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: vancomycin attending: chief complaint: tramatic fx of left fibula major surgical or invasive procedure: revision of left bka s/p epidural ,d/c'd import major surgical or invasive procedure history of present illness: patient who under went left bka for left charchot foot deforimity which was refractory to multiple reconstructions.experienced a tramatic left tibular fx while climbing stair without prothesis on at the time.admitted for peroperative ketamin gtt and bka revision past medical history: pmh: charcot, degenerative disease of the foot, ankle, central cord syrinx, polyneuropathy. he also received left foot fusion and the two other operations of the left foot and ankle and a right foot surgery. psh: fat pad biopsy (amyloidosis ruled out), left foot fusion in , exostectomy of the left foot in , another exostectomy in and a more recent exostectomy in later . social history: sochx: he has a ma degree. he is now not working because of his problems. is single. he smokes less than half a pack a day to one pack a day for the last 10 to 15 years. drinks two to five drinks a week of usually wine; occasional marijuana use. family history: famhx: his mother who is 83 has moderate alzheimer's disease. father died at 84 of stroke. two sisters and a brother in good health without any neurological problems. father's side of the family history is really not very well known. physical exam: vital signs: stable, afebrile heent: no carotid bruits lungs: clear to auscultaation heart: rrr abd: bengin ext: well healed left bka stump,no erythema,no fluctance. right charchot foot deformity without tenderness or erythema. pulses4+ neuro: nonfocal pertinent results: 10:44pm urine color-yellow appear-clear sp -1.021 10:44pm urine blood-neg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 10:44pm urine rbc-1 wbc-1 bacteria-few yeast-none epi-0 10:44pm urine amorph-few ca oxal-occ 10:44pm urine mucous-rare 05:30pm glucose-82 urea n-16 creat-1.0 sodium-141 potassium-3.6 chloride-107 total co2-23 anion gap-15 05:30pm calcium-9.5 phosphate-3.5 magnesium-2.1 05:30pm wbc-5.8 rbc-4.89 hgb-14.3 hct-40.1 mcv-82 mch-29.3 mchc-35.7* rdw-13.6 05:30pm plt count-199 05:30pm pt-14.4* ptt-26.4 inr(pt)-1.3* 07:35am blood wbc-3.1* rbc-4.29* hgb-12.8* hct-36.1* mcv-84 mch-29.7 mchc-35.3* rdw-13.6 plt ct-124* 07:35am blood pt-13.8* ptt-26.6 inr(pt)-1.2* 07:35am blood glucose-104 urean-9 creat-0.9 na-141 k-3.9 cl-108 hco3-25 angap-12 07:35am blood calcium-8.6 phos-2.8 mg-2.1 brief hospital course: admitted. iv kefzol began perioperatively. iv ketamin began by pain service. prepared for surgery. revision og left bka pod#1. no overnight events. inital dressing removed. stump clean dry and intact. epidural d/c'd. foley d/c'd diet advance. pt to evaluate. developed temp 102.5 not resonded to tylenol, repeat 102.7 blood and urine c/s obtained, cbc obtained. antibiotics covereage brodened from kefzol to vanco/cipro/flagyl. patient developed subjective sx of sob,. developed rash on chest and hives on neck shortly after starting antibioitcs.atbx discontinued. wbc 3.6 ua negative for wbc,bacti,nitrates,leuk/rbc 20-50. he than develope temperature of 104 which continued to rise to 105.6 repeat labs obtained.patient pa cxr no infiltrates. placed on cooling blanket and transfered to icu. id consulted. id recommended daptomycin and ceftazidime until 24hours afebrile. blood cultures were sent. ketamine drip dose was tapered. pt was afebrile. pt was afebrile for more than 24 hours. antibiotics were discontinued. pt remained afebrile. blood cultures had no growth to date. pt being discharged in good condition, tolerating regular diet, having bowel movements and voiding and pain well controlled. pt to follow up in three weeks. medications on admission: clonazepam 1mgm tid,topiramate 100mgm tab @hs,tramadol 50mgm q4h, discharge medications: 1. tramadol 50 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed. 2. clonazepam 1 mg tablet sig: one (1) tablet po tid (3 times a day) as needed. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. topiramate 100 mg tablet sig: 1.5 tablets po hs (at bedtime) as needed. 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 3 weeks. disp:*42 capsule(s)* refills:*0* 6. oxycodone 5 mg tablet sig: 1-2 tablets po 3-6 hours for 2 weeks: do not drive, drink or operate heavy machinery while taking oxycodone. disp:*200 tablet(s)* refills:*0* discharge disposition: home with service facility: bayada nurses inc discharge diagnosis: tramatic left fibular fx with migration history of charchot feet,s/p multiple left foot resonstructions-failed,s/p left bka histroy of poly neuropathies discharge condition: stable discharge instructions: no stump shrinkers no tub baths please do not wear prothesis until seen in followup with dr. call if develope fever >101.5 call if wound site becomes red,swollen or drains . 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 3 weeks. this will be done by the surgeon on your follow-up appointment. . wound care: . an appointment will be made for you to return for suture 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: 7-14 weeks dr. , call for an appointment 3weeks for removal of sutures in dr. office provider: infusion phone: date/time: 7:50 procedure: insertion of catheter into spinal canal for infusion of therapeutic or palliative substances systemic to pulmonary artery shunt repair of entropion or ectropion with wedge resection revision of amputation stump diagnoses: dermatitis due to drugs and medicines taken internally other specified complications of procedures not elsewhere classified other specified antibiotics causing adverse effects in therapeutic use arthropathy associated with neurological disorders other amputation stump complication closed fracture of unspecified part of fibula alone postprocedural fever tabes dorsalis 

Answer: The patient is high likely exposed to