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 / ativan / metformin attending: chief complaint: mental status changes major surgical or invasive procedure: - intubation - central line placement - a-line placement history of present illness: 64 year old women with history of mental retardation, mrsa pneumonia, bipolar disorder and chf presenting with a five day history weakness, tremors and altered mental status. she feels her symptoms began three weeks ago when she was started on metformin and glipizide for dm control. she was taken off these medications three days prior to admission. she describes tremors and a fear of falling which have left her bed bound for the last five days. she feels generally weak and has been having diarrhea and polyuria. her po intake has also decreased over the last week. per her and her caregivers, she has been increasingly confused and agitated as well. her pcp recommended coming to the ed for evaluation. . in the ed, vitals were 98.1, bp 101/57, hr 74, r 18, 96% ra. fs was 118. labs demonstrated lithium level 2.2, hyperkalemia, hyponatremia and acute renal failure. she was given kayexelate, insulin and glucose for her hyperkalemia with slight improvement to 6.0. she had a transient hypotensive episode to sbp 89/33 and received a 500 cc bolus and 8 mg iv decadron for presumed adrenal insufficiency. she responded and did not require any further bp support. she received levofloxacin, flagyl and vancomycin given leukocytosis and relative hypotension and was transferred to the micu for furhter monitoring. past medical history: 1) asthma - pfts fev1 0.54 (27%), fvc 0.57 (21%), fev1/fvc 130% c/w restrictive defect 2) mental retardation 3) ?temporal lobe epilepsy: this diagnosis has been questioned in the past 4) h/o mrsa pna requiring intubation : pt was found down in respiratory failure; etiology was unclear, but possible contributors included osa-associated hypercapnia, aspiration, and congestive heart failure - cta (technically limited): no central/lobar pe. improvement in previously-noted opacities in right lung. 5) obstructive sleep apnea: - sleep study with titration of cpap to 19 cm with 4l o2. 6) bipolar disorder: currently on lithium and seroquel 7) hypertension 8) disease: diagnosis is unclear 9) osteoarthritis 10) gerd 11) h/o chf: - ef (limited): dilated, ra moderately dilated, asc aorta mildly dilated, 1+ mr, mod pulm artery systolic htn. 12) morbid obesity social history: lives in in brookeline with visiting services. ambulates with a walker. no tobacco, alcohol, or other drug use family history: cancer nos in mom and dad no htn no dm physical exam: vitals: 147/72, 76, 20, 93% 2l general: pleasant female, mr, a+o x 3, no distress heent: rerrl, op clear, eomi neck: obese, nontender, from car: rrr no murmur resp: bs bilat--ant/lat exam abd: obese, soft, nontender +bs ext: no edema, erythematous rash on left shin neuro: mae, a+ox3, does not cooperate with exam pertinent results: 11:40pm potassium-6.0* 11:30pm glucose-104 urea n-57* creat-2.1* sodium-129* potassium-6.4* chloride-96 total co2-27 anion gap-12 09:56pm comments-green top 09:56pm lactate-1.0 09:40pm urine color-yellow appear-clear sp -1.014 09:40pm urine blood-tr nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 09:40pm urine rbc-0 wbc-0-2 bacteria-occ yeast-none epi-0-2 09:40pm urine hyaline-* 07:30pm glucose-100 urea n-60* creat-2.3* sodium-126* potassium-6.2* chloride-93* total co2-28 anion gap-11 07:30pm estgfr-using this 07:30pm lithium-2.2*# 07:30pm wbc-11.2*# rbc-4.10* hgb-12.4 hct-36.7 mcv-90 mch-30.2 mchc-33.7 rdw-17.0* 07:30pm neuts-85.2* lymphs-11.5* monos-1.9* eos-1.2 basos-0.1 07:30pm plt count-299 brief hospital course: a/p: 64f h/o bipolar on lithium, mr, chf, dm2, admitted with arf, hyperkalemia, hyponatremia, elevated lithium level, now attempting to wean off vent. . # hypercarbic respiratory failure: pt with chronic respiratory acidosis likely osa/pulmonary htn, asthma. in setting of arf diarrhea, poor po, likely triggered inability to eliminate h+ and related worsening uncompensated respiratory acidosis. goal pco2 = 65, as pt is likely obligate rapid shallow breather at baseline given obesity. attempt wean to ps 8/peep 8, with diuresis to improve respiratory mechanics. - first few days of icu admission pt. was maintained on home regimen of cpap while sleeping and nasal cannula / room air while awake - hospital day 4 pt. with increasing somnolence and increased positive fluid balance as renal function worsened and thus increased bipap requirement -> pco2 continued to climb and pt. intubated. pt. underwent slow wean over the next 2 weeks -> coupled with return of renal function, subsequent diuresis, and treatment of mssa pneumonia -> pt. completed 14 day course of vancomycin as she has pcn allergy - extubated in am and doing well -> tolerating cpap overnight and nc during the day. pt reports being complaint at home with her nebulizer, cpap as well as o2 nasal canula. during the day she uses her o2 by nc most of the time. . # acute renal failure: cr 1.3, with baseline 0.8-1.0. - cr elevated on admission and 18-24 hours later pt. stopped