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: sulfa (sulfonamides) attending: chief complaint: code sepsis major surgical or invasive procedure: incision and drainage of l foot x 2 l ankle/foot external fixation history of present illness: patient is a 74 year old male with a history of left foot charcot neuroarthropathy and chronic ulcerations with multiple surgeries for debridement and bone removal for osteomyelitis. he has had numerous treatment including 50 hyperbaric oxygen chamber treatments and numerous courses of antibiotics although which ones are not well delineated in the medical record. the patient has been hospitalized 3 times in the last year, most recently to for correction of a loose left external fixator. during this hospitalization he was started on vanco/levo/flagyl empirically. external fixator was surgically removed and wound swabs revealed mrsa for which the patient was maintained on vancomycin during the hospitalization, and subsequently discharged on to rehab with a 4 week course of linezolid. . the patient now was seen in the e.d. after being sent from the clinic with concern for an infected foot. per podiatry notes, patient's left foot was noted to be very swollen with purulent and sanguinous drainage. patient reports some nausea/vomiting one week prior and additionally endorses some chills this a.m. as well as increasing pain in his foot over the last three weeks. unfortunately the patient is unable to recall with good detail his recent medical course, but per his report, after his hospitalization at , he was d/c to rehab and recently returned home 3 weeks ago with home pt where he felt he was doing relatively well. per his report he completed antibiotics on tuesday although he is unsure if this was the previously prescribed linezolid or a different medication. the patient was scheduled to be seen in clinic two weeks ago but this was delayed for undefined reasons. . in the e.d. the patient's vitals were t - 97.5, hr 90, bp 119/63, rr 18, o2 sat 98% (? o2 flow). per report the patient had an episode of afib with rvr with normalization of hr with volume resuscitation of 2.5l prior to transfer without nodal agents. in the e.d. the patient received levo/flagyl/vanc. a code sepsis was called, a right ij placed and the patient was transferred to the micu for ongoing care. past medical history: history of l foot osteo s/p bilateral cataracts s/p colonoscopy with benign polyp removal history of pna with afib & mild chf in social history: lives with wife in minimal family history: n/c physical exam: t- 99.3 120/47 97(afib) 16 99% on 2l nc . gen: patient is an elderly male, lying in bed, mildly agitated, non-toxic. heent: ncat, eomi, sclera anicteric. conjunctiva wnl. op: mm dry neck: no jvd chest: mod air movement, relatively cta anterior and laterally. left -port in place (present > 1 yr per patient, indication unknown) cor: distant heart sounds. no m/r/g abd: firm, non-rigid. nt, nd +bs ext: +1 le edema bilaterally, chronic venous stasis bilaterally l>r , left foot with dressing in place, not yet taken down. pertinent results: 11:00pm alt(sgpt)-14 ast(sgot)-13 alk phos-129* 11:00pm albumin-2.8* calcium-9.1 phosphate-2.7 magnesium-1.9 11:00pm acetone-moderate 11:00pm cortisol-23.9* 11:00pm crp-231.5* 11:00pm pt-17.7* ptt-39.4* inr(pt)-1.7* 10:57pm comments-green top 10:57pm lactate-2.1* 10:57pm hgb-9.2* calchct-28 o2 sat-79 09:04pm glucose-157* urea n-31* creat-1.7* sodium-136 potassium-4.4 chloride-97 total co2-23 anion gap-20 09:04pm ck(cpk)-54 09:04pm ck-mb-notdone ctropnt-0.02* 09:04pm comments-green top 09:04pm lactate-4.6* 09:04pm wbc-9.4# rbc-3.96* hgb-10.0* hct-30.6* mcv-77* mch-25.4* mchc-32.8 rdw-19.9* 09:04pm neuts-84.8* bands-0 lymphs-10.6* monos-3.6 eos-0.8 basos-0.2 09:04pm hypochrom-1+ anisocyt-1+ poikilocy-occasional macrocyt-normal microcyt-3+ polychrom-1+ ovalocyt-occasional 09:04pm plt smr-normal plt count-318# 09:04pm pt-16.8* ptt-34.4 inr(pt)-1.5* . ap, lateral, and oblique views of the left foot: no localizing history is available. the study is technically limited as the patient was not able to rotate for the mortise and oblique views. the patient is status post charcot foot reconstruction with left fibular osteotomy, tibial calcaneal arthrodesis and left talectomy with femoral head allograft placement. there has been continued interval remodeling at the site of the femoral allograft. circular lucencies seen on the prior film, which represented