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: sulfa (sulfonamides) / demerol / bacitracin / ciprofloxacin attending: chief complaint: hypotension, abdominal pain and distension major surgical or invasive procedure: exploratory laparotomy, extensive lysis of adhesions, abdominal colectomy, end ileostomy, hartmann's pouch creation, transgastric jejunostomy feeding tube placement . history of present illness: mrs. is a 62-year-old female with a history of adrenal insufficiency who had a fall at home with hypotension in the emergency room at an outside hospital. she had an elevated white blood cell count. she was evaluated with multiple imaging studies that showed a dilated colon. she was found to be tender to abdominal exam. she was fluid avid. she was in acute renal failure. she was transferred for surgical evaluation. given her tenderness, hypotension and pressor requirement, she was offered exploratory laparotomy to determine etiology. consent was reviewed and signed with the understanding that she might require an ostomy. past medical history: pmh: adrenocortical insufficiency/congenital adrenal hyperplasia history of addisonian crisis x several episodes neurogenic bladder hashimoto thyroiditis/hypothyroidism insomnia depression glaucoma esophagus restless leg syndrome hypertension -leventhal syndrome gangrenous cholecystitis rectal prolapse psh: tonsillectomy remotely appendectomy, loa, ?ileocecectomy for cecal volvulus vaginoplasty ovarian wedge resection r carpal tunnel release tah-rso (nwh) r tka l tka rye gb () nwh sigmoidectomy/rectopexy () lap ccy lap->open l adrenalectomy () social history: lives with husband, non-, no alcohol use family history: mother deceased at 77 of diabetic complications. father deceased at 77 of lung cancer and strokes. no other changes. physical exam: on admission: . gen: elderly female, nad, no icterus, appears comfortable at rest heent: nc/at, eomi, perrla bilat., dry mm, without cervical lad on my exam, +r periorbital hematoma, 3cm laceration below r eye repaired cor: rrr without m/g/r, no jvd, no bruits lungs: cta bilat. abdomen: hypoactive bs, distended, tender at llq, rlq, focal percussion tenderness at llq, no palpable hernias or masses extrem: cool feet, no edema, palpable pulses . at : . vs: t: 98.2, hr: 87, bp: 138/82, rr: 16, sao2: 99% ra gen: well-appearing, elderly female in nad. heent: sclerae anicteric. o-p moist, intact. neck: supple. no lymphadenopathy. no jvd. cor: rrr; nl s1/s2 w/o m/c/r. lungs: cta(b). abdomen: incision with staples ota c/d/i. gj-tube patent, intact. site w/o erythema. ostomy reddish pink, intact, patent with liquid brown output. appliance intact. bsx4. soft/nt/nd. extrem: no c/c/e. neuro: a+ox3. non-focal/grossly intact. pertinent results: 05:16pm type-art po2-244* pco2-39 ph-7.36 total co2-23 base xs--2 05:16pm lactate-1.7 05:16pm freeca-1.06* 05:13pm glucose-136* urea n-28* creat-1.1 sodium-137 potassium-4.7 chloride-108 total co2-19* anion gap-15 05:13pm calcium-7.7* phosphate-4.0 magnesium-2.1 05:13pm tsh-0.77 05:13pm wbc-7.3 rbc-2.30* hgb-8.0* hct-23.4* mcv-102* mch-34.8* mchc-34.2 rdw-12.3 05:13pm plt count-250 05:13pm pt-16.3* ptt-40.8* inr(pt)-1.4* 05:13pm fibrinoge-165 03:00pm pt-19.4* ptt-52.0* inr(pt)-1.8* 11:30am ctropnt-0.16* 11:30am ck-mb-118* mb indx-5.6 11:30am tot prot-5.5* albumin-3.6 globulin-1.9* calcium-8.2* phosphate-4.3# magnesium-2.6 11:30am osmolal-286 11:30am neuts-85* bands-8* lymphs-0 monos-5 eos-0 basos-0 atyps-0 metas-2* myelos-0 11:30am hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-1+ microcyt-normal polychrom-normal 11:30am urine blood-lg nitrite-neg protein-tr glucose-neg ketone-tr bilirubin-sm urobilngn-4* ph-6.5 leuk-tr 11:30am urine rbc-* wbc-0-2 bacteria-many yeast-none epi-0-2 trans epi-<1 11:30am urine granular-* hyaline-0-2 . pathology: specimen submitted: abdominal colon, fecalith. diagnosis: abdominal colectomy: 1. focal markedly dilated colon with extensive ischemic necrosis of mucosa and focal necrosis of muscularis propria. 2. fecalith. clinical: acute abdomen. gross: the specimen is received fresh in two parts, both labeled with the patient's name, " " and the medical record number. part 1 is additionally labeled "abdominal colon." it consists of a total colectomy specimen measuring 126 cm in length and ranges in diameter from 12 cm to the smallest area and measures 7.0 cm. the area of greatest dilation occurs approximately 17 cm from the distal resection margin. a portion of mesentery is attached to the colon measuring 126 cm x 5.0 cm. the proximal resection margin is not stapled and measures 4.0 cm. the distal resection margin is stapled and measures 2.3 cm. the mesentery appears unremarkable. the serosa of the bowel is erythematous, black and slightly green in appearance. the specimen is opened along the antimesenteric surface to reveal a lumen that is filled with fecal material. the mucosa is diffusely erythematous with multiple large black areas present throughout the entire colon. black areas range in size from 15 x 7 to 2 x 2 cm. no masses or polyps are identified. the bowel wall varies in thickness. the area which is the thinnest measures 0.2 cm. the thickest measures 0.8 cm. no diverticula are identified. an appendix is present. the appendix measures 7.5 cm x 2.5 cm. the serosa of