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 / methotrexate / lisinopril attending: chief complaint: fevers, jaundice, confusion major surgical or invasive procedure: : ercp : liver biopsy : mid-line placement history of present illness: ms. is an 84-year-old female with a remote history of cholecystectomy and choledochoduodenostomy, presumably for her history of caroli's disease and oriental cholangiohepatitis with intrahepatic stones. during the past 10 years she has been having recurrent episodes of cholangitis. she has had multiple ercps at since with severe diffuse dilatation of the common hepatic, left and right hepatic ducts, with multiple stone extractions. the latest ercp was on on by dr. , when she had multiple stones removed. her last ct scan was done on demonstrating no change since the prior exam, with diffuse pneumobilia and high-density material within the biliary tree involving both lobes, consistent with her known cholangiohepatitis. there was chronic occlusion of the left portal vein. she has a 4-mm hypodense lesion in the uncinate process that is stable and most consistent with an ipmn. she was transferred from , with a 1 day history of fevers and altered mental status.at , they did a ct head (negative) and a ct abdomen showing same findings as prior studies, plus a new liver lesion read as a possible abscess. in the ed here, patient with t 104, hypotensive down to 60/30's requiring pressors, and minimally responsive. past medical history: mh: caroli's disease and oriental cholangiohepatitis, gout, diabetes mellitus, type ii (diet controlled), gerd, thrombocytopenia psh: cholecystectomy, choledochoduodenostomy social history: from south of , speaks cantonese, arrived to us on 93'. has no history of alcohol use, smoking, iv drug use, marijuana use, tattoos, or hepatitis. she has had blood transfusions in the past. she is widowed. she has three children and is currently retired. lives with her daughter and has extensive family support. family history: liver cancer in brother physical exam: admission physical exam: vitals: t 104 hr 74 bp 79/49 rr 18 so2 96%/ra gen: a&ox1, somnolient. wakes up to touch and loud voices. heent: positive scleral icterus, jaundice, mucus membranes dry. cv: rrr, no m/g/r pulm: clear to auscultation b/l, no w/r/r abd: soft, nondistended, moderately tender to palpation on ruq. no rebound or guarding, normoactive bowel sounds, no palpable masses. right paramedial scar. ext: mild le edema, le warm and well perfused. pertinent results: 10:26am blood ca -9 -test blood cultures: blood culture, routine (final ): escherichia coli. final sensitivities. cefazolin interpretative criteria are based on a dosage regimen of 2g every 8h. piperacillin/tazobactam sensitivity testing performed by . sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | ampicillin------------ 8 s ampicillin/sulbactam-- 4 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin--------- =>4 r gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin/tazo----- s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s ercp post surgical anatomy with choledochoduodenostomy a single periampullary diverticulum with large opening was found at the major papilla a pediatric gastroscope was introduced into the bile duct and cholangioscopy was performed a large stone measuring 3-4 cm was occupying the main bile ductmultiple stones ranging in size from 4mm to 6mm were noted at the right hepatic duct, left hepatic duct, and intrahepatic biliary radicles a cholangiogram was performed through the choledochoduodenal anastomosis a moderate dilatation was noted at the proximal common bile duct, left hepatic duct, and left intrahepatic biliary ducts lithotripsy with lithotriptor was performed. the stone was broken into multiple smaller fragments that were subsequently removed. multiple stone fragments were extracted successfully using a balloon catheter, spiral basket and rat tooth forceps. brief hospital course: ms. was admitted from with fevers, hypotension, and a new liver lesion on abdominal ct. she was admitted to the hepatobiliary service and, given her severe hypotension and pressor requirement in the emergency department, taken to the sicu for aggressive support, including pressors and intubation. she was off pressors and extubated hd 2 after transferred to the floor on hd 5. she underwent liver biopsy on , and at time of discharge pathology is pending. neuro: mental status was initially altered at admission, pt was confused and non-responsive. after extubation mental status improved and she was alert, oriented, and responsive. she remained interactive and appropriate for the rest of her hospital stay. cv: at admission