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: levofloxacin / morphine / zosyn attending: chief complaint: pulmonary edema, intubation major surgical or invasive procedure: endotracheal intubation history of present illness: 85 y/o with hx of cva in the past and baseline left sided weakness who initially presented to - with abdominal pain. ct scan at bin revealed uncomplicated diverticulitis, and was started on zosyn. she received 600cc of fluid in setting of iv contrast (pt w/ cr of 2.2 at bin) and developed respiratory distress with bp of 209/90 per report. this was thought to be flash pulmonary edema, and was treated with 60mg iv lasix and nitro paste. also received asa. pt was sedated with propofol as well as receiving several doses of ativan and was intubated. no abg obtained at that time. pt then apparently developed hypotension, possibly in setting of lasix, nitro and propofol, and was started on levophed at 0.03. r ij and 2 18's were placed, and transferred to . on arrival to propofol ggt was stopped and started on fent/versed. on admission, vitals were bp: 99/69, hr: 74, rr 23. lactate 2.7. vent settings were ac: tv-500, 5 peep, 100% fio2. abg was 7.32/45/171 on these settings. pt also had ekg at bin which showed lateral st depressions, and upright t waves. repeat at showed twi in avl, v5-v6. troponin noted at 1.51 on admission. vitals on transfer to icu: t:99.0, hr: 81, bp: 144/72, rr: 16, 100% on vent. on 0.02 of levophed. past medical history: -right caudate cva presumptively embolic -gerd -hypertension -gait ataxia -low back pain with history of laminectomy -history of pneumonia -trigeminal neuralgia social history: patient has daughter () who is nicu rn involved in care and son who is a rabbi . patient is divorced. recently moved from to nursing facility. she does not smoke or drink alcohol. no history of illicit drug use. prior to hospitalization, she was ambulating well with a walker. family history: notable for congestive heart failure. mother died at 74. father died at 72 from pulmonary embolism. sister at 82 with myasthenia . brother 84 with heart disease. there is a family history of diabetes. physical exam: admission physical exam vitals: t:99.0, hr: 81, bp: 144/72, rr: 16, 100% general: intubated, sedated, non responsive to verbal or tactile stimulation heent: sclera anicteric, perrla, neck supple, no jvd lungs: bilateral coarse breath sounds cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, mildly distended. no tenderness illicited, bowel sounds present gu: foley ext: bilaterally inverted feet, cool feet, 2+ pulses, trace edema discharge physical exam: tm 97.8 120-140/52-70 60-76 20 95-97% on ra . exam: general: chronically ill appearing. awake, oriented x 3; nad, conversant this am heent: sclera anicteric, oropharynx with dry mucous membranes, no thrush, perrl, eomi neck: supple, no lad, jvp is difficult to assess lungs: improved. scattered crackles at bases bilaterally; no wheezing cv: regular rate and rhythm, normal s1 + soft s2, + murmur heard best at lusb, radiates to carotids - pulsus tardus present, no rubs or gallops abdomen: soft, mildly tender in ruq, non-distended, normoactive bowel sounds present, no rebound tenderness or guarding, no organomegaly; bruises from subq heparin ext: muscle wasting in all limbs; warm, well perfused, 1+ pulses, no clubbing, cyanosis or pitting edema neuro: perrl, eomi, l arm and leg significantly weaker than on r but able to perform hand grip and lift leg off bed; babinski's downgoing, sensation intact, reflexes brisk on l access: pivs pertinent results: labs/studies: 05:42am blood wbc-14.5* rbc-3.39* hgb-10.9* hct-33.6* mcv-99* mch-32.1* mchc-32.4 rdw-16.5* plt ct-538* 05:42am blood pt-33.2* ptt-31.0 inr(pt)-3.4* 06:03am blood pt-34.1* ptt-29.0 inr(pt)-3.5* 05:42am blood glucose-116* urean-47* creat-1.8* na-135 k-3.9 cl-99 hco3-26 angap-14 11:00am blood ck-mb-9 ctropnt-1.16* probnp-* 03:23am blood ck-mb-4 ctropnt-0.34* 05:42am blood calcium-8.3* phos-3.6 mg-1.9 02:35am blood caltibc-166* vitb12-528 folate-13.6 hapto-139 ferritn-577* trf-128* 06:39am blood triglyc-215* 05:02pm blood tsh-4.2 . c.diff negative blood cultures x 2: ngtd . cxr: pulmonary edema has resolved. there are low lung volumes with bibasilar atelectasis. there is no pneumothorax or pulmonary effusions. cardiomegaly is stable. there are no new lung abnormalities. . tte: there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic arch is mildly dilated. the aortic valve leaflets are moderately thickened. there is moderate aortic valve stenosis (valve area 1.0-1.2cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. moderate (2+) mitral regurgitation is seen. there is a very small pericardial effusion. peak velocity: 3.3 m/s; peak gradient 44; valve area 1.1 cm2 . ekg: possible ectopic atrial rhythm. left axis deviation may be due to left anterior fascicular block, although is non-diagnostic. anterolateral lead st-t wave changes are non-specific. since the previous tracing of ectopic atrial rhythm and further st-t wave changes