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: history of present illness: mrs. is a 38 year-old woman with end stage renal failure on dialysis with a history of hypertension, diabetes mellitus type 1, peripheral vascular disease, status post left below knee amputation and multiple digit and toe amputations. she is initially unable to give much history and her family was available initially on arrival. she reportedly had a left sided headache which started on the morning of admission and her blood sugar was low earlier in the day but that corrected with food although her confusion did not improve. subsequently she came into the emergency department with a headache and a head ct which showed a right thalamic basal ganglia bleed with extension into the lateral and third ventricles. past medical history: hypertension, end stage renal disease on dialysis, diabetes mellitus type 1, peripheral vascular disease, status post below knee amputation and a question of stroke and seizures in the past. also a history of naphthalene induced coma from inhaling moth balls. past surgical history: status post left below knee amputation. status post right transmetatarsal amputation. status post parathyroidectomy. status post renal transplant in , now failed and tracheostomy in the past. allergies: no known drug allergies. medications at home: labetalol which she had not been taking regularly, amitriptyline, insulin, analopril, nifedipine. social history: no history of smoking or alcohol. lives with her daughter and granddaughter. again there is a history of naphthalene induced coma. family history: noncontributory. review of systems: unable to obtain on admission. physical examination: initially the patient is afebrile, blood pressure 160 to 210/80 to 100, pulse 70s to 100. in general the patient is lying in bed, at times agitated, in no acute distress. head, eyes, ears, nose and throat: nonicteric sclera, mucous membranes dry. neck supple, no lymphadenopathy, no carotid bruits. heart: normal s1, s2, regular rate and rhythm. pulmonary: clear to auscultation bilaterally. abdomen soft, nontender, nondistended. extremities: left below knee amputation, right toes and fingers all amputated. left hand with three digits amputated. neurological examination: mental status awake, alert, intermittently cooperative and attentive. nonfluent and aphasia with one to two word answers, frequently becomes frustrated and turns away. after she was intubated she was very unresponsive for a long period of time. however, currently by she is awake and alert and does intermittently follow commands and does move all extremities. cranial nerves on admission: disks flat and sharp. visual fields intact to confrontation. pupils normal, round and reactive to light, no rap. pupils continue to remain normal, round and reactive to light. extraocular eye movements full and intact without nystagmus. has subtle left facial droop which is now not present. tongue midline without fasciculations. sternocleidomastoid and trapezius normal bilaterally which not been able to be fully tested since intubation. motor normal bulk and tone without adventitious movement. mild left drift and left hemiparesis in the 4+ to 5 range, worse in the arm. the patient has been moving all her extremities to command and occasionally does move them all spontaneously as well by . sensory grossly intact. reflexes symmetric throughout. laboratory studies: on white count 15.6, hematocrit 27.9. she has been intermittently transfused throughout this hospital course. platelets , inr 1.2, ptt 28.4, pt 13.7. sed rate 128 on . most recent cerebrospinal fluid sent on showed a white count of 8, rbc of 1210, glucose 166, creatinine 4.9, bun 50, sodium 133, potassium 4.0, chloride 94, bicarb 25. she did have rising liver function tests which started to decrease. however, amylase and lipase as of were still rising. amylase on was 142, alt 49, ast 75, ldh 168, alk phos 1102, total bilirubin 0.3, lipase 195. she ruled out for myocardial infarction by enzymes. crp was 19. vancomycin levels were followed and she was redosed per levels. she is no longer on phenytoin and this level is not in the chart. the total protein in cerebrospinal fluid 51, glucose 68. c. difficile was positive. a second c. difficile on is pending. the c. diff on was positive. cerebrospinal fluid on negative. on negative. negative. negative. negative. negative. sputum sent on is growing staph aureus coag positive. on growing staph aureus coag positive. growing staph aureus coag positive sensitive to gentamicin, tetracycline and vancomycin only. on sputum also growing staph aureus coag positive. on also growing staph aureus coag positive with the same sensitivities. on also growing staph aureus coag positive. blood cultures : no growth to date. no growth to date. no growth to date. no growth to date. negative. negative. negative. growing staph coag negative in one out of four bottles sensitive to clindamycin, erythromycin, rifampin, tetracycline and vancomycin. on one out of four bottles was growing two different strains of staph aureus coag negative. one strain sensitive to clindamycin, erythromycin, gentamicin, rifampin, tetracycline and vancomycin. the other strain sensitive to clindamycin, erythromycin, gentamicin and oxacillin. ct of the abdomen and pelvis which was a repeat ct from was unchanged from that date. there was small interval increase in the small amount of ascites present. no new abscess or intra-abdominal or intrapelvic pathology identified and there remained stable appearance of a large retroperitoneal and periportal lymph node. the most recent head ct on showed stable appearance of the brain. provisional head ct revealed hemorrhage in the right basal ganglia area and right thalamus with extension to the right lateral ventricle with mild dilatation of the temporal of the right lateral ventricle which remained unchanged for some time. patient also received bilateral upper and lower extremity dopplers for the question of thrombus. there was found to be a chronic nonocclusive thrombus in the proximal right internal jugular vein but otherwise there were no