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: penicillins / cefazolin / clindamycin attending: chief complaint: abdominal pain major surgical or invasive procedure: none history of present illness: this is a 56 year old man who presented today with acute abdominal pain and nausea without actual vomiting. in ed, he underwent abdominal ultrasound followed by ct of the abdomen. the u/s was technically limited study due to body habitus but there was no evidence for cholelithiasis or cholecystitis. the ct woith contrast showed no acute intra-abdominal process. therefore, he was admitted for further work up after he received iv fluids and antibiotics for unclear reason. the patient was discharged on after 24 hour admission for chest pain with negative workup including cta of the chest (embolism protocol), ekg, cardiac enzymes, and nuclear stress test. he was also admitted between and for "near syncope". the discharge diagnosis was daytime somnolence related to obstructive sleep apnea. he had no orthostasis, hypoglycemia, events on telemetry, or seizure events on continuous eeg monitoring. during that admission, he had nonsignificant carotid ultrasounds and a transthoracic echocardiogram. in , he had admissions related to his diabetic foot and cellulitis. in regards to his current symptoms, he described diffuse mostly upper abdominal pain, sharp, nonradiating since :00 pm last night. no radiation to the back or to the groin. the pain was not related to food. he actually did not eat since last night. this was associated with only nausea and no actual vomiting (although ed m.d documents vomiting at home; nonbloody nonbilious) and no diarrhea. his last bowel movement was regular and nonbloody this morning. he had no fever, chills, chest pain, or shortness of breath. he has stable chronic doe. he denied previous similar abdominal pain. he never had gallstones or kidney stones. he denies hematuria. he denied alcoholism, pancreatitis, or drug seeking or abuse. ros: all remaining systems were reviwed and symptoms were negative. past medical history: - diabetes with neuropathy - right hallux amputation for osteomyelitis - morbid obesity - chronic venous stasis - possible pseudomonas bacteremia (referenced in the chart but not documented by microbiology) - hypertension - obstructive sleep apnea social history: on disability for hand neuropathy. he is married, no children, lives with wife. denies smoking at any time in his life. denies etoh or drugs. currently unemployed former machine assembly worker. family history: mother: copd, died of stroke father: copd, dm, chf, committed suicide physical exam: gen: middle aged male, morbidly obese, laying comfortably on bed heent: perrl, mmm, op clear, small airway neck: supple, difficult to assess for jvd obesity chest: cta bilaterally, no wheezes, rales, ronchi cv: rrr, nls1/s2, 2/6 systolic loudest at axilla abd: bs+, soft obese, diffuse non sepcific tendeness without gaurding or peritoneal signs, no hernia skin: slight erythema under abdominal pannus, dry, no discharge; bruising over abdomen c/w hsq injections ext: 1+ ble edema with signs chronic venous stasis bilaterally, 1+ dp/pt/radial pulses. no active cellulitis neuro: aox3, cn 2-12 intact, loss of fine sensation over hands/feet, motor , slow wide-based gait pertinent results: persantine perfusion stress no anginal symptoms or ischemic st segment changes. appropriate hemodynamic response to the persantine infusion. probably normal myocardial perfusion. fixed inferior wall defect most consistent with attenuation. normal left ventricular cavity size and systolic function. . cta chest 1. no evidence of pe. 2. coronary artery calcifications consistent with coronary artery disease. . echocardiogram the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. there is no aortic valve stenosis. no aortic regurgitation is seen. trivial mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion . carotid series: impression: right ica stenosis 40-59%. left ica stenosis 40-59%. . today: abdominal u/s was technically limited study due to body habitus but there was no evidence for cholelithiasis or cholecystitis. . today: the ct with contrast showed no acute intra-abdominal process brief hospital course: this is a 56 year old morbidly obese man who presented with acute diffuse abdominal pain and nausea without actual vomiting, diarrhea, or fever. the patient was admitted twice recently for unrelated symptoms (near syncope on one admission and a chest pain during a second admission). so far, including the 2 recent admissions, he had unremarkable cta of the chest (embolism protocol), ekg, cardiac enzymes, nuclear stress test, carotid ultrasound, transthoracic echocardiogram, abdominal ultrasound , and, finally, contrast ct of the abdomen. in regards to his current presentation, complete labs (cbc, chem 7, and lft's) and abdominal examination were normal and with only diffuse nonspecific tenderness. the ct of the abdomen was with contrast and did not support any diagnosis or any intraabdominal inflammatory process. the u/s also did not show any evidence of gallstones or cholecystitis. however, it was a technically limited examination. the patient was initially managed conservatively with npo, iv fluids, and pain medications. his