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: codeine attending: chief complaint: pneumonia major surgical or invasive procedure: none history of present illness: 68 year-old woman with recent hemorrhagic stroke secondary to amyloid angiopathy s/p emergent left craniectomy and evacuation of hematoma on , seizures on dilantin and keppra, respiratory failure s/p tracheostomy placement on , also with large gastric ulcer on endoscopy that prevented peg tube placement with gastric mucormycosis infection, currently ventilator dependent, directly admitted to the micu for persistent fevers, presumed to be secondary to mssa pneumonia in addition to follow-up neurosurgery evaluation by dr. team. she was recently admitted on for repeat endoscopic evaluation for treatment response after ambisome therapy for her gastric mucormycosis infection. egd showed known ulcer in the stomach body, and an nj tube was placed by gi and verified on imaging to be in the 4th portion of the duodenum. infectious disease was contact during this admission and recommended no change in therapy with plan to continue ambisome daily as previously prescribed until further id evaluation. she had an isolated temperature of 100.3 during the admission with negative blood and urine cultures. id was contact on regarding antimicrobial regimen. dr. had reported intermittent fevers, and she received a course of vancomycin and zosyn empirically with removal of picc line. dr. was concerned that amphotericin was causing fevers and stopped it. she was afebrile at that time and off antibiotics. it was suggested that she start posaconazole 200 mg qid at this point with a lipid- diet. she spiked again to 102.6f on thursday with wbc 21 at which time it appears she was started empirically on cefazolin and vancomycin. midline was placed friday . antibiotics were narrowed to nafcillin on saturday when sputum culture grew mssa. she was also noted to be having very loose stools but has been c diff negative x4. her hematocrit was noted to be 22.8 (decreased from baseline of 27) over the weekend, for which she received 1 unit prbcs with post-transfusion hct of 25.1. she also has had issues with vent weaning and tachycardia/hypertension. her mental status has remained altered. on arrival to the micu, patient was agitated. review of systems: unable to obtain past medical history: s/p hemorrhagic stroke - large left occipital iph with intraventricular extension - s/p left craniectomy and evacuation of hematoma gastric mucormycosis - s/p several weeks of amphotericin treatment, stopped in setting of intermittent fevers of unclear etiology : left craniectomy and evacuation of hematoma : trach placement : egd w/ gastric biopsy - seasonal allergies social history: was previously living with husband normally in but camps each summer in in a trailer which she was prior to hospitalization for intracranial hemorrhage. no tobacco. currently at rehab. sister is hcp. family history: cva in mother, father, and grandmother. physical exam: admission physical exam: general appearance: no acute distress eyes / conjunctiva: perrl head, ears, nose, throat: normocephalic lymphatic: cervical wnl cardiovascular: (s1: normal), (s2: normal) peripheral vascular: (right radial pulse: not assessed), (left radial pulse: not assessed), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (breath sounds: clear : ) abdominal: soft, non-tender, bowel sounds present extremities: right lower extremity edema: absent, left lower extremity edema: absent skin: warm neurologic: no(t) attentive, no(t) follows simple commands, responds to: not assessed, movement: not assessed, tone: not assessed . discharge physical exam: pertinent results: 09:50am blood wbc-16.1* rbc-3.31* hgb-9.1* hct-27.4* mcv-83 mch-27.4 mchc-33.1 rdw-15.8* plt ct-502* 04:03am blood wbc-16.3* rbc-3.12* hgb-8.4* hct-26.0* mcv-83 mch-26.9* mchc-32.4 rdw-15.6* plt ct-420 07:03pm blood wbc-19.0* rbc-3.13* hgb-8.5* hct-25.9* mcv-83 mch-27.2 mchc-33.0 rdw-15.9* plt ct-492* 03:06am blood wbc-19.1* rbc-3.04* hgb-8.3* hct-24.9* mcv-82 mch-27.2 mchc-33.2 rdw-16.0* plt ct-457* 09:50am blood glucose-119* urean-16 creat-0.8 na-137 k-3.3 cl-96 hco3-30 angap-14 04:03am blood glucose-141* urean-19 creat-1.1 na-135 k-3.6 cl-95* hco3-27 angap-17 07:03pm blood