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: penicillins / aspirin / metformin attending: chief complaint: hematemesis major surgical or invasive procedure: none history of present illness: this is a 87 year-old female with a history of dementia, dm2, chronic utis, recently discharged from with a uti and pna who presents with coffee ground emesis at her nh. patient had emesis over a week ago, for which she was taken to and a uti and a pneumonia per the daughter. she states the patient was treated with levofloxacin. she was then discharged back to the . prior to admission to , she had coffee ground emesis, vitals stable. she has had a cough, though unchanged from discharge. no documented fevers at nh. in the ed, vitals were t 100, hr 86, bp 183/64, rr 18, sa 02 96% 2l. peg lavage was done, cleared after 500 cc. cxr c/w pna, and patient was given azithro/ceftriaxone and also given a dose of vancomycin. she was also started on pantoprazole. ecg was nsr without ischemic changes. she was guaiac positive as well. ros: the patient denies any fevers, chills, weight change, nausea, vomiting, abdominal pain, diarrhea, constipation, chest pain, shortness of breath, orthopnea, pnd, lower extremity edema, cough, urinary frequency, urgency, dysuria, lightheadedness, gait unsteadiness, focal weakness, vision changes, headache, rash or skin changes. past medical history: dm2 dementia chronic utis htn chf (? ef) cad (unknown status) parenchymal hemorrhage () breast ca s/p mastectomy () -unknown status s/p peg tube placement social history: lives in . has most of her care at the hospital. quit smoking in . 2 pks/week. family history: non-contributory physical exam: gen: well-appearing, well-nourished, no acute distress heent: eomi, perrl, sclera anicteric, no epistaxis or rhinorrhea, mmm, op clear neck: no jvd, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline cor: rrr, no m/g/r, normal s1 s2, radial pulses +2 pulm: lungs ctab, no w/r/r abd: soft, nt, nd, +bs, no hsm, no masses ext: no c/c/e, no palpable cords neuro: alert, oriented to person, place, and time. cn ii ?????? xii grossly intact. moves all 4 extremities. strength 5/5 in upper and lower extremities. patellar dtr +1. plantar reflex downgoing. no gait disturbance. no cerebellar dysfunction. skin: no jaundice, cyanosis, or gross dermatitis. no ecchymoses. pertinent results: 05:25am glucose-209* urea n-28* creat-0.7 sodium-142 potassium-4.8 chloride-103 total co2-29 anion gap-15 05:25am alt(sgpt)-11 ast(sgot)-19 ck(cpk)-26 alk phos-82 tot bili-0.3 05:25am lipase-13 05:25am ctropnt-0.01 05:25am ck-mb-notdone 05:25am albumin-3.2* 05:25am wbc-16.7* rbc-3.41* hgb-10.2* hct-29.4* mcv-86 mch-30.0 mchc-34.7 rdw-14.5 05:25am neuts-91.6* lymphs-5.0* monos-2.2 eos-0.8 basos-0.4 05:25am plt count-517* 05:25am pt-12.7 ptt-32.9 inr(pt)-1.1 05:20am wbc-16.9* rbc-3.46* hgb-10.4* hct-29.9* mcv-86 mch-30.0 mchc-34.7 rdw-14.7 05:20am neuts-91.6* lymphs-5.0* monos-2.0 eos-1.1 basos-0.3 05:20am plt count-522* 05:55am urine blood-neg nitrite-neg protein-30 glucose-100 ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-neg 05:55am urine rbc-2 wbc-13* bacteria-few yeast-none epi-<1 trans epi-1 09:16am wbc-24.9* rbc-3.41* hgb-10.1* hct-29.4* mcv-86 mch-29.7 mchc-34.4 rdw-14.5 02:53pm hct-30.3* ecg: sinus rhythm, leftward axis, no signifcant st segment changes imaging: cxr: impression: right middle lobe air space opacity worrisome for aspiration or pneumonia. brief hospital course: 87 year-old female with a history of dementia, cva, dm2, chf, chronic utis who presents with hematemesis and likely aspiration pna # hematemesis: in the ed peg lavage showed coffee ground material which cleared after 500 cc and her hct was 29.9. likely ugib- source gastritis vs duodenol vs gastric ulcer vs esophageal ( , varices). no known liver cirrhosis. she was placed on an iv ppi . gi evaluated her and felt that as her hct has been stable, she did not need an emergent scope. on the evening of her hct fell to 23 so she received a unit of prbc's. her hematocrit initially increased appropriately but then fell again to the 23 range. she received a second unit of prbc's on the evening of at which time her hematocrit increased to 28 and remained stable at 29 the next morning. she had no guiac positive stools in the and no hematemesis. she remained hemodynamically stable. endoscopy was ultimately not performed as the benefits outweighed the indicated this chronically ill, severely demented woman. plan is to continue ppi . h pylori remains pending at time of discharge. # pna: her ed cxr showed a rml infiltrate; left hemidiaphragm also obscured- likely hap vs aspiration given hematemsis. she was treated with vanc, cefepime, and flagyl as she was admitted from a nursing home and there was concern for aspiration. sputum and blood cultures were sent