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: patient recorded as having no known allergies to drugs attending: chief complaint: bilateral gangrenous wounds of lower extremity major surgical or invasive procedure: left fem-post tib in-situ non-reversed saphenous veni graft history of present illness: 81y/o male s/p rt. athectomy of sfa and pfs with left eia stenting hospitalized for cellulitis anf gangrene of left heel and ulcer with ganganerous changes of rty. calf wound . under went diagnositic angiogram which demonstrated left sfa occlusion with 90% stenosis of mid pfa and single vessel via at with occlusion of at at ankle and foot perfused by colateral circulation. returns now for elective left fem-at bpg and perioperative antibiotics. patient was on levofloxcin without improvement of wound. ambulates around room with walker. abi rt. 0.68 abi left 0.57 past medical history: pvd w/ bilateral gangrenous wounds of lower extremity history of hypertension history of gout history of bph psh: s/p rt. sfa/paf ahtrectomy with lt. eia stent ,angio occluded left sfa single vessel runoff at which occludes at ankle, foot perfused by collaterals. s/p turp s/p hernia repairs s/p appendectomy s/p right lower extremity dvt in social history: social history resident since d/c a nursing home in , ma, retired, nonsmoker or drinker. daughter involved in her care: phone family history: n/c physical exam: gen: nad card: rrr lungs: ctab abd: good bowel sounds, soft, non-tender, non-distended extrem: well perfused pulses: fem dp pt left palp dop dop dop right palp palp palp dop pertinent results: 03:59am blood wbc-13.4* hgb-10.5* hct-28.9* plt ct-265 05:02pm blood hgb-11.8* hct-33.5* plt ct-344 03:59am blood plt ct-265 05:02pm blood plt ct-344 03:59am blood glucose-92 urean-37* creat-0.7 na-144 k-3.6 cl-116* hco3-23 angap-9 12:59am blood k-3.9 05:02pm blood glucose-122* urean-39* creat-0.7 na-143 k-3.2* cl-111* hco3-24 angap-11 ecg study date of 12:53:52 pm normal sinus rhythm, rate 79. occasional atrial premature beats. chest (pre-op pa & lat) study date of 5:23 pm ap upright and lateral chest: the cardiomediastinal silhouette is normal. ill definied opacity in the right lower lobe is concerning for pneumonia. the left lung is grossly unremarkable. there is no evidence of effusion or pneumothorax. moderate multilevel degenerative changes in the thoracolumbar spine are similar to . impression: findings are concerning for right lower lobe pneumonia. tee (complete) done at 3:51:36 pm no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. although not seen, due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is low normal (lvef 50%). right ventricular chamber size and free wall motion are normal. there are complex (>4mm) atheroma in the aortic arch. there are simple atheroma in the descending thoracic aorta. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. physiologic mitral regurgitation is seen (within normal limits). drs. and were notified in person of the results in the opertaing room at the time of the study. ecg study date of 11:05:30 am normal sinus rhythm, rate 86, with frequent atrial premature beats and brief multifocal atrial tachycardia. brief hospital course: patient admitted. routine nursing care, labs, ecg, cxr were done. cxr-showed lll pneumonia. dvt prophylaxis started. pre-angio and consented for . initial trop .06, continued to monitor cardiac enzymes. underwent successful left femoral-posterior tibial bypass. central line/pa line, foley, and a-line were plaved. recovered in the pacu, then transferred to 5 vicu, continued w/ telemetry. cardiology consulted for elevated troponin- recs- maximize beta blocker and monitor cardiac enzymes. pod1 on lower extremity bypass pathway. speech and swallow consult for ? aspiration pneumonia, unable to do video swallow- to be done on monday , kept npo. 1/24-25/09 pod2-3 no acute events, continue to be npo. started tpn. transfused 1 unit prbcs hct 25.9<-33.9 on admission. electrolytes repleted. pod4 speech and swallow re-evaluation at bedside, continue to have possible aspirations-recs continue to keep npo, tpn for nutrition. scheduled for video swallow on . pod#5 continues to be npo, on tpn. no acute events. taken to or for wound revision of dehised l le surgical wound. pod#6 somulent, breath sound with ronchi. intubated and transfered to cticu for pulmonary acre. daugnter pat notifed of event.bronchoscoopy done. findings no airway mucus or secreations , new lll pneumonia. bal sent.gen surgery consulted for peg placement.zosyn added to vanco for his hospital acquired pneumonia. pod#7 video swalow cancelled patient still intubated.peg placement. remains npo and on tpn. iv antibiotics continued. speech and swallow signed off.low urinary out put-fluid resustated.extubated.transfered to vicu for continued care. pod# no overnight events. afebrile. tpn continued. gen. surgery- recs not to use peg till pod 2. noted to have large decubiti in his scarl area, wound care nurse consulted, placed in air mattress. changed to floor status. pod9/2 no acute events. started slow tube feeds via gastric tube. continues w/ tpn via central line. continues on antibiotics vanco/zosyn. pod10/3 no acute events. continue tube feeds-advances to goal (60cc/h), tpn. continues on antibiotics vanco/zosyn. physical therapy consult. rehab screening. pod11-12/4-5 no acute events, tube feeds at goal, tpn d/c'd. continues on vanco/zosyn. rehab bed. l leg distal wound still draining, aced from forefoot-below knee. pod12/6 no acute events. continues on vanco/zosyn. physical therapy following. rehab bed. pod13/6 d/c to rehab with one week of po bactrim. medications on admission: asa 325mg po qd plavix 75 m qd altace 2.5 mg qd multivitamin ariecept 10 mg po qd zocor 40 mg po qd lopressor 12.5 mg po qd prilosec 20 mg po qd levoflox 500 mg po qd discharge disposition: extended care facility: - discharge diagnosis: pvd w/ bilateral gangrenous wounds of lower extremity pre-admission pneumonia-likely due to aspiration sacral decubiti- stage iii, sacral- wound care consulted-placed on air mattress dysphagia history of hypertension history of gout history of bph postoperative hypoxia to progressive unilateral to bilateral pneumonia requiring intubation postopaerative faiure to thrive pna, tpn postoperative acute blood loss anemia, transfused. psh: s/p rt. sfa/paf ahtrectomy with lt. eia stent ,angio occluded left sfa single vessel runoff at which occludes at ankle, foot perfused by collaterals. s/p hernia repairs s/p appendectomy s/p right lower extremity dvt in discharge condition: stable discharge instructions: le bypass - ambulate essential distances untill fu with dr. - ace wrap leg from foot-knee when ambulating - elevate leg when sitting - no driving till fu - may shower, no tub baths - keep wound dry and clean, call if noted to have redness, draining, swelling, or if temp is greater than 101.5 - continue all medications as directed - keep all fu appointments - call dr. office for fu appointment followup instructions: call for 2 weeks follow-up w/ dr. phone: procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances other endoscopy of small intestine diagnostic ultrasound of heart insertion of endotracheal tube other (peripheral) vascular shunt or bypass percutaneous [endoscopic] gastrostomy [peg] closed [endoscopic] biopsy of bronchus closure of skin and subcutaneous tissue of other sites diagnoses: pneumonia, organism unspecified unspecified essential hypertension acute posthemorrhagic anemia gout, unspecified pneumonitis due to inhalation of food or vomitus surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other respiratory complications pressure ulcer, lower back atherosclerosis of native arteries of the extremities with gangrene ulcer of heel and midfoot disruption of external operation (surgical) wound pressure ulcer, stage iii dysphagia, unspecified 

Answer: The patient is high likely exposed to