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: adhesive / pravastatin attending: chief complaint: cold left foot major surgical or invasive procedure: left groin exploration history of present illness: hpi: 69f with a longstanding history of pvd who in underwent left fem to above knee popliteal bypass and has subsequently had multiple vascular interventions. she was recently diagnosed with stenosis of the left cfa with blunted graft velocities. endarterectomy with graft revision with dr. was planned after resolution of her groin infections. she returns today with approximately ten days of worsening lle pain. she states that she still has motor function but does not have sensation in the foot. she denies fevers or chills at this time. ros: (+) per hpi (-) syncope, aaa, venous stasis changes, headache, numbness, tingling, fevers, chills, fatigue, malaise, significant weight loss, weight gain, changes in hearing or vision, chest pain, shortness of breath, doe, hemoptysis, cough, wheeze, palpitations, abdominal pain, nausea, vomiting, diarrhea, constipation, denies dysuria, rash, pruritis, joint pain, heat intolerance, cold intolerance, easy bruising, bleeding, mood changes vascular risk factors: diabetes, hypercholesterol, hypertension, obesity, smoking history, genetics. past medical history: htn / cva x2 () / dm / depression / pvd / eczema / l fem- ()/ l cea / bilateral carotid stents / l tkr / choly / left lower extremity angiography w/ iliac stent placement / left common femoral artery angioplasty () social history: smoker. family history: unknown physical exam: t98.6 hr80 bp106/56 rr16 sat98% on 2l nc gen: aox3 intermittently but does have audiovisual hallucinations cv: rrr s1s2 resp: decreased breath sounds throughout, no focal abnormalities, no w/r/r abd: soft, non-tender, non-distended extremities: lle with extensive dry gangrene on the foot beginning to extend up close to the lower leg and spreading in the foot. rle with patchy areas of necrosis but no overt gangrene. she has no detectable pulses or signals below her left femoral artery. pulses: fem dp pt r p p d d l d - - - pertinent results: cta abd:ct of the pelvis and extremities with iv contrast: the bladder is mildly distended. the uterus is normal. no adnexal masses are detected. there is no intrapelvic free fluid or lymphadenopathy. included views of the intrapelvic small and large bowel are normal. there are no bony lesions concerning for malignancy or infection. no acute fracture is detected. the patient is post bilateral total knee arthroplasties, with no evidence of hardware loosening or failure. moderate soft tissue edema extends throughout the subcutaneous tissues of both lower extremities. no focal fluid collections are identified. ct angiogram: severe atherosclerotic calcifications are again seen throughout the abdominal aorta and iliac branches. left vessels: compared to the examination, there is now new occlusion of the left common iliac artery (3a:30) and left external iliac artery. severe atherosclerotic calcifications of the left cfa limits evaluation for patency, but no internal flow is seen. a femoropopliteal (above-knee) bypass is again seen, with unchanged moderate narrowing at the common femoral takeoff (3a:91), but demonstrating wide patency otherwise. branches of the femoral profunda are patent. the native superficial femoral artery is heavily calcified and no internal flow is detected. extensive calcifications are seen throughout the popliteal artery, with the lower segment not visualized due to extensive streak artifacts from the left knee prosthesis. three-vessel runoff is demonstrated (3a:293), however, there is marked attenuation of the left anterior tibial artery in comparison to the prior ct examination (3a:345), and diminutive flow is seen at the dorsalis pedis. in comparison to the examination, there appears to be overall diminished flow of the peroneal and posterior tibial arteries, however, patency remains preserved. right vessels: severe atherosclerotic calcifications and stenosis of the right iliac artery, particularly at the distal portion and external segment, appears minimally changed since . patency of the right profundus femoral is demonstrated. however, there is again complete occlusion of the right superficial femoral artery. evaluation for the right popliteal artery is impossible due to the degree of extensive calcifications and streak artifacts from the right knee prosthesis. a three-vessel runoff is demonstrated at the right calf, with irregular attenuation throughout the right posterior tibial artery, all unchanged since . impression: 1. occlusion of the left common iliac, external iliac, and common femoral artery is new since . 