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: tape attending: chief complaint: infected lower extremity ulcer major surgical or invasive procedure: percutaneous tracheostomy placement history of present illness: cc: respiratory failure . hpi: the patient was initially admitted to osh for treatment of rle ulcers from venous stasis/arterial insufficiency. the patient was intended to have fem- bypass, but the ulcers became infected with mrsa and the patient was taken to the or at the osh for debridement. the patient was then stabilized and transferred to rehab on a regimen of vanc/zosyn/cipro. an mri showed no evidence of osteo, but mra showed minimal inflow to rle with sfa occlusion. at the rehab center, the patient experienced increasing pain and erythema at the rle site, and was then transferred to for further vascular workup. the patient was being monitored and worked up by vascular surgery when urine output began to drop and creatinine bumped from 1.4 --> 2.2, coincident with a fever to 103.3. the patient had no hypotensive episodes. a renal consult was obtained, which suggested atn vs ain as a diagnosis, possibly precipitated by sepsis or worsening chf. the patient was noted to be in fluid overload by the renal team. they finally settled on the diagnosis of non-oliguric atn. a goal of l diuresis per day was set, and easily met using lasix. unfortunately, the patient then became oversedated on her opiates, with some resolution with narcan, then transferred to the sicu for bipap and observation of respiratory status. when her respiratory status had improved sufficiently, she was transferred to the medical floor for further care. . pt then became unarousable on the evening of pt became unarousable, partially responded to narcan. pt was transferred to micu for decreased respiratory drive and unarousability. pt was placed briefly on a narcan drip, then weaned off with good respiratory drive. pt initially had a cr bump with this episode, cr has been fluctuating since. have been trying to get patient in net negative fluid balance with lasix, but has been difficult, and cr has stayed above the level of 3.1, which was her cr when she came out of the sicu. . this am the patient is resting comfortably and breathing with good o2 sats on only 2l by nc, which is a vast improvement over earlier in her hospital course. no complaints, though she notes that her pain level is higher than before, she understands our reticence to use narcotics to treat it. no f/c, no n/v, no cp, mild sob. . at 5 am on , the patient became acutely hypoxic and had respiratiory failure with diffuse wheezing and poor air movement, with evidence of extreme respiratory fatigue prompting a micu evaluation and subsequent call for anesthesia to intubate stat in on the floor before transfer. a stat cxr was obtained which showed acute exacerbation of heart failure. she was given 120 mg of lasix, and was intubated and put on assist control ventilation. an ecg was obtained which showed diffuse low voltages, a leftward axis, late r wave progression, normal intervals and no evidence of ischemia. cardiac markers were sent as well as a sputum sample for gram stain and culture. past medical history: iddm cad s/p mi htn hyperlipidemia cva - residual r facial weakness chf - unknown ef pvd social history: occasional etoh, 40 pack-year tobacco history, quit 1 year ago. no history of illicits. . family history: family hx: mother with dm, pvd. physical exam: exam: . 96.8 (rectal) 88 146/80 30 98 sat on nrb acutely dyspneic and in respiratory distress with audible expiratory wheezing, laborious breathing with accessory muscle use unable to assess jvp 2/2 habitus poor air movement and diffuse expiratory wheezes with a prolonged expiratory phase. rrr, hsm, no rubs abdomen obese, soft, non-tender 1+ peripheral edema, venous stasis changes. pertinent results: wound swab: stenotrophomonas urine cx: yeast picc line removed, tip culture ngtd. r ij enterococcus bld cx () vanc/ampicillin r enterococcus sensitive to linezolid brief hospital course: 53f with severe pvd and infected rle ulcer transferred from osh/rehab for vascular eval. complicated icu course complicated by non-oliguric arf and respiratory depression narcotics - transferred to floor for further management of her infected foot ulcers found to be in acute respiratory failure intubated and sedated and transferred back to the unit. . 1. hypercarbic respiratory failure - in unit pt extubated but required re-intubation c respiratory failure believed due to chf exacerbation. pt then difficult to wean from vent. multiple factors believed to be involved including large pleural effusions that were noted on ct, respiratory muscle weakness (nif of approx -20), pulmonary edema, and obstruction large body habitus. multiple attempts made to diurese pt c approx 1l taken off everyday for one week. the aggressiveness of diuresis had to be slowed last week as pt became hypotensive and intermitently febrile. during this time internentional pulmonary service gave pt a percutaneous tracheostomy. once hypotension relieved pt noted to have large pleural effusuions bilat on ct. interventional pulmonary service tapped one of the l effusion and removed approx 600cc of transudative fluid. pt's respiratory status