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: this is a 56-year-old male with insulin dependent diabetes status post renal transplant in now failing, also status post right tib-fib fracture. in , the patient underwent an orif and at that time and then was removed. the patient was treated with iv zosyn and vancomycin for six weeks. cultures at that time grew gram-positive cocci. patient completed his antibiotic course a few weeks ago. the patient was recently seen by his primary care physician, . and his renal doctor, dr. , and was complaining of increasing discharge from the right leg two wound sites on the knee and on the ankle. a swab was taken at that time which grew gram-negative rods, which turned out to be klebsiella that was sensitive to levofloxacin. patient was started on 250 mg q.d. levofloxacin on . of note, the patient's rapamycin level was also decreased from 2 mg a day to 1 mg a day. patient, hence, did not report any fever, chills, nausea, vomiting, chest pain, or shortness of breath. past medical history: 1. hypertension. 2. insulin dependent-diabetes mellitus. 3. peripheral vascular disease diagnosed three years ago status post lower extremity bypass done by vascular surgery. 4. end-stage renal disease status post failing transplant since pyelonephritis one year ago. 5. osteoarthritis. 6. neuropathy status post right fifth toe amputation and partial left foot amputation. 7. gastroesophageal reflux disease. 8. depression. 9. status post right tib-fib fracture with an orif with removal of infected rod in 06/. allergies: 1. codeine causes swelling. 2. prograf - unknown reaction. social history: patient has a 20 pack year history of smoking. quit six years ago. patient used to drink heavily, but quit 11 years ago. he denies any iv drug abuse. the patient lives with his wife and daughter. medications on admission: 1. aspirin 81 q.d. 2. atenolol 50 q.d. 3. bupropion 100 t.i.d. 4. calcium carbonate 500 t.i.d. 5. celexa 40 q.d. 6. folic acid 1 mg q.d. 7. lasix 40 q.d. 8. lipitor 10 q.d. 9. multivitamin. 10. neurontin 300 q.d. 11. oxycontin 60 b.i.d. 12. peridex swish and swallow b.i.d. 13. prednisone 4 mg q.d. 14. protonix 40 mg q.d. 15. rocaltrol 0.25 mcg q.d. 16. roxicet for breakthrough pain. 17. trazodone 50 prn. 18. viokase two tablets with meals, one tablet with snacks. 19. erythropoietin 10,000 units one time per week. 20. lovenox 40 q.d. 21. rapamune 1 mg q.d. 22. insulin nph 22 units in the a.m. and 6 units in the p.m. with a sliding scale. 23. levaquin 250 mg p.o. q.d. x7 days. 24. cellcept mg q.d. physical exam: temperature 96.5, blood pressure 170/90, pulse 58, respiratory rate 16, o2 saturation 99% on room air. in general, the patient is a thin male in no acute distress. cardiovascular system: regular, rate, and rhythm. lungs are clear to auscultation bilaterally with no rales or rhonchi. abdomen is soft, nontender, nondistended with positive bowel sounds. extremities: fifth digit on the right foot is amputated. left foot has partial amputation. patient has an external fixator in place in the right lower extremity with foul smelling purulent discharge from the wound in the right ankle and the right knee. laboratories on : patient has a wound culture that grew klebsiella sensitive to levofloxacin. white count of 12.8 with no left shift. sodium 141, potassium 5.2, bicarb of 11, bun of 51, creatinine is 7.2, glucose of 189. patient has an albumin of 3.7, calcium 9.1, and a phosphorus of 5.9. rapamycin level of 3.4. hospital course: 1. right leg infection: patient was continued on p.o. levofloxacin. blood cultures were drawn and id was consulted. ortho was also consulted. patient was followed by vascular surgery as well. on hospital day two, vascular surgery debrided the wound at the bedside and sent repeat cultures. repeat cultures eventually grew back just gram-negative rods and so patient was continued on levofloxacin. on , the ortho attending, dr. came to see the patient and presented the option of amputation versus debridement. the patient expressed desire to go the conservative route, and attempt debridement surgery. on , the patient went to the or and debridement was done with intraoperative tissue and bone cultures sent. tissue and bone cultures grew out gram-positive cocci, coag-negative gram-positive cocci, and gram-negative rods not pseudomonas. the patient was then started on iv vancomycin 1 gram dose for levels less than 15. patient is to be followed by ortho. upon discharge, he will follow up with dr. in clinic. 2. renal: the patient has a failing kidney transplant. the renal service decided to discontinue the cellcept and increase prednisone to 5 mg q.d. and continue the rapamycin at 1 mg q.d. renal service discussed with transplant surgery the need for hemodialysis access. he was assessed by transplant surgery and will follow up with them as an outpatient for likely hemodialysis access. patient's renal function, bun and creatinine remained stable throughout the hospitalization. he will follow up with dr. as an outpatient. 3. hyperphosphatemia: on admission, patient had a phosphate of 5.9. his rocaltrol was increased to 0.5 q.d. and then further increased later due to continual increased phosphate to 1 mcg q.d. patient's phosphate then dropped to normal levels and remained there throughout the hospitalization. 4. hypocalcemia: patient's calcium level on admission was within normal limits. patient's calcium carbonate was continued at 1,000 mg t.i.d. 5. acidosis: on admission, patient had a bicarb level of 11. he was started on sodium bicarb 650 b.i.d. by , patient's bicarb level was within normal limits and sodium bicarb was discontinued. patient's bicarb level remained within normal limits throughout the hospitalization. 6. hyperkalemia: throughout the hospitalization, patient required multiple doses of kayexalate to maintain his potassium less than 5. patient's potassium stabilized at 4.6 and remained normal throughout the hospitalization. 7. diabetes: patient's diabetes is very difficult to control and fluctuates widely between very hyperglycemic in the 300s to hypoglycemic down to the 50s with mental status changes and confusion. was consulted to follow the patient. on , patient had an episode of low blood sugar down to 40 with shaking and unresponsiveness. this was treated with d50 and a decrease in his sliding scale. patient continued to have episodes of mild hypoglycemia until , at which point the adjustments in his nph insulin, regular insulin-sliding scale were such that he no longer had episodes of severe hypoglycemia. the patient is to followup with his physician, . as an outpatient for further diabetic control. 8. vomiting: patient had occasional episodes of vomiting throughout the hospitalization with immediate relief after vomiting. patient's vomiting is likely due to mild degree of gastroparesis. on , the patient had an episode of vomiting in the evening and was given phenergan. patient then became agitated and aggressive. the patient was seen by psychiatry. was placed on one-to-one sitter and required restraints. patient was also given haldol with good affect. the day following this episode, the patient was back to baseline mental status with no further episodes of aggression or agitation. the agitation was likely secondary to phenergan and phenergan was avoided for the remainder of the hospitalization. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified local excision of lesion or tissue of bone, tibia and fibula excisional debridement of wound, infection, or burn removal of implanted devices from bone, tibia and fibula diagnoses: other convulsions hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease nonunion of fracture complications of transplanted kidney diabetes with renal manifestations, type i [juvenile type], uncontrolled infection and inflammatory reaction due to other internal orthopedic device, implant, and graft chronic osteomyelitis, lower leg late effect of fracture of lower extremities late effects of unspecified accident 

Answer: The patient is high likely exposed to