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: patient recorded as having no known allergies to drugs attending: chief complaint: hematuria major surgical or invasive procedure: none history of present illness: 83 y/o f with pmh severe dementia (nonverbal at baseline), chronic utis, stage iii-iv sacral decubitus ulcers, afib and recurrent dvts on coumadin p/w hematuria and vaginal bleed in the setting of an elevated inr. per nursing home, patient was found to have an elevated inr to 7.34 on routine labs and her coumadin was being held. she was noted to have vaginal oozing and hematuria so was brought to for further evaluation. in the ed, initial vs 96.4 96 105/72 18 100%. initial exam was notable for large stage 3-4 sacral decub and ulcer on right buttocks with packing in place. pelvic exam revealed dried blood in vaginal vault with no signs of active bleeding. chronic foley in place draining tea colored urine. initial labs notable for na of 174, cr of 1.7 (baseline of 0.8) and inr of 6.5. cxr was negative and ap pelvis to evaluate for oa pnding. she was reversed with vit k 10mg sc x 1, 1l ns bolus x 2, and received vanc and ceftriaxone for uti. she was subsequently transferred to the icu. past medical history: pmh last updated - cholilithiais and choledocholithiasis with recurrent admissions for ascending cholangitis s/p /stents, perc chole. last stent placement, removed on with more stone extraction and another stent placed. - recurrent c.diff and - paroxysmal afib -on coumadin - dvt on coumadin, dx , l common femoral, still present - dm2 on insulin - htn - recurrent admission for dehydration/hypernatremia - recurrent utis with mdr organisms (ecoli, pseudomonas-?colonizer)-on chronic foley - dysphagia-dx , on pureed diet with nectar thicks, 1:1 supervision, aspiration precautions - osteochondroma of l knee as a child - mvp - alzheimer's disease - severe, baseline speaks to self, doesnt recognize people - sacral decub (stage iv) and bilateral heel (stage iii) pressure and deep tissue wounds - severe knee arthitis-bed bound - anemia-?acd, baseline h/h - s/p right orif of hip fracture at age 75 social history: lives at nursing home. no alcohol or drugs. family history: daughter with arthritis, father died of hepatitis c from a blood transfusion. mother died at age 86 of a myocardial infarction. son with hypertension. physical exam: vs: t98.2, p 83, bp 82/40, rr 18, o2 sat 100% on ra gen: extremely frail appearing elderly woman lying in bed heent: perrl, anicteric, mm extremely dry appearing, pt will not open mouth for full exam, no jvd resp: cta bilaterally with good air movement cv: rrr, normal s1 and s1 abd: soft, nt, nd, bs+, no organomegaly ext: no clubbing, cyanosis, edema, faint pulses skin: no rashes/no jaundice/no splinters neuro: babbling a small amount nonsensically, moving all four extremities, no facial droop or other obvious focal deficits. pertinent results: admission/pertinent labs: 05:08am blood wbc-10.3 rbc-5.01# hgb-11.0*# hct-38.1# mcv-76* mch-22.0*# mchc-29.0* rdw-18.7* plt ct-278 05:08am blood neuts-75.1* lymphs-19.2 monos-2.5 eos-2.7 baso-0.5 05:08am blood pt-57.7* ptt-35.5* inr(pt)-6.5* 05:08am blood glucose-256* urean-56* creat-1.7* na-174* k-4.1 cl-144* hco3-19* angap-15 05:08am blood alt-12 ast-13 ld(ldh)-215 alkphos-128* totbili-0.5 05:08am blood lipase-36 05:08am blood ctropnt-0.04* 05:08am blood albumin-3.1* calcium-8.5 phos-2.7 mg-2.3 08:32am blood lactate-1.9 05:20am urine color-red appear-cloudy sp -1.015 05:20am urine blood-lg nitrite-neg protein-75 glucose-neg ketone-neg bilirub-neg urobiln-neg ph-7.0 leuks-mod 05:20am urine rbc->50 wbc-21-50* bacteri-mod yeast-none epi-0 . other pertinent labs: 12:43pm blood caltibc-170* ferritn-46 trf-131* 08:32am blood lactate-1.9 . discharge labs: 05:38am blood wbc-5.5 rbc-4.10* hgb-9.8* hct-30.8* mcv-75* mch-23.8* mchc-31.7 rdw-20.4* plt ct-182 05:38am blood pt-19.1* ptt-34.4 inr(pt)-1.7* 05:38am blood glucose-115* urean-8 creat-0.7 na-141 k-3.8 cl-110* hco3-25 angap-10 05:38am blood calcium-7.7* phos-2.1* mg-1.7 . micro: mrsa screen: positive ucx: negative ucx: yeast. 10,000-100,000 organisms/ml bcx: pending, no growth to date at time of discharge c. diff: negative ucx: yeast. 