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: floxacillin attending: chief complaint: wound infection and ileus major surgical or invasive procedure: washout and debridment of wound infection history of present illness: 59yo m, h/o mechanical aortic valve replacement, developed gangrenous and perforated appendicitis s/p open appendectomy at . the wound was reportedly left open with a wound vac, he was kept on zosyn post-operatively, but has had progressive erythema and induration. he developed abdominal distension and fever, which prompted a ct scan on suspicious for sbo. an ngt was placed for nasogastric decompression yielding 2400cc of fluid. iv flagyl was begun yesterday, but the erythema progressed, prompting the osh surgeon to explore the wound at the bedside noting intact fascia and cultures were taken. the surgeon wished to take the patient to the or for wound exploration, washout, and possible debridement, but the patient and family requested transfer to . his anticoagulation was managed with heparin drip in the post-operative period after reversing his inr of 2.0 with ffp pre-operatively. currently the patient reports mild abdominal discomfort in the rlq, relieved with prn narcotics. + flatus and passing of liquid stool earlier today. denies chest pain or sob. denies ha or dizziness. past medical history: pmh: htn, hyperchol, seasonal depression psh: mechanical aortic valve and ascending aorta replacement ' for ai and ascending aortic aneurysm brief hospital course: pt was admitted to the surgical icu at on intubated, and on vanc zosyn clinda but vital signs stable, making good urine, no pressors, no signs of end organ failure. pt did have a low grade fever (101.5) , and erythematous abdominal wound with sanguinous drainage, but his wbc was 5.4, platelets 254. at osh pt had had ngt placed as they had been concern that pt had ileus. on arrive at , pt was noted to have normal bs, + flatus and stool. on pt was taken to the or for debridement and wash out of wound. on pt was extubated, and out of bed to chair. pt remained afebrile postoperatively, vss. pt was continued on heparin drip ptt 60-80 for mechanical heart valve. pt initially had a foley and an ngt. erythema of wound extended to thigh but started to regress. pt r leg was more swollen then left. pt was noted to have some frequent loose stools on , sent for c-diff (neg x3). on kub showed mildly dilated loops of small bowel with diffuse ascites. pt abd was distended consistent with ileus. pt continued to have + bs, + flatus and stool and so ngt was removed pt diet was advanced as tolerated without complications. on pt was transferred to the floor. pt was by this point on regular diet, still on antibiotics, continued to be afebrile, cbc wnl, passing flatus and guaiac negative c-diff negative stool, ambulating on his own. pt continued to have dressing changes, and an abdominal binder was placed. pt was restarted on his coumadin, with heparin drip. wound cultures taken in the operating room grew ecoli with sparse klebsiella and strep. on a wound vac was placed. pt antibiotics were changed to augmentin on . on pt nr was therapeutic (for mechanical valve) and so pt was discharged home: alert and oriented, tolerating regular diet, ambulating on his own. pt did note a small rash on skin which was identified to be a contact dermatitis just under area where abdominal binder had been placed. pt anticoagulation therapy on coumadin was restarted and levels were checked. on the day of discharge pt was therapeutic (inr 2.9). however antibiotics and nutrition can change these. pt was advised to have the visiting nurse check these levels every day for a goal of inr 2.5 and 3.5. medications on admission: : coumadin 7 alt 6, avalide 150/12.5', pravastatin 20', celexa 20' discharge medications: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q6h (every 6 hours) as needed for wheeze. 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. acetaminophen 500 mg tablet sig: two (2) tablet po q8h (every 8 hours). 4. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*35 tablet(s)* refills:*0* 5. amoxicillin-pot clavulanate 500-125 mg tablet sig: one (1) tablet po tid (3 times a day) for 14 days. disp:*42 tablet(s)* refills:*0* 6. dressing change/-iod tray tray sig: one (1) miscellaneous once a day for 7 days: wet to dry dressing change supplies. disp:*3 sets* refills:*0* discharge disposition: home with service facility: all care vna of greater discharge diagnosis: wound infection with necrosis of abdominal wall. discharge condition: alert and oriented, ambulated, afebrile, vss, tolerating regular diet, wet to dry to wound, small contact dermatitis on abdominal skin and leg. discharge instructions: you are recovering from a bad infection. you will need time to heal. during this process a wound vac will be placed on your wound to help with healing. you will go home with a wet to dry dressing. a nurse will come to your home and place a new vac dressing on the wound. also your anticoagulation medication was restarted. before leaving the hospital your levels were therapeutic (inr 2.9). however antibiotics and nutrician can change these. please have the visiting nurse or your check these levels every day. inr should be between 2.5 and 3.5. if it is too high or too low call your . please call your doctor or nurse practitioner or return to the emergency department for any of the following: *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *your wound becomes red, you have new concerning discharge from your wound including foul smelling discharge, increased pain. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *your pain in not improving. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *any change in your symptoms, or any new symptoms that concern you. please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon. avoid driving or operating heavy machinery while taking pain medications. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *please use bath for own while your vac dressing is on the wound, at least until your follow up appointment. followup instructions: with dr. in weeks. call on friday to make the appointment at . please follow up with your primary care physician to check you inr level. initially you will need to check your levels every day or every other day until it is stablized (antibiotics and poor nuticianal status can alter the effectiveness of coumadin). procedure: excision or destruction of lesion or tissue of abdominal wall or umbilicus diagnoses: pure hypercholesterolemia other postoperative infection cellulitis and abscess of trunk heart valve replaced by other means blood in stool other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation long-term (current) use of anticoagulants paralytic ileus other ascites removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other disorders of muscle, ligament, and fascia other specified bacterial infections in conditions classified elsewhere and of unspecified site, other gram-negative organisms contact dermatitis and other eczema, unspecified cause 

Answer: The patient is high likely exposed to