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: a 44 year old white male with type 1 diabetes, hypertension, end stage renal disease on hemodialysis which was resumed in , following chronic rejection of living unrelated renal transplant from , developed rest pain in his left foot in . the patient has been treated with oxycontin and dilaudid without significant relief. he denies calf or hip claudication. he was referred to dr. for further evaluation and treatment. past medical history: 1. type 1 diabetes since age 13; with triopathy. 2. end stage renal disease, initial hemodialysis started in , and resumed in following chronic rejection of renal transplant placed in . 3. hypertension. 4. gastroesophageal reflux disease/hiatal hernia. 5. lactose intolerance. 6. depression. past surgical history: 1. right inguinal hernia repair. 2. left carpal tunnel release in . 3. left arteriovenous fistula in . 4. left arteriovenous fistula in . 5. living unrelated renal transplant in at by dr. . renal biopsy in . allergies: 1. no known drug allergies. 2. lobster causes nausea and vomiting. 3. lactose-intolerant. medications: 1. prograf 4 mg p.o. b.i.d. 2. prednisone 5 mg p.o. q.d. 3. imuran 100 mg p.o. q. pm 4. bactrim single strength one tablet p.o. q. monday, wednesday and friday. 5. nifedipine xl 30 mg p.o. q.d. 6. norvasc 10 mg p.o. q.d. 7. lisinopril 5 mg p.o. q. pm 8. cardura 4 mg p.o. q. pm 9. nexium 40 mg p.o. q.d. 10. nephrocaps one p.o. q.d. 11. phoslo 667 mg three tablets p.o. q.i.d. with meals and h.s. 12. vitamin e 400 units p.o. q. pm 13. insulin 70/30 40 units subcutaneously q.d. 14. dilaudid 2 to 4 mg p.o. prn pain. family history: non-contributory. social history: the patient is divorced. he quit smoking cigarettes in . he occasionally drinks alcohol. he walks with a cane. he currently is living with his parents. review of systems: the patient complains of a 20 pound weight loss (168 to 147 pounds) since , secondary to a decreased appetite and frequent nausea. physical examination: vital signs revealed temperature 98.9, pulse 60, respirations 16, blood pressure 192/80, oxygen saturation equals 97 percent on room air, height 5 feet 9 inches, weight 148.5 pounds. neck: no jugulovenous distension. chest: heart is regular rate and rhythm with ii/vi systolic murmur best heard at the left lower sternal border. lungs clear bilaterally. abdomen: scaphoid, nontender, bowel sounds present. kidney, in the right iliac fossa not palpable. extremities: dry gangrene of the tip of the right and left second finger is present. left upper extremity had a thrombosed arteriovenous fistula and another functioning fistula with a thrill and bruit. left foot has ischemic toe changes with rubor from the toes to the dorsum of the foot. no ulcers on either foot. pulse examination: carotids palpable bilaterally with bruits versus transmitted cardiac murmurs. radial artery is 2+ on the right and nonpalpable on the left. femoral pulses are 2+ bilaterally. pedal pulses all have doppler signals. laboratory data: admission laboratory data revealed white blood cell count 3.8, hemoglobin 11.8, hematocrit 36.4, platelets 214,000, pt 13.2, ptt 28.3, inr 1.2. sodium 141, potassium 5.4, chloride 100, bicarbonate 33, bun 29, creatinine 5.6, glucose 121, calcium 9.4, phosphorus 5.1, magnesium 1.7. electrocardiogram showed a sinus rhythm at a rate of 66. atrial premature complex present. left ventricular hypertrophy by voltage. his previous tracing of revealed sinus bradycardia is absent. hospital course: the patient was admitted to the hospital on , following hemodialysis in the morning. he was empirically started on vancomycin and zosyn. the renal service managed the patient's hemodialysis on monday, wednesday and friday. they withheld the imuran until follow up appointment with dr. in three to four weeks following discharge from the hospital. a 24 hour urine was collected and creatinine, urea, and protein was reportedly within normal limits. preoperatively the patient's left foot pain was difficult to manage. the dilaudid was not helpful. toradol was more helpful. on , the patient underwent an uneventful below-the-knee popliteal to both posterior tibial bypass grafts with nonreverse saphenous vein. at the end of surgery the patient had a warm left foot with palpable graft and doppler signals at the pedal pulses. the patient had a pca postoperatively for pain