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: keflex attending: chief complaint: left lower extremity ischemic pain major surgical or invasive procedure: left lower extremity angiogram with bilateral common and external iliac arteries stents left common femoral to anterior tibial artery bypass with nonreversed saphenous vein and angioscopy. aortogram, left lower extremity runoff, second order catheterization, ultrasound guidance for femoral access. history of present illness: mr. is a 53m s/p right sfa to anterior tibial bypass with saphenous vein who presents with 3 days of progressively worsening left leg pain, no change in motor function. on presentation, he noted worsening discoloration of his distal left foot. patient reports sensation is always diminished secondary to neuropathy. he denies fevers or chills. he was seen by his cardiologist who referred the patient to the ed. past medical history: diabetes mellitus type ii peripheral vascular disease hypertension hypercholesterolemia ?prior myocardial infarctions without intervention prior transient ischemic attacks history of alcohol abuse s/p right lower extremity sfa to at bypass eith saphenous vein appendectomy laparoscopic cholecystectomy social history: lives with wife, h/o alcohol abuse with withdrawal though reports no alcohol use in 1.5 years, h/o tobacco abuse 3ppd x 35 years though quit 1.5 years ago. denies ivdu. family history: non contribtary physical exam: tmax 98.8, hr 70, bp 122/59, rr 16, o2 sat 98% ra general: middle aged male in nad, a&ox3 neuro: cn ii-xii intact lungs: cta bilat, no resp distress heart: nl s1, s2, rrr, no mrg abd: +bs x4, soft, nt, nd lle surgical wound: staples cdi without erythema or drainage. lle great toe with dry gangrene/eschar extremities, no clubbing, cyanosis, or edema. + doppler pulses dp/pt bilat. pertinent results: 01:55pm blood wbc-9.4# rbc-4.53* hgb-14.5 hct-41.1 mcv-91 mch-32.1* mchc-35.3* rdw-14.8 plt ct-150 07:20am blood wbc-6.6 rbc-3.91* hgb-13.0* hct-36.5* mcv-93 mch-33.2* mchc-35.6* rdw-14.4 plt ct-136* 03:36am blood wbc-6.5 rbc-3.96* hgb-13.3* hct-37.1* mcv-94 mch-33.5* mchc-35.8* rdw-14.5 plt ct-139* 03:06am blood wbc-6.0 rbc-4.18* hgb-13.6* hct-40.6 mcv-97 mch-32.4* mchc-33.4 rdw-14.7 plt ct-141* 08:32pm blood wbc-6.7 rbc-3.84* hgb-12.6* hct-36.0* mcv-94 mch-32.8* mchc-35.0 rdw-14.5 plt ct-160 11:39am blood wbc-6.7 rbc-3.73* hgb-11.6* hct-34.4* mcv-92 mch-31.1 mchc-33.8 rdw-14.4 plt ct-130* 04:35am blood wbc-8.1 hgb-10.7* hct-29.7* plt ct-119* 05:58am blood wbc-8.1 rbc-3.43* hgb-11.1* hct-30.8* mcv-90 mch-32.5* mchc-36.1* rdw-14.8 plt ct-141* 05:30am blood wbc-6.4 rbc-3.45* hgb-11.1* hct-31.4* mcv-91 mch-32.3* mchc-35.5* rdw-14.7 plt ct-140* 05:00am blood wbc-6.1 rbc-3.38* hgb-10.9* hct-31.5* mcv-93 mch-32.1* mchc-34.5 rdw-14.6 plt ct-189 03:00am blood wbc-7.7 rbc-3.63* hgb-11.8* hct-34.1* mcv-94 mch-32.6* mchc-34.6 rdw-15.1 plt ct-227 01:55pm blood pt-12.8 ptt-22.9 inr(pt)-1.1 03:00am blood plt ct-227 01:55pm blood glucose-198* urean-14 creat-0.9 na-133 k-4.3 cl-94* hco3-24 angap-19 07:20am blood glucose-293* urean-8 creat-0.7 na-132* k-4.1 cl-96 hco3-27 angap-13 03:36am blood glucose-180* urean-7 creat-0.8 na-136 k-3.8 cl-98 hco3-30 angap-12 03:06am blood glucose-137* urean-9 creat-1.2 na-139 k-3.8 cl-101 hco3-28 angap-14 04:55am blood glucose-213* urean-6 creat-1.0 na-136 k-3.1* cl-98 hco3-28 angap-13 11:39am blood glucose-216* urean-7 creat-1.0 na-139 k-3.4 cl-103 hco3-26 angap-13 04:35am blood glucose-245* urean-9 creat-1.0 na-136 k-4.6 cl-103 hco3-27 angap-11 05:58am blood glucose-106* urean-13 creat-1.1 na-139 k-3.5 cl-101 hco3-28 angap-14 05:30am blood glucose-118* urean-10 creat-1.0 na-141 k-3.8 cl-103 hco3-29 angap-13 05:30am blood glucose-171* urean-9 creat-1.1 na-135 k-4.1 cl-97 hco3-28 angap-14 05:00am blood glucose-124* urean-14 creat-1.1 na-139 k-3.5 cl-102 hco3-30 angap-11 03:00am blood glucose-207* urean-13 creat-1.2 na-136 k-3.6 cl-98 hco3-27 angap-15 09:03pm blood ck(cpk)-63 09:03pm blood ck-mb-3 ctropnt-<0.01 5:55 pm blood culture **final report ** blood culture, routine (final ): no growth. 