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: sulfa (sulfonamides) / cefazolin / aminophylline attending: chief complaint: left groin infection major surgical or invasive procedure: excision of distal portion of left axillobifemoral graft and replacement with interposition left axillary profunda bypass and left axillary to mid cross-femoral bypass with 8-mm ptfe and debridement and closure of left groin wound. history of present illness: this elderly lady has a history of very severe peripheral vascular disease. she is status post a left axillary bifemoral graft and right femoral peroneal vein graft. she previously had a jump graft from the distal left axillary graft to the profunda femoris artery in . the entire graft occluded about a month and a half ago when she underwent a thrombectomy in the left groin. the left groin wound became infected and opened. the graft was exposed. she developed gram-negative pseudomonas infection with bacteremia, is now having removal of the infected portion of the graft. both her legs are entirely dependent on her axillary bifemoral graft and right femoral peroneal bypass so the graft must be replaced. past medical history: 1) peripheral vascular disease 2) s/p right femoral peroneal bypass 3) s/p common femoral artery thrombectomy 4) status post left axillo bifemoral 5) status post profunda 6) status post left 7) ilioprofunda with ptfe 8) aortic insufficiency 9) htn 10) dm2 diet controlled 11) coronary artery disease 12) status post myocardial infarction 13) status post cabg remote 14) hypothyroidism on no supplement at this time social history: she denies alcohol, drug or tobacco use family history: noncontributory physical exam: a/o x 3 nad supple / farom neg lyphandopathy cts rrr abd - benign surgical incisions c/d/i all pulses palp distally right prosthetic left leg stroke right arm / cntracted pertinent results: on admission: 04:45pm blood wbc-13.8*# rbc-3.11* hgb-9.8* hct-28.8* mcv-93 mch-31.6 mchc-34.0 rdw-15.9* plt ct-261 04:45pm blood pt-61.8* ptt-42.2* inr(pt)-7.7* 04:45pm blood glucose-271* urean-4* creat-1.1 na-134 k-3.4 cl-99 hco3-19* angap-19 04:45pm blood ck(cpk)-47 04:45pm blood ck-mb-4 ctropnt-0.09* probnp-* 05:53am blood calcium-8.2* phos-3.7 mg-2.4 . on discharge: 05:08am blood wbc-4.7 rbc-3.28* hgb-10.2* hct-30.0* mcv-91 mch-31.0 mchc-33.9 rdw-15.9* plt ct-180 05:08am blood pt-24.9* ptt-52.1* inr(pt)-2.5* 05:08am blood glucose-72 urean-26* creat-0.8 na-138 k-4.1 cl-100 hco3-29 angap-13 04:09pm blood alt-15 ast-25 alkphos-75 amylase-57 totbili-0.4 04:09pm blood lipase-30 03:21am blood ck-mb-notdone ctropnt-0.06* 05:08am blood calcium-8.4 phos-3.0 mg-2.6 . radiology final report abdomen (supine & erect) 6:37 pm abdomen (supine & erect) reason: assess for infection/obstruction/ileus medical condition: 81 year old woman with episode of nausea and vomiting and sob today; had infected hematoma at r groin vascular graft site , with wound vac there now reason for this examination: assess for infection/obstruction/ileus history: 81-year-old female with episode of nausea and vomiting and shortness of breath today. known infected right groin hematoma. evaluate for signs of obstruction or ileus. comparison is made to prior abdominal radiographs dated and prior ct dated in . upright and supine abdominal radiographs findings: bowel gas pattern is unremarkable without evidence of dilated large or small bowel. air is noted distally within the rectum. no evidence of pneumoperitoneum. marked degenerative changes of the spine, calcified gallstones, dense vascular calcifications, and left common iliac vascular stent are all unchanged. surgical clips are noted over the left femoral neck. impression: no evidence of bowel obstruction or ileus. . radiology final report chest (pa & lat) 6:36 pm chest (pa & lat) reason: r/o pna, effusion, pulm edema medical condition: 81f with sudden onset sob, crackles at r base, n/v reason for this examination: r/o pna, effusion, pulm edema history: 81-year-old female with sudden onset shortness of breath and right basilar crackles. evaluate for pneumonia, effusion, or pulmonary edema. comparison is made to prior radiographs dated and . pa and lateral chest radiographs. findings: mild interstitial edema persists and may be slightly improved from most recent radiograph as does small bilateral pleural effusions (right greater