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 (sulfonamide antibiotics) / procardia attending: chief complaint: perforated viscus major surgical or invasive procedure: washout, transverse colostomy, fascial closure washout, transverse colectomy, open/discontinuity exlap, l colectomy, open abdomen, dicontinuity history of present illness: 56f with two prior episodes of diverticulitis now with intermittent abdominal pain for 10-14 days worsening over the day prior to admission, found to have large recto-sigmoid perf, taken to or, sigmoid resected, rectum stapled, proximal colon stapled, and abdomen left open on , admitted to icu and started on cvv for acute renal failure. past medical history: pmh: diverticulosis c/b lgib (, ) and diverticulitis x 2, proteinuria, bladder cancer s/p cystoscopic resection, diastolic heart failure (ef 55%), asthma, htn psh: turbt x 2 for bladder tumor, colonoscopy ,,(diverticulosis starting at cecum) social history: the patient currently lives in alone. she is single, 1 son. the patient has no hcp. the patient is currently on disability for arthritis. she previously worked in food services, bartending, catering. tobacco: ppd x 40 years etoh: prior heavy use, has since quit illicits: none family history: mother with dm, htn, diverticulitis, angina at the age of 38 and cva at age 48 from which she passed away. physical exam: physical exam: vitals: t 98.1 hr 133 bp 188/122 rr 24 o2 sat 96% 4l gen: a&o, nad heent: no scleral icterus, mucus membranes dry cv: tachycardic, no m/g/r pulm: clear to auscultation b/l, no w/r/r abd: soft, distended, absent bowel sounds, diffusely ttp with rebound but no guarding dre: soft, brown stool, guiac negative, no masses ext: no le edema, le warm and well perfused physical examination upon discharge: : vital signs: t=97, bp 124/73, hr=67, oxygenation room air 96%, resp. rate 18 general: nad, sitting in chair, pleasant, conversant cv: ns`1, s2, -s3, -s4, no murmurs lungs: clear, diminished bs left side and bases abdomen: ostomy left side abdomen, stoma retracted, golden yellow loose stool in bag. mid-line incision with moist to dry dressing. ext: no pedal edema bil., + dp bil, feet warm, no calf tenderness bil. neuro: alert and oriented x 3, speech clear, no tremors pertinent results: 05:03am blood wbc-14.5* rbc-3.16* hgb-9.4* hct-28.5* mcv-90 mch-29.6 mchc-32.9 rdw-15.1 plt ct-823* 01:54am blood wbc-14.2* rbc-3.07* hgb-9.0* hct-27.9* mcv-91 mch-29.3 mchc-32.3 rdw-15.4 plt ct-760* 03:50pm blood neuts-80* bands-0 lymphs-12* monos-4 eos-0 baso-0 atyps-0 metas-4* myelos-0 05:03am blood plt ct-823* 01:54am blood plt ct-760* 02:19am blood pt-15.3* ptt-29.0 inr(pt)-1.3* 05:03am blood glucose-161* urean-33* creat-0.9 na-141 k-3.9 cl-107 hco3-20* angap-18 01:54am blood glucose-107* urean-41* creat-1.0 na-146* k-3.7 cl-109* hco3-25 angap-16 03:29pm blood glucose-105* urean-38* creat-0.8 na-147* k-3.4 cl-113* hco3-22 angap-15 02:00am blood alt-23 ast-15 ld(ldh)-268* alkphos-309* totbili-0.9 08:16am blood alt-17 ast-35 alkphos-82 totbili-1.3 05:03am blood calcium-9.4 phos-3.7 mg-2.1 07:20am blood vanco-12.7 08:02am blood vanco-14.8 02:55am blood lactate-1.2 02:55am blood freeca-1.18 : ekg: sinus tachycardia. poor r wave progression. non-specific st segment depression most pronounced in the lateral leads. compared to the previous tracing of sinus tachycardia and st segment depression are new. : cat scan of abdomen pelvis: impression: 1. multiple locules of free air and mesenteric fluid surrounding abnormal-appearing loops of small bowel in the right lower quadrant and left mid to lower abdomen consistent with bowel perforation and concern for ischemia. these loops of bowel demonstrate wall thickening; however, they remain enhancing. an air and fluid extraluminal collection in the right pelvis has the appearance of stool and abuts small bowel and the sigmoid colon. extensive colonic diverticulosis, particularly along the sigmoid colon. 2. fat-containing ventral wall hernia with engorged vessels. : echo: conclusions the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. there is moderate global left ventricular hypokinesis (lvef = 30-35 %). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is no pericardial effusion. impression: moderately depressed left ventricular systolic function. : chest x-ray: continued progressive worsening of volume status, with increased cardiomegaly, bilateral effusions and pulmonary edema. dense retrocardiac opacity most likely reflects volume loss. : ekg: sinus tachycardia, rate 102. left atrial abnormality. non-specific st-t wave changes in leads i, ii and v3-v6. compared to the previous tracing of the rate has slowed from sinus tachycardia, rate 129, to sinus tachycardia, rate 102. the non-specific st-t wave changes are less prominent on the current tracing. otherwise, no diagnostic interval change. : chest x-ray: asymmetric pulmonary edema now involves the left upper lobe. left lower lobe remains consolidated, and there is a large band of atelectasis in the right mid lung. right upper lung is clear. mild cardiomegaly is stable. tip of the endotracheal tube above the upper margin of the clavicles is at least 5 cm above the carina, 15 mm above the optimal placement. nasogastric tube passes below the diaphragm and out of view. left subclavian line ends in the mid svc. no pneumothorax. : chest x-ray: findings: as compared to the previous radiograph, the patient has been extubated. the left central venous access line and the nasogastric tube are in unchanged position. unchanged left pleural effusion with retrocardiac atelectasis and right basal atelectasis. no newly appeared focal parenchymal opacities : 3:50 pm blood culture #1. **final report ** blood culture, routine (final ): bacteroides fragilis. beta lactamase positive. anaerobic bottle gram stain (final ): reported to and read back by papavstravrou @ 2100 on - cc6c. gram negative rod(s). : peritoneal fluid: 9:48 pm peritoneal fluid **final report ** gram stain (final ): reported to and read back by dr. . raykar on at 0245. 3+ (5-10 per 1000x field): polymorphonuclear leukocytes. 4+ (>10 per 1000x field): gram negative rod(s). 4+ (>10 per 1000x field): gram positive cocci. in pairs and chains. 2+ (1-5 per 1000x field): gram positive rod(s). fluid culture (final ): due to mixed bacterial types (>=3) an abbreviated workup is performed; p.aeruginosa, s.aureus and beta strep. are reported if present. susceptibility will be performed on p.aeruginosa and s.aureus if sparse growth or greater.. anaerobic culture (final ): mixed bacterial flora-culture screened for b. fragilis, c. perfringens, and c. septicum. bacteroides fragilis group. heavy growth of two colonial morphologies. beta lactamase positive : sputum: 11:59 am sputum source: endotracheal. **final report ** gram stain (final ): pmns and <10 epithelial cells/100x field. no microorganisms seen. respiratory culture (final ): no growth brief hospital course: 56 year old female admitted to the acute care service with diffuse abdomional pain. upon admission, she was made npo, given intravenous fluids, and underwent radiographic imaging. she was found to have a recto-sigmoid perforation. she was taken to the operating room for an exploratory laparotomy and left colecomy. in the operating room a large rectosigmoid perforation was noted, the sigmoid was resected, rectum stapled, proximal colon stapled, an ostomy was not brought up given edema, abdomen was left open). she received 10 liters of fluid between the emergency room and the operating room. post-op, she was kept intubated and transferred to the intensive care unit on pressor for blood pressure support and for monitoring. 24 hours post-op, she returned to the operating room for abdominal washout. her abdomen was left open because of excess fluid and she was started on a lasix drip. despite lasix, she had a poor urine output and nephrology was consulted. a hemodialysis catheter was placed and she was started on cvvh to remove excess fluid. during this time, she was febrile to 102.7 and cultures sent. she returned to the operating room on pod #2 for washout and a transverse colectomy. her abdomen was left open and cvvh resumed to remove excess fluid. the cvvh was discontinued on after she started to have adequate response from lasix. on pod #3, she returned again to the operating room for washout, transverse colostomy and fascial closure. on pod #8, she was reported to have a rise in her white blood cell count and became hypertensive. she had a mild elevation in her creatinine and she was found to be wet on chest x-ray. she received lasix and had an adequate diuresis. her pulmonary status improved and the dialysis cath was discontinued. to help with her nutritional status, she was started on trophic tube feedings. she was reported on pod #9 to have a slight worsening of her chest x-ray and had a free water restriction placed with her nutritional supplements. at this time, diuresis continued. because she was becoming alkalotic from the diuresis she was started on diamox with careful monitoring of her electrolytes. on pod # 14, her electrolytes normalized and her oxygenation and chest x-ray improved. she was successfully extubated. twenty-four hours later, her feeding tube was discontinued and she was started on a regular diet. she was