location of removal of prior hardware are not well seen on today's exam consistent with new bone formation in these locations. the joint spaces in the mid foot are less well-defined on today's exam, which may be partly due to the differences in patient rotation of the foot but may also be due to continued bony destruction and remodeling in the mid foot. extensive resorption of the second through fifth metatarsal and proximal third phalanx degenerations are again noted and are consistent with prior infection or changes secondary to neuropathy. diffuse periosteal reaction along the medial aspect of the fibula is unchanged. no acute fractures are seen. the bone stimulation device remains in place. there is extensive vascular calcification, unchanged. no definite gas is seen in the soft tissues. impression: 1. no definite evidence of gas within the soft tissues. density irregularity at the dorsum of the foot may be due to skin folds. clinical correlation is recommended. 2. evaluation of osteomyelitis is severely limited by the extensive bony remodeling that is continuously taking place over the course of multiple prior radiographs. . pa and lateral radiographs of the chest: a left subclavian central venous catheter is in unchanged position with the tip projecting over the brachiocephalic junction. no pneumothorax is seen. the heart is normal in size. mediastinal and hilar contours appear within normal limits. no pulmonary edema, consolidations or pleural effusions are seen. there are stable bilateral pleural plaques. impression: no acute cardiopulmonary process. stable bilateral pleural plaques. . le u/s impression: 1. no evidence of dvt in the left lower extremity. 2. several moderately sized lymph nodes in the left groin, which could be related to the patient's cellulitis. please correlate clinically. . echo general comments: suboptimal image quality - poor echo windows. the patient appears to be in sinus rhythm. conclusions: the left atrium is moderately dilated. the right atrium is moderately dilated. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). there is no left ventricular outflow obstruction at rest or with valsalva. right ventricular chamber size is normal. the aortic root is moderately dilated. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. trace aortic regurgitation is seen. the tricuspid valve leaflets are mildly thickened. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. . ecg sinus rhythm atrial premature complex low limb lead qrs voltage - is nonspecific modest nonspecific st-t wave changes since previous tracing of , narrow complex tachycardia absent and st-t wave changes decreased . indication: status post left foot i&d with application of antibiotic beads and application of external fixation. seven radiographs showing three views of the left foot and ankle: there is marked osseous disorganization and destruction of the left foot. comparison is made to . there has been interval placement of an external fixation device, and antibiotic beads at the level of the ankle. there is severe osteopenia throughout the foot. overlying dressing obscures fine bony detail. there are heavy vascular calcifications. the plantar soft tissues are thickened and abnormal. there is no air tracking along the subcutaneous tissues. impression: marked arthropathy with interval placement of external fixation device and antibiotic beads. the bony changes are consistent with neuropathic arthropathy, though chronic infection can have a similar appearance. brief hospital course: a/p: 75 yo male c h/o mult. surgeries to l foot for charcot deformity and osteo s/p l foot i&d x 2 and s/p l foot/ankle fixation on . . #) mrsa + l foot wound - pt now s/p l foot i&d with fixation by podiatry on . - wound cx + for mrsa - blood cx neg - d/c vanc per podiatry as he has antibiotic beads in his l foot wound - to follow-up with dr. in 3 weeks . #) anemia -admitted with hct 30, near baseline. drop from 30 to 22 in icu likely partially dilutional given 3-4l volume resusciation, also likely 2/2 blood loss during 1st i& d (? secondary to nutritional coagulopathy). guiaic positive, had polyp on colonoscopy. given 1 u prbc pre-op. given another u on without appropriate bump in hct. given another 2 units on in anticipation of discharge unknown source of bleeding. he refuses another colonoscopy. - iron studies c/ - follow hct at least weekly as outpatient . #) coagulopathy - pt with h/o elevated inr, currently trending