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 is a 70-year old female with a complicated medical history including peripheral vascular disease and insulin-dependent type 2 diabetes. she has recently moved from to . she states she has had multiple surgeries and stent placements on the lower extremities bilaterally. she does not remember the details. she has requested further information from the hospital in ( hospital). she was first seen at our institution, , on for necrotic toes. she was seen in the emergency room and referred to the clinic for podiatry consult. she was then referred to dr. for a vascular evaluation. she is now admitted to our service for iv antibiotics and evaluation. review of systems: positive for a history of chest pain and pressure, dyspnea on exertion (relieved with rest), history of hemorrhoids with bright red blood per rectum, and urinary frequency. past medical history: includes insulin-dependent type 2 diabetes, coronary artery disease (with a history of a myocardial infarction), a history of congestive heart failure (compensated), seasonal allergies, history of gi bleed secondary to hemorrhoids. past surgical history: includes a cholecystectomy, total abdominal hysterectomy with bilateral salpingo-oophorectomy in , right carpal tunnel repair, and trigger finger surgery. allergies: zocor and lipitor (cramps and joint pain), sulfa (caused hives and angioedema), demerol (caused skin blisters), ivp dye (caused hives and blisters), and tape (caused blisters). medications on admission: lasix 40 mg b.i.d., mavik 4 mg daily, omeprazole 20 mg daily, lantus insulin 35 units at bedtime with a humalog insulin sliding scale. family history: positive for father dying at 79 with prostate carcinoma, diabetes, parkinson's, and emphysema. mother was 83 and died of renal failure. social history: she has 3 children, all living, 2 with renal disease and 1 with hypercholesterolemia. the patient denies tobacco or alcohol use and is independent in adls. physical examination on admission: the patient is alert and oriented. obese. teary eyed but pleasant. heent exam is unremarkable. the lungs are clear to auscultation bilaterally. heart has a regular rate and rhythm with a 2/6 systolic ejection murmur at the base. abdominal exam is obese, nontender, nondistended. bowel sounds are present. no masses noted. the extremities show minimal edema with palpable femoral's at 2+ bilaterally with dopplerable dp and pt signals bilaterally. the left 1st toe is with gangrenous changes, dry. the right 1st toe and 2nd toe are with gangrenous changes, dry. summary of hospital course: the patient was admitted to the vascular service. she was begun on vancomycin and levofloxacin. admitting white count was 5.4, hematocrit was 42.5, platelets were 343,000. coag's were normal. urinalysis was negative. bun was 37, creatinine was 1.5, with a k of 5.2. liver enzymes revealed an alt of 19, ast of 23, alkaline phosphatase of 176, amylase of 71, total bilirubin of 0.4, and lipase of 25. albumin of 3.9. cholesterol of 191. triglycerides of 178. hemoglobin a1c was 8. the patient's stress test on showed moderate reversible medium-size lateral wall perfusion defect with an ejection fraction of 68%. foot films done on demonstrated osteomyelitis of the right 1st and 2nd digits, ulceration of the distal left 1st digit with diffusely demineralized bone. an echocardiogram on demonstrated a left atrial dilatation with mild symmetrical left ventricular hypertrophy with an ejection fraction calculated at 55%. the mitral valves were mildly thickened. she had physiological mitral regurgitation with mild pulmonary systolic hypertension. ekg was a sinus rhythm with no acute changes. the patient was continued on her preadmission medications. renal function was monitored. iv hydration was begun in anticipation for arteriogram. podiatry was consulted regarding the necrotic toes and recommendations regarding management and antibiotic therapy. on the patient underwent an abdominal aortic and pelvic vessel arteriogram with bilateral lower extremity angiograms. the study demonstrated patent abdominal aorta, although diffusely and mildly narrowed in the infrarenal portion. there was single renal arteries present bilaterally. there was mild post ostial stenosis of the left renal artery. there was calcification along the infrarenal aorta and iliac arteries. the right side runoff showed significant segmental stenosis at the level of the mid to upper right superficial femoral artery. a patent right above-the-knee popliteal stent was noted. a focal short narrowing of the distal right below- the-knee popliteal artery was seen. there was involvement of the proximal right anterior tibial as well. more distally, the anterior tibial, peroneal, and posterior tibial arteries were patent. the right dp and plantar arteries were widely patent, although there was noted of calcification of the right dp artery. the left side runoff showed a short moderate narrowing of the proximal left common iliac with segmental disease of the left external iliac with areas of moderate stenosis. there were 2 overlying metallic stents visualized in the mid left superficial femoral artery with mild restenosis. there was approximately a 5- to 6-cm length area of significant stenosis just proximal to the stent within the proximal left superficial femoral artery. the popliteal, anterior tibial, peroneal, and posterior tibial arteries were widely patent. the left dp is widely patent as well. the left plantar arteries are small but remained patent. cardiology was requested to see the patient preoperatively given her significant cardiac history. their recommendations were the patient was a high risk for surgery given prior stress test, history of mi, and decompensated failure. recommendations were to cover her perioperatively with iv beta blockade, starting aspirin, postoperative ekg and enzymes, continue her h2 blockers, and monitor her hematocrit and transfuse to maintain a hematocrit of greater than 30, and defer the use of heparin given history of gi bleeds in the past. the service followed the patient during her hospitalization