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: patient recorded as having no known allergies to drugs attending: chief complaint: infected right bka stump major surgical or invasive procedure: right aka history of present illness: patient trnasfered from hospital after being admitted for fever and mental status changes. head ct was negative for any acute findings. amputation summp with gangrenous necrosis and erythema. patient was given iv ancef and levaquin and transfered to here for further evaluation and treatment. past medical history: histroy of dm2, uncontrolled, insulin dependant history of pvd,s/p left cfa endartectomy with dacron patch ,s/p right cfa-at bpgw issvg ,right cfa+pfa endartectomy with dacroin patch angioplasty and akpop exploration ,s/p right bka. history of ischemic heart diseases/p mi,s/p cabg's history of systolic chf-chroinc, compensated (ef 20-25%) history of polycythemia history of prostate cancer s/p radium seed implantations history of dyslipdemia history of gall bladder disease s/p ccy history of cva with residual left sided deficet social history: retired, lives with daughter tobacco use: 120 pk yrs denies etoh use family history: n/c physical exam: vital signs: 101-97.3-79-22 b/p 126/68 o2 sat 99.3% @3l/nc gen: aaox3, no acute distress lungs: clear to auscultation heart: rrr abd: soft nontender,non distended, well healed midline scar ext: right amnp site with open wound 6x4cm in size. outer 2cm with escharremainaing area with clean base and fbrinous excudate. no pus ,doesnot probe. surrounding erythema 2cm pulses: femorals -palpable bilaterally, rt. dopperable, lt. palpable lt. at dopperaable-monophasic, absent lt. dp/pt. neuro: nonfocal pertinent results: 03:45am glucose-144* urea n-53* creat-1.7* sodium-135 potassium-4.5 chloride-98 total co2-24 anion gap-18 03:45am estgfr-using this 03:45am alt(sgpt)-15 ast(sgot)-31 alk phos-234* tot bili-1.8* 03:45am lipase-19 03:45am albumin-3.4 calcium-7.7* 03:45am wbc-23.37*# rbc-3.65* hgb-10.0* hct-32.5* mcv-89# mch-27.5# mchc-30.9* rdw-17.6* 03:45am neuts-75* bands-7* lymphs-5* monos-13* eos-0 basos-0 atyps-0 metas-0 myelos-0 03:45am hypochrom-3+ anisocyt-1+ poikilocy-1+ macrocyt-2+ microcyt-normal polychrom-1+ ovalocyt-1+ schistocy-1+ stippled-1+ teardrop-1+ elliptocy-1+ 03:45am plt smr-high plt count-544* lplt-1+ pltclm-1+ brief hospital course: admitted. iv antibiotics vanco, po levo,flagyl began.wound c/s mssa blood c/s negative.coumadin held for anticipate aka. episode of desaturation 86% improved with o2@ 5/lnc-95%, symptoms associated with nauses and confusion. ekg no acute changes.enzymes cycled.enzymes flat.abg: po2113/pco2 33/ph7.57/base x 8 lactate 2.8 patient diuresed with improvement of symptoms.transfered to vicu for continued monitering. aka cancelled. surgery: rt. aka - pod#1 -3 low urinary out put and hpotension associated with mild confusion and drowsyness. fluid boluses given with out improvement of urinary output.narcan administered with improvement of somulence and confusion. enzymes cycles and blood c/s obtained. wbc 23.2 hct 31.6 bun/cr 48/1.6 inr 3.3 coumadin continued to be held. left subclavian vein line placed.transfered to vicu.cvp monitered for fluid volume assesment.transfused for hct 25.3, post transfusion hct 31.0 inr 5.3 vitamin k given coumadin continued to be held. pod# creatinine continues to rise. 3.9 renal conslulted. urinne na 57,cr 33,urea 285 fen 5% febun 47%. continue to moniter renal function. start phosphate binders if necessary low phos,k diet. hold diuresis , only diurese if oxygenation issues. urine eso pending renal u/s to r/o obstructiion pending. 5/27-28/08 pod# creatinine continues to remain elevated. wbc continues to rise. id consulted, and patient started on zosyn. the patient experienced some wheezing overnight, for which he received nebulized treatments. pod#8 per id recommendations, the patient was continued on zosyn, blood cultures were obtained, and the cvl was removed. the patient was made floor status, and his telemetry order was d/c'd. he also received lasix 20 mg iv x1 as the patient was noted to have crackles over bilateral lung fields. his foley catheter was removed. pod 9 the patient again received 20 mg iv lasix. the patient's bun/cr had plateaud at 4.2-4.5. the patient had a bladder scan for >500cc, and a foley catheter placement was attempted multiple times, however penil/foreskin edema and phimosis precluded placement. urology was called for placement, which was successful. pod 10 the patient had some bleeding at the amputation site, for which was placed with good result. a ct of the torso was obtained as the patient continued to have leukocytosis without a definitive source, which was not revealing. fluconazole was started for yeast in the urine pod 11 the patient had some shortness of breath, disorientation, and dizziness while sitting up, and an ekg was performed, which was stable, and cardiac enzymes were sent, which were negative. pod 12 the patient's lasix was increased to dosing. flagyl was started empirically for c. diff given the persistent leukocytosis, and zosyn was stopped. hematology was consulted for further evaluation given the patient's history of polycythemia . the patient was confused and hypoxic; and abg was drawn, and the patient received supportive care. his hypoxia resolved somewhat. an echo was ordered to assess for other abnormalities. the patient received 60 of po lasix the patient began having melena, and the patient received multiple units of blood and ffp. he was subsequently transferred to the unit as he became hemodynamically unstable. pressors were required to maintain his pressure. serial hematocrits were performed. the patient was intubated and sedated and an upper endoscopy was performed. for details, please see report. no active bleeds were identified. the patients hematocrits were continued to be serially followed. an echo was performed. flagyl and fluconazole were d/c'd tube feeds were started for nutritional support. zosyn was stopped. 