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: synthroid / almond sweet oil attending: chief complaint: recurrent right pyelonephritis major surgical or invasive procedure: 1. right simple nephrectomy - - dr. 2. wound exploration, washout, placement of intraabdominal drains - - dr. history of present illness: 67m s/p childhood traumatic injury necessitating cystectomy and b ureterosigmoidostomy, w/ eventual renal degeneration to stage iv ckd, also found to have persistent fecal reflux into r kidney necessitating r placement and frequent changes/mainpulations due to clogging/pyelonephritis. gi and gu workup negative for fistula. patient is now s/p r "simple" nephrectomy. past medical history: pmh: childhood traumatic injury, stage iv ckd, nephrolithiasis, pelvic lymphocele, lle dvt ' (no longer on anticoag), gerd, r cataract, hypothyroidism, vre, obesity, chronic metabolic acidosis --- psh: cystectomy w/ b ureterosigmoidostomies; r cataract; multiple r procedures; r antegrade ureteroscopy social history: patient lives in with his wife. is a retired school custodian. quit smoking 30 yrs ago, 1ppd x 10 years. no alcohol, no drugs. family history: no family history of renal disease. brother with hemachromatosis. family h.o malignant hyperthermia. physical exam: general: nad, pleasant, conversive heent: nc/at. mmm, clear oropharynx, no scleral icterus neck: supple lungs: ctab anteriorly, no w/w/r cardiac: regular rate, no m/g/r abd: slightly distended, soft, drain in place, incision healing well with two openings, one at each end of the incision with beefy red granulation tissue and mild serous drainage. neuro: alert, oriented. speech appropriate. moving all extremities. psych: appropriate pertinent results: 05:12am blood wbc-10.4 rbc-3.07* hgb-8.7* hct-26.5* mcv-87 mch-28.2 mchc-32.6 rdw-16.9* plt ct-437 06:19am blood glucose-95 urean-13 creat-1.6* na-142 k-3.5 cl-107 hco3-24 angap-15 07:49am blood wbc-7.4 rbc-3.18* hgb-9.0* hct-27.8* mcv-88 mch-28.2 mchc-32.2 rdw-16.8* plt ct-390 05:37am blood pt-25.2* inr(pt)-2.5* 05:00am blood glucose-81 urean-14 creat-1.8* na-142 k-3.9 cl-109* hco3-22 angap-15 brief hospital course: icu course: 1. following the procedure, the patient was admitted to the icu for fluid status and electrolyte monitioring. he required aggressive magnesium repletion (post-op mg was 0.7) following the procedure as well as 2 u prbc. he was given iv hco3 following the procedure, but this was discontinued on transfer to the floor and he was restarted on his home dose of sodium bicarbonate. did receive single dose of lasix for lung crackles. he was treated with a dilaudid pca and fentanyl patch for postoperative pain management. ciprofloxacin was discontinued on pod 2. 2. ckd: baseline creatinine 2-2.6 following the procedure. creatinine rose to 2.6 following the procedure and remained stable, trending down on pod 3. --- floor course: pt was transferred to floor in stable condition. he required some increases in doses for his dilaudid pca on pod 2, but on pod 3 was transitioned to po pain meds once tolerating solid food. he ambulated with the help of physical therapy and the nursing staff. his creatinine stabilized and trended down (2.3 on pod 5) and his electrolytes remained stable for the remainder of his hospital course. renal medicine followed the pt throughout his hospital stay and adjusted his daily sodium bicarbonate regimen to 650 mg po bid rather than qid. his lasix 40 mg po qd was restarted on pod 3. his penrose drain was removed on pod 4. on pod 4, the pt was noted to have a markedly asymmetrically edematous lle. venous doppler ultrasound was performed, which demonstrated a large lle dvt. the pt was started on intravenous unfractionated heparin and titrated to a target ptt of 60-80. coumadin was started in the evening of pod 5. the pt was evaluated by vascular medicine, who recommended anticoagulation for at least one year given the pt's past history of dvt. they also recommended overlap of therapeutic heparin and coumadin for at least 2 days before discontinuation of heparin. the pt's inr became therapeutic on pod 7, and the pt was maintained on a dose of coumadin 1 mg po qhs for two more days before heparin was discontinued on pod 9. his final dose of coumadin was 3 mg po qhs. his discharge inr was 2.5. he will follow up with his pcp, . , for monitoring of his inr. on pod 5, the pt's wound was noted to be erythematous. a lateral-most staple was removed, with extrusion of cloudy serosanguinous fluid that was sent for culture. the wound was packed with nu gauze underneath the incision, which helped reduce the erythema significantly. ancef was started for empiric coverage of a skin infection. on pod 6, more drainage was noted from the medial of the wound, and two more staples were removed and the wound was packed. probing of the underlying fascia revealed fascial weakness and failure of the fascia to heal well. wound cx preliminarily grew gram negative rods. abx coverage was switched initially to ceftriaxone, then to unasyn, and eventually to zosyn. the wound drainage increased throughout the next three days, and his wbc increased from 12 to 17. he remained afebrile, but his metabolic acidosis worsened despite increases in his bicarbonate regimen. his hco3 on pod 9 was 16. on pod 9, a non-contrast ct a/p was performed, which revealed a gas-filled fluid collection at resection bed suspicious for an infected fluid collection. the pt was taken back to the or on pod 10 for a wound exploration, washout of intraabdominal