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: abdominal pain major surgical or invasive procedure: i&d of abdominal wall abscess with placement of drainage ostomy history of present illness: ms. is a 80 yo f nh resident with pmhx of dm2, htn, dementia, pod admitted for a lower abdominal abscess from perforated diverticulosis. patient was transferred from osh for abdominal pain/distention, found to have ct with a possible bladder rupture which turned out to be an abscess. i&d was performed on with drain placed. currently, the patient has feculant material coming from the drain from a presumed fistula. per the surgical team, the patient is not an operative candidate. past medical history: dementia htn diverticulosis gi bleed dm cholescystectomy hysterctomy tonsillectomy social history: unable to obtain due to mental status family history: unable to obtain due to mental status physical exam: night float physical exam gen: nad. oriented x1(name). heent: ncat. sclera anicteric. perrl, eomi. op clear, no exudates or ulceration, dry mm neck: supple, jvp not elevated. cv: rrr, normal s1, s2. no m/r/g. chest: resp were unlabored, no accessory muscle use. faint crackles at b/l bases, no rales, wheezes or rhonchi. abd: obese, mildly distended but soft and nt. no hsm or tenderness. ostomy noted in suprapubic region with pink-brown liquid ext: 2+ edema to bilateral thighs/lower back, 1+ dependent edema b/l upper extremities skin: no stasis dermatitis, ulcers, scars. neuro: alert and oriented x 1, cns ii-xii grossly intact, unable to participate in remainder of exam . accepting team physical exam 97.6 96.7 134/74 (109-139) 92 (86-100) 24 95%ra ill appearing woman in no distress, with ngt in place. she opens eyes to voice and can follow simple commands like smile or hand wave, but can't squeeze hand. she cannot verbalize spontaneously or on command. she does track across the room and is alert. l cvl in place, no surrounding erythema or signs of infxn no jvd ctab anteriorly but poor lung exam, no labored breathing s1 s2 are regular for a bit then spontaneously break into irregular tachycardia, no murmurs are heard. pmi not displaced obese, nd, bs+ with draining bag in place below umbilicus, with tan brown liquid in bag. she is able to nod yes that she is having pain when abdomen is deeply palpated. abd not rigid. bue with scattered ecchymosis, but lue is somewhat larger than rue and on medial aspect rue is erythematous macule ble with pitting edema to just below mid shin. dp's not palpable. . on discharge: nad, vss. pt is aaox0, however responsive and interactive. her anasarca has resolved, she remains tachycardic. ostomy bag in place draining fistula, lungs are clear. she has several excoriations on her l arm. pertinent results: admission labs: 01:03am blood wbc-18.2* rbc-2.78* hgb-7.4* hct-23.8* mcv-86 mch-26.7* mchc-31.2 rdw-16.2* plt ct-278 03:06am blood wbc-25.3* rbc-3.01* hgb-8.3* hct-26.0* mcv-86 mch-27.5 mchc-31.8 rdw-16.1* plt ct-285 02:00pm blood wbc-29.5* rbc-3.34* hgb-9.0* hct-28.5* mcv-85 mch-26.9* mchc-31.6 rdw-15.8* plt ct-348 02:22am blood wbc-24.0* rbc-2.80* hgb-7.4* hct-24.0* mcv-86 mch-26.5* mchc-31.0 rdw-15.8* plt ct-283 04:01am blood wbc-17.5* rbc-3.38*# hgb-9.1*# hct-28.2* mcv-83 mch-27.0 mchc-32.4 rdw-15.9* plt ct-205 03:25am blood wbc-17.2* rbc-3.01* hgb-8.0* hct-25.4* mcv-84 mch-26.7* mchc-31.6 rdw-16.4* plt ct-207 01:03am blood neuts-90.0* lymphs-7.8* monos-2.0 eos-0.1 baso-0.1 11:31pm blood neuts-89.7* lymphs-8.5* monos-1.4* eos-0.3 baso-0.1 01:03am blood pt-16.8* ptt-32.7 inr(pt)-1.5* 01:03am blood glucose-67* urean-28* creat-0.8 na-141 k-3.7 cl-116* hco3-20* angap-9 03:06am blood glucose-84 urean-25* creat-0.7 na-140 k-3.4 cl-117* hco3-18* angap-8 02:00pm blood glucose-121* urean-21* creat-0.8 na-140 k-4.2 cl-116* hco3-18* angap-10 02:22am blood glucose-243* urean-21* creat-0.8 na-138 k-3.9 cl-115* hco3-20* angap-7* 04:10am blood glucose-184* urean-25* creat-0.7 na-137 k-4.1 cl-112* hco3-23 angap-6* 01:03am blood alt-4 ast-6 ck(cpk)-7* alkphos-87 totbili-0.6 11:31pm blood alt-14 ast-29 ld(ldh)-183 alkphos-738* totbili-0.3 06:14am blood lipase-113* ggt-199* 01:03am blood ck-mb-notdone 01:03am blood ctropnt-<0.01 11:01pm blood