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: patient recorded as having no known allergies to drugs attending: chief complaint: diarrhea with fever major surgical or invasive procedure: none history of present illness: yo with htn, cad s/p cabg, severe tr, phtn, pvd, s/p cva in , prior mssa uti in , history of c. diff in , presents with diarrhea. the patient reports over the last week she has experienced diarrhea, up to 4-5 times daily. she reports her diarrhea improved after coming home from rehab, but recurred a week ago. she also reports abdominal pain, located on her right upper quadrant and epigastrium. she discussed her symptoms with her pcp two days ago, and he encouraged her to come in for evaluation, but she declined and was started on empiric flagyl. stool c diff toxin sent from home, found to be positive. her 24 hour caregiver at home noted her temp to be up to yesterday. . in the ed, initial vs were 100 89 131/49 12 100%. labs significant for leukocytosis of 28.9, creatinine up to 1.3, negative cardiac enzymes, negative lactate, normal lfts, negative ua. ekg revealed rbbb. she was given ciprofloxacin and flagyl, prior to noticing positive c diff toxin. she was given 3ls ns. ct abd revealed bile duct dilation, enlarged gallbladder without clear stones, without obstruction, worsening bowel wall edema in sigmoid (present on last ct ) consistent with either ischemic or infectious colitis. general surgery was consulted and recommended no surgical intervention at this time, stated that gallbladder distension could be related to c diff or poor nutrition, will follow. vs on transfer 99.6 145/52 69 16 100% on ra. . on the floor, the patient has persisent abdominal pain at the right upper quadrant. she reports small amounts of liquid stool while in the ed. she denies nausea and vomiting at this time. past medical history: 1. coronary artery disease, status post cabg in . 2. peripheral arterial disease with status post right carotid endarterectomy in . 3. cva , status post right cea. 4. hypertension. 5. dyslipidemia. 6. pulmonary hypertension. 7. severe tricuspid regurgitation. 8. presyncope. 9. depression social history: lives alone, family nearby. uses cane with ambulation. widowed in . worked subsequently in a bank. has 6 living children - children check on her daily. has home health aide 2x/week. + remote minor tobacco, occasional glass of wine with dinner, no ivdu. family history: children with htn physical exam: initial physical exam vitals: t: 97.3 bp: 139/66 p: 80 r: 18 o2: 100% on 4l general: alert, oriented, elderly female in no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, 3/6 systolic murmur at rusb with rv heave, no rubs, gallops abdomen: soft, tender to palpation at ruq, no guarding, no rebound tenderness, mildly distended, bowel sounds present ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema on discharge: vs:97.7 162/82 (140-162/60-86) 74(74-109) 18 94% ra general: elderly woman, confused heent: perrla, mucous membs dry, no lymphadenopathy chest: diffuse inspiratory crackles cv: rapid rate, irregular, ii/vi holosystolic murmur at the apex abd: + bs, non-tender, mildly distended ext: warm, well perfused, no clubbing cyanosis or edema. dorsalis pedis pulses 2+ bl neuro: responsive but confused, oriented to person, place and year. left facial assymetry unchanged from prior, remaining cranial nerves intact bl, difficult to assess neurologically as pt is not cooperative, moving all extremities pertinent results: cbc 09:05am blood wbc-21.8* rbc-4.00* hgb-12.1 hct-36.4 mcv-91 mch-30.3 mchc-33.2 rdw-15.9* plt ct-411 06:50am blood wbc-17.0* rbc-3.77* hgb-11.3* hct-34.6* mcv-92 mch-29.9 mchc-32.6 rdw-15.9* plt ct-385 06:50am blood wbc-20.2* rbc-3.37* hgb-10.5* hct-30.9* mcv-92 mch-31.1 mchc-33.9 rdw-15.8* plt ct-353 04:16am blood wbc-37.2* rbc-3.48*# hgb-10.6*# hct-32.8* mcv-94 mch-30.6 mchc-32.4 rdw-15.9* plt ct-358 04:03am blood wbc-38.4* rbc-2.59* hgb-7.8* hct-24.1* mcv-93 mch-30.3 mchc-32.5 rdw-15.8* plt ct-294 12:12pm blood wbc-31.7* rbc-2.98* hgb-8.9* hct-27.4* mcv-92 mch-29.8 mchc-32.4 rdw-15.8* plt ct-296 10:15am blood wbc-36.4* rbc-2.95* hgb-9.0* hct-27.3* mcv-92 mch-30.4 mchc-32.9 rdw-15.4 plt ct-285 04:05am blood wbc-33.6* rbc-3.20* hgb-9.8* hct-28.8* mcv-90 mch-30.7 mchc-34.0 rdw-15.6* plt ct-269 09:20am blood wbc-28.3* rbc-3.70* hgb-11.3* hct-34.5* mcv-93 mch-30.7 mchc-32.9 rdw-15.7* plt ct-296 11:10pm blood wbc-28.9*# rbc-3.49* hgb-10.7* hct-31.9* mcv-91 mch-30.6 mchc-33.4 rdw-15.6* plt ct-290 coags 09:05am blood pt-12.8 ptt-23.0 inr(pt)-1.1 06:50am blood pt-12.6 