are both now present. . swallow: impression: penetration and aspiration with thin barium. . swallow: much improved but still some degree of aspiration of thin liquids. brief hospital course: 85f yo f p/w diverticulitis c/b shock and respiratory failure after receiving ivf. she was intubated for presumed pulmonary edema c/b post-intubation/lasix hypotension and elevated cardiac biomarkers in the setting of critical as. . # shock: likely both cardiogenic and septic - secondary to ivf followed by lasix, nitro paste in the setting of critical as and patient being volume depleted from diverticulitis and having a uti. pt was weaned off pressors. pt was then started on lasix ggt with good output and stable bps. patient likely pre-load dependent given critical as. she completed a 7-day course of cefepime, flagyl, and vancomycin - which provided coverage for uti, pneumonia, and diverticulitis. . # critical as, improved to moderate as: valve area 1.1 cm2 on tte , consistent with moderate as once she was no longer septic. likely cause of pulmonary edema and subsequent hypotension in setting of fluid shifts. pt had hypertensive episode and had acute pulmonary edema secondary to aortic stenosis. cardiology was consulted and patient was not considered for replacement valve or valvuloplasty at that time because of her critical condition at the time. she was scheduled for follow-up with cardiology - dr. . . #respiratory failure: flash pulmonary edema with xray showing bilateral pleural effusions and edema. likely secondary to critical as. the patient was diuresed with lasix ggt to optimize volume status before extubation. goal diuresis of negative liters was met on multiple days and pt respiratory status improved. her rsbi score gradually decreased and she was able to tolerate psv settings while being weaned off of sedation. pt was eventually extubated, but shortly after extubation, she began to have stridor. we administered racemic epi, and heliox, but ultimately pt was reintubated. she was given 48 hours and then another trial of extubation occured, this time with steroids given 12 hours prior to extubation and then q4hrsx3 after extubation. pt was successfully extubated. she subsequently had episodes of subjective respiratory distress, but all the while was satting in the high 90's and without stridor. these symptoms were best controlled with seroquel to calm her down. pt continued to diurese and she was eventually transitioned to po lasix. he respiratory status stabilized and was ready to be called out of the . on the floor, the patient was diuresed with 40 mg po lasix per day with good response. her pulmonary edema improved - by clinical exam and xray and the patient was thought to be nearly euvolemic on the day of discharge. the patient was not discharged on diuretics because of her dependent on preload given moderate-severe aortic stenosis. . #hypertension: the patient was very hypertensive in the icu and upon transfer to the floor. her bp regimen was changed to captopril 12.5 mg tid and her pressures normalized. she was also on metoprolol 75 mg tid for atrial fibrillation with rapid ventricular response. . #anemia: required 4 units prbcs throughout admission with last being on . with goal to keep hct >30. likely related to elevated coags. anemia work up showed iron 9, tibc 166, ferritin 577, trf 128. b12/folate/hapto are wnl. these indicate likely iron deficiency anemia with component of anemia of chronic dz. her hct was stable ~34 on the days leading up to discharge. . #diverticulitis: pt presenting to osh with abdominal pain found to have diverticulitis of the left colon. likely explained her leukocytosis as high as 28 (trended down to 14.5), as well as her hypotension. abdomen was soft on the day of discharge. she was tolerating prethickened liquids and soft foods on the 2 days leading up to discharge. . #renal failure: per family, baseline is 1.3-1.6, and on admission to is 2.1 but has trended up to 2.7 - thought to be to contrast nephropathy. creatinine was at her baseline - 1.8 on the day of discharge. . #elevated troponin: though to be demand ischemia given sepsis, blood loss, and fluid shifts in the setting of critical as. trops peaked at 1.37 on but now trended downward. she was discharged on aspirin 81 mg qday and metoprolol. . #history of afib: per discussion with family, patient does not really have history of afib. coumadin was started for hx of cva. the patient had episodes of afib w/rvr that required an esmolol or dilt drip. after transfer to the floor, the patient remained in sinus rhythm with infrequent, spontaneously remitting episodes of tachycardia - possibly afib w/ rvr - though appeared regular and could have represented avnrt. she was discharged on metoprolol 75 mg tid and coumadin. she became supratherapeutic on coumadin and her dose was held on and - on the day of discharge, inr was 3.4. she is to restart coumadin on sunday, at 1 mg qday. she should have her inr checked on tuesday, . . #trigeminal neuralgia: not taking tegretol at home per records we