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: the patient is a 56 year old male, with poorly controlled diabetes; history of chronic neck pain and right first metatarsal diabetic ulcer. he was treated with a seven day course of augmentin from to . he has been followed by podiatry who felt the ulcer was improving clinically. on the evening of , the patient developed fever and chills. on , he developed acute onset of right shoulder pain that was worse with movement. he did not notice that it was warm. there was no rash or swelling. he was seen at an outside clinic where he was febrile to 102.2. he had a leukocytosis to 15,000 with 91% polys and a thrombocytopenia to 91 and a sodium of 129. his shoulder film at that time was negative. he was referred to where an acute shoulder film was negative. initially, he was afebrile and hemodynamically stable. at 1 a.m., he developed tachycardia and hypotension to 89/60 with an oxygen saturation of 88% on room air. he became increasing tachycardiac but blood pressure stabilized with four liters of normal saline and saturations improved with three liters of oxygen. in the emergency department, an aspiration of his shoulder was attempted by the emergency department and by orthopedics, unsuccessfully. he then developed abdominal pain and distention. a kub and ct were negative. surgery evaluated him and felt that his abdomen was not surgical. at that point, he was started on ceftriaxone and flagyl. at the time of the medical intensive care unit evaluation, he was complaining of shoulder and neck pain. he had several months of abdominal pain but denied chest pain, shortness of breath, nausea, vomiting or headache. past medical history: diabetes, hypertension, hyperlipidemia and chronic neck pain. allergies: no known drug allergies. medications: insulin. naprosyn. motrin. augmentin. lipitor. lisinopril. social history: no alcohol, tobacco or intravenous drug use. family history: noncontributory. laboratory data: initial laboratory studies showed a white count of 11.2 and hematocrit of 30.2; platelets 109. sodium of 132; potassium of 3.7; chloride 102; bicarbonate 21; bun 23; creatinine 1.0; glucose 274. ck's were 235 and 436 with negative mb's and negative treponin. the calcium was 7.4; magnesium 1.4; phosphorus 1.9; tsh was 1.1. hospital course: orthopedic. the patient was admitted to the medical intensive care unit with a septic shoulder. he had two attempts at aspiration of the joint in the emergency room which were unsuccessful. he then received operative arthrocentesis which was significant for withdraw of 5 cc of purulent fluid, which subsequently grew group a strep. in addition, blood cultures at that time were also positive for group a strep. the joint was washed out and the patient was started on intravenous penicillin and clindamycin and ivig. following this wash-out, the patient continued to have significant right shoulder pain. reimaging by magnetic resonance scan, showed that there was still a fluid collection with significant soft tissue swelling. he received another joint tap by ortho which was significant only for yellow colored fluid which had no organisms and cultures were negative by the date of this dictation. he was seen by physical therapy and he made gradual improvement in the motion of his arm. of note, the magnetic resonance scan had a slight suggestion that there might be osteomyelitis of the clavicle. also, on the day the patient was sent out of the medical intensive care unit, it was noted that he had extreme swelling of his right arm and that it was also difficult to move the elbow. he received a doppler study of the right arm which was negative for deep vein thrombosis and a plain film of the right elbow, which also showed that there was no effusion. foot ulcer: the patient was followed by podiatry for his right foot ulcer, which was likely the source of his group a strep bacteremia. they could not probe to bone. he had a magnetic resonance scan of the foot which showed no osteomyelitis and likely no fluid collections that would be amenable to drainage. continue dressing changes and antibiotics. infectious disease: patient with group a strep bacteremia. he is to receive a total of four weeks of penicillin and an additional two weeks of clindamycin. his clindamycin was initially stopped when he was afebrile coming on the neonatal intensive care unit. since he began having fevers again, it was restarted and it was thought that he would have a total of a two week course. he was also given a five day course of ivig since there was evidence that there was a better outcome for group a strep bacteremia and toxic shock with ivig. orchitis. the patient had some testicular pain while in the medical intensive care unit, although this is chronic. it is probably aggravated by failure. he received an ultrasound which was significant for bilateral epididymitis and possible bilateral orchitis. urology was consulted and it was decided that he would begin ciprofloxacin for likely a three week course and then to re-evaluate how he was doing. cardiovascular: patient with an episode of congestive heart failure in the context of aggressive volume repletion in the operating room. he autodiuresed and his oxygen requirement resolved. hypertension: the patient's hypertensive medications were on hold in the setting of sepsis and were not restarted at the time of discharge. diabetes: insulin dependent diabetes mellitus that had been well controlled throughout most of the admission. hypocortisol: patient with borderline cortisol stimulation test. on re-evaluation, he did not require corticosteroids and had a negative test. fluids, electrolytes and nutrition: the patient was hyponatremic throughout some of the admission, likely secondary to his autodiuresis and lasix. access: the patient received a left picc line to receive his intravenous antibiotics prophylaxis. he was on h2 blocker and subcutaneous heparin throughout the admission. anemia: patient with a hematocrit of 26 which was stable, although he will need an outpatient colonoscopy. on the day of discharge, the patient had been afebrile for 24 hours and had marked improvement in his shoulder pain. discharge medications: insulin 40 units nph in the morning, 16 at night. clindamycin 450 mg p.o. q. six hours until . tylenol 650 mg p.o. every four to six hours prn. morphine 2 to 8 mg intravenous every two hours prn. ibuprofen 600 mg p.o. q. eight hours prn. protonic 400 mg p.o. q. 24 hours. ciprofloxacin 500 mg p.o. q. 12 hours until . heparin subcutaneous 5,000 units twice a day until normal. pen g potassium 4 milliunits intravenous q. four hours. colace 100 mg p.o. twice a day. senna one tablet p.o. twice a day. the patient was on lisinopril when he was admitted and has not yet been restarted since his pressure has been desirable. discharge diagnoses: sepsis. septic arthritis. right foot ulcer. congestive heart failure. orchitis. epididymitis. diabetes. hyperglycemia. hypernatremia. delirium. discharge status: good. discharge disposition: to rehabilitation. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified arthrocentesis injection of therapeutic substance into joint or ligament arthroscopy, shoulder other local excision or destruction of lesion of joint, shoulder synovectomy, shoulder biopsy of joint structure, shoulder diagnoses: anemia, unspecified congestive heart failure, unspecified ulcer of other part of foot diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled hyperosmolality and/or hypernatremia streptococcal septicemia pyogenic arthritis, shoulder region orchitis and epididymitis, unspecified streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group a 

Answer: The patient is high likely exposed to