ck-mb-notdone ctropnt-<0.01 06:11am blood ck-mb-notdone ctropnt-<0.01 04:11pm blood ck-mb-notdone ctropnt-<0.01 11:31pm blood alt-14 ast-29 ld(ldh)-183 alkphos-738* totbili-0.3 06:14am blood alt-11 ast-21 alkphos-368* totbili-0.2 01:03am blood albumin-<1.0* 03:06am blood albumin-1.1* calcium-6.8* phos-2.6* mg-1.1* 03:06am blood triglyc-73 11:01pm blood tsh-3.8 01:06am blood lactate-1.1 02:11pm blood lactate-1.5 03:05am blood glucose-241* lactate-1.7 04:04pm blood lactate-2.0 . ekg regular supraventricular rhythmn with baseline artifact precluding definitive rhythm analysis, possibly sinus rhythm with diminutive p waves. low qrs voltage diffusely. diffuse non-diagnostic repolarization abnormalities. no previous tracing available for comparison. . read by: , . intervals axes rate pr qrs qt/qtc p qrs t 110 160 84 300/387 -49 23 26 . ekg sinus tachycardia. short p-r interval. low voltage. leftward axis. st-t wave abnormalities. since the previous tracing of probably no significant change. clinical correlation is suggested. . read by: , a. . intervals axes rate pr qrs qt/qtc p qrs t 104 100 82 316/393 37 -4 119 . cxr . single supine view of the chest at 12:00 a.m.: lung volumes are low, resulting in vascular crowding. opacity at the left lung base is probably atelectasis or a very small pneumonia. there is no pneumothorax. the heart size is normal. accounting for patient rotation, there is no hilar or mediastinal enlargement. pulmonary vascularity is normal. there is no increase in interstitial markings. there is extensive subcutaneous air in the left abdominal wall, tracking along the left chest wall. . impressions: 1. left lung base opacity may indicate atelectasis or layering pleural effusion. 2. extensive subcutaneous air overlying the left abdominal wall, tracking to the left chest wall. osh abdominopelvic ct (reviewed on a separate workstation and not available on pacs) demonstrates this to extend from a large abscess in the anterior pelvis. . ekg probable atrial fibrillation but baseline artifact makes assessment difficult. low precordial lead qrs voltage. modest low amplitude t wave changes. findings are non-specific. since the previous tracing of the rhythm now appears to be atrial fibrillation but baseline artifact makes comparison difficult. . read by: , w. . intervals axes rate pr qrs qt/qtc p qrs t 92 0 102 380/436 0 1 100 . cxr . impression: et tube in standard placement, nasogastric tube ends in the stomach, left subclavian line in the mid svc. small-to-moderate bilateral pleural effusions, and substantial left lower lobe atelectasis unchanged. heart size normal. no pneumothorax. . cxr . impression: ap chest compared to : . moderate left pleural effusion has increased, small to moderate right pleural effusion is new. left lower lobe previously collapsed is still consolidated and there is new right infrahilar consolidation which could be atelectasis or developing pneumonia. heart size is obscured but mediastinal vasculature is mildly engorged indicative of volume overload or cardiac decompensation. nasogastric tube passes into the stomach and out of view. . rue u/s impression: no evidence of deep vein thrombosis in the right arm. . ct pelvis impression: 1. resolution of fluid collections post surgical drainage of large anterior abdominal wall abscess. 2. small amount o free fluid in the pelvis. 3. dramatic reduction in the subcutaneous/fascial gas in comparison to the prior study. 4. persistent large abdominal wall hernia with nonobstructed loops of bowel 5. increased large pleural effusions with bilateral lower lobe collapse. the study and the report were reviewed by the staff radiologist. . labs on discharge: . na 139 k 4.3 cl 108 bun 23 creat 0.5 gluc 155 wbc 7.5 hct 27.3 platelets 389 brief hospital course: 80 yof with dm, htn, dementia, diverticulosis/gib who was admitted to sicu after found to have perforated diverticulosis/abdominal abscess/fistula which is now s/p drainage/i&d and 3 wk course of vanc/zosyn, whose post-op course complicated by re-intubation for chf vs aspiration pna, extubated after diuresis; also with tachy-brady (atrial tach, asymptomatic bradycardia) syndrome and malnutrition. during this hospitalization, her goals of care were changed to be dnr/dni and goals were shifted towards comfort care after discuassion with hospice and family. she will f/u with hospice at her nursing facility on discharge. . 