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: history of present illness: the patient is a 48-year-old female with no significant past medical history who was in her usual state of health until one day prior to admission to an outside hospital. she developed severe epigastric pain and vomiting which she tried to sleep off for several hours. the pain continued to worsen, and she ultimately presented to hospital. in the emergency room she was tachycardiac in the 130s to 140s with variable systolic blood pressures ranging from 90 to 180. she was transferred to the intensive care unit and required a large amount of intravenous fluids for hemodynamic stabilization up to a total of 5 l. she received bicarbonate for a ph of 7.1 and a metabolic acidosis, and her urine output was 350 cc over 24 hours there. her outside labs included an amylase of 188, lipase of 892, alt 59, ast 123, alkaline phosphatase 111, total bilirubin 1.3, white count 26.4. ultrasound was negative for gallstones, and a ct demonstrated severe pancreatitis with partial necrosis of the pancreatic head. she was then transferred to the for resuscitation and further evaluation. on further review of history, she has no history of gallstones, diabetes. she drinks "socially," and per her husband, her alcohol consumption had recently increased as she was laid off from work. she has been asymptomatic with no nausea, vomiting, fevers, chills, change in bowel habits, prior to this episode of epigastric pain. past medical history: significant for cervical laminectomy in . uterine fibroids. medications on admission: past steroid injections for hand pain. allergies: no known drug allergies. social history: the patient lives with her husband. family history: noncontributory. physical examination: general: on transfer from the outside hospital to the patient was a sleepy but responsive woman in mild distress. vital signs: temperature 98??????, heart rate 149, blood pressure 133/85, respirations 24, oxygen saturation 96% on 5 l nasal cannula. heent: pupils equal, round and reactive to light. lungs: clear to auscultation bilaterally. cardiovascular: tachycardiac but regular with no murmurs, rubs or gallops. abdomen: distended with abdominal wall edema and extreme tenderness in the upper epigastric area. extremities: there were distal pulses. feet were warm bilaterally. neurological: she has no focal deficits. laboratory data: on admission white count was 16.4, hematocrit 38.3, platelet count 77; sodium 132, potassium 4.5, chloride 99, bicarb 21, bun 29, creatinine 1.4, glucose 324; pt 15.9, ptt 46.3, inr 1.8; admission arterial blood gas was 7.82, 38, 141, 19, -7; alt 99, ast 77, alkaline phosphatase 50, amylase 218, lipase 1520, total bilirubin 1.6; ionized calcium 0.88, lactate 6.1. cat scan from outside hospital showed severe pancreatitis, severe extensive inflammatory changes, patchy heterogenous enhancement, necrosis at the head and tail of the pancreas. ultrasound showed no gallstones per outside hospital report. hospital course: respiratory: the patient was transferred to the surgical intensive care unit where she was continued with aggressive fluid hydration. her most pressing issue was her respiratory status, and throughout her early hospital course on hospital day #1 and #2, the patient's arterial blood gases began to deteriorate. initially her blood gas showed a po2 of 141 as above, but by 6 a.m. on hospital day #2, her blood gas was 7.36, pco2 40, po2 66, bicarbonate 24, with a base excess of -2. she was tachypneic. on hospital day #2, the patient was intubated without incident. with ventilatory control, her blood gases immediately improved. her po2 upon intubation was 91. hemodynamic status: the next issue was her hemodynamic status. her blood pressure remained labile with episodes of systolic blood pressure dropping down into the 90s. early in her hospitalization, the patient did require neo-synephrine gtt to maintain the mean arterial pressures above 60. this was very brief and occurred only during the first and second hospital days. otherwise she did remain hemodynamically stable, although tachycardiac essentially for her entire hospitalization. the tachycardia was not aggressively addressed due to her stable blood pressure status after that initial neo-synephrine pressor support. the patient was also aggressively hydrated receiving several liters of fluid to maintain adequate urine output. an ng tube was placed to suction, and thick bilious contents were aspirated from the gi tract. the patient was also started on imipenem. the patient's coagulopathy was corrected with ffp for her inr of 1.8. after intubation, the patient was kept comfortable on ativan and dilaudid gtts. icu course: neurologically the patient was continued to be sedated while intubated. she was arousable, and as her condition improved, the sedation was weaned. late in her intensive care unit stay, the patient began to show signs of agitation and confusion. this was managed with haldol. she has subsequently become oriented and has had no episodes of agitations after being discharged from the intensive care unit. she has shown no focal or neurologic deficits. the patient's respiratory status remained stable. she remained on ventilatory support for several weeks during her intensive care unit stay. she underwent a slow wean and eventually was extubated on hospital