pain worsened and became localized to the right side. in addition, he developed fever and leukocytosis the following day. therefore, surgery was consulted for the possibility of appendicitis. finally, a hida scan was done because of more localized pain to the ruq. the hida showed acute acalculous cholecystitis. the patient was then admitted to the micu because of new relative hypotension and for monitoring after percutaneous cholecystostomy with drain placed by ir for presumed acalculous cholecystitis. copious purulent drainage noted during procedure. there was concern for bacteremia and acute peritonitis post-procedure given his degree of pain and hypotension. he was started on ciprofloxacin, flagyl, and vancomycin. he was volume resuscitated with 1.5 l of ns post-procedure. he did not require additional ivf boluses but was kept on 150 ml ns continuous while npo per surgery recommendations. he was hemodynamically stable in icu: no additional hypotension, fever, or severe abdominal pain. foley catheter was discontinued. he was continued on the same antibiotics. bile cultures grew gpcs in pairs and chains (streptococcus; multiple growth). the biliary drain was productive of clear yellow fluid. he was sent to the floor only after a short micu course. he was seen by id regarding the optimal choice of antibiotics. they recommended moxifloxacin for total 14 days. surgery continued to follow him with a plan for potential lap cholecystectomy in 6 weeks. he remained clinically stable with only minimal symptoms post percutaneous cholecystostomy. specifically, he had no fever or gi symptoms. he was discharged home with vna and follow up with acute care surgery and bariatric surgery for cholecystectomy. medications on admission: smae as discharge medications: 1. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 2. gabapentin 300 mg capsule sig: one (1) capsule po bid (2 times a day). 3. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 4. lorazepam 1 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for anxiety. 5. metformin 1,000 mg tablet sig: one (1) tablet po twice a day. 6. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 7. aspirin 81 mg tablet sig: one (1) tablet po once a day. 8. multivitamin tablet sig: one (1) tablet po once a day. 9. insulin nph & regular human 100 unit/ml (70-30) insulin pen sig: thirty six (36) units subcutaneous twice a day. 10. humalog sliding scale humalog sliding scale . nitroglycerin 0.3 mg tablet, sublingual sig: one (1) sublingual once a day as needed for chest pain. 12. mupirocin calcium 2 % cream sig: one (1) appl topical daily (daily) as needed for to affected foot. 13. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed for indigestion. disp:*50 tablet, chewable(s)* refills:*2* discharge medications: 1. gabapentin 300 mg capsule sig: one (1) capsule po q8h (every 8 hours). 2. lorazepam 1 mg tablet sig: one (1) tablet po bid prn () as needed for anxiety. 3. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 6. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 7. hydromorphone 2 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 8. moxifloxacin 400 mg tablet sig: one (1) tablet po daily () for 10 days. disp:*10 tablet(s)* refills:*0* 9. lasix 40 mg tablet sig: one (1) tablet po twice a day. 10. lisinopril 20 mg tablet sig: one (1) tablet po once a day. 11. metformin 1,000 mg tablet sig: one (1) tablet po twice a day. 12. nph insulin human recomb 100 unit/ml (3 ml) insulin pen sig: thirty six (36) units subcutaneous twice a day. 13. humalog 100 unit/ml solution sig: one (1) home dose per sliding scale subcutaneous three times a day. discharge disposition: home with service facility: vna discharge diagnosis: acalculous cholecystitis obesity diabetes discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted because of inflammation in the gallbladder. we did place a tube in your gallbladder to drain the infected fluid. you need to follow up with dr. with bariatric surgery in few weeks to have your gallbladder removed. you will also follow up with acute surgery clinic regarding your gallbladder tube. followup instructions: department: podiatry when: friday at 9:15 am with: clinic (sb) building: ba ( complex) campus: west best parking: garage department: when: friday at 2:10 pm with: , md building: sc clinical ctr campus: east best parking: garage department: medical specialties when: wednesday at 9:20 am with: drs / building: sc clinical ctr campus: east best parking: garage department: surgical specialties when: wednesday at 3:30 pm with: , md building: sc clinical ctr campus: east best parking: garage department: general surgery/ when: thursday at 1:45 pm with: acute care clinic (dr. ) building: lm bldg () campus: west best parking: garage procedure: percutaneous aspiration of gallbladder diagnoses: obstructive sleep apnea (adult)(pediatric) unspecified essential hypertension acute kidney failure, unspecified hyposmolality and/or hyponatremia polyneuropathy in diabetes morbid obesity acute cholecystitis other toe(s) amputation status venous (peripheral) insufficiency, unspecified diabetes with neurological manifestations, type ii or unspecified type, uncontrolled narcolepsy, without cataplexy 

Answer: The patient is high likely exposed to