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: no known allergies / adverse drug reactions attending: chief complaint: fournier's gangrene major surgical or invasive procedure: flexible bronchoscopy, scrotal debridement, diagnostic laparoscopy, exploratory laparotomy, diverting colostomy history of present illness: patient is a 76 year old male who was initially admitted to osh for a right vats, right upper-lobe wedge resection, upper lobectomy and lymph node dissection performed on , and found to have nsclc. following this operation, he developed increasing subcutaneous emphysema, requiring the re-insertion of chest tubes 2 times. during his hospital stay, he developed urinary retention of and was found to have a uti-enterococcus on that was treated with ampicillin. on , the patient developed scrotal swelling. he was seen by the osh urology service and there was a concern for some type of cellulitis or mass, and they suggested a scrotal ultrasound that was not done because of the weekend. the osh hospitalist on call was called on at 3am because nursing noted a foul-smelling drainage from his rectum. according to the osh discharge summary, "the rectal sphincter was open and there was ulceration and induration with necrotic tissue all around the whole perineal area and pus-brown liquid drainage with air bubbles." there was concern for a fistula and for the cellulitic and swollen scrotum. general surgery at the osh was concerned for an ulcerated perirectal abscess with probable gangrene and a complex polymicrobial infected whole perineum and recommended trasnfer to for immediate surgery. he was started on zosyn, flagyl and vancomycin. the patient reports first noticing pain in his genital/rectal area 5 days ago that he rates as 2 or 3 out of 10 that does not radiate. the patient reports having a cough with sputum and sob. he reports very soft stools/diarrhea and urinary frequency and urgency. past medical history: past medical history: 1. adenocarcinoma, non-small cell lung cancer 2. recurrent subcutaneous emphysema 3. hypertension 4. hypercholesterolemia 5. benign prostatic hypertrophy s/p urinary retention past surgical history: 1. wedge resection, right upper lobectomy vats procedure on 2. inguinal hernia repair 3. hemorrhoidectomy social history: 20 pack-year history of smoking cigarettes, quit smoking 25 years ago. he denies recreational drug use or alcohol use. family history: mother-breast cancer diagnosed in mid-70s sister-brain aneurysm, died at 42yo physical exam: (on admission) physical exam: vitals: 97.3 97.3 76 102/43 18 on 3l gen: a&o, nad heent: no scleral icterus, mucus membranes moist cv: rrr, no m/g/r pulm: clear to auscultation b/l, with decreased breath sounds on the right. abd: soft, nondistended, nontender, no rebound or guarding, normoactive bowel sounds, no palpable masses gu: extremely swollen, erythematous scrotum. wound: perirectal ulceration with necrotic tissue surrounding the rectal opening. pus and brown liquid drainage with foul odor draining from the area of ulceration. the area immediately around the ulcer is erythematous. ext: diffuse crepitus felt along both ue and along the chest wall. no le edema, le warm and well perfused pertinent results: 02:04pm blood wbc-13.1* rbc-3.78* hgb-11.2* hct-34.6* mcv-92 mch-29.6 mchc-32.4 rdw-13.1 plt ct-731* 01:42am blood wbc-9.9 rbc-3.36* hgb-10.0* hct-30.2* mcv-90 mch-29.9 mchc-33.2 rdw-13.5 plt ct-615* brief hospital course: he was taken emergently to the operating room on . he remained intubated post-op and was admitted to the icu. he was extubated without issue later in the day on pod1. his scrotum and wounds were serially checked. some scrotal erythema was present but was stable. dressing changes were done daily and there was no further drainage. his wound is extensive and requires packing with a dampened normal saline gauze using a sterile q tip to apply the packing loosely into the wound which tracks approximately 3-4 cm. dressing changes are best performed with patient lying on his left side with a second person to support his leg for optimal visualization. cultures were sent and final sensitivities are still pending at time of this dictation. preliminary data shows mixed bacterial types. empiric treatment with vanco and zosyn were initiated early on; this course will need to continue for another 2 days (stop date ). he was evaluated for picc line placement by the iv team who were unsuccessful in their attempts at placing. they in turn recommended picc placement by interventional radiology. at time of this dictation he has a functional peripheral line and given that he only has 2 more days of the antibiotics it was discussed with surgical team that he could be discharged with the peripheral iv and if access is lost he may complete his course with augmentin for the remaining 2 days. the right chest tube that was placed by thoracic surgery following vats procedure rul wedge, completion lobectomy, anterior hilar lymph node dissection with persistent subcutaneous emphysema was managed by their service during his entire stay. on the chest tube was clamped, two follow up chest xrays were obtained immediately after clamped and again at 4 hour mark. his chest tube was pulled and post pull film did show some evidence of small pneumothorax. clinically he was stable with oxygen saturations 93% room air, rr 18-20. it should be noted that the subcutaneous emphysema does persist on both upper extremities tracking to his upper chest, neck and ethmoid regions. he will require follow up as an outpatient in thoracic clinic in the next 1-2 weeks. on pod2 his diet was advanced to a regular diet and his pain, which was initially treated with intermittent iv dilaudid, was transitioned to oral pain medications. on pod2 he was stable for transfer to the floor. once transferred to the regular nursing unit he continued to progress. at times he has been noted with intermittent delirium but has been cooperative with care and there have been no behavioral issues. he was evaluated by physical therapy and is being recommended for rehab after his acute hospital stay. medications on admission: atenolol 50, simvastatin 20, tamsulosin 0.4, omeprazole, asa 325, vitamins discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 2. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). 3. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 4. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 5. atenolol 50 mg tablet sig: one (1) tablet po daily (daily). 6. tamsulosin 0.4 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po hs (at bedtime). 7. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) 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: 0.5-1 tablet po q4h (every 4 hours) as needed for pain. 10. vancomycin in d5w 1 gram/200 ml piggyback sig: one (1) gm intravenous q 12h (every 12 hours) for 2 days: stop date . 11. piperacillin-tazobactam-dextrs 4.5 gram/100 ml piggyback sig: 4.5 gm intravenous q8h (every 8 hours) for 2 days. discharge disposition: extended care facility: discharge diagnosis: fournier's gangrene subcutnaeous emphysema discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were admitted to the hospital with an infection in your scrotum which required an operation to clear the infection. you were also treated with a course of intravenous antibiotics. during this operation you required that a colostomy be created so that your bowel movements are being eliminated through a bag on your abdomen. your surgical wounds are extensive and require twice/day dressing changes. you are being recommneded to go to a rehabilitation facility once you leave the hopsital for ongoing wound care and for helping to rebuild your strength and endurance. followup instructions: follow up next week in acute care surgery clinic for evlaution of your wound. call for an appointment. follow up in with with dr. , surgery; call ( for an appointment. md procedure: closed [endoscopic] biopsy of bronchus excisional debridement of wound, infection, or burn other lysis of peritoneal adhesions exteriorization of large intestine biopsy of parathyroid gland excision or destruction of lesion or tissue of scrotum incision and drainage of scrotum and tunica vaginalis other excision of perianal tissue diagnoses: cellulitis and abscess of trunk urinary tract infection, site not specified unspecified essential hypertension personal history of malignant neoplasm of bronchus and lung hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) other and unspecified hyperlipidemia peritoneal adhesions (postoperative) (postinfection) other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation vascular disorders of male genital organs other inflammatory disorders of male genital organs streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] emphysema (subcutaneous) (surgical) resulting from procedure laparoscopic surgical procedure converted to open procedure abscess of anal and rectal regions 

Answer: The patient is high likely exposed to