improved significantly after this tap and c signif diuresis of nearly 1-2l per day via lasix drip this week. able to wean pt from ac to ps and pt tolerated trial of 5/0 this am for appox 4 hours. pt then tolerated trach mask. speech following pt and she tolerated a passy muir valve yesterday am x 30 mins. 2. sepsis: pt c intermitent fevers, hypotension c sbps in 90s last week. bld cx initially grew out staph and pt treated c vancomycin. this stopped when believed contamination as staph speciated as coag negative. pt received tte and tee that showed no signs of infective endocarditis. vascular surgery evaluated her rle wound and felt there were no signs of cellulitis or anything contributing to a more systemic process. a line pulled and grew coag negative staph, pt then placed on vancomycin. pt continued to spike low grade fevers and remained hypotensive c sbps in low 100s. r ij then pulled and grew enterococcus, bld cx from same day grew vre and so pt placed on linezolid 4 days ago. once pt placed on linezolid fevers resolved and no episodes of hypotension. 3. rle wound: vascular surgery followed. no evidence of osteomyelitis/fasciitis on previous mri. wound culture growing stenotrophomonas. this is sensitive to bactrim, have started and vascular indicates abx should be continued until wound improves. they are wary to perform angiography on the leg given pt's kindey function. once this improves they plan to image the leg and determine vascular supply to area. in meantime, they recommend continuing wet-to-dry dressing changes . . 4. arf: pt developed arf amid fevers, no clear evidence of hypotensive episode. renal service followed the patient and indicated they suspect atn. with aggressive fluids initially in the hospital stay pt's creatinine trended downward. it now it 1.3 down from 2.6 on admission. during diuresis have been following cr closely. cr currently 3.3. holding her acei. . 5. iddm: pt on ssi for now. will monitor sugars closely. pt's bs elevated over last week due to multiple changes in diet. increased nph after pt started taking tfs. again recently increased nph dose and ssi to accomodate pt's increased bs since started on tfs and now eating snacks. . 5. hyperlipidemia: continued lipitor throughout hospital stay . 6. fen: pt initially npo. dubhoff then placed but d/c'd by pt multiple times. during most recent placement of dubhoff interventional radiology unable to pass tube past pylorus, so it currently resides proximal to pylor. pt been given tfs according to nutrition reccs. seen by speech and received swallow study and fees that showed pt could tolerate pureed solids and liquids when upright c cuff deflated and passy muir valve in place. . 7. ppx: pt received sqh and ppi as well as pneumoboots for prophylaxis throughout hospital stay. she also was seen by ot/pt for exercises. . 8. full code medications on admission: . discharge medications: 1. miconazole nitrate 2 % cream sig: one (1) appl topical twice a day as needed for rash. 2. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 3. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 4. lansoprazole 30 mg susp,delayed release for recon sig: one (1) po daily (daily). 5. atorvastatin calcium 40 mg tablet sig: one (1) tablet po daily (daily). 6. hydralazine 10 mg tablet sig: one (1) tablet po q6h (every 6 hours): hold for sbps<120 or maps<75. 7. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 8. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 10. lasix 20 mg tablet sig: one (1) tablet po twice a day: hold for sbps<120. 11. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po bid (2 times a day). 12. linezolid 600 mg/300 ml parenteral solution sig: one (1) intravenous q12h (every 12 hours) for 10 days. discharge disposition: extended care facility: - discharge diagnosis: sepsis; respiratory failure due to pulmonary edema, effusions, obstruction and respiratory muscle weaknesss; congestive heart failure; infected right lower extremity ucler; hypertension; type 2 diabetes; hyperlipidemia discharge condition: stable discharge instructions: please return to the ed or see your primary doctor as soon as possible if you become short of breath, weak, unable to do your daily activities, or develop chest pain, abdominal pain, increasing mucous secretions, fever>101, or worsening of any of your symptoms. followup instructions: follow up with your primary care doctor this week and vascular surgery procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more diagnostic ultrasound of heart insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis other bronchoscopy non-invasive mechanical ventilation temporary tracheostomy bronchoscopy through artificial stoma injection or infusion of oxazolidinone class of antibiotics diagnoses: pneumonia, organism unspecified anemia, unspecified coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified unspecified essential hypertension unspecified septicemia severe sepsis acute respiratory failure old myocardial infarction infection and inflammatory reaction due to other vascular device, implant, and graft ulcer of other part of lower limb venous (peripheral) insufficiency, unspecified diabetes with other specified manifestations, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to