the appendix is diffusely erythematous and green in appearance. the specimen is opened to reveal fecal filled lumen. the mucosa appears erythematous. the specimen is represented as follows; a = proximal resection margin, b = distal resection margin, c-d = representative sections of necrotic bowel, e-f = representative sections of appendix. part 2 is additionally labeled "fecalith." it consists of a portion of firm brown to black stool weighing 48 grams and measuring 5.5 x 3.5 x 3.0 cm. the outer surface of the stool has blood. the outer surface of the stool has blood on the surface. the specimen is for gross examination only and has been seen by dr. . . cardiology report ecg study date of 11:44:24 am sinus rhythm. normal tracing. compared to the previous tracing of no diagnostic interim change. intervals axes: rate pr qrs qt/qtc p qrs t 85 162 78 398/441 58 -11 71 brief hospital course: the patient was admitted to the general surgical service for evaluation and treatment of infarcted colon. on , the patient underwent exploratory laparotomy, extensive lysis of adhesions, abdominal colectomy, end ileostomy, hartmann's pouch creation, transgastric jejunostomy feeding tube placement, which went well. after recovering from anesthesia in the pacu, the patient was initially transferred to the sicu, and then to the inpatient floor on pod3. neuro: the patient received dilaudid pca with good effect and adequate pain control. when tolerating oral intake, the patient was transitioned to oral pain medications. psychotropic medications were restarted as soon as able, and the patient remained psychologically stable during hospitalization. cv: the patient was given lr and albumin pod2 for low cvp and low sbp. also, transfused a total of 4 units prbc for abrupt drop in hematocrit, responding well without further issue (see below). the patient remained stable from a cardiovascular standpoint; vital signs were routinely monitored. pulmonary: the patient remained stable from a pulmonary standpoint; vital signs were routinely monitored. good pulmonary toilet, early ambulation and incentive spirrometry were encouraged throughout hospitalization. gi/fen: post-operatively, the patient was made npo with iv fluids. trophic tube feeds were started via the j-tube after the patient tolerated g-tube clamping on . by date, the patient was tolerating full strength tubefeeds at 25ml/hr. on , the patient was started on a clear diet, which was advanced when appropriate to a regular diet, which was well tolerated. patient's intake and output were closely monitored, and iv fluid was adjusted when necessary. electrolytes were routinely followed, and repleted when necessary. ostomy remained intact and patent. the ostomy nurse for care instructions and patient education; recommendations were appreciated and followed. the patient will follow-up with the ostomy nurse from the rehabilitation facility. gu: a foley catheter to gravity drainage was placed peri-operatively, and was retained at due to the patient's history of neurogenic bladder. foley will be discontinued at the rehabilitation facility with voiding trial. id: the patient was started on iv zosyn and vancomycin post-operatively. blood and urien cultures taked during hospitalization revealed no growth. a standard mrsa screen upon sicu admission was negative. the patient's white blood count and fever curves were closely watched for signs of infection. the surgical incision and gj-tube insertion site remained clean, intact without infection during the hospital stay. antibiotics were discontinued on the date. endocrine: peri-operatively and during initial hospitalization, the patient received stress dosing of steroids given history of adrenal insuffiency. endocrinology was regarding steroid taper; their recommmendations were appreciated and followed. at the time of , prednisone was tapered to 10mg po daily. the patient's blood sugar was monitored throughout his stay; sliding scale insulin dosing was adjusted accordingly. the patient did not require exogenous insulin at the time of . hematology: while in the sicu, the patient received a total of 4 units prbcs for progressively declining hematocrit with a low of 15.4. after transfer to the floor, the patient's hematocrit remained stable with a hematocrit at of 25.5. prophylactic heparin was held until hematocrit stable, and the patient monitored closely. prophylaxis: the patient received subcutaneous heparin as above and venodyne boots were used during this stay; was encouraged to get up and ambulate as early as possible with physical therapy. at the time of on , the patient was doing well, afebrile with stable vital signs. the patient was tolerating a regular diet as well as tubefeeds via the j-tube, ambulating with assistance, had a foley catheter to gravity drainage in place due to neurogenic bladder, ostomy was patent and functioning, and pain was well controlled. the patient was discharged to a rehabiliation facility. the patient received teaching and follow-up instructions with understanding verbalized and agreement with the plan. issues to be addressed at follow-up with dr. include: (1) discontinuing or cycling tubefeeds, (2) staple removal, (3) routine post-op follow-up. medications on admission: prednisone 5mg po qd, fludricortisone 0.1mg qam, sanctura 20mg po qam, levothyroxine 175mcg po qd, clonazepam 0.5mg po tid:prn anxiety, olanzapine 20mg po qhs,lumigan od qhs, pantoprazole 40mg po qam, pramipexole 4mg po qam, diclofenac 150mg po bid, quinapril 20mg po qam, hctz 25mg po qam, tramadol 50mg po qid prn pain, cyclobenzaprine 10mg po tid:prn, hydroxychloroquine 200mg . medications: 1. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours) as needed for sob/cough/wheeze. 2. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours) as needed for sob/cough/wheeze. 3. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fevers. 4. olanzapine 20 mg tablet sig: one (1) tablet po once a day. 5. cyclobenzaprine 10 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for spasm. 6. clonazepam 0.5 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for anxiety. 7. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po once a day. 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. cyanocobalamin 500 mcg tablet sig: one (1) tablet po qtuesday & saturday (). 10. hydroxychloroquine 200 mg tablet sig: one (1) tablet po bid (2 times a day). 11. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. 12. levothyroxine 175 mcg tablet sig: one (1) tablet po daily (daily): hold tubefeeds 1 hour before and 1 hour after administration. 13. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 14. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 15. prednisone 10 mg tablet sig: one (1) tablet po daily (daily). 16. tramadol 50 mg tablet sig: one (1) tablet po qid (4 times a day) as needed for pain. 17. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day): hold for sbp<100, hr<60 . 18. plaquenil 200 mg tablet sig: one (1) tablet po twice a day. 19. flonase 50 mcg/actuation spray, suspension sig: two (2) sprays each nostril nasal once a day as needed for allergy symptoms. 20. solu-cortef 100 mg recon soln sig: one hundred (100) mg injection injected once for adrenal crisis; then proceed to er. 21. sanctura 20 mg tablet sig: one (1) tablet po once a day. 22. calcium 500 + d (d3) 500-125 mg-unit tablet sig: one (1) tablet po twice a day. 23. mirapex 1 mg tablet sig: two (2) tablet po twice a day. 24. vitamin d 50,000 unit capsule sig: one (1) capsule po qmonth on the 12th. 25. bimatoprost 0.03 % drops sig: one (1) 1 drop (r) eye ophthalmic at bedtime. 26. quinapril 20 mg tablet sig: one (1) tablet po once a day. 27. vagifem 25 mcg tablet sig: one (1) tab vaginal 1-2x/ per week as needed for vaginal dryness. disposition: extended care facility: of diagnosis: primary: 1. infarcted colon. secondary: 1. adrenal insufficiency 2. htn 3. neurogenic bladder 4. depression/anxiety condition: stable instructions: please call your doctor or nurse practitioner or return to the emergency department for any of the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience a . *your pain in not improving within 8-12 hours or is not gone within 24 hours. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon. avoid driving or operating heavy machinery while taking pain medications. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. *if you have staples, they will be removed at your follow-up appointment. *if you have steri-strips, they will fall off on their own. please remove any remaining strips 7-10 days after surgery. general drain care: *please look at the site every day for signs of infection (increased redness or pain, swelling, odor, yellow or bloody , warm to touch, fever). *if the drain is connected to a collection container, please note color, consistency, and amount of fluid in the drain. call the doctor, nurse practitioner, or vna nurse if the amount increases significantly or changes in character. be sure to empty the drain frequently. record the output, if instructed to do so. *wash the area gently with warm, soapy water. *keep the insertion site clean and dry otherwise. *avoid swimming, baths, hot tubs; do not submerge yourself in water. *make sure to keep the drain attached securely to your body to prevent pulling or dislocation. monitoring ostomy output/prevention of dehydration: *keep well hydrated. *replace fluid loss from ostomy daily. *avoid only drinking plain water. include gatorade and/or other vitamin drinks to replace fluid. *try to maintain ostomy output between 1000ml to 1500ml per day. *if ostomy output >1 liter, take 4mg of imodium, repeat 2mg with each episode of loose stool. do not exceed 16mg/24 hours. followup instructions: please call ( to schedule a follow-up appointment with dr. (pcp) in 2 weeks. please call , , rn, cwocn (ostomy nurse) once discharged from rehabilitation for outpatient follow-up. provider: , md phone: date/time: 9:45. location: office. procedure: enteral infusion of concentrated nutritional substances other gastroenterostomy without gastrectomy other lysis of peritoneal adhesions other permanent ileostomy open total intra-abdominal colectomy diagnoses: unspecified essential hypertension long-term (current) use of steroids acute kidney failure, unspecified unspecified acquired hypothyroidism dysthymic disorder peritoneal adhesions (postoperative) (postinfection) acute vascular insufficiency of intestine restless legs syndrome (rls) bariatric surgery status neurogenic bladder nos other impaction of intestine 

Answer: The patient is high likely exposed to