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: sulfonamides / biaxin / vancomycin / haldol / heparin agents / flagyl attending: chief complaint: fever, leg edema, and fatigue major surgical or invasive procedure: biopsy egd : gi bleed drain removal history of present illness: 47 y.o. female s/p lrrt from sister with complicated postop course including rejection, perinephric collection/hematoma, ttp/hus,htn with 2 drains placed in abd p/w fever x 1 day. also, c/o productive cough with yellow phlegm. complained of decreased po intake and fatigue. denied diarrhea, nausea, vomiting, abd pain, cp/sob. of note vre grew out from jp fluid on . past medical history: living related renal transplant from sister , lupus, htn, osteopenia, drug induced dm, avascular necrosis of hips social history: lives alone family history: nc physical exam: 101.4 115 165/84 18 100% ra nad aniceric sclerae supple cta rrr, tachy no cvat, lower abd drain-bloody fluid, soft, nt, nd\ ext no cce l arm avf-+bruit/thrill wbc 4.4, hct 18.7, plt 28, creat 2.3, lactate 1.4, inr 1.0 pertinent results: 06:20pm fibrinoge-440* 06:20pm pt-11.8 ptt-28.9 inr(pt)-1.0 06:20pm plt smr-low plt count-51* 06:20pm wbc-4.4 rbc-2.12*# hgb-6.6*# hct-18.7*# mcv-88 mch-30.8 mchc-35.0 rdw-15.4 06:20pm calcium-8.6 phosphate-2.8 magnesium-2.0 06:20pm glucose-126* urea n-55* creat-2.3* sodium-143 potassium-3.8 chloride-112* total co2-18* anion gap-17 06:30pm lactate-1.4 brief hospital course: on admission, an abd ct was unchanged in appearance of the heterogeneous hematoma surrounding the superiorly located pigtail catheter with perinephric fluid and free fluid in deep pelvis. the fluid collection surrounding the inferiorly located catheter was unchanged. there was no intraperitoneal hemorrhage or other finding to account for the profound anemia. a transplant u/s revealed a perinephric fluid collection as seen on prior ct scan. mild hydronephrosis of the transplanted kidney, increased since . vascularity to the transplanted kidney had appropriate waveforms. a cxr revealed cardiomegaly, increased edema and l effusion. a cline was inserted and she received 2 prbcs. gi was consulted for concern for gi bleed. ppi was increased. egd was performed after ddavp and plt transfusion. red and clotted blood was seen in the stomach. an erosion or ulcer was found in the stomach antrum partially obscured by edematous folds. epi and electrocautery were successful in obtaining hemostasis. iv vanco and zosyn were started. blood cultures from were negative. the jp fluid had 4+ pmn with staphylococcus, coagulase negative. moderate growth. probable enterococcus. moderate growth. anaerobic culture (final ): no anaerobes isolated. fungal culture (final ): albicans. sparse growth. id was consulted and recommendations included starting flu for thrush, dap to for re, po vanco for c.diff and discontinuation of iv vanco. these recs were followed. stool was negative for c.diff and other pathogens. she continued to have melena. creat was elevated from baseline of 1.7 up to 2.3. nephrology was consulted. elevated creatinine was felt to be due to atn and decreased intravascular volume. she received iv lasix for volume overload which exacerbated her respiratory status. a bx was deferred until . this showed mild interstitial fibrosis and tubular atrophy. mild chronic inflammation accompanied the scarring. no endothelialitis was noted. c4d stain was negative. diagnostic category: thrombotic microangiopathy. urine output continued to be ~ 700cc/day. creatinine increased and hemodialysis was initiated during the week of . urology had been consulted for cytoscopy with stent placement for hydronephrosis of l kidney. a mr urogram was recommended to trace transplant ureter to r/o obstruction and help with stent placement. this showed diffusely narrow appearance of the distal 4 cm of the ureter, without focal stricture. no hydronephrosis. patent arterial supply and venous drainage of the renal transplant cardiology was consulted for sob and pulmonary edema. an echo demonstrated mild symmetric lvh with normal cavity size and systolic function (lvef>55%), + mr and a small pericardial effusion. recs included more aggressive diuresis and decreasing bb dose. on , she became very dyspneic requiring nrb o2 transfer to sicu. she was intubate and diuresed . a repeat echo was done without change. a chest ct was done to eval infiltrates. diffuse ground glass opacities with septal thickening and bibasilar consolidation were noted. these findings were most consistent with atypical viral or mycoplasma infection given the widespread distribution, but a component of hydrostatic pulmonary edema was also likely, and interstitial pneumonitis related to lupus, as well as pulmonary hemorrhage was suggested. moderate bilateral pleural effusions were noted. iv caspo was started on for expanded coverage for fever. id recs included bronch. dapto was changed to vanco and levo was added. a bronchoscopy with lavage was done on . cultures were negative.dapto was stopped and ampicillin was