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: amiodarone / quinidine/quinine & derivatives attending: chief complaint: septic shock major surgical or invasive procedure: percutaneously cholecystostomy tube placement and removal midline iv placement history of present illness: 79m pmh chf ef 20%, cad, copd, dementia transferred from nh with hypoxia 60% - patient initially placed on nrb but titrated down and 100% on 2l evaluation by emt. the patient had complained of epigastric/right-sided abdominal pain x 24 hours per nh records. the patient complained of left sided cp x 5 minutes to emt, resolving without intervention. . in the ed, initial vs: t: 97.0 bp: 98/46 hr: 58 rr: 36 o2sat: 98%ra. temperature rose to 102.2 (rectal) and sbp drifted down to 70s. patient was given ns x 3l, started on peripheral dopamine (13cc/hr - 5ucg/kg). wbc 14.9 with 97% neutrophils, lactate 4.1, inr 7.8. patient was given vitamin k 10 mg iv and ffp x 2 units. ct torso showed findings consistent with acute cholecystitis, small left-sided pleural effusion. patient given ceftriaxone/azithromycin/ vancomycin/flagyl. ekg v-paced but new twi v2-v6. cardiology was consulted and felt the ekg was concerning. patient was given asa, and as coumadin was supratherapeutic, no heparin was given. ua negative and guaiac negative at that time. . on arrival to the micu, patient any pain. ros limited by dementia. past medical history: 1. chronic systolic and diastolic heart failure (ef 25% in ) 2. coronary artery disease 3. chronic obstructive pulmonary disease 4. paroxysmal atrial fibrillation on coumadin 5. tachy brady syndrome s/p 6. arthritis 7. tibial fracture status post replacement 8. right carotid artery stenosis 9. transient ischemic attack with left-sided weakness 10. chronic renal insufficiency with last baseline creatinine in our system 1.6 11. dementia 12. chronic stasis dermatitis 13. h/o alcohol abuse 14. pvd social history: lives at nusing facility. used to smoke 2 ppd since age 12 and quit few years ago. history of etoh abuse. family history: nc physical exam: vs: t: 97.5 (ax) bp: 90/44 (peripheral dopamine 5ucg/kg) p: 67 rr: 29 o2sat: 100%ra gen: nad heent: at, nc, perrla, eomi, no conjuctival injection, anicteric, op clear, mm dry neck: supple, no lad, no carotid bruits cv: distant heart sounds, rrr, nl s1, s2, no m/r/g pulm: crackles l > r abd: soft, nt, nd, + bs, no hsm, no rg rectal: guaiac negative in ed ext: warm, dry, +2 distal pulses bl, venous stasis changes r shin neuro: alert & oriented x 2, cn ii-xii grossly intact, moving all extremities well pertinent results: admission labs: |103|44 -----------<112 5.1|23|2.3 comments: k: hemolysis falsely elevates k estgfr: 28/33 (click for details) ck: 84 mb: 4 trop-t: 0.17 ca: 8.2 mg: 1.7 p: 2.9 alt: 13 ap: 97 tbili: 0.4 alb: 3.4 lip: 18 11.0 14.9>--<369 33.5 n:96.8 band:0 l:1.6 m:1.0 e:0.5 bas:0.2 pt: 57.8 ptt: 74.5 inr: 6.8 lactate:1.6 ekg: v-paced at 64, new twi v2-v6 compared to previous ct torso : 1. acute cholecystitis with impacted 3-mm gallbladder neck stone and dependent stones. 2. calcified outpouching at the aortic isthmus without evidence of mediastinal hemorrhage or intramural hematoma, unchanged since prior study. 3. left pleural effusion, smaller than . 4. centrilobular patchy opacities in the basilar lll and inferior segment of lingula with tracheobronchial debris, raising the possibility of aspiration. . ct head w/o contrast reason: r/o bleed medical condition: 79 year old man with dementai and twi on ekg concerning for bleed reason for this examination: r/o bleed contraindications for iv contrast: none. indication: 79-year-old man with dementia and t-wave inversion on ekg concerning for bleed. comparison: and . technique: non-contrast head ct. findings: no acute intracranial hemorrhage, mass effect or shift of normally midline structures is noted. there are no acute major vascular territorial infarcts. moderately severe prominence of sulci and the ventricles compatible with age-associated involutionary changes is evident. osseous structures are unremarkable. no acute fractures are noted. visualized soft tissue structures are within normal limits. impression: no intracranial hemorrhage or edema. . 11:30 pm fluid,other cholecystostomy. gram stain (final ): reported by phone to @ 0454 on . 4+ (>10 per 1000x field): polymorphonuclear leukocytes. 2+ (1-5 per 1000x field): gram negative rod(s). fluid culture (final ): escherichia coli. heavy growth. sensitivities: mic expressed in mcg/ml ______________________________________________________ escherichia coli | ampicillin------------ =>32 r ampicillin/sulbactam-- 16 i cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 4 s ciprofloxacin--------- =>4 r gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin---------- =>128 r piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- =>16 r . 