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: confusion and left sided weakness major surgical or invasive procedure: central line history of present illness: 81 yo female with history of cad, dm, severe pvd sent from nh with ms changes and new left sided weakness. she was discharged to the nh after a recent stay at for pneumonia, on service. on levo/flagyl for uti from nh. slightly unclear if still on these from . according to notes at baseline she is slightly confused, but was non-verbal on ems arrival. she was found by ems lying down unable to ambulate. . she was recently admitted for l fem endarterectomy and patch angioplasty with l fem- ptfe jump graft() then left ptfe graft, removal of fem-veingraft ptfe graft, ligation of fem-at vein graft . she was started on levo/flagyl for pneumonia and was discharged to complete 2 week course of levofloxacin/flagyl. she was recommended to go to rehab but her family preferred to take her home. she returned as her family was unable to care for her at home and was discharged to rehab . . in the ed her vitals were temp 99.8, hr 60, bp 103/47, rr 20, 100% ra. she was found to smell of ketones. while in the ed her bp dropped to 74/27 but responded to iv fluids. she was found to have a glucose of "critically high". her na 128 k 6.8, bun/creat 86/2.5, a right ij was placed. she was treated with vancomycin, ceftriaxone. she was started in an insulin drip, iv fluids (2l recorded). given calcium gluconate, and bicarb and written for kayaxlate which was never given. in the ed she had minimal urine output. a head ct showed no evidence of bleed. cxr was unremarkable. she was tranfered to the for further care. past medical history: # diabetes mellitus # hypercholesterolemia # coronary artery disease # hypertension # chronic renal insufficiency, baseline creat 0.9-1.0 # peripheral vascular disease s/p left common femoral and profunda femoralendarterectomies with dacron patch angioplasty and left ptfe jump graft from common femoral artery to pre-existing fem-at bypass and then thrombectomy of left profunda femoral artery and common femoral artery and bypass graft to the anterior tibial artery, transposition of proximal ptfe graft off of the common femoral artery over to the profunda femoral artery on the left side, removal of distal ptfe graft, ligation of vein graft to the left anterior tibial artery social history: was admitted from health center nh. living at home previously. cantonese speaking only. family history: noncontributory physical exam: gen: female in nad heent: mm dry, op clear, right and left pupils surgical neck: no lad, no jvd, right ij in place lungs: limited exam, scattered crackles cv: rrr, nl s1s2, no murmers abd: obese, soft, non-tender, non-distended, positive bs ext: no edema, left extremity with surgical scar exuding old blood, no erythema or pus, left sided groin surgical scar with no erythema or exudate, left extremity cold with non-doplerable pulses, doplerable pulses on the right, left buttock stage 2 decub doesn't appear infected. skin tenting, erythema over perineum. neuro: pupils surgical, muscle twitching, unable to get good dtrs, minimal to pain, no grimace pertinent results: 02:40pm wbc-12.2* rbc-4.39# hgb-13.5# hct-44.2# mcv-101*# mch-30.7 mchc-30.5* rdw-16.3* 02:40pm neuts-94.2* bands-0 lymphs-3.0* monos-2.2 eos-0.3 basos-0.3 02:40pm plt smr-high plt count-468* . 03:20pm pt-11.8 ptt-40.6* inr(pt)-1.0 . 03:20pm glucose-872* urea n-82* creat-2.5*# sodium-129* potassium-6.8* chloride-88* total co2-6* anion gap-42* 03:20pm albumin-3.3* calcium-9.0 phosphate-7.6*# magnesium-3.5* . 03:20pm alt(sgpt)-12 ast(sgot)-8 ck(cpk)-51 alk phos-80 amylase-73 tot bili-0.4 03:20pm lipase-56 . 03:20pm ck-mb-notdone ctropnt-0.01 09:44pm ck-mb-7 ctropnt-0.07* 09:00am ck-mb-7 ctropnt-0.21 04:00pm ck-mb-7 ctropnt-0.15 . 04:08pm lactate-2.4* . 06:30pm urine blood-mod nitrite-neg protein-tr glucose-250 ketone-50 bilirubin-sm urobilngn-neg ph-5.0 leuk-mod 06:30pm urine rbc->50 wbc-21-50* bacteria-many yeast-many epi-0-2 . blood cx : no growth urine cx : pending c diff: negative x 1 . 