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 / erythromycin base / nsaids attending: chief complaint: sepsis major surgical or invasive procedure: right internal jugular central line placement right internal jugular temporary dialysis catheter placement right groin tunneled dialysis catheter placement history of present illness: pt is a 71 y/o male with htn, dm2, cad s/p cabg, chf, pvd, esrd on hd with a recent admission for mrsa hd-line sepsis who presents from hd with fever, chills, and altered mental status. he'd been in his usual state of health the night prior to admission, but at dialysis was noted to have chills; he was subsequently noted to be febrile though not hypotensive. the hd team reported purulent drainage from the hd cath site (right subclavian placed at the last admission - to , during which his mrsa infected left subclavian was removed). he has been on vancomycin since this admission, with plans for a 4 week total course due to end in 1 week. he was also notably started on coumadin at the nursing home for a l ij clot, however it is unclear how they obtained this information. . in the ed, he was febrile to 102.3, bp 135/49, hr 122, rr 16, and o2 sat 97% on ra. he was fluid resuscitated with 2 liters of ns, a right ij was placed, and he was given vancomycin, cefepime, and gentamicin. he complained of some developing sore throat. past medical history: 1)hypertension 2)dm2 3)coronary artery disease s/p cabg ; stress in with severe, fixed perfusion defect in the inferior wall; moderate sized, partially reversible perfusion defect in the lateral wall; and fixed left ventricular enlargement with decreased ejection fraction of 18%. 4)chf with ef 30% on tte, e/a 0.6 5)pvd s/p multiple amputations 6)h/o svt 7)esrd on hd 8)cva: right paramedian pontine hemorrhage 9)chronic anemia, labs consistent with acd . psh: 1)r aka 2)l bka 3)cabg social history: resident of . has two sons. > 100 pk yr history; quit 2 years ago. h/o heavy etoh use but has quit (unable to state when he quit and how much he used to drink). pt is unable to state when he quit and how much he used to drink. family history: father and mother had dm. cannot recall what they died of. physical exam: t 102.3, bp 135/50, hr 122, rr 16, spo2 98%ra gen- chronically ill appearing male, lying flat in bed, nad heent- perrl, oropharynx with dentures, clear, mmm neck- r ij in place, oozing at site, no lad chest- r subclv hd line in place with mod erythema at site cv- rrr, s1s2, murmur ulsb pul- soft breath sounds throughout, though moves air fairly well, no w/r/r abd- soft, nt, nd, nabs, no organomegaly extrm- rue without cyanosis/edema, lue with 2+ pitting edema and rubor from wrist to above elbow; right aka, left bka both sites without edema/erythema nails- no clubbing, no pitting/color changes/indentations neuro- awake, alert oriented to person/situation, place with prompting, and season. cn show mild left facial droop but otherwise intact. motor/sensory show no focal deficits. pertinent results: ecg: nsr, lateral mild st-depr, no significant change from prior cxr: no infiltr, effusion, or chf - l ue us: left internal jugular and subclavian vein deep vein thrombosis. - near occlusive thrombus in the right internal jugular vein, which has increased since the previous exam. these findings were relayed to the clinical service on . the remainder of the examination is unremarkable. cxr : the lateral aspect of the left lung and left costophrenic angle are not included on this radiograph. the patient is status post median sternotomy, and there is fragmentation of the superior-most wire. the right ij catheter terminates within the lower svc. there is no evidence for pneumothorax. there is patchy opacity overlying the right lower lung zone, which may relate to developing atelectasis/consolidation. tee: no atrial septal defect is seen by 2d or color doppler. there is moderate regional left ventricular systolic dysfunction included inferior akinesis, anterior hypokinesis, and anteroseptal and inferoseptal hypokinesis. overall left ventricular systolic function is moderate to severely depressed. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the aortic arch and complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened. no masses or vegetations are seen on the aortic valve. