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: all drug allergies previously recorded have been deleted attending: chief complaint: sepsis, hx nec fasc major surgical or invasive procedure: none history of present illness: 62 yo man w/dm, htn, recent admission for necrotizing fasciitis, now readmitted with sepsis. during recent admission from to , pt had operative debridement of necrotizing fasciitis of the lle and groin on , as well as f/u bedside debridements. he initially was started on zosyn, vanco, clinda, and flagyl. intra-op tissue cultures grew coag neg staph and pan- e. coli, and abx narrowed to vanco & . due to cytopenias, switched to dapto & , and completed total 21 day course. cath tip grew c. albicans. o/w multiple blood cx all negative. hospital course c/b bilat pe resulting in intubation, pt discharged on warfarin. pt discharged to rehab on on vac, with picc in place, and off antibiotics. he was originally scheduled for stsg surgery on . on , at rehab, pt developed temp 101.2, bp 80/55, w/foul smell from vac (last changed 2 days ago), and erythema around vac site. pt presented to osh, t 101, hypotensive despite 2l ivf, 36% bands on manual diff, rec'd vanco, clinda, levoflox, started on pressors and transferred to . cta there neg for pe for w/u of sob. per pt, had no pain on lle, but redness that has progressed over past 2 weeks. on arrival here, t 97.3, still on pressors. exam at that time notable for foul odor, beefy soft tissue in wound, and light crepitus over l med thigh. ct showed no gas or fluid collection. started empirically on meropenem, vancomycin, flagyl, and fluconazole. overnight, ij cvl and r art line inserted. this am, weaned off pressors. past medical history: past medical/surgical history: *nec fasc as above *diabetes mellitus type 2 *asthma *bronchitis *hypertension *hyperlipidemia *obesity *s/p knee surgery social history: arrived from rehab. formerly lived alone. on disability. tob: quit 3 months ago after 54 yrs of smoking. etoh: quit 3 mo. ago family history: nc physical exam: tmax: 100.4 p: 95 r: 19 bp: 115/57 off pressors, o2sat 100% 2l nc general: obese man in nad, speech fluent heent: ncat, perrl, op clear without exudates/lesions, lower lip with crusted eschar ("cut myself shaving") neck: no lad/jvd, r ij cvl c/d/i lungs: cta b heart: rrr, no m/r/g abdom: +bs, nt, nd, soft extrem: *lle edematous, warm, non-tender, diffuse erythema sparing knee only, extending from toes to l flank. *ant thigh & groin wound with good granulation tissue, no pus, good margins. *rue picc no erythema gu: foley intact, groin with erythema neuro: mae, perrl skin: no other rash. pertinent results: 01:52am blood wbc-4.0 rbc-3.32* hgb-10.8* hct-29.8* mcv-90 mch-32.7* mchc-36.5* rdw-15.5 plt ct-112* 05:02am blood wbc-8.0# rbc-3.68* hgb-11.5* hct-32.8* mcv-89 mch-31.2 mchc-34.9 rdw-15.4 plt ct-130* 05:02am blood glucose-53* urean-9 creat-0.7 na-139 k-4.1 cl-106 hco3-30 angap-7* 01:20am blood alt-34 ast-38 alkphos-54 totbili-0.8 05:02am blood calcium-7.7* phos-3.9 mg-1.7 06:06am blood vanco-13.8 07:31pm blood lactate-2.4* 01:45am blood lactate-1.3 . radiology report ct pelvis w/o contrast study date of 7:53 pm impression: 1. compared to prior exam, there is improved bibasilar atelectasis and resolution of small bilateral pleural effusions. 2. post-surgical changes involving the left groin and anterolateral thigh. extensive subcutaneous edema involving the postsurgical site and extending down the left leg to the ankle, which may be related ongoing cellulitis. no discrete fluid collection or subcutaneous emphysema. . 7:32 pm swab site: leg left thigh. **final report ** gram stain (final ): 2+ (1-5 per 1000x field): polymorphonuclear leukocytes. 4+ (>10 per 1000x field): gram positive rod(s). 3+ (5-10 per 1000x field): gram positive cocci. in pairs. wound culture (final ): due to mixed bacterial types (>=3) an abbreviated workup is performed; p.aeruginosa, s.aureus and beta strep. are reported if present. susceptibility will be performed on p.aeruginosa and s.aureus if sparse growth or greater.. beta streptococci, not group a. sparse growth. . 7:00 pm catheter tip-iv source: picc. **final report ** wound culture (final ): beta streptococcus group c. >15 colonies. . 