2. unchanged moderate stenosis at the takeoff of the left femoropopliteal bypass (above-knee). patent flow and caliber is demonstrated through the remainder of the course of the graft. 3. three-vessel runoff demonstrated at the left calf, however, there is overall decreased vascular flow, in particular the left anterior tibial artery, in comparison to the examination, likely from poor iliac and femoral inflow. 4. unchanged occlusion of the right superficial femoral artery. right three-vessel runoff is again seen, with mild irregular attenuation of the posterior tibial artery. echo echocardiography report , portable tte (complete) done at 3:36:05 pm final referring physician information , - , status: inpatient dob: age (years): 69 f hgt (in): bp (mm hg): 98/69 wgt (lb): 193 hr (bpm): 106 bsa (m2): indication: left ventricular function. low oxygen saturation. icd-9 codes: 424.1, 424.2 test information date/time: at 15:36 interpret md: , md test type: portable tte (complete) son: , rdcs doppler: full doppler and color doppler test location: west sicu/ctic/vicu contrast: none tech quality: adequate tape #: 2012w000-0:00 machine: e9-2 echocardiographic measurements results measurements normal range left atrium - long axis dimension: 3.1 cm <= 4.0 cm left atrium - four chamber length: *5.6 cm <= 5.2 cm left atrium - peak pulm vein s: 0.4 m/s left atrium - peak pulm vein d: 0.3 m/s left atrium - peak pulm vein a: 0.3 m/s < 0.4 m/s right atrium - four chamber length: 4.1 cm <= 5.0 cm left ventricle - septal wall thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - inferolateral thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - diastolic dimension: 3.9 cm <= 5.6 cm left ventricle - systolic dimension: 2.0 cm left ventricle - fractional shortening: 0.49 >= 0.29 left ventricle - ejection fraction: >= 60% >= 55% left ventricle - lateral peak e': *0.08 m/s > 0.08 m/s left ventricle - septal peak e': *0.06 m/s > 0.08 m/s left ventricle - ratio e/e': *21 < 15 aorta - sinus level: 3.0 cm <= 3.6 cm aorta - ascending: *3.6 cm <= 3.4 cm aortic valve - peak velocity: *2.2 m/sec <= 2.0 m/sec aortic valve - peak gradient: 18 mm hg < 20 mm hg aortic valve - mean gradient: 9 mm hg mitral valve - e wave: 1.5 m/sec mitral valve - e wave deceleration time: 146 ms 140-250 ms tr gradient (+ ra = pasp): *32 mm hg <= 25 mm hg findings left atrium: elongated la. no la mass/thrombus (best excluded by tee). right atrium/interatrial septum: normal ra size. left ventricle: mild symmetric lvh with normal cavity size and global systolic function (lvef>55%). suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. no resting lvot gradient. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. mildly dilated ascending aorta. aortic valve: mildly thickened aortic valve leaflets (3). mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. moderate mitral annular calcification. trivial mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. mild pa systolic hypertension. pericardium: there is an anterior space which most likely represents a fat pad, though a loculated anterior pericardial effusion cannot be excluded. general comments: the rhythm appears to be atrial fibrillation. conclusions the left atrium is mildly elongated. no left atrial mass/thrombus seen (best excluded by transesophageal echocardiography). there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened. there is mild aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is trivial mitral regurgitation. there is mild pulmonary artery systolic hypertension. there is an anterior space which most likely represents a prominent fat pad. impression: suboptimal image quality. mild symmetric left ventricular hypertrophy with preserved global biventricular systolic function. mild aortic valve stenosis. pulmonary artery hypertension. clinical implications: based on aha endocarditis prophylaxis recommendations, the echo findings indicate prophylaxis is not recommended. clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. cxr portable ap chest x-ray indication: evaluation for infiltrate or effusion. the patient with intubation. comparison: at 9:16 a.m. findings: moderate pulmonary edema is slightly improved. the endotracheal tube ends 4.8 cm above the carina. right-sided jugular line ends in the mid svc. the ng tube is in adequate position. the mediastinal contour is normal. cardiac contour is slightly enlarged and