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: no known allergies / adverse drug reactions attending: chief complaint: unresponsive, hypotension major surgical or invasive procedure: 1. arterial line 2. right internal jugular triple lumen catheter 3. picc placement history of present illness: 84f with h/o hepb, diabetes, c/o unresponsive episode at nursing home at 1100 am, found hypotensive in the 80's/sys and o2 was in the 70's. upon ambulance arrival bp wnl and placed on non-rebreather. pt was transferred to ed. in ed, blood pressure was 70/40 initially. a rij and two peripheral ivs were placed and fluid resuscitation was started as well as iv pressors with norepi at 2mcg/kg/min. a foley was placed and frank pus returned with + u/a. she was started on vancomycin and zosyn. labs were significant for sodium of 150, bun/cr of 100/2.7, k of 6.3, lactate of 3.6 and abg = 7.15/8/159/15. imaging significant for head ct unremarkable, cxr with questionable retrocardiac opacity. on arrival to the micu, patient's vs. 97.6, hr 91, sbp 89/37, rr=16, 96% ra. at time of arrival, she had received 3.5l ns and was on 0.1 of norepi. she is alert in nad does not speak english, so cannot answer questions. review of systems: cannot be obtained due to pt not responsive past medical history: diabetes hepatitis b, no known cirrhosis dementia htn ckd? - a few months prior to admission bun went from 20s to 38. reportedly cr is 1.0 oa with reported femoral neck frx in past social history: pt lives in nursing home in , demented at baseline. she can feed herself and is interactive at baseline. as per son, she is alert and oriented to name only at baseline. non-ambulatory and incontinent of stool and urine. no smoking or tobacco history family history: nc physical exam: on arrival to icu vitals: 97.6, hr 91, sbp 89/37, rr=16, 96% ra. general: alert, not interacting does not speak english heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, cvp = 1, no lad cv: rrr no mrg lungs: ctab, no wrr abdomen: soft, non-distended, bowel sounds present, no organomegaly, no tenderness to palpation, no rebound or guarding gu: foley in place ext: cold, clammy. pulse 1+ b/l in le. she has a dry ulcer on lateral calcaneous of r foot. back: she has 2 unstagable decubitis dry ulcers on back neuro: perrla, exam is grossly intact. pertinant discharge: bp 145/75, hr 86 general: alert oriented to person. knows she is in the hospital but does not know date skin: 2 unstagable decubitis dry ulcers on buttocks and on each heal pertinent results: admission labs: 12:00pm blood wbc-15.9* rbc-4.39 hgb-13.1 hct-43.0 mcv-98 mch-29.8 mchc-30.4* rdw-16.9* plt ct-326 12:00pm blood glucose-146* urean-121* creat-2.7* na-151* k-6.2* cl-128* hco3-8* angap-21* discharge labs: 04:27am blood wbc-7.3 rbc-3.12* hgb-9.5* hct-29.1* mcv-93 mch-30.5 mchc-32.7 rdw-16.6* plt ct-216 04:27am blood glucose-213* urean-18 creat-0.9 na-141 k-3.7 cl-116* hco3-16* angap-13 urine culture (): klebsiella pneumoniae | klebsiella pneumoniae | | ampicillin/sulbactam-- 8 s 8 s cefazolin------------- <=4 s <=4 s cefepime-------------- <=1 s <=1 s ceftazidime----------- <=1 s <=1 s ceftriaxone----------- <=1 s <=1 s ciprofloxacin---------<=0.25 s <=0.25 s gentamicin------------ <=1 s <=1 s meropenem-------------<=0.25 s <=0.25 s nitrofurantoin-------- 64 i 64 i tobramycin------------ <=1 s <=1 s trimethoprim/sulfa---- <=1 s <=1 s c.diff negative () ct head (): no acute intracranial process. cxr (): the lungs are clear, without focal airspace consolidation to suggest pneumonia. linear atelectasis is seen at the left lung base. a right side ij catheter tip terminates in the mid svc. there is no pleural effusion or pneumothorax. apical pleural thickening is seen. the heart size is normal. calcifications are present within the aortic arch. renal u/s (): normal renal echotexture without evidence of hydronephrosis. brief hospital course: 1. severe sepsis with shock (hypovolemic/septic): initial sbp in the low 70s. when a foley was placed, it drained frank pus. she required pressor support with norepinephrine and vasopressin. after 7 liters of ns, she was weaned off of pressor medications and after 12l her blood pressure, renal function and mental status improved. 2. urinary tract infection: a renal ultrasound was done which did not show any signs of pyelonephritis. urine cutlure grew out two types of klebsiella, both sensitive to all antibiotics tested except for intermediate sensitivity to nitrofurantoin. ceftriaxone was continued until the day of discharge with ciprofloxacin presribed to complete a 10-day course (through ). 