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: celebrex / zithromax / sulfa (sulfonamides) attending: chief complaint: transfered from osh s/p cholecystectomy with bile leak followed by ex lap with drainage of bilious fluid, and pneumothorax s/p cvl placement being transferred for to correct continue leak major surgical or invasive procedure: intubation s/p extubation history of present illness: 61 yo female with h/o dm2, copd on home o2, h/o dvt/ transferred from . she underwent cholecystectomy on then represented to for abdominal pain. she was found to have significant ileus and ascites, and underwent exploratory laparotomy which showed a 2cm hole in the base of the systic duct with 1 liter bilious ascites. there was ischemic bowel with massive ileus and distention due to bile peritonitis. her hospitalization was also complicated by a cvl placement with subsequent pneumothorax. a left sided chest tube was place, and also a right femoral line was placed. she is being transferred here for in am to fix the continued bile leakage. of note, she has been treated with vancomycin, metronidazole, and levofloxacin at for peritonitis. . currently, she states she is having severe pain in her abdomen. she denies cp. her breathing is slightly labored, but she thinks that's secondary to her large abdomen. she otherwise denies fevers, chills, headache, or any other symptoms. she request pain medications. she was on a dilaudid pca at the osh. . also on chroinc steroids for copd. past medical history: 1. diabetes 2. chronoc obstructive pulmonary disease 3. t9-10 vertebral fractures. 4. h/o dvt/pe 5. chronic back pain 6. right knee osteonecrosis s/p right knee replacement 7. hyperthyroidism 8. anxiety 9. enterococcus bactermia social history: widowed. lives independently. denies alcohol, smoking. family history: nc physical exam: vitals - t 98.8 p 120 st bp 154/74 rr 17 89% o2 sat on 4l nc gen - alert awake, heent - mmm, no icterus, no signs of conjunctivitis cv - s1s2 rrr pulm - coarse breath sounds anteriorly, decreased bs b/l, few scattered rhonci. left chest tube in place with no air leak noted abd - bs hypoactive; ttp diffusely but particulary in rlq. bandage in place with jp drain with bilious fluid. + tympany to percussion ext - warm, no edema. multiple echymosis. neuro - alert and awake. no focal abnormalities. pertinent results: 09:51pm glucose-162* urea n-22* creat-0.9 sodium-145 potassium-3.6 chloride-110* total co2-26 anion gap-13 09:51pm alt(sgpt)-17 ast(sgot)-16 ld(ldh)-253* alk phos-106 amylase-25 tot bili-0.4 09:51pm lipase-8 09:51pm albumin-2.6* calcium-7.1* phosphate-3.3 magnesium-2.2 09:51pm wbc-8.0 rbc-3.40* hgb-10.0* hct-31.0* mcv-91 mch-29.3 mchc-32.1 rdw-16.3* 09:51pm neuts-96.0* lymphs-2.0* monos-1.8* eos-0.2 basos-0.1 09:51pm plt count-229 09:51pm pt-16.3* ptt-29.8 inr(pt)-1.5* . ekg: sinus, no significant st segment changes. . : impression: normal major papilla. cannulation of the biliary duct was successful and deep with a autotome 44 using a free-hand technique. contrast medium was injected resulting in complete opacification. slight extravasation was noted at the cystic duct remnant. the calibre and course of the intrahepatic ducts and the cbd was normal; no filling defects were noted. a 10cm by 9mm cotton biliary stent was placed successfully. otherwise normal to third part of the duodenum . chest x-ray tubing projected over the left lower hemithorax could be a pleural drain, impinges on the mediastinum and then could be folded quite sharply, to the point of occlusion. clinical examination recommended. thickening of the left apical pleural margin extends into the mediastinum is new concerning for hematoma related to line insertion attempt. no radiopaque central venous catheter is seen. mild left lower lobe atelectasis is new. heart size is normal. stomach is moderately distended with air and a right upper quadrant drainage catheter is at the lower margin of the liver . left basal pleural tube is sharply folded as it impinges on the mediastinum, and may be effectively occluded. pleural effusion, if any, is small. no pneumothorax. lobular thickening of the left apical pleural margin could be either loculated effusion or extrapleural hematoma from attempted line placement, as discussed with the house officer caring for this patient earlier in the day. severe left lung atelectasis is unchanged. . marked azygos distention in part reflects supine positioning nevertheless indicates elevated central venous pressure or volume. the heart is probably not enlarged. . 5:13 am peritoneal fluid gram stain (final ): reported by phone to @ 6:05a . 1+ (<1 per 1000x field): polymorphonuclear leukocytes. 