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: hyperglycemia major surgical or invasive procedure: placement of picc line. history of present illness: 84yo woman h/o dm2 (now diet controlled), severe dementia, h/o cad s/p cabg , recurrent utis who presents with hyperglycemia to 788. pt remotely had been on metformin and nph for control of dm2. in at least past 2years, pt??????s bs controlled by diet only, and fs checked qam, normally running b/w 100-200. in past week, pt noticed to have gradually rising bs, from 200s->400s, increasing lethargy, anorexia along with +2-3days of mild, nonproductive, cough. her ros was otherwise negative. husband told by pcp/ to start cipro for possible infection. four days prior to admission patient was seen by podiatrist who stated that here was no evidence of infxn of chronic r foot ulcer. her antibiotics were changed from cipro to keflex. on day of admission, pt noticed to have bs 590, brought to ed by ambulance. in , pt afebrile, brady to 50s, normotensive, o2sat 89%on ra when asleep. na159( 170) glu788. cxr clear, u/a clean. started on insulin drip, given 1lns, then 1/2ns +40meq k @75cc/h. on arrival to unit, pt's sbps were between 80-100. she was given ns with an increase of her bp to a systolic blood pressure of 130. her corrected sodium was elevated to 170. she was started on an insulin drip with rapid control of her blood sugars so she was started on sq insulin. she also received agressive fluid resucitation with correction of her serum sodium. * with normalization of her blood sugars she was called out to the medicine floor. on the day of transfer to the medicine floor the patient developed a great deal of oral secretions and then developed an oxygen requirement-requiring 40% face mask. past medical history: past medical history dm2 ?????? diet controlled, daily bs normally 100-200. last hgba1c 6.7 () previously on metformin, nph, but no meds past 2y. r ft ulcer ?????? per podiatrist, no evidence of infection cad ?????? s/p cabg echo lae, mild lvh, mild/mod mr, 1+tr, no rwma ef>60% dementia ?????? multi-infarcts, does not speak x1y htn recurrent uti gib ?????? slow gib in , presumed ugi source. ppi colonoscopy w/ melena, no colonic pathology pvd hypothyroidism l carotid artery stenosis cataracts atrial myxoma ?????? s/p resection h/o bell??????s palsy cervical spondylosis past surgical history l tkr ?????? l radial fx closed reduction l cataracts extraction social history: lives w/ husband @ home; requires daily nursing aid care. at baseline does not speak, cannot ambulate, cannot perform adls. code status: dnr/dni remote tobacco. physical exam: physical examination vs: tm 98.8 hr51 bp141/23 rr16 100%o2sat 2l nc gen: chronically ill-appearing, awake, responds to noxious stimuli, but does not verbally communicate. heent: mm dry, jvp6cm pulm: crackles r base, crackles @ l base ext ?????? lung field. cards: brady, regular nl s1 s2 2/6 sem abd: soft, nt, no g/r. bs active. no hsm ext: skin tenting. unhealed ulcer r foot on top of 4-5th mtp joint, focal tenderness to palpation medial to ulcer, above 5th mtp joint, no evidence of soft tissue infection. healing ulcer of r gr toe, no tenderness. neuro: rigid, spastic in 4 extremities. pertinent results: 11:17pm urine hours-random creat-66 sodium-59 11:17pm urine osmolal-639 08:00pm glucose-57* urea n-59* creat-1.7* sodium-170* potassium-3.8 chloride-136* total co2-26 anion gap-12 08:00pm calcium-8.8 phosphate-2.7 magnesium-2.1 08:00pm osmolal-357* 06:11pm glucose-171* urea n-58* creat-1.6* sodium-171* potassium-3.2* chloride-134* total co2-24 anion gap-16 06:11pm ck-mb-5 ctropnt-0.13* 06:11pm calcium-8.5 phosphate-3.1 magnesium-2.1 06:11pm osmolal-363* 06:11pm wbc-5.2 rbc-3.30* hgb-10.1* hct-31.2* mcv-95 mch-30.5 mchc-32.2 rdw-13.8 06:11pm plt count-188 03:00pm glucose-650* urea n-66* creat-1.8* sodium-165* potassium-3.5 chloride-131* total co2-19* anion gap-19 12:25pm urine color-straw appear-clear sp -1.020 12:25pm urine blood-neg nitrite-neg protein-neg glucose-1000 ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 12:25pm urine rbc-0 wbc-0-2 bacteria-0 yeast-none epi-0-2 12:05pm glucose-762* na+-160* k+-4.1 cl--130* 11:55am ck(cpk)-91 11:55am ck-mb-4 ctropnt-0.14* 11:55am calcium-9.2 phosphate-3.3 magnesium-2.3 11:55am tsh-0.89 11:55am free t4-1.3 11:55am wbc-7.3 