deep venous thromboses in any extremities. chest x-rays most recently were clear. eeg on showed background slowing indicating widespread encephalopathic condition. there were no focal abnormalities and no epileptiform features. hospital course: mrs. presented on with a right thalamic right basal ganglia bleed extending to the right ventricle. this was felt to be due to hypertension as she came in with systolic blood pressures above 200 and her family stated she had been noncompliant with her antihypertensives at home. on the day of admission she was intubated for apneic spells and her family decided that she would wish to be do not resuscitate but not do not intubate. neurosurgery subsequently placed ventricular drain and initially she was loaded on dilantin for a question of seizures. renal was also consulted to follow up for her end stage renal failure. she neurologically did not have any seizures witnessed by any residents or attending per description by the nurses had had some rhythmic eye movements. however, eeg showed no epileptiform activity and the dilantin was very difficult to keep at therapeutic doses given the renal failure and the frequent dialysis. so the dilantin was discontinued eventually and the patient has not had any witnessed seizure activity. as for the ventricular drain neurosurgery has been managing this. her ventricular drain has been draining a significant amount of fluid throughout the hospital course. when clamping has been attempted the icps have increased to the low to mid-20s and the patient has become more somnolent. the decision has been made to place a ventriculoperitoneal shunt this week. neurologically the patient has improved since she arrived in the intensive care unit. she has now become more awake and alert and will follow both axial and appendicular commands intermittently. she does seem to be more somnolent prior to dialysis and after dialysis will eventually become more awake. as far as her renal issues mrs. has been followed by her outpatient physician, . , and she has continued her regular dialysis schedule while here in the hospital. dialysis has continued through her quinton catheter. from an infectious disease standpoint it was felt that her bacteremia was de to infection of the quinton catheter. instead of removing the catheter the decision was made to treat through this infection and vancomycin was started. the patient has been redosed for levels less than 15 and all blood cultures have been negative since . additionally the patient has been growing staph coag positive in her sputum and again she is on vancomycin for this. she did develop some loose stools and c. difficile was sent which was positive and the patient started on flagyl for treatment of this. however, since the vancomycin and flagyl have been started the patient has continued to have daily fever spikes and infectious disease was consulted. infectious disease recommended repeat ct of the abdomen and pelvis which was not revealing for any new pathology. they also recommended empiric treatment for gram negative rods which was started on in the form of ceftazidine. this will be continued on a trial basis to see if the fevers may stop. no precise cause of the fevers as of has yet been identified. in regards to her diabetes the has been following and recommending humalog sliding scale as well as insulin in the total parenteral nutrition while she was on tpn and also to cover her with lantus at night. her blood sugars have been well controlled with the consulting. from a gastrointestinal standpoint the patient has had severe gastroparesis. she was started on reglan as well as erythromycin. it was felt that the erythromycin may be contributing to worsening of the c. difficile so this was stopped and it was unclear as to whether the reglan was increasing her liver function tests and this was stopped. the patient did improve eventually and a j tube was placed and tube feeds were then restarted after a couple of weeks of tpn. the patient did have transient elevation of alt and ast which now seemed to be decreasing. the alk phos is still remaining high, however, as well as elevated amylase and lipase. it is also not 100 percent clear what may be causing this elevation of enzymes. however, we are following this closely and have considered contributions from all of her medications. per abdominal ct there are no abscesses to explain this and the total bilirubin has not been elevated at all. we will continue to follow this throughout her hospital course. hematologically the patient has had guaiac negative stools, does suffer from chronic anemia and has had intermittent transfusions to attempt to keep her hematocrit at 30. from a cardiovascular standpoint mrs. has been continued on nicardipine, labetalol and hydralazine in order to keep her systolic pressure below 150. she tends to be hypertension on days when she is not having dialysis. however, in dialysis she does tend to become hypotensive. now that she has the g-j tube in place she will be started on p.o. antihypertensives and today has been started on metoprolol 50 mg p.o. b.i.d. and the labetalol drip has been stopped. respiratory-wise mrs. remains ventilated and at some point this week the plan is for her to receive a tracheostomy. for now the patient remains in stable condition in the neuro intensive care unit and the oncoming will dictate the rest of the hospital course and all of the discharge instructions and medications as well as any follow up that may be needed. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis ventricular shunt to abdominal cavity and organs intravascular imaging of intrathoracic vessels temporary tracheostomy biopsy of lymphatic structure percutaneous [endoscopic] gastrojejunostomy transfusion of packed cells diagnoses: obstructive hydrocephalus other convulsions intracerebral hemorrhage hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure infection and inflammatory reaction due to other vascular device, implant, and graft complications of transplanted kidney diabetes with other specified manifestations, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to