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 / ace inhibitors / acebutolol / atenolol / betaxolol / bisoprolol / carvedilol / labetalol / metoprolol / nadolol / penbutolol / pindolol / propranolol / timolol attending: chief complaint: infected -v icd leads and device major surgical or invasive procedure: s/p icd lead and device extraction on history of present illness: 62 year old male patient of dr. , dr. , and dr. who has an extensive past medical history including non-ischemic cardiomyopathy with an ef 15-20%, s/p initial implantation of an icd in and a biv lead upgrade in . following the lead upgrade, the patient developed an erosion of the overlying skin which was complicated by an infection in the device pocket. the pocket was debrided on . since that time, the patient has required multiple courses of antibiotics, both intravenous and oral. he is currently taking a 3-week course of oral cephalexin. he was referred for extraction of the icd leads and device. past medical history: past medical history: 1. nonischemic cardiomyopathy, chronic systolic heart failure. 2. mitral regurgitation with pulmonary hypertension. 3. ventricular tachycardia s/p icd implantation 4. copd. 5. morbid obesity. 6. spinal stenosis. 7. right malignant renal tumor, s/p right nephrectomy 8. stage 4 chronic renal failure. 9. hypertension. 10. leg ulcers. 11. gout other past surgeries: laparoscopic cholecystectomy in , mini thoracotomy , hernia repair. social history: the patient is a disabled former truck driver who currently helps run a home daycare center. he is married with adult children and lives with his wife. quit smoking at age 35. no alcohol,no drugs. family history: no family history of premature cad, sudden cardiac death, or arryhtmias. his father has a history of a cerebral hemmorhage. physical exam: general: obese white male in no acute distress lying in bed. neuro: alert and oriented to person, place, and time. cardiac: regular rate and rhythm. normal s1,s2. no murmurs/rubs/gallops. resp: lungs are diminished throughout. gi: abdomen is large and softly distended. bowel sounds are present. gu: voids concentrated yellow urine. integ: left chest incision is covered with dry sterile dressing. surrounding skin is reddened. no drainage noted. periph vasc: right femoral vein access site is intact. no hematoma or bruit. distal pulses are present. bilateral lower extremities are scaly, dusky, and dry. feet are warm with decreased sensation. right ankle ulcer is approximately inch and no drainage is noted. pertinent results: 05:20am blood wbc-9.0 rbc-4.05* hgb-11.2* hct-34.8* mcv-86 mch-27.7 mchc-32.2 rdw-15.6* plt ct-203 05:20am blood plt ct-203 05:20am blood urean-54* creat-3.1* brief hospital course: icd site infection: patient was admitted to on and underwent extraction of icd lead and device. he was admitted to the inpatient cardiac unit for observation and continuous cardiac monitoring. he was continued on all of his home medications. oral cephalexin was continued as part of 3-week outpatient course. the patient remained afebrile with all vital signs stable during his hospitalization. stage 4 chronic renal failure: patient has a history of a malignant right renal tumor and a right nephrectomy . creatinine at admission was 3.4 and on was 3.1. right foot ulcer: patient has history of right ankle skin graft for a non-healing ulcer. an open area that remains is approximately inch and was evaluated by a wound/ostomy nurse. dressing changes were recommended and should be continued after transfer. medications on admission: 1. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) puff inhalation (2 times a day). 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. lasix 80 mg tablet sig: one and a half tablet po twice a day. 4. imdur 30 mg tablet sustained release 24 hr sig: three (3) tablet sustained release 24 hr po once a day. 5. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 6. quinidine gluconate 324 mg tablet sustained release sig: two (2) tablet sustained release po qam (once a day (in the morning)). 7. quinidine gluconate 324 mg tablet sustained release sig: one (1) tablet sustained release po bid (2 times a day): one tablet in afternoon and one tablet in evening, in addition to two tablets in the morning . 8. cephalexin 500 mg capsule sig: one (1) capsule po q12h (every 12 hours). 9. mexiletine 200 mg capsule sig: two (2) capsule po qam (once a day (in the morning)). 10. mexiletine 200 mg capsule sig: one (1) capsule po bid (2 times a day): one capsule in the afternoon and one capsule in the evening in addition to two capsules every morning. 11. hydralazine 50 mg tablet sig: one (1) tablet po tid (3 times a day). 12. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily). 13. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 14. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal daily (daily). discharge medications: 1. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) puff inhalation (2 times a day). 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. lasix 80 mg tablet sig: one and a half tablet po twice a day. 4. imdur 30 mg tablet sustained release 24 hr sig: three (3) tablet sustained release 24 hr po once a day. 5. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 6. quinidine gluconate 324 mg tablet sustained release sig: two (2) tablet sustained release po qam (once a day (in the morning)). 7. quinidine gluconate 324 mg tablet sustained release sig: one (1) tablet sustained release po bid (2 times a day): one tablet in afternoon and one tablet in evening, in addition to two tablets in the morning . 8. cephalexin 500 mg capsule sig: one (1) capsule po q12h (every 12 hours). 9. mexiletine 200 mg capsule sig: two (2) capsule po qam (once a day (in the morning)). 10. mexiletine 200 mg capsule sig: one (1) capsule po bid (2 times a day): one capsule in the afternoon and one capsule in the evening in addition to two capsules every morning. 11. hydralazine 50 mg tablet sig: one (1) tablet po tid (3 times a day). 12. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po daily (daily). 13. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 14. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal daily (daily). discharge disposition: extended care facility: northeast - discharge diagnosis: s/p icd lead and device extraction secondary to infected pocket discharge condition: vitals: 97.3 - 93/48 - 76 - 20 - 95% on room air labs: bun 54 cre 3.1 wbc 9.0 hgb 11.2 hct 34.8 plt 203 neuro: alert and oriented x 3. cardiac: regular rate and rhythm. normal s1,s2. no murmurs appreciated. respiratory: lungs are diminished throughout. peripheral vascular: right femoral vein access site intact. no bleeding, hematoma, or bruit. distal pulses are present. skin: left chest wall incision is intact and covered with a dry, sterile dressing. surrounding skin has considerable erythema, but scant drainage. discharge instructions: continue your current medications as prescribed. it is important that you complete your 3-week course of cephalexin. keep your chest dressing dry. the nurses at the rehabilitation facility will change the dressing daily. if you develop a fever, chills, or signs of worsening infection at the incision site, notify your doctor. followup instructions: dr. on friday, at 3:40 p.m. ***patient should be transported by acls ambluance to this appointment to maintain continuous cardiac monitoring.*** procedure: removal of lead(s) [electrode] without replacement revision or relocation of cardiac device pocket diagnoses: other primary cardiomyopathies congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified primary pulmonary hypertension morbid obesity chronic systolic heart failure ulcer of heel and midfoot infection and inflammatory reaction due to cardiac device, implant, and graft 

Answer: The patient is high likely exposed to