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: no known allergies / adverse drug reactions attending: chief complaint: neurogenic claudication major surgical or invasive procedure: l4/5 laminectomy history of present illness: as you know, he comes to us with a chief complaint of right-sided leg pain. this has been ongoing since . he states he was in celebrating his grandson's birthday and was walking and began having a sensation of weakness in his right leg. he had trouble walking three blocks due to a combination of both pain and weakness. it became progressively worse. upon returning back to , he went back to a local emergency room and was given oxycodone. he had been visiting the spine center and they have recommended that he do an epidural steroid injection. he underwent an injection for treatment of his right foot pain in and that was very helpful. he also began a course of physical therapy. he was doing quite well. however, on , he was exercising on the treadmill per the recommendation of physical therapy and began having pain in the sole of his foot. he was diagnosed initially with cellulitis and then with gout. he saw both a podiatrist as well as dr. . he was treated with indomethacin, but is now weaning off of that per the recommendation of his nephrologist. his right leg pain persists. he has significant difficulty walking. prior to this, he did have a chronic low back pain, was able to manage this and was walking about 40 minutes a day. more recently, he has not been able to do this. he is sent here for an evaluation for a lumbar stenosis. past medical history: heart disease, triple bypass in , lung resection for tuberculosis 40 years ago, and kidney problems, anemia, prostate removal for cancer. surgical history: include prostate removal in , bypass grafting , cataract surgery bilaterally in . medications: atenolol, hectorol, , furosemide, apidra, crestor, kayexalate, diovan, alpha lipoic acid, vitamin c, baby aspirin, ferrous sulfate, folic acid, centrum silver, and metamucil. allergies: no known allergies. social history: he is retired and he was working as a city engineer for up until last year. he does not smoke. he drinks alcohol. he is married. family history includes pancreatitis and strokes. review of systems: he reports he is in good health other than diabetes. denies recent unexplained weight loss. he is deaf in his right ear. he is currently having gout in his right foot. a 13-point review of systems is otherwise negative. on physical exam, mr. is a pleasant 73-year-old male accompanied by his wife. is alert and oriented x3. affect within normal limits. he appears well groomed and well nourished. he has significant difficulty walking. he is able to stand up on his toes and his heels but with much difficulty. bilateral lower extremity strength demonstrates slight weakness in his left at 4/5, but otherwise it is . sensation grossly intact. straight leg raise negative. no pain with internal and external rotation of his hips. imaging studies: mri of the lumbar spine obtained on , demonstrates a disc protrusion at l4-l5, and severe spinal canal stenosis at this level. at l5-s1, there is a left foraminal disc extrusion impinging the left l5 and left s1 nerve root. this was read by dr. . assessment and plan: mr. is a 73-year-old male who since has had severe right-sided leg pain. symptoms are consistent with neurogenic claudication. although he does have a large foraminal disc extrusion on the left, his symptoms are more right-sided. symptoms are more consistent with severe canal narrowing at l4-l5. dr. reviewed surgery with him, which would be a l5 laminectomy and l4 partial laminectomy. he understands the goal of surgery is to alleviate his right leg pain and increase his walking tolerance. his personal goal is to be able to walk on the beach in , with his grandchildren. surgical details were reviewed and consents signed. he will be scheduled at a mutually convenient time. i will be in contact with dr. to ensure that he can be off aspirin during the periop period. past medical history: coronary artery disease s/p nstemi hypertension hypercholesterolemia diabetes mellitus dilated cardiomyopathy peripheral vascular disease s/p right fem- bypass left foot ulcer (healed) chronic renal insufficiency s/p left lung resection d/t tuberculosis s/p right breast tumor removal (benign) social history: -tobacco, +etoh (2 gin/d), -ivda lives with wife family history: non-contributory physical exam: see hpi pertinent results: 08:15pm glucose-72 urea n-32* creat-1.5* sodium-142 potassium-4.3 chloride-107 total co2-27 anion gap-12 08:15pm estgfr-using this 08:15pm calcium-8.8 phosphate-4.3 magnesium-2.3 08:15pm wbc-5.9 rbc-3.69* hgb-11.4* hct-34.3* mcv-93 mch-30.9 mchc-33.2 rdw-13.0 08:15pm plt count-244 03:55pm type- temp-37 po2-47* pco2-46* ph-7.43 total co2-32* base xs-4 comments-ra 03:55pm glucose-110* na+-140 k+-5.0 03:55pm hgb-12.7* calchct-38 brief hospital course: patient was admitted to the spine surgery service and taken to the operating room for the above procedure. refer to the dictated operative note for further details. the surgery was without complication and the patient was transferred to the pacu in a stable condition. teds/pnemoboots were used for postoperative dvt prophylaxis. intravenous antibiotics were continued for 24hrs postop per standard protocol. initial postop pain was controlled with a pca. diet was advanced as tolerated. the patient was transitioned to oral pain medication when tolerating po diet. foley was removed on pod#2. drain out pod2, then restarted . clinic was consulted and helped managed his sugars. sugars well controlled on insulin pump. . pod3 patient developed low grade temp. u/a was negative for infection. chest xray was normal. . was consulted for management of inslin pump. . physical therapy was consulted for mobilization oob to ambulate. hospital course was otherwise unremarkable. on the day of discharge the patient was afebrile with stable vital signs, comfortable on oral pain control and tolerating a regular diet. medications on admission: atenolol 