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: sulfa (sulfonamide antibiotics) attending: chief complaint: abdominal pain, pancreatitis major surgical or invasive procedure: none at . laparoscopic cholecytectomy at hospital, nh ercp with stone extraction at hospital, nh history of present illness: patient is a 25year old female, 6 weeks s/p c-section for her first child, who was transferred from the hospital icu tonight to dr. care for pancreatitis. she originally underwent a laparoscopic cholecystectomy with ioc on for a pre-operative diagnosis of "biliary colic & passed common bile duct (cbd) stone". grossly, she appeared to have chronic cholecystitis. the cholangiogram demonstrated an obstructing cbd stone, which did not pass with glucagon. a drain was left in the gallbladder fossa. she then underwent an ercp on with sphincterotomy and stone extraction. prior to surgery she had multiple visits to her healthcare providors for abdominal pain during the last 6 weeks of her pregnancy. she reports she was told she had gas and constipation. on she had a 12-hour attack of pain and was noted to have abnormal lft's (ast 387, alt 246, ap 322, tuberculosis 1.5, lip 351). ruq u/s at that point demonstrated cholelithiasis without evidence of cholecystitis; cbd measured 3.00 mm. she was given the name of surgeon and told to follow-up. she saw him on , who suspected she had passed a stone, and scheduled her for an elective cholecytecomy on . her lfts somewhat improved without intervention (ast 115, alt 90, ap 208, tuberculosis 0.4), but she continued to have intermitted ruq/epigastric sharp, crampy abdominal pain with radiation to the right shoulder. her transfer paperwork does not include a discharge summary or md notes aside from initial gi & ob consult notes. the following timeline was pieced together from her nursing notes and the patient: initially after her ercp her abdominal pain was much improved. however, on pod 2/ppd 1 she again developed significant pain with tachycardia to 120's. she was started on a fentanyl pca. transferred to the icu for "sirs". pod 3/ppd 2 she became febrile to 103 with continued tacycardia. a cvl was placed and tpn started. ngt placed for increased abdominal distension. bolused for cvp; jp removed approximately this day. pod 5/ppd 4 diuresed for cvp 20 and pitting edema. continued to be tachy to 120's, with sustained 130-140's. ngt continued with output of approximately 500cc/12 hrs. fleets enema given resulting in small liquid stools. pod 6/ppd 5 continued abdominal pain, febrile to 102.5, then 103. vancomycin was started. remained tachy to 140's. urine output 200cc's/hr. pod 7/ppd 6 continued fever to 103, resistant to tylenol and cooling blankes. cvl d/c'd. pod 8/ppd 7 ngt clamped, minimal residuals. picc placed. pod 9/ppd 8 ngt removed, repeat ct scan, was then transferred to . at this point she feels "crummy". rml/rll abdominal pain worse with movement, reasonably controlled with dilaudid 4mg iv q3. no nausea or vomiting since ngt removed earlier today. no headache or dizziness. feels weak with "heavy legs". has been walking around the icu daily "to keep her strength up". has been npo on tpn. breathing is much better than it was 3-4 days ago. past medical history: 1. anxiety 2. goiter 3. c-section , first child 4. s/p leep for cin 3 5. gallstone pacreatitis s/p lap ccy & ioc ( hospital, nh) 6. s/p ercp with stone extraction ( hosapital, nh) 7. sulfa allergy social history: married. healthy baby boy being cared for by her in-laws. nurse at hospital. no tobacco. minimal alcohol. family history: ovarian cancer, polycystic kidney in maternal grandmother. cancer, ibd, liver disease. physical exam: on admission: . vs: 103.8 133st 138/83 21 100% 2l general: diaphoretic, ill appearing. aox3. pleasant. not distressed. no jaundice or icterus. lungs: cta b/l heart: tachycardia abdomen: trochar sites c/d/i without erythema or induration with steri-strips. old rlq drain exit site closed without drainage. slightly distended, soft. ttp rml/rll. no tap/shake tenderness. no guarding. trace rebound. extrem: trace le edema. (r) ac picc site c/d/i. (l)ij former cvl site c/d/i. pertinent results: 06:45 labwork: report comment: source: line-picc complete blood count white blood cells 17.8* k/ul (4.0 - 11.0), red blood cells 3.18* m/ul (4.2 - 5.4), hemoglobin 8.1* g/dl (12.0 - 16.0), hematocrit 25.1* % (36 - 48), mcv 79* fl (82 - 98), mch 25.4* pg (27 - 32), mchc 32.1 % (31 - 35) rdw 15.6* % (10.5 - 15.5) differential neutrophils 83* % (50 - 70) toxic granulation, bands 0 %(0 - 5), lymphocytes 9* % (18 - 42), monocytes 3 % (2 - 11), eosinophils 4 % (0 - 4), basophils 0 % (0 - 2), atypical lymphocytes 0 %, metamyelocytes 0 %, myelocytes 1* % (0) red cell morphology hypochromia normal, anisocytosis 1+, poikilocytosis normal, macrocytes normal, microcytes 1+,polychromasia normal, platelet count 1017* k/ul (150 - 440). 