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: fevers, leg pain major surgical or invasive procedure: none history of present illness: micu hpi 26y/o gentleman with htn, dm2, h/o peritonsillar phlegmon in who presents with lle pain and fever for 1 day. at hospital, initial vs were t 103.2, hr 116, bp 183/79, rr 22, pox 97%ra. he was lethargic. wbc was 26.3 67%n, 14% bands), bun 18, cr 1.4, k 3.4. lactate was 2.5. received vancomycin and levofloxacin, as well as acetaminophen 1g po and 2l normal saline. he became more alert and oriented, but due to continued concerns over sepsis and possible necritizing fasciitis he was transferred to . in the ed, initial vs were: t 99.7, bp 107, bp 170/99, rr 28, pox 97% 2l nc. spiked to 103 degrees in the ed. exam revealed anterior tibial erythema, tenderness, and edema with superficial skin changes. labs were notable for wbc 18.6 (90.5%n, no bands), hct 38.3 (which is baseline). lactate 1.5. na 146, k 2.6 (repleted with 40mg po), cr 0.9. ua with 2+ protein and no suggestion of uti. cxr did not suggest an acute process. lle u/s negative for dvt. acs was consulted to ensure no necrotizing fasciitis, and they felt there were no surgical issues at this time for his cellulitis. x-ray did not show subcutaneous gas. he received clindamycin 900 mg iv, acetaminophen 1000 mg iv, zofran 4 mg iv. was given 2l lr. is was admitted to medicine for management of cellulitis. vs prior to transfer were: t 103??????f po, hr 106, rr 22, bp 186/74, o2sat 100%ra. on arrival to the floor, he is sleepy and complains of headache in the back of his head. no photophobia or neck stiffness. no chest discomfort now, but did feel that his chest and breathing were "heavy" for a few minutes before he was transferred to the floor. feels chilly despite 2 bankets and asks for the heat to be turned up. he was given 2l lr boluses (in addition to 2l ns in ed which i do not see charted). at 2230, patient was found to have a t of 103.1, blood pressure of 221/127, hr 108, rr of 30 and satting 100%. he was altered and only grunting responses, not answering questions clearly. an abg was done: 7.49, 30, 67 and a lactate of 1.4. an ekg showed lvh and tachycardia with j-point elevation laterally. a fifth l of crystalloid was started, patient was given 5mg iv metoprolol, and decision was made to transfer the patient to the micu for sepsis/ hypertension/ altered mental status. on arrival to the micu, patient reports some previous chest pain and a current headache. he is otherwise more alert. he says he does not take any of his medications because he hates the fact that he has to take them, and also he forgets. past medical history: hypertension diabetes mellitus, type 2 chronic tonsillitis peritonsillar phlegmon social history: -home: staying with his sister in . another sister is in the neighborhood as well, and his 3rd sister lives in . his mother and father live in . he has a young daughter who lives with her mother in state. -occupation: currently unemployed, on disability for his chronic medical conditions and leg pain with prolonged standing. -etoh: social use, never >5 drinks per night. -tobacco: has smoked 1/2ppd for ~12 years. -drugs: occasional mj use, but never used cocaine or heroine. never used any iv drugs. family history: hypertension, diabetes, strokes in both sides of the family. mother and sister are not obese. physical exam: micu admission physical exam general: sleepy, oriented, reports headache. heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl fundoscopic: unable to clearly make out optic disk. neck: obese, supple, jvp not elevated, no lad cv: muffled, although regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: obese, soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema erythema on left tibia, warm, with 2+ pulses dp/pt bilaterally. neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred, finger-to-nose intact pertinent results: micro: urine urine culture-pending blood culture blood culture, routine-pending lle leni: no evidence of deep vein thrombosis. cxr: no acute intrathoracic process. tib/fib (ap & lat) left no subcutaneous gas. ct leg: impression: 1. no bone destructin or periosteal new bone formation to suggest osteomyelitis. no drainable abscess identified. 2. subcutaneous soft tissue stranding consistent with patient's known cellulitis. 3. no evidence of acute fracture or dislocation. : impression: 1. normal son appearance of both kidneys. 2. no doppler evidence for renal artery stenosis. : cxr impression: interval placement of a right-sided picc line that crosses the midline and is malpositioned. labs upon admission: 03:45pm blood wbc-18.6*# rbc-4.73 hgb-12.4* hct-38.3* mcv-81* mch-26.3* mchc-32.4 rdw-13.5 plt ct-190 03:45pm blood neuts-90.5* lymphs-4.8* monos-4.5 eos-0 baso-0.2 11:50am blood pt-20.1* ptt-26.5 inr(pt)-1.9* 03:45pm blood glucose-81 urean-15 creat-0.9 na-146* k-2.6* cl-118* hco3-20* angap-11 05:37am blood alt-32 ast-20 ld(ldh)-250 alkphos-83 totbili-0.3 11:19pm blood calcium-8.4 phos-1.9*# mg-1.4* 04:08am blood %hba1c-6.2* eag-131* 05:37am blood tsh-1.8 07:58am blood cortsol-17.0 05:37am blood crp-232.0* 05:37am blood hiv ab-negative 03:52pm blood glucose-82 lactate-1.5 k-2.6* labs upon discharge: 11:05am blood wbc-10.2 rbc-5.20 hgb-13.4* hct-41.9 