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: lipitor attending: chief complaint: alteration in mental status major surgical or invasive procedure: central venous line history of present illness: 85 yo f with h/o dm2, htn, pvd, av block s/p ppm and cm w/ icd in place who was found with ams at home. the patient was initially admitted after being found in her home, where she lives with her schizosphrenic son. is her hcp, and is a at . she reports that the patient has been declining over past few months, and has refused nursing home. on admission, patient was found to have uti (>100k micrococci) and was started on ampicillin. she was also noted to have left ankle venous ulcer, which has been seen by podiatry and vascular surgery. she was given 1 dose of vanco and zosyn but concern for infection of ulcer was low so these were stopped. she had an episode of hypotension to sbp 70's despite aggressive ivf, also with tenous iv access, and was transferred to micu. upon arrival to micu, ij was placed and blood pressure improved without any futher intervention. a foley catheter was placed to assess urine output, which has been adequate. the patient had low grade fevers initially, now afebrile. she complains only of back pain which is chronic, although communication is difficult due to severe loss of hearing. past medical history: 1. pvd s/p bypass 2. dm2 with complications neuropathy 3. htn 4. cardiomyopathy - systolic chf with ef 35-40% 5. chronic le edema 6. hyperlipidemia 7. osteoporosis 8. gerd 9. s/p appy 10. b12 deficiency 11. vertebral disc surgery - hardware in lumbar spine & chronic lbp 12. pacemaker - in for intermittent av block and bradycardia social history: she lives with her son, who has mental illness. denies any tobacco, alcohol or ivdu. her , is a nurse here at and is her hcp. she has a visiting nurse once weekly. family history: there is no family history of premature coronary artery disease or sudden death physical exam: vs: t97.4, hr 76, bp 113/66 (110-128/66-75), rr 24, o2sat 100%/ra gen: arousable, nad heent: mmm, jvp 6cm, no lad cv: difficult to auscultate, ? irregular vs. physiologic variation, no m/r/g pulm: ctab anteriorly ab: soft, nt/nd, pos bs, no hsm gu: foley in place extrem: venous stasis changes, shallow ulcer on left shin, ulcer on left ankle wrapped. neuro: moves all extremities, follows commands, possible decreased strength in l vs r ue pertinent results: . 11.8 7.3 >---< 235 35.9 neuts-54.2 lymphs-35.7 monos-6.7 eos-3.0 basos-0.4 139 | 105 | 23 / 194 4.2 | 19 | 1.2 \ . lactate-3.0* albumin-3.7 calcium-9.7 phosphate-2.0* magnesium-1.7 . coags: pt-12.7 ptt-20.4* inr(pt)-1.1 . ce: ctropnt-0.03* . lfts: alt(sgpt)-17 ast(sgot)-23 ld(ldh)-283* ck(cpk)-87 alk phos-73 tot bili-0.7 brief hospital course: 85f with dm, pvd, chf and deafness, admitted for altered mental status, found to have uti. . #. ams/uti: the patient was initially agitated and complaining of back pain, which is apparently chronic for her. she was given levaquin given her history of legionella pneumonia. her cxr was unremarkable. her head ct did not show any new lesions. ua normal but urine culture grew micrococcus/stomatococcus >100,000. this was considered a uti and patient was treated with ampicillin for 7 days. blood cx all neg. repeat urine culture was negative. wbc was normal and patient remained afebrile. . the patient's mental status began to return to her baseline. she demonstrated a significant level of underlying dementia, but also brief episodes of delirium. during these, the patient would look around the room, respond to paranoid delusions, and refuse treatment. it was thought that the patient's underlying dementia, deficiency in sensory input (severe hearing loss), resolving infection, and hospital environment all contributed to delirium. tsh was wnl. rpr was negative. b12 was normal. vitamin d levels were pending at discharge, and the patient was treated empirically with vitamin d and thiamine supplements. she was treated with standing zyprexa zydis in morning and bedtime. the patient's lasix was d/ced since she was felt to be dry, complaining of thirst and increased bun. her lasix could be restarted as outpatient if necessary. appears euvolemic on discharge. at discharge, patient was agreeing to treatment, calm, cooperative, with no complaints. she benefitted from amplification headphones and may benefit from hearing aids if she agrees. . #. hypotension: on the medicine floor, the patient had an episode of hypotension with sbp 70's. the patient was given several ivf boluses, and when hypotension did not resolve, micu was called to place central line and arrange transfer. left ij was placed and fluid resusitation continued during transfer. the patient was started on vanco/zosyn. when the patient arrived in the micu, hypotension had resolved without any further intervention. blood pressure remained stable for remainder of course. vanco/zosyn were d/ced, and patient returned to medicine floor. she remained hemodynamically stable and afebrile for remainder of course. . # decubitus left heel ulcer the patient was noted to have a left heel ulcer, unable to be staged without debridement. both vascular surgery and podiatry were consulted. both recommended holding off debridement or more extensive treatment until patient's