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: cephalexin / erythromycin base attending: chief complaint: lethargy major surgical or invasive procedure: internal jugular line placement history of present illness: ms. is a 69 year-old woman with a history of asthma, cad, chf (ef 10%), iddm, ckd, discharged 1 week ago after an admission for cellulitis and hypercarbic respiratory failure, who now presents hypotension and acute on chronic kidney injury. . she was recently admitted - . she had acute on chronic cellulitis and completed a 10 day course of vancomycin. she also had hypercarbic respiratory failure requiring intubation. she was treated for a copd exacerbation as well as volume overload and was extubated after two days. she was called out of the icu. on the medical floor, she was agressively diuresed. her heart failure regimen was also optimized in consultation with cardiology. in particular, metoprolol was increased from toprol xl 100 mg qday to metoprolol tartrate 150 mg . lisinopril 2.5 mg was started. she remained mildly hypoxic and was discharged to home on l o2, having refused rehab. her previous dose of torsemide 100 mg daily was resumed on discharge. creatinine was 1.5 on the day of discharge. . after arrival at home, ms. was living with her husband who noted her to be mostly immobile, unwilling to eat, and taking her medications unreliably. a visiting nurse noted that she was unable to care for herself and so was admitted to rehab from home on . at the time her initial bp was low 70s but quicklky rose into the 80s and then 90s. diuretics were held. despite holding torsemide for two days, the patient remained hypotensive. today, sge was noted to be more lethargic and bp 70s so she was referred to . . upon arrival to ed, initial vs: 96.6 58 103/42 18 99% 6l nc. fs wnl. she was very confused. blood pressure then fell into the 70s systolic. she was given vancomycin 1 g, piperacillin-tazobactam 4.5 g, and 4 l ns. ij was placed and levophed started (initially at .03, titrated up to .12 prior to transfer). she was not more hypoxic than baseline (99% on 2l). ekg was similar to prior. labs were notable for a troponin elevated to .45 and creatinine 2.4. cxr did not demonstrate volume overload or infiltrate. her mental status improved after the initiation of pressors. cardiology was consulted with regard to the elevated troponin. they thought an ischemic event was unlikely and will follow. she was sent for ct head and torso prior to transfer to the icu. however, she refused the torso portion of this exam. she was transferred to the icu. . upon arrival to the micu, the patient complains of low back pain that is chronic for her. she also has leg pain when moved. she denies chest pain, cough, palpitations, abdominal pain, nausea, diarrhea, dysuria. past medical history: 1. asthma 2. cad s/p cabg 3. congestive heart failure with ef 10-15% on tte 4. atrial fibrillation on coumadin 5. dm - insulin dependent, c/b dm retinopathy 6. morbid obesity 7. stage iii chronic kidney disease 8. vitamin d deficiency 9. chronic peripheral edema 10. h/o blood in stool 11. hypercholesterolemia 12. lower extremity cellulitis social history: lives independently with husband. denies alcohol, drugs and smoking. family history: cancer, hypertension, substance abuse, heart disorder, adult onset diabetes. physical exam: vitals: bp 125/38 (on norepi .04), hr 86, rr 20, o2 95% on 4l nc general: obese female, lying in bed with eyes closed, no apparent distress. heent: no apparent lesions in op neck: obese, difficult to assess jvd lungs: distant breath sounds, faint crackles at bases barely audible heart: regular, no murmurs appreciated, sternal defect with palpable heart tones abdomen: obese, soft, nondistended, positive bowel sounds ext: 2+ bilateral partially pitting edema. bilateral lower legs with woody changes, areas of denuded skin, minimal serous drainage, appear much improved compared to prior admission neuro: oriented to self and year, not place. moving all extremities pertinent results: admission labs: 01:00pm glucose-114* urea n-111* creat-2.4* sodium-129* potassium-4.5 chloride-91* total co2-30 anion gap-13 01:00pm wbc-7.5 rbc-3.79* hgb-10.7* hct-34.0* mcv-90 mch-28.3 mchc-31.6 rdw-16.7* 01:00pm neuts-76.1* lymphs-15.1* monos-5.8 eos-2.4 basos-0.6 brief hospital course: assessment and plan: ms. is a 69 year-old woman with ischemic cardiomyopathy and ef 10-15% who presents with hypotension. . # hypotension: given , hyponatremia, hypotension, and good response to 4 l ivf in the ed, this may have been simply related to volume depletion and an aggressive heart failure regimen. however, diuretics have recently been held and it is notable that her bicarb and her hct are actually both lower than discharge on admission labs. cvp on admission was 18. sepsis was also on the differential, but patient afebrile, wbc not elevated, cxr clear, ua not impressive, so she was not initially covered with antibiotics. however, the following morning her wbc was elevated so vancomycin and zosyn were started. norepinephrine was weaned to low doses and continued to maintain map >60. patient was transferred to the floor off pressors and was normotensive for the remainder of her stay. her home hypertension medications were held except for hydrochlorothiazide which was restarted prior to discharge. . # shortness of breath: patient with increased work of breathing on the second hospital day. this was attributed in part chf exacerbation. she intermittently became drowsy. abgs showed hypoxia and hypercarbia. bipap was used, but patient was poorly tolerant of this and consistently took it off when she woke up. she was also diuresed, with improvement in shortness of breath. she was initially maintained on torsemide 20 mg daily with iv lasix 40 mg prn volume overload. after necessitating iv lasix due to tachypnea, torsemide was increased to 30 mg daily. oxygen and iv morphine prn were continued as needed for comfort although