50 mg tablet one tablet(s) by mouth once a day doxercalciferol 2.5 mcg capsule 1 capsule(s)every day fexofenadine ] 180 mg tablet 1 tablet(s) by mouth as needed furosemide 40 mg tablet 1 tablet(s) in morning and 1 tab in evening rosuvastatin 40 mg tablet 1 (one) tablet(s) once a day kayexalate powder 15 grams powder(s) by mouth once a day valsartan 80 mg tablet 1 (one) tablet(s) once a day ascorbic acid 500 mg capsule, sustained release 1 capsule(s) daily aspirin oral 81 mg every day last dose ferrous sulfate 325 mg (65 mg elemental iron) tablet 1 daily tablet 1 tablet(s) by mouth daily folic acid oral 400 mcg every day p.m crestor oral 40 mg every day p.m(dinner) metamucil oral 1 tsp every day as needed for constipation oxycodone oral 5 mg as needed as needed for pain glucagon subcutaneous 1 mg emergency dose as needed for hypoglycemia . apidra subcutaneous 100 unit/ml dose varies at meals and as needed for snacks or based on activity administer within 15 minutes before breakfast, lunch, and supper correction=bs level-120 divided by 30 then based on and bld glucose/a.m=14u bolus,noon=6-7u bolus,dinnertime =approx 12u) . indomethacin oral 50 mg 3 times per day as needed for gout flare alpha lipoic acid 300mg daily as needed for gout flare dinnertime discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): take while on narcotics to prevent constipation. disp:*60 capsule(s)* refills:*2* 2. senna 8.6 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)) as needed for constipation. disp:*30 tablet(s)* refills:*0* 3. bisacodyl 5 mg tablet, delayed release (e.c.) sig: tablet, delayed release (e.c.)s po daily (daily) as needed for constipation. disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 4. acetaminophen 325 mg tablet sig: 1-2 tablets po every hours as needed for fever, pain. 5. oxycodone 5 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain: no driving or alcohol. disp:*90 tablet(s)* refills:*0* 6. doxercalciferol 2.5 mcg capsule sig: one (1) capsule po daily (daily). capsule(s) 7. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 8. rosuvastatin 20 mg tablet sig: two (2) tablet po daily (daily). 9. valsartan 80 mg tablet sig: one (1) tablet po daily (daily). 10. ascorbic acid 500 mg tablet sig: one (1) tablet po daily (daily). 11. multivitamin tablet sig: one (1) tablet po daily (daily). 12. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 13. sodium polystyrene sulfonate 15 g/60 ml suspension sig: one (1) po daily (daily). 14. insulin pump ir1250 miscellaneous 15. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). discharge disposition: home with service facility: vna of -east & visiting nurse hospice discharge diagnosis: lumbar central stenosis, neurogenic claudication discharge condition: good discharge instructions: you have undergone the following operation: lumbar decompression without fusion immediately after the operation: ?????? activity: you should not lift anything greater than 10 lbs for 2 weeks. you will be more comfortable if you do not sit or stand more than ~45 minutes without moving around. ?????? rehabilitation/ physical therapy: &#9702; 2-3 times a day you should go for a walk for 15-30 minutes as part of your recovery. you can walk as much as you can tolerate. &#9702; limit any kind of lifting. ?????? diet: eat a normal healthy diet. you may have some constipation after surgery. you have been given medication to help with this issue. ?????? wound care: remove the dressing in 2 days. if the incision is draining cover it with a new sterile dressing. if it is dry then you can leave the incision open to the air. once the incision is completely dry (usually 2-3 days after the operation) you may take a shower. do not soak the incision in a bath or pool. if the incision starts draining at anytime after surgery, do not get the incision wet. cover it with a sterile dressing and call the office. ?????? you should resume taking your normal home medications. ?????? you have also been given additional medications to control your pain. please allow 72 hours for refill of narcotic prescriptions, so please plan ahead. you can either have them mailed to your home or pick them up at the clinic located on 2. we are not allowed to call in or fax narcotic prescriptions (oxycontin, oxycodone, percocet) to your pharmacy. in addition, we are only allowed to write for pain medications for 90 days from the date of surgery. ?????? follow up: &#9702; please call the office and make an appointment for 2 weeks after the day of your operation if this has not been done already. &#9702; at the 2-week visit we will check your incision, take baseline x-rays and answer any questions. we may at that time start physical therapy. &#9702; we will then see you at 6 weeks from the day of the operation and at that time release you to full activity. please call the office if you have a fever>101.5 degrees fahrenheit and/or drainage from your wound. physical therapy: no restrictions treatments frequency: dressing only if draining followup instructions: provider: xray (scc 2) phone: date/time: 1:20 provider: . phone: date/time: 1:40 provider: , md phone: date/time: 10:00 procedure: other exploration and decompression of spinal canal excision of intervertebral disc diagnoses: other primary cardiomyopathies pure hypercholesterolemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified personal history of malignant neoplasm of prostate coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status polyneuropathy in diabetes peripheral vascular disease, unspecified chronic kidney disease, stage iii (moderate) long-term (current) use of insulin old myocardial infarction osteoarthrosis, unspecified whether generalized or localized, site unspecified diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled displacement of lumbar intervertebral disc without myelopathy heart disease, unspecified personal history of tuberculosis spondylosis with myelopathy, lumbar region spinal stenosis, lumbar region, with neurogenic claudication disorder of eye, unspecified 

Answer: The patient is high likely exposed to