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: transfer from osh for pacemaker removal. this is a 70 yo man c hx of t2 dm, cad, bovine avr, ischemic cardiomyopathy ef 30-35% .pt had aicd placed in . admitted on for aicd pocket infection. aicd was removed and placed on the opposite side. he received 4 weeks of vancomycin through picc line. pt presented to with 2 week history of fever and chills. he had an elevated wbc of . blood cultures had coag (-) staph pan sensitive. tee echo done showed thickening of tricuspid valve , no clear vagetations. there is question of vegetations in the aicd leads.ef was 40%. pt has been seen by id specialists who recommended oxacillin, rifampin and gentamycin. he is on day # 6 pt's blood culture form and have been negative and patient has remained afebrile since starting atb therapy. pt transfered to for removal of aicd and pacemaker leads in the or. . . . pmh cad s/p lad ptca years ago. diabetic neuropathy copd hypothyroidism cva bovine aortic valve replacement hyperlipidemia gerd chronic back pain lumbar sympathectomy . medications on transfer . oxacilllin 2 g q 4 h gentamycin 100 mg q 8 h rifampin 300 q 8 h levothyroxine 150 mcg qd oxycodeone tylenol spironolactone 25 qd metoprolol 50 qd asa neurontin 300 ms contin 30 oxycontin 20 q 3 h prn back pain. lipitor 40 lasix 40 insulin glargine 80 u a lispro ss mvi senna pantoprazole . . allergies nkda . social hx . retired truck driver married .has 10 children no smoking for last 5 years .prior to that smoked 2 packs a day. no etoh or ivdu. . . family hx sister c diabetes. no other known family hx. pe vs t 98 bp 132/90 hr 95 rr 16 gen: obese man nad, lying on stretcher, heent: eomi, perrla (2 mm pupils), neck: no jvd, thyromegaly. r ij c no signs of infection. resp: cta bl cv: brady rr sisem ii/vi 3rd intercostal space. abd: soft ntnd +bs ext: no edema neuro: cn 2-12 intact, ue+le strength, no pronator drift, strength and sensation grossly intact bilaterally . a/p 70 to man c ischemic cm, chf ef 30% , s/p aicd/ pacemaker insertion 6 months ago presents c new mssa bacteremia # mssa bacteremia: most likely secondary to aicd-pacemaker pocket infection. tee no c signs of ie. however there was some concern of possible vegetations on aicd leads. discussed case c ep fellow if this is the case , removal of aicd would need to be in the or and patient will need temporary pacemaker prior to that. -continue oxacillin, gent and rifampin. -obtain reports from of tee to evaluate for possible pfo and vegetations in the aicd leads. -gent levels peak and trough levels. -discuss c ep in am -low threshold for mri of spine considering back pain. -surveillance blood cultures. -id evaluation. # av block : temporary pacemaker in or during removal of aicd -pacemaker. . . #renal failure: pt has renal failure . no previous creatinine values available. -will give single daily dose of for 24 h. -monitor peak and trough levels -urine lytes. -continue hydration. . # cad: pt c severe cad and ischemic cm -continue asa, bblock and statins. . . # chf: continue lasix , aldactone and bblock. # hypokalemia: most likely secondary to gentamycin. replete as needed. .follow mg levels # code : full code. dispo : pending removal of aicd. major surgical or invasive procedure: re-do sternotomy, removal of infected aicd/pacer leads, placement of epicardial leads and pacemaker () diagnostic laparoscopy(negative) evacuation of pericardial tamponade evacuation of pericardial tamponade history of present illness: this is a 70 yo man c hx of t2 dm, cad, bovine avr, ischemic cardiomyopathy ef 30-35% .pt had aicd placed in . admitted on for aicd pocket infection. aicd was removed and placed on the opposite side. he received 4 weeks of vancomycin through picc line. pt presented to with 2 week history of fever and chills. he had an elevated wbc of . blood cultures had coag (-) staph pan sensitive. tee echo done showed thickening of tricuspid valve , no clear vagetations. there is question of vegetations in the aicd leads.ef was 40%. pt has been seen by id specialists who recommended oxacillin, rifampin and gentamycin. he is on day # 6 pt's blood culture form and have been negative and patient has remained afebrile since starting atb therapy. pt transfered to for removal of aicd and pacemaker leads in the or. past medical history: pmh cad s/p lad ptca years ago. diabetic neuropathy copd hypothyroidism cva bovine aortic valve replacement hyperlipidemia gerd chronic back pain lumbar sympathectomy social history: retired truck driver married .has 10 children no smoking for last 5 years .prior to that smoked 2 packs a day. no etoh or ivdu. pertinent results: 04:00am blood wbc-12.8* rbc-3.00* hgb-9.2* hct-28.3* mcv-94 mch-30.7 mchc-32.5 rdw-19.0* plt ct-133* 04:00am blood plt ct-133* 04:00am blood pt-15.0* ptt-32.1 inr(pt)-1.3* 03:01am blood pt-17.4* ptt-29.4 inr(pt)-1.6* 04:22am blood glucose-83 urean-56* creat-2.9* na-139 k-5.3* cl-104 hco3-29 angap-11 03:01am blood alt-611* ast-155* ld(ldh)-650* alkphos-217* amylase-320* totbili-3.0* 04:22am blood calcium-8.2* phos-3.9 mg-2.1 04:22am blood vanco-14.4* 04:00am blood vanco-20.0* 04:06am blood vanco-15.2* brief hospital course: , taken to the or for