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: altace attending: chief complaint: nonhealing foot ulcer major surgical or invasive procedure: failed fem- bypass graft using arm vein, bka history of present illness: ms. is a 90-year old female with a history of prednisone-induced dmii and s/p left femoral to above knee popliteal artery bypass who presents with a non healing ulcer on her right first toe. about 3-4 weeks ago, she first noticed increased swelling and a crusty black lesion on the top of her toe. she recently followed up with dr. for evaluation and was referred for angiography today. over the last few weeks, she denies any changes in the characteristics of her toe ulceration. she had a milder ulceration on her heel which has mostly healed over the last 3 weeks. she denies pain at rest or with activity. patient noted that she has almost no sensation below the ankle because of her neuropathy. in general, she has very minimal physical activity and currently uses a wheelchair. past medical history: vascular history: lower extremity bypass graft, : femoral to above knee . artery (). vein stripping: bilteral lower extremities (). past medical history: pmh: pvd, bullous pemphigoid, prednisone induced dmt2, hx breast carcinoma, hx venous insufficiency , osteoporosis, hld, spinal stenosis, urinary incontinence, single kidney past surgical history: psh: s/p left femoral to above knee popliteal artery bpg , s/p radical right mastectomy 25 yrs ago with associated hyst , s/p portacath removed one week after completing chemotherapy, bilateral lower extremity vein stripping social history: she denies smoking, drinking, or recreational drug use. she is currently living at the / mass nursing home. she has three children. family history: nc physical exam: gen: nad cv: rrr, 3/6 sem resp: cta abd: s, nt/nd ext: no c/c/e, r bka pertinent results: 03:08am blood wbc-12.7* rbc-3.90* hgb-10.5* hct-32.8* mcv-84 mch-26.8* mchc-31.9 rdw-21.2* plt ct-140* 03:08am blood glucose-101* urean-30* creat-1.9* na-139 k-3.9 cl-106 hco3-26 angap-11 brief hospital course: mrs. was admitted to the vascular surgery service on after undergoing a failed fem- bpg using arm vein and a bka. please see the operative report for more information. intraoperatively she became hypotensive and a tee showed as. postoperatively she was kept in the pacu overnight d/t hypoxemia and was transferred to the vicu on pod1. on pod1 she was advanced to a regular diet and was started on her home meds. on pod2 she was unresponsive in the am and noted to have a blood glucose of 12. she was appropriately resuscitated with glucose and her home insulin was decreased as per consult to 24 units qhs with sliding scale. later on pod2 she recieved diuresis as she was still hypoxemic and she became acutely hypotensive and was transferred to the cvicu where she was briefly on pressors. she was slow to wake up and hct performed showed no ischemic changes. on pod3 she awoke and was kept in the icu for close monitoring. on pod4 she was transferred to the floor, advanced to a regular diet and restarted on her home meds with the exception of her insulin. carotid duplexes were negative. a tte performed showed severe as with of 0.8. on pod3 she was diagnosed with cdiff after having significant diarrhea and was started on flagyl and po vancomycin, this was narrowed to po flagyl alone by discharge. by the day of discharge, she was working with pt and was stable for discharge. medications on admission: dulcolax 10 pr prn, antigas 200/200/20 30ml q4 prn, tylenol 650 q4 prn, generlac 30'prn, prochlorperazine pr25'' prn nausea, amlodipine 10', clonidine td 0.1 mg q monday, plavix 75', gabapentin 300''', nadolol 80', hydralazine 25''', procrit 40,000 sc every other month, omeprazole 20', tramadol 50'', prednisone 10', ferrous sulfate 325/63', torsemide 20 qod + 40qod, mytab gas 80''', ipratropium-albuterol 0.5-3/3 ml ''''prn, levemir sc 48 qhs, novolog 4u breakfast +10 u lunch +6u dinner, mirtazapine 7.5 qhs, natural balance tears 1 drop per eye''' discharge medications: 1. torsemide 20 mg tablet sig: one (1) tablet po every other day (every other day). 2. torsemide 20 mg tablet sig: two (2) tablet po every other day (every other day). 3. clonidine 0.1 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qmon (every monday). 4. metronidazole 500 mg tablet sig: one (1) tablet po q8h (every 8 hours) for 2 weeks. disp:*42 tablet(s)* refills:*0* 5. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 6. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 7. insulin glargine 100 unit/ml solution sig: twenty four (24) units subcutaneous at bedtime. 8. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 9. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 10. prednisone 10 mg tablet sig: one (1) tablet po daily (daily). 11. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 12. nadolol 80 mg tablet sig: one (1) tablet po daily (daily). 13. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 14. hydralazine 25 mg tablet sig: one (1) tablet po tid (3 times a day). 