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 / vancomycin attending: chief complaint: diarrhea, hypotension. major surgical or invasive procedure: : exploratory laparotomy. : ct-guided intra-abdominal abscess drainage. history of present illness: pt is a 42f well-known to the service having undergone a colostomy take-down, left and partial right colectomies with primary anastmoses, and abdominal wall reconstruction with component separation on . she was discharged home on doing well. her post-operative course included intermittent fevers for which a ct scan of the abdomen was performed on without any evidence of leak, free air, or abscess. blood cultures were negative on , and she had been afebrile for > 48 hours at the time of discharge. of note, her tunneled hd line was replaced on as the cuff was exposed and again on as the line was not functioning. presented to yesterday with complaints of diarrhea and small amount of blood per rectum. she was treated with iv hydration and discharged home. she then presented to the ed this morning with complaints of diarrhea and intermittent abdominal cramps along with rectal pain. she denies fever, chills, sob, n/v, cp/sob. she reports she has been eating minimally since discharge. past medical history: 1. tuberous sclerosis: s/p bilateral nephrectomy at , c/b bowel perforation requiring end colostomy complicated by large parastomal hernia 2. exploratory laparotomy, repair of peristomal hernia, colon resection x3, colocolostomy, coloproctostomy, ventral hernia repair with component separation and marlex mesh. 3. esrd with hd m/w/f via tunneled l ij hd line 4. tertiary hyperparathyroidism s/p parathyroidectomy 5. gerd 6. right hand pain thought to be d/t steal from right avf, s/p ligation of avf 7. pud 8. pericarditis 9. asthma as a child social history: lives in by herself. son checks in on her. she likes to volunteer at shelters to cook food for the homeless. she has daughters that live in and . denies current tobacco use although she is a former smoker (1 pack per week, quit ). no etoh. no history of ivdu. she is on disability. she has the ride and uses a cane for walking. family history: the patient has had four children with one deceased, from complications of tuberous sclerosis. father also with tuberous sclerosis. two living grandchildren also with tuberous sclerosis. mother with history of breast cancer and hypertension and an mi in her 60s. physical exam: on admission: vs 74/54 75 18 99% ra nad, sleeping but wakes easily. alert, oriented. no jaundice or icterus cta b/l rrr abd soft, sl distended. minimal tenderness to deep palpation. no rebound or guarding. no shake or tap tenderness. l drain in place draining scant serosangeous output. central portion of the midline incision macerated with blood-tinged drainage. no purulence. several staples removed, no drainage could be expressed. no le edema pertinent results: hematology complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 06:36 5.3 3.05* 8.4* 27.6* 90 27.5 30.4* 20.6* 370 differential neuts bands lymphs monos eos baso atyps metas myelos 09:37 80* 5 9* 6 0 0 0 0 0 red cell morphology hypochr anisocy poiklo macrocy microcy polychr target burr tear dr 09:37 occasional 1+ 2+ 1+ occasional 1+ 1+ 2+ 1+ basic coagulation (pt, ptt, plt, inr) pt ptt plt smr plt ct inr(pt) 06:36 370 source: line-dialysis 06:00 20.2* 33.7 1.8* source: line-picc basic coagulation (fibrinogen, dd, tt, reptilase, bt) fibrino 02:08 661* chemistry renal & glucose glucose urean creat na k cl hco3 angap 06:36 811 12 6.6* 140 3.9 98 25 21* enzymes & bilirubin alt ast ld(ldh) ck(cpk) alkphos amylase totbili dirbili 05:53 13 15 131* 1.0 source: line-art chemistry totprot albumin globuln calcium phos mg uricacd iron 06:36 7.5* 3.3 2.2 pituitary tsh 03:02 2.2 8:29 pm blood culture source: line-cvl. **final report ** blood culture, routine (final ): staph aureus coag +. consultations with id are recommended for all blood cultures positive for staphylococcus aureus and species. final sensitivities. staphylococcus species may develop resistance during prolonged therapy with quinolones. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. testing of repeat isolates may be warranted. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin-----------<=0.25 s erythromycin----------<=0.25 s gentamicin------------ <=0.5 s levofloxacin----------<=0.12 s oxacillin-------------<=0.25 s trimethoprim/sulfa---- <=0.5 s aerobic bottle gram stain (final ): gram positive cocci in clusters. reported to and read back by @ 9:49am . anaerobic bottle gram stain (final ): gram positive cocci in clusters. brief hospital course: on , the patient was admitted to the transplant surgery service and started on broad-spectrum antibiotics. that night she underwent attempted exploratory laparotomy for intra-abdominal abscess from anastomotic leak. this was unsuccessful and a wound vac was placed. she was then admitted to the sicu. on , she underwent ct-guided drainage of this abscess. drain produced succus. there was evidence on ct abdomen of enteral fistula into the abscess cavity as well. she remained npo with tpn for most of hospital course. she remained in sinus tachycardia with heart rate ranging 100-130s. cardiology consult was obtained and tachycardia was attributed to infection, hypovolemia, and anemia. there was no evidence of myocardial injury. she was hypotensive and initially required neosynephrine gtt, which was weaned. she was hemodynamically stable on midodrine. this was subsequently discontinued. she was intubated episodically for invasive procedures. infectious work-up found enterobacter pneumonia on broncheoalveolar lavage on , and this was treated with a two-week course of meropenem. she had h/o bilateral nephrectomy. she required intermittent hemodialysis as well as cvvh while hypotensive and requiring vasopressors in the sicu. intravenous fluids were given as needed for maintenance and for hypovolemia. cvvh was switched to intermittent hemodialysis when she was off pressor support. post-operative course was complicated by candidemia found on blood cultures on , which was treated with ambisome ( thru )then micafungin thru ). this was switched to fluconazole for 2 weeks (10/3-1016). ophthalmology was consulted. retinal specialist found changes indicating only tuberous sclerosis. . hematocrit was checked regularly and she was transfused with 2 units of prbc on and . she had no acutely anemic events. central venous access was necessary at all times, with temporary hd catheter and triple-lumen central venous line, as it was not possible to establish peripheral iv access. lines were changed when blood cultures grew . r temporary hd line was removed on when she had head/neck and bilateral arm edema. cta venogram on demonstrated partially occlusive thrombus within the right subclavian vein near the thoracic inlet with probable occlusion of the right internal jugular vein. she was started on a heparin drip. coumadin was initiated on . heparin was stopped once inr was therapeutic. she continued to have intermittent fevers for which blood was cultured. she spiked to 101.4. abdominal ct with po contrast was done on showing decreased size of luq collection with extravasated enteric contrast with pigtail catheter positioned appropriately. foci of gas at the base of a vacuum drainage apparatus in the anterior abdominal wall was noted. bibasilar pulmonary consolidation consistent with pneumonia. a tagged wbc scan was done on that was negative. the abdominal drain was injected and abdomen scanned on . the pigtail catheter was seen with tip coiled in the left paracolic gutter, just inferior to the spleen. contrast was seen entering the lumen of the colon through a fistula track measuring approximately 5 mm in width. contrast then continued to opacify the descending colon rectum. post ct, she spike to 103.6 and was hypotensive to 70s necessitating transfer to sicu for iv fluid bolus and iv neo. she was pan-cultured and started on linezolid which continued until when blood cultures from isolated pan-sensitive staph coag positive. linezolid was switched to nafcillin on per id recommendations. id recommended tte. this was done,and was negative for vegetations, but was a sub-optimal study. tee was planned, but the patient refused this study. us of the known right svc/ij was done to characterize previously known non-occlusive thrombus to rule out another source of bacterial seeding. no thrombus was seen in the svc/ distal ij or right upper extremity. antibiotic plan was for 4 weeks for question endocarditis given that tee was not done in setting of positive blood cultures. nafcillin was switched to cefazolin on . this should be given at dialysis 3xweek until . left ij cvl and r tunnelled groin hd line, were changed to l temporary femoral hd line . r groin line was removed and a left arm picc was placed. daily blood cultures were done and were negative to date. the left groin hd line was changed to a tunnelled line in ir on . the left picc line was placed on then needed repositioning on . vac dressing