infection resolved and placement situation stabilized. the patient is known to have severe pvd, likely not a candidate for revascularization. dressing changes with collagenase ointment and multipodus boots should be continued, feet should be elevated. the patient should follow-up with podiatry and vascular surgery. . # dm the patient's home oral anti-hyperglycemics were held. the patient was controlled on hiss, and standing lantus and humalog with meals was added for improved glycemic control. . # htn the patient's home antihypertensives were held with hypotensive episode. home dose of lisinopril and half home dose of metoprolol was eventually restarted without issues. the patient was on lasix at home, but in setting of hypotensive episode, this was held. a small dose (5 mg ) was tried, but patient seemed dry and bun increased. we will hold off lasix for now since patient euvolemic. . # chronic systolic chf. the patient had a tte which showed worsening ef from 35-40% in to 20-25%. the patient was continued on lisinopril and metoprolol. home lasix was held. the patient did not demonstrate signs of volume overload on physical exam. the patient was restarted on asa 81 mg. ezetimibe was d/ced since of little benefit to patient at this stage. . # hypothyroidism. tsh normal. continued home dose levothyroxine. . # depression continued duloxetine . #. psychosocial: the patient had been cared for by her son, who suffers from mental illness. it was unclear if she was reliably receiving her medications or food. social work and elder care were involved in her course. her is her hcp. the patient's son should not be responsible for care decisions. . the patient was discharged to rehab facility (roscommons) medications on admission: duloxetine 20mg ezetimibe 10mg daily furosemide 40mg daily glipizide 2.5mg daily hydrocodone-acetaminophen 5/500 qid prn levabunolol 0.25% eye gtt ou levothyroxine 75mg daily lisinopril 2.5mg daily metoprolol succinate 25mg daily acetaminophen 325mg daily aspirin 325mg daily cyanocobalamin 1000mcg daily docusate 100mg ergocalciferol 400 units daily ferrous sulfate 325mg daily senokot 2 tabs daily discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 4. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). 5. metoprolol tartrate 25 mg tablet sig: 0.25 tablet po bid (2 times a day). 6. collagenase 250 unit/g ointment sig: one (1) appl topical daily (daily). 7. olanzapine 5 mg tablet, rapid dissolve sig: 0.25 tablet, rapid dissolve po daily (daily). 8. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 9. nystatin 100,000 unit/g cream sig: one (1) appl topical (2 times a day). 10. duloxetine 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 11. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 12. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 13. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours). 14. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 15. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po qhs (once a day (at bedtime)). 16. insulin glargine 100 unit/ml solution sig: ten (10) units subcutaneous at bedtime. 17. insulin lispro 100 unit/ml solution sig: four (4) subcutaneous with breakfast. 18. insulin lispro 100 unit/ml solution sig: six (6) subcutaneous with lunch. 19. insulin lispro 100 unit/ml solution sig: six (6) subcutaneous with dinner. 20. insulin lispro 100 unit/ml solution sig: per sliding scale subcutaneous qachs. discharge disposition: extended care facility: roscommon discharge diagnosis: primary diagnosis: uti . secondary diagnosis: dm2 chronic systolic chf pvd with left heel ulcer discharge condition: stable, afebrile discharge instructions: you were admitted for confusion and found to have a urinary tract infection. you were treated with antibiotics. . you had an episode of low blood pressure, which was treated with fluids. . the following changes were made to your home medications: --> you will stop taking lasix until restarted by physician. please adhere to a low-sodium diet. check daily weights. . you should seek medical attention if you experience fevers, chills, cough, shortness of breath, chest pain or any other new symptoms. followup instructions: md: dr. specialty: podiatry date and time: , at 2:30pm location: , bldg phone number: ( . . md: dr. specialty: vascular surgery date and time: wednesday, at 9:00am location: , bldg phone number: ( procedure: venous catheterization, not elsewhere classified nonexcisional debridement of wound, infection or burn diagnoses: other primary cardiomyopathies urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension unspecified acquired hypothyroidism depressive disorder, not elsewhere classified other persistent mental disorders due to conditions classified elsewhere hypotension, unspecified osteoporosis, unspecified unspecified hearing loss chronic systolic heart failure other constipation automatic implantable cardiac defibrillator in situ pressure ulcer, heel hypovolemia delirium due to conditions classified elsewhere atherosclerosis of native arteries of the extremities with ulceration diabetes with neurological manifestations, type ii or unspecified type, uncontrolled chronic total occlusion of artery of the extremities edema pressure ulcer, unstageable 

Answer: The patient is high likely exposed to