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 attending: chief complaint: 69 year old female admitted from outside hospital with right upper quandrant abdominal pain. status post ercp and sphicterotomy where a stone was removed. febrile and elevated white count now. major surgical or invasive procedure: status post placement of two retroperitoneal drains on and . history of present illness: hpi: 69f h/o chronic steroid use (initially prenisone 60mg daily, now tapered to 2.5mg daily.for uveitis and retinitis who initially presented to center on with severe back pain radiating to the ruq and epigastric region that started at 11am the same day of presentation. she reported vomiting and nausea associated with the pain. she was thought to have acute calculus cholecystitis after us (gallstones and thickened gallbladder wall with dilated cbd) and underwent ercp on which was reported as a successful sphincterotomy and removal of diminutive stone material. her initial admission wbc was 9.6 on admission and on transfer was 18.8. she continued to have persisitent fevers post-procedure and a ct scan done on demonstarted a large retroperitoneal fluid collection. on , she underwent ir drainage with placement of a drain in her retroperitoneal fluid collection with drainage of dark brown fluid, which later cultures . fluid analysis had 2253, prot 2.6, glucose 4, ldh 5945. her initial lfts had ast 661, alt 521, ap 390, albumin 3.8. last lfts ap 362, ast 22, alt 25, t.bili 0.4, 104, lip 467. it was decided that the patient continued fevers, rising wbc, and presistent fluid collection, the patient was transferred to . past medical history: hypertension uveitis retinitis social history: positive for tobacco in past. occasional alcohol use married lives with husband in family history: nc physical exam: t: 99.0 (102.2) p: 90-112 r: 18 95% ra bp: 140-150/60-70 wt: 67.1kg fs 130-170 general: nausea, spitting into bucket. heent: ?oral thrush with adherent white coating on the anterior tongue. neck: {x}wnl cardiovascular: {x}wnl respiratory: {x}wnl back: 2 rp drain sites clean and dry. gastrointestinal: hypoactive bowel sounds. tender to palpation in the ruq. genitourinary: {x}wnl musculoskeletal: {x}wnl skin: {x}wnl neurological: left eye visual field deficits as at baseline. psychiatric: {x}wnl heme/lymph: {x}wnl other: right subclavian site clean and dry, nontender, no erythema. pertinent results: 10:10am blood wbc-21.1*# rbc-3.77*# hgb-10.8*# hct-33.4*# mcv-89 mch-28.6 mchc-32.3 rdw-15.5 plt ct-732* 09:15am blood wbc-13.5* rbc-3.11* hgb-9.0* hct-26.5* mcv-85 mch-28.8 mchc-33.7 rdw-15.2 plt ct-485* 05:25am blood wbc-12.7* rbc-3.09* hgb-9.0* hct-26.9* mcv-87 mch-29.2 mchc-33.6 rdw-15.2 plt ct-570* 12:04am blood wbc-20.7* rbc-3.37* hgb-10.0* hct-30.0* mcv-89 mch-29.6 mchc-33.2 rdw-15.2 plt ct-584* 03:41am blood neuts-86.9* lymphs-6.8* monos-5.1 eos-1.1 baso-0.1 03:41am blood plt ct-469* 12:04am blood pt-13.8* ptt-29.6 inr(pt)-1.2* 03:41am blood glucose-127* urean-17 creat-0.6 na-134 k-4.9 cl-105 hco3-19* angap-15 05:00am blood glucose-122* urean-15 creat-0.6 na-130* k-4.0 cl-100 hco3-21* angap-13 12:04am blood glucose-120* urean-15 creat-0.6 na-130* k-4.3 cl-96 hco3-23 angap-15 03:41am blood alt-12 ast-24 ld(ldh)-219 alkphos-439* amylase-206* totbili-0.3 12:04am blood alt-30 ast-28 alkphos-352* amylase-140* totbili-0.5 03:41am blood albumin-2.2* calcium-8.4 phos-4.0 mg-1.6 12:04am blood albumin-2.9* calcium-8.0* phos-3.6 mg-2.2 iron-16* 10:48am blood osmolal-278 05:00am blood tsh-7.7* 03:15pm blood t4-7.3 t3-77* calctbg-0.99 tuptake-1.01 t4index-7.4 12:45pm blood cortsol-34.6* 04:09am blood type-art po2-91 pco2-30* ph-7.46* caltco2-22 base xs-0 brief hospital course: this is a 69 year old female admitted from center in nh. the patient originally presented on to center with severe back pain radiating to the right upper quadrant and epigastric area. she had associated nausea and vomiting. ultrasound revealed gallstones and a thickened gallbladder wall with a dilated common bile duct thought consistent with acute calculus cholecystitis. she was started on cipro and flagyl on , continued until . on the patient underwent ercp with reported successful sphinterotomy and removal of diminutive stone material. patient's course was then complicated by an increasing white count and fever. abdominal ct revealed a large retroperitoneal fluid collection. placement of two retroperitoneal drains on and were done. - patient continued to be febrile with nausea and vomiting. nasogastric tube inserted and left in for decompression. patient pancultured several times. infectious disease (id) consulted. intravenous antibiotics continued per id's recommendations. patient experienced loose stool, cultures sent for c. difficile. patient became hyponatremic; thyroid studies done showing a high thyroid stimulating hormone. endocrine consulted. ct of abdomen repeated showing a decrease in the fluid collection. nasogastric tube discontinued on . specimen obtained from drains and grew , mrsa and coag - staph. patient was able to get out of bed and ambulate. admitted to sicu: on patient became tachycardic with oxygen desaturation to the 80's. readmitted to sicu for respiratory distress and intubated, then underwent ct torso. this was negative for pulmonary embolism. chest xray did reveal enlarging effusions and bilateral atelectasis with scattered opacities. drain of retroperitoneal fluid collection replaced. patient extubated and then reintubated for desaturations and pulmonary edema. patient diuresised, cxr: interval improvement of b/l pulmonary edema on patient had an abdominal ct - impression: improved appearance of retroperitoneal fluid collections with appropriately placed catheters. no new developing abscess. decreased but persistent pleural effusions and atelectasis. patient was extubated. patient reintubated with cxr revealing pulmonary edema and bilateral pleural effusions. patient went back to the operating room for: 1. incision and debridement of retroperitoneal abscess. 2. tracheostomy tube placement. - patient was weaned from ventilator to cpap. dobhoff tube placed for tube feedings. ct of abd/pelvis on - continued small fluid collection interdigitating within the right retroperitoneum with appropriately placed surgical and pigtail drainage catheters as described. the collections are not significantly changed, although they are slightly decreased in size when compared to prior study. no new collections. enlarging pleural effusions and new biapical airspace disease, likely developing pneumonia/aspiration. l lung effusion drained for 900cc. labetatol drip weaned to off. discontinued aztreonam and flagyl wbc 10.1, all cultures negative. lasix drip being weaned. tube feeds at goal and tolerating well off ventilator, on trach collar mist with good oxygention. - respiratory - trach changed to pmv, good saturations with trach mist. lasix changed to standing dose antibiotics changed to vancomycin and capsofungin patient went to ct, had retroperitoneal catheter replaced with 12 french catheter with resulting drainage of 5cc of purulent fluid. catheter left in place. - cxr done - findings: feeding tube is again seen with tip off the film, past the second portion of the duodenum. tracheostomy tube is unchanged. catheter in the right mid abdomen is unchanged. the alveolar and interstitial infiltrates are not significantly changed. there is a small left effusion that is slightly larger than on the film from three days ago. there continues to be retrocardiac opacity consistent with volume loss/infiltrate/effusion. - patient transferred to floor. - discharge planning begun for rehab. physical therapy consult for chest pt and strengthening psych. consult - assessment and support consult to speech and swallow for evaluation and treatment. l wrist ulcer from old iv site - healing, adaptik with dry sterile dressing daily. family meeting with spouse, daughter, son, and dr. . plan discussed regarding further treatment and course. swallow study done. started thin liquids. out of bed to chair. continued physical therapy. will get abd. ct on and possible discharge to rehab. in one week. /08 out of bed daily with physical therapy. patient c/o nausea, kub + stool throughout colon. ct of abd. - impression: 1. persistent 4.2 x 2.5-cm rim-enhancing fluid collection in the retroperitoneum superior to the right kidney with pigtail catheter that has been partially retracted. although the pigtail catheter lies at the superior portion of this lesion, re-manipulation may be helpful if the catheter is not draining. please correlate clinically. 