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: penicillins attending: chief complaint: lle erythema/hypotension major surgical or invasive procedure: r ij central line placement history of present illness: the patient is a yom with a history of htn, atrial fib/flutter s/p pacemaker, and multiple dvts on lifelong coumadin who presents with right lower leg erythema, swelling, and pain that began earlier this evening. he was in his usual state of health until this subacute pain began, and he later described an intense cold feeling as well as trembling. this prompted an ed visit. . he immediately triggered on admission to the ed with a bp of 63/38, though he was otherwise afebrile with tachycarida to 100. his bp was checked several times in the left arm, yielding 60s/30s on each of these assays. he states that he's had similar swelling and pain before, and that he had to do "shots in the belly." he maintained normal mentation throughout. labs were notable for bandemia to 19%, lactate to 2.9, to cr 1.6, and an inr of 3.6. trauma ultrasound revealed no bleed. cta chest revealed no massive pe, and no intraabdominal acute pathology. cvl was placed and he was resuscitated with 4lns. got one gram vancomycin. placed on low dose norepinephrine with bolstering of pressure to mid-90s systolic prior to transfer. . upon arrival to the micu, his initial vitals were t:96.3 bp:99/43 p:78 r:22 o2: 99ra. he is currently in no pain and has no complaints. he claims to have been asymptomatic during his hypotension, though his wife found him to be more confused than usual. with regard to his rle erythema, he denies previous episodes of cellulitis. he has baseline edema without erythema or pain bilaterally. he also mentioned urinary frequency over the preceding 4-5 days without dysuria or hematuria. past medical history: 1. hypertension. 2. osteoarthritis. 3. benign prostatic hypertrophy status post transurethral resection of the prostate. 4. status post hernia repair. 5. history of depression. social history: lives at with hiswife. former 30 pack year smoker, quit 40 years ago. occasional alcohol. no drugs. married and lives with wife. retired accountant. family history: nc physical exam: vitals: t:96.3 bp:99/43 p:78 r:22 o2: 99ra general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, no lad, no jvd appreciated cv: regular rate and rhythm, normal s1 + s2, 2/6 sem at the right 2nd ics lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: +foley ext: diffuse erythema and warmth encompassing the right leg from ankle to tibial tuberosity. tender to touch. neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred, finger-to-nose intact pertinent results: labs on admission and dc: 12:54am blood wbc-8.2 rbc-4.30* hgb-13.4* hct-38.1* mcv-89 mch-31.2 mchc-35.2* rdw-14.1 plt ct-136* 12:54am blood neuts-74* bands-19 lymphs-1 monos-4 eos-0 baso-0 atyps-1 metas-1 myelos-0 08:05am blood wbc-5.9 rbc-3.92* hgb-11.8* hct-37.0* mcv-94 mch-30.1 mchc-31.8 rdw-13.9 plt ct-228# 12:54am blood pt-35.8* ptt-29.7 inr(pt)-3.6* 08:05am blood pt-18.9* ptt-30.9 inr(pt)-1.8* 12:54am blood glucose-218* urean-32* creat-1.6* na-136 k-3.2* cl-102 hco3-23 angap-14 08:05am blood glucose-258* urean-28* creat-1.2 na-139 k-4.5 cl-99 hco3-32 angap-13 03:56 red clear 1.034 dipstick urinalysis blood nitrite protein glucose ketone bilirub urobiln ph leuks 03:56 lg neg tr neg tr neg neg 5.0 tr microscopic urine examination rbc wbc bacteri yeast epi transe renalep 03:56 >182* 112* few none 1 imaging: tte : there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. there are no echocardiographic signs of tamponade. impression: normal regional and global biventricular systolic function. no significant valvular abnormality seen. anterior echo-lucent space may be due to a loculated pleural effusion or a pericardial cyst. no evidence of tamponade. cta : impression: 1. suboptimal contrast bolus with mixing artifact limits evaluation for pe. within this limitation, there is no evidence of central pulmonary embolism. 2. no acute aortic injury. 3. approximate 9.3 cm x 3.2 cm x 7.5 cm anterior mediastinal cystic lesion without enhancement and with fluid density and extending to the base of the heart. this is most consistent with a pericardial cyst. 4. right adrenal lesion, previously characterized as myelolipoma or adenoma, is unchanged since . 5. uncinate process small cystic lesions as above, unchanged since prior examination, likely represents a small focus of side branch ipmn. 6. persistent cholelithiasis. 7. unchanged fat-containing left inguinal hernia. 8. unchanged enlarged prostate. 