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: penicillins / bactrim attending: chief complaint: fall major surgical or invasive procedure: single lead medical identity adx sr 5180 history of present illness: ms. is a yo female h/o dementia, hypertension, osteoporosis who presented to s/p fall at . she was found down in bathroom with wet floor and did not recall what happened. she initially complained of left knee pain and was found to have left eye hematoma. she denied head injury/loc and had normal head imaging in the ed. additionally with unremarkable c/t/l spine, bilaterall knee xray, and cxr in ed. the patient was initially placed in observation and plan was to have pt and case managment see her and then send her back to assissted living. however, in the ed around 8 am she became bradycarduc to 30s, asystolic, and pulseless. a few compressions were delivered and the patient had rosc, no shock was delivered. after a 7 second pause she went back in to sinus rhythm. the patient was unable to describe how she felt, however was back to her baseline mental status within 1-2 minutes. she had no complaints or recollection of the event. she responded to questions and said she felt "lousy", but could not provide more details. of note the patient visited ed for mechanical fall on and was also admitted for mechanical fall in . most recent previous admission for e. coli septicemia likely secondary to cholangitis c/b pancreatitis that resolved with antibiotics and conservative management. in the ed the patient received asa 300mg pr and oxycodone. prior to transfer to ccu the patient was hemodynamically stable with vs t 97.7, hr 68, bp 128/51, rr 20, 99% on ra. on arrival to the floor, patient reports that her bladder hurts since the foley was placed. she denies pain. she denies cp, sob, palpitations, dizziness/lightheadedness. she reports that she is at the hosptial because she fell, but can not provide other details. review of systems: postive for achy joints and frequency of urination. negative for dysuria. on review of systems, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: - dementia - hypertension - arthritis - sjogrens - cataracts - h/o bleeding ulcer - narrow complex tachycardia: , reverted to sinus, on toprol. - l2-l3 compression fractures - anterior abdominal wall fat-containing hernia and right inguinal hernia - osteoporosis - spinal stenosis social history: lives in facility and ambulates with walker. all of her cooking and cleaning are done for her. she has help in shower three times per week. previously interior decorator, has 3 children, widowed, family very involved. patient states had a daughter in and a daughter in . reports that her grand-daughters visit her frequently. -tobacco history: denies -etoh: denies -illicit drugs: denies family history: mother/father with cad. physical exam: admission exam: vs: t=98.1 bp=161/74 hr= 60 rr=18 o2 sat= 93-97% on ra general: wdwn y/o female in nad. oriented to person, place, and some time (knows month, but not year). hard of hearing. mood, affect appropriate. pleasantly confused. heent: nc. left eye with hematoma and bruising present. sclera anicteric. perrl, eomi. sl dry mucous membranes. neck: supple with flat neck veins. cardiac: rrr, normal s1, s2. 3/6 systolic murmur heard best at right upper sternal border and radiating to clavicles. no thrills, lifts. no s3 or s4. lungs: resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. +bs extremities: no c/c/e. skin: scattered bruises of ue bilaterally. 5-8 mm slightly raised round lesions scattered over upper le bilaterally (posterior>anterior and l>r). pulses: dp pulses 2+ bilaterally discharge exam: t 97.8, p 80, bp: 94-159/50-80, rr: 18, 94% on ra general: wdwn y/o female in nad. hard of hearing. mood, affect appropriate. heent: nc. left eye with hematoma and bruising present. sclera anicteric. perrl, eomi. sl dry mucous membranes. neck: supple with flat neck veins. cardiac: rrr, normal s1, s2. 3/6 systolic murmur heard best at right upper sternal border and radiating to clavicles. no thrills, lifts. no s3 or s4. lungs: resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. +bs extremities: no c/c/e. skin: scattered bruises of ue bilaterally. 