02:33am blood pt-19.6* inr(pt)-1.8* 04:23am blood pt-18.9* inr(pt)-1.7* 04:41am blood pt-20.0* ptt-48.7* inr(pt)-1.9* 04:41am blood glucose-50* urean-9 creat-0.7 na-140 k-4.0 cl-105 hco3-30 angap-9 brief hospital course: this is a 62 yo w/dm, recent admit for nec fasc, who presents with sepsis, gpc bacteremia, likely due to skin & soft tissue infection of lle and perineum. given that organism (gpc in chains, likely strep) has been isolated in blood, recommend continuing meropenem and vancomycin for broad gpc/gnr coverage, and adding clindamycin to optimize anti-toxin effect. would stop flagyl & fluconazole soon, as meropenem covers anaerobes, and no evidence of fungal infection. his picc, given demonstrated bacteremia, was removed and grew beta streptococcus group c. sepsis: he was on pressors for hypotension. his initial exam was notable for foul odor, beefy soft tissue in wound, and light crepitus over l med thigh. ct showed no gas or fluid collection. he continued on abx as stated above. id was consulted and following along and eventually he was switched to penicillin g for 14 days. a new picc was placed on hd 5 and he will complete his abx course at rehab. necrotizing fasciitis: his lle and left groin continued with dressing changes. the celulitis improved and the wound was healing with beefy, red granulation tissue. plastics deffered grafting at this time until the cellulitis resolved and he was off antibiotics. heme: he was anticoagulated for history of pe. he was supertherapeutic on admission and coumadin was held and inr drifted down to a therapeutic range. coumadin was restarted when appropriate. renal: his lasix was restarted when appropriate to help with diuresis. he was discharge to rehab and will continue with abx and pt. medications on admission: lovastatin 20', lisinopril 20', metoprolol 25'', isdn 30', albuterol, ipatropium, combivent, glyburide 5am, 2.5hs, omeprazole 40', advair 250/50'', 60'', ibuprofen 800'', nicotine patch discharge medications: 1. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 2. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 3. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 4. famotidine 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). 5. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 6. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 7. glyburide 5 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). 8. glyburide 2.5 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 9. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 10. warfarin 7.5 mg tablet sig: one (1) tablet po once a day: monitor inr and adjust dose accordingly. 11. penicillin g potassium 20,000,000 unit recon soln sig: 4 million units injection q4h (every 4 hours) for 8 days: 14 days total. stop . 12. heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous prn (as needed) as needed for line flush. discharge disposition: extended care facility: - discharge diagnosis: history of necrotizing fasciitis sepsis: shortness of breath, hypotension cellulitis discharge condition: good discharge instructions: general: * please look at the wound site every day for signs of infection (increased redness, swelling, odor, yellow or bloody discharge, fever). -note color, consistency, and amount of fluid in drain. call doctor if amount increases significantly or changes in character. -continue with vac dressing changes every 3-4 days. -maintain the site clean, dry, and intact. -avoid swimming, baths, hot tubs-do not submerge yourself in water. *please call your doctor or return to the er for any of the following: * increased pain, and erythema of your leg wound. * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomiting, diarrhea or other reasons. * signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * any serious change in your symptoms, or any new symptoms that concern you. . *avoid lifting objects > 5lbs until your follow-up appointment with the surgeon. *avoid driving or operating heavy machinery while taking pain medications. * please resume all regular home medications and take any new meds as ordered. * continue to ambulate several times per day. followup instructions: provider: , md phone: date/time: 9:15 provider: surgery clinic phone: date/time: 1:30 procedure: venous catheterization, not elsewhere classified diagnoses: other postoperative infection unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled sepsis other and unspecified hyperlipidemia cellulitis and abscess of leg, except foot chronic obstructive asthma, unspecified streptococcal septicemia 

Answer: The patient is high likely exposed to