6:05 pm blood culture **final report ** blood culture, routine (final ): no growth. right groin u/s findings: no abnormalities identified in the region of clinical concern in the right groin. no fluid collection or evidence of pseudoaneurysm or fistula is seen. the right common femoral artery displays normal waveform and compressibility. a graft is partially imaged within the right groin. impression: no abnormality identified at the site of clinical concern. no evidence of fluid collection, av fistula, or pseudoaneurysm formation. cxr: findings: as compared to the previous radiograph, there is no relevant change. normal appearance of the lung parenchyma. normal size of the cardiac silhouette. normal hilar and mediastinal contours. the previously placed central venous access line has been removed in the interval. brief hospital course: mr. was admitted on with left lower extremity ischemic pain and left great toe ulcer. he was started on a heparin drip and given pain medication for his ischemic pain. iv antibiotics were initiated for groin cellulitis and continued throughout his admission. a picc line was placed for antibiotics given poor peripheral access. on , mr. was consented and taken to the endovascular suite for left lower extremity angiogram. the angiogram showed severe calcification of the bilateral external and common iliac arteries, complete occlusion of the left superficial femoral artery at its origin with reconstitution below the adductor hiatus from collaterals derived from the profunda femoris artery, and complete obstruction of the posterior tibial artery at its origin. bilateral common and external iliac arteries were stented at that time with a plan to return to the or to bypass the occluded vessels. vein mapping was performed and he underwent evaluation by cardiology for surgical clearance. he was given cardiac clearance by dr. to proceed with bypass. on , the patient went to the or for left common femoral to anterior tibial artery bypass with nonreversed saphenous vein and angioscopy. intra-operatively, he was closely monitored and remained hemodynamically stable. he tolerated the procedure well without any difficulty or complication. post-operatively, he was extubated and transferred to the pacu for further stabilization and monitoring. he was then transferred to the vicu for further recovery. while in the vicu he was monitored closely. on pod1, he was delined, his diet was advanced, and heparin drip was turned off. on pod2, foley was removed, he voided, and a pt consult was obtained. on , there was some concern for ischemia of the left great toe, so he was taken back to the endovascular suite for repeat angiogram, which showed patent bypass and runoff. we continued to monitor his left great toe, which improved in appearance over the next couple days. he remained hemodynamically stable with his pain controlled. he progressed with physical therapy to improve his strength and mobility. pt recommended home with pt services. on the day of discharge, his picc line was removed and he was started on bactrim ds for 2 weeks. he continues to make steady progress without any incidents. he was discharged to home with physical therapy in stable condition. of note, his creatinine was stable(0.9-1.1)throughout his admission. medications on admission: aggrenox 25 mg-200 , ativan 1 qid, metoprolol 50'', protonix 40'', simvastatin 80'', bactrim ds until , trazadone 50-100 qhs, lantus 40'', humalog ss; ativan 1 qid prn anxiety discharge medications: 1. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain: take colace to prevent constipation while you are taking percocet for pain. disp:*40 tablet(s)* refills:*0* 2. simvastatin 80 mg tablet sig: one (1) tablet po once a day. 3. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 4. lorazepam 1 mg tablet sig: one (1) tablet po qid (4 times a day) as needed for anxiety. 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. bactrim ds 800-160 mg tablet sig: one (1) tablet po twice a day for 14 days days: start date: . disp:*28 tablet(s)* refills:*0* 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 8. aggrenox 200-25 mg cap, multiphasic release 12 hr sig: one (1) cap, multiphasic release 12 hr po twice a day. 9. insulin glargine 100 unit/ml solution sig: forty five (45) units subcutaneous qam and qhs. 10. humalog 100 unit/ml solution sig: one (1) subcutaneous with meals: ***resume home humalog sliding scale*** . discharge disposition: home with service facility: vna discharge diagnosis: left lower extremity ischemia peripheral vascular disease diabetes mellitus hypertension hypercholesterolemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: division of vascular and endovascular surgery lower extremity bypass surgery discharge instructions what to expect when you go home: 1. it is normal to feel tired, this will last for 4-6 weeks ??????you should get up out of bed every day and gradually increase your activity each day ??????you may walk and you may go up and down stairs ??????increase your activities as you can tolerate- do not do too much right away! 2. it is normal to have swelling of the leg you were operated on: ??????elevate your leg above the level of your heart (use pillows or a recliner) every 2-3 hours throughout the day and at night ??????avoid prolonged periods of standing or sitting without your legs elevated 3. it is normal to have a decreased appetite, your appetite will return with time ??????you will probably