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: codeine attending: chief complaint: hypotension, afib with rvr major surgical or invasive procedure: cvl history of present illness: ms. is a very pleasant 81 year old woman with a pmh significant dm, copd, cad, and recent abdominal surgeries for necrotic bowl who prsents from rehab with afib with rvr and hypotension. . she was sent to the er from rehab due to hypotension and afib with rvr with rates in the 150s. rehab noted her to be congested on a stat cxr, and so gave her 40 mg iv lasix x 2, as well as dilt 30mg po x 2, with improvement of hr to 80's. however, she then dropped her blood pressure, so they gave her 500 mg ivf prior to her transfer. she was also potentially given zosyn and vancomycin. . initial vs in the ed were were 97.2 87 90/45 18 92% 4l. labs were notable for bun 50, hct 30.5, plts 148, lactate 1.6, dirty u/a. cxr per report showed new bibasilar opacities with possible l sided effusion. surgery was consulted secondary to her history of operative resection of necrotic bowel and primary anastamosis and re-operation for anastomotic leak and re-anastomosis . they dc'ed her retention sutures, and debrieded her abdominal wound. . per note from dr. , has a court appt gaurdian still pending. for now, patient agreed to be full code, and continue all medical care. afib with felt to be volume overload on a stat cxr, with fluid collection l>r. she got 30 mg po dilt x 2, and 40 mg iv lasix x 2. anticoagulation was recently discontineud given apparent recent gi bleed with a hct 24 last week, needing 2 u over two days, at which point lovenox and coumadin were dc'ed. her labs at rehab were recently notable for wbc 9.5, hct 30.3, plt 152, bicarb 28. a wound cultures from showed mrsa. per team there, she had been continued on metronidazole and cipro past the 14 day course outlined by surgery continued wbc count elevation. . on her most recent discharge from , she was admitted with diffuse lower abdominal pain and abdominal distention, with a ct showing small bowel thickening c/w gastroenteritis versus ischemia from a low flow state. gi was consulted and recommended ng decompression in addition to initiation of cipro and flagyl. however, repeat ct scan showed worsened small bowel thickening and interloop fluid, and on she underwent ex-lap with small bowel resection and lysis of adhesions. her prior admission was also complicated with hypotension and afib with rvr, patient has a known history of post operative atrial fibrillation, and initally post op she was intubated and required pressors. her rvr required her to be loaded with digoxin, and she was placed on heparin gtt. she also had difficult to diurese pleureal effusions, so underwent bilateral ct placements, which drained transudates. during her hospitalization, she was on vancomyin for a wound infection (surgical) and cipro/flagyl for her anastaomic leak. . on arrival to the micu, she is aaox3, pleasant, conversant, but hypotensive. past medical history: - diabetes - schizoaffective disorder - copd - htn - cad - hypercholesterolemia - gerd - h/o head injury @ age 11 - perforated duodenal ulcer in s/p cholecystectomy, anterior parietal cell vagotomy, and patch closure by dr. . - ex lap, resection small bowel, primary anastomosis & re-operation for anastomotic leak social history: she denies alcohol and tobacco use. never married. family history: she says her parents are still alive. she thinks her siblings are healthy . physical exam: a&o x 3, somewhat confused. uncomfortable d/t right hip pain heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: irreg irreg lungs: coarse ronchi bilateral bases abdomen: midline incision w/ mixed granulation tissue and minimal fibrinous tissue. no purulence or drainage. skin surrounding retention suture bridge w/ peeling, non-blanching erythema. gu: foley present ext: right foot w/ mottling and dusky, black distal 2nd toe. dopplerable dp pulses bilaterally per surgery. pertinent results: 04:26am blood wbc-6.8 rbc-2.45* hgb-7.5* hct-24.4* mcv-100* mch-30.6 mchc-30.7* rdw-17.1* plt ct-160 04:15am blood wbc-5.6 rbc-2.57* hgb-7.9* hct-24.8* mcv-96 mch-30.6 mchc-31.7 rdw-16.7* plt ct-164 02:59am blood wbc-5.8 rbc-2.50* hgb-7.8* hct-23.8* mcv-95 mch-31.0 mchc-32.6 rdw-16.1* plt ct-164 03:48am blood wbc-6.4 rbc-2.73* hgb-8.3* hct-26.0* mcv-95 mch-30.5 mchc-32.0 rdw-15.6* plt ct-171 03:45am blood wbc-6.0 rbc-2.58* hgb-7.8* hct-23.9* mcv-93 mch-30.3 mchc-32.6 rdw-15.4 plt ct-149* 04:56am blood wbc-7.8 rbc-2.79* hgb-8.5* hct-27.2* mcv-97 mch-30.5 mchc-31.3 rdw-15.6* plt ct-167 04:31am blood wbc-8.3 rbc-2.91* hgb-9.0* hct-28.2* mcv-97 mch-31.0 mchc-32.1 rdw-15.6* plt ct-187 05:44pm blood wbc-7.6 rbc-2.79* hgb-8.5* hct-27.0* mcv-97 mch-30.5 mchc-31.4 rdw-15.3 plt ct-185 03:24am blood wbc-8.3 rbc-2.86* hgb-9.0* hct-27.3* mcv-96 mch-31.3 mchc-32.7 rdw-15.8* plt ct-154 03:12pm blood wbc-8.5 rbc-3.17*# hgb-9.6* hct-30.5* mcv-96 