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: no known allergies / adverse drug reactions attending: chief complaint: non-healing ulcers major surgical or invasive procedure: right lower extremity angiogram without intervention and right lower extremity femoral to popliteal bypass with right saphenous graft history of present illness: the patient is an 89 year-old female who presents with non-healing ulcers on the right lateral three toes. the ulcers have been present for the past 6 weeks. she also complains of leg pain at night. she presents for diagnostic right lower extremity angiogram with possible intervention. past medical history: pmh: cad s/p mi s/p stent, cva , htn, incontinence . psh: bladder suspension, hysterectomy social history: son is hcp. home health aid/bathing, adult daycare 4d/wk family history: non-contributory physical exam: on admission following angio afebrile, vss nad, alert, interactive, aphasic rrr ctab breathing easily abd st, nt, scar noted from previous surgery ext warm, right lateral toes with ulcers, ttp pulses: r&l dp/pt + doppler left groin w/ dressing c/d/i, no bleeding or hematoma pertinent results: 09:23pm urine color-straw appear-clear sp -1.015 09:23pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.5 leuk-neg 04:17am blood wbc-32.3* rbc-3.18* hgb-9.5* hct-31.1* mcv-98 mch-30.0 mchc-30.6* rdw-14.9 plt ct-161 03:36am blood wbc-33.7* rbc-3.70* hgb-11.1* hct-35.3* mcv-95 mch-30.1 mchc-31.5 rdw-15.4 plt ct-168 10:00pm blood wbc-34.6* rbc-3.78* hgb-11.2* hct-35.7* mcv-95 mch-29.6 mchc-31.3 rdw-15.2 plt ct-176 02:53am blood wbc-23.5* rbc-3.90* hgb-11.4* hct-37.3 mcv-96 mch-29.2 mchc-30.6* rdw-14.7 plt ct-233 02:35pm blood wbc-22.7* rbc-4.02*# hgb-11.8*# hct-38.9 mcv-97 mch-29.2 mchc-30.2* rdw-14.3 plt ct-209 05:42am blood wbc-26.4* rbc-3.07*# hgb-9.0*# hct-31.2* mcv-102* mch-29.4 mchc-29.0* rdw-13.8 plt ct-230 10:05pm blood wbc-29.2* rbc-4.11* hgb-12.4 hct-40.6 mcv-99* mch-30.1 mchc-30.5* rdw-14.0 plt ct-300 08:00pm blood wbc-26.8*# rbc-4.17* hgb-12.7 hct-41.8# mcv-100* mch-30.5 mchc-30.4* rdw-13.7 plt ct-321# 03:00am blood wbc-13.7* rbc-3.36* hgb-10.2* hct-31.7* mcv-94 mch-30.4 mchc-32.3 rdw-14.4 plt ct-158 04:17am blood glucose-182* urean-64* creat-2.5* na-137 k-4.4 cl-107 hco3-22 angap-12 04:33pm blood glucose-203* urean-57* creat-2.4* na-136 k-4.2 cl-105 hco3-21* angap-14 03:36am blood glucose-158* urean-52* creat-2.3* na-137 k-4.3 cl-105 hco3-20* angap-16 10:00pm blood glucose-145* urean-49* creat-2.2* na-137 k-4.3 cl-104 hco3-19* angap-18 05:56pm blood glucose-153* urean-49* creat-2.3* na-135 k-4.1 cl-102 hco3-21* angap-16 10:20am blood glucose-161* urean-48* creat-2.2* na-137 k-4.4 cl-103 hco3-20* angap-18 02:53am blood glucose-63* urean-42* creat-2.0* na-136 k-4.5 cl-103 hco3-19* angap-19 02:35pm blood urean-42* creat-1.7* na-136 k-3.8 cl-102 hco3-19* angap-19 11:34am blood alt-1056* ast-2534* ld(ldh)-4045* ck(cpk)-1874* alkphos-80 amylase-156* totbili-0.6 02:53am blood alt-946* ast-1788* ck(cpk)-1830* alkphos-82 amylase-158* totbili-1.9* 10:20am blood alt-863* ast-1318* ld(ldh)-611* ck(cpk)-1438* alkphos-88 amylase-142* totbili-1.2 05:56pm blood alt-534* ast-785* ld(ldh)-488* ck(cpk)-1010* alkphos-74 amylase-109* totbili-1.6* 10:00pm blood alt-553* ast-777* ck(cpk)-856* alkphos-85 amylase-100 totbili-2.1* 04:17am blood alt-333* ast-219* ld(ldh)-383* alkphos-86 amylase-67 totbili-1.8* 04:33pm blood ck-mb-8 ctropnt-0.08* 06:06am blood ck-mb-12* mb indx-2.6 ctropnt-0.07* 10:00pm blood ck-mb-18* mb indx-2.1 ctropnt-0.09* 02:53am blood ck-mb-34* mb indx-1.9 ctropnt-0.15* 10:00pm blood ck-mb-60* mb indx-2.1 ctropnt-0.10* 02:35pm blood ck-mb-69* mb indx-2.5 ctropnt-0.05* 05:42am blood ck-mb-17* mb indx-3.3 ctropnt-0.06* 10:00pm blood tsh-2.0 ruq us: 1. limited examination by portable technique and poor acoustic window. 2. cholelithiasis without evidence of acute cholecystitis. mildly prominent common bile duct measuring 10 mm., possibvly age-related. no intrahepatic ductal dilatation. 3. please see ct report for liver/spleen findings given poor visualization. : echo suboptimal image quality. within these limitations, lv and rv systolic function appears preserved. normal end-diastolic and end-systolic lv chamber size. moderate mitral annular calcification makes determining the severity of mitral regurgitation difficult due to shadowing. lvot flow shows high variabliity with respiration (35%), though in the context of a ventilated patient making respiratory efforts, this value can be misleading. kub: nonspecific colonic dilatation. ct head: right putamen hypodensity is likely a chronic infarct, although subacute infarct cannot be excluded. no evidence of acute intracranial hemorrhage or mass effect. : ct/cta abdomen/pelvis 1. the sma is difficult to follow beyond the proximal portion, but no definite thrombus identified. there is no bowel wall thickening, free fluid or pneumatosis to suggest mesenteric ischemia. 