have available. . #nutrition: the patient was eating soft solids on the day of discharge. she had 2 swallow studies which showed aspiration of thin liquids and she was received nectar pre-thickened liquids. her second swallow showed much improvement and she will need repeat eval at rehab. . #the patient received subq heparin before she was therapeutic on coumadin. on the day of discharge, inr was 3.4. the patient remained full code after her transfer from the icu. long family discussions were held and they are still in the process of finalizing their thoughts. at this time, the patient is full code. . communication was primarily with the patient's daughter at (). medications on admission: (per clinic note on , doses unknown) atenolol 75 mg daily pantoprazole 40 mg daily benicar 40 mg daily multivitamin daily acetaminophen 1g qid warfarin 2mg qmtwrf, 1mg q sat and sun senna 2 tabs daily vitamin d 400 units tegretol 100mg po bid -- unable to find this med listed discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 3. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 4. trazodone 50 mg tablet : one (1) tablet po hs (at bedtime) as needed for insomnia. 5. acetaminophen 325 mg tablet : two (2) tablet po tid (3 times a day) as needed for pain, fever. 6. metoprolol tartrate 50 mg tablet : 1.5 tablets po tid (3 times a day). 7. captopril 12.5 mg tablet : one (1) tablet po tid (3 times a day). 8. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 9. docusate sodium 50 mg/5 ml liquid : ten (10) ml po bid (2 times a day) as needed for constipation. 10. benzonatate 100 mg capsule : one (1) capsule po tid (3 times a day) as needed for cough. 11. multivitamin oral 12. coumadin 1 mg tablet : one (1) tablet po once a day: please hold dose on . restart on sunday, with inr check on tuesday, . 13. vitamin d-3 400 unit tablet, chewable : one (1) tablet, chewable po once a day. 14. outpatient lab work please check inr on tuesday . discharge disposition: extended care facility: newbridge on the - discharge diagnosis: primary: aortic stenosis - moderate hypoxic respiratory failure - s/p intubation hospital-acquired pneumonia diverticulitis atrial fibrillation with rapid ventricular response acute pulmonary edema non-st elevation myocardial infarction . secondary: hypertension cerebrovascular accident chronic kidney disease stage iii discharge condition: mental status: clear and coherent - hard of hearing, confused sometimes about details of history but oriented level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear ms. , it was a pleasure caring for you at . you were initially admitted for diverticulitis, however, you became hypertensive and, with iv fluids, had fluid accumulate in your lungs. you were intubated for this condition and you were on a ventilator for several days. your hospital course was complicated by pneumonia and atrial fibrillation with rapid ventricular response (an abnormal, fast heart rhythm). you improved with antibiotics and we worked to get the fluid out of your lungs with a medication called furosemide (lasix). you will need close follow-up for a condition we discovered, which is known as aortic stenosis. this is a narrowed heart valve. we have made a follow-up appointment with an excellent cardiologist, dr. . this appointment information is listed below. we also performed 2 swallow studies, which showed that you did have a problem swallowing thin liquids - the second study showed improvement, however. you will be followed up for this condition at the rehab facility. . we made the following changes to your medications: we stopped atenolol and started metoprolol 75 mg three times per day for heart rate we stopped benicar and started captopril 12.5 mg three times per day for blood pressure we started aspirin 81 mg once per day we changed pantoprazole to lansoprazole once per day for heartburn we stopped tegretol (carbamazepine) because it was not clear you were taking this for trigeminal neuralgia. we changed your coumadin dosing; you will restart coumadin on sunday, at 1 mg per day - you will need your inr checked on tuesday and may need your coumadin adjusted to 2 mg if your inr is too low . your follow-up information is listed below. followup instructions: department: med grp when: thursday at 11:30 am with: , md building: (, ma) campus: off campus best parking: on street parking md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances diagnoses: pneumonia, organism unspecified subendocardial infarction, initial episode of care acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified congestive heart failure, unspecified severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation aortic valve disorders chronic kidney disease, unspecified acute respiratory failure cardiogenic shock septic shock iron deficiency anemia, unspecified acute diastolic heart failure hyperosmolality and/or hypernatremia septicemia due to escherichia coli [e. coli] diverticulitis of colon (without mention of hemorrhage) 

Answer: The patient is high likely exposed to