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: zantac 75 / lipitor attending: chief complaint: transfer from micu (admitted with hypotension, arf, hypercalcemia) major surgical or invasive procedure: central venous line history of present illness: 49f with mmp including hx of abdominal sepsis, abdominal perforation, diverticulitis (s/p colectomy with ileostomy, c/b abdominal abscess requiring percutaneous drainage) and dvt who presents with a one day history of nausea, vomiting, and increased ostomy output. of note the patient has been admitted to on for an abdominal abscess which grew out mrsa, e.coli, and klebsiella. the patient was discharged home with abx. she was subsequently readmitted on for dehydration. she notes intermittent nausea since discharge the week before. her symptoms significantly worsened after eating a hotdog when she began to have severe nausea, vomiting, and increased ostomy output. she also complains of nonradiating diffuse abdominal pain. in addition she had several hours of shortness of breath but no chest pain, fevers, chills, or sweats. . in the ed the patient's vitals were noteworthy for sbps in the 70s and o2sat of 85% on ra. lactate was 5. code sepsis was activated. a rij was placed, the patient received 5l ivf, vanc/ceftaz. a ct-a and abdominal ct were both obtained. ct-a was negative for a pe. abdominal ct showed partial small bowel obstruction and multiple slightly dilated small bowel loops without a definite transition point, and free fluid in the abdomen. surgery was consulted. per their note, they reviewed the film with radiology. no intra-abdominal abscess/collections were noted. contrast passed through to the ostomy. admitted to micu given concern for sepsis. . in the micu she was fluid resucitated including 2 units prbc with increase in hct and transiently on levophed until blood pressures improved. she was also briefly given antibiotics (vanc/cefepime) for concern sepsis and iv steroids for concern adrenal insufficency which were then withdrawn given no clear source of infection. the patient's hct dropped from 41 -> 25 with rehydration, likely dilutional and ostomy output guaiac negative. she was also noted to have acute renal failure with cre 1.4 (baseline 0.8) and hypercalcemia to 13.2 which both resolved with hydration. the patient was transferred to the floor for further management. . on arrival to the floor the patient denies nausea. continues to have abdominal pain diffusely in abdomen but worse near site of surgical scar. reports frustration with difficult hospital course. denies chest pain, shortness of breath, headaches, or other problems. past medical history: past medical history: --colocutaneous fistula --h/o mrsa aspiration pneumonia --diverticulitis --anxiety --depression --afib, paroxysmal --abdominal abscess with percuteous drain: +mrsa, e.coli, klebsiella --h/o ue dvt (?treated with coumadin 1 month) --- exploratory laparotomy with total colectomy --- takedown ileorectal anastomosis, pouch, ileostomy --- sigmoid colectomy --- cholecystectomy social history: -- married with 4 children (youngest 8 years old) -- 16 pack year smoking hx -- rare etoh -- no illicit drug use family history: m died of lung ca physical exam: t 97.5 hr 88 bp 108/62 rr 18 sao2 96% on ra general: worn appearing, nad, very pleasant, breathing comfortably heent: perrl, eomi, anicteric sclera, conjunctivae pale neck: supple, trachea midline, no thyromegaly or masses, no lad, right ij central line in place cardiac: rrr, s1s2 normal, no m/r/g, no jvd pulmonary: ctab abdomen: +bs, soft, nondistended, healing midline surgical scar, ostomy with copious green-brown stool in bag, tender to palpation near umbilicus, no rebound or guarding, no hsm appreciated extremities: warm, +dp pulses, no edema skin: diffuse erythematous blanching rash on flank, back, upper extremities, nontender, no urtricaria neuro: a&ox3, speech clear and logical, cnii-xii intact, moves all extremities pertinent results: hematology: 11:10pm blood wbc-25.0*# rbc-4.84# hgb-14.6# hct-41.6# mcv-86 mch-30.2 mchc-35.1* rdw-16.7* plt ct-717*# 12:45am blood wbc-19.1* rbc-4.04* hgb-12.0 hct-34.1* mcv-85 mch-29.8 mchc-35.3* rdw-16.8* plt ct-495* 05:40am blood wbc-5.2 rbc-3.57* hgb-11.0* hct-31.7* mcv-89 mch-30.9 mchc-34.7 rdw-15.8* plt ct-229 11:10pm blood neuts-89.1* lymphs-7.7* monos-2.6 eos-0.3 