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 74 year old white female with known coronary artery disease, known abdominal aortic aneurysm, diabetes mellitus and hypertension, who was evaluated by dr. in for aortoiliac disease. the patient was told to return for surgery when her claudication became disabling. the patient did well until about one year ago when her leg and hip claudication became progressively worse. she now is able to walk only 25 feet before becoming symptomatic. she denies any rest pain or foot ulcerations. the patient now is admitted for elective surgery. allergies: no known drug allergies. past medical history: 1. coronary artery disease status post myocardial infarction, remote. 2. history of diabetes mellitus diagnosed two years ago. 3. abdominal aortic aneurysm 3.5 cm diagnosed in . 4. arthritis treated with dolobid and prevacid for prophylaxis. 5. hypertension. 6. hypercholesterolemia. past surgical history: 1. coronary artery bypass graft times four with right and left leg vein in . 2. uterine surgery with incidental appendectomy in . medications on admission: 1. glyburide 2.5 mg q. day. 2. imdur 60 mg q. a.m. 3. lopressor 75 mg twice a day. 4. enteric coated aspirin 325 mg q. day. 5. zestril 20 mg twice a day. 6. lipitor 20 mg q. day. 7. prevacid 15 mg q. day. 8. zoloft 50 mg q. day. 9. dolobid 250 mg twice a day. social history: 74 year old female, married; lives with her husband. she is a former smoker and has not smoked since ; previously two pack per day times 30 years. denies alcohol use. physical examination: vital signs 158/50; 78; 18; o2 saturation is 91 to 94% on room air. alert, cooperative white female in no acute distress. heent examination was unremarkable. her carotids were palpable without bruits. she had palpable radial pulses bilaterally. the abdominal aorta is not prominent. right femoral pulse is palpable but diminished. the left femoral pulse is nonpalpable. the popliteals are non palpable and the pedal pulses bilaterally are doppler-able signals, monophasic. the chest is clear to auscultation. the heart is a regular rate and rhythm without murmur. abdominal examination is obese with bowel sounds present. bone and joint examination shows left brachial area. there is no bleeding, hematoma or ecchymosis. the left hand was pink and warm with palpable radial pulses. the feet are equally warm. there are no lesions. neurologic examination is unremarkable. hospital course: the patient was admitted to the preoperative holding area on . she underwent aorta-bifemoral with end-to-end proximal repair and a right limb to the common femoral, left limb to the profunda femoris with a trans-aortic renal artery endarterectomy. she received one unit of packed cells intraoperatively with 400 cc of cellsaver. she tolerated the procedure well and was transferred to the pacu in stable condition. she was extubated in the pacu. the patient required neo-synephrine intraoperatively and was converted to dopamine in the recovery room to maintain systolic blood pressure. cvp was 16; pa was 27/16; wedge is 11. postoperative hematocrit was 31.8; bun 14, creatinine 0.7. wounds were clean, dry and intact. abdomen was soft and nontender. the extremity examination showed monophasic dorsalis pedis and posterior tibial on the right and biphasic dorsalis pedis and posterior tibial signals on the left. the patient continued to do well and was transferred to the vascular intensive care unit for continued monitoring and care. it was noted on postoperative day one that the patient had normal sensations but could not move her lower extremities. etiology was uncertain. neurosurgery was consulted. they felt that the patient had an anterior cord infarction with possible colonic ischemia. general surgery was consulted and a colonoscopy was performed to 30 cm. the rectum had normal mucosa in the distal 10 to 12 cm and there were circumferential mucosal changes with some mucosal hemorrhage. there were no significant ulcerations and no friability. the proximal end was not visualized secondary to stool. they felt there was no need for surgery, continue her antibiotics and they felt that if the acidosis did not correct, then they would consider open exploration. the patient continued to have persistent acidosis and respiratory distress. the patient was re-intubated on . her swan-ganz was changed. after this, the patient was transferred to the surgical intensive care unit for continued monitoring and care. the patient did require transfusion with two units of packed red blood cells on , for a hematocrit of 24.8. her pulse examination remained unchanged. she remained intubated and sedated. the patient underwent exploratory laparotomy on , for continued acidosis and ischemic colitis. the bowel was normal; the gallbladder, liver, sigmoid were normal; there was no bleeding and she had a strong pulse in the sma and the colic vessels. tpn was begun on . the patient developed thrombocytopenia; intravenous heparin was discontinued. there were changes in her motor and sensory examination of her upper extremities. an mri of the head and cervical spine were suggested by neurology. mri demonstrated multi-level spondylosis with hypertrophy of the posterior elements and narrowing of the spinal canal, most significantly on the right at c5-6 where there is flattening of the spinal cord, also flattening of the spinal cord at c4-5 and c7 and t1. ct scan of the head showed subacute lunar infarction in the posterior right centrum