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: sulfamethoxazole / quinolones attending: chief complaint: abdominal pain major surgical or invasive procedure: tracheal intubation cholecystostomy tube placed nj tube placed by radiology history of present illness: 80yo female h/o multiple intraparenchymal hemorrhages due to amyloid, aphasia, nonverbal at baseline and on chronic tpn, was brought to for c/o increased groans since 4am. per family, pt never groaned in past. brought to where w/u was unrevealing except gas in abdomen. in addition, family commented that in prior few days she had cough, more frequent, w/secretions pooling and sounding gurgly. noted to be tachypneic the morning of admit but resolved after deep suctioning in ed. no fevers, no focal findings on cxr. ros from husband neg. falls or bruises. one decub on sacrum, small and well care for. pt guaic negative. kub here showed a lot of bowel gas. given 2mg morphine and moans resolved. repeat ekg sinus tachy, ste in v1-old. trop 1.02 at osh neg. husband asked for her to be transferred to where she is known for further care. past medical history: 1. multiple intraparenchymal hemorrhages due to amyloid angiopathy. the first hemorrhage was in (presented with r hemiparesis). later had a large l fronto-parietal bleed (became aphasic). 2. focal motor facial seizures. previously treated with dilantin, now on neurontin. 3. myoclonic jerks 4. high cholesterol 5. hypertension 6. hx of hospital admission for pneumonia vs. bronchitis instigated by patient inability to clear secretions from upper respiratory tract. was intubated. 7. chronic tpn, unable to place peg due to anatomy (large hh) social history: lives at home w/ husband who is her primary caregiver. home health aide w/ 24 care. fully dependant on all her adls. she is fairly nonresponsive at baseline. no tobacco, etoh, or illicit drug use. family history: nc physical exam: tc 97.1 bp 122/75 hr 80 rr 20 sat 96% on 35% tent gen: contracted w/ neck to the left, nad, non verbal, appears comfortable heent: mouth breathing, dry mm neck: supple, contracted cv: rrr, no m/r/g pulm: course bs diffusely abd: soft, nabs, nt/nd ext: dp/pt 2+ b/l. skin: no rash pertinent results: 09:11pm lactate-1.2 08:20pm glucose-103 urea n-25* creat-0.7 sodium-137 potassium-4.2 chloride-104 total co2-22 anion gap-15 08:20pm ck(cpk)-153* 08:20pm ctropnt-0.04* 08:20pm wbc-7.9# rbc-3.72*# hgb-11.7*# hct-34.6*# mcv-93 mch-31.5 mchc-33.9 rdw-16.3* 08:20pm neuts-65.9 lymphs-22.0 monos-4.3 eos-7.2* basos-0.6 08:20pm plt count-274 ct abd/pelvis without contrast: ct of the abdomen without contrast: examination of lung bases is limited due to lack of contrast but appears grossly unchanged. there are bilateral pleural effusions and probable compression atelectasis. there is an unchanged appearance to a large diaphragmatic hernia. again identified is a nasogastric feeding tube with its tip extending into the jejunum. limited examination of the liver is unremarkable with no evidence of focal disease. a cholecystostomy tube is again identified with its coiled tip within the gallbladder lumen. there has been marked reduction of gallbladder distention since examination. no focal fluid collections are identified around the gallbladder fossa. otherwise the spleen, kidneys, adrenals, pancreas, and stomach are unchanged in appearance. no pathologically enlarged mesenteric or retroperitoneal lymph nodes are noted. no free air is identified within the peritoneal cavity. no free fluid is noted within the abdomen. there are diffuse vascular aortic calcifications. ct of the pelvis without contrast: there is new hyperdense fluid layering within the pelvic cavity displaying a fluid-fluid level likely related to settling of acute blood. the majority of the collection is located within the most dependent portion of the pelvis. contrast is identified within the rectum from prior examination. the bladder is decompressed and a foley is in place with a small amount of air noted within the bladder. limited examination of the uterus is unremarkable. there are no pathologically enlarged inguinal or pelvic lymph nodes identified. bone windows: unchanged marked degenerative changes of the spine and left acetabular exostotic lesion. ct chest w/o contrast: impression: 1. large right-sided pleural effusion with adjacent compressive atelectasis or consolidation. smaller left pleural effusion, with a minimal amount of compressive atelectasis. 2. no evidence of pulmonary airspace opacities. 