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: right hip pain and cellulitis of left lower extremity major surgical or invasive procedure: none history of present illness: 75 m with history of cardiomyopathy with ef35% 2/2 rheumatic fever, atrial flutter, htn, hl, mantle cell lymphoma in remission, right hip pain secondary to degenerative hip disease presents with fevers, chills, increasing generalized weakness for 3 days as well as productive cough with yellowish phlegm x2 weeks. patient reports that for the past few he has felt increasingly lethargic. he has been taking frequent naps which is unusual for him. he also noted progressively worsening mobility due to pain/stiffness in his joints. he has chronic right hip and knee pain. this morning, he was unable to change positions from sitting to standing. he remained in bed due to weakness. he denies worsening swelling or erythema in his lower extremities. he did have some mild pain in his left leg and knee. he developed chills around 7:15 am and came to the er for evaluation. in addition, he reports 2.5 weeks of cough productive of grey/yellow sputum. he denies any chest pain or shortness of breath associated with cough. he notes that it has improved in the last several days. . of note, patient went to the podiatrist tuesday and had his toe nails clipped. left second toe was accidentally cut. he did not really notice that his left leg was erythematous until he got to the ed. says that his left leg is usually more swollen anyway since his ankle injury. . in the ed, initial vs were as follows: 99.6 86 137/71 18 95% ra. was noted to be in afib with heart rates to 120s, but holding blood pressure. was given iv fluids with return to normal sinus rhythm. tmax in ed was f. he was noted to have erythema of right leg. he was also noted to be soaked in urine and with stage 1 ulcer overlying swelling of right posterior hip. he was also noted to have a dressing on his left 2th toe that had adhered to nailbed from his podiatry appointment on wednesday; dressing was removed with gauze in ed. he was given a dose of vancomycin to treat cellulitis. his hip was considered for septic joint, however exam showed that his hip joint was rangeable. his cxr was not very concerning for pneumonia, but given that he was producing sputum and having fever, was given levofloxacin. . vitals in ed at time of bed request were as follows: 99.6 86 137/71 18 95%ra. about half hour after getting a dose of oxycodone, his blood pressures were 87/50s while asleep, blood pressure responded to iv fluids. patient intermittently would continue to dip down into the 80s, each time responsive to iv fluids. received a total of 3 l ns. lactate improved from 2.7 to 1.1. vs in ed prior to transfer were as follows: 82, 96/41, 17, 96% ra . on arrival to the icu, vital signs were t103.0 bp 119/51 hr 90 saturating on ra. he was talkative and had no complaints of pain. . past medical history: # rheumatic heart disease with mitral regurgitation - status post acute rheumatic fever and pericarditis in # cardiomyopathy, non-ischemic - initially thought to be secondary to chemotherapy, then attributed to potential tachycardia-induced cardiomyopathy - echocardiogram on showed moderate lv global hypokinesis (ef 35%) # atrial flutter - on warfarin - plan by cardiologist to set up holter in 6 months () and consider stopping anticoagulation if no recurrence of arrhythmia # hypertension # hyperlipidemia # prediabetes # mantle cell lymphoma - s/p chemotherapy, 6 cycles bendamustine/rituxan - last session - currently in remission, followed by dr. - on rituximab for maintenance, started # adenocarcinoma of prostate with score of 6 - status post radiation in # right knee degenerative joint disease # status post left scapular fracture # status post right big toe fracture # status post right leg osteomyelitis at age 30 years old # gout associated with hyperuricemia # status post volar plate injury of right fifth digit # abdominal sepsis in # allergic rhinitis # chronic pedal edema # cervical disc disease # lumbar disc disease associated with right sciatica # vitamin d deficiency # s/p open reduction and internal fixation left ankle post-fracture. social history: patient lives with his wife and his two children lvie with their families in the same building. he has three grandchildren. he is retired, but used to work as a maintenance, as machinist and in shipyard (he was exposed to asbestos from and ). he quit smoking 25 years ago. he used to smoke for 10 years approximately one pack per week. he is consuming alcohol occasionally family history: negative for any type of cancer, leukemia, or lymphoma; however, his sister has anemia and significant weight loss. physical exam: vitals: t: 103.0 bp: 119/51 p: 90 r: 18 o2: 94% ra general: alert, oriented, no acute distress heent: sclera anicteric, perrl, oropharynx dry but without exudate or erythema. neck: supple, jvp not elevated, no lymphadenopathy palpated lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding gu: no foley ext: right lower extremity- right hip with limited active range of motion, full passive range of motion without pain. no swelling or erythema of hip, swelling without erythema of right knee. full active/passive rom of ankle. 