9. small hiatal hernia. leni : impression: no right lower extremity dvt. brief hospital course: assessment and plan: mr. is a yom with afib/flutter, and ?previous dvts who presents with rll pain/erythema and who was found to be profoundly hypotensive with bandemia and . # septic shock: felt to be due to cellulitis and possible uti. received ~ 8 liters ns for fluid resuscitation and was on norepinephrine briefly. started on vanc/cefepime for cellulitis and presumed uti. urine culture was negative, but tx for seved days with ciprofloxacin as culture was obtained after antibiotic administration. he remained in intensive care unit overnight only. # cellulitis. initially well responded to vancomycin, however given negatie nasal swab and no evicence of abcess, was changed to ancef iv. leni was negative. slow but steady improvement in erytheme and induration was made and he was transition to po keflext on . he was diuresed with lasix for lower extremity edema and was discharged on a week's course of lasix. ace bandages are to be applied on daily basis at time of discharge. # acute kidney injury: due to hypoperfusion. improved to 1.2 (baseline 1.1 with ivf). lisinopril was held at discharge until patient completes course of lasix at which point it can be reinstituted. hctz was likewise held at discharge. # atrial arrhythmia: has both atrial flutter and fibrillation patterns in previous ekgs/telemetry. according to cards notes, spends about 35% time in atrial arrhythmia. during his icu stay, he remained often in atrial fibrillation although occasionally was atrial paced or venticular paced. as patient was diuresed his rate normalized and he remained in sr vast majority of the time. multiple indicental findings on cta: mediastinal mass: seen on cta, pericardial cyst (benign). adrenal nodule: unchanged from prior exam prostatic enlargement: stable transition issues: - po diuretics for 1 week with lab follow up - resumption of home lisinopril and potentially hctz pending above - cellulitis f/u with dr. . medications on admission: bupropion hcl - 75 mg tablet - 1 tablet(s) by mouth once a day diazepam - (prescribed by other provider; takes prn only) - 10 mg tablet - 1 tablet(s) by mouth once a day as needed for only prn dorzolamide-timolol - 0.5 %-2 % drops - 1 ggts od twice a day doxazosin - 2 mg tablet - 2 tablet(s) by mouth at bedtime folic acid - 1 mg tablet - 1 tablet(s) by mouth once a day hydrochlorothiazide - 12.5 mg tablet - 1 tablet(s) by mouth once a day dispense tablet only latanoprost - (prescribed by other provider) - 0.005 % drops - 1 gtt once a day lisinopril - 10 mg tablet - 0.5 (one half) tablet(s) by mouth once a day simvastatin - 10 mg tablet - 1 tablet(s) by mouth once a day warfarin - 4 mg tablet - 1 tablet(s) by mouth once a day extra tab 3 days per week discharge medications: 1. bupropion hcl 75 mg tablet sig: one (1) tablet po daily (daily). 2. dorzolamide-timolol 2-0.5 % drops sig: one (1) drop ophthalmic (2 times a day). 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 5. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 6. doxazosin 2 mg tablet sig: two (2) tablet po once a day. 7. diazepam 10 mg tablet sig: one (1) tablet po once a day as needed for anxiety. 8. lasix 20 mg tablet sig: one (1) tablet po once a day for 7 days. disp:*7 tablet(s)* refills:*0* 9. keflex 500 mg capsule sig: one (1) capsule po three times a day for 7 days. disp:*21 capsule(s)* refills:*0* 10. warfarin 4 mg tablet sig: one (1) tablet po once a day. 11. warfarin 2 mg tablet sig: one (1) tablet po tuesday thursday saturday: in addition to 4mg tablet for total of 6mg. 12. outpatient lab work cbc, inr and chem 7 on and results to be faxed to , w. phone: fax: 13. potassium chloride 20 meq packet sig: one (1) po once a day for 7 days. disp:*7 packets* refills:*0* discharge disposition: home with service facility: family & services discharge diagnosis: primary: septic shock due to cellulitis and urinary tract infection discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital with severe infection of your leg and urine. you were treated in the intensive care unit followed by treatmet for cellulitis (infection of the leg). with antibiotics your symptoms improved although significant amount of swelling and redness in your leg persisted. you were given water pills to help get rid of some of the water in your legs. in addition, you required wrapping of your legs with ace bandages to help get rid of the fluid. the following changes were made to your medications. started: - furosemide 20mg daily for one week - keflex 500mg three times daily - potassium 20 meq daily for one week stopped: - hydrochlorothiazide - lisinopril (until you complete your furosemide) please ensure that you elevate your legs daily and wrap them with ace bandage. should you develop any symptoms concerning to you, please call dr. (pcp, ) or go to the emergency room. you have an appointment with dr. at the end of , but his office will contact you to set up a follow up within the next week. if you don't hear from him by middle of next week, please call his office. please also obtain labs to check your coumadin level next week. followup instructions: department: infectious disease when: wednesday at 1:30 pm with: , m.d. building: lm campus: west best parking: garage department: cardiac services when: monday at 1:30 pm with: device clinic building: sc clinical ctr campus: east best parking: garage department: cardiac services when: monday at 2:20 pm with: , m.d. building: sc clinical ctr campus: east best parking: garage procedure: central venous catheter placement with guidance diagnoses: coronary atherosclerosis of native coronary artery urinary tract infection, site not specified acute kidney failure, unspecified unspecified septicemia severe sepsis dysthymic disorder cellulitis and abscess of leg, except foot septic shock long-term (current) use of anticoagulants 

Answer: The patient is high likely exposed to