3. encephalopathy, toxic-metabolic: likely related to uti/sepsis. improved throughout admission. was oriented to name and "hospital" at discharge which her son reports as baseline. 4. acute renal failure: initial creatinine 2.7 with bun in 100s. improved with fluid resuscitation 5. hyperkalemia: potassium 6.2 on admission. as her renal failure improved, her potassium levels remained within normal limits. 6. metabolic acidosis: her metabolic acidosis was primarily nongap but she did have a significant gap acidosis most likely secondary to lactic acidosis and renal failure. bicarb autocorrected throughout admission but had not completed normalized on last check. 7. hypernatremia: sodium 150 on admission with increase to 157 on arrival to icu. her free water deficit was corrected with 1/2ns in d5w. over 24hrs her serum sodium corrected to 140s. her serum sodium was within normal limits for remainder of hospital stay. 8. diarrhea: developed diarrhea while in the icu. cdiff assay was negative. 9. pressure ulcers: gluteal and heel. wound care recommended: * turn and reposition off back q 2 hours and prn * limit sit time to 1 hour at a time using a pressure * redistribution cushion * cleanse wound with wound cleanser then pat dry then place sacral mepilex border change every 3 days * critic aid clear to reddened tissue including labial ulcer * no dressing needed to heel - aloe vesta daily for skin conditioning * waffle boots 10. diabetes mellitus type 2: her glipizide was held during hospitalization but restarted at discharge. long-acting insulin was also held with finger sticks in the 100-200 range. 11. hypertension: olmesartan was held in the setting of hypotension. on day of discharge bp was 140s/70s. chronic issues: 1. dementia: namenda was held during hospitalization as this is not a formulary medicatin. restarted on discharge. 2. hepatitis b, chronic: tenofovir was continued, dosed for gfr transitional issuse: 1. antibiotics: ciprofloxacin presribed to complete a 10-day course (through ). 2. held medications - olmesartan: could be restarted if blood pressure remains elevated - 70/30 insulin: could be restrated if finger stick blood glucose remains elevated medications on admission: tylenol benicar 10mg daily glipizide 15mg daily megace 625mg/5ml omeprazole 20mg viread 300mg po daily donepezil 10mg q day amenda 10mg cromolyn 4% instill 2 drops each eye tid senna novolin 70/30 24u qam 14u q5pm mvi discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 2. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 3. tenofovir disoproxil fumarate 300 mg tablet sig: one (1) tablet po once a day. 4. donepezil 10 mg tablet sig: one (1) tablet po hs (at bedtime). 5. namenda 10 mg tablet sig: one (1) tablet po twice a day. 6. cromolyn 4 % drops sig: two (2) ophthalmic three times a day. 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 8. multivitamin tablet sig: one (1) tablet po daily (daily). 9. cipro 500 mg tablet sig: one (1) tablet po twice a day for 6 days. 10. insulin lispro 100 unit/ml solution sig: as directed subcutaneous asdir (as directed). 11. glipizide 5 mg tablet sig: three (3) tablet po once a day: 15 mg daily. 12. megace es 625 mg/5 ml suspension sig: one (1) po once a day. discharge disposition: extended care facility: healthcare center - discharge diagnosis: 1. shock (septic and hypovolemic) 2. urinary tract infection (klebsiella) 3. acute renal failure 4. encephalopathy, toxic-metabolic, with underlying dementia 5. metabolic acidosis 6. pressure ulcers (heal/buttock), unstageable 7. diarrhea 8. anemia 9. hypertension 10. diabetes type ii 11. hepatitis b, chronic discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were admitted for low blood pressure, which was from a combination of dehydration and a urinary tract infection. you improved with iv fluids and antibiotics. you should continue antibiotics to complete a course (through ). followup instructions: i spoke with your primary physician. will coordinate a visit to your nursing home. procedure: arterial catheterization central venous catheter placement with guidance diagnoses: acidosis hyperpotassemia anemia in chronic kidney disease urinary tract infection, site not specified toxic encephalopathy diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, unspecified septic shock pressure ulcer, lower back diarrhea pressure ulcer, heel hyperosmolality and/or hypernatremia chronic viral hepatitis b without mention of hepatic coma without mention of hepatitis delta pressure ulcer, unstageable dementia, unspecified, without behavioral disturbance 

Answer: The patient is high likely exposed to