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: this is a 61-year-old gentleman with known type 2 diabetes and peripheral vascular disease who has undergone multiple surgeries on the right foot and status post right below-knee popliteal to pt bypass graft in , now with a 3-day history of increasing redness, swelling, and drainage from the plantar left foot callous that has been developing and within the last several days has broken down and has become infected. the patient denies any constitutional symptoms. he was admitted to the podiatry service for management of foot ulceration. allergies: tetanus toxoid. medications on admission: cozaar 25 mg daily, protonix 40 mg daily, colchicine 0.6 mg daily, warfarin 4 mg daily, plavix 75 mg daily, coreg 50 mg b.i.d., lasix 40 mg b.i.d., aspirin 81 mg daily, zocor 40 mg daily, folic acid 400 mcg daily, multivitamin tablet, nph insulin 32 units q.a.m. and 34 units q.p.m. with a regular insulin sliding scale. past medical history: type 2 diabetes, insulin dependent, poorly controlled, hypertension, history of dyslipidemia, history of skin melanoma status post multiple excisions, history of coronary artery disease status post multiple coronary stenting over the last 10 years, history of atrial fibrillation with a defibrillator implant 1 year prior to admission, episode of tia with no residual affects, remote history of multiple foot surgeries, peripheral vascular disease, status post right below-knee popliteal to pt bypass graft in . physical examination: vital signs are stable. general appearance, no apparent distress. alert and oriented times three. heent exam shows no lymphadenopathy. sclera are clear. pupils equal, round and reactive to light and accommodation. extraocular movements intact. cardiac exam shows a regular rate and rhythm with no murmurs, rubs, or gallops. no jvd. pulmonary exam shows clear to auscultation without adventitious sounds. abdomen is soft, nontender, nondistended. bowel sounds are present x 4 quadrants. extremities with full-thickness ulcer along the plantar aspect of left fifth metatarsal head that probes to soft tissue covering bone. wound base is moist, dark, fibrotic, with slough that mildly probes distal and dorsally. there is no evidence of purulent drainage but there is surrounding erythema progressing proximally on the dorsum of the foot. pulse exam shows dopplerable dp and pt of the left foot. neurological exam is unremarkable, nonfocal. hospital course: the patient was admitted to the podiatry service. he was placed on bed rest. antibiotics with unasyn were instituted. wound cultures were obtained. white count was 12.8, hematocrit 31.2, platelets 241,000, bun 46, creatinine 1.4, with a potassium of 3.8. foot x-ray on admission was negative for foreign body. there was no air in the soft tissues. there was no plain film evidence of osteomyelitis. medical service was consulted for a preoperative cardiac assessment and management of the patient's chronic medical issues. last echocardiogram done was which showed an ejection fraction of 20%-25% with left ventricular hypertrophy and moderately dilated cavity. there was severe global left ventricular hypokinesis, overall left ventricular systolic function severely depressed. the aortic root was mildly dilated. the aortic leaves were mildly thickened and the mitral valve leaflets were thickened. there was 1+ mr. there was no pericardial effusion. the patient also had a persantine mibi in which showed a thick myocardial perfusion, defective volume in inferior wall and an ejection fraction of 34%. the patient is anticoagulated for his atrial fibrillation and his carvedilol was increased for better rate control. his renal insufficiency recommendations were to make sure the patient was adequately hydrated prior to any study requiring contrast and to renal dose all medications. for his leukocytosis, they recommended continuing his current antibiotic therapy and to consider starting iron supplement if the patient's iron studies showed iron deficiency anemia. the medicine service recommended a stress test if the patient would require peripheral bypass surgery. the patient would be at a higher risk given his cardiac history. the patient's antibiotics were changed to vancomycin and ciprofloxacin. the patient's arterial studies showed a patent right popliteal pt bypass graft. the arterial studies demonstrated a triphasic dopplerable femoral and popliteal with the monophasic dp and pt. the lower left thigh was 25 mm, calf 29, ankle 12, and metatarsal 7 mm. ankle brachial index could not be calculated secondary to noncompressive vessels. an arteriogram was recommended at this point. the patient underwent a diagnostic arteriogram on , with left leg run-off via right femoral artery access. study demonstrated patent aorta with brisk nephrogram, no renal artery stenosis. the common external and internal iliacs were patent bilaterally. the left sfa was patent with diffuse disease with a 50%-60% stenosis in the proximal portion with a patent profunda femoris. the ak popliteal and bk popliteal were patent. the tibial peroneal trunk was patent. the pt showed a proximal stenosis of 60%. the vessel was small caliber. the peroneal was patent with reconstruction of the distal at. the dp was patent. the plantars were patent. the at occluded at the midportion. the patient tolerated the arteriogram well. his renal function remained stable. he had been hydrated with bicarbonate and mucomyst p.o. prior and post angiogram. the patient complained of some chest pain and an ekg was obtained on , which was unremarkable. vein mapping was obtained to assess for adequate conduit for bypass grafting. he had a patent left greater saphenous and a patent less saphenous vein. he had patent bilateral basilic veins. was consulted for glycemic management. his nph insulin was adjusted to 35 units b.i.d. cardiology was consulted for assessment of outside studies. they