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 83-year-old patient resides at a rehab center with a past medical history of insulin dependent diabetes mellitus, peripheral vascular disease, multiple falls, chronic depression, chronic atrial fibrillation, and hypertension. the patient had developed pressure ulcers to the left heel and calf which escalated to gangrene. the patient also has ulcerations to the right heel. he was brought to for angiogram studies of his lower extremities. intraoperatively found that both right and left femoral arteries were occluded and multiple inflation stent placements and removal was done with total of 10,000 units of heparin given. the studies were significant for severe peripheral vein disease on the right, but more so to the left. patient was recanalized with left cia, external iliac artery, and cfa with mechanical thrombectomy. postangiogram, the patient was transferred to the micu for observation due to heparin gtt for anticoagulation and strict control of blood pressure. on admission to the tsicu, the patient was status post angiogram and bilateral external iliac stents with thrombectomy requiring intensive care unit care secondary to close blood pressure monitoring, strict control requiring the nitroglycerin. diastolic blood pressures went as high as 120 postoperatively. past medical history: 1. peripheral vascular disease. 2. insulin dependent-diabetes mellitus. 3. as. 4. coronary artery disease. 5. hypertension. 6. chronic renal failure. 7. depression. medications at home: 1. dulcolax. 2. apap. 3. ultram. 4. milk of magnesia. 5. mvi. 6. zinc. 7. diovan. 8. niferex. 9. norvasc. 10. insulin. allergies: penicillin. physical exam on admission: neurologically, the patient was a pleasant and confused at times and was able to follow simple commands, slow mentation needing repeated questioning at times. patient denied seizure activity, and was able to move upper extremities without difficulty, lower extremities were move on bed. cardiovascularly, the patient was in chronic atrial fibrillation with occasional pvcs noted, systolic blood pressure to 140s and above. nitroglycerin was used for blood pressure control, and regular heart rate at 60s to 70s and palpable pulses to bilateral radials, peripheral pulses showed dopplerable bilateral femoral pulses, right posterior tibial dorsalis pedis, no doppler pulse to the left dorsalis pedis or pt. patient was continued on heparin and denied chest pain. lungs had coarse rhonchi and crackles to the upper lobes, but the patient does not complain of any shortness of breath at time even during episodes of desaturation to the high 80s. respiratory rate never increased above 18-20 and was unlabored. gi: abdomen was round, soft, and slightly distended. bowel sounds x4 quadrants. the patient was able to tolerate po's with observation and monitoring. no complaints of nausea, vomiting, or diarrhea. genitourinary: there is an indwelling foley catheter secure and patent with adequate, but minimal output. the patient had elevated bun and creatinine at time of admission to 50/1.8. integument: there was no signs of breakdown noted to the back or buttocks. gangrenous toes noted to bilateral feet, large black, necrotic ulcers to bilateral heels and to left calf. the patient was very sensitive to these areas needing repositioning for comfort and to minimize friction to the areas. physical exam on admission to the sicu: generally, a temperature of 36.9, blood pressure 118/47, heart rate of 81, and o2 saturation of 98% on room air, respiratory rate of 16. generally, alert, awake, oriented male. heent: pupils are equal, round, and reactive to light and accommodation. extraocular movements are intact. cardiovascularly, irregularly, irregular. respiratory is clear to auscultation bilaterally. abdomen was soft and nontender. extremities showed 1+ palpable femoral pulses, dopplerable right pt and dorsalis pedis and nondopplerable left. two second capillary refill on the right lower extremity, second capillary refill to the left lower extremity without groin hematomas. neurologically: there were no focal deficits. mentation was still slow. laboratories on admission to the sicu postangiogram: white count of 17, hematocrit of 31.2, platelets of 530 with pt, ptt, and inr of 14.6, 34.2, and 1.4. chemistries of 129, 5.3, 98, 17, 50, and 1.8. in the sicu, the patient was weaned on his nitroglycerin drip. was started on norvasc and diovan. goal systolic blood pressure less than 150 with doppler pulse examinations followed closely. on postintervention day two, laboratories showed increased creatinine to 2.4 and renal team became involved. they they discontinued the , norvasc, and allowed the blood pressure to increase to 140-60 range with lasix prn indicated for volume overload and hypoxia. the patient was fluid restricted 1 liter a day for hyponatremia and volume overload. patient's iv fluids were discontinued and no aces, arbs, or nsaids were placed. the urine was checked for protein-to-creatinine ratio. antibiotics dosed appropriately for renal. postangio day three, the patient is continued without incident and renal input was noted and in place. patient's creatinine then went to 3.0 and stabilized at 3.0 for one day following renal's input, and then rose to 3.6. on hospital day seven, a right ij was placed with good position, and urine output was 30 cc an hour with lasix, creatinine at 4.0 with 3+ bilateral femoral pulses, and coumadin started 5 mg with a goal inr of 1.8 to 2.0. patient was made out of bed at this time and transferred to the floor. on postprocedure day seven, patient was continued to be followed by renal with continued increase in creatinine and recommendations were to continued the map greater than 70, systolic blood pressure greater than 120, hematocrit greater than 30 with assessment for no urgent need for hemodialysis. however, patient on hospital day eight, was assessed to need left above the knee amputation for increasing infection gangrene. family was spoken to about this and seemed to need more time to think about it. we will continue to follow and continued expected management for hemodialysis needs. patient on the was found to have acute tubular necrosis by renal, and on examination showed generalized edema with weakly dopplerable pulses and desperate need of left aka. levofloxacin and flagyl were continued on postprocedure day 11, and iv fluids again were discontinued. lasix 40 mg iv bid started to try to diurese patient. patient then underwent left above the knee amputation on , hospital day 13 without incident. the patient was then transferred back to the floor, and on postoperative day #1, showed stump intact with decreasing edema. renal fellow noted on postoperative day one that family did not want patient to be on dialysis. postoperative day one, the patient was made comfort measures only, and at 14:45 on , the patient was found unresponsive in his bed. the patient had acute renal failure on chronic renal disease with congestive heart failure and went into respiratory arrest. time of death: 14:45. diagnoses: 1. peripheral vascular disease. 2. insulin dependent-diabetes mellitus. 3. acute renal failure. 4. atrial fibrillation. 5. coronary artery disease. 6. hypertension. 7. chronic renal insufficiency. 8. depression. , m.d. 2914 , m.d. dictated by: medquist36 procedure: angioplasty of other non-coronary vessel(s) arteriography of femoral and other lower extremity arteries aortography incision of vessel, lower limb arteries insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) amputation above knee diagnoses: acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified atrial fibrillation aortic valve disorders hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease atherosclerosis of native arteries of the extremities with gangrene ulcer of heel and midfoot acute osteomyelitis, ankle and foot ulcer of calf 

Answer: The patient is high likely exposed to