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: ischemic right lower extremity major surgical or invasive procedure: : 1. aortogram with right lower extremity runoff, third order catheterization. 2. brachial artery access with third order catheterization. 3. right superficial femoral artery antegrade access with second order catheterization. 4. mechanical thrombectomy (angiojet). 5. infusion for thrombolysis (tpa). 6. right femoral-popliteal pta. 7. right popliteal stent 5 x 40 times two for residual stenosis. 8. right peroneal 4 x 40 and 3 x 120 pta. right lower extremity lytic check/catheter change removal of arterial sheath and percutaneous closure, diagnostic right lower extremity arteriogram, follow-up tibial thrombolysis, percutaneous balloon angioplasty of the mid peroneal artery. history of present illness: the patient is an elderly gentleman who has an entire aortobiiliac bypass graft with occlusion of the right limb and femoral-femoral crossover graft. he presented to with knee pain and they thought that he had a septic knee. he represented with worsening foot pain and discoloration. he was sent here urgently. when we evaluated him, he had a very ischemic foot. he had limited sensation, but did have motor, although it was not completely normal. he had some calf tenderness. physical exam: on admission: 98.1 76 113/52 16 97% room air nad rrr cta bilaterally soft, nd, nt, nabs right extremity: knee tender to palpation with any motion, pt dopplerable, dp not-dopplerable, cold foot. left extremity: dp palpable, pt dopplerable, warm throughout. . on discharge: 97.8 67 142/60 18 96% room air nad rrr cta bilaterally soft, nd, nt, nabs right extremity: warm throughout, knee non-tender, dp/pt dopplerable. left extremity: dp palpable, pt dopplerable, warm throughout. pertinent results: on admission: 06:21pm blood wbc-22.6*# rbc-3.81*# hgb-10.7*# hct-31.3*# mcv-82 mch-28.0 mchc-34.0 rdw-15.7* plt ct-317# 06:21pm blood neuts-93.2* bands-0 lymphs-4.8* monos-1.6* eos-0.3 baso-0.1 06:21pm blood pt-14.3* ptt-60.9* inr(pt)-1.3* 06:21pm blood glucose-118* urean-57* creat-2.1* na-139 k-4.1 cl-107 hco3-24 angap-12 06:21pm blood ck(cpk)-188* 06:42pm blood lactate-1.4 . on discharge: 04:50am blood wbc-8.0 rbc-4.26* hgb-12.0* hct-36.4* mcv-85 mch-28.1 mchc-32.9 rdw-16.4* plt ct-387 04:50am blood pt-22.5* ptt-62.2* inr(pt)-2.2* 07:44am blood fibrino-624* 04:50am blood glucose-111* urean-28* creat-1.3* na-137 k-4.3 cl-107 hco3-24 angap-10 06:05am blood ck(cpk)-29* 05:15am blood lipase-89* 12:32pm blood ck-mb-4 ctropnt-0.13* 04:50am blood calcium-8.1* phos-3.5 mg-2.3 . radiology final report chest (portable ap) 6:11 pm chest (portable ap) reason: eval medical condition: 84 year old man with rle thrombosis reason for this examination: eval pre-op examination: ap chest. indication: right leg thrombosis. a single ap view of the chest was obtained at 18:13 and is compared with the prior study performed . cardiomediastinal silhouette is unremarkable. the lungs show no evidence of acute infiltrate, pleural effusion or pneumothorax. there is some minimal linear atelectasis in the left base. impression: minimal linear basal atelectasis. no other acute process demonstrated. . radiology final report chest (portable ap) 11:53 pm chest (portable ap); -77 by different physician : check ett position medical condition: 84 year old man with rle ischemia reason for this examination: check ett position ap chest 1:27 a.m. on history: ischemia. check et tube placement. impression: ap chest compared to at 6:13 a.m.: moderate-to-severe pulmonary edema is new, accompanied by increased dilatation of pulmonary arteries though heart size is normal and unchanged. pleural effusions may be collecting posteriorly, but are not substantial in size. et tube in standard placement. no pneumothorax. . radiology final report knee (ap, lat & oblique) right port 7:42 pm knee (ap, lat & oblique) right reason: assess for medical condition: 84 year old man with reason for this examination: assess for sffusion examination: right knee, 8:20 p.m., on . history: possible effusion. impression: frontal and a lateral view of the right knee suggests a small joint effusion in the suprapatellar recess. the knee is other unremarkable. a vascular catheter lies posterior to the lower femur and an arterial stent is posterior to the upper aspect of the tibia. . radiology final report chest (portable ap) 10:40 am chest (portable ap) reason: assess pulm edema medical condition: 84 year old man with rle ischemia, mi s/p angio reason for this examination: assess pulm edema indication: right lower extremity ischemia, myocardial infarction. chest, one view: comparison with multiple previous examinations, the most recent being . endotracheal tube is unchanged in position. pulmonary edema has resolved. cardiac, mediastinal, and hilar contours are now within normal