and remained negative as of the time of discharge. picc was placed for a 10 day course of antibiotics for hap. # chronic utis: she was recently treated at for uti; ua currently not very consistent with active infection (le negative- wbc 13). her foley was pulled. urine culture was negative for growth. # dm: she was continued on her outpatient insulin glargine and riss. her tube feeds were briefly stopped for concern of gi bleed and during that time despite her glargine dose being halved she had some asymptomatic hypoglycemia for which she received 2 amps of dextrose. at that point her tube feeds were restarted and she was placed on half her usual glargine dose. her gluxose was high and her glardine dose was increased. this will likely need continued adjustment in the outpatient setting. # dementia: the patient is quite demented at baseline and unable to regularly answer questions appropriately. this is her baseline. no further management was initiated. at time of discharge she was still unable to state name or follow basic commands. # chronic heart failure: unclear if systolic or diastolic; no echo here. the patient appeared mildly fluid overloaded on the morning of and received 20 mg of furosemide iv. her cxr improved with decreased hilar markings but as she still had an o2 requirement she received another dose of iv furosemide on . her home cv meds ( captopril and metoprolol) were switched to once a day formulations. her isosorbide was held as these pills were not able to be crushed and placed in peg. she does not tolerate asa (allergy). further titration of cardiac medications is recommended in the outpatient setting. # fen: she was started on tube feeds on as her third hct returned stable. this was then held on as her hematocrit was decreasing. these were restarted on after hct was once again stable. she was evaluated by the speech and swallwing service. at that time, patient was not accepting pos and recommended if patient taking/accepting pos would continue trials of nectar thick liquids. she did swallow very small amounts of nectar thick liquid from the cup with maximum cues without overt s/sx of aspiration .primary nutrition, hydration, and medications should be via peg tube. # code: full code: this was confirmed by the patient's daughter who appeared to have very poor insight into her mother's debiliated state and chance for meaningful recovery from multiple chronic conditions and acute medical issues. medications on admission: calcium carbonate 1250 mg captopril 50 mg tid colace 100 mg lovenox 40 mg sc daily ergocalciferol 50,000 units sc weekly insulin glargine 34 units qhs plus riss isosorbide dinitrate 20 mg tid maalox 30 mg q6h prn metoprolol tartrate 75 mg omeprazole 40 mg daily polyethylene glycol 17 gm simvastatin 80 mg daily multivitamlin 5 ml daily tylenol prn diet: pureed, nectar liquid, no egg discharge medications: 1. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 2. multivitamin tablet sig: one (1) tablet po daily (daily). 3. calcium carbonate 500 mg tablet, chewable sig: two (2) tablet, chewable po bid (2 times a day). 4. metoprolol tartrate 25 mg tablet sig: three (3) tablet po bid (2 times a day). 5. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 6. metronidazole 500 mg tablet sig: one (1) tablet po q8h (every 8 hours) for 10 days. 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours): via peg. 8. insulin glargine 100 unit/ml solution sig: nineteen (19) units subcutaneous at bedtime: **will likely need further adjustment**. 9. cefepime 2 gram recon soln sig: one (1) recon soln injection q24h (every 24 hours) for 10 days. 10. vancomycin in dextrose 1 gram/200 ml piggyback sig: one (1) intravenous q 24h (every 24 hours) for 10 days. discharge disposition: extended care facility: - discharge diagnosis: 1) upper gi bleed-nos 2) hospital aquired pneumonia 3) dementia 4) diabetes 5) chronic heart failure discharge condition: stable discharge instructions: you were admitted for an upper gi bleed and have a hospital aquired pneumonia. you should return to the hospital should you develop worsening fevers, chills, have vomiting with blood or any other concerning symptoms. followup instructions: please follow-up with your primary care doctor within the next 3-4 weeks procedure: venous catheterization, not elsewhere classified diagnoses: pneumonia, organism unspecified coronary atherosclerosis of native coronary artery unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled personal history of malignant neoplasm of breast other persistent mental disorders due to conditions classified elsewhere pneumonitis due to inhalation of food or vomitus hemorrhage of gastrointestinal tract, unspecified ileostomy status urinary incontinence, unspecified acquired absence of breast and nipple 

Answer: The patient is high likely exposed to