2+ pitting edema to knee. left lower extremity- full active/passive rom of hip/knee/ankle. strength 5/5. skin: right lower extremity with superficial excoriation on right shin without surrounding erythema and no exudate. left 2nd toe with dried blood above nailbed, no swelling of toe. erythema from base of left mtps tracking up to knee and then continuing in lymphatic pattern into medial aspect of thigh. mild induration, mostly 2+ pitting edema. + warmth. no tenderness. . on discharge: pe: af tmax 99.6 bp 102-120/70 70s 20 97% ra appearance: alert, nad eyes: eomi, perrl, anicteric ent: op clear s lesions, mmm, no jvd, neck supple cv: +s1, s2 -m/r/g, 1+ peripheral lower extr edema pulm: clear bilaterally abd: soft, obese, nt, nd, +bs msk: 5/5 strength throughout, + left ankle deformity, no cyanosis or clubbing neuro: cn 2-12 grossly intact, no focal deficits. pt can not lift his left leg off the bed skin: lle erythema - improved, mildly tender, some wrinkling of skin, erythema significantly reduced, 2+ pitting edema walking with walker with limp, but able to apply weight to both legs from of left hip psych: appropriate, pleasant heme: no cervical pertinent results: admission labs: 09:20am blood wbc-12.8*# rbc-3.19* hgb-10.2* hct-32.7* mcv-102* mch-31.9 mchc-31.2 rdw-18.8* plt ct-207 09:20am blood neuts-82* bands-8* lymphs-6* monos-4 eos-0 baso-0 atyps-0 metas-0 myelos-0 09:20am blood pt-33.7* ptt-46.9* inr(pt)-3.3* 09:20am blood esr-60* 09:20am blood glucose-117* urean-22* creat-0.9 na-137 k-6.6* cl-98 hco3-25 angap-21* 09:20am blood probnp-1199* 09:20am blood ctropnt-0.03* 04:08am blood ctropnt-0.02* 09:20am blood crp-47.7* 09:40am blood lactate-2.7* k-5.5* 03:46pm blood lactate-1.1 micro: ua () - negative blood cultures x2 () - pending . images: lle leni () - no evidence of dvt, although the left peroneal veins not visualized . cxr () - my read - mild cardiomegaly, no pleural effusion, no infiltrate . discharge labs: 05:45am blood wbc-4.6 rbc-2.26* hgb-7.6* hct-23.3* mcv-103* mch-33.8* mchc-32.8 rdw-17.8* plt ct-106* 05:45am blood pt-26.2* inr(pt)-2.5* 05:45am blood glucose-101* urean-21* creat-0.7 na-136 k-3.7 cl-100 hco3-28 angap-12 05:45am blood calcium-8.5 phos-4.5 mg-1.6 brief hospital course: brief hospital course: this is a 75 m with history of degenerative hip disease, mantle cell lymphoma, presenting with fevers, chills, fatigue, right hip pain, and cough, noted to be intermittently hypotensive in the ed, concern for sepsis who was admitted to the icu briefly for stabilization then transferred to the floor for management of cellulitis. . active issues: #. hypotension/cellulitis - met sirs criteria with fever and white count. hypotensive to sbp to 80s in the ed, which was fluid responsive. cbc with differential showing 8% bands. most likely source seems to be from left lower extremity cellulitis, point of entry probably from the cut on his toe. he also has skin breakdown on his right leg however with no localized erythema. patient complains of a nagging cough, but cxr without any signs of pneumonia. ortho examined the patient and felt hip unlikely to be source or septic joint. his blood pressure and anti-hypertensive medications were held. he was started on vancomycin for treatment of his cellulitis with significant improvement in his leg exam. he was called out to the floor on hd 2. pt remained normotensive, vancomycin was discontinued and bactrim and keflex were started. pt has penicillin allergy but he stated it made him turn red and he never had any difficulty breathing. he also felt that he recalled being treated with keflex in the past. his home bp meds were also restarted on hd 2. tolerated po abx well with continued improvement in leg exam. . #. afib w/ rvr - patient was tachycardic in the ed which persisted on arrival to with hr stably in 130-140s - afib with rapid ventricular response on ekg. he has a history of paroxysmal afib that failed cardioversion this summmer. thought fluid depletion and infection. he was given ivf, started on po metoprolol and given iv metoprolol 2.5 with initial conversion into sinus. his cardiologist was emailed regarding his admission and recommended that no significant changes be made to his medication list. accordingly he was sent out on his home dose of carvedilol and warfarin. he had no episodes of a fib on telemetry on the oncology floor. was continued on coumadin, last inr 2.5 on . pt needs inr closely monitored as this is a rapid overnight change. additionally he was started on bactrim which can alter warfarin levels. . inactive issues: #. right hip pain- limited rom, concerning for seeded joint from initial cellulitis