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: past medical history: 1. chf. an echocardiogram in revealed an ef of 55%, 4+ tr, severe pulmonary hypertension. 2. copd. 3. obstructive sleep apnea. the patient refuses to use a bipap machine. 4. hypertension. 5. atrial flutter. 6. end-stage renal disease, on hemodialysis. 7. peripheral vascular disease. 8. multiple utis in the past. allergies: the patient is allergic to nuts which cause anaphylaxis. the patient also has an allergy to demerol. admission medications: 1. amiodarone 200 q.d. 2. hydroxychloroquine 200 b.i.d. 3. nephrocaps one tablet q.d. 4. prozac 20 q.d. 5. albuterol and atrovent p.r.n. 6. neurontin 300 q.o.d. 7. amphojel 30 cc t.i.d. social history: she lives alone at home with her husband. she apparently is not ambulatory and uses a wheelchair. she has a 70 pack tobacco history but not currently smoking. she uses alcohol rarely. she denied iv drug use. family history: mother and father both died of an mi, mother in her 60s, father in his 70s. her sister had breast cancer. physical examination on admission: vital signs: temperature 98.7, blood pressure 100/80, pulse 70, respiratory rate 18, saturating 95% on 2 liters. general: the patient was a comfortable obese female in no acute distress. moist mucous membranes. neck: no jvd. no lymphadenopathy. supple. lungs: poor air movement. no crackles. no wheezes. heart: very distant sounds, suggestion of systolic murmur at the base. abdomen: obese but soft. no real distention. normoactive bowel sounds, nontender. extremities: the right lower extremity revealed no edema, was nontender, and had no chronic venostasis changes, no palpable pulse. the left lower extremity has a large area of what appears to be a hematoma with associated erythema and tenderness. there was no discharge from the site. laboratory data on admission: white count 19.2, differential 88 polys, 0 bands, 5 lymphs, hematocrit 33, platelets 220,000. the initial ultrasound revealed no dvt and large hematoma. hospital course: 1. infectious disease: the patient initially was started on levofloxacin and clindamycin for what appeared to be significant cellulitis. a consultation with the surgical service was obtained and their feeling was that this was a large hematoma requiring debridement. the patient received several debridements in the room and was subsequently transferred to the or on day number three for extensive surgical debridement. their feeling was that this was most likely extravasation of blood that is probably not associated with a significant amount of infection. while being taken to the operating room, the patient apparently decompensated with hypotension requiring intubation and was transferred to the medical intensive care unit. she stayed about three days in the medical intensive care unit requiring occasional pressors for hypotension. her blood pressure eventually resolved and there is no evidence that she was septic. during her micu stay, she received some vancomycin. she hemodynamically significantly improved. her blood cultures were negative. she was transferred to the regular floor where surgery continued to debride the wound. a consultation with plastics was obtained and they felt that the patient required an eventual skin graft to this area. she is going to be discharged home on a vac dressing which she will need for the next four weeks. she will follow-up with outpatient plastics in about two weeks and may require a skin graft in about four weeks. even though we cannot exclude the possibility of cellulitis, she was continued on her p.o. levofloxacin and p.o. clindamycin. she also had arterial studies of her lower extremity in anticipation of future surgery. 2. renal: the patient continued on hemodialysis. she was also started on renagel 1,600 t.i.d. p.o. she was reluctant to take her amphojel most of the time. 3. cardiovascular: the patient remained relatively stable except from a hypotension standpoint. the hypotension originally resolved with 250 cc of normal saline boluses and there was no evidence at any point that the hypotension was due to sepsis. discharge condition: stable. discharge diagnosis: 1. left lower extremity hematoma requiring multiple surgical debridements with possible associated cellulitis. 2. chronic obstructive pulmonary disease. 3. congestive heart failure. 4. morbid obesity. discharge medications: 1. amiodarone 200 q.d. 2. hydroxychloroquine 200 b.i.d. 3. nephrocaps one tablet q.d. 4. prozac 20 q.d. 5. levofloxacin 250 q. 48 hours for the next five days. 6. renagel 1,600 t.i.d. 7. albuterol p.r.n. 8. atrovent p.r.n. 9. neurontin 300 p.o. q.o.d. 10. amphojel 30 cc t.i.d., although the patient is reluctant to take this medication. 11. clindamycin 450 p.o. q.i.d. for five days. the patient will have vna at home to assist with vac dressing changes for the next four weeks. , m.d. dictated by: medquist36 procedure: hemodialysis excisional debridement of wound, infection, or burn nonexcisional debridement of wound, infection or burn application of other wound dressing infusion of drotrecogin alfa (activated) diagnoses: anemia, unspecified unspecified septicemia cellulitis and abscess of leg, except foot morbid obesity striking against or struck accidentally by other stationary object without subsequent fall contusion of lower leg 

Answer: The patient is high likely exposed to