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: ambien / codeine attending: chief complaint: fever and hypotension major surgical or invasive procedure: ct guided drainage of abdominal fluid collection and tube placement ct guided pigtail catheter placement in abdominal fluid collection picc line placement right brachial vein history of present illness: 80m with history of splenic abcess/splenectomy c/b colonic ec fistula and long complicated hospital course with tracheostomy, discharged earlier today to rehab, returns woth fevers 101.6 and sbp 80s at rehab facility. not compaining of any pain or shortness of breath. no nausea or vomiting, no chest pain. received 1l ns and imipenem on transfer, and vancomycin on arrival to ed. past medical history: past medical/surgical history: - splenic trauma s/p coiling c/b abcess and splenectomy - tracheostomy - copd - cad - htn - hypercholesterolemia - pneumonia psh: - splenectomy - coronary stent - embolization of splenic artery branches social history: he is widowed and lives alone. he denies etoh and has a remote smoking history. family history: noncontributory physical exam: t98.7 hr107 bp86/51 rr18 95% trach mask gen: no distress, alert and oriented heent: perla, eomi, anicteric, mmm, dobhoff tube in place neck: trach site clean chest: rrr, lungs with rhonchi bilaterally abdomen: soft, protuberant, healing midline incision with good granulation tissue at the base with a small area of necrosis at the base of the incision, colocutaneous fistual track without discharge and no surrounding erythema, flank edema ext: 1+ edema neuro: moves all extremities well, strength and sensation intact pertinent results: 09:40pm wbc-15.5* rbc-3.13* hgb-8.0* hct-26.7* mcv-85 mch-25.7* mchc-30.1* rdw-16.2* 09:40pm neuts-56.8 lymphs-35.7 monos-6.8 eos-0.1 basos-0.7 09:40pm plt count-467* 09:40pm alt(sgpt)-22 ast(sgot)-21 ck(cpk)-9* alk phos-70 tot bili-0.4 09:40pm glucose-129* urea n-24* creat-0.5 sodium-136 potassium-4.0 chloride-100 total co2-34* anion gap-6* ct chest/abd/pelvis : 1. rim-enhancing fluid collections adjacent to the descending colon concerning for abscess. this is increased in size. in addition, there is foci of air within some of these fluid collections as well as within the splenectomy bed. known colocutaneous fistula is again identified. 2. bilateral pleural effusions and atelectasis. 3. emphysematous changes with loculated hydropneumothorax on the right. 4. small pericardial effusion and pleural effusions. 5. small hypodensities, some of which are cysts and others are too small to characterize or incompletely characterized. 6. cholelithiasis. 7. liver hypodensity, stable. 8. infrarenal abdominal aortic aneurysm, stable. 9. diverticulosis. left upper ext ultrasound : no left upper extremity dvt. brief hospital course: mr. was admitted to the trauma icu, pan cultured and hydrated. he underwent an abdominal ct which revealed a fluid collection adjacent to the descending colon. it was percutaneously drained for 350 cc. and a drainage catheter was left in place. the fluid culture grew bacteroides and sputum culture grew 2 types of pseudomonas and stenotrophonomas. urine culture was negative and blood cultures are negative to date. the infectious disease service was consulted for drug coverage and they recommended a 2 week course of meropenum, tobramycin, bactrim and fluconozole followed by reimaging. following drainage of the fluid collection he had no further temperature spikes but his wbc remained elevated at 13-17k. he had no abdominal tenderness. he may need long term treatment with antibiotics if his colocutaneous fistula persists but for the present time percutaneous drainage and antibiotics for multi drug resistent pseudomonas. his abdominal wound is clean and granulating well with dressing changes. he was transferred to the trauma floor with stable hemodynamics, continuation of antibiotics and daily assessment by id. his pulmonary status was stable in that he maintained good o2 saturations with a 35% trach collar. he had a very strong cough and was able to cough his secretions up for the most part. he was seen by the speech and swallow service to try a pm valve however he