5-8 mm slightly raised round lesions scattered over upper le bilaterally (posterior>anterior and l>r). bruising over left knee. pulses: dp pulses 2+ bilaterally pertinent results: admission labs: 02:30am blood wbc-9.7 rbc-5.00 hgb-13.7 hct-41.6 mcv-83 mch-27.3 mchc-32.8 rdw-16.6* plt ct-517* 02:30am blood neuts-66.0 lymphs-21.4 monos-10.5 eos-1.3 baso-0.7 02:30am blood pt-9.4 ptt-20.4* inr(pt)-0.9 02:30am blood glucose-107* urean-12 creat-0.5 na-127* k-7.8* cl-94* hco3-26 angap-15 (hemolyzed specimen) 04:41pm blood ck(cpk)-209* 04:41pm blood ck(cpk)-209* 08:55am blood ctropnt-<0.01 04:41pm blood ck-mb-7 ctropnt-<0.01 01:00pm blood calcium-9.2 phos-4.3 mg-2.2 04:21am blood na-132* k-4.2 discharge labs 05:47am blood wbc-9.6 rbc-4.45 hgb-12.4 hct-37.4 mcv-84 mch-27.9 mchc-33.2 rdw-17.0* plt ct-518* 05:47am blood urean-14 creat-0.7 na-131* k-4.4 cl-94* hco3-25 angap-16 08:30am blood calcium-9.4 phos-3.9 mg-2.1 images: ct head : 1. no acute intracranial hemorrhage or fractures. 2. new opacification of the left mastoid air cells and middle ear cavity, please correlate with signs of infection. ct c-spine : no acute cervical spine fracture. multilevel moderate-to-severe degenerative changes of the cervical spine, worse at c4-c5 level. ct l-spine : 1. no new lumbar spine fracture. stable compression of l2 and l3 vertebral bodies. 2. multilevel severe degenerative changes of the lumbar spine, worse at l3-l4 level with moderate spinal canal stenosis. ct t-spine : no acute thoracic spine fracture. mild compression of the superior endplate of t3 vertebral body, is likely chronic. bilateral knee xray : 1. no acute fracture. 2. bilateral tricompartmental osteoarthritis, severe on the left and mild on the right. cxr : the cardiomediastinal and hilar contours are normal. the lung volumes are low, with crowding of the bronchovascular markings in the lung bases. patchy right basilar opacity may reflect atelectasis, aspiration or focal/early pneumonia. cxr (post chest compressions): cardiomediastinal contours are normal in appearance. lungs are clear except for a tiny calcified granuloma in the periphery of the right lower lobe. no rib fractures are identified, but portable chest radiographs are relatively insensitive for detecting rib fractures, especially those involving the anterior ribs. there is no visible pneumothorax or pleural effusion. echo: the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is unusually small. regional left ventricular wall motion is normal. left ventricular systolic function is hyperdynamic (ef>75%). doppler parameters are most consistent with grade i (mild) left ventricular diastolic dysfunction. there is a mild resting left ventricular outflow tract obstruction. with normal free wall contractility. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. there is no valvular aortic stenosis. the increased transaortic velocity is likely related to high cardiac output. mild to moderate (+) aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. trivial mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. the tricuspid valve leaflets are mildly thickened. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: mild symmetric lvh with small lv cavity size with hyperdynamic lv systolic function. consequently there is a mild left ventricular outflow tract gradient during systole. the aortic valve is thickened but opens reasonably well - the high velocity is due to the lvot gradient. mild to moderate aortic regurgitation. probable diastolic dysfunction. cxr single-lead pacemaker in standard position, terminating in the right ventricle. no acute cardiopulmonary disease. brief hospital course: ms. is a y/o female with a history of dementia, hypertension, and previous h/o narrow complex tachycardia with no known other cardiac history that presented to fall and was found to have a symptomatic 7 second asystolic pause in ed with rosc after chest compressions, no shock delivered. active issues: # rhythm: patient with previous history of narrow complex tachycardia on metoprolol. now with 7 second asystolic pause in ed. patient with mulitple falls recently, unclear whether mechanical or secondary to bradycardia and conduction abnormality. differential includes high vagal tone, sick sinus syndrome, junctional abnormality. tropnoin negative x 2. normal k+ and mg2+. metoprolol was held. patient monitored on telemetry and xx. ep consulted and followed patient. a pacemaker was implanted on out of concern for arrhythmia as a cause for recurrent falls. the patient will follow up with ep for pacemaker interrogation after discharge. she was started on diltiazem 45 mg po qid for control of rate and rhythm given