than left). no new focal parenchymal infiltrates are identified, and there is no evidence of pneumothorax. cardiomediastinal silhouette remains mildly enlarged and there is stable appearance to median sternotomy wires and left- sided picc catheter, which terminates in the upper svc. chronic changes involving the left glenohumeral joint are stable. impression: persistent mild bilateral interstitial pulmonary edema at the lung bases with small bilateral pleural effusions. . radiology final report chest (pa & lat) 8:16 am chest (pa & lat) reason: eval chf medical condition: 81f with sudden onset sob, crackles at r base, n/v reason for this examination: eval chf indication: 81-year-old female with sudden onset shortness of breath and crackles. comparison: . frontal and lateral chest radiographs: a left-sided picc line is seen with tip in the proximal svc. the patient is status post cabg and median sternotomy wires are intact. mild interstitial edema has slightly worsened and there are persistent small bilateral pleural effusions. no focal parenchymal infiltrate or pneumothorax is identified. chronic left glenohumeral joint changes are stable. impression: 1. mild interstitial pulmonary edema and small bilateral pleural effusions. . radiology final report chest (pa & lat) 3:07 pm chest (pa & lat) reason: eval for low grade fever medical condition: 81f p/w l groin exposed graft s/p thrombectomy of r fem-peroneal graft, fem-fem, patch angioplasty of l ax-fem, pta/stent of r tp trunk and prox peroneal, c/b post-op mi; presents with fuo and acute chf with low grade fevers reason for this examination: eval for low grade fever pa lateral chest indication: extensive vascular surgical history as above. evaluate for low-grade fever/chf. findings: compared with , the pulmonary edema and bilateral pleural effusions have resolved except for a tiny posterior right effusion. no overt chf or pneumonia. . radiology final report ct pelvis w&w/o c 10:37 am ct abd w&w/o c; ct pelvis w&w/o c reason: please go down to above the knee; eval for fluid collection medical condition: 81f p/w l groin exposed graft s/p thrombectomy of r fem-peroneal graft, fem-fem, patch angioplasty of l ax-fem, pta/stent of r tp trunk and prox peroneal, c/b post-op mi; presents with fuo and acute chf with continued low grade fevers reason for this examination: please go down to above the knee; eval for fluid collection contraindications for iv contrast: none. ct abdomen, pelvis and thighs with and without contrast, history: peripheral vascular disease, status post recent thrombectomy of right fem/peroneal graft, fem/femoral graft and patch angioplasty of left ax/fem graft. left groin wound left open to granulate. also, status post pta/stent of right tibioperoneal trunk and proximal peroneal. complicated by postoperative mi. now with fever of unknown margin and acute chf. technique: multidetector axial images were carried out through the abdomen, pelvis and thighs both before and after intravenous administration of 100 ml of optiray nonionic contrast. coronal and sagittal reformatted images were filmed. comparison is made to prior ct of the abdomen and pelvis from , and cta from . findings: abdomen: upper images include the chest and show that there is no lung parenchymal edema or pleural fluid at the bases. a less than 2 mm nodular density seen at the right lung base peripherally is not seen on prior studies. some pleural thickening and atelectasis or scar is seen at the right base posteromedially. prominent coronary and mitral annular calcifications are seen. the lower chest and abdominal subcutaneous portion of the patient's left axillofemoral graft is patent. at the level of the left groin, the origin of the fem/fem component of the graft has significant filling defect, nearly occluding the lumen focally. there is, however, complete opacification of the femoral crossover portion of the graft, and the right-sided anastomosis appears widely pain as does the visualized portion of the right femoral/peroneal graft (distal anastomosis into peroneal not included in view of study). on the left, the femoral to profunda portion of the graft is seen to the level of the mid thigh, where it appears to be anastomosed with profundus femoris measuring only millimeters. immediately anterior and adjacent to the left profunda femoris is a 5-6 mm nonenhancing