138/101/15 ----------< 88, agap=17 4.7/25/0.6 ca: 8.8 mg: 2.0 p: 3.9 : 233 lip: 458 . microbiology: mrsa screen: negative. blood cultures x2: no growth. urine cx: no growth. stool for c. diff: negative. : blood cx: pending. blood cx: pending. urine cx: mixed bacterial flora ( >= 3 colony types), consistent with skin and/or genital contamination. blood cx: pending. urine cx: pending. blood cx x2: pending. . cxr: the right picc line tip is at the cavoatrial junction. cardiomediastinal silhouette is unremarkable. bibasal opacities may represent areas of atelectasis in conjunction with small bilateral pleural effusions, although infectious process cannot be excluded. followup on the subsequent radiographs is recommended for documentation of resolution or at least absence of progression. . ekg: sinus tachycardia. otherwise, within normal limits. no previous tracing available for comparison. intervals axes rate pr qrs qt/qtc p qrs t 105 126 88 334/412 13 53 28 . outside read of abdominal ct with iv/po contrast: 1. extensive multiloculated slightly complex intraperitoneal and retroperitoneal fluid collection extending from the posteroinferior aspect of the pancreas and third/fourth portion of the duodenum. the degree of complexity of the collections as well as multiple loculations would make any percutaneous drainage attempt difficult. 2. no pancreatic necrosis. branches of the sma and smv passing through the dominant fluid collection appear attenuated and may be at risk for future thrombosis or hemorrhage. 3. reactive thickening of the adjacent loops of small and large bowel, most marked involving the ascending . 4. simple bilateral mild-to-moderate pleural effusions. 5. small enhancing fluid collection tracking within the mid right lateral abdominal wall, just adjacent to the tip of the liver, likely corresponding to patient's prior port track. 5. atypical configuration of the right kidney likely representing a form of congenital malrotation. the kidney itself appears to enhance normally. . cxr: small bilateral pleural effusions. . cta abd w&w/o c & recon: interval decrease in size of extensive multiloculated pancreatic pseudocyst, although with increase in wall enhancement. the collection now measures roughly 11.3 x 3.8 x 10 cm, previously approximately 13.8 x 5.6 x 10 cm. no pancreatic necrosis. no evidence of vascular complications, including no pseudocyst, thrombus or evidence of hemorrhage. however, persistent encasement and attenuation of ileocolic vessels, particularly venous tributaries to the smv, although without bowel wall thickening or secondary signs of ischemia at this time. interval decrease in size of bilateral pleural effusions, now minimal. improvement in reactive bowel wall thickening of nearby loops of bowel, but increase in mesenteric lymphadenopathy. brief hospital course: the patient was transferred from the icu at hospital, nh to the sicu here for further evaluation and treament of the aforementioned problems. she arrived npo on tpn for nutrition and hydration, received iv dialudid for pain relief, and had a foley catheter, a-line, and picc in place, with the placement of the latter confirmed by cxr. an abdominal ct performed at the outside hospital, which was re-evaluated by radiology, demonstrated a large complex, multiloculated fluid collection adjacent to pancreas and into the paracolic gutter, likely representing a pancreatic pseudocyst. iv meropenem and vancomycin were continued. she was hemodynamically stable. neuro: initially, pain was controlled on prn iv dialudid, which was converted to dilaudid pca. on , the pca was discontinued, and changed to percocet po prn as well as the addition of toradol iv for back pain with good effect. last day of toradol . cv: arrived in sinus tachycardia due to dehydration, anemia and fevers, which imporved with aggressive hydration and fever reduction. anemia remained stable. platelet count slowly trended upward, most likely due to inflammation. otherwise, remained stable from a cardiovascular standpoint. pulmonary: the patient remained stable from a pulmonary standpoint. good pulmonary toilet, early ambulation and incentive spirometry were encouraged throughout hospitalization. fen/gu: admitted npo on tpn from outside hospital. iv fluid and boluses given with good response and resolution of oliguria. she was started on clear liquids on hd 2, which she tolerated, and progressively advanced to a low residue, low fat diet by hd 5 with initial poor intake due to nausea. improved dietary tolerability by discharge day, but still with inadequate po intake. tpn was continued at time of transfer with recommendation to discontinue when tolerating diet with adequate nutritional intake. electrolytes were routinely followed, and repleted when necessary. nutrition consulted during stay; provided dietary teaching regarding low residue, low fat diet. gi: multilobular pancreatic pseudocyst on abdominal ct. lfts, lipase and amylase followed closely, improving over time; diet advanced as results trended downward. managed conservatively. underwent cta pancreas on , which revealed interval decrease in size of extensive multiloculated pancreatic pseudocyst with maturation. id: c-section and laparoscopic incisions remained c/d/i during hospitalization. continued experiencing episodic fevers 100.1 - 103.5 po