started. she continued to require plt and prbc transfusions for plt counts in 41-51. hematology was consulted. a peripheral smear showed mild-moderate schistos. ttp was not felt to be the cause of low plt. dic was also not felt to be a diagnosis as fibrinogen and coags were ok. an antiplt antibody was done to r/o itp.this result was found to be positive as of . it was felt that she had itp, thrombotic microangiopathy and aiha. recommendations included increasing steroids, but this was not done due to h/o avn of hips and gastric ulcer. she continued to receive prbc and plt for hcts in 25 range and plts in 30 range. a repeat hit was negative. epogen was started for anemia. respiratory status improved with diuresis and empiric antibiotics. she was extubated on . on hct decreased to 19.7 and plt 51 for which she was transfused. she c/o distention and abd pain. a repeat abd ct showed slight decrease in size of previously noted hyperdense peri-transplant fluid collection consistent with hematoma with larger decrease in size of more inferior medially located simple fluid collection when compared to . bilateral increase in previously noted pleural effusions with new patchy airspace consolidation most marked in the left lower lobe, consistent with underlying pneumonia. stable appearance to mild fullness of the transplant kidney collecting system with no frank hydronephrosis identified. myfortic and were stopped given septic appearance and marrow suppression. prednisone continued. there was concern for infiltrates secondary to rapamune. on , flagyl was added for fever and persistent diarrhea which was c.diff neg. she experienced hemolysis and had a +dat. there was concern that rapamune could cause tms. this was stopped on . pheresis with ivig was started for thrombocytopenia and hemolysis. pheresis was done x 6 sessions without much improvement of plt. ldh decreased somewhat. there was no evidence of ttp. hus was considered given bx. on , a rpt egd was done for decreased hct. an ulcer in the pre-pyloric region was noted. there were multiple oozing areas in the antrum of the stomach and a site of active oozing of blood in the duodenal bulb.cautery was performed. ddavp was given. she required intermittent plt/prbc transfusions. she continued to intermittent fevers while on antbx. respiratory status slowly improved. on urine was + for >100,000 yeast. she continued on iv caspo. on a rectal swab for screening was vre +. she remained on dapto/caspo for drain cultures. on she had a urine positive for bk virus with 20,000 copies. recs included decreasing immunosuppression. sidofovir was deferred due to the nephrotoxicity. persistent fevers were felt to be due to known abd hematoma/fluid collections. on cefepime iv was added for empiric coverage and concern for hosp acquired pna. a lll retro cardiac infiltrate was noted. she experienced persistent diarrhea. flagyl continued for empiric treatment despite neg c.diff cx. e.coli h0157:h7 was check as this can cause ttp. this was negative. on she transferred out of the sicu. but returned to the sicu on for hct to 17, melena and hct drop. a repeat egd was done on again blood was noted in the stomach with no definitive sites seen. electrocautery was applied for hemostasis. a small ulcer was seen in the superior wall of the antrum and a 6-7 mm ulcer was found in the posterior wall of the duodenal bulb. on an abd ct revealed new intraperitoneal hemorrhage, with largest amount of blood seen anterior to the transplanted kidney, tracking down to the pelvis. there was slight decrease in size of previously noted peri-transplant fluid collections, with draining catheters again noted. persistent bilateral pleural effusions with associated atelectasis. on she was transferred out of the sicu. on repeat abd ct was essentially unchanged. the drains were removed. hd was held x 6 days during which time she received iv lasix and diuril with low urine outputs and creatinine increase to 4. on she became hypoxic, tachycardic, hypertensive and volume overloaded. she required emergent intubation for respiratory failure. she was transferred back to the sicu on where hd was done with removal of 5 liters. she was extubated later that day. subsequently, she was dialyzed each day with improvement in fluid overload and goal dry weight of 56 kg. cardiology was re-consulted for echo findings of an ef of 30% and global lv hypokinesis. recommendations included volume reduction, bb, ace, statin,correction of anemia, low na diet,avoidance of nifedipine and repeat tte once euvolemic. concern was given for possible pe given sle. on a chest ct without contrast revealed moderate amount of ascites tracking down the paracolic gutters into the pelvis, not significantly changed compared to the prior study. mild interval decrease in size of well organized superior peri-transplant fluid collection containing multiple foci of air. the inferior collection was not well appreciated. 