6/7 per renal recommendations, the patient received 40 mg of iv lasix. vent was weaned. the patient was extubated and pulmonary toilet was performed. lasix dosing was adjusted to 40 iv bid. a ct of the head was ordered as the patient had a persistently altered mental status; no major abnormalities were noted. please see report for details tube feeds were continued. an mri of the head was going to be performed, however, the patient was noted to have a bb in his face from a prior incident, and the mri could not be performed. a picc was placed for iv access. neurology was consulted for further recommendations, and an eeg was performed. speech and swallow was involved to determine if the patient would tolerate a diet. : the patient was stable for transfer to the vicu : the patient was stable, and a pt consult was obtained. medications were transitioned to oral medications. nt suctioning was performed as the patient had thick secretions. that afternoon, the patient became hypotensive to an sbp of 70s-80s, and was hypoxic with an spo2 in the 70s-80s. he was transferred back to the cvicu for further care. pan cultures were performed to assess for a possible source of infection. the patient was intubated and sedated, and received supportive care for his hypotension. cts were ordered, however the patient was not stable for transfer. an lp was performed, and more cultures were sent. the patient was restarted on zosyn per consultation service recommendations. : ct of the head, pelvis and abdomen was performed, however no acute collections were seen. bilateral pleural effusions were noted, however, and ip was contact for a possible thoracentesis. during the patient's remaining hospital course, the patient's white blood count decreased to a low of 13.9. a trach and peg were performed on . on , the patient was weaned from the vent to trach collar, which he tolerated well. rehab screening was started. on , the patient was doing well on trach collar, and his antibiotics were stopped, as there was no definite source of infection. during the remainder of his stay, the patient was afebrile, with stable vital signs, tolerating trach mask/collar well. he was stable for trasfer to rehab. medications on admission: coumadin 1', lasix 20', metolazone 1.5', coreg 3.125', lovastatin 40', lisinopril 40', neurontin 600', nph 70/30 20qam & 10qpm, prilosec 20', singulair 10', calcium 600', folate 1', albuterol prn, percocet prn, dulcolax prn discharge medications: 1. carvedilol 3.125 mg tablet sig: one (1) tablet po daily (daily). 2. albuterol 90 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours) as needed for wheeze, dyspnea. 3. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 4. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 5. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 6. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours). 7. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. oxycodone 5 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 10. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 11. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 12. sevelamer hcl 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). 13. heparin flush (10 units/ml) 1 ml iv prn line flush temporary central access-floor: flush with 10 ml normal saline followed by heparin as above daily and prn. 14. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection (2 times a day). 15. sodium chloride 0.9% flush 3 ml iv prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. 16. insulin regular human 100 unit/ml cartridge sig: one (1) injection once a day: per insulin sliding scale. 17. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q2h (every 2 hours) as needed. 18. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 19. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 20. carvedilol 12.5 mg tablet sig: one (1) tablet po bid (2 times a day). 21. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 22. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). 23. sodium chloride 0.9% flush 3 ml iv prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. 24. heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. 25. sodium chloride 0.9% flush 3 ml iv prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. 26. pantoprazole 40 mg iv q12h discharge disposition: extended care discharge diagnosis: infection right bka stump history of perpheral vascular diseases s/p left cfa endartectomy with dacron patch,s/p right cfa-at bpg with ssvg,rt. cfa&pfa endartectomy dacron profundaplasty, akpop exploration,rt. bka history of dm2, insulin dependant, controlled history of ischemic heart disease s/p mi,cabg's history of systolic congestive heart failure, chroinic-compensated (ef 20-25%) history of polycythemia history of prostate cancer s/p radium seeds history of hypercholestremia history of gall bladder disease s /p ccy history of cva with left sided deficet history of 120pk yrs tobacco use postop hypotension secondary to intravascular depletion postop confusion secondary to narcotics-narcan postop elevated inr secondary to antibiotics -reversed postoperative chroinc chf compounded by acue-diureses postoperative blood loss anemia -transfused postoperative arf secondary to hypotension postoperative fever uti w leukcytosis-treated postoperative leukocytosis, persistant upper gi bleed discharge condition: stable discharge instructions: discharge instructions following above knee or below knee amputation this information is designed as a guideline to assist you in a speedy recovery from your surgery. please follow these guidelines unless your physician has specifically instructed you otherwise. please call our office nurse if you have any questions. dial 911 if you have any medical emergency. activity: there are restrictions on activity. on the side of your transmetatarsal amputation you are non weight bearing for weeks. you should keep this amputation