unchanged. conclusion: there is a slight improvement of moderate pulmonary edema. the study and the report were reviewed by the staff radiologist. brief hospital course: the pt was admitted through the emergency room after 10 days of worsening lle pain. her foot was cool to touch with pallor distal to ankle, delayed cap refill, diminished sensation throughout but she had preserved motor function. she was placed on a heparin gtt and brought to the endovascular hybrid room for left groin cut down and possible intervention. a meeting was had with her husband in the midst of the case and he asked that we try to do what we could. her vessels were heavily calcified and intervening was thought to be unsafe and so the case was aborted. the wound was closed loosely as to not compress the graft and a vac dressing was placed. she was extubated immediately. she was later transferred to the floor with the heparin drip continued. while on the floor a palliative care consult was obtained. on the 15th she went into afib with rvr to the 150's. shw was given 20 of iv lasix as well as transfused 2 units prbc's for a hct of 22.8. ultimately she received an additional 3 units of packed cells. we offered the pt amputation as an option for her dry gangrene, she refused. she refused most care and intervention and a psych consult was obtained for competancy. a meeting was held with the pt and her husband and it was determined that she was able to make appropriate decisions for her own care. discharge planning to hospice was initiated and she was discharged to hospice once a bed was available. medications on admission: accupril 40', asa 325, foltx 1-2.5-25, lasix 20', metformin 500'', metoprolol 100', norvasc 10', oxybutynin 5'''', plavix 75', pravachol 80', salsalate 1500'', zoloft 25' discharge medications: 1. sertraline 25 mg po daily 2. olanzapine (disintegrating tablet) 5 mg po bid:prn agitation 3. gabapentin 600 mg po tid 4. albuterol 0.083% neb soln 1 neb ih q6h:prn sob 5. baclofen 2.5 mg po bid 6. fentanyl patch 12 mcg/hr tp q72h rx *fentanyl 12 mcg/hour one patch q72hrs disp #*10 transdermal patch refills:*0 7. acetaminophen (liquid) 650 mg po q6h:prn fever 8. baclofen 5 mg po qhs 9. miconazole powder 2% 1 appl tp qid:prn to groin 10. olanzapine (disintegrating tablet) 5 mg po qhs agitation 11. oxycodone liquid 2.5-5 mg po q2h:prn pain rx *oxycodone 20 mg/ml 2.5-5 mg by mouth q2hrs disp #*1 bottle refills:*0 discharge disposition: extended care facility: livingcenter - discharge diagnosis: left lower extremity ischemia / dry gangrene discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: bedbound. discharge instructions: you were seen at because you have problems with arterial blood supply to your left leg. because of the damage to the blood vessels you are unable to have any bypass or stenting to improve the blood flow. it was recommended that you have both the left leg as well as the right leg amputated below the knees. you did not wish to have this procedure. you were advised that the infection/gangrene in your foot will likely spread and that it is very likely that you will die. you are being discharged to hospice care please use caution with fentanyl patch in the setting of fever please do not hesitate to contact the hospital if you change your mind or with any other questions. followup instructions: none. call the hospital or surgery department at if you have any further questions. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours enteral infusion of concentrated nutritional substances closed [endoscopic] biopsy of bronchus suture of vein other incision of skin and subcutaneous tissue diagnoses: pneumonia, organism unspecified anemia, unspecified esophageal reflux tobacco use disorder unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation aortic valve disorders occlusion and stenosis of carotid artery without mention of cerebral infarction alkalosis late effects of cerebrovascular disease, hemiplegia affecting unspecified side encounter for palliative care obesity, unspecified atherosclerosis of native arteries of the extremities with gangrene surgical or other procedure not carried out because of contraindication knee joint replacement embolism and thrombosis of iliac artery cellulitis and abscess of foot, except toes chronic total occlusion of artery of the extremities atherosclerosis of autologous vein bypass graft of the extremities acute respiratory failure following trauma and surgery wheelchair dependence transfusion associated circulatory overload 

Answer: The patient is high likely exposed to