2. fluid filled nondilated small and large bowel is compatible with diarrhea and likely post operative ileus. no evidence of megacolon. appendix not seen. per discussion with general surgery, pt may be status post appendectomy. 3. small right groin hematoma is likely post-surgical. 4. cystic lesion in the pancreatic head is probably an ipmn. given size and patient's age, no specific follow up is needed. brief hospital course: the patient was admitted on for elective right lower extremity angiography with possible stent placement. the patient was prepped and brought down to the endo suite room for the procedure. intra-operatively, the patient was closely monitored and remained hemodynamically stable. the stenosis in the right superficial femoral artery was visualized. please see the angiography report for further details. based on these results the patient was determined to be a candidate for a right femoral-popliteal bypass the following day, on . during bypass procedure, operation was complicated by low urine output. jp drain was placed. a central line was placed emergently in the or for hypotension, and she received phenylephrine. please see operative note for further details. post-operatively, the patient was transferred to the pacu for further stabilization and monitoring. her sbp was low to the 60s, and her urine output continued to be low. she was bolused 500cc of ns, and subsequently put out 10cc of concentrated urine, and her bp improved. she underwent bladder scan which showed no urine, and received one unit of prbc for a hematocrit of 27.4. she received several more boluses with improvement in urine output. the patient received appropriate peri-operative antibiotics. on she had an elevated wbc count and was found to have a uti on urine culture. she was treated with bactrim for this uti. she was continued on fluids to improve her urine output. she received 1u prbcs. on the patient was transfused 2u prbcs for low hct. on the patient developed increased difficulty breathing, likely due to this fluid increase which was supporting her urine output. a chest x-ray did not show clear signs of fluid overload, but the lung exam had crackles at the lung bases. she was given lasix for diuresis and her oxygen requirement decreased and she was breathing much easier. she was given additional doses of lasix for diuresis as needed. on a cxr showed improved pulmonary edema, her ekg was stable, and she reported improved shortness of breath. her right leg drain was removed. on the patient had several episodes of diarrhea. her bowel regimen was discontinued, however the bowel movements continued and a c. diff test was negative. on early the patient developed abdominal pain, and had a rising wbc in the 20s'. she had a systolic bp in the 60's. she was given fluid but did not respond appropriately. she was tachypneic and tachycardic and so was intubated and transferred to the icu. : a kub obtained in the icu showed colonic dilation, and a ct/cta was obtained which ruled out toxic megacolon and perforation. there were no signs of ischemic bowel on the scan. c. diff tests were negative, however the patient was treated for presumed c. diff with iv vancomycin, as well as vancomycin enemas and vancomycin through an ng tube. she was also started on ciprofloxacin and flagyl. a non-contrast head ct was negative for bleed, but did show a chronic vs. subacute right putamen hypodensity. the patient remained intubated and general surgery was consulted. they recommended no operative intervention at that time, and the family also did not want further surgery at that time. she was started on pressors to support her blood pressure, and her urine output decreased to less than 10ml per hour. she was given additional fluids but did not initially respond. nephrology was consulted and recommended decreasing her fluids. overnight her uop increased and her sbp was >100s. she was transfused 2u prbcs for low hct. : the patient went into atrial fibrillation with hr 150s and was given metoprolol and diltiazem, as well as a diltiazem drip which were unsuccessful in converting her or controlling her heart rate. her blood pressure was stable during this time. she was continued on the dilt drip. : the patient continued to have paroxysmal afib with rapid rate. she was cardioverted x2 which successful conversion to sinus rhythm with rates in the 50s. her blood pressure was stable and she was weaned off pressors as tolerated. a family meeting was held and it was decided that a repeat ct scan would be performed the following day to decide if improvement had occurred. infectious disease was consulted for her persistently elevated wbc, and she was switched from cipro to cefepime, and rifimaxin was added to her c. diff regimen. overnight her urine