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. no mass or vegetation is seen on the mitral valve. mild to moderate (+) mitral regurgitation is seen. there is no pericardial effusion. admit labs: 09:55am lactate-5.1* 09:55am glucose-122* urea n-20 creat-3.3* sodium-139 potassium-5.2* chloride-106 total co2-19* anion gap-19 11:08am fibrinoge-113* 11:08am pt-27.2* ptt-45.6* inr(pt)-5.5 11:08am plt smr-low plt count-93* 11:08am hypochrom-2+ anisocyt-1+ poikilocy-occasional macrocyt-2+ microcyt-normal polychrom-normal ovalocyt-occasional 11:08am neuts-85.4* bands-0 lymphs-9.8* monos-3.8 eos-0.6 basos-0.3 11:08am wbc-4.5 rbc-2.95* hgb-9.2* hct-30.0* mcv-102* mch-31.4 mchc-30.8* rdw-14.9 11:08am ck-mb-notdone 11:08am ctropnt-0.04* 11:08am lipase-6 11:08am alt(sgpt)-16 ast(sgot)-19 ck(cpk)-22* alk phos-128* amylase-6 tot bili-0.4 11:44am lactate-3.4* 12:20pm urine rbc-0-2 wbc-0-2 bacteria-none yeast-none epi-0 trans epi-0-2 12:20pm urine blood-neg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-8.0 leuk-neg 12:43pm lactate-2.3* 02:21pm lactate-1.3 discharge labs: 07:45am blood wbc-3.6* rbc-3.05* hgb-9.8* hct-30.5* mcv-100* mch-32.1* mchc-32.1 rdw-15.2 plt ct-92* 07:45am blood plt ct-92* 07:45am blood glucose-103 urean-15 creat-3.5* na-135 k-4.2 cl-101 hco3-26 angap-12 07:45am blood albumin-2.5* calcium-7.8* phos-3.4 mg-1.6 anti- factor 10a level on was 0.22 (low) inr on was 1.4 brief hospital course: # sepsis -- patient was started on broad spectrum abx with vancomycin and ceftazidime. bp remained stable. he did not require pressors. his lactic acid trended down from 5. source of infection thought to be right subclavian hd catheter vs b/l internal jugular and subclavian thrombosis (septic thrombophlebitis). he had been treated with vanco at hd since his last admission for mrsa bacteremia. he had a tee which was negative for vegetations during his last admission. he received linezolid and ceftaz initially for concern for pseudomonas and vre. id was consulted and felt the cause of his sepsis was likely a persistent mrsa infection and not vre. he was continued on vanco at hd. he will complete a 6 week course to end on . he will have follow-up b/l ue u/s. he will be seen in the clinic to determine the need for further treatment at that time. his urine and blood cultures were w/o growth at the time of discharge. a right groin tunneled dialysis catheter was placed on and his temporary right ij line was removed. a repeat tee on was negative for vegetations. # nsvt: he had two 20 beat runs of vt while off his b-b. they did not recur once his b-b was restarted and his mg was aggressively repleted. also, his bb was increased. consider ep consult for aicd placement as an outpatient once his infection and thromboses have resolved. # right and left ij venous thrombus and left subcalvian venous thrombus. right u/s revealed >80% stenosis of ij. he was maintained on a heparin gtt (hit ab negative) until his tunneled dialysis cath was placed. he was started on lovenox 30mg qd as a bridge to a theraputic inr. his initial coumadin dose was 10, then 7.5, then he was discharged on 2. the lovenox will be stopped once his inr is above 2. # coagulopathy. elevated inr (5.5) on admission thought to be secondary to coumadin and malnutrition. he was given vit k. # dic. his labs were concerning for dic given his thrombocytopenia, low fibrinogen, occasional schistocytes on smear, low haptoglobin, elevated fdp's and d-dimer level. however his ldh was normal. his dic labs remained stable throughout his hosptial stay. hit ab was negative. his sepsis was treated aggressively. he initially received ffp and vit k prior to dialysis catheter removal. he needs to have his plts monitored as an outpatient. if they do not return to baseline he should f/u with a hematologist. # cad -- ecg with slight lateral st-depressions, not significantly changed from baseline. his trop was stable (baseline elevated secondary to renal failure). his asa and plavix were restarted prior to discharge. his plavix was held to low platlets and it can be restarted after checking a cbc in a week. # chf -- he was euvolemic without evidence of chf on cxr. his was continued on lisinopril 5 mg daily and metoprolol 50 mg tid (b-b was titrated up as tolerated). these were held when he was septic. he was euvolemic at discharge. # esrd on hd trsatmon. vanco was dosed at dialysis. epo was given at dialysis. # anemia to esrd. he was transfused to keep his hct > 28 given h/o cad and pvd. he was given epo at dialysis. # swallowing: pt received a speech and swallow evaluation for aspiration risk and a video swall eval. it was determined that he does not aspirate during these studies ane can have normal fluids. # comm -- with