer caring for the patient. conclusions: the left atrium is elongated. the estimated right atrial pressure is 0-5mmhg. there is severe symmetric left ventricular hypertrophy with normal cavity size and dynamic systolic function (lvef>80%). regional left ventricular wall motion is normal. there is a moderate (25mmhg peak) resting left ventricular outflow tract obstruction that increased (64mmhg) with the valsalva manuever. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. trace aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: marked symmetric left ventricular hypertrophy with dynamic systolic function and resting lvot gradient that increased with valsalva. compared with the prior study (images reviewed) of , the severity of left ventricular hypertrophy has increased and trace aortic regurgitation is now identified. dynamic lv systolic function and the resting intracavitary gradient are similar. . ue ultrasound 1. abrupt occlusion of the right internal jugular vein and its distal most aspect as it joins with the distal subclavian vein. 2. recanalization of the left subclavian vein with some peripheral residual clot. recommend analysis of the svc, central subclavians and internal jugular veins with dedicated magnetic resonance venography, which can be performed without intravenous contrast for a global assessment of the venous patency. brief hospital course: pt is a 22 yo female with sle, esrd on hd, amongst other problems who presented with symptoms likely bacteremia. found to be in hypertensive urgency after missing a run of dialysis. she is now transferred to the floor for further managment after dialysis x 1 and starting vancomycin. . in the micu she was started kept briely on a labetalol gtt, and then restarted on her home antihypertensives and dialyzed x 1 with resolution of hypertension. she was found to be bacteremic and was started on vancomycin. she felt well and was transferred to the floor. . 1. hypertensive urgency- pt with long history of very difficult-to-control htn. she was initially on a labetalol gtt as above, was dialyzed with resolution of her htn urgency. she was then transitioned to her her outpatient medication regimen of valsartan, lisinopril, clonidine, labetalol, terazosin, and nicardipine at max doses, but because of persistent htn to the 180's she was started on hydralazine 50mg po tid on discharge. . 2. coag negative staph bacteremia: most likely source is line sepsis. she was started on vancomycin and her blood cultures cleared after 2 days in the hospital. the patient felt strongly about keeping her hd line, which was felt to be reasonable because her infection was coag negative staph. ecchocardiogram did not show any valvular vegitations. she will continue on vancomycin for 3 weeks at hemodialysis. . 3. esrd on dialysis-euvolemic clinically. had dialysis inhouse. continued sevelamer. . 4. left uveitis/endopthalmitis-continued prednisone 30 mg po qday. will also continue bacitracin-polymyxin b. . 5. lupus- not on any other medications than above. . f/e/n- insists on regular diet . access: right dialysis catheter . prophylaxis: heparin sc, ppi per outpatient . code status: full code medications on admission: nephrocaps 1 cap po daily vancomycin 1000 mg iv hd protocol vancomycin 1000 mg iv x1 duration: 1 doses diphenhydramine 25 mg po q6h:prn labetalol 600 mg po tid heparin 5000 unit sc tid acetaminophen 325-650 mg po q4-6h:prn oxycodone (immediate release) 10 mg po q3h:prn bacitracin/polymyxin b sulfate opht. oint 1 appl both eyes q8h terazosin hcl 8 mg po bid gabapentin 100 mg po qtuesday, thursday, saturday sevelamer 800 mg po tid nicardipine 40 mg po q8h prednisone 30 mg po daily sulfameth/trimethoprim ds 1 tab po qmonday, wednesday, friday lorazepam 1 mg po q4-6h:prn senna 1 tab po bid:prn docusate sodium 100 mg po bid pantoprazole 40 mg po q24h clonidine tts 3 patch 1 ptch td qfri lisinopril 40 mg po bid valsartan 320 mg po daily ondansetron 4 mg iv q8h:prn oxycodone sr (oxycontin) 70 mg po q8h discharge medications: 1. clonidine 0.3 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qfri (every friday). 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po qmonday, wednesday, friday (). 4. prednisone 20 mg tablet sig: 1.5 tablets po daily (daily). 5. nicardipine 20 mg capsule sig: three (3) capsule po q8h (every 8 hours). 6. lisinopril 20 mg tablet sig: two (2) tablet po bid (2 times a day). 7. valsartan 160 mg tablet sig: two (2) tablet po daily (daily). 8. terazosin 2 mg tablet sig: four (4) tablet po bid (2 times a day). 9. oxycodone 5 mg tablet sig: two (2) tablet po q3h (every 3 hours) as needed. 10. oxycontin 20 mg tablet sustained release 12 hr sig: 3.5 tablet sustained release 12 hrs po every eight (8) hours. 11. sevelamer 400 mg tablet sig: two (2) tablet po tid (3 times a day). 12. gabapentin 100 mg capsule sig: one (1) capsule po qtuesday, thursday, saturday (). 13. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 14. vancomycin in dextrose 1 g/200 ml piggyback sig: one (1) intravenous per hemodialysis for per hd days: per hemodialysis. 15. bacitracin-polymyxin b 500-10,000 unit/g ointment sig: one (1) appl ophthalmic q8h (every 8 hours). 16. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 17. gabapentin 100 mg capsule sig: one (1) capsule po qtuesday, thursday, saturday (). 18. labetalol 200 mg tablet sig: five (5) tablet po tid (3 times a day). 19. lorazepam 1 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for anxiety. 20. vancomycin in dextrose 1 g/200 ml piggyback sig: one (1) intravenous hd protocol (hd protochol): 1g q dialysis. 21. hydralazine 50 mg tablet sig: one (1) tablet po three times a day. disp:*90 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: primary diagnosis: hypertensive urgency coagulase negative staphylococcus bacteremia secondary diagnosis: lupus esrd s/p l eye enucleation discharge condition: good. blood pressure is in the 130s-150s systolic. her vitals are stable, she is ambulatory, and taking in po discharge instructions: please follow up as below; i have also made a new cardiology appointment for you . take all medications as prescribed; other than giving you vancomycin we have added hydralazine (a blood pressure medicine), but otherwise we have not changed any of your medicines. if you have fevers, chills, light-headedness, or other problems then you should contact your doctor because this may be a sign that your infection is not resolving. you should go for hemodialysis as scheduled saturday where they should give you vancomycin. followup instructions: provider: , m.d. phone: date/time: 1:00 dr. tuesday at 3pm with dr. in cardiology. md procedure: hemodialysis diagnoses: chronic glomerulonephritis in diseases classified elsewhere systemic lupus erythematosus end stage renal disease anemia, unspecified bacteremia unspecified iridocyclitis acquired absence of organ, eye infection and inflammatory reaction due to other vascular device, implant, and graft staphylococcus infection in conditions classified elsewhere and of unspecified site, other staphylococcus hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage v or end stage renal disease other endophthalmitis 

Answer: The patient is high likely exposed to