2+ (1-5 per 1000x field): gram negative rod(s). fluid culture (preliminary): reported by phone to dr ,j 3pm. gram negative rod(s). moderate growth. anaerobic culture (preliminary): brief hospital course: micu course: 63 y/o female with copd,diabetes, and h/o dvt is transfered from osh after exploratory laparotomy for bile duct leak following cholecystectomy, also s/p left cvl placement with subsequent ptx s/p left chest tube placement, transferred here for to address continued bile duct leak. done and stent placed without difficulty. patient electively intubated during procedure and successfully extubated. # bile duct leak: patient underwent cholecystecomy on , followed by exploratory laparotomy on found to have 2 cm hole at cystic duct with bilious drainiage, and 1l of bilious ascites, and likely peritonitis given acute abdomen on vanco/levo/flagyl transferred to for . she remained hemodynamically stable throughout hospital stay. was performed on and a stent successfully placed. antibiotics changed to vanco/zosyn for better gnr coverage, as peritoneal fluid grew gnrs, yet to be speciated. she should have a repeat in 8 weeks to remove the stent and to reassess. her diet should be advanced slowly as tolerated. # left pneumothorax: in context of subclavian attempt at osh s/p chest tube placement. on arrival to , x-ray revealed malpositioning of chest tube. thoracics was consulted for removal. on serial chest x-rays here, ptx resolved. # copd: was intubated at postoperatively, but self extubated. transferred on ventimask 50% fio2. on chronic po steroids at home, transitioned to iv regimen initially as she was npo. should be transitioned back to her home regimen as tolerated. # history of dvt/pe: on coumadin as outpatient which was held in preparation for and removal of chest tube. heparin resumed following these procedures. medications on admission: medications on transfer: 1. fortical 1 spray each nostril every 48 hrs 2. vitamin b12 1000 mcg every 30 days 3. dilaudid pca (dose unclear) 4. narcan prn 5. zofran 4 mg iv q6h prn 6. dilaudid 1 mg q4h prn 7. tylenol 650 mg q6h prn 8. lopressor 5 mg iv q2h prn hr>120 9. fentanyl citrate 25 mcg q30 mins prn 10. hiss 11. solumedrol 20 mg iv x 3 days 12. spiriva inhaler 1 puff daily 13. advair 500/50 puff 14. xopenex 1.25 mg q4h prn 15. coumadin 2 mg daily (currently held) 16. protonix 40 mg iv daily 17. levofloxacin 500 mg iv daily 18. metronidazole 500 q8h 19. vancomycin 1 gm q12h 20. tpn daily . admission medications: 1. kcl 40 meq 3 x daily 2. spiriva 18 mcg inh daily 3. fortical 1 spray alternating nostrils daily 4. vitamin d 400 units daily 5. prednisone 30 mg daily 6. mag oxide 400 mg 7. mvi daily 8. trazadone 50 mg qhs 9. advair 1 puff 10. amoxicillin 500 mg 11. neurontin 300 mg tid 12. oxycodone 50 mg q6h prn 13. singulair 10 mg daily 14. cymbalta 60 mg daily 15. lasix 40 mg daily 16. protonix 40 mg 17. synthroid 112 mcg daily 18. b12 1000 mcg im monthly 19. iron 325 mg daily 20. oxycontin 20 mg 21. xopenex 1 puf q4h prn 22. dilaudid 2 mg po q4h prn 23. coumadin 2 mg daily 24. ativan 0.5 mg 25. albuterol inh q4h prn 26. atroven neb q4h prn discharge medications: 1. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed. 2. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 3. bupivacaine (pf) 0.25 % (2.5 mg/ml) solution sig: one (1) ml injection infusion (continuous infusion). 4. pantoprazole 40 mg recon soln sig: one (1) recon soln intravenous q24h (every 24 hours). 5. vancomycin in dextrose 1 gram/200 ml piggyback sig: one (1) intravenous q 12h (every 12 hours). 6. levothyroxine 200 mcg recon soln sig: one (1) recon soln injection daily (daily). 7. piperacillin-tazobactam-dextrs 4.5 gram/100 ml piggyback sig: one (1) intravenous q8h (every 8 hours). 8. methylprednisolone sodium succ 40 mg/ml recon soln sig: one (1) recon soln injection q24h (every 24 hours). 9. lorazepam 2 mg/ml syringe sig: one (1) injection q4h (every 4 hours) as needed for anxiety. discharge disposition: extended care discharge diagnosis: primary # bile duct leak # left pneumothorax s/p chest tube placement at osh secondary # copd # dvt/pe discharge condition: hemodynamically stable discharge instructions: you were admitted to the for an . this procedure went well and you had a stent placed to fix your biliary leak. you were intubated during the procedure and successfully extubated following the . you should have a repeat in 8 weeks to have the stent removed. your diet should be advanced as tolerated. you also had your chest tube removed on this admission. followup instructions: you have the following appointments for repeat provider: 2 (st-4) gi rooms date/time: 8:00 provider: , md phone: date/time: 8:00 procedure: venous catheterization, not elsewhere classified endoscopic insertion of stent (tube) into bile duct diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation long-term (current) use of anticoagulants personal history of venous thrombosis and embolism 

Answer: The patient is high likely exposed to