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: patient recorded as having no known allergies to drugs attending: chief complaint: abdominal and back pain for past few days after falling at home major surgical or invasive procedure: laparotomy, abdominal washout, closure of perforated ulcer with omental overlay patch, gastrostomy and jejunostomy. history of present illness: ms. is a 61yo female, current smoker with no other pmh who presented to ed after falling several days ago at home. she has had some pain in her shoulder. she was not complaining of any abdominal pain in the ed. workup in the emergency documented leukocytosis acidosis and free air under the diaphragm. of note is that the patient had fairly significant renal dysfunction with a creatinine of 3.5, as well as a significant coagulopathy in the absence of anticoagulant therapy. after antibiotics and a brief resuscitation including fresh frozen plasma, the patient was brought to the operating room for exploration with dr. . past medical history: denies social history: lives alone. unemployed. some supportive family. reports smoking 3 cigarettes per day. no medical insurance. family history: noncontributory physical exam: t: 98.4 p: 82 r: 18 bp: 122/68 general: thin, nad cardiovascular: rrr, no murmur appreciated respiratory: slightly decreased at bases abdomen: midline incision well approximated, no erythema, gj site without erythema, r flank dressing c/d/i, + bs, nontender pertinent results: radiology final report ct abdomen w/contrast 9:06 am ct abdomen w/contrast; ct pelvis w/contrast reason: 61 yo female sp gastric ulcer perforation now wbc 27 with lo contrast: optiray medical condition: 61 yo female sp gastric ulcer perforation now wbc 27 with low grade temperatures. please vealutae for an abescess and if there is a coillection please drain reason for this examination: 61 yo female sp gastric ulcer perforation now wbc 27 with low grade temperatures. please vealutae for an abescess and if there is a coillection please drain contraindications for iv contrast: none. indication: status post gastric ulcer perforation, now with white blood cell count of 27 and low-grade temperatures. please evaluate for abscess, and if there is a collection, please drain. comparison: . procedure: the patient was placed supine on the ct table, and initial axial mdct images were obtained from the lung bases to the pubic symphysis following the intravenous administration of optiray. coronal and sagittal reformatted images were provided. contrast: intravenous nonionic contrast was administered. ct of the abdomen with intravenous contrast: since the examination of , the degree of consolidation in the right and left lower lobes has improved to some extent, as has ground-glass opacity in the right middle lobe, although an area of more dense atelectasis along the lateral aspect of the right middle lobe with adjacent non-layering pleural effusion has progressed. a right pleural effusion has increased. a left pleural effusion is stable. the imaged portion of the heart and pericardium appear within normal limits. moderate ascites is again present throughout the abdomen with peritoneal enhancement, an unchanged finding. in the right mid abdomen, an oblong collection with slightly more prominent peritoneal enhancement measures 0.3 x 9.1 cm (2:36), slightly decreased in size from , at which time it measured 1.6 x 9.3 cm. a jejunostomy tube is in place in the left mid- abdomen, and percutaneous gastrostomy tube is in place in the left upper abdomen. surgical staples are seen at the midline. the large and small bowel loops are normal in caliber. the gallbladder is distended to a similar degree as it was on . ct of the pelvis with intravenous contrast: the uterus is enlarged with a calcified fibroid at the fundus and with a hypodense mass measuring 8.6 x 7.2 cm consistent with a noncalcified fibroid. posterior to the uterus, a pocket of fluid measuring 7.4 x 2.8 cm, also with peritoneal enhancement, has decreased in size slightly from , at which time it measured 3.4 x 8.3 cm. a small focus of gas and fluid anterior to the uterus on sagittal images is shown to represent the fundus of the bladder and could be consistent with recent foley catheter placement. there are no pathologically enlarged inguinal or pelvic lymph nodes. bone windows: bone windows show no lesions worrisome for osseous metastatic disease. impression: 1. unchanged moderate ascites with peritoneal enhancement and slight decrease in size of two focal collections in the right flank and deep pelvis. 2. distended gallbladder, an unchanged finding. ultrasound could be performed for further evaluation if there are referable symptoms. 