leading to bacteremia. orthopaedics evaluated joint and felt joint not septic. . #. hypertension - intermittently hypotensive, held home antihypertensives while in but restarted on the floor prior to discharge without issue. . #. h/o rheumatic heart disease - tte in shows moderate lv global hypokinesis with ef 35%. cxr shows a heart silouette that is larger than it had been in the past. pt to follow up with cardiologist. . #. hyperlipidemia - not on statin at home, did not start here. . #. pre-diabetes - had been on metformin in the past, but currently not on anything at home. pt was maintained on insulin sliding scale and sent home without medications for blood sugar management as he had been admitted without those as well. . #. mantle cell lymphoma - s/p 6 cycles of bendamustine/rituxan (last session ). currently in remission, maintained on rituximab, last dose on . followed by dr. with tentative plan for dose at next appointment. . #. gout- continued allopurinol . transitional issues: - follow-up: pt needs inr checked tomorrow . inr of 1.9 and of 2.5. coumadin restarted . pt was sent out on his home dose of warfarin, 5mg daily. - appointment with dr. on for oncology follow up . pt was maintained as full code throughout the course of this hospitalization. contact: wife - son - ter medications on admission: allopurinol 300 mg daily carvedilol 3.125 mg furosemide 40 mg hydrocodone-acetaminophen 5 mg-500 mg tablet - 1-2 tabs q6h prn pain lisinopril 5mg daily lorazepam 0.5 mg q6h prn anxiety omeprazole 20 mg daily ondansetron 8 mg q8h prn nausea polyethylene glycol daily prn constipation warfarin 5 mg daily acetaminophen 325-650 mg q6h prn fever, pain docusate sodium 100 mg prn constipation senna 2 tabs qhs discharge medications: 1. allopurinol 300 mg tablet sig: one (1) tablet po daily (daily). 2. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 3. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 4. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 5. lorazepam 0.5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for anxiety. 6. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 7. ondansetron 8 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po q8prn as needed for nausea. 8. polyethylene glycol 3350 17 gram powder in packet sig: one (1) dose po daily:prn. 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 10. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 11. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 12. warfarin 5 mg tablet sig: one (1) tablet po once daily at 4 pm. 13. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever, pain. 14. sulfamethoxazole-trimethoprim 800-160 mg tablet sig: one (1) tablet po bid (2 times a day) for 9 days. 15. cephalexin 500 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 9 days. 16. neomycin-bacitracnzn-polymyxin 3.5-400-5,000 mg-unit-unit/g ointment sig: one (1) appl topical (2 times a day) as needed for abrasion. discharge disposition: extended care facility: rehab discharge diagnosis: primary: left lower leg cellulitis secondary: follicular lymphoma chronic systolic heart failure discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear mr. , it was a pleasure taking care of you during your hospitalization. you were admitted because of a severe cellulitis of your left lower leg. your blood pressure was low initially so you were admitted to the icu. they stabilized you and you were transferred to the oncology floor. you were initially getting iv antibiotics, but we switched these to oral antibiotics and watched for 24 hours on them; you did fine. you were seen by our physical therapists who recommended rehab placement to give you some extra support while you increase your strength. . we are keeping you on your same regimen for your heart disease. . we made the following changes to your medications: bactrim ds 2 tabs by mouth twice daily for 9 more days keflex 500mg by mouth every 6 hours for 9 more days bacitracin ointment to be applied to the scab on your right foreleg followup instructions: department: hematology/oncology when: monday at 9:00 am with: , md building: campus: east best parking: garage department: bmt chairs & rooms when: monday at 9:30 am department: hematology/oncology when: monday at 9:30 am with: , rn building: sc clinical ctr campus: east best parking: garage md procedure: venous catheterization, not elsewhere classified diagnoses: other primary cardiomyopathies other chronic pain congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia gout, unspecified atrial fibrillation personal history of malignant neoplasm of prostate atrial flutter sepsis cellulitis and abscess of leg, except foot chronic systolic heart failure long-term (current) use of anticoagulants osteoarthrosis, localized, not specified whether primary or secondary, pelvic region and thigh mantle cell lymphoma, unspecified site, extranodal and solid organ sites 

Answer: The patient is high likely exposed to