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: history of present illness: this is a sixty-one-year-old female with a history of alcohol abuse and mild chronic obstructive pulmonary disease, hepatitis c and positive ca-125 with cystic ovarian disease who was originally admitted to the gynecologic service on , for elective total abdominal hysterectomy bilateral salpingo-oophorectomy for work up of ovarian cystic disease. on postoperative day number two after an uncomplicated surgery, which revealed only benign cystic disease, the patient was noted to be acute hypoxic and an arterial blood gas at the time was 7.43/30/62 on four liters of nasal cannula oxygen. a chest x-ray obtained at the time was remarkable for evidence of volume overload and an evolving left upper lobe infiltrate. the patient was intubated for respiratory distress and transferred to the intensive care unit for further care. there had been no history or fevers in the postoperative period. past medical history: 1) history of alcohol abuse, status post admission to hospital for alcoholic pancreatitis. no history of delirium tremens or hospitalizations for detoxification. 2) history of multiple sigmoid diverticula. 3) history of chronic low back pain on fentanyl patch. 4) status post cholecystectomy in . 5) status post left breast lumpectomy in . 6) history of hepatitis c. 7) history of mild chronic obstructive pulmonary disease. allergies: no known drug allergies. medications: medications at the time of admission, zyrtec, ativan, effexor xr, trazodone, combivent, aerobid, prilosec. social history: the patient has an extensive alcohol and drug use history. there is twenty-five pack year tobacco history. the patient lives with her husband, . family history: noncontributory. admission physical examination: vital signs, temperature 100.3 f, blood pressure 100/48, pulse 107, respiratory rate 16, oxygen saturation 90% on four liters nasal cannula oxygen. general, appearance, agitated, confused woman who appears older then her stated age in moderate respiratory distress. head, eyes, ears, nose and throat examination, anicteric. pupils were equal, round and reactive to light, extraocular movements intact. sclera anicteric. no nystagmus. oropharynx clear. neck, no thyromegaly, jugular veins flat. chest, diffuse inspiratory crackles, no wheezes, decreased breath sounds, bibasilar. cardiovascular, tachycardiac, regular rhythm, normal rate, no murmurs, rubs or gallops. abdomen, soft, mildly distended, positive bowel sounds. extremities, no rash, no clubbing, no cyanosis, no edema. admission laboratory studies: white blood cell count 15.4, hematocrit 26.7, platelet count 240,000. white blood cell count differential, 76 neutrophils, 11 lymphocytes, 13 monocytes, no bands. sequential multiple analysis-7 131, 4.3, 102, 20, 15, 0.5, 128. electrocardiogram, normal sinus rhythm at a rate of 95, normal axis, normal intervals, non-specific diffuse t wave flattening, no change from prior. , chest x-ray, bilateral pulmonary interstitial infiltrates with perihilar haziness, early left upper lobe infiltrate, no pleural effusions. hospital course: the patient was admitted to the micu for progressive respiratory distress and was intubated shortly after arrival. the following will summarize her hospital course from to by systems. 1) neurologic, the patient required heavy sedation with benzodiazepines and fentanyl throughout her hospitalization with an underlying concern for development of alcohol withdrawal symptoms. she manifested no signs or symptoms suggestive of withdrawal syndrome and was maintained on benzodiazepines throughout her hospitalization. she was also given folate and thiamin daily. 2) cardiovascular, the patient developed a high cardiac output, low svr state on and after aggressive volume resuscitation required vasopressors and vasopressin to support her blood pressure. these were maintained for a period of a week and were difficult to wean. vasopressin was ultimately discontinued on . the patient developed atrial fibrillation on and was loaded on digoxin and maintained on a therapeutic dose thereof. she was also anticoagulated with heparin. an echocardiogram obtained on was notable for ejection fraction of greater then 55% and e to a ratio of 2.0 and normal right ventricular size and function, normal left ventricular size and function, 1 to 2+ tricuspid regurgitation, 1+ mitral regurgitation. 