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: bactrim / sulfonamides / morphine / shellfish attending: chief complaint: lethargy major surgical or invasive procedure: none history of present illness: 44-year-old female with collagenous colitis/crohn's disease presented to er with fatigue and fever to 101.7 f at home after having had her hickman (x 18 hrs) repaired the previous day. in the ed, temp 103 f, bp 142/69; bp dropped to 96/35. she received vanco/cefipime for presumed lung infection and 2l ns. she was admitted to the , covered with vanco/cefapime until cx grew coag negative staph, switched to vanco. volume resuscitated with stabilization of bp in 110s. icu course also notable for d/c coumadin (had completed 6 mos course for prior pe), hyponatremia (resolving with fluid resuscitation), anemia (hct dropped to 19.8) for which she received 1unit prbc, and facial/neck swelling (chronic in the setting of venous stenosis from multiple prior line placements. ir and surgery consulted, goal is to preserve hickman. currently, the patient reports generalized myalgias, occasional lightheadedness. she denies fevers/chills . ros: no weight loss. (+) fatigue/malaise. no chills, night sweats, loss of vision. (+) dry mouth. no sinus pain, sore throat, chest pain, palpitations. (+) chronic le edema and doe. no current shortness of breath or hemptoysis. (+) dry cough this a.m. no nausea, vomiting. (+) chronic ruq/rlq abdominal pain, unchanged from baseline. (+) diarrhea, bm/day, at baseline, no melena or hematochezia. no bleeding, lymphadenopathy, dysuria, hematuria, increased urinary frequency/urgency, rash. (+) loss of energy. (+0 myalgias/arthralgias. no numbness/tingling, headache. (+) chronic lbp, no change from baseline. past medical history: 1) crohn's disease (dx , on mtx/remicaide, baseline bm's per day), s/p colectomy , reanastamosis (ileo-rectal) , h/o collagenous colitis 2) crohn's arthropathy (seronegative) 3) gerd 4) raynaud's 5) depression/anxiety 6) migraine ha's 7) iron def anemia 8) mssa line infxn 9) burkholderia bacteremia and 10) chronic hickman catheter for ivf 11) svc syndrome, left ij and left subclavian stenosis s/p angioplasty in 12) hx of left exudative pleural effusion of unclear etiology h/o vats~ - for left exudative pleural effusion around time of #7 13) hx of left pneumothorax due to porta-cath placement 14)left knee arthroscopy 15)schatzki's ring-noted on egd 16) h/o post menopausal vaginal bleeding 17) oral hsv social history: the pt lives in with her husband and two children, she does not work, she smokes 0.5-1ppd x 20 yrs, she drinks beers/day family history: father has polycythemia, mother has melanoma. physical exam: pe: tc 98.5, pc 91, bpc 96/64, pc 91, resp 16, 96% ra gen: chronically-ill appearing elderly female, a&ox3, nad heent: anicteric, pale conjunctiva, omm dry, op clear, neck supple, no lad. (+) generalized neck swelling w/o cords palpated cardiac: rrr, ii/vi sm at lsb pulm: cta bilaterally chest: hickman catheter with minimal erythema at opening, non-tender abd: nabs, moderately distended, tympanitic, mod rlq/llq tenderness without rebound or guarding ext: trace le edema at ankles bilaterally, warm, 2+ dp bilaterally neuro: cn ii-xii grossly intact and symmetric bilaterally, strength throughout with encouragement, sensation intact to light touch proximally and distally in upper and lower extremities bilaterally. pertinent results: ekg: sinus tach, low voltage in limb leads . radiology: cxr ap (-) pna . micro: ucx: >100k yeast, >3 colony types bcx pending. cns sensitive to oxacillin, gent, levo (all drawn from line . brief hospital course: 1) coag neg staph line sepsis: patient presented with fatigue and fever of 101.7. in the ed she was noted to have a temperature of 103, bp 142/69, hr 118, and 95% on 2l nc. wbc was 12.9 with 93% neutrophils but no bands. initial lactate 3.1 but improved to 2.6 with iv fluids. patient was admitted to the icu for monitoring and was treated with vancomycin and ceftazidime. cxr and urinalysis were unremarkable and her initial lfts were normal. her blood cultures drawn off her line subsequently grew coag neg staph. her ceftazidime was discontinued. she was continued on vanc but had persistent fever spikes. her subsequent sensitivities revealed oxacillin sensitivity. thus, the patient was switched to nafcillin and thereafter defervesced. ir was consulted but all parties agreed it was in the best interest of the patient to attempt to treat through this infection given she has very difficult access. other than her initial blood cultures, all of her surveillance cultures have so far been no growth to date. she did undergo an echo while in house to rule out a vegetation. this revealed a normal ef with no evidence of vegetation. she was discharged home on an additional 11 days of nafcillin for a total of 14 days of this antibiotic, which seemed much more effective in clearing her infection. she understands to monitor the site for new erythema, pain, or temperature > 101. she will be following up with her primary care doctor , for interval assessment at which time her lfts will need to be rechecked given she is on nafcillin. . ## anemia: patient admitted with a hematocrit of 22.6 which dropped to 18.7 with iv hydration. she was thus transfused 3 units of prbc. her hematocrit bumped appropriately to 30 and has since slowly trended down to 26.7 on the day of discharge. she was continued on her niferex-150 and will follow-up with her regular providers to continue iv iron as needed. her vitamin b12 and folate are normal. . ## crohns and collagenous colitis: patient was continued on her home dose of mesalamine. she continued to have her baseline chronic diarrhea. during her stay she complained of diffuse arthralgias. she has taken alleve for this in the past but did not receive nsaids while in house. she moved comfortably with only her home pain medications in addition to tylenol as needed. she did inquire regarding her methotrexate infusion but was informed this cannot be restarted