removal of infected pacer leads, placement of epicardial leads, and permanent pacemaker. see op note for details. post-op, he had elevated lft's, worsening acidosis, elev. wbc. general surgery consulted, and yook him to the or on for diagnostic laparoscopy which was negative. neurology service was consulted for decreased level of wakefulness. ct scan was negative for any acute infarct. he continued with low cardiac output, acidosis, pressor and inotrope requirement, and had a tee on . this showed pericardial fluid collection with signs of rv copmpression. he had evacuation of pericardial tamponade/washout at the bedside on . over the next few days, he improved hemodynamically, drips were eventually weaned off. his mental status also improved significantly as well. he was extubated on , and stable from cardiac and respiratory standpoints. he did, however, have rising creatinine which the renal service attributed to atn. he remained non-oliguric, his creatinine peaked at 6.5, but has steadily decreased throught the remainder of his stay. on , he was again noted to have elevarted lft's, acidosis, and decreased cardiac output. he underwent evacuaiton of pericardial tamponade on . he has continued to make steady pregress in all areas, had remained hemodynamically stable, and is now ready to be discharged to rehab for continued physical therapy to increase mobility. medications on admission: oxacilllin 2 g q 4 h gentamycin 100 mg q 8 h rifampin 300 q 8 h levothyroxine 150 mcg qd oxycodeone tylenol spironolactone 25 qd metoprolol 50 qd asa neurontin 300 ms contin 30 oxycontin 20 q 3 h prn back pain. lipitor 40 lasix 40 insulin glargine 80 u a lispro ss mvi senna pantoprazole discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for temperature >38.0. 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. levothyroxine 100 mcg tablet sig: 1.5 tablets po daily (daily). 5. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 6. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). 7. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: puffs inhalation q4h (every 4 hours) as needed. 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical qd/prn (). 10. tramadol 50 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 11. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day): until fully ambulatory. 12. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 13. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). 14. epoetin alfa 10,000 unit/ml solution sig: 0.5 ml injection twice weekly, q tues/fri () as needed for chronic kidney disease: 5000 units. 15. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 16. gabapentin 300 mg capsule sig: one (1) capsule po twice a day. 17. vancomycin 1,000 mg recon soln sig: one (1) gm intravenous once a day: please dose daily for level < 20 last dose . discharge disposition: extended care facility: hospital - discharge diagnosis: infected pacemaker lead pericardial tamponade acute renal failure chronic back pain dm copd cva (in ) gerd hypothyroidism cad s/p avr cri discharge condition: good discharge instructions: no lifting > 10# for 10 weeks may shower, no bathing or swimming for 1 month no creams lotions or powders to any incisions followup instructions: with dr. in 2 weeks, or upon discharge from rehab with dr. upon dischrge from rehab with pcp, . in weeks please call to schedule these appointments procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters left heart cardiac catheterization diagnostic ultrasound of heart diagnostic ultrasound of heart diagnostic ultrasound of heart diagnostic ultrasound of heart diagnostic ultrasound of heart insertion of endotracheal tube fiber-optic bronchoscopy enteral infusion of concentrated nutritional substances laparoscopy reopening of recent thoracotomy site reopening of recent thoracotomy site other and unspecified repair of atrial septal defect other incision of pleura pulmonary artery wedge monitoring revision of lead [electrode] other operations on heart and pericardium incision with removal of foreign body or device from skin and subcutaneous tissue transfusion of packed cells transfusion of other serum replacement of any type pacemaker device with dual-chamber device other operations on thorax injection or infusion of nesiritide infusion of vasopressor agent diagnoses: acidosis coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension acute and subacute necrosis of liver severe sepsis unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified atrial fibrillation hematoma complicating a procedure diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes percutaneous transluminal coronary angioplasty status ostium secundum type atrial septal defect acute and subacute bacterial endocarditis heart valve replaced by transplant other candidiasis of other specified sites hemopericardium iatrogenic cerebrovascular infarction or hemorrhage infection and inflammatory reaction due to cardiac device, implant, and graft other staphylococcal septicemia other diseases of mediastinum, not elsewhere classified vascular complications of other vessels embolism and thrombosis of unspecified artery 

Answer: The patient is high likely exposed to