control which was unsatisfactory. the acute pain service was consulted and recommended oxycontin 10 mg p.o. t.i.d., oxycodone for breakthrough pain, and nortriptyline 50 mg p.o. q.h.s. this regimen was helpful in controlling the patient's foot pain. plastic surgery was consulted regarding the patient's gangrenous fingertips. they recommended continuing silvadene treatment, continuing the patient's calcium channel blocker, and magnetic resonance angiography of the upper extremities. the magnetic resonance angiography was done on and results are pending at the time of dictation. further follow up or possible surgery in the future will be made with dr. , plastic surgery. the patient finished a ten day course of intravenous zosyn and vancomycin. antibiotics were discontinued on . at the time of dictation, the patient's left leg incision is clean and intact with only a minimal amount of serous drainage from the distal incision. the distal surgical staples were removed on . the remaining surgical staples in the incision will be removed in about three weeks following surgery by dr. in the office. the bypass graft is palpable and the dorsalis pedis and posterior tibial pulses have doppler signals. during the course of admission, the patient's blood sugars were erratic. the consult service did not manage the patient's insulin requirements because the patient insisted that he was capable of managing his insulin. he frequently refused to take his bedtime dose of 40 units of 70/30 insulin. his blood sugars were very erratic but the patient insisted that he manage his own insulin requirements. physical therapy evaluated the patient for full weightbearing ambulation. rehabilitation stay was advised. while the patient was on antibiotic therapy he developed very loose stools. clostridium difficile cultures times two were negative. the patient ascribed his diarrhea to taking vancomycin. after the negative clostridium difficile studies, loperamide was ordered prn. within 24 hours, the patient had formed stool and no longer required loperamide. discharge medications: 1. prograf 4 mg p.o. b..d. 2. prednisone 5 mg p.o. q. am 3. bactrim single strength one tablet p.o. b.i.d., monday, wednesday and friday. 4. imuran 100 mg p.o. q. pm; held until follow up appointment with dr. in three to four weeks. 5. nephrocaps one p.o. q.d. 6. calcium acetate 2,001 mg p.o. t.i.d. with meals, h.s., and one tablet with snacks prn. 7. amlodipine 10 mg p.o. q.d. 8. lisinopril 10 mg p.o. h.s., hold for systolic blood pressure less than 110. 9. doxazosin 4 mg p.o. q.h.s. 10. pantoprazole 40 mg p.o. q.d. 11. vitamin e 400 units p.o. q.d. 12. nortriptyline 50 mg p.o. h.s. 13. ambien 5 to 10 mg p.o. h.s. 14. oxycontin 10 mg p.o. q. 8 hours 15. percocet 1 to 2 tablets p.o. q. 4-6 hours prn breakthrough pain. 16. tylenol 325 to 650 mg p.o. q. 4-6 hours prn 17. dulcolax 10 mg p.o./p.r. q.d. prn 18. loperamide 2 mg p.o. q.i.d. prn 19. 70/30 insulin 40 units subcutaneously q. breakfast. 20. 70/30 insulin 4 units subcutaneously q. bedtime. 21. humalog sliding scale q.i.d. 22. silvadene 1 percent cream applied to affected fingertips 23. tube gauze dressings q.d. disposition: to rehabilitation facility. condition on discharge: satisfactory. primary diagnosis: 1. ischemic rest pain, left foot. 2. left below-knee popliteal to distal posterior tibial bypass graft with nonreverse greater saphenous vein, . secondary diagnosis: 1. type 1 diabetes with triopathy. 2. end stage renal disease, hemodialysis every monday, wednesday and friday via left arteriovenous fistula. 3. hypertension. 4. gastroesophageal reflux disease/hiatal hernia. 5. depression. , m.d. dictated by: medquist36 procedure: hemodialysis other (peripheral) vascular shunt or bypass other (peripheral) vascular shunt or bypass arteriography of other intra-abdominal arteries diagnoses: nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere polyneuropathy in diabetes hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease cellulitis and abscess of leg, except foot complications of transplanted kidney other complications due to renal dialysis device, implant, and graft diabetes with renal manifestations, type i [juvenile type], not stated as uncontrolled atherosclerosis of native arteries of the extremities with ulceration diabetes with neurological manifestations, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to