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: severe chest and back pain with fever and leukocytosis major surgical or invasive procedure: - cardiac catheterization. placement of iabp - cabgx3 (left internal mammary artery graft to the left anterior descending and reversed saphenous vein graft to the marginal branch and the posterior descending branch. - placement of an iabp - exploratory laparotomy history of present illness: this is a 59 yo male with a past medical history significant for diabetes, hypertension, question of sarcoidosis who presented to the emergency department with fever, chills, and back pain. patient states that he has had the back pain for months but now the pain is more localized to his midline. the patient states that he has had diarrhea for the last couple of weeks but in combination with constipation. pt denies any dyspnea, diaphoresis, melena, hematuria, dysuria. in emergency department, mr. was febrile to 102.9. he was initially worked up for aortic dissection and had a ct of the chest and abdomen. an ekg was done after he returned from ct and he was found to have st elevations, .5-1mm in i, avl and 2 mm in v2. he was urgently taken to the cath lab where he was found to have a 90% ostial lesion of the left anterior descending artery, 50% stenosed circumflex artery and an 80% stenosed right coronary artery. hemodynamics showed a cardiac output of 5.76, an index of 2.44 and a sytemic vascular resistance (svr) of 444. no intervention was made as patient's left anterior descending artery lesion was near the circumflex and there was concern for blocking left coronary ciculation as patient was left side dominant. an intra-aortic balloon pump was placed and mr. was transferred to the floor for stabilization with antibiotics for infection, and potential evaluation for surgical revascualrization when stable. upon leaving the cath lab, he became hypotensive. he was started on low dose dopamine but then he became tachycardic so pt was switched to neo-synephrine with good relief. upon arriving to the floor the patient had a white cell count of 25. he was started on empiric coverage of vanomycin, levofloxacim and flagyl. the white cell began trending up from 23.4 on admission -> 26.5 -> 36.8 -> 46.1. later linezolid was added when it was found that he had a history of methicillin resistent staph aurea (mrsa) and vancomycin resistent enterococcus (vre) from past wound infections. pt on the floor trended upwards from 259 -> -> 3352. cardiology fellow called about possibility of taking patient to cath lab in light of continued ischemia. it was deemed that due to pt anatomy, he was not a candidate for peructaneous intervention. when mr. initially came to the floor his blood gas (abg) was 7.34/28/94 with a lactate of 1.4. he was found to have a non-anion gap metabolic acidosis. he was on a nonrebreather and then transitioned to cpap. a 3am gas showed 7.25/47/131 w/ lactate of 2.1. he seemed to be tiring and anesthesia was called to intubate mr. . chest x-ray showed bilateral patchy infiltrate. he was transitioned to low volume to mimize barotrauma for suspected acute respiratory distress syndrome. other issues included a rising creatinine of 2.3 (baseline 1.5-1.8)on and a question of vertebral osteomyelitis. id consult was obtained and the abx recommendations were followed. he also developed hyperkalemia and was seen by renal service for arf. pt. also had a small gi bleed with ngt coffee grounds emesis on heparin. iabp was removed and treatment continued for lle cellulitis. he also continued lasix duresis with periodic neosynephrine support. he was extubated on . referred to dr. of ct surgery. he recommended infectious issues be competely resolved before cabg and a myocardial viability study. patient contnued to have episodes of diarrhea. he continued his courses of vanco and zosyn.cabg was scheduled but then postponed for a rising creatinine again (2.2). dr. reviewed the high risk status of his surgery with the patient (10-15% mortality). cabg performed on by dr. with a lima to lad, svg to om and svg to pda. he was transferred to the csru on epinephrine, levophed, milrinone and insulin drips.he was extubated on . pressor wean was begun and epinephrine and levophed were off later in the day. pt. remained on lidocaine, milrinone, and neosynephrine drips. chest tubes were removed. creatinine was 2.9 on . he had an episode of vt and had cardioversion on . he was also transfused and started on a natrecor drip. swan was exchanged to a triple lumen catheter on . ep was consulted for recurrent vt. amiodarone drip was started. he also had episodes of rapid afib. on , he had a vfib arrest and was shocked x 4. cath was considered but his creatinine was at 3.0 at the time and cardiology felt it best to monitor him closely. ischemia was not suspected given the large area of his anterolateral infarction.the following day it was 3.2. he continued to receive sq heparin for his mobility status. he remained on amio, natrecor, and lidocaine drips and continued with zosyn. he was diuresed with lasix drip for volume overload. on the afternoon of , the pt. was reintubated for respiratory