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: this 66 year-old white male smoker with a 60 pack year history with a past medical history significant for diabetes noninsulin dependent times thirty years, hypertension treated times forty years, coronary artery disease questionable myocardial infarction times seven according to the patient (last myocardial infarction in ). the patient has had no surgical intervention for his coronary artery disease. he is transferred from hospital for surgical evaluation. he was admitted to hospital on after enduring a right foot infection times five months. initial injury occurred while removing a callus from the lateral surface of his right foot. the pain has persisted over the last three months becoming impossible with onset of drainage. the patient was seen in the emergency department for care where he was prescribed antibiotics levaquin, tequin and erythromycin. he was given a follow up with vascular surgeon, but the patient did not follow up. on the last admission the patient was diagnosed with osteomyelitis via bone scan. he received intravenous clindamycin. the patient is now here for peripheral vascular evaluation. the patient is able to walk a full block six months prior to admission. he denies any claudication, shortness of breath, chest pain, but admits to claudication starting two months prior to admission on the right side before on the left, currently only able to walk of a block and then claudication ensues. past medical history: 1. diabetes type 2. 2. hypertension. 3. coronary artery disease. past surgical history: tracheostomy reason unknown. allergies: penicillin, manifestations not documented. home medications: 1. quinine 325 mg q.h.s. 2. naproxen 500 mg b.i.d. 3. enalapril 5 mg q.d. 4. lipitor 20 mg q.h.s. 5. metformin 500 mg b.i.d. 6. levaquin 500 mg q.d. 7. tequin 400 mg q.d. 8. erythromycin 1000 mg q.d. medications at transfer: 1. enalapril 10 mg q.d. 2. lopressor 50 mg b.i.d. 3. metformin 500 mg b.i.d. 4. zocor 20 mg q.d. 5. tylenol #3 tablets one to two q 4 to 6 hours prn for pain. 6. clindamycin 600 mg intravenous q 12 hours. social history: he is a sixty pack year smoker. he has smoked since until present time. alcohol intake is three bottles of beer per day. last drink was in of this year. he is a retired shipyard pipe fitter. he has also worked with mercury compounds. physical examination: vital signs 99.5, 78, 157/65, 18, 97% on 2 liters. weight is 63 kilograms. general appearance, alert, cooperative white male in no acute distress. heent examination is remarkable for left carotid bruit. heart is a regular rate and rhythm with no murmur. lungs are clear to auscultation bilaterally. bowel sounds present. he has a nondistended, nontender abdomen. there is no ankle edema. pulse examination shows palpable femorals bilaterally. popliteals are dopplerable bilaterally. dorsalis pedis pulse and posterior tibial pulse are dopplerable signal bilaterally. the right fifth metatarsal wound is 2.5 by 2.5 cm full thickness ulceration, very tender with gangrenous changes. admission laboratories: white blood cell count 11.4, hematocrit 33.3, platelets 254k. bun 28, creatinine 1.8, k 4.6. electrocardiogram was normal sinus rhythm, normal axis, no acute changes. chest x-ray showed appearance of lung abnormal with diffuse increase in interstitial markings with indistinctness of vessel and hilar outline findings, may reflect congestive heart failure with primary diffuse interstitial edema. there is apparent elevation of the right hemidiaphragm, which may reflect true elevation or subpulmonic pleural effusion, blunting of the costophrenic angle consistent with a component of right pleural effusion. there is no significant left pleural effusion. admitting urinalysis was negative. hospital course: the patient was admitted to the vascular service. he was placed on bed rest. vancomycin, levo and flagyl were continued. cultures were obtained. initial wound cultures on the right foot ulcer grew oxacillin resistant staph coag positive of two colony morphologies. sensitivities showed organisms sensitive to vancomycin, rifampin and gentamycin, resistant to clindamycin, erythromycin, oxacillin, penicillin and tetracycline. there were no anaerobic growth from the cultures. during the first 48 hours the patient had multiple episodes of nausea and vomiting. electrocardiograms were without significant change and cks were flat and troponins were flat. gi was consulted regarding the patient's nausea and vomiting. recommendations after review of the chart and evaluation of the patient felt that the patient's symptoms might be related to anxiety, questionable gastritis and gastroenteritis or cardiac issues. the patient has been constipated for several weeks with low frequency of bowel movements, which could also cause nausea and vomiting. recommendations were to do liver function tests, lipase and amylase to rule out any liver or pancreatic problems. the patient was ruled out for cardiac source for his nausea by his enzymes and electrocardiogram. continued diet as tolerated. consider starting reglan on a prn basis if patient's symptoms return, guaiac all stools and a bowel regimen to prevent his constipation. they felt an endoscopy at this time was not indicated, but could be done if the symptoms persisted. because of a left carotid bruit, which was auscultated on the initial physical examination the patient underwent carotid ultrasounds, which showed a very significant stenosis of the left internal carotid artery with a narrowing of 80 to 99% with increased velocities. the left vertebral artery was completely occluded. the right internal carotid artery showed diminished flow with right vertebral and antegrade flow and no diastolic flow suggesting distal occlusion. echocardiogram was done, which showed an ef of 25 to 30% with bilateral atrial enlargement, aortic valve was mildly thickened with mild mitral regurgitation and symmetric left ventricular hypertrophy without reciprocal systolic dysfunction. kub demonstrated obstipation and the patient was given appropriate medications to improve. cardiology did see the patient in preparation for consideration for his carotid endarterectomy and revascularization. stress test was obtained, which showed no anginal with an uninterpretable electrocardiogram at baseline. the nuclear portion of the study demonstrated a moderate defect involving the inferior wall. there were no other