making urine. renal was consulted and initially pt did not respond to lasix. during this time pt. given some fluids and kidneys slowly recovered on their own. pt. had cr. back to normal level and we started lasix -> now cr stable at 1.3, pt. making adequate amounts of urine and processing meds appropriately -initially held further diuresis as overall fluid balance per physical exam seemed to be even. diuresis started with 20 mg lasix po on medical floor again as pt's renal function o baseline. pt need weekly check of her renal function as long as lithium treatment continues. . # intermittent low - grade temps: vancomycin as above sputum mssa. completed full 5 day azithromycin course. pt. had central venous line placed which was removed once 14 day course of vanco was complete. she remained afebrile after above. . # bipolar d/o: titrated lithium per arf, now at lithium 150mg qhs, with quetiapine 100mg po tid, quetiapine 350mg po hs. lithium level was elevated on arrival - 2.0 and psych / renal advised that hd was not needed for lithium. we held lithium until level was <1.0 with return of renal function. restarted lithium and following daily levels. pt. will need to follow-up with primary psychiatrist for further medication alterations. pt needs 2-3 times weekly lithium levels check until stabilized on this regiment for 3-4 weeks,. . # chf: continued with lasix 20 mg daily as above . # dm2: continued on humalog insulin ss q6h. pt. with history of reaction to oral hypoglycemics. pt refused taking oral antidiabetic but is now agreeing to take glipizide 2.5 mg . will need follow-up with pcp and further dose adjustment. uncertain about capacity to learn how to use insulin. . # asthma: continued on home regimen of albuterol and ipratropium. . # decubitus ulcer -> on air mattress for much of her icu stay. sacral decub dressed daily - stage i. . # fen: diet . # full code medications on admission: metformin 500mg --stopped x 3 days glipizide 2.5mg --stopped x 3 days prilosec 20mg daily loperamide 4mg 4 times daily prn seroquel 300mg tid + 350mg qhs lithium 150mg tid ibuprofen 600mg 4 times daily furosemide 20mg daily lisinopril 2.5mg daily folic acid 1mg daily singular 10mg daily atrovent neb 4 times daily pulmicort discharge medications: 1. quetiapine 100 mg tablet sig: one (1) tablet po tid (3 times a day). 2. quetiapine 100 mg tablet sig: 3.5 tablets po hs (at bedtime). 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 5. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed. 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 7. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 8. lithium carbonate 150 mg capsule sig: one (1) capsule po qhs (once a day (at bedtime)). 9. quetiapine 100 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 10. ipratropium bromide 17 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours). 11. albuterol 90 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours). 12. albuterol sulfate 0.083 % (0.83 mg/ml) solution sig: one (1) solution inhalation q4h (every 4 hours) as needed. 13. ipratropium bromide 0.02 % solution sig: one (1) solution inhalation q6h (every 6 hours) as needed. 14. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 15. glipizide 2.5 mg tab,sust rel osmotic push 24hr sig: one (1) tab,sust rel osmotic push 24hr po bid (2 times a day). discharge disposition: extended care facility: discharge diagnosis: - acute renal failure - hypercarbic respiratory distress - mssa pneumonia - chf exacerbation - h/o bipolar - h/o diabetes - h/o asthma discharge condition: - good discharge instructions: - you should take all medications as instructed - some of your medications have been changed -> please note these changes - you need to follow-up with you primary care doctor in the next week chills, nasuea, vomiting, chest pain, shortness of breath, inability to urinate or urinating more than normal, change in mental status, or any other concern followup instructions: **it is very important for you to keep the following appointments** - you need to follow-up with your primary care doctor within one week of discharge -> this is for post-hospitalization follow-up, medication review, blood testing for medication levels, and diabetes management. - you need to follow-up with your primary psychiatrist within one week of discharge for post-hospitalization eval and medication adjustment. . provider: np/dr phone: date/time: 12:00 provider: ,interpret w/lab no check-in intepretation billing date/time: 12:00 provider: breathing test phone: date/time: 11:40 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances arterial catheterization diagnoses: acidosis hyperpotassemia obstructive sleep apnea (adult)(pediatric) esophageal reflux congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hyposmolality and/or hyponatremia acute on chronic diastolic heart failure asthma, unspecified type, unspecified acute respiratory failure morbid obesity methicillin susceptible pneumonia due to staphylococcus aureus pressure ulcer, lower back unspecified intellectual disabilities shock, unspecified 

Answer: The patient is high likely exposed to