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: heparin agents attending: chief complaint: dyspnea major surgical or invasive procedure: right ak /pedal bypass with gsv r heel ulcer debridement (podiatry) w/ primary closure temporary hd line placement tunnelled hd line placement; peritoneal dialysis line placement history of present illness: mr. is a 57 year old man with a history of chronic renal insufficiency (baseline cr ), cardiomyopathy and type ii diabetes who presents to the ed complaining of shortness of breath. . over the past year, he has been diagnosed with coronary artery disease after being found to have had a silent ami, which likely happened in early during a trip in . he has had fractionated care between , , and . the ami was found during a routine echocardiogram in , along with an apicla thrombus. most recently, he was hospitalized in for a right heel ulcer. he was discharged without antibiotics and has travelled back to the us for an appointment at the clinic. while he usually has a strict diet, during the prolonged plan trip, he was unable to adhere to his diet. early in the trip he felt okay, but after about 7 hours, he began feeling short of breath with exertion. he got off the plan at 3pm yesterday and had difficulty ambulating. he went home, and he believes that his dyspnea would improves when he is lying flat. overnight, he presented to and was found to be hypoxic. in the ed he was bolused with lasix 40mg iv and nitro, and was placed on cpap. ekg showed lateral st depressions. cardiac enzymes were mildly elevated. his potassium was elevated so calcium and insulin we administered. past medical history: hypertension diabetes, type ii complicated by nephropathy and retinopathy. a1c 6.6 in hypercholesterolemia, ldl 160 ami w/ lv thrombus () with ef 41% fatty liver cholecystitis peripheral vascular disease wet gangrene r heel w/ reported mrsa, got 10d course of pip-taz/clinda social history: retired pharmacist. he does not and has never smoked, and does not drink alcohol family history: n/c physical exam: vs: t hr 105 bp 123/87 rr 24 sat 94% gen: pleasant asian man in bed on cpap via facemask heent: op clear, mmm, perrl neck: jvp to earlobes when sitting up at 60 degrees. cv: normal s1/s2, rrr, no m/r/g pul: crackles throughout both lung fields abd: soft, nt, nd +bs ext: 2x2cm by about 1cm deep ulcer in r heel, dry appearing. neuro: a&ox3 pertinent results: cardiology reports echo lv concentric hypertrophy ak of distal septum, apex, anteroapical segment lv apical thrombus ef 40-45% trace tr and ar, normal pasp no effusion . ekg on arrival to ccu: loss of anterior r waves, lateral st depressions/twi likely due to lvh. ~~~~~~~~~~~~~~~~~~~~~~~~ follow-up stress & echo . cardiology report stress study date of interpretation: this 57 year old type 2 niddm man with a history of chf was referred to the lab for evaluation. the patient was infused with 0.142 mg/kg/min of dipyridamole over 4 minutes. no arm, neck, back or chest discomfort was reported by the patient throughout the study. there were no significant st segment changes. the rhythm was sinus with no ectopy. appropriate hemodynamic response to the infusion. the dipyridamole was reversed with 125 mg of aminophylline iv. impression: no anginal type symptoms or ischemic ekg changes. nuclear report sent separately. cardiology report echo study date of conclusions: the left atrium is mildly dilated. moderate to severe spontaneous echo contrast is seen in the body of the left atrium. moderate to severe spontaneous echo contrast is present in the left atrial appendage. the left atrial appendage emptying velocity is depressed (<0.2m/s). a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen at rest. left ventricular wall thicknesses and cavity size are normal. there is severe regional left ventricular systolic dysfunction with akinetic apex. overall left ventricular systolic function is mildly depressed. transmitral doppler and tissue velocity imaging are consistent with grade iii/iv (severe) lv diastolic dysfunction. the remaining left ventricular segments are hypokinetic. right ventricular chamber size and free wall motion are normal. there are simple atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ laboratory admission laboratory 02:20am blood wbc-15.3* rbc-3.37* hgb-10.5* hct-30.8* mcv-91 mch-31.1 mchc-34.1 rdw-15.3 plt ct-250 02:20am blood neuts-82.5* lymphs-13.2* monos-3.9 eos-0.3 baso-0.2 02:20am blood pt-30.5* ptt-35.4* inr(pt)-3.2* 02:20am blood glucose-242* urean-87* creat-4.9* na-135 k-5.8* cl-104 hco3-15* angap-22* 02:20am blood alt-96* ast-100* ld(ldh)-514* ck(cpk)-470* alkphos-88 totbili-0.3 02:20am blood ck-mb-17* mb indx-3.6 probnp-* 07:05am blood %hba1c-6.9* -done -done 02:20am blood triglyc-99 hdl-48 chol/hd-2.9 ldlcalc-73 ~~~~~~~~~~~~~~~~~~~~~ discharge laboratory 05:40am blood wbc-8.8 rbc-2.78* hgb-8.5* hct-25.4* mcv-92 mch-30.6 mchc-33.4 rdw-16.5* plt ct-197 05:35am blood pt-18.0* ptt-30.4 inr(pt)-1.7* 05:35am blood glucose-132* urean-42* creat-3.7*# na-136 k-4.2 cl-98 hco3-30 angap-12 05:35am blood calcium-7.9* phos-2.9# mg-1.7 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ please see individual reports for results of radiology studies brief hospital course: mr. is a 57 year old man with a history of type ii diabetes, diabetic nephropathy, coronary artery disease, s/p anterior mi with apical thrombus, preserved ef, presenting with shortness of breath. bnp elevated to >25,000. . 