mcv-81* mch-25.9* mchc-32.1 rdw-13.3 plt ct-317 11:05am blood urean-11 creat-1.0 07:58am blood calcium-8.8 phos-3.1 mg-1.9 05:37am blood tsh-1.8 07:58am blood cortsol-17.0 05:37am blood crp-232.0* 05:37am blood hiv ab-negative 11:05am blood vanco-7.8* 07:58am blood aldosterone-pnd 07:58am blood renin-test 07:58am blood metanephrines (plasma)-test name 09:49pm urine vanillylmandelic acid-test 09:49pm urine metanephrines, fractionated, 24hr urine-pnd brief hospital course: mr. is a 26 year old gentleman with class iii obesity (bmi 39.6), untreated htn and dm2, as well as h/o peritonsillar phlegmon, admitted with htn urgency and sepsis from lle cellulitis, with extreme lethargy. he was initiatially admitted to the micu and called out to the medical floor when his lethargy improved. # sepsis secondary to lle cellulitis: he presented with fever, tachypnea, tachycardia, and leukocytosis with 14% bandemia. initially treated with clindamycin, then transitioned to vanomycin/ciprofloxacin. his lle erythema gradually improved, fevers resolved and leukocytosis improved. infectious disease was consulted. they recommended transitioning him to ertapenem, for a total of 14 days. a picc line was placed and he was discharged on ertapenem with vna care to assist with the delivery of the medication. # hypertensive urgency/emergency: initial sbp was 200 mmhg, prompting management with nitroglycerin drip. he was transitioned to oral medications with a regimen that included labatelol, lisionpril, hctz and amlodipine. given refractory hypertension and his young age, secondary hypertension workup was begun. renal ultrasound with doppler did not reveal evidence of renal artery stenosis. laboratory workup included: am cortisol normal, serum metanephrines normal, urine vma normal, tsh normal, renin low (but aldosterone level pending). he will need ongoing close management of his severe hypertension in order to prevent future renal disease. # psychosocial issues: his mother expressed concern regarding his motivation to take his medications and manage his diabetes and hypertension. he reportedly does not exercise or socialize and she is concerned about an underlying depression. we recommended he follow up with his primary care doctor and see an outpatient social worker to encourage medication adherence and behavioral change. chronic issues - f/u aldosterone level and urine metanephrines (pending at discharge) - smoking cessation counseling - meeting with pcp and outpatient social worker for medication adherence and behavioral change, likely needs depression screening. medications on admission: preadmission medications listed are correct and complete. information was obtained from patientfamily/caregiver note: has not taken any of these medications for a few months.. 1. labetalol 200 mg po bid 2. lisinopril-hydrochlorothiazide *nf* 20-25 mg oral daily 3. metformin (glucophage) 1000 mg po daily discharge medications: 1. labetalol 400 mg po tid hold for sbp<120 hr<70 rx *labetalol 200 mg 2 tablet(s) by mouth three times a day disp #*60 tablet refills:*0 2. amlodipine 10 mg po daily rx *amlodipine 10 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 3. ertapenem *nf* 1 gram intravenous daily reason for ordering: patient is going to be discharged on this medication and would like him to receive one dose today before going to ensure that he does not develop an allergic reaction given documented allergy to pcn rx *invanz 1 gram 1 gram intravenous daily disp #*9 gram refills:*0 4. hydralazine 25 mg po tid hold for sbp <90 rx *hydralazine 25 mg 1 tablet(s) by mouth three times a day disp #*90 tablet refills:*0 5. hydrochlorothiazide 25 mg po daily hold for sbp <90 rx *hydrochlorothiazide 25 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 6. lisinopril 40 mg po daily hold for sbp <90 rx *lisinopril 40 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 7. nicotine patch 14 mg td daily rx *nicotine 14 mg/24 hour 1 patch daily for 7 days, then patch daily for 7 days then stop disp #*14 tablet refills:*0 8. metformin (glucophage) 1000 mg po daily rx *metformin 1,000 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 discharge disposition: home with service facility: home solutions discharge diagnosis: sepsis secondary to cellulitis hypertension diabetes mellitus discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , you came to the hospital because of an infection in your leg (cellulitis). you were treated with intravenous antibiotics and improved. your blood pressure was very difficult to control, but improved after addition of several new medications. it is very important that you take your medications as perscribed and follow up closely with your primary care to care for your high blood pressure. you will continue to take intravenous antibiotics when you leave the hospital. it was a pleasure caring for you. followup instructions: name: , m. location: internal medicine address: , , phone: appointment: wednesday 9:30am procedure: central venous catheter placement with guidance diagnoses: tobacco use disorder unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia sepsis hypopotassemia cellulitis and abscess of leg, except foot morbid obesity body mass index 39.0-39.9, adult 

Answer: The patient is high likely exposed to