rounded structure, probably the patient's old left iliac- profunda bypass. dense calcification is seen in the patient's occluded native arteries. the open left groin wound shows some smooth induration consistent with granulation tissue, but no fluid collection or abnormal enhancement is seen. an inguinal lymph node just lateral to the open wound on the left measures 9 mm in short- axis dimension. on the right, a low-density fluid collection is seen anterior to and surrounding the region of the femoral to distal anastomosis. this measures almost 4 cm in greatest dimension, but is relatively homogeneous and low in density. there is a smaller, 16 x 10 mm ovoid collection, possibly in continuity with this, just superior to this, and a smaller ovoid density just inferomedial to this on the right representing an enhancing right inguinal lymph node. no findings suggestive of infected groin abscesses are seen on either side. the right common femoral vein appears non-acutely thrombosed (denser than left common femoral vein pre-contrast and unenhanced post- contrast, but not distended or showing any inflammatory change). the liver and spleen have an unchanged appearance compared to prior studies, with single small hypodensities unchanged compared to . large heterogeneous calcified gallstone is seen without evidence of acute cholecystitis. the inflammatory change in the anterior pararenal space suggestive of acute pancreatitis on the study has resolved; however, there is now a focal 9-10 mm hypodensity at the tail of the pancreas, which may be sequela from that inflammation. this does not have density measurements consistent with fluid, but is also rather small to accurately characterize. the native aorta shows dense atherosclerotic plaque including origins of the celiac axis and superior mesenteric artery which are stenosed. calcified plaques are seen at the origin of both renal arteries. a large area of wedge- shaped hypodensity in the right kidney laterally appears to have decreased in volume, suggesting this was related to old infection or infarction. this had been noted since , but it appears more contractive. new on today's study is a tiny wedge-shaped hypodensity in the left kidney anteriorly. there are calcifications seen on the pre-contrast view of the kidneys, probably vascular. there is a small amount of fluid around the right kidney superiorly which is new from the study. this is low in density. some fatty induration in the subcutaneous fat of the anterior abdominal wall is probably related to subcutaneous injections. pelvis: see above for vascular bypass details. in addition, old occluded metallic stent is seen in the left iliac system. there is some free low- density intraperitoneal fluid seen, right greater than left, and this was also noted in , but no regional bowel inflammation is seen. as noted above, the right common femoral vein may be occluded (apparently non-acute). the urinary bladder is nearly empty at the time of scanning. evaluation of bones shows severe diffuse osteopenia, mottled at the level of distal femora and probably at least partially secondary to disuse. thoracic spine osteophytes are seen, and facet osteoarthritis is seen in the lower lumbar spine bilaterally. an anterior intrathecal calcification is seen at the level below the inferior body of l2, possibly arising from the vertebral body. grade 1 spondylolisthesis of l4 on l5 is unchanged. hypertrophic bone at the anterior superior iliac spine on the left may be enthesopathic related to previous healed fracture. conclusion: 1. incompletely occlusive filling defect consistent with thrombus or heaped neointima at left inguinal level of fem/fem crossover graft. 2. right groin fluid collection surrounding femoral portion of graft, most consistent with seroma, with no definite infection seen in either groin region. inguinal nodes seen bilaterally. 3. new 1-cm hypodensity in tail of pancreas, with inflammatory change seen in resolved. recc f/u. 4. free intraperitoneal fluid, most notable dependently in the right side of the pelvis, not significantly different compared to , but with some new low-density fluid seen at the superior portion of the right kidney. 5. a 2-mm right base pulmonary nodule--recommend follow up in approximately 1 year's time, which can be coordinated with any other vascular follow up the patient has (pulmonary nodule follow up need not require contrast). 