distress. he went to the cath lab for iabp and swan placement. heparin was switched to iv dosing. milrinone and neo drips were restarted. on , a quinton cath was placed in the left femoral vein to allow for the institution of cvvhd. he remained sedated with propofol. tee was performed on which revealed severely depressed lv function with ef 20-25%.a small pericardial effusion was noted and there were multiple wall motion abnormalities including anterolateral akinesis. on , he had a run of afib, torsades and a 23 beat run of vt with poor perfusion and severe hypotension. he was cardioverted and then paced. he had 4+ ble edema. right dp pulse was not dopplerable at this time, and toes were cyanotic, but warm. iabp was pulled at 4:30am by cardiology for the compromised circulation in that leg. he remained somewhat hypotensive at this time (sbp 70-80's). vascular surgery was called when the pulse did not return in this foot. he continued to be severely acidotic with base excess of minus 4 to minus 16. there was slight improvement in his doppler signal, but ischemia with ?thrombus was considered. platelet count was 69k at that time with an inr of 2.3. at this time, there was concern for his bowel circulation given his acidosis that was not responding to therapy. the patient remained critically ill and ischemic mesentery was suspected by the transplant service. mr. was seen and evaluated by dr. of general surgery. he had requested correction of the coagulopathy and additional lfts in preparation for emergency exploratory laparotomy. the patient was taken to the or on the morning of and had an emergency lap by dr. . during the attempted bowel resection for mesenteric ischemia, the patient suffered vtach and a vfib arrest that did not respond to multiple shocks, cpr, and acls protocol meds. he was pronounced expired at 10:24 am by dr. of transplant surgery. past medical history: charcot foot - vre/mrsa past infecftions hypertension hyperlipidemia diabetes mellitus questionable sarcoidosis morbid obesity social history: smokes cigars 1-2 per day. denies alcohol use. works for local sports radio show. family history: non-contributory physical exam: ed vitals - temp 102.9 bp 60/palp hr 110 rr 24 o2 sat 97% on nrb gen: ill appearing heent: pupils eaqual and reactive, oropharynx clear resp: clear cv: distant heart sounds, no murmur, gallop or rub abd: obese, nontender, guaiac (-) back: no costovertebral tenderness ext: no cyanosis, clubbing or edema, left charcot foot deformity w/ bulging at left ankle, no drainage, warmth, or erythema neuro: alert, appropriate, moving all four extremities pertinent results: initial cxr - no acute cardiopulmonary disease ecg - st elevations .5-1 mm in i, avl, 2 mm in v2 cath - 90% ostial lesion of the left anterior descending artery, 50% circumflex artery, and an 80% right coronary artery. echo - ef 40-45%, nl lv cavity size, possible hypokinesis at apex, rv free wall motion preserved echo - lvef 35-40%, mild lvh, moderate systolic dysfunction, sever hypokinesis of basal system. ct chest/abdomen - 1) severe coronary artery calcification 2) mediastinal lymphadenopathy unchanged from prior 3)left sided exophytic renal cysts, probable hyperdense cysts within mid pole of right kidney. labs; (admission/discharge) 03:00pm wbc-23.4*# rbc-4.43* hgb-13.0*# hct-36.8* mcv-83 mch-29.4# mchc-35.3* rdw-15.5 03:00pm ctropnt-0.03* 03:00pm ck(cpk)-81 03:00pm glucose-217* urea n-82* creat-1.5* sodium-138 potassium-5.7* chloride-104 total co2-23 anion gap-17 03:44pm lactate-2.5* 05:43pm wbc-26.5* rbc-3.99* hgb-11.8* hct-33.7* mcv-85 mch-29.6 mchc-35.0 rdw-15.7* 05:43pm alt(sgpt)-22 ast(sgot)-34 ck(cpk)-259* alk phos-65 amylase-59 tot bili-0.3 08:25pm ck-mb-169* mb indx-9.5* ctropnt-2.87* 08:25pm glucose-262* urea n-79* creat-1.6* sodium-138 potassium-5.2* chloride-108 total co2-17* anion gap-18 08:25pm wbc-36.8* rbc-4.12* hgb-11.9* hct-34.8* mcv-85 mch-28.9 mchc-34.1 rdw-15.7* 02:44am blood wbc-33.7* rbc-3.71* hgb-11.1* hct-34.0* mcv-92 mch-29.8 mchc-32.5 rdw-16.8* plt ct-69* 06:30am blood plt smr-very low plt ct-50* 06:30am blood pt-23.4* ptt-150* inr(pt)-3.4 02:44am blood urean-43* creat-2.7* na-132* cl-89* hco3-12* 07:46am blood alt-3820* ast-8175* ld(ldh)-9610* alkphos-168* totbili-4.0* 10:00am blood glucose-79 lactate-23.0* na-132* k-5.1 cl-90* x-ray marked arthropathy consistent with the given history of charcot foot, worse since the prior studies. infection can have a similar appearance and clinical correlation is requested. echo conclusions: 1 the left atrium is dilated. 2. the left ventricular cavity is mildly dilated. there is moderate global left ventricular hypokinesis, apical akinesis and some preservation of basal wall motion. overall left ventricular systolic function is moderately depressed. no masses or thrombi are seen in the left ventricle with and without contrast. 3. the aortic valve leaflets (3) are mildly thickened. 4. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. echo 1. technically difficult study. 2.left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is severely depressed. resting regional wall motion abnormalities include apical and lateral wall akinesis. 