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: tetracycline / paper tape attending: chief complaint: fevers, nausea, vomiting, hypotension major surgical or invasive procedure: none history of present illness: mrs. is a 59 yo f with dm, htn, hl, osa and gerd who presented to the ed with fevers, nausea/vomiting and found to be hypotensive. patient was in her usual state of health until this morning when she woke up and felt nauseated. she reports vomiting ~5 times, non-bloody, non-coffee ground emesis and feeling chills. she took her temperature and it was 101 and decided to come to the ed for evaluation. in the ed initial vital signs were t 103, hr 112, bp 154/73, rr 17 pox 97. she had normal cxr, ua and ct abd/pel. she then became hypotensive to sbp 70's, received 3l ns but her bp did not make a marked response. due to this a lij was placed, norepinephrine was started with a bp response to 105/86 and she was transfered to the icu. in the the patient states that her nausea and vomiting have resolved but she is having l shoulder pain (which she has had for 4 months) and as a , frontal ha that she reports she has in association with fevers. denied neck stiffness, photo/phonophobia. review of systems: (+) per hpi (-) denies sinus tenderness or rhinorrhea. denies chest pain or tightness, palpitations. denies shortness of breath, or wheezes. denied diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria, frequency or urgency. denies rashes or skin breakdown. no numbness/tingling or weakness in extremities. all other review of systems negative. past medical history: hyperlipidemia morbid obesity hypertension anal fistula sleep apnea gerd fatty liver disease osteoarthritis positive ppd social history: denies alcohol, tobacco, and illicit drugs. from . family history: mother with leukemia. one sibling deceased of cva at the age of 52. physical exam: gen: obese female, in pain but nad vs: t 99.5, hr 67, bp 150/120, rr 17, rr 100% 2l nc heent: perrl, eomi, dmm, no op clear, jvp could not be assessed due to body habitus, neck is supple with from, no cervical or supraclavicular lad cv: rr, nl s1s2, ii/vi sem, no s3s4 pulm: ctab abd: obese, bs+, soft, ntnd, no masses or hsm limbs: no le edema, 2+ pulses all 4 extremities skin: area of erythema around r leg, that is warm and non-painful (area has been demarkated). evidence of tinea pedis on both feet with onycomycosis neuro: cnii-xii nonfocal pertinent results: 07:02pm type-mix po2-32* pco2-55* ph-7.34* total co2-31* base xs-1 06:24am urine color-yellow appear-clear sp -1.020 blood-tr nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.5 leuk-sm rbc-0-2 wbc-0-2 bacteria-few yeast-none epi-0 05:36am lactate-2.2* 05:23am glucose-138* urea n-18 creat-1.3* sodium-141 potassium-4.2 chloride-102 total co2-32 anion gap-11 05:23am alt(sgpt)-15 ast(sgot)-22 ld(ldh)-195 alk phos-61 tot bili-0.3 albumin-4.4 05:23am wbc-7.5 rbc-3.96* hgb-10.7* hct-32.5* mcv-82 plt 138* 05:23am neuts-73.3* bands-0 lymphs-22.0 monos-2.6 eos-1.8 basos-0.2 05:23am pt-12.4 ptt-26.5 inr(pt)-1.0 05:33am blood wbc-6.2 rbc-3.28* hgb-8.8* hct-26.8* mcv-82 plt-109* 05:33am blood glucose-84 urean-12 creat-1.0 na-139 k-3.5 cl-106 hco3-29 angap-8 calcium-8.5 phos-2.3* mg-1.7 05:15am blood wbc-5.1 rbc-3.53* hgb-9.5* hct-29.4* mcv-83 plt-113* 05:15am blood glucose-97 urean-7 creat-1.2* na-144 k-3.6 cl-107 hco3-31 angap-10 mrsa screen : negative urine culture: mixed bacterial flora ( >= 3 colony types), consistent with skin and/or genital contamination. blood culture : ngtd chest (pa & lat) : no acute intrathoracic abnormality. ct abdomen w/contrast : 1. no acute intra-abdominal or pelvic process to explain the patient's symptoms. 2. fat-containing umbilical hernia. 3. prominent endometrium (15mm), also noted on the prior ct from 03/. in a patient of this age (presumed post-menopasual), recommend further evaluation with outpatient pelvic ultrasound. brief hospital course: this is a 59 year old female with dm, htn, hl, osa, and gerd with a recent admission, -11th for gbs sepsis and suspected skin source, who presented with fevers, nausea/vomiting, hypotension, and sepsis likely due to cellulitis of the rle. #. sepsis / hypotension: on initial admission, pt met sirs criteria w/temp to 103, hr of 112, and sbp in the 70s. initial work-up revealed rle cellulitis as the only sourse of infection: cxr, ct abd/pelvis, ua all normal. cellulitis preceded pt's previous hospitalization for gbs sepsis. blood cultures, urine cultures here ngtd. pt responded well to goal directed therapy, with cvps trending and maps > 65 with 3 l boluses of lr and brief requirement for levophed. fever downtrended, as did lactate, from 2.4 to 0.8. on hospital day 2, she remained afebrile and she was transferred out of the icu. on the floor, the patient remained stable with sbps in the 100s. #. rle cellulitis: hematogenous source of recurrent cellulitis not apparent as blood cultures were negative. the likely portal of entry for bacteria is through the skin breakdown on her feet from tinea pedis. the patient was initially treated with ceftriaxone/vancomycin. on , she was transitioned to a po