3. no significant change in significant diaphragmatic defect with bilateral herniation of stomach and portions of large bowel. tte: conclusions: the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. trace aortic regurgitation is seen. the mitral valve leaflets are structurally normal. physiologic mitral regurgitation is seen (within normal limits). the pulmonary artery systolic pressure could not be determined. there is a trivial/physiologic pericardial effusion. no vegetation seen (cannot definitively exclude). compared with the prior study (images reviewed) of , mitral regurgitation is now less prominent. brief hospital course: 80 yo f with multiple intraparenchymal hemmorhages secondary to amyloid angiopathy, aphasic at baseline, on chronic tpn (aspiration risk), admitted to on for abdominal pain. believed initially to be gas related (seen on kub). in ed at had temp of 101 and blood cultures were drawn. had had recent foley change. on had witnessed vomitting with oxygen sat down to 70%--needed 100% nrb. was intubated and transferred to icu. improved over the following 24 hours with aggressive suctioning. an ngt was placed to suction. there was concern that emesis contained fecal material. pt was started empirically on vanco/zosyn for aspiration pneumonia. after discussion with family regarding goals of care and ?sbo, decision was made not to workup possible sbo as they would not want surgery. she was extubated on . . on pt was sat'ing well on 50% face tent. her blood cultures were remarkable for coag negative staph on in bottles, sensitivies pending. her urine grew pan-sensitive klebsiella on . her sputum culture from grew coag positive staph and pseudomonas. pt had a chronic picc for tpn, which was removed. tip culture ng. a supraclavicular line was attempted s/p intubation but failed; ij placed instead. patient had tte that showed no signs of vegs. continued on vanc and cefepime for 14 days. decision made with family not to do tee as more invasive and higher risk for patient. with recurrence of blood cultures positive and picc tip negative raised question of osteomyelitis from sacral decub; thought unlikely from imaging studies. patient received sacral decub wound care through hospital time. more likely probably with picc care at home. . around patient noted to have increased jerking, raised question of seizure. d/w neurologist who felt more c/w myoclonic jerks, so no role for eeg at that time. . with recurrent picc line infections raised question of again attempting enteral feeds. had another picc placed and restarted on tpn. evaluated by surgery and on taken to radiology where nj tube was placed under fluoro successfully. started on tube feeds on . on had difficulty with nj tube flushes. also spiked temp to 100.4. had dirty ua and ct scan revealed dilated gallbladder with wall edema c/w cholecystitis. ruq ultrasound revealed stones. pt also had bump in her transaminases and alk phos. started again on zosyn/flagyl for 14 day course and nj tube feeds held. after extensive d/w husband and consent, pt taken to ir for cholecystostomy tube placement. urine culture also grew yeast, so foley changed and treated with 10 days fluconazole (id rec since patient had been on long term broad spectrum antibiotics). blood cultures remained no growth. on also noted to have some facial asymmetry but head ct done without change from previous. . on spiked a temp of 100.6. blood cultures remained no growth. on had hct drop from 26 to 18. ct scan of pelvis revealed retroperitoneal blood. transfused 2 units prbcs with good response. also given ffp and vit k (had been getting some heparin in flushes). believed secondary to cholecystostomy insertion site. needed 1 more unit later in week. bleed appeared to tamponade on its own. . on , pt had tf restarted after d/w surgery said would likely be ok and permission of family. noted to have some increased coughing and concern that ngt was further out so held for 2 days; when restarted noted bleeding from tube so again held. evaluated by surgery who said should not be contraindication. also mild transaminitis should be tolerable. njt feeds restarted on and taken to goal and patient appeared to tolerate. surgery again consulted about possible j tube and cholecystostectomy. recommend cholecystostomy tube left in place 4-6 weeks and not remove until then. . on pt had temperature of 102.3. blood cultures again grew mrsa bacteremia. urine also positive for 10-100,000 yeast. picc line removed on and cultures resent; all no growth to date. urine catheter changed. bile culture also grew vre but no wbcs seen so belived to be colonized, not infected. after picc removed and antibiotic started pt defervesced. tte was again repeated and again showed no visible vegetations. vanc trough initially high so dose decreased. to do: 1) mrsa bacteremia: pt is on day vanc. needs to get full course through picc line. remove picc once course finished. consider checking vanc trough in next few days and adjust dose if necessary. 