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: flagyl / proton pump inhibitors (benzimidazole) attending: chief complaint: altered mental status major surgical or invasive procedure: picc line placed history of present illness: mr is an 85 year old man with history of diastolic heart failure, copmlete heart block (now s/p ppm ) esrd, now on hd, h/o mrsa bacteremia and thrombocytopenia, likely secondary to drug reaction (ppi?) presenting with abdominal pain and altered mental status from rehab facility. of note, patient had been discharged on after a 10 day admission for mrsa bacteremia (last positive culture ). . patient has had a complicated recent history, starting with elective admission for d/c cardioversion of atrial fibrillation on , complicated by tachy/brady syndrome requiring permanent pacemaker, c diff infection, acute on chronic renal failure requring initiation of dialysis and most recently mrsa bactermia hd line infection. . patient transferred from after we was found to have a temp of 94.5 (no information of route) hr 82-112 rr: 22 bp: 98/78 o2 sat 94% @2l nc. paitent was found to have nausea, vomiting, increased lethargy and upper abominal pain / tenderness. in ed (per report) patient's son refused new blood draws. ct abdomen/pelvis was performed and did not reveal any acute process. osh labs: wbc: 10.5, hct: 27.9, plts: 104. na 140, k 4.5, cl 99, co2 31, bun 25, cr 6.0. alb 3.0, phos 4.9, t bili 1.0, alk phos 140, ast 23, alt 18, 76, lip 42, tni 0.17. vanc: 19.3 . . ros: patient reports abdominal pain, denies chest pain, fevers, cough, or difficulty breathing. otherwise per hpi. past medical history: # diastolic congestive heart failure: echo ef of 50% & severe lvh # atrial fibrillation previously on coumadin (until gi bleed ), failed cardioversion # s/p pacemaker placement for complete heart block # peripheral vascular disease s/p right lower extremity bypass # hiatal hernia with intrathoracic stomach (confirmed by ct) # hypertension # gout # ?prostate followed by urology (denies symptoms of bph) # chronic kidney disease (, cr 2.2, stage iii, est gfr 35) social history: patient has an insurance business and worked daily until recent sicknesses. no current tobacco use. there is no history of alcohol abuse. family history: there is no family history of premature coronary artery disease or sudden death. patient's daughter had "kidney disease" and is now s/p renal transplant. 2 sons and 1 daughter. physical exam: temp: 95.2 hr: 72 bp: 97/78 rr: 17 o2 sat: 100% 4l nc . gen: no acute distress, somnolent, arousable skin: dry, warm, lower extremity chronic venous changes heent: eomi, dry mucous membranes neck: no cervical lyphadenopathy, no thyromegaly cv: regular rate, no murmurs, rubs or gallops lungs: clear to auscultation bilaterally abd: soft, some voluntary guarding, no rebound tenderness neuro: somnolent, arousable, cn ii-xii intact, (+) asterixis pertinent results: ================== admission labs ================== 09:41pm blood wbc-9.8 rbc-2.86* hgb-9.7* hct-31.2* mcv-109* mch-33.8* mchc-31.1 rdw-16.8* plt ct-132* 09:41pm blood neuts-80.1* bands-0 lymphs-9.9* monos-2.5 eos-7.3* baso-0.3 09:41pm blood pt-14.3* ptt-44.7* inr(pt)-1.2* 09:41pm blood glucose-110* urean-30* creat-6.3* na-139 k-5.5* cl-100 hco3-30 angap-15 09:41pm blood alt-19 ast-32 ld(ldh)-275* alkphos-149* amylase-67 totbili-0.6 09:41pm blood albumin-3.7 calcium-9.4 phos-6.1*# mg-2.6 uricacd-7.4* 09:41pm blood cortsol-29.6* 09:41pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 01:31am blood vanco-30.7* 09:28pm blood type-art po2-117* pco2-73* ph-7.23* caltco2-32* base xs-0 09:28pm blood glucose-109* lactate-1.0 na-137 k-4.9 cl-97* calhco3-32* brief hospital course: #. altered mental status: differential diagnosis was very broad in this frail patient with several medical conditions, including intracraneal process, systemic infection, delirium, etc. at presentation, given x-ray findings this was felt to most likely represent hospital acquired pneumonia. patient was initiated on vancomycin, add zosyn and azithromycin for atypical coverage. cultures were obtained and after very prompt improvement, antibiotic regimen was narrowed. after no evidence of infection was found, antibiotics were discontinued and the patient continued to improve. it appears this episode of altered mental status and somnolence was not far from