rbc-3.63* hgb-11.0* hct-33.7* mcv-93 mch-30.4 mchc-32.7 rdw-13.3 11:55am hypochrom-1+ 11:55am plt count-198 11:55am pt-12.9 ptt-29.3 inr(pt)-1.1 eeg: impression: this is an abnormal portable eeg obtained in wakefulness and drowsiness due to the presence of a disorganized and slow background rhythm in the 6 hz theta frequency range. in addition, there is scattered mixed delta and theta frequency slowing as well as occasional generalized delta frequency slowing. these findings suggest widespread subcortical dysfunction and are consistent with an encephalopathy. no lateralizing or epileptiform abnormalities were seen. note was made of frequent ectopy on the cardiac monitor. * head ct findings: there is no intracranial hemorrhage, mass effect, or shift of normally midline structures. there is stable ventricular enlargement, consistent with moderate to severe brain atrophy. there is stable extensive periventricular and subcortical hypodensity, consistent with chronic microvascular ischemic changes. the osseous and soft tissue structures are unremarkable. impression: no significant interval change when compared with the prior study of . moderate to severe brain atrophy * chest ap: findings: there is an increasing infiltrate in the left lower lobe, and to a lesser extent at the right base, since . the heart is normal in size. post-cabg changes are evident. there are no other changes in the chest. impression: bilateral lower lobe infiltrates, left more than right. micro: blood and urine cultures negative 6:38 pm sputum site: endotracheal **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gram positive cocci. in pairs and clusters. respiratory culture (final ): oropharyngeal flora absent. staph aureus coag +. moderate growth. oxacillin resistant staphylococci must be reported as also resistant to other penicillins, cephalosporins, carbacephems, carbapenems, and beta-lactamase inhibitor combinations. rifampin should not be used alone for therapy. please contact the microbiology laboratory () immediately if sensitivity to clindamycin is required on this patient's isolate. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- =>8 r oxacillin------------- =>4 r penicillin------------ =>0.5 r rifampin-------------- <=0.5 s tetracycline---------- <=1 s vancomycin------------ <=1 s 11:53 am stool consistency: watery source: stool. **final report ** clostridium difficile toxin assay (final ): feces negative for c. difficile toxin by eia. reference range: negative. 3:28 pm swab site: foot source: right foot sub 4th/5th met head. **final report ** gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. 2+ (1-5 per 1000x field): gram positive cocci in pairs and clusters. wound culture (final ): staph aureus coag +. heavy growth. please contact the microbiology laboratory () immediately if sensitivity to clindamycin is required on this patient's isolate. oxacillin resistant staphylococci must be reported as also resistant to other penicillins, cephalosporins, carbacephems, carbapenems, and beta-lactamase inhibitor combinations. rifampin should not be used alone for therapy. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- =>8 r oxacillin------------- =>4 r penicillin------------ =>0.5 r rifampin-------------- <=0.5 s tetracycline---------- <=1 s vancomycin------------ <=1 s anaerobic culture (final ): mixed bacterial flora-culture screened for b. fragilis, c. perfringens, and c. septicum. none isolated. brief hospital course: 84f w/dm2 (diet controlled), severe dementia, recurrent utis who p/w nonketotic hyperosmolar hyperglycemia: * nonketotoic hyperosmolar hyperglycemia: the actual precipitant of her hyperosmolar hyperglycemia was initially unclear. the patient had low grade temps which suggested an occult infection but the patient's blood and urine culture remained negative as did her cdiff . a swab of her wound and her secretions eventually grew mrsa and the patient was started on vancomycin. she was also noted to have a mild troponin leak on admission but we thought that this was secondary to demand ischemia in the setting of an occult infection and not acute coronary syndrome. the patient is dnr/dni adn the family did not want to pursue agressive interventions thus she was not ruled out for an mi. * new oxygen requirement. pt now requiring 40% o2 via shovel mask. our intial differential