6:30 pm urine site: catheter **final report ** urine culture (final ): yeast. >100,000 organisms/ml.. . ekg : sinus rhythm consider prior inferior myocardial infarction nonspecific low amplitude anterolateral t wave changes since previous tracing of , further t waves changes present . non-contrast head ct : there is no evidence of intracranial hemorrhage, shift of normally midline structures, or major vascular territorial infarct. there is mild asymmetry to the ventricles with slight prominence of the left ventricle. moderate-to-severe periventricular hypoattenuation is consistent with chronic microvascular ischemic changes. there is no evidence of major vascular territorial infarct. faint lacunar infarcts are seen in the left caudate and internal capsule. osseous structures and soft tissues are unremarkable. the visualized paranasal sinuses and mastoid air cells are clear. impression: no acute intracranial hemorrhage or major vascular territorial infarct. if there is strong suspicion for a cva, mri with dwi is more sensitive for acute ischemia. . brain mri : diffusion images demonstrate subtle areas of increased signal in both external capsules as well as in the left periventricular region which demonstrate increased signal on adc map indicative of chronic changes and t2 shine through. there is no evidence of a slow diffusion identified to indicate acute infarct. there is no mass effect, midline shift or hydrocephalus. moderate brain atrophy is seen. there are diffuse periventricular and subcortical white matter hyperintensities predominantly in the frontal lobe indicative of severe changes of small vessel disease. impression: severe changes of small vessel disease. subtle areas of increased signal on diffusion images appear to be due to t2 shine through. moderate brain atrophy. mra of the head: the head mra demonstrates atherosclerotic disease affecting the distal vertebral arteries, proximal basilar artery and left middle cerebral artery with irregularity of the flow signal. there is an area of narrowing at the distal right vertebral artery which appears to be due to greater than 50% narrowing of the vertebral artery. no evidence of occlusion seen in the arteries of anterior and posterior circulation. impression: atherosclerotic disease affecting both cavernous carotids, left middle cerebral artery and vertebral and proximal basilar arteries as described above. probable stenosis of distal right vertebral artery near its junction with the vertebrobasilar artery. . chest, one view : comparison with multiple previous examinations, including and . new right ij central venous line with the tip at the cavoatrial junction. thickening in the right lung apex, unchanged since the last exam. linear atelectasis at the left lung base. lungs otherwise appear clear. cardiac, mediastinal, and hilar contours are unchanged. midline sternotomy wires and evidence of previous cabg. no pneumothorax. impression: no acute cardiopulmonary abnormality. successful right ij line placement. . us extremity nonvascular left focused ultrasound scanning was performed in the left lower extremity over the patient's known fluid collections in the left thigh and left groin. between the patient's two suture sites in the left lateral thigh is an ovoid fluid collection measuring 3.7 x 1.1 x 1.5 cm, which contains some heterogeneous internal echogenicity most consistent with hematoma. color doppler evaluation demonstrates no internal flow within this collection. left inguinal collection is similar in appearance, measuring 4.0 x 1.6 x 3.1 cm, with heterogeneous internal echogenicity, also most consistent with hematoma. note is also made of several prominent lymph nodes in the left groin. impression: two fluid collections in the left lower extremity, one overlying the left thigh laterally, and second in the left groin, with son features most consistent with hematoma. . brief hospital course: # diabetic ketoacidosis: likely precipitant = lack of insulin administration. no underlying infection (urine cx, cxr, wound site evaluation/ultrasound without evidence of infection) so antibiotics d/c after 48 hours, no mi, and no other precipitant identified. gap closed on an insulin gtt in the icu and volume restored with aggressive ivf. patient was restarted on a insulin 70/30 regimen, similar to her home