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: latex / oxaliplatin / iodine; iodine containing / fluconazole / ace inhibitors attending: chief complaint: hypotension/uti/bacteremia major surgical or invasive procedure: multilumen cvc placement and removal a line placement and removal. history of present illness: the patient is a 68 year old female with history of stage iv metastatic colon cancer complicated by an enterocutaneous fistula and extensive spread of carcinoma into the osotomy bag. the patient presents with gross hematuria. one month ago, she began to have dysuria and chills. she was found to have a uti, a urinary catheter was placed, and she was given a ten day course of iv cipro. the catheter was left in place for about three weeks and removed one week ago. 2 days prior to admission, patient had dysuria and ua was positive for uti. she was started on cipro pending sensitivities. on day of admission, the patient had three episodes of hematuria and she was told by her doctor to come to the ed. she has no abdominal or back pain, but has complained of chills for "a long time". she currently has no change in her appetite, increased weakness, cough, sob, chest pain, fevers. she does have blood out of her colostomy, which is normal for her due to colon ca. . in the ed, initial vs were: t 98.7 hr 110, bp 101/55, o2sat 95%ra. the patient underwent ct abdomen/pelvis, two units were typed and screened, and recieved vancomycin and unasyn. sbp went to 85 in the ed and she got 3l ivns with 40meq kcl with improvement in her blood pressure to sbp 90-110. . on the floor, the patients vitals were: hr 105 bp 108/61 rr 18. she has no complaints. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. . past medical history: metastatic colon cancer to lung and peripancreatic mass. 0riginally diagnosed in with a t3 n0 m0 ulcerating colon adenocarcinoma of the ascending colon. : developed metastatic disease in porta hepatis pulmonary embolism recurrent sbo svc syndrome dm (patient denies, being treated for at ) past surgical history: per omr s/p small bowel resection, resection of mass, lysis of adhesions s/p right cataract s/p port s/p repair of incarcerated incisional hernia w/mesh s/p orif right ankle distal fibular fracture with plate and screws s/p right colectomy oncologic history: per omr prior chemotherapy and history: oxaliplatin/xeloda- discontinued after 1 dose because of allergic reaction to oxaliplatin ankle fracture (admitted to hospital) - irinotecan/xeloda for 9 cycles. discontinued because of rising cea erbitux/irinotecan weekly started, baseline cea 45. she received a total of 7 combined erbitux/irinotecan treatments. cea fell to 7 () begin single erbitux, baseline cea repair of surgical hernia - erbitux/irinotecan, discontinued because of allergic reaction to erbitux (see below) begin /irinotecan, cea rose to 43 begin 5-fu/lcv/ cyberknife treatment (radiation therapy) begin hospitalization for pneumococcal mastoiditis and meningitis - begin 5-fu/leucovorin/ cyberknife (radiation treatment) 5-fu/leucovorin/ : 5fu/leucovorin x 33cycles present: cycle 2 vectibix social history: husband died of cancer recently on . she immigrated from in . lives alone now. has 3 sons (1 in me, 1 in ut, 1 in ). currently on disability secondary to cancer; formerly worked housekeeping for . etoh: none. tobacco: none family history: mother and father with unknown cancer. physical exam: admission pe: vitals: t: bp:118/94 p:108 r:23 18 o2: 100%ra general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: left colostomy in place with fungating mass protruding, small amount of brown fecal material in bag, no erythema, colostomy site c/d/i, abdomen soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: foley catheter in place draining bright red blood ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: 01:22pm blood wbc-9.1 rbc-3.01*# hgb-8.0*# hct-24.9*# mcv-83 mch-26.5* mchc-32.0 rdw-19.4* plt ct-411 01:22pm blood glucose-115* urean-13 creat-0.7 na-139 k-2.5* cl-107 hco3-25 angap-10 05:54am blood alt-5 ast-11 ld(ldh)-151 alkphos-60 totbili-0.3 04:55pm blood cortsol-19.5 05:54am blood cortsol-6.7 03:31am blood type-art temp-37.1 po2-77* pco2-28* ph-7.45 caltco2-20* base xs--2 intubat-not intuba 01:24pm blood lactate-1.4 microbiology: urine urine culture-final {escherichia coli} inpatient mrsa screen mrsa