regimen of bactrim and keflex. on day of discharge, her rle cellulitis had significantly improved, and the patient was discharged on keflex to complete a 14 day course. bactrim was discontinued because mrsa screen was negative. the patient was prescribed clotrimazole cream to address the issues of tinea pedis to try to prevent future episodes of cellulitis. #. acute renal failure: the patient presented with a cr of 1.3 from a baseline of 0.8, which was likely pre-renal azotemia due to dehydration. fena at that time 0.3%. her cre improved to 1.0, and was 1.2 after bactrim was initiated. her creatinine should be followed as an outpatient. #. anemia: the patient presented with a hct of 32 from a baseline of 34-36. her hematocrit ranged between 26-32 without transfusion or evidence of hemorrhage. the patient did have guaiac positive brown stools. discharge hct was 29.4. #. htn: the patient's hypertensive medications were initially held. she was restarted on lisinopril on the day of discharge. she will need follow-up with her pcp to have bp rechecked and to address whether or not to restart metoprolol and hctz. #. l shoulder pain: the patient was continued on cyclobenzaprine. #. osa: the patient was continued on cpap at night. #. dvt prophlaxis: heparin subcutaneous #. full code medications on admission: fluticasone 50 mcg 2 sprays in each nostril once a day hydrochlorothiazide 12.5 mg daily ketotifen fumarate 0.025 % drops 1 gtt in each eye twice a day lisinopril 5 mg daily metoprolol succinate 25 mg daily ranitidine 150 mg simvastatin 40 mg daily bisacodyl 10 mg daily prn calcium carbonate-vitamin d3 docusate sodium 100 mg loratadine 10 mg daily discharge medications: 1. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 2. simvastatin 40 mg tablet sig: one (1) tablet po hs (at bedtime). 3. fluticasone 50 mcg/actuation spray, suspension sig: two (2) spray nasal daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 6. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* 7. cephalexin 500 mg capsule sig: one (1) capsule po q8h (every 8 hours) for 10 days. disp:*30 capsule(s)* refills:*0* 8. clotrimazole 1 % cream sig: one (1) topical twice a day: apply to feet twice daily. disp:*30 grams* refills:*2* 9. cyclobenzaprine 10 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for shoulder pain. disp:*30 tablet(s)* refills:*0* 10. ketotifen fumarate 0.025 % drops sig: one (1) drop ophthalmic in each eye twice daily. 11. calcium 500 + d 500 mg(1,250mg) -400 unit tablet sig: one (1) tablet po twice a day. 12. loratadine 10 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: primary diagnoses: - sepsis - cellulitis, right lower leg - tinea pedis - acute kidney injury - anemia, unspecified - stool occult blood positive secondary diagnoses: - hypertension - obstructive sleep apnea - hyperlipidemia - gastroesophageal reflux disease - osteoarthritis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the hospital for fevers and low blood pressure. the cause of your fevers was likely an infection that started on your right lower leg. you were started on antibiotics to treat the infection. you should continue the antibiotic at home to complete a 14-day course. to help prevent future infections, it is important for you to keep your feet and lower legs clean and dry. you should use the clotrimazole/lotrimin cream twice daily to treat fungal infections which may increase your risk of developing skin infections in the future. the following changes were made to your home medication regimen: -you were started on cephalexin 500mg. you should take this medication every 8 hours for 10 additional days after you are discharged. -you were started on clotrimazole 1% cream. you should use the clotrimazole cream twice daily on your feet for at least 8 weeks. -we made some adjustments to your blood pressure medications. we stopped your metoprolol and your hydrochlorothiazide. you should continue your lisinopril as prescribed. you should follow up with your primary doctor your other blood pressure medications. -you should continue to take cyclobenzaprine 10mg three times a day as needed for shoulder pain. please continue your medications as prescribed, and keep all of your follow-up appointments. followup instructions: please make a follow-up appointment with your pcp, . at your convenience over the next 3 weeks for hospital discharge follow-up. 1. department: orthopedics when: wednesday at 12:10 pm with: ortho xray (scc 2) building: sc clinical ctr campus: east best parking: garage 2. department: orthopedics when: wednesday at 12:30 pm with: , md building: sc clinical ctr campus: east best parking: garage 3. department: surgical specialties when: tuesday at 1 pm with: , np building: sc clinical ctr campus: east best parking: garage procedure: venous catheterization, not elsewhere classified diagnoses: obstructive sleep apnea (adult)(pediatric) anemia, unspecified esophageal reflux unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia severe sepsis cellulitis and abscess of leg, except foot septic shock morbid obesity dermatophytosis of foot 

Answer: The patient is high likely exposed to