his baseline, currently there is no evidence of systemic infection. . #. hypotension: on admission, concern for sepsis physiology, although as above no signs of infection at this time. patient also evaluated for adrenal insufficiency, with a normal cosyntropin stimulation response. patient placed back on midodrine at time of discharge, tolerating dialysis well. . #. hypoxia / hypercarbia: likely secondary to restrictive process from intrathoracic stomach. episode has improved without further intervention, patient discharged on 2l nc. . #. h/o mrsa bacteremia: cultures remained negative this hospitalization, 14 day course of vancomycin completed , patient given last dose after dialysis. . #. end stage renal disease: we continued hd per outpatient schedule on , wednesday, friday. . #. c diff colitis: patient with (+) c diff tox x 3 during last admission, completing 14 day course of abx, currently on po vancomycin x 4 more days. . #. pleural effusions: chronic effusions bilaterally, do no appear to be changed at this time. . #. diastolic heart failure: last echo with ef >55% and mild mitral regurgitation. . #. atrial fibrillation: currently paced, not active issue. we continued amiodarone 200mg , and did not anticoagulate given recent history of lower gi bleeding, defer restarting anticoagulation to primary care team. . #. thrombocytopenia: per omr, drug reaction vs mds. , with hit panel negative, not active during this admission. . #. fen: diet advanced to regular . #. prophylaxis: sc heparin . #. code: patient remained dnr/dni, clarified with son, (hcp) . #. access: tunneled hd line () . #. contact: , ( medications on admission: ferrous sulfate 325mg amiodarone 200mg simethicone 80mg acetaminophen calcium acetate 667mg tid vanc igm with hd midodrine 5mg tid vancomycin 250mg po (last day ) lactulose prn bisacodyl senna discharge medications: 1. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 2. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 3. vancomycin 250 mg capsule sig: one (1) capsule po q6h (every 6 hours). 4. midodrine 5 mg tablet sig: two (2) tablet po tid (3 times a day). 5. megestrol 40 mg tablet sig: one (1) tablet po qid (4 times a day). 6. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 7. heparin, porcine (pf) 10 unit/ml syringe sig: one (1) ml intravenous prn (as needed) as needed for line flush. 8. ferrous sulfate 325 mg (65 mg iron) capsule, sustained release sig: one (1) capsule, sustained release po once a day. 9. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po once a day. 10. calcium acetate 667 mg capsule sig: one (1) capsule po three times a day. 11. lactulose 10 gram/15 ml solution sig: fifteen (15) ml po twice a day as needed for constipation. 12. senna 8.6 mg capsule sig: one (1) capsule po once a day. 13. bisacodyl 5 mg tablet sig: one (1) tablet po twice a day as needed for constipation. discharge disposition: extended care facility: rehab discharge diagnosis: primary: respiratory distress altered mental status discharge condition: hemodynamically stable, with systolic blood pressure in 90's to 100's discharge instructions: you were admitted to the hospital after you were found to be somolent and less interacive. we evaluated you for any signs of infection and did not find any indication that you are currently infected. you improved back to baseline and you are now ready for discharge back to your rehabilitation facility. weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet please take all medications as prescribed and keep all doctors . if you experience any chest pain, shortness of breath, or any other new symptom that concers you, please seek medical attention. followup instructions: please follow up with your pcp weeks. procedure: venous catheterization, not elsewhere classified hemodialysis diagnoses: end stage renal disease unspecified pleural effusion congestive heart failure, unspecified gout, unspecified infection with microorganisms resistant to penicillins methicillin susceptible staphylococcus aureus septicemia sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease atrioventricular block, complete intestinal infection due to clostridium difficile cardiac pacemaker in situ sinoatrial node dysfunction chronic diastolic heart failure other alteration of consciousness chronic respiratory failure 

Answer: The patient is high likely exposed to