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 78 year old gentleman with a history of hypertension and known five cm type iv thoracoabdominal aortic aneurysm. he was being followed by dr. . he presented to hospital with worsening abdominal and back pain. pain began about a day prior to admission and gradually worsened. it is not associated with food. no nausea, vomiting, no chest pain, shortness of breath. the pain was band-like around his abdomen. at hospital, the patient underwent abdominal ct scan which did not show a ruptured aneurysm. the patient was transferred to for further management. upon arrival, he had a tender, pulsatile mass. past medical history: significant for hypertension; type iv thoracoabdominal aortic aneurysm; gout; arthritis. past surgical history: right hip open reduction and internal fixation and right carotid endarterectomy and colonoscopy with polypectomy a year ago. medications at home: atenolol, hydrochlorothiazide, aspirin, multi-vitamin, verapamil, colchicine. physical examination: the patient was alert and oriented times three. chest was clear. abdomen was soft and there was a tender pulsatile mass but no rebound. rectal was normal tone and guaiac negative. he has palpable dorsalis pedis and posterior tibial artery bilaterally. the patient underwent another ct scan at on admission, which showed no rupture of the aneurysm. all of his laboratory values were stable. hospital course: the patient was admitted to medical intensive care unit. however, given his abdominal pain, it was deemed that the patient had a symptomatic aneurysm and the patient fell into a group of increased risk of rupturing, inspite of ct demonstrating no rupture and the aneurysm size was 5.6 cms. the patient was taken emergently to the operating room. he underwent repair of the thoracoabdominal aortic aneurysm with a supraceliac crossclamp by dr. on . intraoperatively, the patient had gotten 17 liters of fluid and four units of ffp and five units of packed red blood cells and six packs of platelets and some cryo. in order to cross the aorta, unfortunately we had to cross the aorta above the celiac artery. postoperatively, the patient was transferred to the trauma intensive care unit, intubated. the patient underwent a long hospital course. on postoperative day number one, the patient had low to no urinary output. cvh was considered. renal consult was obtained. on postoperative day number one, the patient's creatinine was elevated from 1.4 from baseline of 1.0. the patient remained intubated. cardiology was consulted for perioperative management of this patient. renal recommended 200 mg of intravenous lasix to see if the patient had any response to that. however, there was no response to the lasix treatment. throughout the day, patient continued requiring intravenous fluids and urinary output continued to be an issue. on , a renal ultrasound was performed and a cardiac echo was done. the ultrasound showed that there was no obstruction of the renal artery flow. on , the patient was started on tpn. from this point on, it was somewhat apparent that the patient was going to have a long and tortuous hospital course. over the next few days, the patient's creatinine continued to elevate. on , the patient's creatinine was 2.8. renal ultrasound showed excellent perfusion to both kidneys and there was no hydronephrosis. also, the patient had a four compartment fasciotomy on the left lower extremity, performed on the same day of surgery and the patient had creation of a left to right femoral-femoral bypass on , the same day of surgery. the patient was put on lasix and dopamine drip on for renal recommendations, for an attempt to removal of fluids prior to the onset of cvh. throughout the postoperative days, progress has been made in terms of ventilatory management. the settings have been gradually decreased, however, the patient was never deemed ready for extubation, due to his excessive fluid over load and his acute renal failure. nutritionally, the patient was doing well on tpn. the patient was started on tube feeds after he showed some bowel function. the patient tolerated the tube feeds well the pyloric feeding tube was then placed via interventional radiology. the patient was placed on c-pap; however, the patient was still in acute renal failure. creatinine reached a peak of 5.1. on , under renal's recommendations, hemodialysis and cvh became apparent. at the same time, the patient was on a dopamine drip at 2.5 and lasix drip of 10, in order to help him make urine. on , the patient began to spike a fever. at that point, we put the patient on broad spectrum antibiotics, including vancomycin, levofloxacin and flagyl. infectious disease was consulted. blood culture was sent off. the patient began to have some purulent drainage coming out of her right groin. at the same time, the patient was placed on broad spectrum antibiotics. the patient was septic appearing. on , a small, two cm incision was made over the mid abdomen, at a site of the graft tunnel. some local anesthetic was then given and the local incision and drainage was then carried out through a right groin access. the patient's antibiotics were then switched to vancomycin, zosyn and ciprofloxacin per infectious disease recommendations. the patient continued to be intubated, although hemodynamically, he appeared to be somewhat stable except that the groin graft appeared to be infected. the patient was continued on the cvh hemodialysis. over the next few days, the patient's creatinine had dropped down somewhat, to about 3.0 or 3.3, but still the patient was in acute renal failure. cvh was continued and antibiotics were continued. the patient was pan cultured. the right groin wound was growing out gram negative rods, probably enterococcus and