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: patient is a 43-year-old female with past medical history of type 1 diabetes, end-stage renal failure on hemodialysis, and chronic bilateral heel ulcers, neuropathy, personality disorder, who presents with a one day history of chills, fever, and diarrhea without any vomiting or abdominal pain. she reports she has had greater than 20 stools with some incontinence without blood or mucus. reports drenching sweats. on the last dialysis, on , her graft was working well at that time. she did not complain of any headache, chest pain, shortness of breath, or urinary symptoms. in the emergency department, the patient received 1 liter of normal saline, 1 gram of vancomycin, 1 gram of ceftazidime, 500 mg of levaquin, 1 gram of tylenol, and 600 mg of ibuprofen. physical examination: temperature is 101. heart rate 83. blood pressure 92/51. respirations 20. heent: pupils are equal, round, and reactive to light. dry mucous membranes. oropharynx is clear. heart: normal s1, s2, regular, rate, and rhythm, no murmurs, rubs, or gallops. lungs are clear to auscultation bilaterally. abdomen is soft, nontender, nondistended, with normoactive bowel sounds. extremities are without clubbing, claudication, or edema. she has bilateral heel ulcers. left ulcer with a sinus tract to the bone. laboratories: white count 24.0, hematocrit 42.3, platelets 463, 93% segs, 5% lymphocytes, 2% monocytes. sodium is 129, potassium is 5.6, and a hemolyzed specimen. chloride is 80, bicarb is 24, bun is 47, creatinine is 8.6, glucose is 230. lactate is 5.6, anion gap is 25. chest x-ray: no infiltrates. hospital course: 1. infectious disease: patient admitted with a question of sepsis. patient also with bilateral calcaneus osteomyelitis. patient initially thought to be septic on admission with a low blood pressure in the 80s/40s, fever, diarrhea on admission, but her only positive blood culture was drawn on and it was 1/2 bottles positive for peptostreptococcus. all of her surveillance cultures have remained negative. she was initially covered empirically with vancomycin, ceftazidime, and levofloxacin. her hypotension was then felt to also be secondary to diabetic ketoacidosis as patient had an elevated serum anion gap of 27. her normal baseline between 14-19. she also had a blood sugar of 230. she was started on an insulin drip and her gap fell by the 11. she was then changed to sliding scale insulin. patient also has bilateral chronic lower extremity ulcers, and she was followed by podiatry and vascular surgery while on the medical floor. she had a bone scan, which revealed bilateral osteomyelitis of both calcaneus bones. the patient was then treated with vancomycin and zosyn for two days, and then switched to vancomycin, ceftazidime, and po flagyl as her iv access became problem and needed to have her antibiotics dosed at dialysis only. the patient then became febrile to 104 with altered mental status on after not having dialysis or antibiotics for three days due to access issues. an emergent femoral catheter was placed for hemodialysis by interventional radiology and she received hemodialysis that day, and was treated with vancomycin, ceftazidime, gentamicin, and po flagyl. her mental status improved that day and blood culture was drawn, and she had nothing growing from this blood culture to date. she will continue on vancomycin, ceftazidime, and flagyl for a total course of six weeks for treatment of osteomyelitis. 2. renal: patient with end-stage renal disease on hemodialysis, awaiting living donor transplant. patient initially thrombosed her arteriovenous graft on during hemodialysis. she was also having borderline hypotension at that time. she was treated with a thrombectomy on , which then re-thrombosed. she was then scheduled for a permacath on the floor, but she was unable to have this for multiple days secondary to fevers, scheduling delays. when they attempted to place this permacath, they were unable because of her bilateral internal jugular occlusions, which were checked by mrv and found to be nonbypassable. the next best access was felt to be a repeat thrombectomy for clotted a-v graft. as her blood pressure had improved at this time, but her repeat thrombectomy was unsuccessful secondary to proximal stenosis. she was then scheduled for a tunneled right femoral catheter, which she was unable to get due to spiking fevers to 104. she had a temporary femoral catheter placed for hemodialysis, and she is now awaiting clearance for her tunneled right femoral catheter. she had cannot have a tunneled femoral catheter due to the left femoral vein being staged for transplant on that side. she has been continued on phoslo and epogen during this admission. 3. gastrointestinal: admitted with diarrhea and fevers. diarrhea continued especially after dialysis despite negative stool cultures, ova and parasites and clostridium difficile toxin negative x3. yesterday her nurse remarked that her stool is actually well formed, but the patient reports this is still diarrhea. patient may still be incontinent secondary to autonomic neuropathy. 4. endocrine/type 1 diabetes complicated by neuropathy, retinopathy, nephropathy, gastropathy, chronic bilateral ulcers, and autonomic dysfunction. patient initially thought to be in diabetic ketoacidosis with increased gap and hypotension. her gap responded to an insulin drip and her hypotension was found to be secondary to autonomic neuropathy and improved with treatment of midodrine and fludrocortisone which she has continued during this admission. she was followed by with very difficult to control blood sugars, was maintained on sliding scale humalog and pm lantus. the patient had multiple episodes of low blood sugars as well as excessively high blood sugars in the morning. she was continued on neurontin. her heel ulcers have also been followed by podiatry and debrided surgically on with a right medial malleolar abscess, which was sent for culture, which grew multiple organisms. the patient was continued with bedside debridement as performed by podiatry and is scheduled to go for a subtotal left calcanectomy tomorrow on . 5. cardiovascular: patient presenting with hypotension initially thought secondary to autonomic neuropathy and diabetic ketoacidosis. her hypotension is improved with treatment with midodrine and fludrocortisone, and she has had no further episodes of remarkable hypotension. patient with many vascular access problems including bilateral internal jugular occlusion. her left femoral vein is currently being reserved for possible future renal transplant. vascular surgery has followed the patient and performed an angiogram of her left femoral artery, which was found to be normal, and patient not felt to need any vascular surgery at this time. 6. psychiatry: patient with a history of personality disorder. patient also with very labile mood on the floor and very abusive to staff at times. she threatened to leave against medical advice on multiple occasions. 7. pulmonary: patient's oxygen saturations have been stable since this admission. 8. fluids, electrolytes, and nutrition: initially presenting with hyponatremia, but her sodium of 129 improved to 131 after her insulin drip corrected her serum anion gap in the medical intensive care unit. she has had no other gross electrolyte abnormalities during this admission, and she was continued on phoslo tid with meals. 9. prophylaxis: the patient has been on proton-pump inhibitor, and had podas boots. 10. code status: patient is full code. patient will have her discharge summary addendum upon discharge. dr., 12-aan dictated by: medquist36 procedure: other revision of vascular procedure other revision of vascular procedure reconstruction of eyelid with hair follicle graft other local excision or destruction of lesion or tissue of skin and subcutaneous tissue hemodialysis arteriography of femoral and other lower extremity arteries venous catheterization for renal dialysis excisional debridement of wound, infection, or burn other incision with drainage of skin and subcutaneous tissue arteriography of other intra-abdominal arteries nonexcisional debridement of wound, infection or burn other partial ostectomy, tarsals and metatarsals other partial ostectomy, tarsals and metatarsals diagnoses: other shock without mention of trauma cellulitis and abscess of leg, except foot streptococcal septicemia diabetes with renal manifestations, type i [juvenile type], not stated as uncontrolled ulcer of heel and midfoot diabetes with neurological manifestations, type i [juvenile type], not stated as uncontrolled acute osteomyelitis, ankle and foot diabetes with other specified manifestations, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to