15. acetaminophen 500 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain. 16. tramadol 50 mg tablet sig: 0.5 tablet po three times a day. disp:*20 tablet(s)* refills:*0* discharge disposition: extended care facility: house nursing home - discharge diagnosis: foot ulcers s/p bka discharge condition: mental status: clear and coherent. activity status: out of bed with assistance to chair or wheelchair. level of consciousness: alert and interactive. discharge instructions: discharge instructions following below knee amputation . this information is designed as a guideline to assist you in a speedy recovery from your surgery. please follow these guidelines unless your physician has specifically instructed you otherwise. please call our office nurse if you have any questions. dial 911 if you have any medical emergency. . activity: . there are restrictions on activity. on the side of your amputation you are non weight bearing until cleared by your surgeon. you should keep this amputation site elevated when ever possible. . you may use the other leg to assist in transferring and pivots. but try not to exert to much pressure on the amputation site when transferring and or pivoting. please keep knee immobilizer on at all times to help keep the amputation site straight. . no driving until cleared by your surgeon. . please call us immediately for any of the following problems: . redness in or drainage from your leg wound(s) . . watch for signs and symptoms of infection. these are: a fever greater than 101 degrees, chills, increased redness, or pus draining from the incision site. if you experience any of these or bleeding at the incision site, call the doctor. . exercise: . limit strenuous activity for 6 weeks. . do not drive a car unless cleared by your surgeon. . try to keep leg elevated when able. . bathing/showering: . you may shower immediately upon coming home. no bathing. a dressing may cover you??????re amputation site and this should be left in place for three (3) days. remove it after this time and wash your incision(s) gently with soap and water. you will have sutures, which are usually removed in 4 weeks. this will be done by the surgeon on your follow-up appointment. . wound care: . sutures / staples may be removed before discharge. if they are not, an appointment will be made for you to return for staple removal. . when the sutures are removed the doctor may or may not place pieces of tape called steri-strips over the incision. these will stay on about a week and you may shower with them on. if these do not fall off after 10 days, you may peel them off with warm water and soap in the shower. . avoid taking a tub bath, swimming, or soaking in a hot tub for four weeks after surgery. . medications: . unless told otherwise you should resume taking all of the medications you were taking before surgery. you will be given a new prescription for pain medication, which can be taken every three (3) to four (4) hours only if necessary. . remember that narcotic pain meds can be constipating and you should increase the fluid and bulk foods in your diet. (check with your physician if you have fluid restrictions.) if you feel that you are constipated, do not strain at the toilet. you may use over the counter metamucil or milk of magnesia. appetite suppression may occur; this will improve with time. eat small balanced meals throughout the day. . cautions: . no smoking! we know you've heard this before, but it really is an important step to your recovery. smoking causes narrowing of your blood vessels which in turn decreases circulation. if you smoke you will need to stop as soon as possible. ask your nurse or doctor for information on smoking cessation. . avoid pressure to your amputation site. . no strenuous activity for 6 weeks after surgery. . diet : . there are no special restrictions on your diet postoperatively. poor appetite is expected for several weeks and small, frequent meals may be preferred. . for people with vascular problems we would recommend a cholesterol lowering diet: follow a diet low in total fat and low in saturated fat and in cholesterol to improve lipid profile in your blood. additionally, some people see a reduction in serum cholesterol by reducing dietary cholesterol. since a reduction in dietary cholesterol is not harmful, we suggest that most people reduce dietary fat, saturated fat and cholesterol to decrease total cholesterol and ldl (low density lipoprotein-the bad cholesterol). exercise will increase your hdl (high density lipoprotein-the good cholesterol) and with your doctor's permission, is typically recommended. you may be self-referred or get a referral from your doctor. . if you are overweight, you need to think about starting a weight management program. your health and its improvement depend on it. we know that making changes in your lifestyle will not be easy, and it will require a whole new set of habits and a new attitude. if interested you can may be self-referred or can get a referral from your doctor. . if you have diabetes and would like additional guidance, you may request a referral from your doctor. . follow-up appointment: . be sure to keep your medical appointments. the key to your improving health will be to keep a tight reign on any of the chronic medical conditions that you have. things like high blood pressure, diabetes, and high cholesterol are major villains to the blood vessels. don't let them go untreated! . please call the office on the first working day after your discharge from the hospital to schedule a follow-up visit. this should be scheduled on the calendar for seven to fourteen days after discharge. normal office hours are 8:30-5:30 monday through friday. . please feel free to call the office with any other concerns or questions that might arise followup instructions: follow up with dr. in 2 weeks follow up with your pcp 1 week procedure: other (peripheral) vascular shunt or bypass other amputation below knee diagnoses: thrombocytopenia, unspecified acute posthemorrhagic anemia aortic valve disorders ulcer of other part of foot other and unspecified hyperlipidemia hypotension, unspecified long-term (current) use of insulin osteoporosis, unspecified intestinal infection due to clostridium difficile hypoxemia altered mental status spinal stenosis, unspecified region personal history of antineoplastic chemotherapy atherosclerosis of native arteries of the extremities with ulceration acquired absence of breast and nipple secondary diabetes mellitus with other specified manifestations, not stated as uncontrolled, or unspecified 

Answer: The patient is high likely exposed to