10,000-100,000 organisms/ml. probable enterococcus. ~3000/ml. bcx: pending, no growth to date at time of discharge . studies: ecg: baseline artifact. probable sinus rhythm with atrial premature beats with some aberration. borderline low limb lead voltage. st-t wave abnormalities. since the previous tracing of the rate is slower. st-t wave abnormalities are less prominent. cxr: stable left basilar atelectasis and/or scarring. no acute cardiopulmonary process including no evidence of pneumonia. pelvic film: suboptimal exam. no osteomyelitis suggested. chest x-ray (portable ap) findings: as compared to the previous radiograph, there is a diffuse increase in density of the lung parenchyma, presumably caused by projection. however, in addition, there is a newly appeared retrocardiac opacity that could be caused by a combination of atelectasis and pneumonia. increasing diameter of the azygos vein, increasing diameters of the pulmonary vessels. both could indicate mild overhydration. the presence of a minimal left pneumothorax cannot be excluded. the left picc line has been pulled back, the tip now projects over the mid svc. brief hospital course: 83 y.o. female w/ history of dvt, af, decubitus ulcers, and hypernatremia who presents with vaginal bleeding and hypernatremia. #. hypernatremia: patient appeared volume depleted and had perfusion-related kidney injury on admission. likely associated with free water deficit from inadequate access to fluids/free water. the patient was hydrated with iv fluid, and had general downward trend in na levels to within normal range prior to discharge. ivf were discontinued, and the patient's na remained wnl with adequate po intake. the patient should have adequate access to food/fluids on discharge, as this is essential to prevent recurrence of hypernatremia.. she is unable to ask for food and water, but is able to eat if she is fed. #. hypotension: after transfer from icu to floor, the patient was noted to be hypotensive to the 80s on occasion. during one episode of hypotension, she was noted to have an axillary temperature of 99.5. blood cultures obtained () were negative to date at time of discharge. urine culture was positive for yeast, thought to be colonization and not acute infection. a cxr was also obtained, and showed a possible retrocardiac opacity, ?atelectasis vs pneumonia. she was not started on antibiotics given absence of fever, leukocytosis, pulmonary symptoms or findings on lung exam. sbp had improved to 130s prior to discharge after transfusion of 2 units prbcs on for anemia, other vitals remained stable, and the patient remained afebrile. . #. blood loss/anemia: bleeding (hematuria/vaginal bleeding prior to admission) was presumably secondary to elevated inr, which occurred in setting of antibiotic use/interaction with regular warfarin dose. no signs of bleeding on ed pelvic exam and the patient was hemodynamically stable on arrival to micu. she received vitamin k in ed and was given ffp on arrival to micu, to decrease inr for picc line placement. upon transfer to the floor the patient was noted to have anemia, but it was unclear how much of her hct drop was secondary to hemodilution in setting of fluid resuscitation. iron studies c/w iron deficiency anemia, and the patient was started on iron supplementation as she did not have any active signs of bleeding. hct continued to trend down, but there was no clear source of active bleeding. stool was guiac negative. the patient was transfused 2 units prbcs on , with appropriate rise in hct. hct stable prior to discharge. of note, her coumadin was restarted prior to discharge, inr still subtherapeutic at 1.7 on day of discharge. . #. stage iii/iv decubitus ulcer: wound care and social work consults placed on admission. the patient was given vitamin c and zinc therapy. she should continue to receive wound care at nursing facility, and a foley catheter should remain in place to help prevent infection of sacral/perineal wounds. she had a flexiseal in place during this admission, which was removed prior to discharge as she leaked stool around it. . #. acute kidney injury: cr elevated at 1.7 on admission, from baseline of 0.8, in setting of severe dehydration. cr improved with iv fluids, and was back to baseline of 0.7 at time of discharge. #. diabetes mellitus type ii: the patient was written for an insulin sliding scale, which was uptitrated early in micu admission. she was started on long-acting insulin once taking po. #. urine yeast: urine culture from showed 10,000-100,000 yeast. foley was changed, and repeat urine culture from also positive for yeast. the patient