and managed her glycemia control. the patient was seen by social service for emotional support given her hospitalization and also for a reported difficult domestic situation. the patient did require adjustments in her sliding scale during her perioperatively period to maintain adequate glucose control. the patient proceeded to surgery on and underwent a right femoral/dorsalis pedis bypass graft with in situ saphenous vein. the patient had a palpable graft and triphasic dp and pt at the end of the procedure. she was transferred to the pacu in stable condition. postoperatively, she remained hemodynamically stable. her hematocrit remained stable at 31.3. bun and creatinine were stable at 15 and 1.0. her magnesium, phosphate, and potassium were repleted. the chest x-ray was without pneumothorax, and the line was in appropriate position. the ekg was without ischemic changes. the patient continued to do well and was transferred to the vicu for continued monitoring and care. on postoperative day 1, there were no overnight events. she remained hemodynamically stable. her hematocrit remained stable. her bun and creatinine remained stable. the patient's pulse exam remained unchanged. the foot showed stable dry gangrene. the patient was begun on percocet for analgesic control. her diet was advanced as tolerated. her iv fluids were hep-locked. she was maintained on bedrest and remained in the vicu for continued hemodynamic monitoring. on postoperative day 2, the patient had low urinary output overnight with a poor response to fluid boluses. her hematocrit dropped from 30.4 to 28.7. swan was continued. the jp's remained in place and were monitored for drainage. the patient received a lasix challenge with good urinary output. on postoperative day 3, hematocrit was 27.3. the patient's cordis was converted to triple lumen catheter. ambulation with touchdown weightbearing essential distances only was begun. physical therapy was requested to see the patient. the patient was transferred to the floor on telemetry. postoperative ck and troponin levels were flat. ekg was without ischemic changes. on postoperative day 4, the patient had episodes of bradycardia to rates in the 40s without symptoms. the bradycardia resolved spontaneously. her hematocrit remained stable at 27.7. otherwise, the patient continued to progress. her glycemic control was excellent. she was evaluated by physical therapy who felt they would recommend rehab prior to discharge to home when medically stable. the patient returned to surgery on for a right 1st and 2nd toe amputation and left 1st toe amputation. she tolerated the procedure well. the patient tolerated the toe amputations. hematocrit continued to show some drifting to 26. the recommendations were to consider a transfusion by cardiology. the patient remained in a sinus rhythm with bradycardia which was asymptomatic. the initial dressings were removed on postoperative day 1. the amputation sites were clean, dry, and intact with well approximated skin edges. there was no ecchymosis or erythema. glycemic control continued to remain stable. the patient continued to be monitored. her hematocrit continued to show a mild drifting. on , in the morning, her hematocrit was 25.6. a repeat hematocrit was to be followed up on. rectal exam was guaiac- negative stool. her bun and creatinine were stable at 22 and 1.4. discharge status: the patient was transferred to rehab in stable condition. all wounds were clean, dry, and intact without erythema. she had a working graft. discharge followup: she should follow up with dr. in 2 weeks' time. discharge instructions: she may ambulate essential distances, full weightbearing with humin sandals. she should keep the legs elevated when sitting in a chair or in bed. the skin clips should remain in place until seen in followup, and the amputation sutures to remain in place until seen by dr. who will then decide on followup when to discontinue the amputation site sutures. medications on discharge: include levofloxacin 500 mg q.24h. (for a total of 2 weeks post discharge), protonix 40 mg daily, alprazolam 1 mg b.i.d. p.r.n. (for anxiety), hydromorphone 2 mg 1 to 2 tablets q.4h. p.r.n. (for breakthrough pain), colace 100 mg b.i.d. (hold for loose stools), bisacodyl 5-mg tablets 2 daily as needed, aspirin 81 mg daily, oxycodone/acetaminophen 5/325 tablets 1 to 2 q.4- 6h. p.r.n. (for pain). her trandolapril 4 mg daily has been held secondary to her low urinary output postoperatively and low systolic blood pressures. her blood pressure should continue to be monitored at rehabilitation and restart if indicated. lasix 40 mg b.i.d. has also been held because of low blood pressure. recommendations were to monitor blood pressure and restart if indicated. insulin regimen is glargine 35 units at bedtime with a humalog sliding scale before meals and at bedtime. senna tablets 1 b.i.d. p.r.n. discharge diagnoses: bilateral ischemic toe gangrene, status post bilateral lower extremity arteriograms, right femoral/dorsalis pedis bypass with in situ saphenous vein, and right toe amputation (toes 1 and 2), and left 1st toe amputation, insulin-dependent type 2 diabetes (controlled), coronary artery disease with a history of myocardial infarction and congestive heart failure (stable), history of gastrointestinal bleed with postoperative low hematocrit and negative guaiac. , procedure: arteriography of femoral and other lower extremity arteries amputation of toe amputation of toe amputation of toe other (peripheral) vascular shunt or bypass aortography pulmonary artery wedge monitoring diagnoses: nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere coronary atherosclerosis of native coronary artery congestive heart failure, unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes long-term (current) use of insulin old myocardial infarction obesity, unspecified atherosclerosis of native arteries of the extremities with gangrene diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy unspecified osteomyelitis, ankle and foot cellulitis and abscess of toe, unspecified neural hearing loss, bilateral 

Answer: The patient is high likely exposed to