3) pulmonary, the patient was diagnosed with aspiration pneumonia after being unresponsive to diuresis attempts. this suggested this was not simply cardiogenic pulmonary edema. she appeared to develop adult respiratory distress syndrome, subsequent to that with the evolution of multilobar air space infiltrates in the setting of a low pulmonary capillary wedge and fever plus secretions consistent with pneumonia. this occurred on top of baseline of mild chronic obstructive pulmonary disease. the patient was managed with a low title volume strategy. her respiratory status was further complicated by development of volume overload from aggressive volume resuscitation. she was begun on basic strip after vasopressin was discontinued on with moderate success, secondary to borderline low venal arterial pressures. on , the patient was diagnosed with a ventilator associated pneumonia in the setting of developing a new retrocardiac opacification and increased purulent secretions. after treating her initial aspiration pneumonia with levaquin and flagyl, for a ten day course from to , she was restarted on with vancomycin and ceftazidine. all cultures to date are negative. the patient received a tracheostomy after sixteen days of endotracheal intubation on , with a #8 french forceps tube. the procedure was complicated by inability to pass the original shiley tracheotomy tube. surgery was consulted emergently at the bedside for placement of the tracheostomy. the patient has been switched from assist control ventilation to pressure support ventilation, which she is tolerating well from the ventilatory pattern and gas exchange as the end point. 4) gastrointestinal, the patient was noted to have mild abdominal distension at the time of presentation. an abdominal ct scan early in the hospital course revealed a nodular liver edge with borderline enlarged spleen and moderate to large ascites, given her history of alcohol use and hepatitis c, it was felt that the patient was cirrhotic. there is no biopsy to confirm this. the patient's acidic fluid was tapped, it was not neutrocytic. cultures were also negative. 5) infectious disease, the patient's aspiration pneumonia was initially managed with levaquin and flagyl from to . vancomycin was added empirically on for clinical decompensation. this was continued for a seven day course after one out of four blood cultures grew out coagulase negative staphylococcus. all antibiotics were discontinued on . vancomycin and ceftazidine started on for suspicion of a ventilator associated pneumonia. the patient's right ij initially had an introducer with a swan-ganz catheter placed on . this was traded out over a wire for a triple lumen catheter on . tip cultures are negative. the site continues to be without erythema or external evidence of developing line sepsis including negative blood cultures drawn through the line. 6) endocrine, the patient initially underwent a high dose acch stimulation test at the time of admission, which was negative. this was repeated on and returned positive. the patient was subsequently started on hydrocortisone and fludrocortisone for a seven day course to be completed on . the patient has had elevated glucose throughout her hospitalization, which has been managed successfully with an insulin drip. 7) nutrition, the patient was initially on hyperalimentation which has since been transitioned to tube feeds which were our goal at the time of this dictation. diagnoses: diagnoses at the time of this dictation, 1) status post aspiration pneumonia. 2) slowly resolving adult respiratory distress syndrome. 3) gross volume overload. 4) atrial fibrillation. 5) status post tracheostomy. 6) ventilator associated pneumonia. 7) adrenal insufficiency. 8) glucose intolerance. 9) strong evidence for underlying cirrhosis. medications: medications at the time of this discharge summary dictation, 1) ativan ggt 1 mg per hour. 2) fentanyl ggt 50 mcg per hour. 3) insulin ggt 3 units per hour. 4) heparin ggt 1200 units per hour. 5) lasix ggt 2 mg per hour. 6) digoxin 0.125 mg intravenous every day. 7) hydrocortisone 50 mg intravenous every six hours to be completed on . 8) fludrocortisone 0.1 mg by mouth every day to be completed on . 9) vancomycin 1 gm every twelve hours to be completed on . 10) ceftazidine 2 gm every eight hours to be completed on . 11) protonix. 12) folate. 13) thiamin. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances percutaneous abdominal drainage temporary tracheostomy other removal of both ovaries and tubes at same operative episode pulmonary artery wedge monitoring peritoneal lavage biopsy of peritoneum diagnoses: unspecified septicemia atrial fibrillation sepsis pneumonitis due to inhalation of food or vomitus other shock without mention of trauma benign neoplasm of ovary 

Answer: The patient is high likely exposed to