6. severe native atherosclerotic disease with coronary artery calcification and calcified stenoses origins of visceral vessels, as described, with occlusion of native infrarenal aorta. 7. cholelithiasis without evidence of cholecystitis. 8. severe osteopenia, degenerative changes and disc disease in the lumbar spine, with unchanged spondylolisthesis. . radiology final report chest (portable ap) 6:11 pm chest (portable ap) reason: eval acute cardiopulmonary process medical condition: 81f p/w l groin exposed graft s/p thrombectomy of r fem-peroneal graft, fem-fem, patch angioplasty of l ax-fem, pta/stent of r tp trunk and prox peroneal, c/b post-op mi; presents with fuo and acute chf now septic reason for this examination: eval acute cardiopulmonary process study: ap portable chest x-ray. indication: 81-year-old female post-op mi presenting with fever and acute chf. assess for acute cardiopulmonary process. comparisons: . findings: compared to the film from the previous day the right sided small pleural effusion appears slightly more prominent. a left pleural effusion may also be present. the cardiomediastinal contour is stable. a picc remains unchanged in position. multiple median sternotomy wires are unchanged. the lungs are overall clear. there severe loss of joint space of the left shoulder and bone on bone articulation consistent with end stage degenerative disease. impression: no acute cardiopulmonary process. persistent right pleural effusion. possible small left pleural effusion. . radiology final report persantine mibi persantine mibi reason: pre-op eval radiopharmeceutical data: 9.6 mci tc-m sestamibi rest (); 29.2 mci tc-99m sestamibi stress (); history: cad s/p cabg. summary of data from the exercise lab: dipyridamole was infused intravenously for 4 minutes at a dose of 0.142 mg/kg/min. method: resting perfusion images were obtained with tc-99m sestamibi. tracer was injected approximately one hour prior to obtaining the resting images. two minutes after the cessation of infusion of dipyridamole, approximately three times the resting dose of tc99m sestamibi was administered iv. stress images were obtained approximately one hour following tracer injection. imaging protocol: gated spect. this study was interpreted using the 17-segment myocardial perfusion model. interpretation: there is no prior study for comparison. there is soft tissue attenuation from the patient's arm. left ventricular cavity size is moderately enlarged more on stress than on rest. rest and stress perfusion images reveal severe, fixed defects involving the a apical, inferior, inferolateral, and anterolateral walls. gated images reveal severe, global hypokinesis. the wall motion in the basal anterior wall appears the best. the calculated left ventricular ejection fraction is 17%. impression: 1. no reversible myocardial perfusion defects. 2. severe, fixed defects in the apical, inferior, inferolateral, and anterolateral walls. 3. evidence of transient cavitary dilatation. 4. ef is 17%. the findings were discussed with dr. . . cardiology report stress study date of resting data ekg: sinus, lafb, prwp, nssttw heart rate: 78 blood pressure: 120/- protocol / stage time speed elevation heart blood rpp (min) (mph) (%) rate pressure 1 0-4 0.142mg/ kg/min 88 total exercise time: 4 % max hrt rate achieved: 63 symptoms: none st depression: none interpretation: this 81 year old type 2 iddm woman s/p cabg ~91 was referred to the lab for evaluation. the patient was infused with 0.142 mg/kg/min of dipyridamole over 4 minutes. no arm, neck, back or chest discomfort was reported by the patient throughout the study. there were no significant st segment changes during the infusion or in recovery. the rhythm was sinus with occasional isolated apbs and vpbs. appropriate hemodynamic response to the infusion. the patient noted a history of upset stomach with p.o. aminophylline use in the past. to reverse the dipyridamole she received 50 mg of aminophylline iv with no adverse events. impression: no anginal type symptoms or ischemic ekg changes. nuclear report sent separately. . radiology final report guidance for abscess () 1:45 pm us simple/sing absc/cyst drain; us extremity nonvascular right reason: pt has fluid collection over ptfe graft in right groin by medical condition: 81 year old woman