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 75-year-old gentleman who was initially admitted to the vascular surgery service, coming with the complaint of lower extremity ulcers. the patient had bought new shoes and over the month prior to his admission had developed a friction ulcer which had become gradually worse. after being evaluated by his primary care physician, was sent to dr. surgery service for evaluation and work-up for peripheral vascular disease. the patient had had an angiography done of the lower extremities at hospital and was referred here for a second opinion. on admission the patient had bilateral lower extremity ulcers. he reports having rest pain at night. he denied any claudication and denied any shortness of breath, fevers, chills, dyspnea on exertion. past medical history: significant for diabetes mellitus, peripheral vascular disease, hypercholesterolemia. patient has decreased hearing. past surgical history: significant for status post turp times three, status post right total hip replacement. allergies: no known drug allergies. medications: on admission include lasix 20 mg po q d. social history: the patient smokes one pack per day of cigarettes, had smoked one pack per day for 50 years. he is a retired corrections officer, lives with his wife. physical examination: patient's temperature is 99.6, blood pressure 120/50, heart rate 57, 96% on room air. he is alert and oriented times three, pupils are equal, round and reactive to light. tongue is midline. oropharynx is clear. his neck is supple. he has no lymphadenopathy. his chest is clear to auscultation. his heart is regular rate and rhythm with a harsh systolic ejection murmur at the base which radiates to the carotids. abdomen is soft and nontender with no bruits, has bowel sounds, no masses. extremities, on the right lower extremity he has a 2 by 2 circumferential ulcer on the medial aspect of his medial malleolus with dry gangrene surrounding it with positive odor. he has dry gangrene of the right fourth toe. his left lower extremity has a medial malleolar ulcer which is 1 by 1 cm with positive odor. his pulse exam is 1+ carotids bilaterally, 2+ brachial, 2+ radial bilaterally. he has 2+ femoral bilaterally, no popliteal. he has a doppler signal of his pts bilaterally, doppler signal of the left dp and no doppler signal of the right dp. laboratory data: on admission, white count 12.5, hematocrit 33.8, platelet count 364,000, pt 12.5, ptt 29.7, inr 1.1, sodium 139, potassium 4.8, chloride 102, co2 26, bun 51, creatinine 2.1, glucose 166, hemoglobin a1c of 7.2. wound cultures of his ankle wound showed pseudomonas which was pansensitive and staph coag positive which was resistant only to penicillin. he had a moderate growth of bacteroides. chest x-ray showed no evidence of chf, no pleural effusion, no consolidation. bilateral carotid studies were significant for right internal carotid artery stenosis of 70-79%, left with no significant stenosis. hospital course: the patient was admitted to the vascular surgery service. he was placed on antibiotics and received wet to dry dressing changes on his bilateral lower extremity ulcers. he was planned to go to the operating room for revascularization of his right lower extremity. he was evaluated by cardiology who suggested for him to undergo a transthoracic echo which showed an ef of 55%, aortic stenosis with a peak gradient of 55 mmhg and an aortic valve area of 1 cm sq. ekg showed sinus brady at 50 with normal axis and isolated q wave in lead 3 and j point elevations of leads v1 and v2. based on that, he underwent a stress thallium study which was significant for no anginal symptoms, no st changes and a mild inferior wall defect with partial reversibility. he also had an ef of 49% on this study. he was deemed a candidate for surgery and on patient went to the operating room and underwent a right cfa to posterior tibial bypass graft with in situ greater saphenous vein graft. postoperatively his ekg remained unchanged. only significant postoperative event was patient began to have hematuria which he noted occurred intermittently secondary to his history of multiple qrps and question of prostate cancer. he was evaluated by urology who suggested continuous bladder irrigation until clear and then intermittent irrigation for clots. the patient remained stable and on postoperative day #2 on the patient went to the or again for debridement of his right ankle ulcer and right fourth toe amputation. he tolerated the procedure well. postoperatively there were ekg changes, specifically st depressions in v4 through v6. he was evaluated by cardiology and remained hemodynamically stable and cardiac enzymes were cycled. he ruled in for mi according to enzymes. his cpks were respectively 295, 306, 419 and his troponin i