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: history of present illness: the patient is a 68 year old white male with known coronary artery disease, cabg and in , diabetes, hypertension, end stage renal disease status post renal transplant in , who had excision of the left fifth met head on by dr. of the podiatry service. cultures then grew two species of enterococcus which were sensitive to ampicillin, penicillin, vancomycin and resistant to levaquin. the surgical amputation site never completely healed per patient. foot x-ray on did not show any osteomyelitis. arterial noninvasives on showed significant bilateral tibial disease. the patient was followed by dr. and seen in the office on . cultures were taken and the patient was started on linezolid 600 mg b.i.d. and levaquin 500 q.d. the patient was referred to dr. and was seen in the office on and he is now admitted for further evaluation and treatment. the patient denies claudication or rest pain. allergies: iv contrast causes renal failure. penicillin causes a rash. past medical history: coronary artery disease. diabetes since the age of 45 with retinopathy, neuropathy and nephropathy. hypertension. hypercholesterolemia. end stage renal disease secondary to iv contrast. the patient was put on hemodialysis post cabg for 11 months and then underwent transplant from his wife. gerd. pneumonia, was in ............ hospital in . colon polyp which was excised in with no further colonoscopy. past surgical history: cabg times three using left greater saphenous , . in . this was done at hospital. left av fistula. renal transplant in at hospital. excision of left fifth met head with ulcer excision on . medications on admission: zyvox 600 mg b.i.d.; levaquin 500 mg q.d.; coumadin 10 mg monday, tuesday, wednesday, thursday, 7.5 friday, saturday, sunday; prednisone 5 mg q.d.; gengraf 75 mg b.i.d.; rapamune 5 mg q.d.; multivitamin tablet q.d.; nph insulin 20 units q.a.m. and 18 units in the evening; lopressor 50 mg b.i.d.; avapro 300 mg q.d.; pravachol 40 q.d.; gemfibrozil 600 mg b.i.d., regranex ulcer wound care. social history: the patient is married and lives with his wife. ambulates independently. he is a nonsmoker and nondrinker. review of systems: unremarkable. physical examination: vital signs: 98.6, 70, 16, 138/70, o2 sat 99 percent in room air. in general, he was an alert, cooperative, white male in no acute distress. heent exam was unremarkable. there were no carotid bruits or jvd. carotid pulses were palpable. right radial is dopplerable signal, left is 2+. left forearm had an old av fistula which had a thrill and a bruit. femoral pulses were 2+ bilaterally. popliteals were not palpable. pedal pulses bilaterally were dopplerable signal. chest was clear to auscultation. heart had regular rate and rhythm with a mechanical valve click in the aortic position. abdominal exam was unremarkable. there was mild edema, left greater than right. right foot was warm and pink. left foot had a lateral surgical site with ulcer which was shallow and dry with surrounding erythema. it was nontender to palpation. neurologic exam was unremarkable. laboratory data: admitting labs included white count 9.0, hematocrit 33.0. bun 28, creatinine 1.7. pt/inr normal. ekg was sinus rhythm, left axis deviation, intraventricular conduction disturbance, no acute changes. the patient underwent a thallium stress at an outside hospital on which showed no ischemic defects. hospital course: podiatry followed the patient during the hospitalization. the patient was followed by the renal service to manage his immunosuppression. the patient was begun on levo, flagyl and vancomycin antibiotics. wound cultures were obtained which showed a species of enterococcus which was vanco sensitive. the patient was nonweight bearing on the foot. the patient's coumadin was held when his inr was less than 2.5 and heparinization was begun for a 40 to 60. the patient was rehydrated and mucomyst protocol was instituted. on the patient underwent arteriogram which showed diseased bk/ and tibial/peroneal trunk, patent mildly diseased peroneal artery, reconstructed distal at. the pt reconstructed was markedly diffusely diseases. the plantar was diffusely diseased. the patient was evaluated by cardiology. no further workup was initiated. he underwent surgery on . he underwent left sfa/dp bypass with greater saphenous and brachial graft. he tolerated the procedure well and was transferred to the pacu in stable condition. preoperatively the patient ran high grade temperature with t-max of 102. id was consulted. the patient underwent a workup and blood cultures