pt had a pressor requirement, however, after fluid resuscitation and extubation all pressors were weaned. she remained cardiovascularly stable for the remainder of her hospital stay. pulm: pt was intubated on hd1 for altered mental status; she underwent ercp and was able to extubate later that evening. she was weaned off oxygen and at discharge is stable on room air with no acute pulmonary issues. gi: ercp was consulted at time of admission, and on she was taken for ercp. multiple stones were visualized including a large 3-4mm stone obstructing the main duct. lithotripsy was performed and multiple stone fragments extracted. after extubation from this procedure, sepsis picture was resolving and her diet was slowly readvanced to a regular diabetic diet which she tolerated with no issues. bilirubin was elevated during this admission but have been trending downward for the last several days of her stay; at time of discharge her bilirubin is 1.9. gu: aggressive fluid resuscitation was started and uop closely monitored during her icu stay. foley was kept into place; she recieved intermittent lasix doses for diuresis. after transfer to the floor foley was removed and she voided without issues. heme: after liver biopsy on , hct dropped from 28-> 25.5; she recieved 1u prbc and responded appropriately. she is hemodynamically stable at time of discharge. aspirin will be restarted as an outpatient and with continued stability post-procedure. id: at admission, pt had blood cultures positive for e. coli x2 here at . additionally, on transfer the transfer report indicated positive cultures growing klebsiella at the outside hospital. she was originally started on vanc/ and then narrowed to meropenem. a midline was placed prior to discharge to continue iv antibiotics after discharge, per recommendations from transplant pharmacist she will finish out 7 more days of ertapenem after discharge. she has been afebrile since coming to the floor. prophylaxis: she was kept on sqh and compression stockings for dvt prophylaxis. pt visited with the patient and identified no acute issues. early pulmonary toilet was encouraged. at time of discharge, she is afebrile and hemodynamically normal. she is tolerating a regular diet with no nausea or vomiting, and no abdominal pain. she is ambulating unaided and at her baseline. she will continue ertapenem for positive blood cultures for one week. pathology is pending, and will be discussed with ms. and her family at her follow up appointment, as well as restarting certain home medications in clinic with dr. . medications on admission: fosamax 70 once a week, amlodipine 5', ciprofloxacin 250", cromolyn, fluticasone, lasix 40', gabapentin 300''', hctz 25', losartan 100', meloxicam 15', lopressor er 100', kcl 20', ursodiol 300", zolpidem 10' qhs prn, asa 81', ca+vitd3, mvt, omeprazole 20" discharge medications: 1. ertapenem 1 gram recon soln sig: one (1) gram injection once a day for total of 6 weeks 2. ursodiol 300 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. fosamax 70 mg tablet sig: one (1) tablet po once a week. 4. amlodipine 5 mg tablet sig: one (1) tablet po once a day. 5. cipro 250 mg tablet sig: one (1) tablet po twice a day: hold while getting iv antibiotics. 6. cromolyn 100 mg/5 ml solution sig: home dose po once a day. 7. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal daily (daily). 8. gabapentin 300 mg capsule sig: one (1) capsule po three times a day. discharge disposition: home with service facility: vna discharge diagnosis: cholangitis sepsis e coli bacteremia discharge condition: mental status: clear and coherent. (non-english speaking) level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: please call dr office at for fever, chills, nausea, vomiting, dairrhea, increased abdominal pain, increased yellowing of skin or eyes, inability to tolerate food, fluids or medications, problems with the mid-line, intolerance of medication. no heavy lifting followup instructions: provider: , md, phd: date/time: 1:00, , , , ma . provider: , md phone: date/time: 9:40 md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube closed (percutaneous) [needle] biopsy of liver endoscopic removal of stone(s) from biliary tract other cholangiogram central venous catheter placement with guidance diagnoses: thrombocytopenia, unspecified esophageal reflux diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled severe sepsis gout, unspecified septic shock septicemia due to escherichia coli [e. coli] cholangitis calculus of bile duct without mention of cholecystitis, with obstruction other anomalies of gallbladder, bile ducts, and liver clonorchiasis 

Answer: The patient is high likely exposed to