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: hepatic sepsis major surgical or invasive procedure: ir drainage of hepatic abscess history of present illness: 65yo m with cad, stroke, dm presented to with 2 wk h/o fevers, chills, malaise. temps up to 101 that would go away for several days, then on monday was acutely worse with high fevers and rigors, went to er, there found to be hypotense and febrile 102.8, tachy 158. given 3l ivf's and neo, started on vanc, ceftriaxone, flagyl. cxr, ua negative. poor uop improved with ivf's. . ct non-con at for increased lfts (alkp 278, bili 1.8) and increased wbcs 19.2 --> showed 4x7cm hypodense lesions, ? abscess, no gb dz, no stones --> confirmed by ruq u/s. +bcx growing gnr's --> pan sensitive ecoli. id saw and rec'd ceftriaxone, but continued on vanc, zosyn, flagyl in icu. prior to tx to , pt was on neo 20 (down from 45) with maps 75, hr 60, and picc line. . in icu, neo turned off and maps stayed in 60's. pt covered with zosyn to cover gn's, pseudomonas and anaerobes, was pan cx'd. surgery and ir consulted for drainage. trop's mild elevated. abg 7.36/88/34. lactate 2.0. repeat lfts --> alt/ast 41/49, alkp 148. pt hemodynamically stabilized and was transferred to the floor for further management. past medical history: diabetes r paritotemporal cva with left-sided arm residual weakness, sustained cad with mi and stents in chronic low-back pain s.p multple back surgeries gerd social history: retierd plumber, denies significant etoh, smokes ppd x 56 years, independent adls, denies ivdu family history: two brothers with mi physical exam: vitals: t:35.6 bp:96/56 p:70 r: 18 o2: 97% general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: crackles bilaterally, loudest at base; no wheezing; decreased breath sounds in upper lung fields cv: distant heart sounds, but regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: obese, soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, + hepatomegaly, no splenomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: 5/5 strength bilaterally, grossly normal cn 3-12 pertinent results: labs, summarized: wbc's on admission 23.6 that trended down to 12.1 by d/c. h/h stable, admission 10.4/32.3, d/c 11.0/32.4 plts stable, by d/c 291 . chems were stable through admission, was not in acute renal failure on admission --> bun/cr 24/1.0 admission, by d/c 16/0.9 . lfts on admit alt/ast 41/49, trended down to 36/36 by d/c. ldh admit 218 ck's 41, 33, 30 alkp 148 admission, by d/c 189 tbili 1.2 --> 0.6 . negative cardiac enzymes x3 . entamoeba histolytica ab pending . ua significant for rbc's 21-50. neg nitrites, trace leuks, many bacteria, wbc . 30 protein, 15 ketones . bcx negative x2 by d/c, ucx <10,000, gstain with 3+ pmn's, 2+ gnr's, 2+ gpr's gram stain (final ): reported by phone to @ 6:10a . 3+ (5-10 per 1000x field): polymorphonuclear leukocytes. 2+ (1-5 per 1000x field): gram negative rod(s). 2+ (1-5 per 1000x field): gram positive rod(s). smear reviewed; results confirmed. wound culture (final ): escherichia coli. moderate growth. citrobacter freundii complex. sparse growth. this organism may develop resistance to third generation cephalosporins during prolonged therapy. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. for serious infections, repeat culture and sensitivity testing may therefore be warranted if third generation cephalosporins were used. sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | citrobacter freundii complex | | ampicillin------------ =>32 r ampicillin/sulbactam-- =>32 r cefazolin------------- 16 i cefepime-------------- <=1 s <=1 s ceftazidime----------- <=1 s <=1 s ceftriaxone----------- <=1 s <=1 s cefuroxime------------ 4 s ciprofloxacin---------<=0.25 s <=0.25 s gentamicin------------ <=1 s <=1 s meropenem-------------<=0.25 s <=0.25 s piperacillin---------- =>128 r <=4 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s <=1 s trimethoprim/sulfa---- <=1 s <=1 s anaerobic culture (preliminary): mixed bacterial flora-culture screened for b. fragilis, c. perfringens, and c. septicum. anaerobic gram negative rod(s). moderate growth. of two colonial morphologies. . imaging: ekg sinus bradycardia. low voltage. rsr' pattern in lead v2. q-t interval prolongation. no previous tracing available for comparison. read by: , a. intervals axes rate pr qrs qt/qtc p qrs t 57 162 86 77 cxr portable ap chest is compared to same day radiograph from 12:15 p.m. a right picc tip projects over the mid svc in good position. widening of the vascular pedicle, pulmonary vascular cephalization, and mild bilateral perihilar haze is compatible with mild fluid overload. the lungs are clear without focal consolidation. there is no pneumothorax or appreciable pleural effusion. impression: 1. right picc tip projects over the mid svc. 2. mild fluid overload. us guided abscess drain findings: targeted ultrasound reveals an 8.5 cm hypoechoic lesion within the superior portion of the anterior right hepatic segment with increased through transmission suspicious for abscess. incidental note is made