ptt-22.8 inr(pt)-1.1 06:50am blood pt-12.9 ptt-23.3 inr(pt)-1.1 04:03am blood pt-14.3* ptt-25.5 inr(pt)-1.2* 12:12pm blood pt-15.2* ptt-36.5* inr(pt)-1.3* 11:10pm blood pt-13.2 ptt-24.7 inr(pt)-1.1 chemistry 09:05am blood glucose-147* urean-15 creat-0.8 na-144 k-4.0 cl-111* hco3-25 angap-12 06:50am blood glucose-133* urean-19 creat-0.9 na-143 k-3.7 cl-114* hco3-20* angap-13 06:50am blood glucose-76 urean-22* creat-1.0 na-144 k-3.7 cl-115* hco3-21* angap-12 04:16am blood glucose-81 urean-29* creat-1.2* na-140 k-4.1 cl-112* hco3-16* angap-16 04:24pm blood glucose-99 urean-34* creat-1.3* na-137 k-3.4 cl-110* hco3-16* angap-14 04:03am blood glucose-63* urean-37* creat-1.4* na-138 k-3.3 cl-110* hco3-14* angap-17 12:12pm blood glucose-63* urean-40* creat-1.6* na-136 k-3.4 cl-106 hco3-18* angap-15 04:05am blood glucose-120* urean-35* creat-1.5* na-134 k-3.7 cl-103 hco3-19* angap-16 09:20am blood glucose-96 urean-17 creat-1.0 na-139 k-3.7 cl-104 hco3-22 angap-17 11:10pm blood glucose-110* urean-20 creat-1.3* na-135 k-3.3 cl-99 hco3-23 angap-16 09:05am blood calcium-7.8* phos-2.8 mg-2.0 06:50am blood calcium-8.2* phos-2.0* mg-2.0 06:50am blood calcium-8.3* phos-2.2* mg-2.1 04:16am blood calcium-8.6 phos-1.9* mg-2.4 04:24pm blood calcium-8.3* phos-1.8* mg-2.3 04:03am blood calcium-7.6* phos-2.9 mg-1.7 12:12pm blood calcium-8.0* phos-3.2 mg-1.7 04:05am blood calcium-8.3* phos-3.7 mg-1.8 09:20am blood calcium-8.8 phos-3.1 mg-1.8 lft 04:03am blood alt-10 ast-15 alkphos-66 totbili-0.3 12:12pm blood alt-9 ast-17 alkphos-76 totbili-0.4 04:05am blood alt-6 ast-15 ld(ldh)-184 alkphos-87 totbili-0.5 09:20am blood alt-7 ast-13 alkphos-93 totbili-0.6 11:10pm blood alt-10 ast-13 alkphos-91 amylase-25 totbili-1.1 lipase 12:12pm blood lipase-11 11:10pm blood lipase-8 liver or gallbladder us (single organ) study date of 2:34 pm impression: 1. massively dilated gallbladder with pericholecystic fluid without gallbladder wall edema. acute cholecystitis cannot be excluded. 2. diffuse biliary dilatation and pancreatic duct dilatation, unchanged from ct . the specific etiology cannot be identified and could be further evaluated with ercp. abdomen (supine & erect) study date of 12:40 am impression: multiple dilated loops of bowel, can be seen in syndrome. portable abdomen study date of 10:50 am impression: diffuse dilation of the proximal large bowel and small bowel loops, which do not appear significantly changed compared to prior. these findings are concerning for ileus or syndrome. no evidence of large amount of free air. the bowel gas pattern is not suggestive of obstruction. no significant change from the prior. cta chest w&w/o c&recons, non-coronary study date of 12:08 am impression: 1. massive dilation of the gallbladder with intra- and extra-hepatic biliary dilation. 2. diffuse sigmoid and rectal wall thickening concerning for infection. proximal loops of large bowel are dilated, which can be seen in syndrome. 3. no evidence of pulmonary embolism or acute aortic process. 4. bibasilar interstitial abnormality concerning for interstitial lung disease, similar in appearance to the prior examination. clostridium difficile toxin a & b test (final ): reported by phone to @ 11:28p . clostridium difficile. feces positive for c. difficile toxin by eia. (reference range-negative). a positive result in a recently treated patient is of uncertain significance unless the patient is currently symptomatic (relapse). brief hospital course: yo female with cad, cva, pvd, severe tr, htn, depression, admitted for persistent c diff colitis and abdominal pain. hospital course complicated by micu stay for tachycardia & hypotension likely sepsis. . #. c diff colitis/abdominal pain: patient was admitted for persistent diarrhea secondary to c diff. had been treated at home with flagyl, then vancomycin, but not improving. on admission, she was noted to have a large distended abdomen especially in ruq and was found to have a large dilated gallbladder on ct. gi and surgery were consulted, but they were of the opinion that it was likely due to ileus from the c diff infection. there were also concerns for obstruction given her dilated cbd, however no obstruction was visualized on ultrasound, and there were no signs of acute cholecystitis radiologically. patient was urgently transferred to the micu on this admission for hypotension and unresponsiveness, likely due to sepsis from the severe c diff infection. her blood pressure was fluid responsive, but still required pressors in the icu to maintain blood pressures. she stablizied in the icu and was subsequently