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: diarrhea major surgical or invasive procedure: intubation with mechanical ventilation femoral cvl placement a-line placement history of present illness: 56f w esrd on pd last hd 3 days pta (), history of recurrent c. difficile infection currently on flagyl and vancomycin taper discharged on , whose friends called ems today after friends called them because the patient hadn't contact them in a few days and she was found to be slightly altered. she was brought to the ed where she was found to have continued abdominal pain. she reports that her pain is described as an crampy nonradiating pain located across the epigastrium that has not associations with food and is relieved with psin medications. she reports that her bms have increased from ~4/day to ~7 loose, watery copius, nonbloody bms. when she was initially admitted on she reports having 24bms per day. this abdominal pain was associated with lightheadedness, dizziness but no syncope. she denies any chest pain or palpiations. she denies fevers. she does, however, report that she's sob with doe with increasing leg swelling, but no increase in orthopnea or pnd. as above her last hd was 3 days pta. . in the ed her vitals: 99.2 72/45 56. the hypotension (72/45) was refractory to ns boluses thus requiring levophed and r femoral line placement. she had a leuckocytosis with left shift and ct abdomen with evidence of colitis. patient also had a negative head ct. she was given dextrose for hypoglycemia, cultures taken, and she was given vanc/zosyn empirically. past medical history: past medical history: - esrd on peritoneal dialysis daily (transitioned off hd just before ), ? htn vs proliferative gn vs ? history of lupus. dry weight 78kg. - syndrome secondary to clots, on coumadin - h/o peritonitis (cloudy pd fluid) - h/o e cloacae line bacteremia - c diff colitis; first dx in , recurrence in and , requiring po vancomycin w taper - cad--per omr - htn - dyslipidemia - anemia: baseline hct 25-31 - asthma - osa on cpap - h/o right gluteal bleed while on heparin gtt - h/o rheumatic fever - oa in left shoulder - h/o rotator cuff tear on left - h/o tah for fibroids - s/p b/l total knee replacements - h/o herpes zoster with post-herpetic neuralgia - sbo social history: used to be a social worker. currently smoking occasionally, history of tobacco use of ppd x 30 years. occasional alcohol. former cocaine user in remote past. family history: father, uncle, and brother had cad in their 40s. brother had renal disease and a stroke. physical exam: general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: labs on admission: . 01:50pm blood wbc-18.2*# rbc-3.49* hgb-10.2* hct-33.0* mcv-95 mch-29.3 mchc-31.0 rdw-18.5* plt ct-375 01:50pm blood neuts-90.4* lymphs-5.2* monos-3.7 eos-0.5 baso-0.3 01:50pm blood pt-57.1* ptt-53.6* inr(pt)-6.7* 01:50pm blood glucose-58* urean-54* creat-11.6* na-136 k-4.4 cl-99 hco3-17* angap-24* 09:44pm blood alt-5 ast-22 ld(ldh)-372* ck(cpk)-746* alkphos-168* totbili-0.1 09:44pm blood ck-mb-18* mb indx-2.4 ctropnt-0.12* 09:44pm blood calcium-7.2* phos-7.0*# mg-2.0 . hospital course: 04:55am blood tsh-3.4 04:55am blood free t4-0.98 04:55am blood cortsol-22.1* 02:42am blood cortsol-12.3 03:11am blood cortsol-20.2* 10:10am blood igg-1171 iga-523* igm-81 . ct head: conclusion: 1. no acute intracranial process. 2. small focus of heterotopic matter as described above, present on multiple prior examinations. 3. prominence of the retropharyngeal soft tissues, although was seen on the prior ct, warrants direct visual inspection. . ct abd/pelvis: impression: 1. no evidence for megacolon. 2. extremely limited study due to suboptimal contrast phase and paucity of mesenteric fat and lack of oral contrast. 3. mild colonic wall thickening could be seen in the setting of colitis or bowel wall edema in the setting of peritoneal dialysis. 4. chest wall collaterals and suboptimal contrast phase raised the possibility of stenosis/occlusion versus sequlae of surgical a/v dialysis fistula. . ct chest: impression: 1. small bilateral bibasilar consolidation, right greater than left. 2. small bilateral pleural effusions. 3. cardiomegaly. . cxr (): reason for exam: respiratory failure, pneumonia. comparison is made with prior studies including 2/24,25,26/. there are low lung volumes. bibasilar opacities have improved markedly on the right. small right pleural effusion is unchanged. cardiomegaly is stable. there is no pneumothorax. brief hospital course: in short, ms is a 56f w multiple medical problems, notably htn, esrd (on pd), clot (on home coumadin), and recent admission w recurrent c. difficile colitis (on /vanc po), who was originally admitted to the micu w altered mental status, hypotension in the setting of worsened diarrhea. she was found to be in respiratory failure from a pneumonia requiring mechanical ventilation, was treated with vanc/zosyn x 7 days (completed), levofloxacin x 14 days (through ) and fluids. she was also on norepinephrine drip temporarily for pressure support. she was then transferred to medicine for further treatment. # pneumonia: patient presented with septic physiology, initially with unclear source. in the icu, patient was started on levophed gtt for bp support. she was treated empirically with broad-spectrum coverage with vancomycin and zosyn at time of admission. on , patient was intubated due to acute respiratory decompensation. a ct chest revealed bilateral infiltrates. levofloxacin was added for double-coverage of a hospital-acquired pneumonia, both due to worsening respiratory status and radiographic worsening of right-sided pulmonary infiltrate. subsequently, her leukocytosis