with reason for this examination: pt has fluid collection over ptfe graft in right groin by ct scan / please aspirate and send for cx's and sensitivities examination: ultrasound-guided aspiration of fluid in right groin. indication: status post fem-fem bypass. query infected. findings: informed written consent was obtained. timeout with double patient identifiers was performed. using local anesthetic, aseptic technique and ultrasound guidance, 5 cc of serous fluid was aspirated from the right groin. the procedure was well tolerated with no complications. the attending, dr. , was present and actively participated throughout the procedure. fluid was sent for culture and sensitivity. impression: status post successful diagnostic aspiration of fluid in the right groin. . radiology final report chest port. line placement 11:27 am chest port. line placement reason: s/p swan insertion medical condition: 81f p/w l groin exposed graft s/p thrombectomy of r fem-peroneal graft, fem-fem, patch angioplasty of l ax-fem, pta/stent of r tp trunk and prox peroneal, c/b post-op mi; presents with fuo and acute chf now septic reason for this examination: s/p swan insertion portable chest : comparison: . indication: swan-ganz catheter insertion. a swan-ganz catheter has been placed with distal tip terminating in the right interlobar pulmonary artery, with no pneumothorax evident. left picc line remains in standard position. cardiac silhouette is upper limits of normal in size. patchy bibasilar opacities have developed and are probably due to atelectasis, but aspiration is an additional consideration in the appropriate setting. there are also probable small bilateral pleural effusions. impression: swan-ganz catheter terminates in interlobar portion of right pulmonary artery with no pneumothorax. . cardiology report echo study date of patient/test information: indication: hypertension. left ventricular function. valvular heart disease. intraop monitoring. height: (in) 60 weight (lb): 122 bsa (m2): 1.51 m2 bp (mm hg): 139/55 hr (bpm): 61 status: inpatient date/time: at 12:08 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2007aw000-0:00 test location: anesthesia west or cardiac technical quality: adequate referring doctor: dr. measurements: left ventricle - septal wall thickness: *1.3 cm (nl 0.6 - 1.1 cm) left ventricle - inferolateral thickness: *1.3 cm (nl 0.6 - 1.1 cm) left ventricle - ejection fraction: 25% (nl >=55%) aorta - ascending: 2.9 cm (nl <= 3.4 cm) aortic valve - peak velocity: 1.6 m/sec (nl <= 2.0 m/sec) aortic valve - peak gradient: 11 mm hg aortic valve - mean gradient: 5 mm hg aortic valve - lvot peak vel: 2.00 m/sec aortic valve - lvot vti: 12 aortic valve - lvot diam: 1.8 cm aortic valve - valve area: *1.0 cm2 (nl >= 3.0 cm2) mitral valve - e wave: 1.4 m/sec mitral valve - a wave: 0.7 m/sec mitral valve - e/a ratio: 2.00 mitral valve - e wave deceleration time: 126 msec tr gradient (+ ra = pasp): *40 mm hg (nl <= 25 mm hg) interpretation: findings: left atrium: mild la enlargement. mild spontaneous echo contrast in the laa. good (>20 cm/s) laa ejection velocity. all four pulmonary veins identified and enter the left atrium. right atrium/interatrial septum: a catheter or pacing wire is seen in the ra and extending into the rv. no asd by 2d or color doppler. left ventricle: mild symmetric lvh. severe regional lv systolic dysfunction. severe global lv hypokinesis. severely depressed lvef. tdi e/e' >15, suggesting pcwp>18mmhg. transmitral doppler and tvi c/w grade iii/iv (severe) lv diastolic dysfunction. no resting lvot gradient. lv wall motion: regional lv wall motion abnormalities include: mid anterior - akinetic; mid anteroseptal - hypo; mid inferoseptal - akinetic; anterior apex - hypo; septal apex - hypo; inferior apex - hypo; right ventricle: normal rv chamber size and free wall motion. aorta: normal ascending aorta diameter. aortic valve: three aortic valve leaflets. severely thickened/deformed aortic valve leaflets. moderate as (aova 1.0-1.2cm2) mild (1+) ar. mitral valve: moderate mitral annular calcification. moderate thickening of mitral valve chordae. no ms. mild to moderate (+) mr. tricuspid valve: moderate to severe tr. moderate pa systolic hypertension. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. no pr. pericardium: no pericardial effusion. general comments: no tee related complications. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. the patient was under general anesthesia throughout the procedure. results were personally reviewed with the md caring for the patient. conclusions: overall left ventricular systolic function is severely depressed. there is severe global left ventricular hypokinesis. there is severe regional left ventricular systolic dysfunction with akinesis of mid to distal septal wall and severe hypokinesis of mid to distal infero-lateral walls. estimated ejection fraction is 25%. there is mild symmetric left ventricular hypertrophy. right ventricular chamber size is normal. right ventricular is mildly hypokinetic. there are three aortic valve leaflets. the aortic valve leaflets (3) are moderately thickened/deformed. there is moderate aortic valve stenosis (area 1.0 cm2). mild (1+) aortic regurgitation is seen. mild to moderate (+) mitral regurgitation is seen. moderate to severe tricuspid regurgitation is seen. restrictive diastolic filling pattern. there is moderate pulmonary artery systolic hypertension. mild spontaneous echo contrast is present in the left atrial appendage. no atrial septal defect is seen by 2d or color doppler. there is moderate thickening of the mitral valve chordae. there is no pericardial effusion. . radiology final report chest port. line placement 5:16 pm chest port. line placement reason: r/o ptx medical condition: 81f p/w l groin exposed graft s/p thrombectomy of r fem-peroneal graft, fem-fem, patch angioplasty of l ax-fem, pta/stent of r tp trunk and prox peroneal, c/b post-op mi; presents with fuo and acute chf now septic reason for this examination: r/o ptx study: portable ap upright chest x-ray from 5:35 p.m. indication: 81-year-old female status post thrombectomy of right femoral- peroneal graft. patient with fever of unknown origin, acute chf, now septic. assess for pneumothorax. comparisons: . findings: a left-sided picc with tip projecting over the mid svc is unchanged compared to the prior examination. there has been interval removal of a swan- ganz catheter, however, right internal jugular venous line is present with tip projecting over right atrium. the cardiomediastinal silhouette is stable. the lungs are grossly clear. there are multiple sternotomy wires overlying the midline of the chest. impression: no pneumothorax. no chf. . brief hospital course: the patient was admitted to dr. vascular surgery service on for management of her right groin wound infection. she was immediately placed iv antibiotics (vancomycin, ciprofloxacin, and flagyl), wound cultures were went, and wet-to-dry dressings were started. on hd 2, she was transfused 1 unit of prbc for a decrease in her hct to 24.2. on hd 3, she was transfused an additional 1 unit prbc for a hct of 24.9. she continued to have low grade temperatures and surveillance blood cultures were sent from both her picc line and a peripheral site. she continued to report diarrhea and c.diff cultures were sent. her initial admission blood cultures grew multi-resistant pseudomonas and she was placed on tobramycin on hd 4. with the continued low grade fevers and poitive blood cultures, a ct a/p was performed on hd 5, demonstrating a right groin fluid collection and a thrombus in the fem-fem bypass graft. a vac dressing as then applied to the left groin wound infection site. she complained of some shortness-of-breath and a chext xray was performed demonstrating persistent right pleural effusion and possible small left pleural effusion. on hd 6, she underwent a pmibi demonstrating lvef of 17%. she was also started on a heparin drip for the thrombosis within her fem-fem bypass graft. following return from her pmibi study, she complained of increasing shortness-of-breath and she was transferred to the csru. in the icu, her cultures continued to be positive for pseudomonas and she required desensitization to meropenem per infectious disease consult recommendation. while in the icu, her respiratory status improved with continued diruesis. on hd 7, surveillance blood cultures continued to be sent with blood cultures for hd 8 still positive for pseudomonas. she was ctoninued on the heparin drip and iv antibiotics. on hd 10, she was stable for trasnfer to the floor. in was decided that she would need to have her infected graft removed. cardiology was consulted for pre-operative