screen-final inpatient blood culture blood culture, routine-final emergency blood culture blood culture, routine-preliminary {enterococcus faecalis}; anaerobic bottle gram stain-final brief hospital course: the patient is a 68 year old female with a history of metastatic colon cancer with extensive local spread into ostomy bag and enterocutaneous fistula who presents with dysuria and gross hematuria; now in septic shock with vanc-sensitive enterococcus bacteremia and cipro-resistant e. coli # hypotension ?????? for the patient's hypotension, she was initially placed on pressor support with levophed; she also received broad-spectrum antibiotics per id recommendations. her antibiotic regimen was tapered to cover her enterococcus bacteremia as well as cipro-resistant e. coli uti with unasyn. her indwelling picc line was removed and a temporary cvc was placed. her pressure continued to be labile after appropriate antibiotic therapy and she maintained clear mentation and good uop despite bps in the 80s-90s/50s. her pressors were weaned off. she was continued on antibiotics on (amp/sulbactam). she has remained afebrile. her heart rate has been persistently in the low 100s, apparently her baseline. she was weaned off of pressors. she was transferred to the oncology service for further management where her blood pressure remained stable. #fluid balance - the patient's fluid balance remained tenuous with depleted intravascular volume hypoalbuminemia. she had worsening bilateral pleural effusions as well as increased ue edema and the decision was made to begin a lasix drip. she diuresed a portion of this fluid and her edema had improved prior to transfer to the floor. while on the floor and after discussion with patient, tpn was discontinued, and patient began to take po. she received intermittent fluids iv, however over the past 24 hours, has not required further ivfs. after transfer to the oncology service, she was able to tolerate po. she was started on tpn and was maintained on this regimen until the day of discharge. we discussed discontinuing tpn and the patient agreed to this. #rash: the patient developed an erythematous rash on her abdomen and thorax around her ostomy bag. the rash appeared fungal and she was given miconazole cream as well as micafungin, this was completed on (7 days of micafungin). #coagulopathy: the patient had an elevated inr during her icu course. she was given po vitamin k to normalize her pt. the coagulopathy was thought to be to poor po. she did have one episode of bleeding from her ostomy site and the patient's lovenox was discontinued. she was transfused 2u prbc in addition, last tranfusion on 2 units. her hematocrit had stabilized prior to transfer from the icu with slow decline to range of 23-26 over the last two days. given high risk of dvt and hx of pe, lovenox was restarted at 60mg sc bid. she should have a hct checked within 3 days of admission to the facility. #nutrition: the patient had decreased po during her icu stay. she was placed on tpn. she received nutritional supplements as per her home regimen. see above for nutrition discussion. . #. metastatic colon cancer: for the patient's colon cancer - metastatic and locally invasive, oncology recs were followed. her ostomy was closely cared for and she was placed on anti-diarrheals to decrease output. she was given ivf to keep up with ongoing losses. she was placed on a fentanyl patch for pain. near the end of her icu stay, the patient and her family decided to change her code status to dnr/dni and a morhpine drip was added to help control the pain. no further interventions were made. she was comfortable and pain free at time of discharge. # history of pe's - the patient received lovenox for her history of pes. this was discontinued, however, when she had increased bleeding from her ostomy site. she was placed on pneumoboots for dvt prophylaxis, however, as listed above, lovenox was restarted give her high risk for vte and stable hematocrit. she did have rue edema at site of picc, us was negative for dvt, picc was left in place due to difficult placement in ir and in case she requires further ivf or transfusions. # h/o depression: she was kept on her home medication mirtazapine. # hematuria ?????? the patient's hematuria early in her admission resolved with antibiotic treatment of her uti. # stoma care: fistula pouch was