2) fen: nj tube in place. in discussion with radiology, concern that if it is removed it will be very hard to replace with large hiatal hernia. unclogged on and recommend continue to maintain if possible. believe risk of not being able to replace outweighs risks of leaving in greater than 30 days. this was communicated to the patient's husband. at this time surgical services believe risk of placing j tube high. continue tube feeds, which pt has tolerated, through nj. 3) cholecystitis s/p cholecystostomy tube: tube placed on by ir. surgery recommends not removing for 4-6 weeks. follow up appointment should be made with dr. to discuss removal and further plans. 4) htn: well controlled at this time with clonidine patch and nitro patch. 5) pulm: pt kept on humidified air with shovel mask to keep membranes moist. 6) gu: foley kept in for neurogenic bladder. medications on admission: clonidine 0.1 mg qwk tpn atrovent/albuterol discharge medications: 1. ipratropium bromide 0.02 % solution : one (1) neb inhalation q6h (every 6 hours). 2. albuterol sulfate 0.083 % solution : one (1) neb inhalation q6h (every 6 hours) as needed. 3. acetaminophen 325 mg tablet : two (2) tablet po q6h (every 6 hours) as needed. 4. heparin (porcine) 5,000 unit/ml solution : 5,000 units injection tid (3 times a day). 5. nitroglycerin 2 % ointment : 0.5 inch transdermal q6h (every 6 hours). 6. dolasetron 12.5 mg/0.625 ml solution : 12.5 mg intravenous q8h (every 8 hours) as needed. 7. heparin lock flush (porcine) 100 unit/ml syringe : two (2) ml intravenous daily (daily) as needed. 8. clonidine 0.1 mg/24 hr patch weekly : one (1) patch weekly transdermal qsun (every sunday). 9. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 10. lactulose 10 g/15 ml syrup : thirty (30) ml po tid (3 times a day) as needed for constipation. 11. vancomycin 500 mg recon soln : one (1) recon soln intravenous q 12h (every 12 hours) for 8 days. 12. outpatient lab work please check a vanc trough level on and adjust vanc dose as needed (goal trough about 15) discharge disposition: extended care facility: discharge diagnosis: aspiration pneumonia mrsa bacteremia times 2 klebsiella uti sacral decubitus ulcer cholecystitis retroperitoneal bleed from cholecystostomy tube candidal urinary tract infection vre in bile htn discharge condition: stable: passing gas, abdominal pain resolved, stable on room air, tolerating tube feeds discharge instructions: please call your pcp or come to the emergency room if develop fevers, chills, abdominal discomfort. followup instructions: 1. please call to a follow-up appointment with dr. within 1-2 weeks of leaving rehab. phone: 2. please call to up a follow up appointment with dr. in surgery 4-6 weeks after cholecystostomy tube placed (placed on ). phone: procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances transfusion of packed cells transfusion of other serum percutaneous aspiration of gallbladder diagnoses: unspecified essential hypertension friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site acquired coagulation factor deficiency unspecified protein-calorie malnutrition candidiasis of other urogenital sites infection with microorganisms resistant to penicillins diaphragmatic hernia without mention of obstruction or gangrene hemorrhage complicating a procedure acute respiratory failure pneumonitis due to inhalation of food or vomitus methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site other late effects of cerebrovascular disease pressure ulcer, lower back epilepsy, unspecified, without mention of intractable epilepsy streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] dehydration cholangitis late effects of cerebrovascular disease, aphasia urinary incontinence, unspecified calculus of gallbladder with acute cholecystitis, without mention of obstruction other alteration of consciousness myoclonus infection and inflammatory reaction due to indwelling urinary catheter other staphylococcal septicemia neurogenic bladder nos other amyloidosis contracture of joint, multiple sites 

Answer: The patient is high likely exposed to