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: penicillins / bactrim attending: chief complaint: chest pain major surgical or invasive procedure: coronary artery bypass graft x 2 (lima-lad, svg to om) history of present illness: 65 yo f with pmh significant for hypertension, hyperlipidemia, diabetes who was transferred from after developing chest pain and subsequently ruled in for nstemi with trop 0.19 on pod 1 from her left foot ulcer skin graft. cardiac catheterization today revealed lm and 3vd. we are asked to evaluate for surgical revascularization. past medical history: hypertension hyperlipidemia congestive heart failure insulin dependent diabetes peripheral neuropathy hypothyroidism obstructive sleep apnea- does not wear cpap *h/o mrsa cellulitis- needs contact precautions for mrsa bilateral charcot feet with a nonhealing ulcer(plantar surface of right foot) social history: lives with: in process of looking for apt. recently sold house she lived in with her mother as her mother moved to a nursing home. occupation:disability tobacco:quit 40 years ago etoh: glasses of wine daily rec drugs: denies family history: denies physical exam: vs: t 98.2, bp 136/47, hr 74, rr 16, 96/ra gen: obese f, nad heent: mmm, op clear, no jvd visualized cv: cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no thrills, lifts. no s3 or s4. sem , loudest at lusb. resp: ctab abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: l foot wrapped in gauze, r foot pulses non palpable. left thigh skin graft neuro: aaox3, face symmetric, speech fluent skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: 04:58am blood wbc-6.2 rbc-2.76* hgb-9.0* hct-26.2* mcv-95 mch-32.6* mchc-34.4 rdw-15.0 plt ct-308 05:13am blood wbc-6.8 rbc-2.71* hgb-8.9* hct-25.9* mcv-95 mch-32.7* mchc-34.3 rdw-15.1 plt ct-240 04:58am blood glucose-144* urean-25* creat-0.9 na-130* k-4.6 cl-92* hco3-31 angap-12 05:13am blood glucose-84 urean-25* creat-0.9 na-129* k-4.2 cl-92* hco3-33* angap-8 05:35am blood wbc-5.4 rbc-3.66* hgb-11.9* hct-35.4* mcv-97 mch-32.6* mchc-33.7 rdw-15.2 plt ct-296 12:40pm blood pt-14.0* ptt-37.4* inr(pt)-1.2* 05:35am blood glucose-134* urean-23* creat-0.9 na-133 k-4.6 cl-93* hco3-33* angap-12 12:40pm blood alt-19 ast-23 ck(cpk)-55 alkphos-86 totbili-0.6 dirbili-0.2 indbili-0.4 05:35am blood ck-mb-3 ctropnt-0.28* 09:45pm blood ck-mb-3 ctropnt-<0.01 05:35am blood calcium-9.5 phos-4.6* mg-1.9 12:40pm blood %hba1c-5.8 eag-120 cath: comments: 1. coronary angiography of this right dominant system revealed severe left main and two vessel coronary artery disease. the lmca was calcified with a distal 80% lesion leading into the ostial lad and ostial lcx. the lad was calcified with the ostial 80% lesion and mild diffuse disease. the lcx was calcified with the ostial 80% lesion and an additional 80% stenosis proximally. the av groove lcx was small distally. the rca had a high anterior origin and was mildly calcified with mild diffuse plaquing to 25%. 2. abdominal aortography demonstrated mild tapering of the distal aorta, a 60% proximal left renal artery stenosis, and mild bilateral common iliac artery plaquing to 30% on the right. 3. limited resting hemodynamics demonstrated moderate systemic arterial hypertension (sbp 174 mm hg). the left ventricular filling pressure was moderately elevated (lvedp 23 mm hg). there was no gradient upon pullback of the catheter from the lv into the aorta. final diagnosis: 1. left main and two vessel coronary artery disease. 2. moderate left ventricular diastolic dysfunction. 3. moderate left renal artery stenosis. echo: the left atrium is moderately dilated. the estimated right atrial pressure is 0-5 mmhg. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild regional left ventricular systolic dysfunction with mid to distal inferolateral wall hypokinesis. overall left ventricular systolic function is normal (lvef>55%). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. there is moderate thickening of the mitral valve chordae. trivial mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is an anterior space which most likely represents a prominent fat pad. impression: mild regional left ventricular systolic dysfunction with normal global systolic function. estimated elevated left ventricular filling pressures. intra-op echo pre bypass no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity is mildly dilated. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are simple atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. physiologic mitral regurgitation is seen (within normal limits). there is a trivial/physiologic pericardial effusion. dr. was notified in person of the results in the operating room at the time of the study. post bypass the patient is being a-paced. there is overall normal biventricular systolic function. the thoracic aorta appears intact. no significant change from the pre-bypass study. brief hospital course: 65 year old female with history of diabetese c/b foot ulcers, chf presents with nstemi on pod#1 from skin grafting to right foot ulcers. the patient remained on the medicine service for preoperative plavix washout. she did develop some epistaxis. ent was consulted. this resolved