mch-30.3 mchc-31.4 rdw-15.6* plt ct-148* 02:59am blood neuts-70 bands-0 lymphs-14* monos-13* eos-3 baso-0 atyps-0 metas-0 myelos-0 03:45am blood neuts-77.8* lymphs-14.6* monos-5.0 eos-2.1 baso-0.5 04:56am blood neuts-76.5* lymphs-15.4* monos-4.6 eos-2.7 baso-0.8 03:24am blood neuts-85.0* lymphs-9.4* monos-4.3 eos-0.9 baso-0.3 03:12pm blood neuts-83.9* lymphs-9.4* monos-4.5 eos-1.9 baso-0.4 04:26am blood pt-14.4* ptt-28.4 inr(pt)-1.3* 05:04pm blood pt-20.0* ptt-69.8* inr(pt)-1.9* 09:29am blood pt-18.5* ptt-86.3* inr(pt)-1.7* 02:59am blood pt-17.4* ptt-63.8* inr(pt)-1.6* 03:48am blood pt-16.3* ptt-70.9* inr(pt)-1.5* 04:31am blood pt-15.5* ptt-83.5* inr(pt)-1.5* 05:34pm blood pt-13.4* ptt-28.8 inr(pt)-1.2* 04:26am blood glucose-391* urean-45* creat-2.3* na-130* k-4.4 cl-100 hco3-20* angap-14 04:15am blood glucose-140* urean-43* creat-2.1* na-139 k-4.4 cl-108 hco3-23 angap-12 02:59am blood glucose-79 urean-39* creat-1.6* na-141 k-4.2 cl-109* hco3-21* angap-15 03:24am blood glucose-137* urean-46* creat-1.1 na-138 k-3.9 cl-106 hco3-23 angap-13 11:51pm blood glucose-195* urean-47* creat-1.0 na-139 k-3.9 cl-107 hco3-23 angap-13 03:12pm blood glucose-160* urean-50* creat-1.1 na-137 k-3.6 cl-104 hco3-24 angap-13 03:24am blood alt-9 ast-22 ld(ldh)-209 ck(cpk)-177 alkphos-58 totbili-0.2 09:48pm blood alt-7 ast-22 ld(ldh)-161 alkphos-59 totbili-0.2 04:56am blood probnp-3042* 04:31am blood ctropnt-0.12* 03:24am blood ck-mb-6 ctropnt-0.10* 09:48pm blood ck-mb-6 ctropnt-0.10* 03:12pm blood ctropnt-0.10* 03:12pm blood ck-mb-6 probnp-* 04:26am blood calcium-8.2* phos-5.2* mg-2.1 04:15am blood calcium-8.4 phos-5.1* mg-2.2 03:24am blood calcium-8.1* phos-2.8 mg-1.9 cholest-77 11:51pm blood calcium-8.3* phos-2.9 mg-2.0 09:48pm blood caltibc-133* ferritn-295* trf-102* 03:24am blood triglyc-129 hdl-20 chol/hd-3.9 ldlcalc-31 03:12pm blood tsh-3.3 03:12pm blood free t4-1.1 03:12pm blood cortsol-24.4* 04:56am blood vanco-21.7* 03:13am blood type- po2-36* pco2-60* ph-7.22* caltco2-26 base xs--5 12:26pm blood type- po2-58* pco2-58* ph-7.22* caltco2-25 base xs--4 12:04am blood type-art temp-36.7 o2 flow-3 po2-68* pco2-49* ph-7.32* caltco2-26 base xs--1 intubat-not intuba comment-nasal 10:13pm blood type- po2-35* pco2-61* ph-7.25* caltco2-28 base xs--2 10:13pm blood lactate-2.4* 03:11pm blood lactate-1.6 12:26pm blood lactate-0.8 08:08am blood lactate-0.8 07:06pm blood o2 sat-73 12:04am blood freeca-1.28 micro: urine urine culture-final {yeast} inpatient catheter tip-iv wound culture-final inpatient sputum gram stain-final; respiratory culture-final inpatient stool clostridium difficile toxin a & b test-final inpatient mrsa screen mrsa screen-final {positive for methicillin resistant staph aureus} inpatient urine urine culture-final {yeast} emergency blood culture blood culture, routine-final emergency imaging: ct head w/o contrast study date of 8:00 am wet read: ehab wed 9:27 am no ct evidence for acute intracranial process. however, mr is more sensitive for acute infarct. bilat lower ext veins study date of 9:14 am impression: no evidence of deep vein thrombosis in either leg; however, note is made that this study is somewhat technically limited. the left calf veins and the right peroneal veins could not be visualized. portable tte (complete) done at 11:30:00 am final conclusions the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. the right ventricular cavity is mildly dilated with normal free wall contractility. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild to moderate (+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. impression: suboptimal image quality due to body habitus. mild symmetric lvh. left ventricular systolic function is probably normal, a focal wall motion abnormality cannot be excluded. mild to moderate mitral regurgitation. borderline dilatation of the right ventricle with normal function, moderate tricuspid regurgitation and mild to moderate pulmonary hypertension. compared with the prior study (images reviewed) of , the degree of mitral regurgitation has increased. the right ventricle was probably borderline dilated on the prior echo. chest (portable ap) study date of 3:04 am impression: ap chest compared to through 4: moderate bilateral pleural effusion right greater than left may have increased in between and 4, currently unchanged. persistent mediastinal and pulmonary vascular engorgement, and mild cardiomegaly. pulmonary edema is probably mild, though substantially obscured by pleural effusion. left jugular line ends above the thoracic inlet. no pneumothorax. brief hospital course: ms. is a very pleasant 81 year old woman with a pmh significant dm, copd, cad, and recent abdominal surgeries for necrotic bowl who presents from rehab with afib with rvr and hypotension. . # goals of care: spoke with attorney and newly appointed guardian during hospitalization, patient is to be made dnr/dni as well as cmo given worsening