ovale. ultrasounds of the carotids were obtained and there was no significant hemodynamic disease. the patient was extubated on ; the final drain was removed at the same time. the patient's neurological findings: lower extremities were still without motor function. the left upper extremity was without motor function. the right upper extremity was with sensation and motor function. neurology signed off at this time. an arterial line was replaced on and the cvp line was replaced on . tube feeds were begun. tpn was continued. cardiology was consulted to help determine if there was a cardiac source for the right frontal infarction. cardiology felt that the source of the embolic stroke was not secondary to cardiac origin but most likely related to hypertension and recommended improvement on blood pressure control. a transesophageal echocardiogram demonstrated posterior lateral ventricular wall aneurysm which was consistent with old myocardial infarction; there was no clot. sputum cultures on , grew serratia which was pan sensitive. the patient was continued on current antibiotic regimen of levofloxacin. the patient was noted to have some improvement of left upper extremity motor function on . right internal jugular was changed on secondary to temperature spike. tip was sent for culture. the arterial line was replaced at the same time. the patient was pan-cultured. sputum grew as indicated previously. blood cultures were no growth. urine culture was no growth and cvl line was no growth. over the next 48 hours, there was significant improvement in the patient's left upper extremity motor movement. the lower extremities remained paralyzed. postoperative day 12 and 10, on , the patient developed diarrhea. stool for clostridium difficile was sent which was negative. pleurocentesis was done on , secondary to difficulty weaning the patient off a ventilator after being re-intubated because of respiratory distress. this was done under ultrasound guidance. greater than 200 cc of straw-colored fluid were obtained. these were sent for cultures and these were all negative. physical therapy was requested to evaluate the patient and began strengthening exercises. the patient was extubated on for the second time. she finished her course of levofloxacin and flagyl for her pneumonia. speech and swallow was requested to see the patient on , and evaluate her ability to swallow. the patient tolerated pureed and thick liquids better than just plain sips and recommendations were that she could continued on thickened liquids only, with aspiration precautions. the patient was transferred to the vicu on . abdominal staples were removed on . the cvl was discontinued and a peripheral line was placed. she was continued on aspiration precautions. she continued to be followed by physical therapy. she had episodes of blood bowel movements on , requiring a unit of packed red blood cells. she underwent a colonoscopy on to the cecum. there is resolving ischemia in the sigmoid. there is hyperemic granulation tissue and pseudo-polyps. there is a loss of vascular markings. one area in the mid-sigmoid where ischemia was, expected maximal at risk for recurrence. since ischemia was improving, they felt that a follow-up scope should be done in six weeks' time. the patient was transferred the regular nursing floor on . she was re-evaluated by speech and swallow on . they felt that she could tolerate a soft diet and standard liquids, and continue standard aspiration precautions. the patient had some melanotic stools on and . the hematocrit remained stable at 30.0. the patient was begun up and out of chair on . physical therapy was continued. case management was requested to see the patient regarding rehabilitation discharge planning. the patient will be discharged when rehabilitation bed available. condition at discharge: stable. discharge medications: 1. miconazole powder 2% applications to affected areas twice a day. 2. calcium carbonate 500 mg four times a day p.r.n. 3. propranozole 40 mg q. 24 hours p.o. 4. omeprazole 5 mg q. six hours; hold for systolic blood pressure less than 90; heart rate less than 60 p.r.n. 5. glyburide 5 mg q. day. 6. isordil 20 mg three times a day. 7. ranitidine 150 mg twice a day. 8. heparin 5000 units q. eight hours. 9. acetaminophen 325 to 650 mg q. six hours p.r.n. 10. sertraline 50 mg at h.s. 11. atorvastatin 20 mg q. day. discharge diagnoses: 1. bilateral hip and calf claudication status post aorta-bifemoral bypass graft. 2. spinal cord infarction. 3. right frontal infarction. 4. respiratory failure secondary to pneumonia, treated. 5. spinal cord compression secondary to spondylolisthesis of the cervical spine. 6. blood loss anemia, corrected. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube aorta-iliac-femoral bypass thoracentesis exploratory laparotomy arterial catheterization endarterectomy, abdominal arteries venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube aorta-iliac-femoral bypass thoracentesis exploratory laparotomy arterial catheterization endarterectomy, abdominal arteries diagnoses: pneumonia, organism unspecified acidosis thrombocytopenia, unspecified acute posthemorrhagic anemia atherosclerosis of native arteries of the extremities with intermittent claudication atherosclerosis of aorta accidental puncture or laceration during a procedure, not elsewhere classified acute respiratory failure iatrogenic cerebrovascular infarction or hemorrhage 

Answer: The patient is high likely exposed to