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: history of present illness: this is a -year-old female with a history of coronary artery disease, status post a stent to the right coronary artery three years ago, several bilateral lower extremity peripheral vessel disease, hypothyroidism, polycythemia , chronic atrial fibrillation and chronic urinary tract infections who was admitted on to with acute respiratory distress, fever and hypotension after an episode of substernal chest pressure, nausea and vomiting. the patient was brought to the emergency room where she acutely decompensated. at the outside hospital, over one month course the patient was started on dopamine from to was acutely febrile, had a white blood count of 34 and was intubated shortly after admission. the patient had been on ciprofloxacin as an outpatient for chronic urinary tract infection. it was felt at that time that the patient had sepsis due to urinary tract infection verses pneumonia. she was also anuric on presentation. the patient was started on vancomycin, tequin and ceftazidime. she had improvement with decrease in her white blood count to 14 however, she continued to have fevers of 101 to 102 during the hospital course without ever isolating the source. the patient's antibiotic regimen was changed to zosyn, gatafloxacin and diflucan for urinary tract infection. she was also started on solu medrol on for four days for unclear reasons. she became less ventilatory dependent and tolerated pressure support of 5 with a peep of 0. she was actively diuresed with daily lasix. on all the antibiotics were discontinued. on the patient was extubated however, several hours later was re-intubated for tachycardia and tachypnea. was restarted on dopamine and dobutamine on through . she was unable to diurese secondary to hypotension. an echocardiogram one on showed an ef of 55 to 65%, moderate ai and mr. bilateral atrial enlargement. for sedation the patient received ativan and morphine on a p.r.n. basis. upon family request the patient was transferred to for further management. past medical history: chronic urinary tract infection, hypothyroidism, coronary artery disease, status post stent to rhe right coronary artery three years ago, status post left clavicular fracture, hypotension, polycythemia , history of a transient ischemic attack, question of a b12 deficiency, bilateral lower extremity, peripheral vascular disease, question of renal artery stenosis by catheterization in , hemorrhoids, status post hysterectomy. allergies: question of an anaphylactic reaction to marcaine, intolerance to narcotics. allergies to procainamide (?). medications: 1. insulin drip 2. heparin drip. 3. synthroid 100 mg q day. 4. hydroxyurea 500 mg q day. 5. flagyl 500 mg three times a day. 6. aspirin 81. 7. morphine p.r.n. 8. ativan p.r.n. 9. prevacid 30 mg 10. tylenol p.r.n. 11. hydrochloride 100 mg three times a day. assessment: this is a -year-old female with urosepsis verses pneumonia sepsis. hospital course: 1. hypotension - initially responded well to intravenous fluids but remained hypotensive despite cvp's in the 20's. swann on was labile numbers. have tried multiple pressors. needs levophed to keep scl up, lytes, dopamine to keep the heart rate up. dropped cardiac output with dobutamine. the next pressor to try would have been vasopressin. also initially had a court stim test to which she responded. we also treated hypothyroidism without improved hemodynamics. by she was still requiring levo and dopamine to maintain pressures. 2. atrial fibrillation/sick sinus - when admitted had atrial fibrillation in the 60's, occasionally up to 100. over the last few days of admission had been bradycardiac down to the junctional scape rhythms. holding digoxin and had pacer pads placed in case she bradycardia down again. if she did clear the sepsis the plan was that she may need a pacer. however, by she had no bradycardiac episodes in the last 48 hours and was off the heparin because she had a bleed at the right ij swann site a few days ago requiring one unit of packed red blood cells for a four point hematocrit drop. 3. polycythemia - with leukocytosis and thrombocytosis. dr. from hematology was following. there was no evidence of a leukemic transformation just a leukemoid reaction. she was started on hydroxyurea to treat the platelets and white blood cell count. 4. pulmonary status: the patient was vent dependent with bilateral effusions and pulmonary edema secondary to diastolic dysfunction, total body overloaded and hypoalbuminemia. she was trached on which went well. she did have a bronchoscopy done which was normal and no tissue or lavage was done at the time. 5. oliguria - the patient was currently oliguric most likely to poor hemodynamics. this did not improve even with a lasix drip, dobutamine or dopamine initially. however, by she had some improved urine output when greater than 70's on levophed and dopamine. 6. infectious disease. the patient was c. diff negative but had pseudomonas in the urine and was changed to cefepime on as it was not sensitive to the ceftazidime that she was initially placed on. sputum was growing coag positive staphaureus that was methicillin resistant staphylococcus aureus positive so she was started on vancomycin. the exam was consistent with sepsis and without the levophed her svr dropped to the 500. 7. fluids, electrolytes, nutrition: the patient was continued on tube feeds and electrolytes were repleted as needed. 8. endocrine. tsh was 20 on admission, did not get synthroid for one month at the outside hospital. was loaded with intravenous levoxyl and the t4-t3 came back to normal range on therefore she was switched to p.o. levothyroxine. stress dose steroids were weaned completely by . 9. neurological. the patient responds to pain, is hard of hearing which may be contributing to the non-responsiveness of voice. we attempted to minimize ativan and morphine throughout the admission. a head ct at the outside reportedly is negative for bleed or stroke. 10. communication. extensive conversations with the family and with the attending about lack of improvement on antibiotics. several family meetings were held and the family had initially wanted to continue on aggressively for several days. finally as recovery seemed futile and the patient had not responded to many days on antibiotics the decision was finally made to change her care to comfort measures. this was done and the patient passed away peacefully on on a morphine drip for pain. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more temporary tracheostomy diagnoses: pneumonia, organism unspecified hypocalcemia urinary tract infection, site not specified congestive heart failure, unspecified unspecified septicemia unspecified acquired hypothyroidism atrial fibrillation congenital factor xi deficiency 

Answer: The patient is high likely exposed to