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: iodine; iodine containing attending: chief complaint: lethargy, nausea/vomiting, abdominal pain major surgical or invasive procedure: 1. intubation x2 2. exploratory laparotomy 3. placement of r internal jugular venous catheter 4. placement of femoral line 5. placement of picc line history of present illness: pt was brought to the ed with mental status changes/lethargy, nausea/vomiting, and abdominal pain. he was unable to give much of a history given his mental status. he had been vomiting and unable to keep food down for the past several days, but cannot give more specific details. in the ed, he was found to have a bp of 50/40, with a lactate of 8.1, with guaiac positive stool and acute renal failure (baseline cr 0.4, cr on admission 3.9). in addition, his wbc count was 12.9. the must protocol was initiated, and pt was intubated. as there was concern for intraabdominal infection as source of sepsis, pt was taken for an exploratory laparotomy. past medical history: 1. pituitary tumor, now panhypopit 2. seizure disorder 3. hypothyroidism 4. gerd 5. hypercholesterolemia 6. legally blind social history: he is single, smokes 1.5 to 2ppd, and abstains, after previous problems with alcoholism 11 years ago. he is a housing manager. family history: f died of cva m - tuberculosis physical exam: initial pe: pe on transfer to floor: vs: tm 98.7 tc 97.3 155/69 69 18 95% 3l nc gen: appears stated age, somewhat hoarse voice, nad, appears fatigued heent: perrl, eomi, mmm, op clear neck: no cervical lad pulm: mainly clear bilaterally, good air movement, trace bibasilar crackles, dullness to percussion at r base cv: rrr, nl s1/s2, no murmurs abd: soft, nt/nd, +bs, no masses; midline wound with staples - minimally tender at superior edge; wound intact without drainage ext: 2+ distal pulses, trace edema pertinent results: admission labs: cbc: wbc-12.9*# rbc-5.84# hgb-16.5# hct-50.5# mcv-87 mch-28.3 mchc-32.8 rdw-14.3 neuts-80.6* bands-0 lymphs-15.0* monos-3.5 eos-0.7 basos-0.2 plt smr-normal plt count-169 coags: pt-15.9* ptt-35.3* inr(pt)-1.6 electrolytes: glucose-117* urea n-21* creat-3.9*# sodium-147* potassium-3.8 chloride-106 total co2-20* anion gap-25* albumin-4.2 calcium-9.3 phosphate-5.2*# magnesium-1.7 10:09am lactate-8.1* 12:11pm lactate-3.1* 02:55pm lactate-2.0 ct abdomen/pelvis : impression: 1) no evidence of an acute pathologic process in the abdomen or pelvis on extremely limited examination without oral or intravenous contrast. evaluation of the bowel for ischemia or other pathologic process is particularly limited. 2) dilatation of the proximal small bowel with normal-caliber distal small bowel and colon. this appearance is nonspecific but may be seen in early ileus. 3) ectatic infrarenal aorta with maximal ap diameter of 2.5 cm. 4) diverticulosis. 5) probable left renal cyst. if there are no outside prior studies to document stability, further evaluation may be performed by ultrasound. echo : conclusions: the left atrium is normal in size. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). the right ventricular cavity is mildly dilated. right ventricular systolic function is normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is mild pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. cxr: worsening bibasilar atelectasis/consolidation and right pleural effusion. cxr: impression: ng tube terminating in right upper quadrant. increasing opacity in the left lower lobe, which may represent atelectasis, however, pneumonia cannot be totally excluded. cxr: bibasilar pulmonary opacities, which could be secondary to effusion or atelectasis. stable appearance of mild prominence of the central pulmonary vasculature. labs on transfer to floor: cbc: wbc-7.5 rbc-3.78* hgb-10.6* hct-30.3* mcv-80* mch-28.1 mchc-35.0 rdw-14.0 plt ct-274 electrolytes: glucose-96 urean-4* creat-0.4* na-128* k-4.1 cl-94* hco3-31* angap-7* calcium-8.1* phos-2.5* mg-1.7 micro data: multiple blood/urine cultures negative sputum cultures: 1+ gpcs in pairs/clusters on gram stain , c/w contamination : mrsa in sputum brief hospital course: note: hospital course written by floor resident, with information gleaned from chart regarding sicu and micu stay but without the benefit of input from caretakers from these units. 1. sepsis - pt initially presented with fatigue/mental status changes, hypotension, acidosis, acute renal failure, and a lactate of 8.1. in the ed, the must protocol was initiated, and the pt was intubated and transiently placed on levophed. lactate decreased over 4 hours to 2. broad spectrum antibiotics were given - levo/flagyl/vanco. concern was for peritonitis, and pt was emergently taken to or on for an exploratory laparotomy. no source of peritonitis was found; there was some purulent peritoneal fluid, which did not grow any microorganisms, and dusky-appearing, but viable, bowel; the duskiness was thought to be due to hypoperfusion in setting of sepsis. pt was taken to the sicu and followed. he was extubated on , then reintubated on due to mental status decline and hypoxia, as below. he was transferred to the micu. for the remainder of pt's hospitalization, he was hemodynamically stable and did not display further septic physiology. 