until she has cleared her infection and only at the discretion of her primary care doctor. i have arranged follow-up for her with her gastroenterologist to consider possibly increasing her mesalamine in hopes of improving her joint complaints if they persist. there was no warmth or erythema of her joints on exam to suggest infectious involvement. . ## gerd: patient complained of significant gerd which she states is long standing. an h2blocker was added to her home ppi. in addition, her regular gi attending advised adding a sucralfate slurry. in addition, at the request of her gi physician, outpatient gastric emptying study has been ordered to evaluate for delayed emptying as motility agents may also help her symptoms if she does in fact have delayed emptying. . ## hyponatremia: sodium 132 on admission. this was likely resolved to her initial dehydration and revolved with ivf. . ## chronic abdominal pain: patient was continue on her home doses of dilaudid, methadone, and amitriptyline. . ## h/o pe: patient was taken off her coumadin given she is 6 months status post her pe and required prbc transfusion for ongoing iron deficiency anemia. she was scheduled to see dr. to address this further but wishes to follow-up with her pcp first to determine if this is necessary. she has been seen by dr. previously who suggested a 6 month course. he wishes to follow-up with her off of coumadin for a hypercoagulable work-up to determine if her anticoagulation should be continued further. . ## transaminitis: patient noted to have bump in lfts on nafcillin. she will follow-up with her primary care doctor her labs while on this antibiotic. . ## face/neck swelling: patient had swelling with iv fluids which improved with restriction of her iv fluid administration. . ## prophylaxis: ppi, anticoagulated, given she is on methotrexate, it was thought patient would benefit from pcp . given her bactrim allergy, she will need to follow-up with her primary care doctor to consider inhaled pentamadine for prophylaxis. . ## access: hickman . ## code status: full . ## dispo: discharged home with services medications on admission: 1. advair one puff b.i.d. 2. albuterol p.r.n. 3. pentasa 1 gm t.i.d. 4. klonopin 1 mg q.i.d. 5. protonix 40 mg b.i.d. 6. amitriptyline 50 mg q.h.s. 7. methadone 10 mcg/ml, 3 ml or 30 mg q.i.d. 8. dilaudid 8 mg one to two tablets every four hours p.r.n. pain. 9. weekly methotrexate (q ). 10. folate supplements. 11. niferex 150 twice a day. 12. coumadin 7.5 mg 4x/wk, 5 mg 3x/wk. . discharge medications: 1. hickman line care per ccs protocol 2. nafcillin 2 g recon soln sig: two (2) grams intravenous every four (4) hours for 11 days: through . disp:*132 grams* refills:*0* 3. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for joint pain. 4. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 5. mesalamine 250 mg capsule, sustained release sig: four (4) capsule, sustained release po tid (3 times a day). 6. clonazepam 1 mg tablet sig: one (1) tablet po qid (4 times a day). 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 8. amitriptyline 25 mg tablet sig: two (2) tablet po hs (at bedtime). 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 10. hydromorphone 4 mg tablet sig: 8-16 tablets po q4h (every 4 hours) as needed for abdominal pain. 11. fluticasone-salmeterol 100-50 mcg/dose disk with device sig: one (1) inhalation inhalation (2 times a day). 12. methadone 10 mg tablet sig: three (3) tablet po qid (4 times a day). 13. cimetidine 300 mg tablet sig: one (1) tablet po qid (4 times a day). disp:*360 tablet(s)* refills:*2* 14. sucralfate 1 g tablet sig: one (1) tablet po bid (2 times a day): please add tablet to 2 tablespoons of water to form a slurry. disp:*180 tablet(s)* refills:*2* 15. niferex-150 150-50 mg capsule sig: one (1) capsule po twice a day. discharge disposition: home with service facility: critical care systems discharge diagnosis: primary: coagulase negative staph line sepsis secondary: arthralgias, crohns colitis, iron deficiency anemia, gastroesophageal reflux discharge condition: good - afebrile discharge instructions: please call your primary care doctor or go to the emergency room if you experience temperature > 101, worsening redness around your line, worsening or change in your chronic diarrhea, or other concerning symptoms. you can try your alleve for your joint pain but beware of worsening reflux and irritation of your bowel disease on this medication. tylenol may also help with the discomfort and has no gi side effects. i have contact dr. about possibly increasing your mesalamine, which may also help your symptoms. you will be following up with her on . please note, you are no longer taking coumadin. i have started you on cimetidine and sucralfate for your reflux. you also are on iv antibiotics for the next 11 days to treat your line infection. you cannot restart your methotrexate until you have finished your antibiotics and cleared your infection. please see your primary care doctor to determine when it is safe to restart this medication. followup instructions: please follow-up with your primary care doctor , at 2:50 pm at atrium suite. phone: please follow-up with dr. on at 8:40 am on the of . phone: you are scheduled for a gastric emptying study on at 8:00 am. do not eat breakfast on the day of your exam. the exam will take up to 4 hours. please go to the main entrance of the on the day of your exam. the scan will be done on the of the building in nuclear medicine. phone: procedure: transfusion of packed cells diagnoses: other and unspecified noninfectious gastroenteritis and colitis anemia, unspecified hyposmolality and/or hyponatremia sepsis dysthymic disorder regional enteritis of unspecified site infection and inflammatory reaction due to other vascular device, implant, and graft raynaud's syndrome other staphylococcal septicemia nonspecific abnormal results of function study of liver arthropathy associated with gastrointestinal conditions other than infections 

Answer: The patient is high likely exposed to