family report of "fuzziness" and fatigue that they attributed to the beta-blocker. she will have one more day of levofloxacin after discharge for prophylaxis against infection. # s/p fall: patient presented to ed secondary to fall. patient with multiple falls recently. cause unclear, likely multifactorial given dementia, patient uses walker, and now found to have symptomatic 7 second asystolic pause. patient with negative head ct, c/t/l spine ct, bilateral knee xrays in ed. falls sound mostly mechanical after talking with family. pt consulted and recommended rehab. # ? bladder pain and increased frequency of urination: ua with neg nitrite, neg leuks. patient with mild leukocytosis, however after cpr preformed and likely stress reaction. of not on last admission patient with asymptomatic bacturia. urine culture sent in ed, grew proteus mirabilis sensitive to ciprofloxacin and levofloxacin. she received a dose of ciprofloxacin and was continued on levofloxacin for prophylaxis after pacemaker insertion. she completed a three day course for uti on . # hypertension: patient with reported hypertension, labile on last admission. home metoprolol held for bradycardia and asystole. bp monitored throughout stay and was stable on 45mg of diltiazem qid. chronic issues: # dementia: patient currently aao x 3, however confused. home donezepil continued. # sjogren's: continued saline eye drops # osteoporosis, compression fractures: continued calcium, vitamin d, and weekly alendronate. home oxycodone continued prn for pain. transitional: -will need pacemaker interrogated in weeks -titrate diltiazem dose to target bp and hr, then change to long-acting formulation when on a stable dose medications on admission: the preadmission medication list is accurate and complete. 1. donepezil 10 mg po hs 2. omeprazole 20 mg po daily 3. vitamin d 1000 unit po daily 4. metoprolol succinate xl 25 mg po daily 5. artificial tears preserv. free 1-2 drop both eyes hs:prn dry eyes 6. alendronate sodium 70 mg po qmon 7. calcium carbonate 600 mg po daily 8. oxycodone (immediate release) 10 mg po bid:prn pain 9. polyethylene glycol 17 g po tid 10. cranberry *nf* unknown oral daily 11. glucosamine sulf-chondroitin *nf* (glucosamine 2kcl-chondroit) 500-400 mg oral daily 2 tabs daily discharge medications: 1. alendronate sodium 70 mg po qmon 2. artificial tears preserv. free 1-2 drop both eyes hs:prn dry eyes 3. calcium carbonate 600 mg po daily 4. donepezil 10 mg po hs 5. omeprazole 20 mg po daily 6. oxycodone (immediate release) 10 mg po bid:prn pain 7. vitamin d 1000 unit po daily 8. glucosamine sulf-chondroitin *nf* (glucosamine 2kcl-chondroit) 500-400 mg oral daily 2 tabs daily 9. cranberry *nf* 0 unknown oral daily 10. levofloxacin 500 mg po q24h duration: 1 days last day 11. diltiazem 45 mg po qid 12. polyethylene glycol 17 g po daily discharge disposition: extended care facility: - discharge diagnosis: sinus arrest urinary tract infection discharge condition: mental status: confused - always. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: it was a pleasure taking care of you at . you fell at home and was brought to the hospital. all of the tests to look for serious injury were negative. you had a slow heart rate and needed a pacemaker. the pacemaker was placed on and there were no complications. a urine sample showed that you had a urinary tract infection and you will be on an antibiotic for one week. no lifting more than 5 pounds with your left hand or lift your left arm over your head for 6 weeks. followup instructions: department: cardiac services when: monday at 11:00 am with: , np building: sc clinical ctr campus: east best parking: garage department: center when: friday at 1 pm with: , od building: campus: east best parking: garage procedure: initial insertion of transvenous lead [electrode] into ventricle initial insertion of single-chamber device, not specified as rate responsive diagnoses: urinary tract infection, site not specified unspecified essential hypertension hyposmolality and/or hyponatremia unspecified fall cardiac arrest pain in joint, lower leg osteoporosis, unspecified sinoatrial node dysfunction accidents occurring in residential institution proteus (mirabilis) (morganii) infection in conditions classified elsewhere and of unspecified site sicca syndrome black eye, not otherwise specified dementia, unspecified, without behavioral disturbance 

Answer: The patient is high likely exposed to