day #23 without incident. she has tolerated extubation well and has been able to manage her secretions and maintain high oxygen saturations. cardiovascular status: as described as above, she continued to remain stable. she remained tachycardiac for most of her hospitalization. she was recently started on beta-blockade and is currently tolerating lopressor with good heart rate control and adequate blood pressure. gi issues: included nasogastric placement. initially the patient was placed to suction, and then several attempts at tube feedings were made. she began with .................. tube feeds and had several episodes of high residuals. she eventually tolerated tube feeds at goal which was peptamen at 60 cc/hr. during the time when she was only on ................... tube feeds or no tube feeds, she was on tpn which eventually was weaned when she was tolerating tube feeds at goal. her amylase and lipase quickly normalized, and her most recent lipase was 30, and her amylase was 22. during her hospitalization, she also developed multiple, frequent, loose stools which were sent for c-diff, and the patient was started on intravenous flagyl empirically. all c-diff cultures have returned as negative. the frequency of loose stools has decreased substantially. gu: issues include diagnosed urinary tract infection on with diagnosed e. coli greater than 100,000 colonies. she was started on a five-day course of floxacillin which she completed. infectious disease: issues included multiple temperature spikes early during her hospital course with temperatures up to 103??????. she was pancultured multiple times which resulted in no positive blood cultures. the patient's central lines and peripheral lines were all changed appropriate after each temperature spike. she had been started on imipenem and completed a 14-day course, and more recently, the patient has been afebrile for a significant period of time with at least seven days. also when the patient had begun to spike fevers on , she underwent a cat scan of the abdomen to rule out abscess. no abscesses were found, but it was noted that 60% of the pancreas was necrotic at that time. she also had bilateral effusion and patent portal and splenic veins. hematologic: the patient's coagulopathies were corrected earlier. the patient's hematocrit remained ultimately stable. there were two episodes where the patient required transfusion for a decrease in her hematocrit, but the patient did not have any active signs of bleeding. the patient was found to have a right upper extremity dvt after noticing right arm edema. the patient was started on heparin and then switched to lovenox subcue for anticoagulation. endocrine: her endocrine status included a labile blood sugar. she required insulin drip to control blood sugars in the 300s at the time. she otherwise responded well to an insulin sliding scale. currently her insulin has been under well control which has not required any insulin recently, although she will be closely monitored for diabetes due to the extensive pancreatic mass. in summary, the patient's sicu course remained progressively to improve. after extubation, the patient remained stable, tolerated her tube feeds at goal, was evaluated by physical therapy and was begun on conditioning, and she became ready for discharge to the floor on hospital day #33. her course on the surgical floor has remained uneventful. she had a speech and swallow study which had originally categorized her as a poor candidate for aspiration. she was going to be continued on tube feeds, but then a repeat swallow evaluation demonstrated that the patient could tolerate thickened liquids and pureed diets. she tolerated this without any evidence of aspiration and has been now advanced to a diabetic diet which she is tolerating. the patient has been ambulating with physical therapy, and although her activity level is improved, she will truly benefit from rehabilitation for conditioning. the patient's respiratory status has remained stable with oxygen saturations in the high 90s on room air. her secretions have dramatically decreased and essentially is none. the patient has remained afebrile. the patient continues to have some loose bowel movements, but otherwise the frequency has not increased, and all c-diff toxin assays have remained negative. the patient did have a cat scan on , with aspiration of fluid collection which has not grown any organisms to date. the cat scan also demonstrated a decrease in fluid collections from the one done early which earlier which was slightly improved. the patient is stable and is now ready for discharge to rehabilitation. discharge diagnosis: necrotizing pancreatitis. discharge medications: protonix 40 mg p.o. q.d., asa 81 mg p.o. q.d., lovenox 70 mg subcue b.i.d., clonidine tts 3 patch 0.2 mg q.week on thursday's, lopressor 50 mg p.o. t.i.d., tylenol 650 mg p.o. q.6 hours p.r.n., albuterol mdi q.6 hours p.r.n., insulin sliding scale. condition on discharge: stable. the rehabilitation potential is good. follow-up: the patient will follow-up with dr. in two weeks unless clinically necessary to follow-up earlier. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances diagnoses: acidosis thrombocytopenia, unspecified urinary tract infection, site not specified acute respiratory failure acute pancreatitis 

Answer: The patient is high likely exposed to