was not started on antibiotics or antifungals, as this was felt to represent colonization and not acute infection. her foley was replaced after , and should remain in place chronically. . #. h/o dvt/a fib: the patient was in sinus rhythm during the admission. her coumadin was initially held in setting of supratherapeutic inr and bleeding, and inr was reversed. as above, coumadin restarted prior to discharge. dose should be adjusted accordingly based on inr trend, and dose was changed back to pre-admission dosing of 3mg daily prior to discharge. inr 1.7 on day of discharge. . code status: the patient is dnr, but may be intubated for short-term airway protection per family wishes. medications on admission: medications at rehab: -regular insulin sliding scale -insulin nph 20 units qam -coumadin 3 mg daily -omeprazole 40 mg daily -trazodone 12.5 mg po qhs -vitamin c -zinc sulfate 220 daily -ciprofloxacin 250 mg dialy (started ) discharge medications: 1. zinc sulfate 220 mg capsule : one (1) capsule po daily (daily). 2. ascorbic acid 500 mg tablet : one (1) tablet po bid (2 times a day). 3. omeprazole 20 mg capsule, delayed release(e.c.) : one (1) capsule, delayed release(e.c.) po daily (daily). 4. ferrous sulfate 300 mg (60 mg iron) tablet : one (1) tablet po daily (daily). 5. acetaminophen 650 mg tablet : one (1) tablet po q6h (every 6 hours) as needed for fever/pain. 6. heparin (porcine) 5,000 unit/ml solution : one (1) injection injection tid (3 times a day). 7. cholecalciferol (vitamin d3) 400 unit tablet : one (1) tablet po bid (2 times a day). 8. polyethylene glycol 3350 17 gram/dose powder : one (1) 17 gram/dose po daily (daily) as needed for constipation. 9. calcium carbonate 200 mg (500 mg) tablet, chewable : one (1) tablet, chewable po tid (3 times a day). 10. warfarin 3 mg tablet : one (1) tablet po once a day. 11. insulin glargine 100 unit/ml solution : twenty (20) units subcutaneous at bedtime. 12. insulin regular human 100 unit/ml (3 ml) insulin pen : as per sliding scale subcutaneous with meals and at bedtime. discharge disposition: extended care facility: senior healthcare of discharge diagnosis: primary diagnosis: - hypernatremia, hypovolemic secondary diagnosis: -anemia of chronic disease plus iron deficiency -dementia -multiple decubitus ulcers -diabetes mellitus type ii, controlled discharge condition: mental status: confused - always. level of consciousness: lethargic but arousable. activity status: bedbound. discharge instructions: ms. , you were admitted to the hospital after having an episode of bleeding. we also found that your sodium level was high, and you were brought to the icu to be given fluids. your bleeding resolved while you were in the hospital after we stopped your blood-thinning medication. your sodium levels also improved after we gave you fluids. you became more anemic after the bleeding, and we started you on an iron supplement. we also gave you a blood transfusion. we made the following changes to your medications: 1. stopped ciprofloxacin 2. stopped trazaodone 3. started ferrous sulfate 4. started vitamin d 5. started calcium carbonate 6. started miralax as needed for constipation 7. changed omeprazole from 40mg daily to 20mg daily . we did not make any other changes to your medications, so please continue to take them as prescribed by your physician. followup instructions: please have your facility make an appointment for you with dr. by calling . md procedure: venous catheterization, not elsewhere classified diagnoses: anemia of other chronic disease abnormal coagulation profile unspecified essential hypertension acute kidney failure, unspecified candidiasis of other urogenital sites hypotension, unspecified long-term (current) use of insulin long-term (current) use of anticoagulants pressure ulcer, lower back iron deficiency anemia, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled do not resuscitate status alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance pressure ulcer, heel hyperosmolality and/or hypernatremia hematuria, unspecified pressure ulcer, stage iv personal history of methicillin resistant staphylococcus aureus personal history, urinary (tract) infection other fluid overload infection with microorganisms with resistance to multiple drugs dysphagia, unspecified arthropathy, unspecified, lower leg pressure ulcer, hip postmenopausal bleeding 

Answer: The patient is high likely exposed to