site elevated when ever possible. no driving until cleared by your surgeon. please call us immediately for any of the following problems: redness in or drainage from your leg wound(s). new pain, numbness or discoloration of your foot or toes. watch for signs and symptoms of infection. these are: a fever greater than 101 degrees, chills, increased redness, or pus draining from the incision site. if you experience any of these or bleeding at the incision site, call the doctor. exercise: limit strenuous activity for 6 weeks. do not drive a car unless cleared by your surgeon. no heavy lifting greater than 20 pounds for the next 14 days. try to keep leg elevated when able. bathing/showering: you may shower immediately upon coming home. no bathing. a dressing may cover you??????re amputation site and this should be left in place for three (3) days. remove it after this time and wash your incision(s) gently with soap and water. you will have sutures, which are usually removed in 4 weeks. this will be done by the surgeon on your follow-up appointment. wound care: sutures / staples may be removed before discharge. if they are not, an appointment will be made for you to return for staple removal. when the sutures are removed the doctor may or may not place pieces of tape called steri-strips over the incision. these will stay on about a week and you may shower with them on. if these do not fall off after 10 days, you may peel them off with warm water and soap in the shower. avoid taking a tub bath, swimming, or soaking in a hot tub for four weeks after surgery. medications: unless told otherwise you should resume taking all of the medications you were taking before surgery. you will be given a new prescription for pain medication, which can be taken every three (3) to four (4) hours only if necessary. remember that narcotic pain meds can be constipating and you should increase the fluid and bulk foods in your diet. (check with your physician if you have fluid restrictions.) if you feel that you are constipated, do not strain at the toilet. you may use over the counter metamucil or milk of magnesia. appetite suppression may occur; this will improve with time. eat small balanced meals throughout the day. cautions: no smoking! we know you've heard this before, but it really is an important step to your recovery. smoking causes narrowing of your blood vessels which in turn decreases circulation. if you smoke you will need to stop as soon as possible. ask your nurse or doctor for information on smoking cessation. avoid pressure to your amputation site. no strenuous activity for 6 weeks after surgery. diet: there are no special restrictions on your diet postoperatively. poor appetite is expected for several weeks and small, frequent meals may be preferred. for people with vascular problems we would recommend a cholesterol lowering diet: follow a diet low in total fat and low in saturated fat and in cholesterol to improve lipid profile in your blood. additionally, some people see a reduction in serum cholesterol by reducing dietary cholesterol. since a reduction in dietary cholesterol is not harmful, we suggest that most people reduce dietary fat, saturated fat and cholesterol to decrease total cholesterol and ldl (low density lipoprotein-the bad cholesterol). exercise will increase your hdl (high density lipoprotein-the good cholesterol) and with your doctor's permission, is typically recommended. you may be self-referred or get a referral from your doctor. if you are overweight, you need to think about starting a weight management program. your health and its improvement depend on it. we know that making changes in your lifestyle will not be easy, and it will require a whole new set of habits and a new attitude. if interested you can may be self-referred or can get a referral from your doctor. if you have diabetes and would like additional guidance, you may request a referral from your doctor. follow-up appointment: be sure to keep your medical appointments. the key to your improving health will be to keep a tight reign on any of the chronic medical conditions that you have. things like high blood pressure, diabetes, and high cholesterol are major villains to the blood vessels. don't let them go untreated! please call the office on the first working day after your discharge from the hospital to schedule a follow-up visit. this should be scheduled on the calendar for seven to fourteen days after discharge. normal office hours are 8:30-5:30 monday through friday. please feel free to call the office with any other concerns or questions that might arise no stump shrinkers call if stump develps redness, drainage or swelling call if develops fever >101.5 followup instructions: 2 weeks dr. , call for an appointment procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy closed [endoscopic] biopsy of bronchus amputation above knee transfusion of packed cells transfusion of other serum closed [endoscopic] biopsy of stomach diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified pleural effusion congestive heart failure, unspecified toxic encephalopathy acute posthemorrhagic anemia acute kidney failure, unspecified candidiasis of other urogenital sites hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified personal history of malignant neoplasm of prostate peripheral vascular disease, unspecified personal history of tobacco use chronic kidney disease, stage iii (moderate) acute respiratory failure other shock without mention of trauma bacteremia hemorrhage of gastrointestinal tract, unspecified urinary complications, not elsewhere classified acute on chronic systolic heart failure drug-induced delirium other and unspecified coagulation defects personal history of irradiation, presenting hazards to health infection (chronic) of amputation stump other specified analgesics and antipyretics causing adverse effects in therapeutic use polycythemia vera 

Answer: The patient is high likely exposed to