were negative. an echocardiogram was done to rule out potential intracardiac disease. there was no obvious mass or vegetation seen. ejection fraction was calculated at greater than 55 percent. at the time of surgery the patient was afebrile. postoperatively he required one unit of packed red blood cells in the pacu for hematocrit of 29.4. chest x-ray was unremarkable. ekg was without acute changes. the patient remained hemodynamically stable and was transferred to the vicu for continued monitoring and care. the patient did require overnight, because of low urinary output, a fluid bolus to maintain his urinary output. on postoperative day one he was continued on morphine sulfate for analgesic control. his preoperative medications were reinstituted. his diet was advanced as tolerated. he continued on iv heparin and coumadinization was begun. mri of the left foot showed no evidence of osteomyelitis. the patient was continued on his antibiotics. he continued to be followed by renal. he did not require any adjustment in his immunosuppression. on postoperative day two he still required fluid boluses for low urinary output. hematocrit post transfusion was 28.1. bun 26, creatinine 1.8, up from 1.6. the patient was delined and transferred to the regular nursing floor. podiatry planned wound debridement. on the patient underwent resection of the fifth metatarsal head on the left. he tolerated the procedure well. he was transferred to the pacu in stable condition and returned to the regular nursing floor. the day after his podiatry procedure his central line was discontinued. ambulation was begun nonweight bearing on the right foot. adjustments were made in his rapamune level which was 9.1. the dosing was decreased to 4 mg q.d. and avapro was restarted. after two more units of packed red blood cells the patient's hematocrit was 30.0. the patient's vancomycin was discontinued on . he had a total of five days of vancomycin. the patient was evaluated by physical therapy who felt that he was a good rehab candidate. his foley and central line were discontinued on . he remained nonweight bearing. at the time of discharge recommendations were for a total of four more weeks from of antibiotics with linezolid. cbc should be monitored at days 10 and 20 of his antibiotics to insure there are no bone marrow effects. the patient should follow up with dr. and he should call for an appointment at . the remaining hospital course was unremarkable. the patient was discharged in stable condition. wounds were clean, dry and intact. there was no active drainage. discharge medications: 1. prednisone 5 mg q.d. 2. sirolimus 5 mg q.d. 3. pravastatin 40 mg q.d. 4. gemfibrozil 600 mg b.i.d. 5. acetaminophen 325 to 650 mg q.four to six hours p.r.n.. 6. colace 100 mg b.i.d. 7. bisacodyl 10 mg p.r. p.r.n. 8. senna tabs two q.d. p.r.n. 9. zolazepam 5 to 10 mg h.s. p.r.n. 10. pentamidine 20 mg q.d. 11. nitroglycerin 0.5 mg sublingual for a total of three doses q.five minutes, if no relief to call physician. 12. nystatin ointment to the penis and foreskin b.i.d. 13. cyclosporine modified (neoral) 75 mg q.12 hours. 14. metoprolol 100 mg t.i.d., hold for systolic blood pressure less than 100, heart rate less than 55. 15. aluminum magnesium hydroxide 15 to 30 cc q.i.d. p.r.n. for heartburn. 16. avapro 300 mg q.d. which is on hold. 17. nitroglycerin 2 percent 0.5 inches topical q.six hours p.r.n. for systolic blood pressure greater than 170. 18. warfarin 10 mg on monday, tuesday, wednesday, friday; 7.5 mg on sunday, thursday, saturday. 19. linezolid 600 mg q.12 hours. discharge diagnoses: 1. enterococcal foot infection status post debridement with resection of fifth met head. 2. ischemic ulceration with sfa tibial disease status post angio status post left sfa to bp bypass with greater saphenous and basilic composite graft. 3. status post renal transplant immunosuppressed, stable. 4. blood loss anemia, corrected. , m.d. dictated by: medquist36 procedure: arteriography of femoral and other lower extremity arteries other (peripheral) vascular shunt or bypass other partial ostectomy, tarsals and metatarsals diagnoses: other postoperative infection iron deficiency anemia secondary to blood loss (chronic) candidiasis of other urogenital sites coronary atherosclerosis of unspecified type of vessel, native or graft streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] atherosclerosis of native arteries of the extremities with gangrene complications of transplanted kidney cellulitis and abscess of foot, except toes chronic osteomyelitis, ankle and foot 

Answer: The patient is high likely exposed to