down from 1.7 -> 1.2. likely nutritional as responded to vitamin k and on long-term antibiotics. - continue to trend inr but no active bleeding - will likely correct with d/c of vanc . #) afib - he continues to go in and out of afib but rate well-controlled. patient not on oral anticoagulation fall risk. - as pt normotensive, bb or ccb prn for rvr - no oral anticoagulation for now - dig level sub-therapeutic at 0.6 now on 0.125 4 days per week and 0.25 3 times per week. . #) h/o daily etoh: no symptoms of dt during hospital stay - was on ciwa scale and given thiamine and folate . #) leukopenia/thrombocytopenia: wbc ct went as low as 2.7 during hospital course but anc >1000. ? vanc related. stopped zosyn and now with small increase in wbc ct. has a h/o leukopenia when on linezolid. - follow wbc ct as outpatient . #) hyperglycemia: consistent with undiagnosed diabetes (he denies prior history). once he began eating more he was noted to be increasingly hyperglycemic. he does not have a history of diabetes but it appears that this may be a new diagnosis for him. - ssi for now - will start metformin 500 mg po bid and have him f/u as outpatient. . #) fen - regular diet. unclear how pt able to effectively chew food given no teeth and does not have dentures; however pt insists he is able to tolerate regular diet and refuses a soft diet. - nutrition consult recommended ensure tid. - repleted lytes prn . #) ppx: heparin sq tid, ppi, pt consult . #) code: full . #) communication - wife/hcp . #) dispo - to inpatient rehab - f/u with pcp 1 week - weekly cbc checks - f/u with dr. in 3 wks for possible surgical revision of l foot in 4 weeks. . medications on admission: medications (on discharge ) - patient reports not taking his medications regularly zolpidem 5 mg po qhs oxycodone 5 mg po q4-6h prn fluconazole 100 mg po q24h digoxin 125 mcg po qd furosemide 40 mg po qd ferrous sulfate 325 po tid linezolid 600 mg x 4 weeks (end ) discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 2. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po tid (3 times a day). 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 5. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 6. digoxin 250 mcg tablet sig: one (1) tablet po mwf (monday-wednesday-friday). 7. digoxin 125 mcg tablet sig: one (1) tablet po tues thurs sat sun (). 8. heparin lock flush (porcine) 100 unit/ml syringe sig: one (1) ml intravenous daily (daily) as needed. 9. furosemide 20 mg tablet sig: one (1) tablet po once a day. 10. zolpidem 5 mg tablet sig: one (1) tablet po qhs prn as needed for insomnia. 11. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 12. heparin (porcine) 5,000 unit/ml syringe sig: one (1) syringe injection three times a day. discharge disposition: extended care facility: rehab discharge diagnosis: l foot mrsa cellulitis guiac positive stool anemia atrial fibrilation elevated inr/coagulopathy diabetes mellitus, type 2 discharge condition: hemodynamically stable discharge instructions: please take all medications as instructed. there were several changes made to your current medications regimen. if you experience any nausea, vomiting, lightheadedness, chest pain, shortness of breath, or any other concerning symptoms please seek medical attention immediately. followup instructions: please make an appointment to see your primary care physician, . within the next 2 weeks. tel . please have him follow your cbc at least weekly. we recommend that you have another colonoscopy to evaluate a source of your guiac positive stools. please have dr. titrate your metformin dose. . please make a follow-up appointment with dr. in 3 weeks. tel . procedure: venous catheterization, not elsewhere classified application of external fixator device, tarsals and metatarsals local excision of lesion or tissue of bone, tarsals and metatarsals other arthrotomy, ankle diagnoses: thrombocytopenia, unspecified congestive heart failure, unspecified acute posthemorrhagic anemia unspecified septicemia severe sepsis chronic airway obstruction, not elsewhere classified atrial fibrillation infection with microorganisms resistant to penicillins septic shock diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled disorder of bone and cartilage, unspecified cellulitis and abscess of foot, except toes chronic osteomyelitis, ankle and foot arthropathy associated with neurological disorders ulcer of ankle tabes dorsalis 

Answer: The patient is high likely exposed to