with afrin and pressure. she was transferred to cardiac surgery on . she was brought to the operating room on where the patient underwent cabgx4 as detailed in the operative report. overall the patient tolerated the procedure well and post-operatively was transferred to the cvicu in stable condition for recovery and invasive monitoring. vancomycin was used for surgical antibiotic prophylaxis. pod 1 found the patient extubated, alert and oriented and breathing comfortably. the patient was neurologically intact and hemodynamically stable on no inotropic or vasopressor support. beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. she did develop hyponatremia, which improved with free water restriction. this will be followed by cardiology as an outpatient. the patient was transferred to the telemetry floor for further recovery. chest tubes and pacing wires were discontinued without complication. the patient was evaluated by the physical therapy service for assistance with strength and mobility. given her recent skin graft to right foot ulceers- she is non-weight bearing on the rle. she will follow up with podiatry next week. by the time of discharge on pod 4, the sternal wound was healing and pain was controlled with oral analgesics. the patient was discharged to rehab in good condition with appropriate follow up instructions. medications on admission: metformin (received today) heparin sq received this morning aspirin 325mg lantus metoprolol lisinopril lasix 80mg today folate lanoxin calcium + d iv magnesium. home medications: digoxin 125 mcg daily simvastatin 80 mg daily folic acid 1 mg daily, lasix 80 mg daily lantus 50 units subcutaneous injection twice a day humalog 26 units subcutaneous injection twice a day with meals synthroid 150 mcg daily lisinopril 20 mg daily metformin 1000 mg twice a day metoprolol sr 50 mg daily darvocet-n 100 p.r.n. pain aspirin 81 mg daily calcium carbonate/vitamin d 600/400 mg daily zetia 10 mg daily. discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. outpatient lab work sodium with results to dr. fax: 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 6. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 7. levothyroxine 50 mcg tablet sig: three (3) tablet po daily (daily). 8. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 9. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for fever, pain. 10. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po hs (at bedtime) as needed for constipation. 11. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 12. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 13. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 14. lisinopril 10 mg tablet sig: one (1) tablet po bid (2 times a day). 15. toprol xl 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 16. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 17. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 18. insulin glargine 100 unit/ml solution sig: one (1) subcutaneous twice a day: 35units with breakfast, 25units hs. 19. insulin lispro 100 unit/ml solution sig: one (1) subcutaneous twice a day: 12 units at breakfast, 10 units at dinner. 20. insulin lispro 100 unit/ml solution sig: one (1) subcutaneous four times a day: per humalog sliding scale. 21. ciprofloxacin 750 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 3 doses: for uti. discharge disposition: extended care facility: - discharge diagnosis: coronary artery disease hypertension,hyperlipidemia,congestive heart failure,insulin dependent diabetes, peripheral neuropathy, hypothyroidism, obstructive sleep apnea- does not wear cpap, *h/o mrsa cellulitis- needs contact precautions for mrsa, bilateral charcot feet with a nonhealing ulcer(plantar surface of right foot), s/p split thickness skin graft right thigh to 2 nonhealing ulcers,on plantar surface of her right foot, s/p tonsillecomy, s/p multiple foot procedure on right foot, s/p right shoulder arthroscopic surgery discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram and lortab incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month until follow up with surgeon no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments provider: , md phone: date/time: 1:00 provider: , dpm phone: date/time: 2:30 please call to schedule appointments with your primary care dr. in weeks cardiologist dr. at in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** **please draw sodium in 1 week with results to dr. fax: ** md procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters left heart cardiac catheterization (aorto)coronary bypass of one coronary artery aortography diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery pure hypercholesterolemia urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension hyposmolality and/or hyponatremia unspecified acquired hypothyroidism diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes other and unspecified hyperlipidemia long-term (current) use of insulin proteus (mirabilis) (morganii) infection in conditions classified elsewhere and of unspecified site epistaxis unspecified disorder of plasma protein metabolism monoclonal paraproteinemia 

Answer: The patient is high likely exposed to