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: quinine sulfate / beta-blockers (beta-adrenergic blocking agts) attending: chief complaint: abdominal pain major surgical or invasive procedure: diagnostic paracentesis history of present illness: 73 with history of htn, type 2 dm, recent recurrent cholecystitis non-operatively managed, newly diagnosed cirrhosis c/b ascites transferred from hospital to for abdominal pain. patient has had recent admissions for ruq abdominal pain, diagnosed with cholecystitis, non-operatively managed due to poor surgical candidate. most recently, she was discharged from on after treatment for lll pneumonia. she was transferred to hospital. per her son, he was notified that she had decreased po intake, no stooling. on day prior to admission, patient was found to have abdominal pain, kub at that time showed possible early sbo. due to worsening pain, she was transferred to for further evaluation. in the ed, initial vitals were 96f 126/84 60 16 99%ra. she underwent ct abdomen and pelvis that showed small bowel distention and mild dilation with air-fluid levels and possible point of subtle caliber transition in the right lower quadrant, ascites, no free air. surgery was consulted and recommended ct with contrast to rule out ischemia. ct with contrast showed small bowel/colonic wall thickening/edema, likely secondary to third spacing. slight terminal ileal hyperemia in the right lower quadrant could indicate infectious or inflammatory process. she was given zosyn empirically. patient developed transient hypotension to systolic 70's, resuscitated wtih 4l ivf. at that time, diagnostic para was done and she recieved iv ceftriaxone. right groin line placed. she was transferred to the icu for hypotension. on arrival, she is uncomfortable with pain, unable to articulate her exact symptoms. past medical history: 1. fibromyalgia. 2. cva 3. hl 4. coronary artery disease with an lad stent 5. congestive heart failure. 6. hypertension. 7. bradycardia. 8. type 2 diabetes on insulin and metformin 9. history of thyroid cancer s/p thyroidectomy 10. spinal stenosis 11. depression with prior hospitalizations 12. e. coli septicemia in 13. bilateral renal lesions on mri suspicious for renal cell carcinoma 14. radiographic evidence of cirrhosis, seen on recent ct scan and mri () 15. pancytopenia 16. + 17. oophorectomy. she still has one ovary remaining. 18. hysterectomy secondary to fibroids. 19. s/p laminectomy social history: she is divorced. in she moved to to live with her son in . she recently has been living at harbour house in where she is dependent for all of her adl's except eating. she is lift dependent. she was an administrative assistant for a technical editor to a biotech research and development firm and also worked in the irs. she retired at age 70. she never smoke or drank alcohol. hcp: family history: father who died of complication of diabetes at age 50. mother died of a stroke at age 67 and had a mi at age 65. brother with disease and bladder cancer. sister is diabetic and hypertensive. physical exam: vs: temp: 95.5 bp: 107/56 hr: 85 rr: 15 o2sat: 99%ra gen: lying in bed, intermittantly moving in pain heent: dry mucous membranes, eomi, no scleral icterus, poor dentition, jvd not elevated resp: decreased bs l>r at bases, upper lung clear cv: rr, s1 and s2 wnl, no m/r/g abd: distended with non-tense ascites, no bowel sounds appreciated, tenderness to deep palpation, minimal rebound tenderness. when distracted, pain response not as great. ext: dependent pitting edema. bilateral dp pulses by doppler. no cyanosis. right fem line in place, gauze surrounding. skin: no jaundice, multiple ecchymoses on bilateral arms in various stages of healing. neuro: alert, oriented to self. spontaneously moves all 4 extremities. trace asterexis. pertinent results: 12:10pm blood wbc-4.1# rbc-3.44* hgb-11.9* hct-36.9 mcv-107*# mch-34.5*# mchc-32.2 rdw-19.7* plt ct-66* 11:30pm blood wbc-1.7*# rbc-2.51*# hgb-8.7*# hct-26.7*# mcv-107* mch-34.5* mchc-32.4 rdw-19.6* plt ct-37* 11:50pm blood wbc-1.9* rbc-2.59* hgb-9.3* hct-27.3* mcv-105* mch-35.8* mchc-34.0 rdw-19.4* plt ct-39* 11:30pm blood pt-21.7* ptt-150* inr(pt)-2.0* 12:10pm blood glucose-152* urean-20 creat-1.0 na-153* k-3.7 cl-118* hco3-25 angap-14 01:10am blood glucose-90 urean-19 creat-0.9 na-154* k-3.5 cl-122* hco3-23 angap-13 12:10pm blood alt-16 ast-41* alkphos-333* totbili-1.5 01:10am blood alt-14 ast-31 alkphos-253* totbili-1.3 01:10am blood calcium-7.4* phos-2.2* mg-1.8 06:04am blood calcium-7.2* phos-2.1* mg-1.7 12:15pm blood lactate-2.6* k-3.7 12:08pm blood lactate-1.8 10:50pm ascites wbc-51* rbc-6083* polys-3* lymphs-16* monos-0 mesothe-6* macroph-75* 10:50pm ascites totpro-1.4 glucose-113 1. multifocal small bowel and colonic wall thickening and edema, most likely related to third spacing and low protein state secondary to cirrhosis. mild hyperemia of the terminal ileum could be seen in the setting of infection or inflammation with ischemia considered less likely. 2. cirrhosis with splenomegaly and ascites. 