glucose-138* urean-23* creat-1.4* na-133 k-3.0* cl-92* hco3-26 angap-18 03:06am blood glucose-158* urean-23* creat-1.4* na-134 k-3.3 cl-93* hco3-27 angap-17 09:50am blood calcium-9.2 phos-3.9 mg-1.8 10:36am blood albumin-3.0* 04:03am blood calcium-9.0 phos-4.3 mg-1.8 07:03pm blood calcium-8.8 phos-4.2 mg-1.7 03:06am blood calcium-8.9 phos-4.2 mg-2.4 10:36am blood vitb12-1106* 10:36am blood tsh-2.5 10:47am urine color-yellow appear-clear sp -1.011 12:33am urine color-yellow appear-clear sp -1.008 10:47am urine blood-sm nitrite-neg protein-tr glucose-neg ketone-neg bilirub-neg urobiln-neg ph-7.0 leuks-neg 12:33am urine blood-sm nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.0 leuks-neg 10:47am urine rbc-12* wbc-3 bacteri-none yeast-none epi-0 12:33am urine rbc-12* wbc-3 bacteri-none yeast-none epi-<1 12:33am urine casthy-34* urine culture (final ): no growth. brief hospital course: 68f with recent hemorrhagic stroke secondary to amyloid angiopathy s/p emergent left craniectomy and evacuation of hematoma on complicated by seizures, continuing respiratory failure s/p tracheostomy on , large gastric ulcer with mucormycosis presents for repeat neuroimaging/neurosurgery evaluation; also with mssa pneumonia. # ich secondary to amyloid angiopathy s/p left craniectomy and hematoma evacuation complicated by seizure: the patient underwent mr imaging of her head. the imaging showed expected changes with continued swelling and no new hemorrhage. the neurosurgery service was satisfied with the imaging and plans for a repeat non-contrast head ct in weeks, and for reconstruction of her skull sometime in . # fever patient being treated for vap, sputum culture positive for mssa pneumonia. she is ventilator dependent, but sputum cultures have allowed for narrowing antibiotic regimen to nafcillin. patient does have persistent loose stools with negative stool studies as above. she also has history of mucormycosis of the gi tract and has been treated with ambisome for several weeks, recently switched to posaconazole. no other sources of infection identified. her last dose of nafcillin will be . # respiratory failure patient has been ventilator dependent since hemorrhagic stroke in , currently at rehab with unsucessful weaning. by the end of her icu stay she was able to tolerate pressure support ventilation of with an fio2 of 0.4. # pulmonary edema cxr with pulmonary edema, which appears to be consistent problem on prior cxr. it is not entirely clear if this is cardiogenic or non-cardiogenic pulmonary edema. the elevated bnp suggests a cardiac cause, but her echocardiogram showed essentially normal cardiac function with a lvef of 55%. she was easier to diurese with iv furosemide, so it may be worth considering iv rather than po diuretics. # diarrhea patient with diarrhea likely secondary to medication side effect or high-lipid tube feeds. multiple stool c diff toxin assays have been negative. she was started on loperamide since the diarrhea seemed to be causing perineal irritation. # chronic toxic-metabolic encephalopathy patient intermittently agitated as she has been at rehab. likely multifactorial from central process, pulmonary infection, medication side effect such as levetiracetam. however, neurosurgery states that she was in her current state before starting on levetiracetam, making it an unlikely cause of her condition. tsh, b12, and rpr were normal. there was no suggestion of encephalitis on her mr. # agitation she was continually agitated throughout her micu stay, except when sedated with propofol for imaging studies. the level of agitation is unchanged from her baseline at rehab. she will continue on her prior quetiapine dose. # atrial fibrillation during her icu stay the patient developed atrial fibrillation with rapid ventricular response. attempts at rate control were not successful and so she was started on amiodarone, which converted her to sinus rhythm. she was transitioned to amiodarone per tube, with a plan for 400 mg tid until to finish 10g loading dose. then, discontinue amiodarone and re-evaluate the need for rhythm control. # tachycardia/hypertension hemodynamics have been variable at rehab with bp 140-170 and persistent tachycardia in 100s. excepting the atrial fibrillation noted above, she has been in sinus tachycardia. during her icu