changed as needed. her peri-fistula skin remained intact but was red. the fungating tumor continues to get larger and also continues to bleed a significant during the cleansing of the site. she was again pouched with coloplast /fistula pouch. seals and surgical cement were added to the adhesive surface of the pouch and cement was added to her skin and allowedto dry for a few minutes prior to applying the pouch to her. the pouch's edges were taped using pink hy tape. the cover of thepouch was cemented on as well as taped in place. both ports of the pouch were connected to gravity drainage. hospital order numbers for the items used: pouch # cement # seal # stomahesive paste # optional supplies: stomahesive powder # no sting barrier wipe # code status: dnr/i. medications on admission: ensure supplement tid neutraphos packet tid fluticasone 50 mcg 2 prays each nostril ferrous gluconate 324 mg with meals sodium bicarb 650 mg tab 2 tabs by mouth tid vitamin c 500 mg omeprazole 20 mg rifaxamin 200 mg daily lovenox 60 mg q12h fentanyl 100 mcg patch q72h discharge medications: 1. fluticasone 50 mcg/actuation spray, suspension : two (2) spray nasal (2 times a day). 2. ferrous gluconate 325 mg (37.5 mg iron) tablet : one (1) tablet po tid (3 times a day). 3. ascorbic acid 500 mg tablet : one (1) tablet po bid (2 times a day). 4. omeprazole 20 mg capsule, delayed release(e.c.) : one (1) capsule, delayed release(e.c.) po bid (2 times a day). 5. rifaximin 200 mg tablet : one (1) tablet po tid (3 times a day). 6. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 7. psyllium 1.7 g wafer : one (1) wafer po tid (3 times a day). 8. mirtazapine 15 mg tablet : one (1) tablet po hs (at bedtime). 9. miconazole nitrate 2 % cream : one (1) appl topical (2 times a day): please apply to affected area around ostomy site and under left breast. 10. miconazole nitrate 2 % powder : one (1) appl topical (2 times a day): please apply to affected area around ostomy site and under left breast. . 11. opium tincture 10 mg/ml tincture : fifteen (15) drop po q 12h (every 12 hours). 12. loperamide 2 mg capsule : one (1) capsule po q4h (every 4 hours). 13. fentanyl 100 mcg/hr patch 72 hr : one y five (125) mcg transdermal q72h (every 72 hours). 14. insulin regular human 100 unit/ml solution : one (1) per sliding scale injection asdir (as directed). 15. acetaminophen 325 mg tablet : two (2) tablet po q6h (every 6 hours) as needed for pain, fever. 16. morphine 100 mg tablet sustained release : two (2) tablet sustained release po q12h (every 12 hours). 17. morphine 10 mg/5 ml solution : one (1) mg po q2h (every 2 hours) as needed for pain. 18. prochlorperazine maleate 10 mg tablet : one (1) tablet po q6h (every 6 hours) as needed for nausea. 19. lovenox 60 mg/0.6 ml syringe : one (1) subcutaneous twice a day. 20. outpatient lab work hct weekly to assess for anemia. discharge disposition: extended care facility: of discharge diagnosis: enterococcal sepsis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were admitted to with infection on your blood. you were treated with antibiotics and have restarted to take some food by mouth. you tpn (supplemental iv nutrition) was discontinued after discussion with you. now that you infection is controlled and you are taking some food by mouth, you are being discharged to your facility. please take all medications as written. please follow up with your doctor at the nursing home. please call the office of dr. , to confirm your follow up plans. followup instructions: please follow up with you care giver at nursing home. please call the office of dr. , to confirm your follow up plans. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances diagnoses: anemia, unspecified malignant neoplasm of liver, secondary cellulitis and abscess of trunk urinary tract infection, site not specified severe sepsis depressive disorder, not elsewhere classified septic shock long-term (current) use of anticoagulants personal history of malignant neoplasm of large intestine rash and other nonspecific skin eruption personal history of venous thrombosis and embolism secondary malignant neoplasm of skin gross hematuria secondary malignant neoplasm of lung streptococcal septicemia other and unspecified coagulation defects colostomy status fistula of intestine, excluding rectum and anus 

Answer: The patient is high likely exposed to