1. respiratory failure: unclear if truly chf vs aspiration pneumonia, but pt with bilateral pleural effusions and vascular engorgement reflective of gross volume overload. she was intubated on admission and intubated a second time through admission, however was extubated after diuresis. she was called out of the icu and diuresed further, and had no further respiratory issues through admission, was satting well on ra and not tachypneic by discharge. she was kept on aspiration precautions, had s/s evaluation showing that she can tolerate soft solids and should have nutritional supplement with meals and 1:1 supervision during eating. . 2. abscess: pt was admitted to sicu septic from abdominal abscess. taken to or and is s/p i&d with feculent material draining into ostomy bag several days after procedure. assumed fistula between gi tract, abscess, and skin; however pt not a surgical candidate given poor nutritional state. she was therefore treated with 3 wks of vanc/zosyn with no further signs of infection. she was discharged with an ostomy bag draining the fistula. . 3. tachy/bradycardia: pt noted to have runs of narrow complex svt through sicu and started on metoprolol; then noted to have bradycardia and beta blockade held. ep was consulted and did not feel any intervention warranted. off beta blockade, had fewer episodes of bradycardia and noted to have 4.5 second pauses, so transferred to ccu for further monitoring. after transfer to the ccu, a family meeting was held to discuss the possibility of pacemaker placement, however not consistent with goals of care which are to avoid further interventions and procedures. pt was discharged off of her bblocker given risk of bradycardia, and hrs in the low 100s were tolerated. . 4. mental status: has baseline dementia with superimposed delirium, although unclear whether this may also be her new baseline mental status. she was occasionally oriented to person only, alert and conversational but oftentimes lethargic, but would respond to voice and carry conversational. she was often inattentive though. she could do days of the week forward with frequent prompting and months of the year forward to about , again with frequent prompting. she had improved greatly through her course though with ability to state days of the week backwards in the week prior to discharge and at baseline ms per family . 5. nutrition: pt with low albumin precluding fistula repair. in discussion with surgery, she was a poor candidate for peg placement her hx of pulling tubes. dobhoff was placed but then pulled by pt. discussion of goals of care was held with family and palliative care, who opted for no further interventions to help improve pts nutrition other than supervision while eating and nutritional supplements. . 6. htn/pump: she was continued on metoprolol (as above, continued on it after pacer placement), lasix, valsartan, simva, baby asa. she had an echo while admitted that showed ef 60% but with some evidence of diastolic failure through elevated pulmonary pressure. she was grossly anasarcatous but unlikely due to chf, more likely due to poor albumin and overly aggressive volume resuscitation. her bblocker was held due to her bradycardia, and simvastatin and asa were dc'd on discharge given newly defined goals of care. she was discharged on a smaller dose of lasix than what she was taking on admission due to her poor po intake. . 7. dm: continued on regular insulin sliding scale with good control. . 8. anemia: hct's stable through admission. has h/o gib, was continued on ppi. ostomy contents were guaic and were positive, so likely having chronic slow ooze from gi tract. hct 27 and stable on discharge. . 