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: benadryl / morphine attending: chief complaint: right lower extremity ischemia major surgical or invasive procedure: - s/p fem-fem bipass status post right groin exploration, evacuation of hematoma, vac dressing placement. history of present illness: 63m s/p fem-fem bypass c/b r groin hematoma. past medical history: 1. coronary artery disease: myocardial infarction in , mqwmi in . most recent cath, : lcx stenting; previous rca stent patent at that time. 2. nonischemic dilated cardiomyopathy; ef 33%. ef to 25% 3. diabetes greater than 20 years; with triopathy. 4. hypertension. 5. end stage renal disease on hemodialysis, q. monday, wednesday and friday via right arteriovenous fistula. 6. hypothyroidism. 7. chronic obstructive pulmonary disease. 8. hepatitis c. 9. chronic pancreatitis. 10. peptic ulcer disease. 11. right perinephric hematoma; status post embolization. 12. obstructive sleep apnea on cpap. 13. ruptured right groin abscess; recurrent right groin abscess in . 14. peripheral vascular disease. 15. status post r pfa to bk bypasss graft with vein 16. status post 2nd and 3rd toe amps 17. status post left cfa to ak with ptfe 18. status post l inguinal hernia repair 19. status post umbilical hernia repair 20. ischemic left foot 21. a - fib social history: social: , lives with wife, has older children, tob: 1 ppd x 60 yrs. quit 3 months ago, no etoh family history: non contributary physical exam: on discharge vital: 97.9 88 116/69 16 99%ra fs 113-161 wd, wn, nad ctab no w/c/r rrr, no m/r/g soft, nt, nd, nabs groin: right - vac dressing in place / wound c/d / exposed graft l foot w/well granulated wound on w->d dressing changes; right foot warm pulses: r dp.pt dop, l dp/pt dop, graft palp pertinent results: 08:00am blood wbc-8.7 rbc-3.51* hgb-12.3* hct-38.6* mcv-110* mch-35.2* mchc-31.9 rdw-26.8* plt ct-336 07:25am blood neuts-75* bands-0 lymphs-10* monos-6 eos-7* baso-0 atyps-2* metas-0 myelos-0 nrbc-1* 05:08am blood pt-15.0* ptt-36.5* inr(pt)-1.4* 07:30am blood glucose-120* urean-58* creat-6.9* na-135 k-5.7* cl-96 hco3-20* angap-25* 01:23pm blood alt-34 ast-30 ld(ldh)-149 alkphos-177* amylase-182* totbili-0.2 07:55am blood albumin-3.9 calcium-8.7 phos-5.5* mg-2.2 uricacd-5.0 01:09am blood caltibc-213* ferritn-678* trf-164* 09:18am blood pth-609* 8:30 am blood culture **final report ** aerobic bottle (final ): no growth. anaerobic bottle (final ): no growth 1:19:38 pm sinus rhythm. left anterior fascicular block qt interval prolonged for rate lateral st-t changes may be due to myocardial ischemia since previous tracing of earlier , no significant change intervals axes rate pr qrs qt/qtc p qrs t 83 170 100 416/455.71 -4 -48 128 2:09 pm findings: subcutaneous edema was present in the left lower extremity. the left greater saphenous vein has been previously harvested. the left lesser saphenous vein is patent with diameters varying between 0.16 and 0.23 cm. the vein measures 0.18 cm superiorly, 0.23 cm in its mid portion, and 0.16 cm inferiorly. the right greater saphenous vein has been previously harvested. the right lesser saphenous vein contains mural calcifications but is patent. the diameters of the right lesser saphenous vein vary between 0.14 and 0.18 cm. a picc line is present in the left cephalic vein, which is otherwise patent. the left basilic vein is patent with diameters of 0.25 cm superiorly, 0.14 cm in the mid arm, 0.39 cm at the antecubital fossa, and 0.14 cm in the forearm. the right forearm has an arteriovenous fistula. the right cephalic vein has diameters varying between 0.35 and 0.52 cm and is patent. there is pulsatility of the flow in the right cephalic vein and this possibly represents an outflow vein from the arteriovenous fistula. the right basilic vein is patent in the arm with diameters varying between 0.29 and 0.51 cm. impression: prior harvesting of the greater saphenous veins bilaterally. small caliber lesser saphenous veins bilaterally with calcifications in the right lesser saphenous vein murally. patent left cephalic vein containing a picc. the left basilic vein is patent with some diameters less than 0.20 cm. there is an av fistula on the right forearm. the cephalic and basilic veins on the right are patent. 10:58 am ct head w/o contrast technique: noncontrast head ct scan. comparison studies: . noncontrast head ct scan, also performed for mental status changes and interpreted by dr. as showing "small area of low attenuation involving the right occipital lobe, suggestive of a small infarct of uncertain age." findings: the present study has a few images which are degraded by streak artifacts. allowing for this deficiency, no overt interval change is noted. once again, a small area of low density is noted within the right occipital lobe region, which likely represents an area of chronic infarction. also, both studies disclose a small linear area of low density within the left parietal white matter, again probably representing an area of chronic infarction within border zone distribution. upon referral to the prior mr report of (the images not being available on pacs at this time), apparently areas of t2 hyperintensity within the white matter were detected by dr. , and may well conform to the ct abnormalities noted above. there is no hydrocephalus or shift of normally midline structures. the surrounding osseous and extracranial soft tissues are otherwise unremarkable. impression: stable, abnormal study as noted above. 