11:50 am blood culture **final report ** blood culture, routine (final ): escherichia coli. final sensitivities. sensitivities: mic expressed in mcg/ml ________________________________________________________ escherichia coli | ampicillin------------ =>32 r ampicillin/sulbactam-- 16 i cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 4 s ciprofloxacin--------- =>4 r gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- =>16 r aerobic bottle gram stain (final ): reported by phone to macaully grissith @ 0635 on . gram negative rod(s). anaerobic bottle gram stain (final ): gram negative rod(s). . discharge labs: 06:15am blood wbc-10.8 rbc-3.41* hgb-9.9* hct-30.9* mcv-91 mch-29.1 mchc-32.1 rdw-13.4 plt ct-308 06:30am blood wbc-13.6* rbc-3.82* hgb-11.3* hct-35.0* mcv-92 mch-29.4 mchc-32.2 rdw-13.8 plt ct-393 06:30am blood neuts-74.2* lymphs-13.5* monos-5.2 eos-6.7* baso-0.5 07:15am blood fdp-10-40 07:15am blood fibrino-658*# 07:15am blood ret aut-1.7 06:30am blood glucose-92 urean-41* creat-1.9* na-147* k-5.1 cl-110* hco3-30 angap-12 06:15am blood lipase-32 11:38am blood ctropnt-0.17* 04:18am blood ck-mb-4 ctropnt-0.07* 06:30am blood calcium-8.4 phos-3.6 mg-1.8 06:15am blood albumin-3.0* calcium-7.8* phos-2.6* mg-2.0 07:15am blood caltibc-208* vitb12-724 folate-9.1 hapto-273* ferritn-149 trf-160* 07:15am blood cortsol-16.5 06:22pm blood lactate-1.6 . brief hospital course: # septic shock/cholecystitis: resolving. on admission, met criteria for septic shock given temperature >38.5??????c and wbc count of >12,000 cells/ml; lactate >2 mmol/l; systemic mean bp of <60 mm hg and need for dopamine. source was most likely biliary given ct findings and gram negative rod bacteremia. patient was seen by surgery who felt he was not a surgical candidate. the patient initially required brief peripheral dopamine, but became hemodynamically stable within 12 hours and it was discontinued. he was intially treated with broad spectrum antibiotics which were changed to ceftriaxone as both gallbladder drainage and blood cultures grew ceftriaxone-sensitive e. coli. a percutaneous cholecystostomy tube was placed under ultrasound guidance on which has continued to drain serosanguinous/bilious fluid since placement. it was then pulled out of place during repositioning of patient. after speaking with radiology and surgical consulting teams, as the patient was clinically well, with improving liver tests, and given the morbidity of replacing the tube and reversing his inr, the decision was made to defer replacement of the tube. in addition, ercp was consulted who felt that he was not a candidate at this time for ercp given lack of obstructive symptoms. he will be treated with a total 2 week course of ceftriaxone (day 1=). he has a midline in place which should be removed once antibiotic course is completed. liver function tests trended down throughout his hospital course. the patient was hemodynamically stable for the remainder of his hospitalization. . # anemia: baseline appears to be around 30 based on omr from the last several years, though per , his most recent hct's have been around 37. on admission, was 33.5, dropped to 25 and has been stable and improving since transfer to the medicine floor. no evidence of bleeding, guaiac has been negative. fibrinogen, fdp, ldh, haptoglobin, reticulocyte count without evidence of hemolysis. tbili within normal limits. iron studies showed iron deficiency and possibly anemia of inflammation, though ferritin not elevated, b12 and folate wnl. patient did not require any blood transfusions during admission. . # chronic obstructive pulmonary disease: good oxygen saturations on room air and minimal evidence of copd on ct chest. he was continued on outpatient montelukast with albuterol and atrovent nebulizers as well as advair inhaler. patient did not require bipap or intubation. he was transitioned back to mdi inhalers on discharge. . # eosinophilia: absolute count around 1000 and stable. likely due to ceftriaxone as no other new medications. patient did not have any signs or symptoms of allergic reaction. urine eosinophils were negative. it was monitored and patient was continued on his current medications. this should be evaluated within the next few days to ensure no significant increase in peripheral eosinophils. . # chronic systolic heart failure: ef 25% on most recent pmibi in . was initially hypovolemic due to sepsis and received several liters of fluid. beta blocker was restarted once blood pressure stabilized, and acei at low dose was started for afterload reduction. patient was stable on this regimen. . # acute on chronic renal failure: creatinine 2.3 on admission, improved after volume