nh; hcp is h , w and/or h , cell . # code -- dnr/dni, this was confirmed with the patient. medications on admission: coumadin 2 mg po daily albuterol inh q6 hours prn percocet 5/325 mg po q6 hours prn reglan 10 mg po qachs zestril 2.5 mg po mwf prevacid 30 mg po bid folic acid t mg po daily plavix 75 mg po daily iron sulfate 325 qd reglan 10 mg po before meals and at bedtime - hold on dialysis days vitamin c 500 mg po daily lomotil t tab po t, thurs, sat lopressor 12.5 mg po 3x/day nephrocap 100 mg po qd atarax 25 mg po 3x daily prn novasource, renal 120 cc po tid lipitor 20 mg po daily tylenol prn bisacodyl 10 m supp senna nystatin 2% powder tp 4 times daily to groin insulin ssi, lantus 6u sq qhs mom questran 4g 1 packet mixed with h2o daily artificial tears to both eyes prn discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. ascorbic acid 500 mg tablet sig: one (1) tablet po daily (daily). 5. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 6. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 7. prevacid 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 8. albuterol 90 mcg/actuation aerosol sig: one (1) inhalation every six (6) hours as needed for shortness of breath or wheezing. 9. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 10. nystatin 150,000,000 unit powder sig: one (1) miscell. every six (6) hours as needed: to groin. 11. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 12. metoclopramide 10 mg tablet sig: 0.5 tablet po qid (4 times a day): hold on dialysis days . 13. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 14. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 15. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed). 16. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 17. enoxaparin 30 mg/0.3 ml syringe sig: one (1) subcutaneous q24h (every 24 hours) for 2 days: md lovenox dose daily based on anti-factor 10a levels. 18. humalog 100 unit/ml solution sig: asdir subcutaneous asdir per sliding scale. 19. insulin glargine 100 unit/ml solution sig: four (4) units subcutaneous at bedtime. 20. warfarin 2 mg tablet sig: one (1) tablet po daily (daily): patient should have qweek inr drawn. 21. heparin flush cvl (100 units/ml) 1 ml iv daily:prn 10ml ns followed by 1ml of 100 units/ml heparin (100 units heparin) each lumen daily and prn. inspect site every shift 22. vancomycin hcl 1000 mg iv qhd dialysis nurses will give. no longer need to check level. 23. plavix 75 mg tablet sig: one (1) tablet po once a day: on hold until his platlets are above 100. 24. iron 325 (65) mg capsule, sustained release sig: one (1) capsule, sustained release po once a day: to be given with vit c. 25. lomotil 2.5-0.025 mg tablet sig: one (1) tablet po once a day as needed for diarrhea. 26. questran 4 g powder sig: one (1) po once a day: mixed with water. discharge disposition: extended care facility: nursing & rehabilitation center - discharge diagnosis: sepsis bilateral upper extremity thrombi end stage renal disease discharge condition: fair discharge instructions: please call your primary care physician or return to the hospital if you experience fever, chills, worsening ue edema, shortness of breath, chest pain, or have any other concerns. you are scheduled to have an ultrasound of your arms on at 10 am. please do not miss . followup instructions: please follow-up with dr. (pcp) at the nh in one week. you have the following appointments scheduled: 1. provider: study where: cc clinical center radiology phone: date/time: 10:00 2. provider: , md where: lm disease phone: date/time: 10:30 procedure: venous catheterization, not elsewhere classified diagnostic ultrasound of heart hemodialysis venous catheterization for renal dialysis transfusion of packed cells transfusion of other serum injection or infusion of oxazolidinone class of antibiotics diagnoses: anemia in chronic kidney disease congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified protein-calorie malnutrition severe sepsis infection with microorganisms resistant to penicillins aortocoronary bypass status peripheral vascular disease, unspecified methicillin susceptible staphylococcus aureus septicemia paroxysmal ventricular tachycardia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease infection and inflammatory reaction due to other vascular device, implant, and graft other and unspecified coagulation defects below knee amputation status above knee amputation status family history of diabetes mellitus 

Answer: The patient is high likely exposed to