was changed on . wound bed was ~10cm 5cm x1cm with granulation tissue. blue prolene sutures were visible in wound bed. this will stay in place until f/u with dr. on . abdominal pigtail output was scant cloudy fluid. pt evaluated and recommended rehab. she will be transferring to , in . she was ambulating with supervision. diet with supplements was well tolerated. coumadin was started on for svc thrombus then held for supratherapeutic inr from thru . coumadin was resumed on at 2mg. inr was 1.8 at time of discharge. goal inr was . last hd session was with 0.5 liter uf. medications on admission: . acetaminophen 1000 mg q8hr prn 2. docusate sodium 100 mg 3. calcium carbonate 500 mg calcium (1,250 mg) 4. aspirin 81 mg daily 5. hydromorphone 2-4 mg q3hr prn 6. nephrocaps 1 mg once a day. discharge medications: 1. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day). 2. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: two (2) tablet, chewable po daily (daily). 3. glucagon (human recombinant) 1 mg recon soln sig: one (1) recon soln injection q15min () as needed for hypoglycemia protocol: of note, patient off insulin due to hypoglycemia. 4. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: four (4) puff inhalation q4h (every 4 hours) as needed for wheezing. 5. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours) as needed for wheezing. 6. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed for pruritis. 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 9. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain, fever. 10. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 11. warfarin 2 mg tablet sig: one (1) tablet po once a day: inr goal for r svc thrombus. . 12. dextrose 50% 12.5 gm iv prn hypoglycemia protocol 13. ondansetron hcl (pf) 4 mg/2 ml solution sig: four (4) mg injection q6h (every 6 hours) as needed for nausea. 14. heparin flush (10 units/ml) 1 ml iv prn line flush temporary central access-floor: flush with 10 ml normal saline followed by heparin as above daily and prn. 15. cefazolin 2 g iv 2x/week (mo,we) every monday and wednesday after hemodialysis stop date 16. cefazolin 3 g iv 1x/week (fr) give after hd on friday stop date 17. sodium chloride 0.9% flush 10 ml iv prn line flush picc, non-heparin dependent: flush with 10 ml normal saline daily and prn per lumen. 18. outpatient work weekly cbc, ast, alt, alk phos, t.bili fax to id attn: drs 19. outpatient work pt/inr 3x/wk, goal inr for r svc thrombus 20. dilaudid 0.5mg ivp prn: prior to vac change discharge disposition: extended care facility: hospital - discharge diagnosis: esrd tuberous sclerosis abdominal abscess abdominal incision wound intestinal leak fungemia enterobacter pneumonia mssa bacteremia partially occlusive thrombus within the right subclavian vein near the thoracic inlet discharge condition: mental status: clear and coherent. mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: please call dr. office if you experience any of the following: fever (temperature of 101 or greater), shaking chills, nausea, vomiting, increased drain output, abdominal wound has increased drainage/foul odor, malfunctioning of tunnelled hd line, constipation/diarrhea followup instructions: provider: , md phone: date/time: 1:10, , transplant institute, , provider: , md phone: date/time: 8:00 in clinic, , (basement) procedure: parenteral infusion of concentrated nutritional substances diagnostic ultrasound of heart hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis venous catheterization for renal dialysis venous catheterization for renal dialysis venous catheterization for renal dialysis percutaneous abdominal drainage exploratory laparotomy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus excision or destruction of lesion or tissue of abdominal wall or umbilicus angiocardiography of venae cavae central venous catheter placement with guidance diagnoses: end stage renal disease renal dialysis status anemia, unspecified esophageal reflux pneumonia due to other gram-negative bacteria other postoperative infection hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site peritoneal adhesions (postoperative) (postinfection) disseminated candidiasis secondary hyperparathyroidism (of renal origin) hypovolemia other and unspecified infection due to central venous catheter acquired absence of kidney peritoneal abscess fistula of intestine, excluding rectum and anus acute venous embolism and thrombosis of subclavian veins tuberous sclerosis 

Answer: The patient is high likely exposed to