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: iodine attending: chief complaint: left leg ischemia left 1st toe amputation site necrosis major surgical or invasive procedure: left below knee popliteal-peroneal bpg and 1st metatarsal wound debridement history of present illness: this is a 78 man s/p left big toe amp 3 weeks ago subsequently complicated by ulceration and infection of the amputation site. he has been receiving local wound care, debridements, and oral antibiotics at a wound care clinic at hospital over the past few weeks, had an diagnostic angiogram on , recommended to have l le bypass on friday . he is being admitted today for iv antibiotics. past medical history: dm-2 diagnosed 10 years ago (not on insulin), bradycardia s/p pacemaker placement 5 years ago, renal insufficiency near esrd (will start pd soon per patient), htn social history: tobacco - quit smoking 40 years ago. denies etoh and illicit drug use. lives alone in a house in , nh. family history: non-contributory physical exam: vs: 96.8, 79, 105/59, 20, 97 ra gen: nad, aaox3 cv: rrr, s1s2 pulm: ctab/l abd: soft, ntnd ext: lle - the foot and toes are warm. the ray amputaion site w/ sutures, incision line is intact, no erythema. bypass incison line is w/ staples, inatact. there is some erythema along the incision line. rle - warm and dry, the incison line is w/ staples, inatact w/ some erythema along the incision line. pulses: fem dp pt p p dop dop left p p dop dop pertinent results: 04:09am blood wbc-6.3 rbc-3.64* hgb-10.9* hct-32.3* mcv-89 mch-30.0 mchc-33.8 rdw-17.4* plt ct-126* 03:58am blood wbc-6.4 rbc-3.50* hgb-10.5* hct-31.1* mcv-89 mch-30.0 mchc-33.8 rdw-17.3* plt ct-125* 04:09am blood plt ct-126* 03:58am blood plt ct-125* 04:09am blood glucose-109* urean-77* creat-3.9* na-144 k-3.5 cl-120* hco3-14* angap-14 03:58am blood glucose-84 urean-87* creat-4.5* na-143 k-4.1 cl-117* hco3-16* angap-14 03:15am blood glucose-73 urean-91* creat-4.5* na-144 k-4.0 cl-118* hco3-14* angap-16 ecg study date of 11:17:40 am normal sinus rhythm with ventricular pacing at a rate of 72 beats per minute. compared to the previous tracing of only ventricular pacing is observed. chest (pre-op pa & lat) study date of 7:16 pm frontal and lateral views of the chest: there is cardiomegaly, stable. mild congestive failure is again present, not significantly changed. a left-sided pacemaker is seen with the leads terminating in the expected location of the right atrium and right ventricle, stable. otherwise, the lungs appear clear with no areas of definite consolidation. the study and the report were reviewed by the staff radiologist. brief hospital course: mr. was admitted on directly to the vascular surgery service. he was started on empiric antibiotics for his necrotic left foot ulcer. renal failure: nephrology was consulted for continued management of his chronic esrd. the decision was to hold of on hd prior to his surgery chronic anemia: the patient was transfused 2 units of prbcs on and 1 unit prbcs on for his chronic anemia preoperatively in anticipation of substantial blood loss in the or. the patient was taken to the or on for his lle bypass graft, invasive monitoring lines were placed, patient tolerated procedure and was brought to the pacu for recovery. developed hypothermia and acidosis, patient was intubated, sedated and transferred to cvicu. continued w/ broad spectrum antibiotics. riss for glycemic control. pod1 patient in cvicu- weaned and extubated. fluid resuscitated. given lasix iv for low urine output. continues to be followed by nephrology. hemodynamically stable. continued w/ broad spectrum antibiotics. pod2 patient continue to be hemodynamically stable, transferred to 5 vicu for further montoring. initiated lower extremity bypass pathway. continue to diurese daily. continued w/ broad spectrum antibiotics. resumed home meds. 5/25-26/09 pod3-4 vss. pain well controlled. pa line d/c'd. continue lower extremity bypass pathway. continued w/ broad spectrum antibiotics. renal following creatinine improving. physical therapy referral, for discharge planning. rehab placement/screening. pod5 vss. pain continue to be well controlled w/ current meds. discharged to rehab in good condition. will d/c on bactrim for 2 weeks. staples/sutures will be removed on fu w/ dr. . medications on admission: aspirin 81 mg po daily, ascorbic acid 500 mg po daily, oxycodone-acetaminophen tab po carvedilol 6.25 mg po daily atorvastatin 10 mg po daily doxercalciferol 2 mcg po daily glyburide 5 mg po daily amlodipine 5 mg po daily keflex 500mg qid levaquin 250 mg daily discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. bactrim ds 160-800 mg tablet sig: one (1) tablet po twice a day for 2 weeks. 3. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 4. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 6. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 7. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 8. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed for itching. 9. acetaminophen 500 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 10. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). 11. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 12. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 13. insulin sliding scale humalog breakfast lunch dinner glucose insulin dose 0-60 mg/dl amp d50 61-150 mg/dl 0 units 151-200 mg/dl 2 units 201-250 mg/dl 4 units 251-300 mg/dl 6 units 301-350 mg/dl 8 units > 350 mg/dl notify m.d. discharge disposition: extended care facility: hospital discharge diagnosis: left lower extremity ischemia necrotic left 1st toe amputation site chronic anemia-requiring blood transfusions chronic renal failure- diuresing twice daily history of: dm bradycardia s/p pacemaker placement ' cri htn psh: s/p big toe amp on left foot discharge condition: stable discharge instructions: division of vascular and endovascular surgery lower extremity bypass surgery discharge instructions what to expect when you go home: 1. it is normal to feel tired, this will last for 4-6 weeks ?????? you should get up out of bed every day and gradually increase your activity each day ?????? unless you were told not to bear any weight on operative foot: you may walk and you may go up and down stairs ?????? increase your activities as you can tolerate- do not do too much right away! 2. it is normal to have swelling of the leg you were operated on: ?????? elevate your leg above the level of your heart (use pillows or a recliner) every 2-3 hours throughout the day and at night ?????? avoid prolonged periods of standing or sitting without your legs elevated 3. it is normal to have a decreased appetite, your appetite will return with time ?????? you will probably lose your taste for food and lose some weight ?????? eat small frequent meals ?????? it is important to eat nutritious food options (high fiber, lean meats, vegetables/fruits, low fat, low cholesterol) to maintain your strength and assist in wound healing ?????? to avoid constipation: eat a high fiber diet and use stool softener while taking pain medication what activities you can and cannot do: ?????? no driving until post-op visit and you are no longer taking pain medications ?????? unless you were told not to bear any weight on operative foot: ?????? you should get up every day, get dressed and walk ?????? you should gradually increase your activity ?????? you may up and down stairs, go outside and/or ride in a car ?????? increase your activities as you can tolerate- do not do too much right away! ?????? no heavy lifting, pushing or pulling (greater than 5 pounds) until your post op visit ?????? you may shower (unless you have stitches or foot incisions) no direct spray on incision, let the soapy water run over incision, rinse and pat dry ?????? your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing over the area that is draining, as needed ?????? take all the medications you were taking before surgery, unless otherwise directed ?????? take one full strength (325mg) enteric coated aspirin daily, unless otherwise directed ?????? call and schedule an appointment to be seen in 2 weeks for staple/suture removal what to report to office: ?????? redness that extends away from your incision ?????? a sudden increase in pain that is not controlled with pain medication ?????? a sudden change in the ability to move or use your leg or the ability to feel your leg ?????? temperature greater than 100.5f for 24 hours ?????? bleeding, new or increased drainage from incision or white, yellow or green drainage from incisions fu w/ pcp , (to monitor renal status and adjust medication) please follow up with dr. in 2 weeks. call to make your appointment followup instructions: please follow up with dr. in 2 weeks. call to make your appointment fu w/ pcp , (to monitor renal status and adjust medication) procedure: venous catheterization, not elsewhere classified arteriography of femoral and other lower extremity arteries other (peripheral) vascular shunt or bypass amputation through foot local excision of lesion or tissue of bone, other bones aortography diagnoses: acidosis end stage renal disease anemia, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease atherosclerosis of native arteries of the extremities with ulceration ulcer of heel and midfoot infection (chronic) of amputation stump acute osteomyelitis, ankle and foot 

Answer: The patient is high likely exposed to