3. worsening right pleural effusion and stable left pleural effusion. 4. improved pulmonary consolidation, but progression of right middle lobe atelectasis with adjacent loculated effusion. 5. fibroid uterus. procedure: despite a slight decrease in size of focal collections in the pelvis and right flank, due to clinical concern for untreated infection, aspiration of a right flank collection was requested. the risks and benefits of the procedure were explained to the patient, and written informed consent was obtained. a pre-procedure timeout was performed using two patient identifiers. after local anesthesia with 7 cc of 1% lidocaine, and under direct ct guidance, a 4.5 french catheter was advanced into the collection. however, no fluid could be aspirated despite confirmation of the needle tip in the collection. therefore, a second pass was made into a slightly more superior portion of the collection with similar results. following this, a 0.018 wire was advanced via the catheter into the collection and the system was exchanged for a 4.5 french microaccess catheter. despite manipulation of the wire and catheter within the collection, only approximately 1 cc of serosanguineous material could be aspirated. therefore, a 0.038 wire was advanced via the microaccess catheter into the collection and manipulated to achieve possible lysis of loculations. the 4.5 french catheter was again placed over the 0.038 wire and approximately 5 cc of serosanguineous material was then aspirated, capped and sent to microbiology. the wire and the catheter were removed. post-procedural scanning showed no evidence of complications at the procedural site. the patient tolerated the procedure well, with no complications evident at the time of the procedure, and remained stable throughout her stay in the ct suite. the attending radiologist, dr. , was present and supervising throughout, and performed portions of the procedure. impression: technically successful access of a right flank collection which yielded only 5 cc of serosanguineous material. sample sent to microbiology. echo findings left atrium: elongated la. right atrium/interatrial septum: mildly dilated ra. left ventricle: normal lv wall thickness, cavity size and regional/global systolic function (lvef >55%). no resting lvot gradient. no vsd. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. focal calcifications in aortic root. normal ascending aorta diameter. focal calcifications in ascending aorta. aortic valve: mildly thickened aortic valve leaflets (3). no as. no ar. mitral valve: normal mitral valve leaflets. no mvp. no mass or vegetation on mitral valve. normal mitral valve supporting structures. of the mitral chordae (normal variant). no resting lvot gradient. no ms. mild (1+) mr. normal lv inflow pattern for age. tricuspid valve: normal tricuspid valve leaflets with trivial tr. no mass or vegetation on tricuspid valve. normal tricuspid valve supporting structures. no ts. borderline pa systolic hypertension. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. no vegetation/mass on pulmonic valve. normal main pa. no doppler evidence for pda pericardium: trivial/physiologic pericardial effusion. no echocardiographic signs of tamponade. conclusions the left atrium is elongated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 60%) there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. the focal nature of aortic valve thickening raises the possibility of vegetation, although it is more likely to represent age-related fibrocalcific thickening. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. no mass or vegetation is seen on the mitral valve. mild (1+) mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. no vegetation/mass is seen on the pulmonic valve. there is a trivial/physiologic pericardial effusion. there are no echocardiographic signs of tamponade. if clinically suggested, the absence of a vegetation by 2d echocardiography does not exclude endocarditis. c diff b toxin - pending wound culture (final ): (torulopsis) glabrata. sparse growth. caspofungin and fluconazole sensitivities requested sent to for sensitivity testing. refer to sendout system for results. 