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: adhesive tape / percocet attending: chief complaint: s/p esophageal stent placment admitted to for respiratory distress major surgical or invasive procedure: egd with esophageal stent placement history of present illness: this is a 74 year old female with recently diagnosed gastric ca, s/p resection transfered from on to the for esophageal stenting. the follow history is taken from and notes. the patient egd in for w/u anemia. she was found to have a gastric mass, poorly differentiated adenocarinoma. on , she partial proximal gastrectomy and pylorplasty with j-tube placment. she was discharged home on but returned to the ed later that day for hematemasis. egd was done showing some clots in the stomach but no active bleeding. the follwing day she had another episode of hematemasis, was transfered to the icu and electively intubated for airway protection. she repeat endoscopy which showed a small separtion in one portion of the esophagastric anatomosis with oozing. she then exploratory laparotomy on where a tear in the capusle of the spleen was found, but was not able to be repaired given concerns with disrupting the anastomosis. tear was controlled with thombin-soaked gel foam, bleeding stopped. she then an arteriogram showing a 6mm splnic pseudoaneurysm. she was transfused multiple units during these few days, hct around 26. she was on zosyn and fluconazol 200mg iv daily. she was transfered to sicu for treatment on the pseudoaneurysm. she was taken to ir for stenting of of splenic artery aneursym. she was weaned off the ventilator. however, she was noted to be on 3l nc during ambulance transport. lasix was given. there was a question of vomiting enroute. she was then reintubated on for respiratory distress and hypotension on . she was diuresed for the following two days and then extubated on . on , she ct chest, which only showed moderate pleural effusions. on , she was switched from zosyn to cefepime. during this time a ct abdomen, demonstrated perforation of the ge junction by the ng tube. ngt was pulled back and secured. gastrografin swallow on showed a contained anastomotic leak to the left of the remaining stomach measuring approx 6x3cm. she was then transfered to for esophagastric stenting. here she ercp with placement of esophagastric metal 9cm x10mm stent proximal clipping. she stent placement was verified by a pediatric scope. she had been electively intubated prior to the procedure and was extubated post ercp. post proceedure, she was ordered 125ml/hr ns; she likely received 400cc lr during the procedure. she then developed respiratory distress with respiratory rates in 40's, no documented hypoxia. she was then reintubated in the pacu. she was given lasix 20mg iv in the pacu. she was transfered to the on ac 500x 14, fi02 50%, peep 5. in the , the patient was aggressively diuresed with furosemide because of flash pulmonary edema. the patient's respiratory condition improved and pt subsequently extubated on . an echocardiogram performed revealed an ef 40%, severe diastolic dysfunction, moderate mitral regurgitation, akinesis of the septum and hypokinesis of the inferior wall which could suggest recent mi. serial troponins were negative. the patient was to return to , but the admitting surgeon, dr. , does not have icu admitting privileges, so the patient is to be transferred to the floor and then have transfer reattempted. past medical history: gastric ca s/p resection breast ca s/p mastectomy partial thyroidectomy for thyroid ca bladder ca s/p transurethral resection htn splenic artery aneurysm s/p stenting social history: married and lives with her husband, children live nearby, she is a former smoker of less than one pack per day, she drinks wine occasionally. family history: breast ca, sister with gastric ca, a sister with lung ca, cad and copd in various family members physical exam: exam upon presentation on medicine floor: vitals: t 98.6 hr 85 bp 160/88 rr 22 sao2: 97 on 2l nc general: nad heent: eomi, anicteric sclerae, mmm, oropharynx clear, neck supple pulmonary: ctab cardiac: rrr, normal s1 and s2, no murmurs abdomen: soft, nontender, nondistended, bowel sounds present extremities: no edema. warm. skin: no rashes or lesions noted. neurologic: alert and oriented x 4. fluent speech. strength 5/5 bue and ble. sensory intact throughout. no dysmetria. psych: appropriate, calm pertinent results: blood: 04:28am blood wbc-13.0* rbc-3.41* hgb-9.9* hct-30.8* mcv-90 mch-29.1 mchc-32.3 rdw-15.4 plt ct-479* 04:28am blood neuts-89.9* lymphs-6.1* monos-3.7 eos-0.1 baso-0.1 04:28am blood pt-13.3 ptt-29.1 inr(pt)-1.1 08:51pm blood ck(cpk)-14* ck-mb-2 ctropnt-0.02* 04:40am blood ck(cpk)-18* ck-mb-2 ctropnt-0.02* 10:30pm blood probnp-* 04:28am blood calcium-8.3* phos-3.1 mg-2.2 microbiology: mrsa swab: negative central venous line tip culture: no significant growth and sputum culture: staph aureus coag +. sparse growth. jp drain fluid 4+ (>10 per 1000x field): polymorphonuclear leukocytes. 