baso-0.2 12:45am blood pt-12.4 ptt-22.8 inr(pt)-1.1 05:41pm blood fibrino-293 . chemistry: 11:10pm blood glucose-206* urean-30* creat-1.4* na-130* k-6.8* cl-92* hco3-16* angap-29* 05:40am blood glucose-82 urean-9 creat-0.7 na-142 k-3.6 cl-114* hco3-24 angap-8 11:10pm blood alt-52* ast-87* ck(cpk)-98 alkphos-260* amylase-106* totbili-0.4 12:45am blood alt-39 ast-35 alkphos-221* amylase-99 totbili-0.4 08:34am blood ld(ldh)-82* 11:10pm blood lipase-49 12:45am blood lipase-34 11:10pm blood ctropnt-<0.01 11:56am blood ck-mb-notdone ctropnt-<0.01 11:10pm blood albumin-5.0* 12:45am blood albumin-4.3 calcium-13.2* phos-5.4*# mg-1.7 07:00am blood albumin-3.3* calcium-10.1 phos-3.0 mg-1.9 11:56am blood hapto-72 09:52am blood pth-8* 12:45am blood cortsol-29.6* 11:56am blood cortsol-33.5* 11:56am blood cortsol-28.1* 12:45am blood crp-2.0 11:19pm blood lactate-5.3* 06:32am blood lactate-1.7 03:28pm blood alkaline phosphatase, bone specific-pnd . ecg: sinus rhythm. modest non-specific precordial/anterior t wave changes could be positional/normal variant, but clinical correlation is suggested. since the previous tracing of sinus tachycardia and right atrial abnormality are absent and st-t wave abnormalities have decreased. . cta chest, abdomen, pelvis (): ct angiogram chest: the study is slightly limited due to the phase of contrast injection. allowing for this, there are no filling defects within the pulmonary artery or proximal branches to suggest the presence of pulmonary embolism. the heart, pericardium, and great vessels are normal in appearance. there is no pleural or pericardial effusion. scattered mediastinal lymph nodes do not meet ct criteria for pathologic enlargement. the largest prevascular lymph node measures 4 mm in short axis. there is no axillary or hilar lymphadenopathy. on lung windows, there are no focal areas of consolidation. multiple small calcified granulomas are again seen. multiple small cystic are noted peripherally within the lung apices. these are unchanged since . ct abdomen with oral, with intravenous contrast: the liver enhances normally without focal nodules or masses. the patient is status post cholecystectomy. the common bile duct is dilated, but tapers normally to the head of the pancreas. the pancreas, spleen, bilateral adrenals, and both kidneys are normal. contrast opacifies the small bowel to the level of the right lower quadrant ileostomy. multiple proximal small bowel loops are distended, filled with fluid. no definite transition point is identified. in the area of prior surgery, and multiple clips in the left mid abdomen, prominent inflammatory change surrounds a focal loop of somewhat prominent small bowel. a small amount of fluid extends within the mesentery and into the pelvis. there is no free air. ct pelvis with oral, with intravenous contrast: the patient is status post hartmann's pouch. a foley catheter is seen within a collapsed bladder. the intrapelvic loops of small bowel are normal. there is a moderate amount of intrapelvic free fluid. bone windows: there are no suspicious lytic or sclerotic osseous abnormalities. impression: 1. no evidence of pulmonary embolism. 2. partial small bowel obstruction. multiple slightly dilated small bowel loops without a definite transition point. single loop within the left mid abdomen demonstrates inflammatory change and is at the site of prior surgery. new free fluid is seen within the abdomen, extending to the level of the pelvis. 3. interval resolution of large right-sided peritoneal fluid collection. 4. status post total colectomy with hartmann's pouch and right lower quadrant diverting ileostomy. status post cholecystectomy. brief hospital course: 49f h/o diverticulitis c/b abdominal perforation and abscess s/p colectomy with multiple recent admissions for abdominal processes, presents with nausea, vomiting, abdominal pain, increased ostomy output leading to dehydration and hypotension. . # hypotension: initial concern for sepsis given recent history of abscesses, elevated wbc count, and hypotension; however afebrile and responded to iv fluids appropriately lending weight to dehydration as most likely cause vomiting and increased stool output. was initially placed on antibiotics in the icu but taken off then after transfer to the floor. patient continued to improve and bp remained stable. . # hypercalcemia: significant negative w/u during last admission and this including renal and endocrine consults. noted to have low pth, low pthrp, nl bonescan, nl spep/upep, nl vit d, nl vit d. calcium normalized with iv fluids, but then elevated intermittently. endocrine consultation who recommended additional tests, but they were normal (including bone specific alkaline phosphatase). patient instructed to have follow up calcium drawn in 2 days. if the level is elevated she should get iv bisphosponates and/or steroids. - f/u blood test with pcp, >11 should get iv bisphosphonates/steroids - follow up with endocrine (scheduled for , but may need sooner appt) . # hypoxia: unclear etiology, resolved after fluid administration in micu. ef preserved on recent echo. cta r/o pe. patient does have smoking history but no known underlying lung disease. . # anemia: chronic normocytic. prior iron studies c/w acd. received 2 units prbc in micu with increase to baseline hct ~ 30. stool from ostomy was guaiac negative. . # atrial fibrillation: paroxysmal. currently sinus rhythm. not on anticoagulation but started on aspirin. . # anxiety/depression: continue remeron per home regimen; clonazepam prn. patient to follow up with outpatient psychiatrist. medications on admission: trazadone 150qhs protonix remeron 15mg qhs discharge medications: 1. trazodone 50 mg tablet sig: three (3) tablet po hs (at bedtime). disp:*150 tablet(s)* refills:*0* 2. clonazepam 1 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*21 tablet(s)* refills:*0* 3. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*0* 4. hydromorphone 2 mg tablet sig: 1-2 tablets po q2h (every 2 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 5. morphine 15 mg tablet sustained release sig: two (2) tablet sustained release po q12h (every 12 hours): ok to decrease dose as pain control improves. disp:*50 tablet sustained release(s)* refills:*0* 6. nystatin 100,000 unit/ml suspension sig: five (5) ml po tid (3 times a day) for 5 days. disp:*75 ml(s)* refills:*0* 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): while taking pain medications. disp:*60 capsule(s)* refills:*0* 8. phenergan 12.5 mg tablet sig: one (1) tablet po every hours as needed for nausea: cause sedation. disp:*15 tablet(s)* refills:*0* 9. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 10. outpatient lab work calcium, ionized calcium. please send results to outpatient pcp: phone: discharge disposition: home with service facility: partners home care discharge diagnosis: primary: 1) partial small bowel obstruction 2) dehydration vs sepsis 3) hypercalcemia - idiopathic 4) chronic abdominal pain 5) hypoxica with negative cta, normal ef . secondary: 1) recurrent abdominal abscesses with history of recurrent diverticulitis s/p abdominal surgery, ostomy placement 2) anemia of chronic inflammation 3) paroxysmal atrial fibrillation 4) anxiety/depression 5) malnutrition discharge condition: good discharge instructions: please take all medications as prescribed. . new medications: clonazepam (for anxiety), docusate (stool softener), hydromorphone (dilaudid), morphine sr (ms contin) for pain . you should stop taking pantoprazole as it be causing your calcium to be high. call your doctor or return to the ed immediately if you experience chest pain, shortness of breath, nausea, vomiting, sweating, fevers, chills, bleeding, or other concerning symptoms. followup instructions: you are scheduled for the following appointments. please contact the provider with any questions or if you need to reschedule. . . you will also have an appointment with endocrinology: 3pm. 7. (but they may call you if the appointment should be sooner)provider: , md phone: date/time: 3:00. . **patient to have outpatient blood work done . if calcium is 11 or greater, she may need iv bisphosphinates or steroids. procedure: venous catheterization, not elsewhere classified transfusion of packed cells diagnoses: acute kidney failure, unspecified unspecified septicemia unspecified protein-calorie malnutrition atrial fibrillation dysthymic disorder septic shock iron deficiency anemia, unspecified hypoxemia dehydration systemic inflammatory response syndrome due to noninfectious process with acute organ dysfunction ileostomy status unspecified intestinal obstruction hypercalcemia 

Answer: The patient is high likely exposed to