output decreased and she was unresponsive to fluids. : her atrial fibrillation continued and she was bolused with amiodarone and a drip was started which converted her back into sinus rhythm. her bp were stable, and she was given several doses of lasix which improved her urine output. she remained on the ventilator. she underwent a ct scan of her abdomen which showed anasarca, jejunal wall thickening and heterogeneous renal enhancement. her urine output came up after being administered lasix. - : she remained stable, continued to produce urine, and remained intubated. : her amio drop was stopped and she was started on metoprolol and amiodarone po, she continued to be diuresed with lasix, and miconazole was started for a likely yeast infection in the l groin. : her lasix was weaned as was her sedation, and she was extubated. she tolerated this well. her abdomen remained tender, but appeared to be improving. her antibiotics were altered with the cefepime and po vancomycin being stopped and starting tigecycline. : her oxygen was weaned and she became more alert. her white count began to rise, however, rising from 30 to 34. : her oxygen continued to be weaned, she became more alert, and her white count rose to 46. after discussing her antibiotics with id, the tigecycline was stopped and she was restarted on po vancomycin as well as meropenem. her anti-fungal was changed to nystatin cream as the fungal infection was not responding well. : she was intermittently off of oxygen and began to have short coherent conversations though remained somewhat confused still. her white count came down to 36. her abdomen was also significantly less tender. : her white count continued to decrease, but her mental status worsened, likely due to a combination of benzodiazepines and hypernatremia. she was started on free water bolus through her dobhoff tube, but became agitated and pulled out the tube. her tube was replaced and a psych consult was called, which recommended using haldol instead of ativan for anxiety. : her mental status continued to deteriorate and she was tachypneic in the morning. abg showed respiratory alkalosis and a chest xray was wet. she was started on aggressive diuresis with lasix and metolazone, and given morphine and haldol for anxiety. her respiratory status initially improved somewhat, but then she became hypotensive. her pressure improved with some free water boluses. after consulting with the family the decision was made to proceed with a ct scan of the torso, which was negative for pe and intraabdominal abscess. unfortunately, upon returning from the ct scan her respiratory status acutely worsened. she was nasotracheally suctioned, but gradually became more obtunded and her breathing became agonal and hypotensive. she passed away at 1:22 am. the family was notified and came in to see the patient. autopsy was declined. medications on admission: amlodipine 5, plavix 75, vitamin d, hctz 12.5, imipramine 50, lisinopril 20, pravastatin 40, trazodone 50, atenolol 100, omeprazole 20 discharge medications: none discharge disposition: extended care discharge diagnosis: right superficial femoral artery stenosis discharge condition: expired discharge instructions: none 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 arteriography of femoral and other lower extremity arteries other (peripheral) vascular shunt or bypass arterial catheterization atrial cardioversion aortography diagnoses: coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis other postoperative infection urinary tract infection, site not specified unspecified essential hypertension acute and subacute necrosis of liver unspecified septicemia severe sepsis cardiac complications, not elsewhere classified atrial fibrillation percutaneous transluminal coronary angioplasty status anxiety state, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure 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 septic shock intestinal infection due to clostridium difficile old myocardial infarction paralytic ileus do not resuscitate status hyperosmolality and/or hypernatremia ventilator associated pneumonia drug-induced delirium delirium due to conditions classified elsewhere late effects of cerebrovascular disease, aphasia leukocytosis, unspecified atherosclerosis of native arteries of the extremities with ulceration acquired absence of both cervix and uterus candidiasis of skin and nails acute edema of lung, unspecified mixed acid-base balance disorder benzodiazepine-based tranquilizers causing adverse effects in therapeutic use other and unspecified escherichia coli [e. coli] contact dermatitis and other eczema, unspecified cause physical restraints status dementia, unspecified, without behavioral disturbance other digestive system complications postoperative shock, other 

Answer: The patient is high likely exposed to