of a homogeneously hyperechoic 1.1 cm lesion in the posterior right hepatic lobe consistent with a hemangioma. there is some gallbladder wall thickening. this is likely due to patient's low albumin. brief hospital course: 1. septic shock from hepatic abscess: in the icu, initial abg: 7.59 / 22 / 67 and 7.43 / 26 / 104. lfts: alk phos 278, bili 1.8. wbc 19.2. poor uop improved with ivf and pt weaned off neo. lft elevation prompted ct abdomen with oral but not iv contrast, showed abscess. ct abdomen: 7 x 4 cm hypodense lesion ?abscess. bcx from er grew gnrs . gi thought likely abscess. ultrasound confirmed 7x4 cm collection concerning for abscess or phlegnom. ir aspiration got 2cc sent fot gs and culture, placed drain. vanc, flagyl and zosyn started in the icu. . abscess continued to drain o/n. no persistent signs of sepsis after drainage. . pt hemodynamically stablized, transferred to floor where he was continued on iv vanc and zosyn. no acute issues while on floor, vitals were stable. by the time of discharge the pt's cx's had come back and pt was switched to po levofloxacin. pt will follow up with clinic, who will call him to make an appointment. the pt will also be called by ct radiology to follow up managment of the drain that was placed. . no source of infection was found, including negative cxr, no other source in abdomen on ct from osh, ucx negative. will need outpt colonscopy. . 2. hypotension: resolved with ivf at osh and abx . 3. cad s/p stents: negative cardiac enzymes x3 and st changes on ekg. lisinopril was held due to normal blood pressures while on the floor and will need to be reassessed in the outpt setting. lipitor was held due to increased lft's also need outpt assessment. the pt reported no chest pain during admission, no acute cardiac issues. . 4. s/p cva: asa was continued. no acute neurologic issues. . 5. dm: home metformin was held and bs's controlled with sliding scale insulin. no acute issues. medications on admission: metformin 1 tab daily aspirin 81 mg daily lisinopril and lipitor, but had not been taking. formerly on prilosec discharge medications: 1. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: home with service facility: discharge diagnosis: primary diagnosis: 1. septic shock from hepatic abscess . secondary diagnoses: 1. cad s/p stents in 2. cva in 3. dm2 discharge condition: by the time of discharge the pt had vital signs, was taking oral food and liquids, was ambulating, was not in pain, and was set up with an antibiotic regimen to treat his infection. discharge instructions: you were admitted to with a bacterial infection of your blood causing low blood pressures. you were admitted to the icu, where you were started on iv antibiotics and your blood pressure was monitored. you had a ct that showed abscesses in your liver. when you were stable enough, you were brought out of the icu onto the regular wards were we continued to give you iv antibiotics. the abscess in your liver was drained. . while you were in the hospital, the metformin you were taking at home was stopped, but the aspirin was continued. we did not continue the lipitor or lisinopril that you said you had not been taking. on discharge, you should continue to take aspirin. you will also need to continue a ........... week course of ............. you should follow up with your primary care physician to assess whether you need to restart lipitor, lisinopril, and metformin. . please return to the hospital if you experience: fevers, chills, or night sweats, yellowing of your skin or eyes, problems with bleeding or excessive bruising on your skin, white stools, or very dark urine, or any other concerns. followup instructions: you will need to have follow-up arranged with the infectious disease clinic. you will be contact with an appointment date and time. if you do not hear from someone by tuesday, , please call the infectious disease clinic at to have an appointment scheduled. . you will also need an appointment with ct radioliogy for management of your drain. someone will call you with information about a scheduled appointment. please call ( if you do not hear from them by and let them know that dr. performed your procedure on . . please also follow up with your primary care physician , within 2-3 weeks of discharge by calling: . you will need an outpt colonoscopy as you are due for your screening. your primary care doctor can discuss setting this up for you. you should also discuss the medication changes described above with your primary care doctor. procedure: percutaneous aspiration of liver diagnoses: other chronic pain coronary atherosclerosis of native coronary artery esophageal reflux tobacco use disorder diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified severe sepsis percutaneous transluminal coronary angioplasty status other late effects of cerebrovascular disease septic shock abscess of liver old myocardial infarction lumbago septicemia due to escherichia coli [e. coli] other musculoskeletal symptoms referable to limbs 

Answer: The patient is high likely exposed to