1) cardiac: a) pump: presented with florid chf requiring 100% nrb. he had h/o anterior mi with apical thrombus, apical akinesis, lvh. repeat eccho showed ef 35-40% no apical thrombus + apical akinesis. he was started on a nitro drip and diuresed aggressively 1.5-2l/d with lasix (and put out well to 100mg bolus). this was bridged to imdur + lasix with the addition of metoprolol to improve his filling time. . b) ischemia: mr presented with lat std and nstemi; his ck peaked at 470. it was thought that he likely had demand ischaemia from hypoxia/chf. his metoprolol was titrated up to 100mg po tid, he was kept on aspirin, and his anticoagulation was continued (for lv thrombus). he was kept on high-dose statin. . c) rhthym: nsr throughout stay. mr was tachycardic in the 90-100 range, he was begun on metoprolol which was quickly increased to 100mg metoprolol tid. . 2) diabetes, type ii: likely diagnosed late given his nephropathy and retinopathy would be incosistent with the short duration of his diagnosis and his relatively good (6.9). his glyburide was d/c'd b/c of renal insufficiency and he was started on an insulin regimen. . 3) r foot ulcer: pt with post-tibial disease; s/p debridement with non-healing. dr. (vascular surgeon) was consulted and performed an above-knee popliteal to dorsalis pedis artery bypass with reverse saphenous vein and angioscopy on . he also underwent a right heel debridement with primary closure on by dr. of podiatry. he tolearated both of these procedures well. please see operative notes for procedural details. he recovered well with evidence of improved distal blood flow. his graft remained palpable and distal pulses dopplerable throughout his hospital course. his heel wound progressed well with primary closure. levofloxacin was continued for a 2 week course and discontinued on the day of discharge to rehab for gnr (non-fermenter non-pseudomonas) from his wound. he remained non-weight bearing on the right due to his heel wound. this will remain his status until clearance from podiatry. sutures and staples remain from the operations and will be taken out at follow-up visits. . 4) acute on chronic renal failure: with hyperkalemia on presentation. this continued without evidence of resolution. nephrology recommended intiation of dialysis. the patient initially refused to begin dialysis despite recommendations, however he eventually decided on this course. a temporary hd line was placed and hd was initiated on a daily basis for 3 days. the line was exchanged in the or for a tunnelled line and he also received a peritoneal dialysis catheter. he will be converted to a tiw dialysis schedule at rehab and pd will be taught and initiated at rehab as well. . 5) anemia: likely due to chronic kidney disease. stable. it is the recommendation of vascular surgery to maintain a hct of approximately 30. . 6) hit+: heparin antibody positive on . patient anticoagulated for this with argatroban converted to coumadin. goal inr>2.0. he should follow-up with his pcp or hematologist for duration of therapy guidelines. . 7) elevated lft's on admission, resolved on discharge. history of steatohepatitis by report. - ruq showed tumorfactive sludge w/o gb wall thickening; no liver dz. pt should have repeat us in months per medical team. - hepatitis serologies w/ +havab only. negative hepb & hepc studies. . 8) f/e/n: fluid restricted renal diet, diabetic, cardiac diet. . 9) access: peripheral iv, tunnelled hd line rij . 10) ppx: heparin sq, no need for ppi for now. . contact: his sister/pcp, . , at medications on admission: simvastatin 40mg daily norvasc 10mg daily dologesic 1 tab qid:prn metoprolol 25mg (also has been on metoprolol 100mg ) lasix 40mg daily glyburide 5mg discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 3. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 4. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 6. warfarin 2 mg tablet sig: one (1) tablet po hs (at bedtime): please adjust dosing per inr. 7. furosemide 40 mg tablet sig: 1.5 tablets po bid (2 times a day). 8. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 9. iodine 10 % solution sig: one (1) appl topical asdir (as directed): to right plantar foot wound dressings. 10. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). 11. metoprolol tartrate 50 mg tablet sig: two (2) tablet po bid (2 times a day). 12. glipizide 5 mg tablet sig: one (1) tablet po daily (daily). 13. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 14. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). discharge disposition: extended care facility: discharge diagnosis: peripheral vascular disease acute renal failure myocardial infarction heparin antibody positive discharge condition: good discharge instructions: please see d/c summary. please transfuse 1unit prbc with hd saturday for hct=25. goal hct=30 given cad. followup instructions: please f/u with dr. 1 week for evaluation of heel. ( please f/u with dr. in 1week. call for appointment. ( follow-up with your cardiologist, nephrologist, and your pcp. procedure: hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis other (peripheral) vascular shunt or bypass non-invasive mechanical ventilation transfusion of packed cells transfusion of other serum local excision of lesion or tissue of bone, tarsals and metatarsals creation of cutaneoperitoneal fistula diagnoses: other primary cardiomyopathies hyperpotassemia anemia in chronic kidney disease end stage renal disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere subendocardial infarction, initial episode of care congestive heart failure, unspecified acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hypoxemia anticoagulants causing adverse effects in therapeutic use diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled atherosclerosis of native arteries of the extremities with ulceration cellulitis and abscess of foot, except toes ulcer of heel and midfoot unspecified osteomyelitis, ankle and foot 

Answer: The patient is high likely exposed to