respiratory status, possible stroke this am, and worsening pain. she was started on a morphine gtt, and ativan prn, and passed away shortly after her status was changed. # unilateral weakness: concern fvor stroke this am; prelim read on ct does not show any evidence of obvious stroke, but mri would be more sensitive. . # respiratory distress: intubated during admission midway through hosptialization secondary to increased respiratory effort. efforts were made to diurese her, without great effect, and bilateral pleural effusiosn were not thought amentable to tap. extubated on . initially did well, but then became progressively more tachypneic and ultimately developed ams. efforts at suctioning have yielded limited success despite use of saline nebs to loosen secretions and cough assist machine. tolerates np suctioning poorly. some component of respiratory failure may be due to effusions, which have re-accumulated since her prior admission (not tapped given no optimal fluid pocket on u/s). trialed on bipap overnight on which resulted in improved ph, mental status and clinical appearance, but there is concern for further drying out already thick secretions leading to mucous plugging and/or aspiration. weaned off bipap on . this morning has increased o2 requirement, likely due to increasing volume/pleural effusions. she was treated for several days with vancomycin/cefepime for a presumed pna, but never grew any cultures, and did not spike any fevers during her hosptialization. acute renal failure: likely secondary to previous episodes of hypotension previously. giving more colloid threatens her respiratory status. her renal failure developed 2-3 days prior to her death, likely secodnary to poor intravascular volume. # mottled lower extremites: likely in the setting of some vasculopathy in addition to poor perfusion state. causing significant pain. was on heparin gtt, but dc'ed heparin gtt 2 days prior to passing. her r toes were evaluated by vascular surgery, who did not have any acute interventions for her. her rle gave her a great deal of pain during her hosptialization # atrial fibrillation with rvr: repeat echo showed an lvef that was probably normal, with some mitral regurgitation, and dilated rv. troponins have essentially been stable. she has been started on amiodarone for rhythm control. has completed amiodarone load w/ iv gtt, but developed tachycardia when transitioned to po amiodarone. she was trialed on iv amiodraone, as well as iv digoxin, with some effect; amiodraone gtt was dc'ed after patient made cmo. # hypotension: infectious etiologies have been excluded w/ negative cultures. it seems like her hypotension is most directly related to her heart rate- pressures drop when heart rate exceeds 100. of note, doppler pressures have been about 10 mmhg above regular cuff pressure . we are tolerating maps of 50-55 given tough cuff readings and severe pvd. we had difficulties obtaining maps given that she had a diffiulct a-line placement. # s/p laparatomy: secondary to necrotic bowel as well as anastomotic leak. both of these continue to remain concerns given the patient's current presentation and lactate, surgery following. wound appears clean, no e/o infection. # persistent ileus: secondary to bowel surgery as above. high residuals with attempt at tf; tf now held. she was started on tpn while in house. medications on admission: albuterol 2.5 mg q2h aspirin 325 mg daily diltiazem 30 mg tid fluticasone proprionate 2 puff guaifenesin 600 mg insulin ss miconazole nitrate daily nystatin 50,0000 u tid swish and swallow omeprazole 40 mg daily quetiapine 25 mg hydromorphone 1 mg iv q6h pnr ipratropium bromide 0.5 mg q4h pnr zofran 4 mg q8h prn ocean spary camph/meth/phenol 1 appl discharge disposition: expired discharge diagnosis: afib with rvr< deceased discharge condition: deceased discharge instructions: deceased followup instructions: deceased procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours parenteral infusion of concentrated nutritional substances insertion of endotracheal tube non-invasive mechanical ventilation excisional debridement of wound, infection, or burn central venous catheter placement with guidance central venous catheter placement with guidance diagnoses: acidosis thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia other postoperative infection unspecified pleural effusion urinary tract infection, site not specified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified acute respiratory failure surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation paralytic ileus encounter for palliative care cerebral embolism with cerebral infarction do not resuscitate status other specified disorders resulting from impaired renal function arterial embolism and thrombosis of lower extremity schizoaffective disorder, unspecified other digestive system complications 

Answer: The patient is high likely exposed to