7:26 pm mra neck w/o contrast; mra brain w/o contrast mra of the neck: the neck mra demonstrates normal flow signal within the carotid and vertebral arteries. no evidence of vascular occlusion or stenosis is identified. the left vertebral origin is not well visualized. if further evaluation is clinically indicated consider gadolinium-enhanced mra. impression: no evidence of stenosis or occlusion in the arteries of neck. the left vertebral origin is not well visualized and if clinically indicated, gadolinium-enhanced mra would help for further assessment. mra of the head: the head mra demonstrates normal flow signal within the arteries of anterior and posterior circulation. the distal left vertebral artery is small in size secondary to the left cervical vertebral artery ending in posterior inferior cerebellar artery, a normal variation. impression: normal mra of the head. echo measurements: left atrium - long axis dimension: *5.2 cm (nl <= 4.0 cm) left atrium - four chamber length: *6.7 cm (nl <= 5.2 cm) right atrium - four chamber length: *5.7 cm (nl <= 5.0 cm) left ventricle - septal wall thickness: *1.4 cm (nl 0.6 - 1.1 cm) left ventricle - inferolateral thickness: 1.0 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: *7.1 cm (nl <= 5.6 cm) left ventricle - systolic dimension: 6.3 cm left ventricle - fractional shortening: *0.11 (nl >= 0.29) left ventricle - ejection fraction: 20% (nl >=55%) aorta - valve level: *3.8 cm (nl <= 3.6 cm) aorta - ascending: *3.6 cm (nl <= 3.4 cm) aortic valve - peak velocity: 1.9 m/sec (nl <= 2.0 m/sec) mitral valve - e wave: 0.9 m/sec mitral valve - a wave: 1.0 m/sec mitral valve - e/a ratio: 0.90 mitral valve - e wave deceleration time: 228 msec tr gradient (+ ra = pasp): *35 mm hg (nl <= 25 mm hg) interpretation: findings: left atrium: moderate la enlargement. elongated la. right atrium/interatrial septum: mildly dilated ra. left ventricle: mild symmetric lvh. severely dilated lv cavity. severe global lv hypokinesis. severely depressed lvef. tvi e/e' >15, suggesting pcwp>18mmhg. lv wall motion: regional lv wall motion abnormalities include: basal inferoseptal - hypo; mid inferoseptal - hypo; basal inferior - akinetic; mid inferior - akinetic; basal inferolateral - akinetic; mid inferolateral - akinetic; septal apex - hypo; inferior apex - hypo; lateral apex - hypo; right ventricle: normal rv wall thickness. normal rv chamber size. rv function depressed. aorta: mildly dilated aortic root. mildly dilated ascending aorta. aortic valve: mildly thickened aortic valve leaflets. trace ar. mitral valve: mildly thickened mitral valve leaflets. trivial mr. tricuspid valve: mild tr. mild pa systolic hypertension. pericardium: no pericardial effusion. conclusions: 1the left atrium is moderately dilated. the left atrium is elongated. 2. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is severely dilated. there is severe global left ventricular hypokinesis. overall left ventricular systolic function is severely depressed. tissue velocity imaging e/e' is elevated (>15) suggesting increased left ventricular filling pressure (pcwp>18mmhg). resting regional wall motion abnormalities include basal and mid inferior and inferolateral akinesis.. 3. right ventricular chamber size is normal. right ventricular systolic function appears depressed. 4.the aortic root is mildly dilated. the ascending aorta is mildly dilated. 5.the aortic valve leaflets are mildly thickened. trace aortic regurgitation is seen. 6.the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. 7.there is mild pulmonary artery systolic hypertension. 8.there is no pericardial effusion. compared to the previous report of , there has been a decrease in the severtiy of the mr while the ef has unchanged. the pa pressure has decreased from 44 mmhg. persantine mibi left ventricular cavity size is markedly enlarged during rest and stress. the edv=331 cc. resting and stress perfusion images reveal a mild reversible lateral wall perfusion defect. the inferior wall perfusion defect seen in the prior study is not apparent in this study. gated images reveal severe global systolic dysfunction. the calculated left ventricular ejection fraction is 18%. impression: 1. mild reversible lateral wall perfusion defect. the inferior wall perfusion defect seen in the prior study is not apparent in this study. 2.dilated lv with severe global systolic dysfunction. edv=331 cc and ef=18%. the findings are consistent with dilated ischemic cardiomyopathy. stress total exercise time: 4 % max hrt rate achieved: 45 symptoms: none st depression: none interpretation: this 63 year old type 2 iddm man with a history of cad and pvd was referred to the lab for evaluation. the patient was infused with 0.142 mg/kg/min of dipyridamole over 4 minutes. no arm, neck, back or chest discomfort was reported by the patient throughout the study. there were no significant st segment changed during the infusion or in recovery. the rhythm was sinus with frequent isolated apbs and several isolated vpbs. appropriate hemodynamic response to the infusion. the dipyridamole was reversed with 125 mg of aminophylline iv. impression: no anginal type symptoms or significant ekg changes. brief hospital course: pt had a very long hospital course. the hospital course was uneventful for the patient. he did have the below procedures done. fem-fem bypass using the pre-existing axillary femoral bypass as our inflow on the left and our outflow was the pre-existing profunda to popliteal bypass on the right with ptfe 8 mm ringed graft. status post right groin exploration, evacuation of hematoma, vac dressing placement. the patient was kept in the hospital for an exposed graft / iv antibiotics / vac dressing changes. pt recieved hd on his scheduled days. m/w/f pt worked with the patient on dc pt is taking po / ambulating with asst. / pos bm / he does make urine, but is on hd most importantly the patient is groin is closing in considerably around the graft site. medications on admission: heparin 5000"" lasix 80" sevelamer 1600" protonix 40' metoprolol 25" epoetin 4000"" lisinopril 5' amiodarone 200' atorvastatin 10' lactulose 30' 75' 81' tylenol 650 prn albuterol mdi prn regular isulin sliding scale ipratropium mdi prn discharge medications: 1. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 4. ipratropium bromide 17 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 5. zinc sulfate 220 mg capsule sig: one (1) capsule po daily (daily). 6. linezolid 600 mg tablet sig: one (1) tablet po q12h (every 12 hours). 7. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed. 8. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 9. metoclopramide 10 mg tablet sig: one (1) tablet po tid (3 times a day). 10. cinacalcet 30 mg tablet sig: two (2) tablet po daily (daily). 11. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 12. citalopram 20 mg tablet sig: 0.5 tablet po daily (daily). 13. ceftazidime-dextrose (iso-osm) 1 g/50 ml piggyback sig: one (1) intravenous q48h (every 48 hours). 14. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day). 15. furosemide 80 mg tablet sig: one (1) tablet po bid (2 times a day). 16. gabapentin 100 mg capsule sig: one (1) capsule po hs (at bedtime). 17. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). 18. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 19. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 20. lactulose 10 g/15 ml syrup sig: thirty (30) ml po daily (daily). 21. levothyroxine 25 mcg tablet sig: one (1) tablet po daily (daily). 22. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 23. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed. 24. epoetin alfa 10,000 unit/ml solution sig: one (1) injection asdir (as directed). 25. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 26. albuterol sulfate 0.083 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 27. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical (2 times a day) as needed. 28. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 29. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 30. sevelamer 800 mg tablet sig: three (3) tablet po tid (3 times a day). 31. tramadol 50 mg tablet sig: 0.5 tablet po bid (2 times a day). 32. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime). 33. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 34. picc care heparin flush picc (100 units/ml) 2 ml iv daily:prn 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. 35. heparin insulin sc sliding scale breakfast lunch dinner bedtime regular glucose insulin dose 0-50 mg/dl 4 oz. 51-150 mg/dl 0 units 0 units 0 units 0 units 151-200 mg/dl 2 units 2 units 2 units 2 units 201-250 mg/dl 4 units 4 units 4 units 4 units 251-300 mg/dl 6 units 6 units 6 units 6 units 301-350 mg/dl 8 units 8 units 8 units 8 units 351-400 mg/dl 10 units 10 units 10 units 10 units 36. imipenem-cilastatin 500 mg recon soln sig: one (1) intravenous once a day: on hemodilaysis days give after hemodilaysis. discharge disposition: extended care facility: - discharge diagnosis: s/p fem-fem bipass cri mental status changes / hypotension discharge condition: - good discharge instructions: - you may shower; no bath or swimming pool for several weeks - you should take all medications as instructed to in the hospital - you should take pain medication as needed - do not drive while taking pain medicaiton - every day you take pain medication you should also take stool softeners: colace, senna, or dulcolax are all good options - md or return to ed if t>101.5, chills, nausea, vomiting, chest pain, shortness of breath, severe pain in leg or at incision site, redness or smelly drainage from incision site, or any other concern followup instructions: - you will need to follow-up with dr. in 1 week for follow-up and staple removal. please call her office at ( to schedule an appointment. procedure: venous catheterization, not elsewhere classified other revision of vascular procedure hemodialysis other (peripheral) vascular shunt or bypass excisional debridement of wound, infection, or burn excisional debridement of wound, infection, or burn other incision with drainage of skin and subcutaneous tissue transfusion of packed cells repair of blood vessel with synthetic patch graft other immobilization, pressure, and attention to wound diagnoses: other primary cardiomyopathies end stage renal disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery chronic hepatitis c without mention of hepatic coma unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified atrial fibrillation infection with microorganisms resistant to penicillins hematoma complicating a procedure other chronic pulmonary heart diseases diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hypotension, unspecified surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation accidents occurring in residential institution chronic pancreatitis 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 atherosclerosis of autologous vein bypass graft of the extremities carrier or suspected carrier of other specified bacterial diseases other amputation stump complication 

Answer: The patient is high likely exposed to