began to resolved, and respiratory status gradually improved. sputum sample was unrevealing, and legionella testing was negative. on , she successfully underwent at trial of ps at 5/5, but was found to have no cuff leak. given concerns for laryngeal edema due to her facial edema (underlying syndrome), she was treated per protocol with decadron 5 mg q 6 hours x 24 hours. she was successfully extubated with anesthesia at bedside on . vancomycin and zosyn were continued for 7-day day course. plan is to complete a 14 day course of levofloxacin given suspicion for atypical infection. # hypotension: patient was maintained on levophed gtt with goal map > 60. cardiac enzymes were mildly elevated, secondary to demand from esrd. an urgent tte on night of admission showed no evidence of tamponade. levophed was weaned on , and subsequent bp's were in the high 70's systolic with maps > 60. cortisol stim (12 -> 22) ruled out adrenal insufficiency. septic physiology was treated as above. all culture data were unrevealing. she received a dose of iv albumin 25 grams without improvement of bp. # recurrent c. diff infection: patient has documented history of recurrent c. diff infection. given that source of infection was initially undetermined, she was empirically started on iv flagyl and po vancomycin at time of admission to cover for c. diff infection. her c. diff toxin was negative this admission, and iv flagyl was discontinued. she was continued on po vancomycin given her high risk of recurrent c. diff infection while on antibiotics. plan is to complete previously prescribed taper of po vancomycin following completion of levofloxacin course: vancomycin 125 mg qid , through . vancomycin 125 mg through . vancomycin 125 mg daily through . vancomycin 125 mg capsule sig: one (1) capsule po as directed for 8 doses: on , , , , , , . # esrd on pd: pd was continued while inpatient. her oral medications including lanthanum, sevelamer, and cinacalcet were briefly held while she was npo and intubated. she was started on calcitriol during this admission. # syndrome: inr was supratherapeutic during length of icu stay in the setting of antibiotics, and coumadin was held. goal inr . substantial facial edema was noted, and intubation was difficult. medications on admission: citalopram 20 mg daily lorazepam 0.5 mg 1-2 tablets po q12h prn cinacalcet 60 mg daily lanthanum 500 mg po tid w/meals (3 times a day with meals). sevelamer carbonate 2400 mg po tid w/meals gabapentin 300 mg daily acetaminophen 500 mg tid prn warfarin 5 mg daily vancomycin 125 mg qid , through . vancomycin 125 mg through . vancomycin 125 mg daily through . vancomycin 125 mg capsule sig: one (1) capsule po as directed for 8 doses: on , , , , , , . metronidazole 500 mg day 1: , through . morphine 15 mg tablet sig: 1-2 tablets po q6h:prn saccharomyces boulardii 250 mg po daily discharge medications: 1. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 2. lorazepam 0.5 mg tablet sig: 1-2 tablets po twice a day as needed for anxiety. 3. cinacalcet 30 mg tablet sig: two (2) tablet po daily (daily). 4. lanthanum 500 mg tablet, chewable sig: one (1) tablet, chewable po tid w/meals (3 times a day with meals). 5. sevelamer carbonate 800 mg tablet sig: three (3) tablet po tid w/meals (3 times a day with meals). 6. gabapentin 300 mg capsule sig: one (1) capsule po daily (daily). 7. warfarin 5 mg tablet sig: one (1) tablet po once a day. 8. outpatient lab work twice weekly labs at dialysis for inr to manage coumadin. please fax results to dr (). 9. vancocin 125 mg capsule sig: as directed capsule po as directed: through : 1 tab four times daily; : 1 tab twice daily; : 1 tab daily; 1 tab on , , , , , , . 10. morphine 15 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain for 10 days. 11. saccharomyces boulardii 250 mg capsule sig: one (1) capsule po once a day. 12. calcitriol 0.25 mcg capsule sig: one (1) capsule po daily (daily). disp:*30 capsule(s)* refills:*2* 13. miconazole nitrate 2 % ointment sig: one (1) topical once a day for 2 weeks. disp:*1 bottle* refills:*0* 14. levofloxacin 250 mg tablet sig: one (1) tablet po daily (daily) for 6 days: end date . disp:*6 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: sepsis hypotension acute respiratory failure hospital-acquired pneumonia . c. difficile colitis end-stage renal disease superior vena cava syndrome discharge condition: good discharge instructions: you were admitted to the hospital with confusion, worsened diarrhea and low blood pressure. you were found to have a lung infection and bowel infection. you were temporarily in the intensive care unit for critical care. your condition has improved. your medications were changed as follows: 1. added levofloxacin for pneumonia; to take until 2. added calcitriol 3. please continue your other medications as prescribed. should you have any worsening in your symptoms, please call your physicians immediately. followup instructions: provider: on friday 6th at 11 am. . provider: , md phone: date/time: 2:00 provider: , md phone: date/time: 10:30 provider: phone: date/time: 1:55 provider: , md phone: date/time: 8:45 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube peritoneal dialysis diagnoses: pneumonia, organism unspecified acidosis end stage renal disease obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery unspecified septicemia severe sepsis asthma, unspecified type, unspecified hypopotassemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia acute respiratory failure compression of vein septic shock long-term (current) use of anticoagulants delirium due to conditions classified elsewhere edema 

Answer: The patient is high likely exposed to