4+ (>10 per 1000x field): gram negative rod(s). this is a concentrated smear made by cytospin method, please refer to hematology for a quantitative white blood cell count.. fluid culture gram negative rod(s). moderate growth. gram negative rod(s). moderate growth strain 2. c diff toxin: negative studies: ct abdomen w/ contrast : 1. extraluminal gas collection to the left of the body of the somach, ng tubes through an area of surgical clips in the ge junction into this extraluminal gas collection, findings compatible with perforation at the ge junction 2. retroperitoneal hematoma in the right anterio pararenal space 3. j-tube in place bilateral leni's : no dvt above the knees abdominal flouroscopy : a metal stent is visualized projecting over the gej, extending from the t9 vertebral body to the l1 vertebral body. there is dense material in the t9 vertebral body likely secondary to prior vertebroplasty. there is a small left pleural effusion and retrocardiac opacity. chest radiograph is recommended for further work-up. ct chest : no pe, bilateral moderal pleural effusion l>r cxr (portable ap) : new esophageal stent. mild pulmonary edema, left lower lobe atelectasis. cxr (portable ap) : the esophageal stent, right-sided ij venous catheter and endotracheal tube are unchanged since stable in position. there is a tortuous thoracic aorta and some mild cardiomegaly. there is a unchanged left retrocardiac opacity and bilateral pleural effusions. there is mild fluid overload as evident by mild pulmonary interstitial marking prominence. egd : a large defect was seen at the esophagogastric anastamosis. the endoscope was passed into the stomach. a 10.5cm by 23mm wallflex fully covered metal stent was placed successfully across the defect. the position was verified endoscopically and fluoroscopically. an endoclip was successfully deployed to clip the proximal end of the stent to the esophageal wall to maintain stent position. ref 1673 lot (stent placement) post surgical gastric anatomy was noted. ekg : sinus tachy at 106, left axis, deep twi in v2-v3, twf in v4-v6, i, avl, ? q waves in iii, avf, no st elevations or depressions ekg : twi in v2-v6 echo : impression: moderate regional left ventricular systolic dysfunction consistent with coronary artery disease. severe diastolic dysfunction. moderate mitral regurgitation. gi bleeding study: brisk bleeding in the left upper quadrant with spread of activity consistent with the know retroperitoneal location. brief hospital course: ms. is a 74 year-old lady with recently diagnosed gastric adenocarcinoma, s/p gastric resection who was transfered from for esophageal stenting, admitted to after intubation for respiratory distress from pulmonary edema, with a hospital course complicated by pulseless vtach/vfib arrest while on the floor and massive splenic hemorrhage requiring splenic artery embolization. due to prolonged icu course, her problems are addressed chronologically in detail below: : ms. egd which showed a large defect at the esophagogastric anastamosis. a 10.5cm by 23mm wallflex fully covered metal stent was placed successfully across the defect. post-procedure, she remained strictly npo, with feeding through her j-tube. fluconazole and cefepime were continued. she was electively intubated for egd. she was extubated after the procedure but developed respiratory distress in the pacu, requiring reintubation which was felt to be secondary to pulmonary edema. she was diruesed with lasix, her sedation was weaned, and she was successfully extubated on . the patient transthoracic echocardiogram on to evaluate why she developed pulmonary edema. tte showed moderate regional left ventricular systolic dysfunction consistent with coronary artery disease. severe diastolic dysfunction and moderate mitral regurgitation. hypokinesis and akinesis seen on echocardiogram suggested recent mi. serial cardiac enzymes were checked and had been negative. she was transferred to the general medical floor, alert and conversant on in hemodynamically stable condition. : on on the general medical floor, a code blue was called as ms. was in vt/vf arrest. as per her floor rn, she was in the solarium and afterwards was moved back to her room. shortly thereafter, she became unresponsive in bed. a code blue was called. she initially had a pulse but quickly lost it. cpr was begun. her rhythm was noted to be vt/vf and a single shock was administered with return of pulse and blood pressure. no medications were administered. she was breathing spontaneuously but her respirations were felt to be feeble and she was intubated for airway protection following femoral line placement and administration of etomidate and