3. moderate bilateral pleural effusions. brief hospital course: icu course: 73 female with history of cirrhosis, pancytopenia/presumed mds, medically managed cholecystitis, recent lll pna admitted for abdominal pain and hypotension. 1. hypotension - treated empirically with antibiotcis to cover intraabdominal source. responded to ivf. held diuretics/anti-hypertensives. morning cortisol 23 ruling out adrenal insufficiency. 2. abdominal pain - initial concern for sbo based on osh radiology. seen by surgery. they were not concerned for sbo. ct with contrast showed hyperemic bowel. lactate of 2.6--> not consistent with ischemic bowel or perforation. passing flatus and small amounts of stool. 3. pleural effusions - bilateral, found on ct. recent treatment for lll pna at . no tachypnea, on room air with good o2 saturations. diff includes hepatic hydrothorax, parapneumonic effusion, chf, effusion related to thyroid disease. 4. hypernatremia - 154 on arrival to floor, concern for decreased po in rehab hospital. also hyperchloremic, which may correlate. free water deficit 2.7l. given d5 but held after sodium dropped 154-149. 5. cirrhosis - hepatitis serlogy, anti-smooth muscle, anca all negative in late . + ascites, para negative for sbp. restarted lactulose. held diuretics. will need outpatient liver follow-up. 6. coagulopathy - likely underlying liver disease. fibrinogen normal. trended. 7. elevated alkaline phosphatase - trending down, monitor. while has chronic elevation, if this presentation was from cholecystitis, would expect acute change. 8. pancytopenia - long-standing, concern for mds. repeat labs in ed with acute drop in all cell lines in setting of ivf resuscitation. emailed heme-onc to comment on bone marrow. 9. uti - on cefepime 10. history of vtach - continued amiodarone 11. hypothyroidism - continued levothyroxine 175mcg/day, checked tsh/ft4. 12. gerd - continued ppi. 13. depression - continued zoloft 50 mg daily . 14: multiple medical problems/several re-admissions: following discussion with hcp and pcp and overall unclear diagnosis but subsequent decline and several admissions consulted palliative care. . medical floor course: ms. was transferred to the regular medical floor from the icu. her blood pressure was stable, but it was clear to the medical team that she would not recover from her complicated illness. a family meeting was held prior to transfer, and her code status was changed to dnr/dni keeping with the wishes of her health care proxy and son, mr. . two days passed without improvement in her condition. during this time, the management that had been initiated in the icu, including antibiotics, were continued. another family meeting was held, resulting in the decision to apply comfort focused care. initially, a concentrated morphine elixir was administered. this resulted in copious vomiting. the morphine was administered subcutaneously with a patient controlled analgesic device, which had to be operated by the nursing staff. ms. looked comfortable after this intervention. her other son was also able to visit her. she expired on at 7:02 am. a death note was written by hand in the chart, a death report was filed, the pcp and in house attending were notified, and the family was notified. the hcp declined autopsy. medications on admission: potassium chloride 20 meq daily furosemide 40 mg daily lactulose 20 gram prilosec 20 mg daily magnesium oxide 400 mg folic acid 1 mg daily aspirin 81 mg daily ferrous sulfate 325 mg daily amiodarone 200 mg daily docusate 100 mg zoloft 50 mg daily lisinopril 5 mg daily albuterol nebulizer qid levothyroxine 175 mcg daily levaquin 500 mg daily () discharge medications: expired discharge disposition: expired discharge diagnosis: expired discharge condition: expired discharge instructions: expired followup instructions: expired procedure: venous catheterization, not elsewhere classified percutaneous abdominal drainage diagnoses: thrombocytopenia, unspecified abdominal pain, unspecified site coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia unspecified pleural effusion urinary tract infection, site not specified congestive heart failure, unspecified toxic encephalopathy unspecified essential hypertension cirrhosis of liver without mention of alcohol diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia unspecified acquired hypothyroidism depressive disorder, not elsewhere classified sepsis other persistent mental disorders due to conditions classified elsewhere myelodysplastic syndrome, unspecified long-term (current) use of insulin pressure ulcer, lower back rash and other nonspecific skin eruption other ascites personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] do not resuscitate status hyperosmolality and/or hypernatremia spinal stenosis, unspecified region other and unspecified coagulation defects personal history of malignant neoplasm of kidney myalgia and myositis, unspecified adult failure to thrive electrolyte and fluid disorders not elsewhere classified acquired absence of both cervix and uterus pressure ulcer, stage ii chronic cholecystitis personal history of malignant neoplasm of thyroid history of physical abuse 

Answer: The patient is high likely exposed to