felt his left ventricular dysfunction is out of proportion to the report and coronary artery disease suggesting a contaminant dilated cardiomyopathy. the patient was placed at a high risk for revascularization. the patient proceeded to surgery on . he at induction went into cardiogenic shock and cardiac arrest. he was resuscitated and transferred to the coronary care unit. an intra-aortic balloon was placed via the left femoral artery. ep was requested to interrogate the patient's aicd and they felt that this was functioning appropriately. cardiothoracic surgery followed the patient after placement of intra-aortic balloon. the patient was weaned in an attempt to maintain an arterial vein pressure of greater than 65 with the possibility of extubating. intra-aortic balloon was discontinued on . his inr was allowed to drift and heparin drip was instituted per protocol. the patient was placed on an amiodarone and the patient converted to normal sinus rhythm. cultures were obtained for an elevated white count from 10- 29. antibiotics were continued. the patient was weaned and extubated on . he was transferred to the vicu for continued monitoring and care. the patient's vancomycin and ciprofloxacin were discontinued on and he was begun on augmentin for a total of 10 days. the patient had a low-grade temperature of 100.2 to 99.1. white count improved to 13.9 with a hematocrit of 26.9 down from 29. he required transfusion at that time. bun was 39 with a creatinine of 3.5 up from 2.8. they felt this was probably secondary to his vascular collapse and underlying chronic renal insufficiency. on postoperative day 3, , the patient continued to show improvement from a clinical standpoint. white count was 11.5. post-transfusion hematocrit was 27.7. bun 46, creatinine 4.1. renal function and urinary output were monitored. dr. was consulted regarding advisement to an interventional approach to the patient's left lower extremity ischemia. continued to make adjustments in his insulin dosing with improvement in his glycemic control. he continued to be followed by podiatry. diuresis was held secondary to the patient's increasing creatinine. coumadin continued to be held at this point but aspirin and plavix and subcu heparin were continued. foot cultures showed no segs and no polyps on gram stain. augmentin was continued. the patient was transferred to the floor for continued monitoring and care. podiatry continued to follow the patient and recommendations were that he would initially require a debridement at some point of the left heel. this could be done on an outpatient basis or once the patient returns for consideration for revascularization when he is medically stable. the remaining hospital course was unremarkable. the patient will be discharged to home when medically stable. discharge medications: plavix 75 mg daily, aspirin 81 mg daily, simvastatin 40 mg daily, folic acid 1 mg daily, protonix 40 mg daily, amiodarone 400 mg daily, carvedilol 3.125 b.i.d., acetaminophen 325 mg tablets q.4-6 hours p.r.n. pain, hydromorphone 2 mg q.2 hours p.r.n. pain, amoxicillin/clavulanate 5/125 mg tablets q.12 hours for a total of 1 week, glargine insulin 40 units at breakfast with a regular sliding scale before meals and at bed time, coumadin addendum will be made regarding dosing of this medication at discharge. discharge diagnosis: ischemic infected left foot ulcer on the plantar surface of the left foot, history of peripheral vascular disease status post multiple right foot surgeries and a right below-knee posterior tibial bypass graft in which is patent by ultrasound, history of type 2 diabetes, insulin dependent, uncontrolled, history of dyslipidemia, history of skin melanomas, history of coronary artery disease status post cardiac stenting with multiple stents over the last 10 years, history of atrial fibrillation status post automatic implantable cardiac defibrillator, history of transient ischemic attacks without residual, operative cardiac arrest, resuscitated, cardiogenic shock, operative intra-aortic balloon placement, resolved, postoperative acute tubular necrosis secondary to diuresis, postoperative fever with negative cultures, postoperative blood anemia, transfused. major surgical procedures: diagnostic arteriogram with left leg runoff via the right femoral access on , an aborted left leg bypass on , cardiac arrest with cardiogenic shock on , left femoral intra-aortic balloon placement on , left femoral intra-aortic balloon removal on . follow up: the patient should follow-up with dr. in 2 weeks' time to discuss appropriate management of his leg ischemia. he should follow-up with dr. in 1 weeks' time for management of his left heel ulceration. discharge instructions: the patient should continue all medications as directed. he should follow-up with the appropriate appointments as recommended. he should follow-up with his primary care physician and cardiologist after discharge from home. , procedure: other electric countershock of heart arteriography of femoral and other lower extremity arteries aortography implant of pulsation balloon arteriography of other specified sites transfusion of other serum nonoperative removal of heart assist system automatic implantable cardioverter/defibrillator (aicd) check diagnoses: coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis acute posthemorrhagic anemia atrial fibrillation percutaneous transluminal coronary angioplasty status ulcer of other part of foot other and unspecified hyperlipidemia cardiac arrest cardiogenic shock personal history of other diseases of circulatory system long-term (current) use of insulin iron deficiency anemia, unspecified personal history of malignant melanoma of skin cellulitis and abscess of foot, except toes degeneration of cervical intervertebral disc diabetes with peripheral circulatory disorders, type ii or unspecified type, uncontrolled 

Answer: The patient is high likely exposed to