called out to the floor, remaining on po vancomycin. she will be discharged to rehab where she will continue to receive po vancomycin 4x/day for another week, then once every 3 days for 2 weeks. . #. goals of care: patient is dnr/dni. following call out from the micu, a family meeting was held in order to discuss patient's goals of care. hcp (daughter) and son were present at this meeting. the family would like for her to be discharged to a rehabilitation facility where she can be reconditioned, and then go home with bridge to home hospice. we discussed at length what her comfort measures would include. the family would like for her diarrhea to be addressed as a comfort measure. should the patient again have diarrhea concerning for c diff while at home on hospice, the family will call her pcp, . , who will provide them with a prescription for po vancomycin, in this way they would like to avoid admission to the hospital. . #. gallbladder distension: likely related to her c diff infection causing ileus. surgery and gi were consulted and no acute interventions were warranted. . #. upper gi bleed - patient noted to have coffee ground emesis prior to transfer to the icu. she received one unit of prbc, and since then has had stable hematocrits and been normotensive. aspirin and cilostazol were discontinued at the time given the acute bleed. patient will continue on pantoprazole. as her hematocrits have been stable, we will also restart aspirin given her history of stroke. . #. cad/pvd: patient is s/p cabg, however aspirin was held for gi bleed. patient will continue on betablocker, ace inhibitor, and statin. . #. htn: patient will continue on metoprolol and lisinopril. blood pressure has been well controlled on this regimen. . #. depression/agitation - home bupropion and trazadone were held given acute illness. her mood and affect have been fairly good. had been agitated in the icu, but has since felt well following transfer to the medicine floors. bupriopion and trazadone may be restarted as needed. . #. hx of cva - patient had been on cilostazol at home, but was held for acute upper gi bleed. she will be continued on aspirin. medications on admission: bupropion hcl 75 mg po bid cilostazol 50 mg po twice a day. labetalol 100 mg po bid lisinopril 10 mg po daily nifedipine 30 mg po daily pravastatin 80 mg po q pm. acetaminophen 325 mg 1-2 tablets po q6h as needed for pain. aspirin 81 mg po daily vitamin d 1,000 unit po once a day. senna 8.6 mg po every other day. trazodone 50 mg 0.5 tablet po hs as needed for insomnia. flagyl started discharge disposition: extended care facility: newbridge on the - discharge diagnosis: primary diagnosis c. difficil colitis . secondary diagnoses: 1. coronary artery disease, status post cabg in . 2. peripheral arterial disease with status post right carotid endarterectomy in . 3. cva , status post right cea. 4. hypertension. 5. dyslipidemia. 6. pulmonary hypertension. 7. severe tricuspid regurgitation. 8. presyncope. 9. depression 10. upper gastrointestinal bleed 11. massively enlarged gallbladder discharge condition: mental status: confused - sometimes. level of consciousness: lethargic but arousable. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: ms , it was a pleasure taking care of you in your stay at . as you know, you were admitted for c. diff colitis. you were treated with antibiotics with improvment in your symptoms. your hospitalization was complicated by a bleed from your stomach, you were transfused one unit of blood and stabalized in the intensive care unit. - we made the following changes to your medications - stop cilostasol - continue vancomycin antiboitic daily for one week, then change to every three days for two weeks (total of three weeks of therapy with decreasing frequency in last two weeks) followup instructions: we recommend that your follow up with your primary care provider, . 1-2 weeks after leaving rehabilitation to discuss your goals of care. md, procedure: arterial catheterization diagnoses: acidosis unspecified essential hypertension acute kidney failure, unspecified severe sepsis coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status other chronic pulmonary heart diseases depressive disorder, not elsewhere classified septic shock intestinal infection due to clostridium difficile paralytic ileus personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits hemorrhage of gastrointestinal tract, unspecified encephalopathy, unspecified septicemia due to anaerobes diseases of tricuspid valve 

Answer: The patient is high likely exposed to