3. no change in appearance of two hypodense foci within the transplanted kidney. a linear consolidation within the right upper, right middle, left upper, and left lower lobes were noted as well as a dense consolidation/atelectasis in the right lower lobe. moderate-sized right-sided pleural effusion and small sized left-sided pleural effusion. moderate sized stable pericardial effusion. a sputum culture was sent on , but was contaminated. she continued dialysis daily achieving dry weight of 56kg and was seen regularly by id and the transplant medicine service. hematology felt thrombocytopenia was related to itp and drugs (cefepime/valcyte). should plt <20 then would consider ivig or steroids. for discharge the plan was to administer dapto q 48 hours at hd, dapto/fluc/cipro were to continue for 3 weeks then re image abd. new eng home therapies will supply dapto. gentiva vna was arranged for pt/nsg and hha. medications on admission: tums oscal, nystatin, lopressor, lasix, myfortic, nifedipine, rapamune, fosamax, prednisone, valcyte, discharge medications: 1. daptomycin 500 mg recon soln sig: one (1) recon soln intravenous 3 times/week at dialysis: continue until notifies otherwise. disp:*15 recon soln(s)* refills:*5* 2. epoetin alfa 10,000 unit/ml solution sig: one (1) injection q tues, thurs sat at hemodialysis. 3. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). disp:*180 tablet(s)* refills:*2* 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 5. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 6. fluconazole 200 mg tablet sig: one (1) tablet po q48h (every 48 hours): take following hemodialysis. disp:*15 tablet(s)* refills:*2* 7. ciprofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours). disp:*30 tablet(s)* refills:*2* 8. prednisone 5 mg tablet sig: three (3) tablet po once a day. disp:*90 tablet(s)* refills:*2* 9. nifedipine 60 mg tablet sustained release sig: one (1) tablet sustained release po daily (daily). disp:*30 tablet sustained release(s)* refills:*2* 10. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 11. vicodin 5-500 mg tablet sig: one (1) tablet po every hours. disp:*60 tablet(s)* refills:*0* discharge disposition: home with service facility: gentiva discharge diagnosis: bk virus vre perinephric hematoma/fluid collections + yeast/vre/coag neg staph pneumonia gastric/duodenal ulcer-gi bleed renal transplant failure thrombotic microangiopathy ?hus?ttp lupus uti anemia thrombotic microangiopathy, biopsy gi bleed esrd: now on hemodialysis discharge condition: good discharge instructions: please call your doctor or return to the er for any of the following: * fever, chills * 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 if you vomit or have a bowel movement. * your skin, or the whites of your eyes become yellow. * any serious change in your symptoms, or any new symptoms that concern you. *continue labwork weekly and have faxed to clinic at cbc, chem 7, ca, phos, ck, ast, t bili home therapies will provide daptomycin for infusion at hemodialysis. duration will be determined at clinic appointment hemodialysis q tues,thurs, sat. you will receive epogen at the dialysis unit check finger stick blood sugars daily and record. bring this record with you to dr appointment. if you get readings greater than 160 with a fasting blood sugar in the morning please call your primary care physician. followup instructions: , md phone: date/time: 8:30 , md phone: date/time: 9:00 , md phone: date/time: 4:00 , md phone: date/time: 1:00 phone: date/time: 8:30 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances other endoscopy of small intestine insertion of endotracheal tube insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis percutaneous abdominal drainage arterial catheterization closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus endoscopic control of gastric or duodenal bleeding endoscopic control of gastric or duodenal bleeding closed [percutaneous] [needle] biopsy of kidney therapeutic plasmapheresis transfusion of packed cells transfusion of platelets injection or infusion of immunoglobulin diagnoses: other primary cardiomyopathies systemic lupus erythematosus acute gastric ulcer with hemorrhage, without mention of obstruction acute kidney failure with lesion of tubular necrosis unspecified pleural effusion congestive heart failure, unspecified other specified disorders of pancreatic internal secretion adrenal cortical steroids causing adverse effects in therapeutic use iron deficiency anemia secondary to blood loss (chronic) unspecified acquired hypothyroidism candidiasis of other urogenital sites hematoma complicating a procedure candidiasis of mouth pulmonary collapse diaphragmatic hernia without mention of obstruction or gangrene hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure diarrhea other disorders of plasma protein metabolism hypovolemia hydronephrosis aseptic necrosis of head and neck of femur other specified viral infection complications of transplanted kidney immune thrombocytopenic purpura autoimmune hemolytic anemias lung involvement in other diseases classified elsewhere 

Answer: The patient is high likely exposed to