transferred to the surgical floor on . her foley catheter was discontinued and she has been voiding without difficulty. she had a vac dressing placed onto her abdominal wound to assist with wound closure. she was evaluated by physical therapy andrecommendations made for discharge to a rehabilitation facility. her vital signs are stable and she is afebrile. her hematocrit has stabilized at 29 and her creatinine has stabilized at 0.9. she is tolerating a regular diet. her pulmonary status is stable with an oxygen saturation of 94% on room air. she has resumed her cardiac medications. she is preparing for discharge to a rehbilitation facility with follow-up appoinments with the acute care service, cardiology, and her primary care provider. will need close monitoring of her electrolytes since she has resumed her cardiac medications. she will need re-application of the vac dressing to the abdomen with vac dressing changes q 72 hours medications on admission: : albuterol, diltiazem er 300', enalapril 20'', felodipine er 5', propafenone225 er'', spritulina, vit c 500', asa81', cholecalciferol 1000', mag500', melatonin 2.5hs', mvi, vit e discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 2. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation q6h (every 6 hours) as needed for wheeze. 3. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 4. hydromorphone 2 mg tablet sig: one (1) tablet po q3h (every 3 hours) as needed for pain: hold for increased sedation, resp. rate <12. 5. acetaminophen 500 mg tablet sig: two (2) tablet po q 8h (every 8 hours). 6. colace 100 mg capsule sig: one (1) capsule po twice a day: hold for diarrhea. 7. diltiazem hcl 300 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po daily (daily): hold for blood pressure <100, hr <60. 8. enalapril maleate 20 mg tablet sig: one (1) tablet po bid (2 times a day): hold for blood pressure <100, hr <60, continue to monitor k+. 9. felodipine 5 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po daily (daily): hold for blood pressure <100, hr<60. 10. propafenone 150 mg tablet sig: one (1) tablet po q 8h (every 8 hours). 11. insulin sliding scale (as per scale) 12. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. discharge disposition: extended care facility: , discharge diagnosis: perforated diverticulitis sepsis atn discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance, support discharge instructions: you were admitted to the hospital with abdominal pain. you were found to have a colon perforation. you were taken to the operating room for an exploratory laparotomy and you had a portion of your large bowel removed. you returned to the operating two other times for cleaning of the wound and for an ostomy. you had a special dressing called a vac dressing appllied. your vital signs are stable and you are preparing for discharge to a rehabilitation facility. followup instructions: department: general surgery/ when: tuesday at 3:30 pm with: acute care clinic building: lm bldg () campus: west best parking: garage name: ,md specialty: internal medicine location: address: , , phone: please discuss with the staff at the facility the need for a follow up appointment to see dr. or your nurse practitioner once you are discharged from the facility. the staff at the facility can call the number listed above to make the appointment. you have an appointment with your cardiologist which is scheduled for: 11:40a -cc7 sc clinical ctr, cc7 cardiology (sb) the telephone number is # md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more open and other left hemicolectomy temporary colostomy enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis arterial catheterization open and other sigmoidectomy other open umbilical herniorrhaphy delayed closure of granulating abdominal wound open and other resection of transverse colon peritoneal lavage peritoneal lavage diagnoses: pneumonia, organism unspecified acidosis tobacco use disorder acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified unspecified essential hypertension unspecified septicemia severe sepsis asthma, unspecified type, unspecified pulmonary collapse cardiogenic shock septic shock personal history of malignant neoplasm of bladder obesity, unspecified hyperosmolality and/or hypernatremia acute vascular insufficiency of intestine chronic diastolic heart failure diverticulitis of colon (without mention of hemorrhage) other suppurative peritonitis nontraumatic compartment syndrome of abdomen acute respiratory failure following trauma and surgery body mass index 40.0-44.9, adult umbilical hernia with obstruction 

Answer: The patient is high likely exposed to