stay, her home diltiazem and metoprolol were held in the setting of hypotension and initiating amiodarone therapy, but metoprolol was restarted at low doses before discharge. the plan will be to restart her prior metoprolol dose of 100 mg tid. continue to hold diltiazem. # gastric ulcer with mucormycosis colonization patient with known gastric ulcer, h. pylori negative. egd showed very broad ulcer with hyphal forms seen on biopsy recognized as zygomycosis with negative culture. etiology of ulcer is not known definitely. repeat biopsy for culture did not grow any organisms. she was continued on posaconazole per infectious disease's original recommendations. follow up with infectious disease to clarify duration of posaconazole therapy. # anemia etiology likely multifactorial. stool guiaic has been negative. her hemoglobin fell from 9.1 to 8.3 over the course of her icu stay with no obvious source of bleeding. she was transfused one unit of packed red blood cells, after which her urine output improved modestly. # code status the patient was full code throughout her hospital course and will remain so after discharge. medications on admission: from rehab list - levetiracetam 100 mg/ml solution : () mg po bid per ng tube. - metoprolol tartrate 100 mg tablet tid - nafcillin 2mg q4hours iv - started - nystatin 100,000 unit/ml suspension - 5ml po tid after meals. - omeprazole 40mg daily - posaconazole 200mg qid - kcl po elixir 20 meq daily - vancomcyin 250mg po tid - quetiapine fumarate 6.25mg daily oral - quetiapine fumarate 12.5mg qhs - albuterol/ipratrop inhaler - 6 puffs q4hrs - chlorhexidine gluconate - 15ml qid swish and spit - cholestyramine 4grams - diltiazem 30mg q6 hours per g tube (total 45mg q6hrs) - diltiazem 15mg q6hrs per g-tube (total 45mg q6hrs) - furosemide 20mg po (by ng tube) - lidocaine jelly q6hrs topical - zinc oxide q8h topical - prn acetaminophen 650mg q4h - prn dextrose oral gel - prn glucagon 1mg im - prn ondansetron 4mg q8h discharge disposition: extended care facility: for the aged - macu discharge diagnosis: methicillin-sensitive staphylococcus aureus pneumonia intracranial hemorrhage, status post craniectomy discharge condition: mental status: confused - always. has a tracheostomy but does not attempt to respond verbally to speech or stimuli. does not follow commands. not purposefully interactive. level of consciousness: awake but not attentive. opens eyes spontaneously. moves all extremities spontaneously and continuously. activity status: bedbound. discharge instructions: dear ms. , you were admitted to the hospital because you had a pneumonia, and you had a scheduled follow up with dr. , your neurosurgeon. you were continued on antibiotics for your pneumonia, which is improving. you were seen by the neurosurgeon, dr. , who was very pleased with your progress. while you were in the hospital, we also started a new medication to help control an abnormal rhythm that your heart went into. we also were able to change your ventilator settings after getting a little extra fluid out of your lungs. the following changes were made to your medications: - please start amiodarone 400 mg po tid x 2 more days, then stop - please stop diltiazem home dose for now. this medication can be restarted and uptitrated as necessary in the rehabilitation facility. - please continue nafcillin iv 2gm q4 hours for 2 more days (for total of 10 day course of antibiotics), then stop. - please stop po vancomycin - start loperamide as needed for loose stool followup instructions: you will need to follow up with dr. and the neurosurgery team in weeks for repeat head imaging. dr. plans to reconstruct your skull in . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: anemia, unspecified toxic encephalopathy other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site other late effects of cerebrovascular disease epilepsy, unspecified, without mention of intractable epilepsy diarrhea ventilator associated pneumonia accidents occurring in residential institution tracheostomy status acute edema of lung, unspecified dependence on respirator, status physical restraints status chronic gastric ulcer without mention of hemorrhage or perforation, without mention of obstruction bed confinement status 

Answer: The patient is high likely exposed to