lose your taste for food and lose some weight ??????eat small frequent meals ??????it is important to eat nutritious food options (high fiber, lean meats, vegetables/fruits, low fat, low cholesterol) to maintain your strength and assist in wound healing ??????to avoid constipation: eat a high fiber diet and use stool softener while taking pain medication what activities you can and cannot do: ??????no driving until post-op visit and you are no longer taking pain medications ??????you should get up every day, get dressed and walk ??????you should gradually increase your activity ??????you may up and down stairs, go outside and/or ride in a car ??????increase your activities as you can tolerate- do not do too much right away! ??????no heavy lifting, pushing or pulling (greater than 5 pounds) until your post op visit ??????you may shower (unless you have stitches or foot incisions) no direct spray on incision, let the soapy water run over incision, rinse and pat dry ??????your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing over the area that is draining, as needed ??????take all the medications you were taking before surgery, unless otherwise directed what to report to office: ??????redness that extends away from your incision ??????a sudden increase in pain that is not controlled with pain medication ??????a sudden change in the ability to move or use your leg or the ability to feel your leg ??????temperature greater than 100.5f for 24 hours ??????bleeding, new or increased drainage from incision or white, yellow or green drainage from incisions lower extremity angiogram discharge instructions medications: ??????continue all other medications you were taking before surgery, unless otherwise directed ??????you make take tylenol or prescribed pain medications for any post procedure pain or discomfort what to expect when you go home: it is normal to have slight swelling of the legs: ??????elevate your leg above the level of your heart (use pillows or a recliner) every 2-3 hours throughout the day and at night ??????avoid prolonged periods of standing or sitting without your legs elevated ??????it is normal to feel tired and have a decreased appetite, your appetite will return with time ??????drink plenty of fluids and eat small frequent meals ??????it is important to eat nutritious food options (high fiber, lean meats, vegetables/fruits, low fat, low cholesterol) to maintain your strength and assist in wound healing ??????to avoid constipation: eat a high fiber diet and use stool softener while taking pain medication what activities you can and cannot do: ??????when you go home, you may walk and go up and down stairs ??????you may shower (let the soapy water run over groin incision, rinse and pat dry) ??????your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing or band aid over the area that is draining, as needed ??????no heavy lifting, pushing or pulling (greater than 5 lbs) for 1 week (to allow groin puncture to heal) ??????after 1 week, you may resume sexual activity ??????after 1 week, gradually increase your activities and distance walked as you can tolerate ??????no driving until you are no longer taking pain medications what to report to office: ??????numbness, coldness or pain in lower extremities ??????temperature greater than 101.5f for 24 hours ??????new or increased drainage from incision or white, yellow or green drainage from incisions ??????bleeding from groin puncture site sudden, severe bleeding or swelling (groin puncture site) ??????lie down, keep leg straight and have someone apply firm pressure to area for 10 minutes. if bleeding stops, call vascular office . if bleeding does not stop, call 911 for transfer to closest emergency room. followup instructions: dr. (cardiology) , janurary 12, 11:45am provider: , md phone: date/time: 10:00 procedure: angioplasty of other non-coronary vessel(s) arteriography of femoral and other lower extremity arteries arteriography of femoral and other lower extremity arteries other (peripheral) vascular shunt or bypass aortography aortography arteriography of other intra-abdominal arteries insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) transposition of cranial and peripheral nerves insertion of two vascular stents procedure on two vessels diagnoses: pure hypercholesterolemia cellulitis and abscess of trunk unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled other and unspecified alcohol dependence, in remission ulcer of other part of foot old myocardial infarction unspecified hereditary and idiopathic peripheral neuropathy atherosclerosis of native arteries of the extremities with gangrene cellulitis and abscess of foot, except toes chronic total occlusion of artery of the extremities 

Answer: The patient is high likely exposed to