doses. on the day of discharge, her afternoon blood sugar was still in the 200's so her am 70/30 dose was increased to her home dose. her home pm dose has not yet been reached (25 units qpm) but her am blood sugars have been well controlled. continue to check fingerstick blood sugars and cover with sliding scale humalog prn. . # delirium: patient confused on admission. likely toxic metabolic related to hyperglycemia + uremia. she is now alert and oriented x 3. head ct and mri were done given reports of left sided weakness. these show definite vascular disease but no evidence for acute stroke. she does have chronic microvascular disease. again, no evidence found for an underlying infection, as a possible contributor. . # acute renal failure: likely prerenal due to hyperglyceia/dka. resolved with ivf. . # cad: troponin leak but in the setting of acute renal failure and mb flat. ekg unremarkable. no complaints of chest pain. stress without inducible ischemia. patient continued on her asa, plavix, statin (dose doubled this admission for ldl 79), bb, and . she has evidence of diastolic chf on echo from but is euvolemic. recommend increasing valsartan and metoprolol to her home doses, as needed for goal sbp < 130 and dbp < 80. . # pvd: no acute issues. wounds clean/dry/intact. vascular saw patient in house and recommend continuing dry dressing to left groin and packing left thigh wound with wet to dry with overlying dry dressing. she can weight bear on her left lower extremity, as tolerated. ultrasound only showed stable hematoma at the wound sites. dr. from vascular aware patient has only intermittent dorsalis pedis pulses in the left foot but is deferring any further intervention for the time being. he will see her in follow-up outpatient to discuss continued managment. . # ppx: heparin sc, ppi, bowel regimen, wound care (see nursing notes and page 1) . # fen - monitor lytes as above. . # contact: daughter cell . # dnr/dni (changed in ed) . # rehab, , ma medications on admission: aspirin 81 mg po daily metoprolol 50 mg po bid atorvastatin 20 mg po daily pantoprazole 40 mg po q24h bisacodyl 10 mg po/pr daily:prn clopidogrel bisulfate 75 mg po daily docusate sodium (liquid) 100 mg po bid senna 1 tab po bid:prn percocet prn valsartan 320 mg po daily discharge medications: 1. docusate sodium 50 mg/5 ml liquid sig: one hundred (100) mg po bid (2 times a day). 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 4. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day): until ambulating regularly. 5. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. valsartan 80 mg tablet sig: one (1) tablet po daily (daily): hold for sbp < 110. 9. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 10. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day): hold for sbp < 110 or hr < 60. 11. tylenol 325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain: max 3 grams per day. 12. insulin 70/30 38 units sq qam 13. insulin 70/30 22 units sq qpm 14. humalog insulin sliding scale 1 injection sq , insulin sliding scale discharge disposition: extended care facility: rehabilitation & nursing center - discharge diagnosis: primary: diabetic ketoacidosis delirium stage 2 sacral decubitus ulcer secondary: peripheral vascular disease coronary artery disease hypertension hypercholesterolemia discharge condition: good: hemodynamically stable, afebrile off antibiotics, blood sugars in 200s discharge instructions: please monitor for temperature > 101, redness/pain/drainage at surgical wounds, change in mental status, or other concerning symptoms. followup instructions: please schedule follow-up with patient's primary care doctor within 1 week of discharge from rehab. phone: procedure: venous catheterization, not elsewhere classified diagnoses: pure hypercholesterolemia congestive heart failure, unspecified acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified peripheral vascular disease, unspecified chronic kidney disease, unspecified pressure ulcer, buttock pressure ulcer, lower back pressure ulcer, heel dehydration chronic diastolic heart failure diabetes with ketoacidosis, type ii or unspecified type, uncontrolled 

Answer: The patient is high likely exposed to