patient did not require iv morphine. she remained stable on 1-3l nc with no respiratory distress during her hospital stay. . # acute on chronic kidney injury: baseline creatinine per records obtained at last hospitalization ~1.5, which was what it was on discharge a week ago. 2.5 on this admission. given concominant mild hyponatremia, hypotension, this may be simply due to volume depletion. creatinine fell with ivf in the ed. urine electrolytes showed a prerenal etiology. labs were discontinued on the floor per patient request. she continued to have good urine output throughout the rest of her hospital stay. . # elevated troponin: troponin .45. recently, .08 in the setting of not quite so bad renal function. it does seem likely that she has had some cardiac ischemia, probably in the setting of poor coronary perfusion secondary to systemic hypotension. this was trended and fell appropriately. . # hyponatremia: likely secondary to volume depletion. improved after ivf resuscitation. labs discontinued on floor after discussion with patient. . # chf: ef 10%: metoprolol, acei, torsemide held in the setting of hypotension but were restarted at lower-than-home-doses. she will be discharged on lower doses of these medications as she has been stable during hospital stay. . # atrial fibrillation: rate controlled and anticoagulated on admission. was subtherapeutic inr after having warfarin held at rehab for several days (for inr 5 on ). warfarin was restarted at a lower dose and she was started on a heparin drip while warfarin subtherapeutic. inr was then found to be supratherapeutic and warfarin was held. risks and benefits of anticoagulation were discussed with patient and she decided that she did not want to continue anticoagulation. warfarin was thus stopped and will not be continued at discharge. no evidence of bleeding or clots on exam. will continue metoprolol for rate control as described above. . #end of life: palliative care consult was obtained per pcp . patient was confirmed dnr/dni and also did not wish to be transferred to the micu or undergo nippv should she decompensate. she will be discharged to hospice . # dm: home dose of glargine 15 units qam was initially continued, with humalog sliding scale. glargine was decreased to 5 units daily on the floor. blood sugars were well controlled on this regimen. . medications on admission: -insulin glargine 15 units qhs -humalog sliding scale -warfarin 1.5 mg daily (but held on and decreased to .5 mg , not given ) -metoprolol tartrate 150 mg -torsemide 100 mg daily -simvastatin 40 mg qhs -cholecalciferol 1000 iu daily -ipratropium-albuterol nebs prn -calcium carbonate 500 mg daily -asa 81 mg daily -docusate 100 mg -senna 8.6 mg -acetaminophen 650 mg tid prn -oxycodone 1.25 - 2.5 mg prn dressing changes -lisinopril 2.5 mg daily discharge medications: 1. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. oxycodone 5 mg tablet sig: 0.5 tablet po q3h (every 3 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 3. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 5. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. ipratropium bromide 0.02 % solution sig: one (1) spray inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 7. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) spray inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 8. lantus solostar 100 unit/ml (3 ml) insulin pen sig: five (5) units subcutaneous once a day. disp:*30 ml* refills:*2* 9. humalog subcutaneous 10. acetaminophen 325 mg tablet sig: two (2) tablet po every eight (8) hours as needed for pain. 11. docusate sodium 100 mg capsule sig: one (1) capsule po twice a day. 12. senna 8.6 mg capsule sig: one (1) capsule po twice a day. 13. cholecalciferol (vitamin d3) 1,000 unit tablet sig: one (1) tablet po at bedtime. 14. calcium carbonate 500 mg (1,250 mg) tablet sig: one (1) tablet po once a day. 15. torsemide 10 mg tablet sig: three (3) tablet po once a day. disp:*90 tablet(s)* refills:*2* 16. needle (disp) needle sig: one (1) miscellaneous once a day. disp:*30 needles* refills:*2* 17. lancets misc sig: one (1) miscellaneous once a day. disp:*30 lancets* refills:*2* 18. one touch basic system kit sig: one (1) miscellaneous once a day. disp:*1 kit* refills:*0* discharge disposition: extended care facility: - discharge diagnosis: hypotension, responsive to fluids acute renal failure, likely pre-renal uti diabetes chf afib chronic pain respiratory failure, resolved, cad s/p cabg chronic lower extremity venous stasis discharge condition: mental status: clear and coherent. level of consciousness: lethargic but arousable. activity status: bedbound. discharge instructions: dear mrs. , it was a pleasure participating in your health care. you were admitted to for hypotension and acute renal failure for which you were admitted to the intensive care unit where you were given fluids. in the intensive care unit, you were treated with pressors and diuresis as well as antibiotics. the decision was made to transition to hospice care and to stop anticoagulation with warfarin. please make the following changes to your medications: stop warfarin decrease torsemide to 30 mg daily increase lisinopril to 5 mg daily decrease metoprolol to 25 mg twice a day decrease glargine to 5 units daily start oxycodone 2.5 mg every 3 hours as needed for pain followup instructions: please follow-up with a physician as desired md procedure: venous catheterization, not elsewhere classified diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia hyposmolality and/or hyponatremia severe sepsis candidiasis of other urogenital sites atrial fibrillation asthma, unspecified type, unspecified chronic kidney disease, stage iii (moderate) acute respiratory failure long-term (current) use of anticoagulants acute on chronic systolic heart failure volume depletion, unspecified venous (peripheral) insufficiency, unspecified unspecified vitamin d deficiency 

Answer: The patient is high likely exposed to