until hd 6. pan-cultures from outside hospital as well as those performed at were unremarkable. cdiff x1 negative. as fevers felt to be due to inflammation, iv vancomycin and meropenem were discontinued on ; antibiotic therapy never restarted. wbc 17.8 (up from 13.9). blood cultures, u/a and ucx sent . endocrine: the patient's blood sugar was monitored throughout her stay while on tpn; sliding scale insulin dosing was adjusted accordingly. hematology: the patient's complete blood count was examined routinely; anemia remained stable. no transfusions were required. prophylaxis: the patient received subcutaneous heparin and venodyne boots were used during this stay; was encouraged to get up and ambulate as early as possible. psychosocial: patient's newborn son being cared for by male partner's parents and himself. son in for frequent visits while patient on floor. during stay, the patient was very emotional, had coping issues due to homesickness and separation from newborn son as well as question of possible post-partum depression. social work consulted. emotional support given. outpatient re-evaluation recommended. at the time of discharge and transfer back to hospital in , the patient was doing well, afebrile with stable vital signs. the patient was tolerating a low residue regular diet while being continued on tpn, ambulating, voiding without assistance, and pain was well controlled. the patient was transferred back to hospital to complete her recovery, so that she could be near her family, especially her newborn son. the patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. medications on admission: : vicodin prn (s/p c-section) . meds on transfer: 1. zosyn 3.375 iv q6hrs () 2. protonic 40mg iv bid 3. lorazepam 0.5-1mg q8hrs prn 4. lr @ 125 5. dilaudid 1-4mg iv q2hrs 6. tylenol 650mg q4hrs prn 7. ambien 5-10mg qhs prn 8. fluconazole 150mg q4days (started ) for vulvar edema & possible early yeast infection, to continued while on abx 9. lopressor 5mg iv q4hrs prn hr > 140 10. vancomycin 1000mg q12hrs (started ) 11. meropenem 1gm iv q8hr (started ) 12. tpn discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po every hours as needed for fever or pain. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 4. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*30 tablet(s)* refills:*0* 5. ibuprofen 600 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for fever or pain. disp:*60 tablet(s)* refills:*0* 6. prenatal vitamin with minerals 28-0.8 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 7. amylase-lipase-protease 33,200-10,000- 37,500 unit capsule, delayed release(e.c.) sig: one (1) cap po qidwmhs (4 times a day (with meals and at bedtime)). disp:*120 cap(s)* refills:*0* 8. ondansetron 4-8 mg iv q8h:prn nausea 9. famotidine 20 mg iv q12h 10. insulin regular human 100 unit/ml solution sig: 2-8 units injection as directed per regular insulin sliding scale. 11. picc care: 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. 12. piv care: sodium chloride 0.9% flush 3 ml iv q8h:prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. 13. metoclopramide 10 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for nausea. tablet(s) discharge disposition: extended care facility: healthcare, nh discharge diagnosis: primary: 1. gallstone pancreatitis 2. pancreatic pseudocyst secondary: 1. post-partum discharge condition: good. discharge instructions: please call your doctor or nurse practitioner or return to the emergency department for any of the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *your pain in not improving within 8-12 hours or is not gone within 24 hours. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon. avoid driving or operating heavy machinery while taking pain medications. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. *if you have staples, they will be removed at your follow-up appointment. *if you have steri-strips, they will fall off on their own. please remove any remaining strips 7-10 days after surgery. picc line: *please monitor the site regularly, and your md, nurse practitioner, or nurse if you notice redness, swelling, tenderness or pain, drainage or bleeding at the insertion site. * your md to the emergency room immediately if the picc line tubing becomes damaged or punctured, or if the line is pulled out partially or completely. do not use the picc line in these circumstances.please keep the dressing clean and dry. contact your nurse if the dressing comes undone or is significantly soiled for further instructions. followup instructions: please call ( to arrange a follow-up appointment with dr. (pcp) in 2 weeks. please call ( to schedule a follow-up appointment with dr. (surgery) in weeks. procedure: parenteral infusion of concentrated nutritional substances diagnoses: anemia, unspecified dehydration acute pancreatitis cyst and pseudocyst of pancreas calculus of bile duct with other cholecystitis, with obstruction anemia of mother, postpartum condition or complication other complications of puerperium, postpartum condition or complication 

Answer: The patient is high likely exposed to