abscess, and drain placement. he tolerated the procedure well and was taken to the floor post-operatively. after his second operation, his clinical status improved. his wbc trended down, and became normal at 10.4 on pod . his drains had minimal but consistent output. one drain was removed on pod from a renal standpoint, the pt continued to improve. his creatinine continued to trend down and was 1.6 on pod 14. on pod 13, some drainage was noted from the lateral aspect of his wound. two stitches were removed on pod 14 and the wound was packed with 2x2 gauze. healthy, beefy-red granulation tissue was noted on the internal aspects of the wound. his old staples were removed on pod 17, and some discharge was noted from the medial aspect of the wound, which was again packed. the discharged appeared serous, and was manageable with dressing changes. the wound appeared to be well-healing and nonerythematous. his wbc count remained normal and he was afebrile. on discharge, the pt was ambulating, tolerating a regular diet, and his pain was adequately controlled on oral pain medication. he was discharged with vna to manage his one jp drain, his dressing changes, and to complete his course of zosyn. he will follow up with dr. for management of his inr, dr. to address his dvt, dr. of the renal service, and dr. , who will see the patient within one week. medications on admission: 1. fentanyl 25 mcg/hr patch 72 hr sig: one (1) patch 72 hr transdermal q72h (every 72 hours). 2. liothyronine 25 mcg tablet sig: two (2) tablet po daily (daily). 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 4. sodium bicarbonate 650 mg tablet sig: one (1) tablet po twice a day. 5. magnesium oxide 400 mg tablet sig: one (1) tablet po daily (daily). 6. propranolol 120 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po daily (daily). 7. lasix 40 mg tablet sig: one (1) tablet po once a day. 8. metolazone 2.5 mg tablet sig: one (1) tablet po once a day. discharge medications: 1. fentanyl 25 mcg/hr patch 72 hr sig: one (1) patch 72 hr transdermal q72h (every 72 hours). 2. liothyronine 25 mcg tablet sig: two (2) tablet po daily (daily). 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 4. magnesium oxide 400 mg tablet sig: one (1) tablet po daily (daily). 5. propranolol 120 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po daily (daily). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 7. lasix 40 mg tablet sig: one (1) tablet po once a day. 8. hydromorphone 4 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 9. sodium bicarbonate 650 mg tablet sig: three (3) tablet po qid (4 times a day). 10. warfarin 3 mg tablet sig: one (1) tablet po once a day: please follow up with dr. within two days to follow your inr for your coumadin. disp:*30 tablet(s)* refills:*2* 11. heparin, porcine (pf) 10 unit/ml syringe sig: one (1) ml intravenous once a day as needed for line flush. disp:*30 ml(s)* refills:*2* 12. piperacillin-tazobactam 2.25 gram recon soln sig: one (1) recon soln intravenous q8h (every 8 hours) for 5 days. disp:*15 recon soln(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: recurrent right pyelonephritis discharge condition: stable discharge instructions: -you may shower but do not bathe, swim or immerse your incision. -do not eat constipating foods for 2-4 weeks, drink plenty of fluids. -do not lift anything heavier than a phone book (10 pounds) or drive until you are seen by your urologist in follow-up. -do not drive or drink alcohol while taking narcotics. -your medications have been adjusted. please see your discharge medication worksheet for the adjustments. please take your sodium bicarbonate 3 tabs four times/day. do not take nsaid (aspirin, advil, motrin, ibuprofin) medications. -call your urologist's office today to schedule a follow-up appointment in 3 weeks and if you have any questions. -if you have fevers > 101.5 f, vomiting, or increased redness, swelling, or discharge from your incision, call your doctor or go to the nearest er. -take coumadin for at least one year. follow up within one week with your primary care physician for an inr check and coumadin dose adjustment. -please continue your antibiotics to complete a 14 day course. followup instructions: please call dr. for a follow-up appointment. please follow-up with dr. in wks ( for management of dvt. please follow-up with dr. within 2-3 days of discharge for management of inr. please follow-up with dr. - call him for a f/u appt procedure: venous catheterization, not elsewhere classified incision of abdominal wall nephroureterectomy transfusion of packed cells diagnoses: acidosis hyperpotassemia anemia in chronic kidney disease hypocalcemia esophageal reflux other postoperative infection unspecified acquired hypothyroidism chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified paroxysmal ventricular tachycardia peripheral vascular complications, not elsewhere classified infection with microorganisms without mention of resistance to multiple drugs other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation unspecified disorder of kidney and ureter obesity, unspecified acute venous embolism and thrombosis of deep vessels of proximal lower extremity hydronephrosis disorders of magnesium metabolism other retroperitoneal abscess carrier or suspected carrier of other specified bacterial diseases chronic pyelonephritis without lesion of renal medullary necrosis chronic glomerulonephritis with other specified pathological lesion in kidney 

Answer: The patient is high likely exposed to