8. goals of care: extensive goals of care discussion was held by medical team, palliative care and pts family whose goals are towards comfort. therefore, pacemaker and peg tube placement were not done and medications were minimized on discharge. she was permitted to maintain hr in the 100s given decision not to place pacemaker. hospice has been notified at her rehab facility and the family will follow up with them on discharge. family also expressed interest in not rehospitalizing, however this will need to be further addressed by hospice on discharge. pts code status was changed to dnr/dni during the hospitalization. . comm: (in ) . (daughter) (work), . (son) **** or medications on admission: meds: toprol xl 25', diovan 80', aricept5', duoneb, zocor 20mg qdaily, prilosec, insulin sliding scale, iron 325mg twice daily discharge medications: 1. miconazole powder : one (1) application miscellaneous once a day: apply to affected areas daily. 2. ipratropium bromide 0.02 % solution : one (1) inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 3. oxycodone 5 mg/5 ml solution : one (1) po q4h (every 4 hours) as needed for pain: hold if rr<12, oversedated. disp:*100 ml* refills:*0* 4. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 5. acetaminophen 325 mg tablet : two (2) tablet po q6h (every 6 hours) as needed for pain. 6. valsartan 80 mg tablet : three (3) tablet po daily (daily). disp:*90 tablet(s)* refills:*2* 7. fluticasone 50 mcg/actuation spray, suspension : one (1) nasal once a day. 8. acetaminophen 650 mg tablet : one (1) tablet po three times a day as needed for pain. 9. lasix 20 mg tablet : one (1) tablet po once a day. 10. insulin regular human 100 unit/ml solution : one (1) unit injection four times a day: please take according to your sliding scale prior to hospitalization. 11. albuterol sulfate inhalation discharge disposition: extended care facility: - discharge diagnosis: ruptured abdominal abscess with likely communicating fistula. tachy-brady syndrome, s/p pacemaker placement malnutrition volume overload/anasarca altered mental status discharge condition: mental status: confused - always level of consciousness: lethargic but arousable activity status: bedbound discharge instructions: you were admitted to for septic shock in the setting of a ruptured abdominal abscess. you were in the icu where they resuscitated you. you received antibiotics for your abscess. you also had a problem with you heart rhythm and your medications were changed to help control your heart rhythm. you had a tube placed in your nose to your stomach so that you can improve your nutrition, however you eventually removed this tube on your own. given that our goal was to make you comfortable, we decided not to place a permanent feeding tube. you were discharged to your nursing facility and will follow-up with hospice at your facility. . the followed changes were made to your medication regimen: 1) your blood pressure medications were changed. please stop taking metoprolol, lisinopril and nifedipine. you should start taking valsartan 240 mg daily. 2) your lasix dose has been decreased from 40 to 20 mg. this may need to be adjusted after you leave the hospital. 3) you were given a prescription for oxycodone for pain 4) please take your insulin per your pre-hospitalization schedule 5) your donepezil was discontinued . please call your doctor if you feel that your pain is not well controlled or you are not comfortable. please follow up with your doctor and the hospice service at your nursing facility followup instructions: please follow up with hospice and your doctor at your nursing facility. hospice has notified that you will be coming and will be discussing goals of care with your family when you arrive. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances other bronchoscopy arterial catheterization other incision with drainage of skin and subcutaneous tissue diagnoses: cellulitis and abscess of trunk congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia iron deficiency anemia secondary to blood loss (chronic) severe sepsis other persistent mental disorders due to conditions classified elsewhere hypopotassemia acute respiratory failure septic shock encounter for palliative care acute diastolic heart failure sinoatrial node dysfunction delirium due to conditions classified elsewhere diverticulitis of colon with hemorrhage fistula of intestine, excluding rectum and anus paroxysmal supraventricular tachycardia nutritional marasmus edema essential thrombocythemia 

Answer: The patient is high likely exposed to