12:41 pm blood culture source: line-cvl. **final report ** blood culture, routine (final ): (torulopsis) glabrata. fluconazole available on request. anaerobic bottle gram stain (final ): yeast. brief hospital course: ms. was taken to the or after her evaluation in the ed revealing an emergent abdominal process via ct scan and laboratory findings. in the operating room, a perforated prepyloric ulcer was identified and she underwent a laparotomy, abdominal washout, closure of perforated ulcer with omental overlay patch, gastrostomy and jejunostomy. she was stabilized, and transferred to the icu for close monitoring due to her critical state. . pod 1 () - she continued on the ventilator, cipro, fluconazole, and flagyl and resuscitated with 4 units of ffp, 4 units rbcs and iv fluids. pod 2 () - the patient was extubated but had to be electively reintubated due to decreasing saturations. j-tube feedings started at 10ml/hr pod 3 () - cont abx, tube feeds advanced slowly as tolerated pod 4 () - antibiotics changed to vanc, zosyn, cipro, fluconazole. bedside bal performed. pod 5 () - the patient was extubated without complications and continued aggressive pulmonary toilet. pod 6 ()- ct abdomen performed which showed ascitic fluid. cvl discontinued. ophthalmology consult for fungemia - no retinal involvement. pod 7 - antibiotics changed to vanc po/iv, zosyn, caspo and flagyl. c diff sent. - patient transferred to the floor in stable condition. foley catheter discontinued. continued pulmonary toilet and tube feeds - started on a clear liquid diet - ct guided drainage of abdominal abscess - regular diet started - tolerated well - continued regular diet, tube feeds stopped. picc line placed. - all antibiotics except for caspo and flagyl were stopped. - echo to rule out fungal vegetations - equivocal - advised to perform tee as an outpatient in days. - discharged home with follow up arranged for daily infusion center appointments for caspo treatment, tee the following week and weekly labs to be faxed to clinic. medications on admission: motrin prn discharge medications: 1. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 1 weeks. disp:*21 tablet(s)* refills:*0* 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. caspofungin 50 mg recon soln sig: one (1) intravenous once a day for 21 days. disp:*21 * refills:*0* 4. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q4h (every 4 hours) as needed for wheeze. disp:*2 * refills:*2* discharge disposition: home discharge diagnosis: primary: profuse abdominal peritonitis sepsis pre-pyloric perforated ulcer post-op hypovolemia post-op hypoxemia discharge condition: stable tolerating a regular diet with ensure supplements adequate pain control with oral medication discharge instructions: ** be sure to come to infusion clinic for caspofungin infusions ** gtube & jtube care: -please look at the tube sites every day for signs of infection (increased redness, swelling, odor, yellow or bloody discharge, fever). -flush tubes with 30cc of water at least once a day -you may shower, wash around area gently with warm, soapy water. -maintain the site clean, dry, and intact. -avoid swimming, baths, hot tubs-do not submerge yourself in water. -keep attached safely to body to prevent pulling. -call doctor fall out, apply pressure to sites with guaze, and go to local emergency room for replacement of . you will need weekly blood tests (lfts, cbc w/diff, chem 7) and have the results faxed to . please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in 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. * your skin, or the whites of your eyes become yellow. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * avoid driving or operating heavy machinery while driving. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered. * continue to ambulate several times per day. . incision care: -your staples will be removed at your follow-up appointment -you may shower, and wash surgical incisions. -avoid swimming and baths until your follow-up appointment. -please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. followup instructions: 1. please make a follow-up appointment with dr. in 2 weeks. 2. please arrange for routine follow-up care with a primary care . an appointment has been made for you to follow up with infectious diseases on - any questions please call . you will need weekly blood tests (lfts, cbc w/diff, chem 7) and have the results faxed to . 4. you will need to call the echo lab at to make an appointment for a trans-esophageal echo within the next week to evaluate for vegetations on your heart valves. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified other enterostomy insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous abdominal drainage gastric lavage transfusion of packed cells other gastrostomy transfusion of other serum suture of gastric ulcer site diagnoses: pneumonia, organism unspecified disseminated candidiasis other and unspecified complications of medical care, not elsewhere classified chronic or unspecified gastric ulcer with perforation, without mention of obstruction peritonitis in infectious diseases classified elsewhere 

Answer: The patient is high likely exposed to