2. respiratory failure - extubation was attempted a couple of times, which failed. sputum cultures were unrevealing. pt continued a course of vanc/levo/flagyl, and then vanc/ceftaz/flagyl. vanco was ultimately continued for 17 days, levo for about 10 days, and flagyl for about 12 days. ceftazidime was on board for 5 days. pt was noted to have rll collapse on cxr, and areas of consolidation vs atelectasis on cxr. however, no microorganisms were isolated in sputum (save for mrsa, 2+ on sputum, thought perhaps to be a colonizer). concern for increased secretions prompted consideration of trach placement, but pt was able to be extubated successfully. he was given an incentive spirometer, and pt was placed on nebs. since extubation, pt has been doing quite well from a respiratory standpoint, sats in 96-97% on room air. 3. hyponatremia - pt was noted to develop hyponatremic around . initially it was thought that he was hypovolemic, but with fluids, sodium did not correct. endocrine was consulted, particularly as pt has h/o panhypopituitarism. urine and serum osms were sent, the results of which were consistent with siadh. pt was free water restricted, and sodium was monitored. his mental status remained stable after transfer to the floor. on discharge, his sodium had improved to 129. pt should continue on fluid restriction to 1l while he is at rehab. 4. seizure disorder - pt was placed on iv dilantin starting on . this was switched to po dilantin. levels were checked and were found to be low. however, steady state takes about 7-10 days to reach; therefore, pt is currently on 100mg po tid, and levels should be checked again on to determine whether an increased dose is needed (goal level: ). he will continue on dilantin 100 mg po tid. 5. anemia - pt's hct remained stable without evidence of gi bleed or other source of bleed. workup revealed that this was most consistent with anemia of chronic disease. hct was monitored, and remained stable. 6. panhypopituitarism - pt was maintained on low dose prednisone, per outpatient regimen, of 5mg po bid. also was continued on synthroid. of note, tsh has been <0.02, but this was checked in the setting of acute illness. pt had repeat tsh checked just prior to discharge but this was still pending; this level will need to be followed up while pt is at rehab. 7. acute renal failure - pt's cr on admission was 3.9. his baseline is 0.5. creatinine trended towards normal with ivf. arf thought most likely to be due to prerenal azotemia in the setting of shock and hypoperfusion, and it corrected easily with ivf. 8. s/p exploratory laparatomy - as mentioned in hpi, pt had ex lap for concern of intraabdominal infection which was unrevealing except for some evidence of small bowel ischemia which was thought to be in the context of hypoperfusion due to sepsis. pt has had no further abdominal symptoms. his staples were removed just prior to discharge. he will follow-up with surgery dr. in 2 weeks. medications on admission: lipitor protonix ranitidine prednisone fexofenadine discharge medications: 1. nystatin 100,000 unit/ml suspension sig: five (5) ml po tid (3 times a day) as needed for thrush. 2. heparin sodium (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day): may discontinue if pt walking consistently. 3. albuterol sulfate 0.083 % solution sig: one (1) nebulizer inhalation q4h (every 4 hours) as needed. 4. levothyroxine sodium 100 mcg tablet sig: one (1) tablet po daily (daily). 5. prednisone 5 mg tablet sig: one (1) tablet po bid (2 times a day). 6. ipratropium bromide 0.02 % solution sig: one (1) nebulizer inhalation q6h (every 6 hours) as needed. 7. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. ranitidine hcl 150 mg tablet sig: one (1) tablet po hs (at bedtime). 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 10. phenytoin sodium extended 100 mg capsule sig: one (1) capsule po tid (3 times a day). discharge disposition: extended care facility: - discharge diagnosis: 1. septic shock 2. acute renal failure, due to prerenal azotemia 3. respiratory failure 4. syndrome of inappropriate antidiuretic hormone 5. panhypopituitarism 6. seizure disorder discharge condition: stable, tolerating po discharge instructions: please tell the staff if you experience chest pain, shortness of breath, abdominal pain, or any other concerning symptom. followup instructions: provider: , .d. where: lm (ent) phone: date/time: 10:30 please call ( to make an appointment with dr. . follow-up with surgery for post-op check: provider: ,md where: lm associates phone: date/time: 3:30 md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances exploratory laparotomy exploratory laparotomy transfusion of packed cells infusion of vasopressor agent diagnoses: pneumonia, organism unspecified acidosis tobacco use disorder acute kidney failure with lesion of tubular necrosis unspecified septicemia severe sepsis other convulsions acute respiratory failure septic shock metabolic encephalopathy acute vascular insufficiency of intestine other disorders of neurohypophysis legal blindness, as defined in u.s.a. panhypopituitarism 

Answer: The patient is high likely exposed to