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: history of present illness: onset of right foot pain, swelling and erythema x1 week. the patient continued to walk on her foot, denies pain is minimal. she admits to diminished vision, polydipsia, polyuria. labs obtained in the emergency room included cbc with a white count of 28.7, hematocrit 32.7, platelets 577. bun 18, creatinine 1.3, potassium 4.0, glucose 637. pt/inr were normal. blood cultures were obtained. she was given 3 gm of unasyn, insulin bolus of 10 mg intravenous and then 6 mg q1h checking glucoses q1h was begun. she was begun on intravenous fluid of normal saline 20 cc an hour of kcl. vascular was consulted. our recommendation is that the patient be admitted to the medical service and her diabetic ketoacidosis treated. once she was stabilized on an insulin regimen, we would consider further evaluation or treatment. psychiatry was requested to see the patient because of changes in her mental status and refusing treatment. the patient was admitted to the medical service for further evaluation and treatment. past medical history: 1. the patient is diabetic since . 2. she has a history of hypertension and depression. 3. no previous surgeries were noted. allergies: the patient has no known drug allergies. medications: the patient is not on any medications. she also has a history of hypertension, but has never been on medications. previous surgical history: none social history: patient is an avid tobacco user. she has a history of alcohol excess of two to three bottles per week and alcohol with meals. she works as a retail person at . hospital course: over the next 24 to 48 hours, the patient's diabetic ketoacidosis was corrected. vascular reviewed the situation. the patient underwent a right second toe amputation, open. noninvasives were obtained which showed ankle brachial indexes of 0.71 on the right, 0.78 on the left, forefoot pressures 5 mm on the right and 4 mm on the left. she was continued on her unasyn and flagyl which was instituted in the emergency room. because of the positive blood cultures, a tee was done that showed no vegetation. on , she underwent an arteriogram which showed distal sfa disease, ak stenosis with occlusion of the tibial peroneal trunk. the at had a long area of stenosis in the first 3 cm. the distal pta had a shorter stenosis. the dp was not visualized. the lateral tarsals were visualized. foot cultures grew beta streptococcus group b moderate growth, alpha streptococcus moderate growth, staphylococcus coagulase negative, sparse growth of two colonies, staphylococcus coagulase positive, morganella morganii, escherichia coli and corynebacterium. the staphylococcus coagulase positive was sensitive to clindamycin, erythromycin, gentamicin, levofloxacin, oxacillin, resistant to penicillin. the morganella morganii was pan sensitive. th escherichia coli was resistant to ampicillin intermediate to unasyn, sensitive to cefazolin, ceftazidime, ceftriaxone and cefuroxime. it was also sensitive to gentamicin, imipenem and levofloxacin. it was intermediate to piperacillin, but sensitive to zosyn, tobramycin and bactrim. three out of four bottles on the blood cultures grew beta strep group b. infectious disease was consulted for recommendations on antibiotic therapy. recommendations were to discontinue the current regimen, begin the patient on zosyn. this was done on . psych was also requested to evaluate the patient secondary to the patient comprehends her illness and recommendations of treatment. after extensive psychological exam, they felt that the patient who initially refused treatment was secondary to delirium. she was now pleasant, cooperative without signs consistent with delirium at the time of the interview without effective disorder or psychosis being present. recommendations were to check liver function tests, vitamin b12, folate, her rpr. she should follow up in the psych clinic and be followed by psych. because of persistent fever and white count, the patient underwent, on , a foot debridement. the patient required transfusion post a foot debridement. she continued to be followed by infectious disease in her diabetes service. clostridium difficile was sent on because of elevated white count. this culture result was negative. the patient underwent, on , a right sfa to pt bypass graft with reverse saphenous vein and angioscopy. she tolerated the procedure well and was transferred to the pacu in stable condition with a palpable graft and dopplerable pt. immediate postoperatively, she remained hemodynamically stable, afebrile. she continued to do well and was transferred to the vicu for continued monitoring and care. she was continued to be followed by the ancillary services of , psych and infectious disease. postoperative day #1, there were no overnight events. she remained afebrile. her white count was 15.6, hematocrit 25.5. bun and creatinine remained stable. she had a palpable graft pulse on the right and a right dp was dopplerable with a palpable dp and dopplerable pt on the left. she did have edema on the lower extremities bilaterally. the incision sites were clean, dry and intact. her fluids were hep-locked. her diet was advanced as tolerated. her zosyn was continued. her cordis was converted to the cvl and she was transferred to the regular nursing floor. infectious disease felt the patient would require a total of six weeks of intravenous zosyn. physical therapy saw the patient and felt that recommendations were skilled nursing facility prior to return to home. case management was consulted to help arrange discharge planning. the right foot was debrided at the bedside on and again on . decision regarding ultimate treatment for the wound will be determined over the next 48 hours. the patient may require split thickness skin graft. if this is the case, discharge will be deferred and the patient will undergo recommended procedure prior to going to rehabilitation. discharge medications: 1. miconazole powder 2% application to affected areas and prn 2. metoprolol 75 mg tid, hold for systolic blood pressure less than 100, heart rate less than 55 3. tylenol 325 to 650 mg q 4 to 6 hours prn for pain 4. zosyn 4.5 gm intravenous q8h. this was started and was converted on to 2.25 gm intravenous q6h. 5. percocet tablets 1 to 2 q4h prn for pain. 6. folic acid 1 mg qd 7. thiamine 100 mg qd 8. multivitamin tablet 1 qd 9. heparin 5000 units subcutaneous 10. pantoprazole 40 mg qd 11. ferrous sulfate 325 mg tid 12. heparin 5000 units subcutaneous q 12 hours discharge diagnoses: 1. diabetic ketoacidosis corrected, right toe necrosis secondary to ischemia with septicemia, status post right toe amputation open on , status post right foot debridement and status post right sfa to pt bypass graft on . 2. septicemia 3. blood loss anemia corrected discharge instructions: the patient will be discharged in stable condition. she will follow up with dr. in two weeks' time. she should be non weight bearing on the affected extremity on the right. dressings will be depend on whether she continues on wound care or whether she gets a split thickness skin graft. an addendum will be dictated at that time. she will be on an 1800 calorie diet. her insulin is humalog 75/25, 15 units q a.m. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified arteriography of femoral and other lower extremity arteries amputation of toe 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 nonexcisional debridement of wound, infection or burn nonexcisional debridement of wound, infection or burn other myectomy other partial ostectomy, tarsals and metatarsals other tenonectomy percutaneous angioscopy diagnoses: unspecified pleural effusion acute posthemorrhagic anemia pulmonary collapse other complications due to other vascular device, implant, and graft streptococcal septicemia atherosclerosis of native arteries of the extremities with gangrene cellulitis and abscess of foot, except toes acute osteomyelitis, ankle and foot diabetes with ketoacidosis, type ii or unspecified type, uncontrolled 

Answer: The patient is high likely exposed to