was inability to handle secretions which had developed secondary to fluid repletion vs chf secondary to agressive fluid repletion or aspiration pneumonia. she was given several doses of iv lasix to which she responded with a fair urine outpu but there was no improvement in her o2 saturation. we then thought that her o2 requirement was most likely due to an aspiration pneumonia secondary to her inability to handle her oral secretions. she was started on iv levofloxacin, flagy and vancomycin. our suspicions were confirmed by an x ray which demosntrated worsening bilateral lower lobe infiltrates. * aspiration precautions: the patient was put on aspiration precautions, made npo and all of her medications were changed to iv. * mental status: despite our aggressive antibiotics the patient's mental status only improved slightly despite an improvement in her o2 requirement. we thus thought that her decreased mental status was most probably secondary to her severe advanced dementia. we also obtained a neurology consult along with an eeg, and ct of the head which confirmed this. in light of this the patient's family, medical team thought it fitting that the patient be put into the care of home hospice. * disposition: in light of her advanced dementia and her poor prognosis for recovery of any function especially that of protecting her airway, along with her previous wish to be comfortable at the end of her life we, in close dicussion with the family and palliative care team decided that it would be best for her to go home with hospice. medications on admission: asa 325 mg po qd atenolol 12.5 mg qd feso4 325 lasix 20 mg po bid lipitor 10 mg po qd levothyroxine 50 mcg qd nifedipine 30 mg protonix 40 mg po qd ca, b12, mvi keflex 250 mg qid since discharge medications: 1. scopolamine base 1.5 mg patch 72hr sig: one (1) patch 72hr transdermal q 72 hrs prn as needed for secretions. disp:*10 patch 72hr(s)* refills:*2* 2. opium 10 % tincture sig: ten (10) drop po q 4-6 hrs prn as needed. disp:*3 vials* refills:*0* 3. furosemide 8 mg/ml solution sig: twenty (20) mg po daily (daily). disp:*4 vials* refills:*2* 4. diphenoxylate-atropine 2.5-0.025 mg/5 ml liquid sig: tablets po q 6hrs prn as needed: please crush in applesauce or custard. . disp:*30 tablets* refills:*2* 5. propranolol hcl 10 mg tablet sig: two (2) tablet po tid (3 times a day): please give patient liquid form. . disp:*180 tablet(s)* refills:*2* 6. levothyroxine sodium 50 mcg tablet sig: one (1) tablet po daily (daily): please crush in applesauce. . disp:*30 tablet(s)* refills:*2* 7. morphine concentrate 20 mg/ml solution sig: 2-20 mg po q 1hr prn. disp:*30 ml* refills:*0* 8. nystatin 100,000 unit/g ointment sig: appls topical qid (4 times a day) as needed. disp:*3 vials* refills:*2* discharge disposition: home with service facility: hospice of the good discharge diagnosis: primary: 1. nonketotic hyperosmolar hyperglycemia 2. aspiration pneumonia 3. multi-infarct dementia secondary dm2 ?????? diet controlled, daily bs normally 100-200. r ft ulcer cad ?????? s/p cabg dementia ?????? multi-infarct, non verbal x 1year htn recurrent utis slow gi bleed from a presumed ugi source. pvd hypothyroidism l carotid artery stenosis cataracts atrial myxoma ?????? s/p resection h/o bell??????s palsy cervical spondylosis s/p left total knee replacement. s/p l closed radial fracture reduction - s/p l cataract extraction discharge condition: fair. close to baseline, non-verbal and totally dependent for all activities of daily living. discharge instructions: patient is going home with hospice and is currently dnr/dni. followup instructions: provider: , clinic where: cc-2 unit phone: date/time: 11:00 please follow up with home hospice and dr. at as needed. procedure: venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances transfusion of packed cells diagnoses: unspecified essential hypertension acute kidney failure, unspecified other pulmonary insufficiency, not elsewhere classified unspecified acquired hypothyroidism atrial fibrillation aortocoronary bypass status pneumonitis due to inhalation of food or vomitus methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site ulcer of heel and midfoot vascular dementia, uncomplicated cerebral atherosclerosis diabetes with hyperosmolarity, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to