pseudomonas, e. coli and morganella from the right groin wound. blood culture was growing out enterococcus at the same time, despite the broad spectrum antibiotic coverage. on postoperative day number 21 or , the patient was taken back to the operating room. the patient underwent a left axillofemoral bypass graft and ligation of the right to left femoral-femoral bypass. postoperatively, the patient was ruled out for myocardial infarction and the patient appeared to be doing well. the patient had dopplerable dorsalis pedis and posterior tibial pulses bilaterally. the patient was continued on cvh in an attempt to remove additional fluids. intraoperatively, the patient was given argatroban given the fact that he was hit positive. intraoperatively, the patient required five liters of fluids and 12 units of ffp and 12 units of packed red blood cells and five bags of platelets. estimated blood loss was four liters. the patient was continued on the cvvh dialysis. at the same time, gastrointestinal wise, the patient was tolerating tube feeds. tube feeds were initiated on postoperative day number one from the left axillofemoral bypass. over the next few days, the patient was continued on antibiotics per infectious disease recommendations. vancomycin, zosyn and ciprofloxacin were continued. the patient's laboratory values showed an elevation of total bilirubin of 9.1. there was a question of dic and hematology consult was then obtained. the hematology team apparently felt that it was a combination of bacteremia, sepsis and renal failure that led to the elevated total bilirubin and hemolysis. they felt that using products to support him was adequate for current management. on , the patient spiked a low grade temperature to 101 and his white count elevated to 16. the patient's dialysis catheter was then changed over a wire. his left central line was also changed. the patient was again pan cultured. on , the patient was taken back to the operating room for removal of the infected femoral-femoral bypass graft. after excising the graft, a right femoral artery vein patch angioplasty was also performed. the procedure went well and the patient was returned to the trauma intensive care unit with palpable pulses. at the same time, the patient was continued on the cvh dialysis for fluid over load. on , the patient underwent an open tracheostomy by the thoracic team due to his extended failure to wean off ventilation. the patient did well on a tracheostomy. nutritionally, the patient has a dopoff feeding tube and the patient was getting napro per nutrition recommendations at his goal of 50 cc per hour. on , the patient was fitted for a pasmir valve while on tracheostomy. the patient's renal function appeared to be improving and the patient was briefly off cvh and continued on lasix and dopamine drip, in order for him to make urine. his creatinine was then followed over the next few days; however, the patient's creatinine continued to elevate, trending up, and the patient had to be put back briefly on hemodialysis, cvh. the antibiotic regimen was continued per infectious disease recommendations. meanwhile, the patient was doing well on his tracheostomy. rehabilitation has begun to work with the patient. occasionally, the patient was placed on tracheostomy mask. the patient appeared to be doing well and gradually, his time on the tracheostomy mask was increased. on , hemodialysis was held because creatinine appeared to be stabilizing. on , the patient's white count was elevated at 20,000 and the patient underwent a left thoracentesis for his pleural effusion. the fluid was sent for culture, which returned to be negative. his wound appeared to be clean, dry and intact. his right groin was openly packed. the rest of the incisions were all clean, dry and intact. his fasciotomy site appeared to be healing. the skin was skin stapled. the staple was then discontinued on and the wound was then steri-stripped. the patient's lasix drip was stopped and his dopamine drip was stopped. the patient was still requiring intermittent dialysis for renal. over the next few days, until , the patient was doing extremely well. respiratory wise, he was on a tracheostomy collar during the day and smiv at night. the patient was still on vancomycin, zosyn and ciprofloxacin for antibiotic coverage. the wound looked very well and the wound was packed with wet to dry dressing change. the patient was begun to be screened for tracheostomy rehabilitation. the plans are that we will plan to change over to a fenestrated tracheostomy. the patient will be ready for vented rehabilitation. the patient was scheduled to get a tunneled dialysis catheter for permanent dialysis. once completed, the patient will be ready for rehabilitation. his discharge medications and plans will be dictated in an addendum to this discharge summary. , m.d. 2914 dictated by: medquist36 procedure: parenteral infusion of concentrated nutritional substances other revision of vascular procedure enteral infusion of concentrated nutritional substances hemodialysis thoracentesis other (peripheral) vascular shunt or bypass temporary tracheostomy graft of muscle or fascia aortography incision of vessel, lower limb arteries resection of vessel with replacement, aorta, abdominal other repair of vessel resection of vessel with replacement, lower limb arteries other incision of soft tissue diagnoses: acute kidney failure with lesion of tubular necrosis hematoma complicating a procedure hemorrhage complicating a procedure peripheral vascular complications, not elsewhere classified infection and inflammatory reaction due to other vascular device, implant, and graft abdominal aneurysm without mention of rupture other and unspecified coagulation defects 

Answer: The patient is high likely exposed to