succynylcholine. an abg at the time showed 7.50/42/128. sedation was given with midazolam and fentanyl. ekg showed sinus tachycardia with premature beats and stable twis in the anterior precodial leads. she was then brought to the icu. access was obtained, she became hypotensive and hematocrit steadily dropped from 33.5-> 24.1->19.8 so she was transfused 5 units prbcs, 1 unit ffp, 1 bag platelets repeat hct 33. ct abdomen revealed large hematoma of spleen. tagged rbc scan was done showing active bleed of the spleen. she was given multiple additional units of blood, 1 unit of platelets and taken to interventional radiology for splenic artery embolization. broad spectrum antibiotics were initiated and patient was pan-cultured as she started to spike fevers on and off during this time. she was aggressively diuresed initially, for goal tbb -1.0 to -1.5 l but lasix drip was stopped in the setting of hypotension and increasing creatinine. increasing creatinine was also thought to be secondary to contrast dye needed for ct. : sputum culture grew mrsa, but patient was already being treated with vancomycin. due to increasing leukocytosis and fevers, she was pan-cultured again. repeat ct abdomen and pelvis revealed a large left-sided pleural effusion with collapse of the left lower lobe, small right pleural effusion with associated atelectasis, stable splenic jp drain and infrasplenic fluid collection/hematoma, percutaneous j-tube without evidence of intestinal obstruction and no definitive abscesses. right upper extremity ultrasound was performed and was negative for dvt. due to no identifiable source of infection in the setting of leukocytosis and fever, interventional pulmonology was called to perform thoracentesis of pleural effusion to rule out empyema. 600cc of serosanguinous turbid fluid was drained but was negative for microorganisms and cytology revealed no malignant cells. her abdomen continued to be rigid and bilious fluid was emerging from her j-tube site. additonally, she started having bilious emesis. after speaking with dr. , her surgeon from , a possible source of infection could be splenic necrosis from inadequate blood supply as splenic artery was embolized and patient did not have adequate collateral supply due to alterations of her vasculature from gastric resection. surgical team, attending spoke with patient's family regarding goals of care and splenectomy was not an option given patient was a poor surgical candidate. multiple family meetings were held and ultimately the family decided that comfort-directed care was the best option for the patient. she was made comfort-measures only and extubated. she expired on at 8:10pm in the presence of her family. medications on admission: home medications: arimidex 1mg daily diovan 80mg daily asa 81mg daily prilosec 20mg da day carafate 1 gram per day calcium vit d toprol xl 50mg daily medications on transfer: albuterol ipratropium cefepime 1gram q12 fluconazole 200mg iv once a day heparin 5000 units tid hydromorphine 0.6mg -1,g q2-4hrs prn pain reglan 5mg iv q 6hrs lopressor 75mg zofran 5mg iv q 6hrs percocet 5mg protonix 40mg q12hrs insulin sliding scale diovan 80mg qhs via j-tube asa 81mg via j-tube discharge medications: expired discharge disposition: expired discharge diagnosis: cardiopulmonary arrest sepsis gastroesophageal anastamotic leak s/p gastrectomy gastric cancer discharge condition: expired discharge instructions: expired followup instructions: expired procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis arterial catheterization arteriography of other intra-abdominal arteries other endovascular procedures on other vessels cardiopulmonary resuscitation, not otherwise specified injection or infusion of oxazolidinone class of antibiotics insertion of permanent tube into esophagus diagnoses: hyperpotassemia coronary atherosclerosis of native coronary artery mitral valve disorders unspecified pleural effusion congestive heart failure, unspecified acute posthemorrhagic anemia acute kidney failure, unspecified unspecified septicemia severe sepsis hematoma complicating a procedure personal history of malignant neoplasm of breast accidental puncture or laceration during a procedure, not elsewhere classified paroxysmal ventricular tachycardia acute respiratory failure cardiac arrest personal history of malignant neoplasm of bladder ventricular fibrillation acute combined systolic and diastolic heart failure hyperosmolality and/or hypernatremia removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation personal history of malignant neoplasm of thyroid benign essential hypertension status of other artificial opening of gastrointestinal tract methicillin resistant pneumonia due to staphylococcus aureus malignant neoplasm of stomach, unspecified site injury to splenic artery 

Answer: The patient is high likely exposed to