defects identified. the resting perfusion showed the same defect involving the inferior wall. the ejection fraction was calculated at 31%. there was global hypokinesia and the inferior wall could not be assessed, because of lack of counts. the patient received a unit of packed red blood cells prior to his surgery for a hematocrit of 26.5. he underwent a left carotid endarterectomy on . his post transfusion hematocrit was 34.2. the patient tolerated the procedure well and was transferred extubated, but required reintubation secondary to difficulty with breathing and labile blood pressure. his blood gas was on slimv 60% pressure support and 5 of peep was 7.3, 54, 93, 28 and 0. neurologically he remained intact. the tongue did deviate slightly to the right. nitroglycerin was instituted to maintain systolic blood pressure less then 130. postoperative day one there were no overnight events. his antibiotics were vancomycin and levofloxacin. he continued to do well. his morphine was discontinued. he was placed on tylenol for incisional wound pain. his diet was advanced as tolerated. his fluids were heplocked and he remained in the vicu for continued monitoring. followed the patient for his diabetic needs. postoperative day two from his endarterectomy, he had a low grade temperature of 100.2. he required transfusion of one unit of packed red blood cells for his hematocrit of 28, post transfusion hematocrit was 32.8. neurologically he was doing well. he had some rhonchi at rest. he was placed on subq heparin for deep venous thrombosis prophylaxis. he was delined and transferred to the regular nursing floor. the patient underwent on a left axial by fem bypass with 8 mm dacron graft. he tolerated the procedure well. he was transferred to the pacu in stable condition. he was hemodynamically stable. he was transferred to the vicu for continued monitoring and care. he continued to do well. he continued on his antibiotics. he required intravenous hydralazine for his blood pressure control. his hematocrit remained stable at 33.3. aggressive pulmonary toiletry was begun. spirometry was encouraged. reglan was instituted for his persistent nausea. ambulation was begun and the patient underwent on a ray amputation of the right toe without complications. he returned to the floor in stable condition. perioperative enzymes were obtained after the toe amputation. his total cks peaked at 142 and he defervesced to baseline of 52 over the next 72 hours. his troponin t levels peaked at 55. on postoperative day five from the toe amputation the patient was found unresponsive in his bed with the right ij port disconnected. a code was called and the patient was intubated. chest compressions were instituted. the patient's rhythm was sinus bradycardia. he was given 2 mg of epinephrine and 1 mg of atropine. the patient required electrical conversion with 200 and then 360 jewels. amiodarone 150 mg was given. blood pressure stabilized at 200/80 and heart rates in the 140s. the patient was transferred to the intensive care unit for continued management. neo-synephrine for blood pressure was begun. cardiology was requested to see the patient, because of the arrest and recommendations were etiology undetermined. the possibility was cardiomyopathy versus embolism. aspirin was continued. beta blockers were continued and amiodarone was begun. the patient self extubated himself on postoperative day number six. the patient's intravenous amiodarone was discontinued on . the patient was transferred to the vicu on . the day prior to transfer his dnr/dni status was reversed to full code. a central line was placed for intravenous access on , because of poor peripheral access. the patient was transferred to the regular nursing floor and placed on telemetry. on a central line was discontinued. the patient was continued on his glyburide 1.25 mg b.i.d. and insulin sliding scale for glucoses greater then 150. lopressor was adjusted to 75 mg b.i.d. for his systolic hypertension and rate control. the patient was seen by physical therapy. their recommendations were short term rehab to advance the mobility for safety for discharge to home. the remaining hospital course was unremarkable. the amputation site showed good granulation tissue. all his staples were discontinued prior to discharge. the patient should follow up with dr. in two weeks. discharge medication:; 1. subcutaneous heparin 5000 units q 12 hours. 2. albuterol nebulizers q 6 hours prn. 3. ipratropium bromide nebulizer q 6 hours prn. 4. acetaminophen 325 mg to 650 mg po q 4 to 6 hours prn. 5. aspirin 325 mg q day. 6. lansoprazole 30 mg q.d. 7. enalapril 10 mg q.d. 8. trazodone 25 mg at h.s. prn. 9. sarna lotion to back prn. 10. metoprolol 75 mg po b.i.d. hold for systolic blood pressure less then 100, heart rate less then 60. 11. glyburide 2.5 mg b.i.d. 12. insulin sliding scale regular before meals and at bedtime as follows, breakfast glucoses less then 150 no insulin, 151 to 200 2 units, 201 to 250 4 units, 251 to 300 6 units, 301 to 350 8 units, 351 to 400 10 units, greater then 400 12 units. lunch sliding scale glucoses less then 200 no insulin, 201 to 250 2 units, 251 to 300 4 units, 301 to 350 6 units, 351 to 400 8 units, greater then 400 10 units. dinner sliding scale glucoses less then 150 no insulin, 151 to 200 2 units, 201 to 250 4 units, 251 to 300 6 units, 301 to 350 8 units, 351 to 400 10 units, greater then 400 12 units. bedtime insulin sliding scale as follows glucoses less then 200 no insulin, 201 to 250 2 units, 251 to 300 4 units, 301 to 350 6 units, 351 to 400 8 units, greater then 400 8 units. discharge diagnoses: 1. progressive claudication secondary to aortoiliac disease status post axial femoral bypass graft. 2. left carotid stenosis status post left carotid endarterectomy. 3. respiratory cardiac arrest etiology undetermined, resuscitated. 4. blood loss anemia, transfused, corrected. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube amputation of toe other (peripheral) vascular shunt or bypass endarterectomy, other vessels of head and neck repair of blood vessel with synthetic patch graft diagnoses: congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled occlusion and stenosis of carotid artery without mention of cerebral infarction cardiac arrest atherosclerosis of native arteries of the extremities with gangrene ulcer of heel and midfoot acute osteomyelitis, ankle and foot 

Answer: The patient is high likely exposed to