limits. bilateral small pleural effusions may be present. no pneumothorax. osseous structures are unchanged. a 5-mm round opacity overlying the right lung field has not been seen on previous studies and probably represents a confluence of shadows. impression: bilateral pleural effusions. improvement in pulmonary edema . radiology final report chest (portable ap) 7:34 am chest (portable ap) reason: r/o infiltrates medical condition: 84 year old man with rle ischemia, mi s/p angio reason for this examination: r/o infiltrates history: 84-year-old man with right lower extremity ischemia, myocardial infarction, status post angiogram. comparison: . chest, ap: cardiac, mediastinal, and hilar contours are stable. there is mild pulmonary edema, not significantly changed from prior exam. the small bilateral pleural effusions appeared to have slightly increased in size accounting for differences in technique. endotracheal tube is in unchanged position. impression: mild pulmonary edema. slight increase in size of small bilateral pleural effusions. . cardiology report echo study date of left ventricle - ejection fraction: 55% to 60% (nl >=55%) conclusions: the left atrium is normal in size. the estimated right atrial pressure is 16-20 mmhg. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild regional dysfunction with focal mild hypokinesis of the distal septum and mid-anterior walls. the remaining segments contract normally and overall lvef is preserved. tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (?#) are mildly thickened. there is no aortic valve stenosis. trace aortic regurgitation is seen. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with mild regional systolic dysfunction c/w cad or focal myocarditis. moderate pulmonary artery systolic hypertension. mild mitral regurgitation. . radiology final report chest (portable ap) 9:50 am chest (portable ap) reason: assess for infiltrates/effusions medical condition: 84 year old man with rle ischemia, mi s/p angio reason for this examination: assess for infiltrates/effusions reason for examination: followup of a patient after _____. portable ap chest radiograph compared to . the patient was extubated in the meantime interval. the heart size is normal. the bibasilar atelectasis and bilateral small pleural effusion is unchanged, and there is no evidence of congestive heart failure. . radiology final report ct head w/o contrast 8:42 am ct head w/o contrast reason: r/o cva/ medical condition: 84 year old man s/p rt popleteal stent and thrombectomy w/ms changes. had tpa w/thrombectomy reason for this examination: r/o cva/hemorrage contraindications for iv contrast: none. indication: status post right popliteal stent and thrombectomy with mental status changes. head tpa with thrombectomy. evaluate for an intracranial hemorrhage or infarct. technique: non-contrast head ct. comparison examination: . findings: since the prior examination, there has been development of an old appearing small right frontal lobe infarct. the previously noted left frontal lobe infarct is unchanged. since the prior exam; however, there are new periventricular white matter hypodensities, any one of which could represent a small acute infarct. a mri would be recommended if exclusion of an acute infarct is needed. as before, there are small lacunes in the caudate heads bilaterally. there is no midline shift, mass effect or hydrocephalus. there is no intracranial hemorrhage. the mastoid sinus air cells are hypoplastic. these findings were discussed with , the nurse practitioner surgery at the time of dictation. impression: since the head ct, there has been interval development of a small right frontal lobe infarct which appears chronic on this examination. numerous additional periventricular white matter hypodensities are present, any one of which could represent a small acute infarct. mri would be needed to exclude that diagnosis. there is no intracranial hemorrhage. . radiology final report dup extext bil (map/dvt) 9:58 am dup extext bil (map/dvt) reason: pre-op for bypass medical condition: 84 y/o man presents with mi, cold r foot and hot r knee5/27: r knee tap by ortho, r peroneal thrombectomy, stent, angioplasty and placement of lysis catheter5/28 repeat angio, tpa5/29 peroneal cutting balloon, tpa5/30 angio, tpa cath removed reason for this examination: pre-op for bypass venous study dated 6 history: extensive intervention for a cold right foot, now requires vein mapping for possible bypass. findings: the greater saphenous veins are patent bilaterally. please see digitized images on pacs for formal sequential vein dimensions. . radiology final report persantine mibi persantine mibi reason: 84 yo w/ mi; rt peroneal thrombectomy, stent, angioplasty, tpa angio, tpa cath removed radiopharmeceutical data: 10.2 mci tc-m sestamibi rest (); 29.6 mci tc-99m sestamibi stress (); history: cad, pre-operative evaluation. summary of data from the exercise lab: dipyridamole was infused intravenously for 4 minutes at a dose of 0.142 mg/kg/min. method: resting perfusion images were obtained with tc-99m sestamibi. tracer was injected approximately one hour prior to obtaining the resting images. two minutes after the cessation of infusion of dipyridamole, approximately three times the resting dose of tc99m sestamibi was administered iv. stress images were obtained approximately one hour following tracer injection. imaging protocol: gated spect. this study was interpreted using the 17-segment myocardial perfusion model. interpretation: the image quality is good. left ventricular cavity size is dilated at stress and rest. rest and stress perfusion images reveal uniform tracer uptake throughout the left ventricular myocardium without signs of reversible or irreversible ischemia. gated images reveal hypokinesis. the calculated left ventricular ejection fraction is low at 40%. impression: 1. dilated left ventricle at rest and stress without ischemic changes. 2. hypokinesis with depressed ejection fraction of 40%. . cardiology report stress study date of impression: no anginal symptoms or significant st segment changes from baseline. nuclear report sent separately. brief hospital course: the patient was admitted to dr. vascular surgery service on . he was acutely taken to the operating room where he underwent a aortogram with right lower extremity runoff, third order catheterization, brachial artery access with third order catheterization, right superficial femoral artery antegrade access with second order catheterization, mechanical thrombectomy (angiojet), infusion for thrombolysis (tpa), right femoral-popliteal pta, right popliteal stent 5 x 40 times two for residual stenosis, and right peroneal 4 x 40 and 3 x 120 pta on . during the procedure the patient became acutely agitated with an elevated heart rate, and he was electively intubated. immediately post-op he was transferred to the csru intubated. tpa infusion was continued into his right lower extremity and his heart rate contorlled with b-blocker. on pod 1, his cardiac enzymes were elevated (trop 2.13) and cardiology was consulted, recommending aspirin, anticoagulation with heparin drip, hr control with lopressor, and starting lipitor. his knee was tapped by ortho after an knee xray showed a possible effusion and cultures were later negative. he continued to remain intubated and sedated and the tpa infusion was continued. he was taken back for a right lower extremity lytic check/catheter change. please refer to the operative report for further details. on pod 2, he was again taken back for a diagnostic right lower extremity arteriogram, follow-up tibial thrombolysis, percutaneous balloon angioplasty of the mid peroneal artery. his cardiac enzymes continued rise peaking at 2.41 and then continued to trend downward until discharge. on pod 4, he was extubated without complications. he was continued on vancomycin for a possible knee infection and cipro floxacin was started for a pneumonia (enterococcus). post-extubation he had a somnolent mental status with waxing and agitation. neurology was consulted believed it was post-operative delirium. his mental status continued to improve daily after extubation. he continued to remain afebrile and on pod 7 from the first operation, he was stable for transfer from the csru to the floor. while on the floor, the haperin drip was continued and his post-operative course on the floor was uncomplicated. he underwent a pmibi per cardiology recommendations which showed a dilated left ventricle at rest and stress without ischemic changes and hypokinesis with depressed ejection fraction of 40%. cardiology felt this was unchanged from his previous studies and recommeded no further intervention except follow-up on an outpatient basis. he was started on coumadin in transition from his heparin drip and was therapeutic by the day of discharge with an inr of 2.2. he was deemed stable for discharge to a rehab facility in pod 11 form the first operation. he was afebrile and tolerating a regular diet. all his lines have been discontinued without complications and he will be discharged no 14 days of ciprofloxacin for his pneumonia. his trop level was 0.13. he will follow-up with dr. in 1 month with a duplex of his lower extremities. medications on admission: plavix 75', lipitor 20', nifedipine 90', lisinopril 10', metoprolol 25'' asa 81' discharge medications: 1. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 14 days. disp:*28 tablet(s)* refills:*0* 2. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 4. warfarin 2 mg tablet sig: 2.5 tablets po once a day. disp:*75 tablet(s)* refills:*2* 5. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 6. acetaminophen 325 mg tablet sig: 1-2 tablets po every hours as needed for pain. tablet(s) 7. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 8. nifedipine 10 mg capsule sig: three (3) capsule po q8h (every 8 hours). 9. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). discharge disposition: extended care facility: hospital - discharge diagnosis: ischemic right leg, acute thrombosis mi discharge condition: stable discharge instructions: medications: ?????? take aspirin 325mg (enteric coated) once daily ?????? if instructed, take plavix (clopidogrel) 75mg once daily ?????? continue all other medications you were taking before surgery, unless otherwise directed ?????? you make take tylenol or prescribed pain medications for any post procedure pain or discomfort what to expect when you go home: it is normal to have slight swelling of the legs: ?????? elevate your leg above the level of your heart (use pillows or a recliner) every 2-3 hours throughout the day and at night ?????? avoid prolonged periods of standing or sitting without your legs elevated ?????? it is normal to feel tired and have a decreased appetite, your appetite will return with time ?????? drink plenty of fluids and eat small frequent meals ?????? it is important to eat nutritious food options (high fiber, lean meats, vegetables/fruits, low fat, low cholesterol) to maintain your strength and assist in wound healing ?????? to avoid constipation: eat a high fiber diet and use stool softener while taking pain medication what activities you can and cannot do: ?????? when you go home, you may walk and go up and down stairs ?????? you may shower (let the soapy water run over groin incision, rinse and pat dry) ?????? your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing or band aid over the area that is draining, as needed ?????? no heavy lifting, pushing or pulling (greater than 5 lbs) for 1 week (to allow groin puncture to heal) ?????? after 1 week, you may resume sexual activity ?????? after 1 week, gradually increase your activities and distance walked as you can tolerate ?????? no driving until you are no longer taking pain medications ?????? call and schedule an appointment to be seen in weeks for post procedure check and ultrasound what to report to office: ?????? numbness, coldness or pain in lower extremities ?????? temperature greater than 101.5f for 24 hours ?????? new or increased drainage from incision or white, yellow or green drainage from incisions ?????? bleeding from groin puncture site sudden, severe bleeding or swelling (groin puncture site) ?????? lie down, keep leg straight and have someone apply firm pressure to area for 10 minutes. if bleeding stops, call vascular office . if bleeding does not stop, call 911 for transfer to closest emergency room. followup instructions: appointments to be made: call your primary care md- dr. at for a follow-up appointment and inr (coumadin test). he will manage your anticoagulation but you must call for appointment for inr/blood draw. goal inr is 2.5-3.0. expect to receive a call from dr. office to schedule your appointment and lower extremity duplex. please call dr. , md at to schedule a follow-up appointment for 1 month from today if you do not hear from the office within one week. you will need to get a lower extremity duplex prior to your visit. . scheduled appointments : you have a visit scheduled with cardiology dr. phone: date/time: 4:00. he is located in . he is the cardiologist that followed you during this hospital stay. you will need close follow up with cardiologist as outpatient given your cardiac history and inpatient events. provider: , m.d. phone: date/time: 10:15 provider: , md phone: date/time: 2:00 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more angioplasty of other non-coronary vessel(s) angioplasty of other non-coronary vessel(s) injection or infusion of thrombolytic agent injection or infusion of thrombolytic agent arteriography of femoral and other lower extremity arteries arteriography of femoral and other lower extremity arteries aortography arthrocentesis insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) transfusion of packed cells transposition of cranial and peripheral nerves insertion of two vascular stents procedure on single vessel procedure on two vessels diagnoses: subendocardial infarction, initial episode of care unspecified essential hypertension personal history of malignant neoplasm of prostate aortocoronary bypass status chronic kidney disease, unspecified other and unspecified hyperlipidemia personal history of other diseases of circulatory system old myocardial infarction other complications due to other vascular device, implant, and graft delirium due to conditions classified elsewhere arterial embolism and thrombosis of lower extremity effusion of joint, lower leg pneumonia due to other streptococcus 

Answer: The patient is high likely exposed to