resuscitation. likely partially prerenal given na 10 on admission, though only mild improvement after fluids. creatinine 1.7 at nh in . creatinine improved to baseline of 1.7 during admission after resuscitation and resuming po intake. . # atrial fibrillation: status post ppm for tachy/brady syndrome. on coumadin as outpatient. initially with supratherapeutic inr which was reversed for ccy tube placement. now therapeutic on home regimen of 3mg 5 days per week. rate-controlled with v-paced rhythm. continuing beta blocker. . # erosive gastritis: by report from nh, patient maintained on ppi during admission. . # fen: ground diet, thin liquids, aspiration precautions. . # ppx: coumadin, bowel regimen. patient was on sc heparin until inr therapeutic. . # code: dnr but can intubate for reversible causes . # communication: next of = nephew , medications on admission: albuterol-ipratropium 2 puff ih q4h:prn sob, wheeze montelukast sodium 10 mg po daily namenda *nf* 10 mg oral aspirin 81 mg po daily pantoprazole 40 mg po q24h zocor 20 mg po daily lopressor 25 mg po daily actonel 35 mg po weekly magnesium oxide 400 mg po daily calcium and vitamin d supplementation discharge medications: 1. toprol xl 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. memantine 5 mg tablet sig: two (2) tablet po bid (2 times a day). 5. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 6. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 10. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 11. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 12. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po qhs (once a day (at bedtime)) as needed for insomnia. 13. ceftriaxone-dextrose (iso-osm) 1 gram/50 ml piggyback sig: one (1) gm intravenous q24h (every 24 hours) for 6 days. 14. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) inh inhalation (2 times a day). 15. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: two (2) inh inhalation every four (4) hours as needed for shortness of breath or wheezing. 16. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 17. warfarin 3 mg tablet sig: one (1) tablet po 5x/week (,mo,we,th,fr): please adjust dosing based on inr. 18. heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous prn (as needed) as needed for line flush. discharge disposition: extended care facility: facility - discharge diagnosis: acute cholecystitis e. coli bactermia - septic shock acute on chronic renal failure erosive gastritis nonthrombotic troponin elevation acute exacerbation of copd paroxysmal atrial fibrillation sss s/p pm chronic systolic heart failure non-ischemic cardiomyopathy dementia poor functional status hypernatremia supratherapeutic inr anemia nos discharge condition: hemodynamically stable discharge instructions: you were found to have cholecystitis and bacteria in your blood. you had a tube placed to drain your gallbladder which was in for 6 days. you will be treated with a total of 14 days of iv antibiotics for your infection. it is very important that you continue to follow with your primary care physician. if you develop chills, fevers, abdominal pain, weight loss, severe diarrhea, shortness of breath, chest pain or other concerning symptoms, please go to the emergency room or call your physician as soon as possible. followup instructions: please follow with your physician within the next week. you can call to set up this appointment. you should also follow with the physician at . in addition you should keep the following appointment. provider: clinic phone: date/time: 11:00 procedure: venous catheterization, not elsewhere classified other percutaneous procedures on biliary tract diagnoses: other primary cardiomyopathies abnormal coagulation profile anemia, unspecified coronary atherosclerosis of native coronary artery unspecified pleural effusion congestive heart failure, unspecified acute kidney failure, unspecified severe sepsis atrial fibrillation other persistent mental disorders due to conditions classified elsewhere chronic kidney disease, unspecified occlusion and stenosis of carotid artery without mention of cerebral infarction osteoporosis, unspecified septic shock pressure ulcer, other site long-term (current) use of anticoagulants pressure ulcer, lower back cardiac pacemaker in situ accidents occurring in residential institution septicemia due to escherichia coli [e. coli] other and unspecified alcohol dependence, continuous venous (peripheral) insufficiency, unspecified cephalosporin group causing adverse effects in therapeutic use calculus of gallbladder with acute cholecystitis, with obstruction eosinophilia obstructive chronic bronchitis with acute bronchitis chronic combined systolic and diastolic heart failure 

Answer: The patient is high likely exposed to