3. the number of aortic valve leaflets cannot be determined. the aortic valve is not well seen. no ai seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen 4.there is no pericardial effusion echo left ventricular systolic function appears depressed, probably severely, in technically suboptimal views. the anterior septum appears akinetic, there may be septal hypokinesis and there is hypokinesis elsewhere. there is a small pericardial effusion. there are no echocardiographic signs of tamponade. compared to the prior study of , the pericardial effusion is now larger (a trivial effusion was previously present) echo the left atrium is mildly dilated. no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. the left ventricular cavity is mildly dilated. the lv systolic function is severely depressed (ef 25%). the best preserved segments are the basal inferior and basal inferolateral segments. the anterior wall and the septum are severely hypokinetic/akinetic, the anterolateral wall is hypokinetic and the apex is akinetic/hypokinetic. no lv aneurysm is seen. right ventricular chamber size and free wall motion are normal. intraaortic balloon pump is noted in the descending thoracic aorta. simple aortic plaque is noted in the aortic arch. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is a small pericardial effusion. mri foot small crescentic area of nonspecific enhancement immediately abutting the distal edge of the fibula with associated signal abnormality on the t1- weighted images. the differential includes both reactive tissue (eg granulation tissue, fibrosis, synovium) and infectious phlegmon. no focal fluid collection is identified. there is no marrow edema to suggest osteomyelitis. a small area immediately around the hardware is obscured by metal artifact but much of the remainder of the heel and foot is well-seen. cardiac catheterization 1. severe systolic and diastolic ventricular dysfunction. 2. severe primary pulmonary hypertension. 3. placement of iabp brief hospital course: mr. was admitted to the medical center on for further management of his chest pain. he was taken to the cardiac catheterization lab where he was found to have severe three vessels coronary disease. as his left anterior descending artery was markedly calcified with a short left main, intervention was declined given the risk of jailing the circumflex artery which was his dominant vessel. an intra-aortic balloon pump was placed. heparin, integrillin and aspirin were started for anticoagulation. mr. became hypotensive after his catheterization and pressors were started. he subsequently became acidotic and required intubation in the cardiac care unit. given his leukocytosis, sepsis was suspected and vancomycin, flagyl and linezolid were started. given his charcot foot, the podiatry service was consulted. medications on admission: kcl furosemide 80 po bid allopurinol 100 mg po daily diovan hct 160/25 po daily atenolol 50 mg po bid folic acid 1 mg po qd norvasc 10 mg po qd lipitor 40 po qd sl nitroglycerin discharge medications: none discharge disposition: expired facility: discharge diagnosis: s/p coronary artery bypass grafting x3 acute myocardial infarction severe acidosis with mesenteric ischemia acute renal failure s/p intraaortic ballon pump removal with ischemia of leg lle cellulitis leukocytosis discharge condition: expired in or procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization coronary arteriography using two catheters (aorto)coronary bypass of two coronary arteries diagnostic ultrasound of heart insertion of endotracheal tube hemodialysis other electric countershock of heart exploratory laparotomy implant of pulsation balloon implant of pulsation balloon pulmonary artery wedge monitoring monitoring of cardiac output by other technique injection or infusion of nesiritide injection or infusion of oxazolidinone class of antibiotics infusion of vasopressor agent diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia acute kidney failure with lesion of tubular necrosis unspecified essential hypertension unspecified septicemia severe sepsis cardiac complications, not elsewhere classified atrial fibrillation infection with microorganisms resistant to penicillins other chronic pulmonary heart diseases diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled acute myocardial infarction of anterolateral wall, initial episode of care cardiac arrest cellulitis and abscess of leg, except foot methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site cardiogenic shock septic shock morbid obesity other complications due to other cardiac device, implant, and graft acute vascular insufficiency of intestine below knee amputation status arterial embolism and thrombosis of lower extremity atherosclerosis of native arteries of the extremities with ulceration acute on chronic combined systolic and diastolic heart failure diabetes with peripheral circulatory disorders, type ii or unspecified type, not stated as uncontrolled acute gastritis, with hemorrhage chronic osteomyelitis, ankle and foot arthropathy associated with neurological disorders 

Answer: The patient is high likely exposed to