were 11.3, 30.2 and 21.6. he was ruled in for a non q wave mi. he remained hemodynamically stable and during his postoperative recovery he underwent cardiac catheterization on . this was significant for stenosis of the rca of 70% and lm stenosis of 80% and lad stenosis of 60% and om1 stenosis of 95%. they also demonstrated aortic gradient of 35 mmhg and of 1.2 gm sq. there was also significant hypokinesis of anterior, lateral and inferior wall and ef of 42%. he was then evaluated by cardiothoracic surgery and it was decided the patient is still requiring a further procedure for revascularization of lower extremities on the left and would need to undergo a cabg avr. he was evaluated by infectious disease due to the ulcers and question of placing valve and is deemed to be low risk for infecting the valve. he was continued on perioperative antibiotics which include zosyn and levaquin. on postoperative day #14 the patient was taken to the operating room by cardiothoracic team led by dr. where he underwent cabg times three and avr with a ce valve #23. the grafts were lima to lad, svg to om1 and svg to ramus. the patient tolerated this procedure well, was transferred to the cardiac intensive care unit on a propofol drip of 20 mcg/min and a neo drip of 0.5 mcg/kg/minute. postoperatively the patient was weaned to extubate without any difficulty. the patient remained paced for the first two postoperative day but hemodynamically stable and he was weaned off all drips. he required transfusion of 4 units of packed red blood cells for a hematocrit of 24. patient's post transfusion hematocrit was 28.9. he remained on zosyn and levaquin perioperatively. the patient continued on continuous bladder irrigation for hematuria. on postoperative day #3 the patient was transferred to the floor for the remainder of his recovery. chest tubes were discontinued on postoperative day #3 without any problems. his pacing wires were discontinued on postoperative day #4 without incident. he could receive physical therapy and is currently at level 2 activity. after discussion with urology, the patient's foley was discontinued on postoperative day #6. the patient has been able to void. post void residual will be checked. plan for urologic follow-up will be four weeks postoperatively. the patient will undergo rigid cystoscopy to evaluate cause of the hematuria. in the meantime the patient, if requires, may receive foley catheterization until appropriate follow-up with dr. in the urology clinic. on the floor the patient has remained afebrile, hemodynamically stable, blood sugars have remained from 81 to 150's. the patient is now stable, is ready for rehabilitation. follow-up: the patient will follow-up with dr. in four weeks for post cabg avr check-up. the patient will follow-up with dr. in one week for evaluation of skin grafting of the lower extremity ulcers. the patient will continue on wet to dry dressing changes. patient will continue on keflex 400 mg po qid per id for continued antibiotic prophylaxis. the patient will follow-up with dr. in weeks for cystoscopy to evaluate the hematuria. the patient will follow-up with dr. , his primary care physician in two weeks. discharge diagnosis: 1. peripheral vascular disease, status post right sfa to pt bypass graft with insitu greater saphenous vein. 2. status post 4th toe amputation. 3. coronary artery disease status post cabg times three. 4. aortic stenosis status post avr. 5. diabetes mellitus. 6. hypercholesterolemia. discharge medications: lopressor 25 mg po bid, lasix 20 mg po bid times 7 days, kcl 20 meq po bid times 7 days, colace 100 mg po bid, enteric coated aspirin 325 mg po q d, protonix 40 mg po q d, nystatin powder on affected areas, tylenol 650 mg po q 4 hours prn, keflex 500 mg po qid until skin grafts are done. special instructions: the patient will receive wet to dry, normal saline dressings on the ankle and lower extremity ulcers. if foley requires to be placed, patient should receive irrigation with normal saline until clear for clots. , m.d. dictated by: medquist36 procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery combined right and left heart cardiac catheterization (aorto)coronary bypass of two coronary arteries angiocardiography of left heart structures amputation of toe other (peripheral) vascular shunt or bypass open and other replacement of aortic valve with tissue graft excisional debridement of wound, infection, or burn diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery pure hypercholesterolemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled aortic valve disorders occlusion and stenosis of carotid artery without mention of cerebral infarction atherosclerosis of native arteries of the extremities with gangrene ulcer of ankle 

Answer: The patient is high likely exposed to