workup. she underwent an excision of distal portion of left axillobifemoral graft and replacement with interposition left axillary profunda bypass and left axillary to mid cross-femoral bypass with 8-mm ptfe and debridement and closure of left groin wound on . for details of the operation, please refer to the operative report. her postoperative course was uncomplicated. immediately post-operatively, she was trasnferred to the csru. she was extubated in the or without complications. she had a single jp drain in her left groin which continued to have minimal output and was d/c'd on pod 2. while in the csru, she was found to have a yeast infection and was started on fluconazole in addition to her previous iv antibiotics. on pod 1, she was transfused 2 units prbc for a hct of 26.5. she was stable for transfer to the floor on pod 2. her blood cultures remained negative beginning on hd 9. she continued to remain afebrile and tolerating a regular diet. on pod 4, she was restarted on coumadin forher grafts. the fulconazole was discontinued on pod 6 and the linezolid was discontinued on pod 7. she was continued on po vancomycin, meropenem, and tobramycin per infectious deisease recommendations. a tunneled line was placed by interventional radiology on pod 7 for administration of iv antibiotics and she was deeemed stable for discharge to a rehab facility. she will continue on the meropenem for a total of 12 weeks, tobramycin for 2 weeks, and po vancomycin for 2 additional weeks after the meropenem has been discontinued. she will follow-up with dr. and cardiology. medications on admission: lopressor 37.5", asa 325, plavix 75, isordil 10'", lisinopril 5, lipitor 80, lasix 40", kcl 10, diabinese 100, coumadin 0.5, protonix 40' discharge disposition: extended care facility: - discharge diagnosis: wound infection / infected bpg septecima asthma, ai, htn, dm2, cad, mi, hypothyroid discharge condition: stable discharge instructions: wound care: please call us immediately for any of the following problems: redness in or drainage from your wound(s). new pain, numbness or discoloration of your lower or upper extremities (notably on the side of the incision). 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. other information: you may shower immediately upon coming home. no bathing. a dressing may cover you??????re wound, keep your wound dry at all times you will have sutures, which are usually removed in 4 weeks. this will be done by the surgeon on your follow-up appointment. avoid taking a tub bath, swimming, or soaking in a hot tub. limit strenuous activity and or heavy lifting until the wound is well healed. activity may prevent the wound from healing. do not drive a car unless cleared by your surgeon. try to keep your affected limb elevated when not in use, this decreases swelling to the affected wound and helps in the healing process. antibiotics: you may have a prescription for antibiotics. take as directed. be sure you take the full course even if the wound looks well healed. failure to do so may lead to infection. followup instructions: provider: , md phone: date/time: 11:00 follow - up with dr in two weeks. he can be reached . she will follow up with id. id will call with time for follow-up. if they don't call there (. ask for dr . you have to have your tunneled catheter line. you are schedule to have this out on @ 0830. please 1 daycare center at o7oo hrs. procedure: venous catheterization, not elsewhere classified other revision of vascular procedure diagnostic ultrasound of heart excisional debridement of wound, infection, or burn transfusion of packed cells other immobilization, pressure, and attention to wound injection or infusion of oxazolidinone class of antibiotics diagnoses: coronary atherosclerosis of native coronary artery other postoperative infection congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism aortocoronary bypass status asthma, unspecified type, unspecified aortic valve disorders peripheral vascular disease, unspecified candidiasis of mouth bacteremia intestinal infection due to clostridium difficile old myocardial infarction infection and inflammatory reaction due to other vascular device, implant, and graft below knee amputation status other specified noninflammatory disorders of vagina candidiasis of skin and nails 

Answer: The patient is high likely exposed to