had severe coughing with slow deflation of the trach cuff and lots of secretions. down sizing the trach tube was recommended at some point prior to using a pm valve. his tube feeds continued via a dobhoff feeding tube and were tolerated well. on he underwent a repeat abdominal ct for re-evaluation of the fluid collection. the study showed that the fistula is from the small bowel. the drainage catheter was replaced in ir and he subsequently had his picc line replaced as well for iv antibiotics. on he was discharged to rehab after receiving all three of his post splenectomy vaccines including pneumovax, haemophilus and meningococcus. he will follow up in 2 weeks for a repeat abd ct. medications on admission: heparin 5,000 unit tid insulin regular per sliding scale units injection albuterol sulfate 90 mcg q4h as needed for wheeze/sob. ipratropium bromide 17 mcg q4h as needed for wheeze/sob. fluoxetine 10 mg daily acetaminophen 325-650 mg q6h as needed for fever >101.5. oxycodone 5 mg/5 ml solution q4h as needed for pain. docusate sodium 50 mg/5 ml liquid 2 teaspoons metoprolol 12.5 mg tid ferrous sulfate 325 mg daily ondansetron 4 mg q8h as needed for nausea. discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 2. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day). 3. famotidine(pf) in (iso-os) 20 mg/50 ml piggyback sig: twenty (20) mg intravenous q12h (every 12 hours). 4. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 5. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: 2.5 mg inhalation q6h (every 6 hours). 6. tobramycin sulfate 40 mg/ml solution sig: four y (450) mg injection q48h (every 48 hours). 7. meropenem 1 gram recon soln sig: one (1) recon soln(s)gm. intravenous q8h (every 8 hours). 8. fluconazole in saline(iso-osm) 400 mg/200 ml piggyback sig: four hundred (400) mg intravenous q24h (every 24 hours). 9. trimethoprim-sulfamethoxazole 80-400 mg/5 ml solution sig: four hundred (400) mg intravenous q8h (every 8 hours). 10. morphine 2 mg/ml syringe sig: 2-4 mg injection q4h (every 4 hours) as needed for pain. 11. potassium & sodium phosphates 280-160-250 mg powder in packet sig: one (1) powder in packet po tid (3 times a day): thru . discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis s/p percutaneous drainage of left paracolic abscess secondary diagnoses - splenic trauma s/p coiling c/b abcess and splenectomy - tracheostomy - copd - cad - htn - hypercholesterolemia - pneumonia discharge condition: stable blood pressure, afebrile, strong cough to keep trach clear but unable to tolerate pmv. tube feedings continue. 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. general drain care: *please look at the site every day for signs of infection (increased redness or pain, swelling, odor, yellow or bloody discharge, warm to touch, fever). *if the drain is connected to a collection container, please note color, consistency, and amount of fluid in the drain. call the doctor, nurse practitioner, or nurse if the amount increases significantly or changes in character. be sure to empty the drain frequently. record the output, if instructed to do so. *wash the area gently with warm, soapy water. *keep the insertion site clean and dry otherwise. *make sure to keep the drain attached securely to your body to prevent pulling or dislocation. 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 follow up with dr. in 2 weeks. you should have a repeat ct scan of the abdomen and pelvis just prior to that. call ( to schedule both. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances percutaneous abdominal drainage percutaneous abdominal drainage diagnoses: coronary atherosclerosis of native coronary artery unspecified pleural effusion unspecified essential hypertension unspecified septicemia percutaneous transluminal coronary angioplasty status sepsis pulmonary collapse other and unspecified hyperlipidemia pneumonia due to pseudomonas other emphysema abdominal aneurysm without mention of rupture peritoneal abscess diverticulosis of colon (without mention of hemorrhage) tracheostomy status fistula of intestine, excluding rectum and anus bacteroides fragilis 

Answer: The patient is high likely exposed to