2. improving bilateral pleural effusions and atelectasis. small pericardial effusion. 3. pneumobilia and air within the gallbladder. please correlate with any recent manipulation. - pigtail drain discontinued. - patient continued to improve with complaints of intermittent nausea. bowel regimen began and medication administration spaced out. tube feedings weaned to just at night and then discontinued. patient placed on soft diet with calorie counts and supplements. patient also complained of trouble sleeping, psychiatry suggested remeron at night for sleep. she is now at 15mg and is sleeping better. on penrose drains removed. beta blockers weaned from 150mg tid to 50mg tid. current issues: 1. surgical follow up - will return for abdominal ct and appointment with dr. in weeks. 2. nausea/nutrition - will continue to encourage oral intake at rehab. with the addition of high calorie supplements in between meals. 3. insomnia - continue remeron 15mg q hs. 4. mobility - will continue physical therapy at a more intense level at . 5. antibiotics - as infectious disease recommended, we will continue vancomycin and capsofungin until 2 weeks post discontinuation of penrose drains. () medications on admission: omeprazole 20 qd prednisone eye drop cosopt eye drops (both in left eye) nystatin discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection (2 times a day). 2. dorzolamide-timolol 2-0.5 % drops sig: one (1) drop ophthalmic (2 times a day). 3. prednisolone acetate 1 % drops, suspension sig: one (1) drop ophthalmic daily (daily). 4. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 5. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 6. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 7. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. heparin lock flush (porcine) 100 unit/ml syringe sig: one (1) ml intravenous daily (daily) as needed. 10. caspofungin 70 mg recon soln sig: fifty (50) recon soln intravenous q24h (every 24 hours): discontinue on . 11. famotidine(pf) in (iso-os) 20 mg/50 ml piggyback sig: twenty (20) mg intravenous q24h (every 24 hours). 12. vancomycin in dextrose 1 gram/200 ml piggyback sig: one (1) gram intravenous q 24h (every 24 hours). discharge disposition: extended care facility: & rehab center - discharge diagnosis: s/p biliary perforation from ercp s/p placement of two retroperitoneal drains retroperitoneal abscess complicated by respiratory failure. discharge condition: stable discharge instructions: please call your doctor or return to the emergency room if you have any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in 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 have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered. * continue to ambulate several times per day. followup instructions: your follow up appointment with dr. is 1 pm friday febuary 1st, building. you are to have an abdominal ct on the building, . you are to arrive at 9:45m, your ct is scheduled for 10:45. you must have nothing to eat 3 hours prior to ct. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous abdominal drainage incision of abdominal wall temporary tracheostomy excision or destruction of lesion or tissue of abdominal wall or umbilicus diagnoses: other postoperative infection unspecified pleural effusion urinary tract infection, site not specified infection with microorganisms resistant to penicillins accidental puncture or laceration during a procedure, not elsewhere classified acute respiratory failure methicillin susceptible pneumonia due to staphylococcus aureus pulmonary congestion and hypostasis acute pancreatitis other retroperitoneal abscess accidental cut, puncture, perforation or hemorrhage during surgical operation 

Answer: The patient is high likely exposed to