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: morphine / codeine / sulfonamides / compazine / iodine; iodine containing attending: chief complaint: fevers major surgical or invasive procedure: none history of present illness: 49 yo f w/ ms catheter w/ h/o mult utis (pseudomonas, morganella/klebsiella res to gati) and mrsa cellulitis presented from home w/ change in mental status and fever. the patient reports that she had felt "tired" for the 24 hrs prior to admission. her vna found her on am lethargic w/ t103 and ems brought her to the ed. in ed, t 102.8, hr 122, bpc 129/90; pt received 5 l ns, vanco 1 g iv x 1, and zosyn 4.5 g iv x 1, and decadron 10 mg iv x 1 (given pt is on baseline prednisone). the pt denied ha, stiff neck, n/v, abd pain, diarrhea, rashes, rhinorrhea, shortness of breath, chest pain, rhinorrhea, or sore throat. she notes no recent change in her chronic foot ulcers or in her catheter output/drainage. no change in baseline neurologic deficit. history obtained now on transfer: patient says that her right foot ulcer has been present for years but about a week ago she scraped both her feet on her scooter introducing "dirt" into her right foot ulcer and creating a new ulcer on her left foot. has had pain that is well-controlled by oxycodone in both feet since incident. she says she had been feeling her usual self until sunday night when she started having fevers and maybe was a little confused. she denies cough, chest pain. says that usually she can tell when she is getting a urinary tract infection because she notices increased odor from urine. did not notice any increase in odor at this time. no change in color either and no purulent drainage from tube which is due to be changed today. denies abdominal pain, diarrhea, change in bowel habits. past medical history: 1) secondary progressive ms dx 2) mrsa cellulitis 3) catheter for incontinence 4) h/o multiple utis: pseudomonas, klebsiella/morganella (resistant to gatifloxacin) 5) s/p viral meningitis 6) orif right ankle fracture 7) htn social history: lives at home with vna services; former nurse; divorced with 2 children; has 2 estranged brothers; remote etoh use; no tobacco, no ivdu family history: 2 paternal aunts with ms physical exam: on admit: tc 99.7, pc 96, bpc 104/56, resp 15, 97% 4l nc-->94%ra gen: middle-aged caucasian woman, very sleepy but arousable to touch/voice, oriented to person and place, nad heent: nc/at, perrl, eomi, omm slightly dry, op clear, neck supple w/o lad. cardiac: rrr, nl s1 and s2, no m/r/g pulm: crackles at right base, clears w/ coughing abd: obese, soft, nt/nd, catheter in place w/ minimal surrounding erythema, non-tender, small amt of clear discharge noted ext: warm with 1+ dp bilaterally, 2 cm ulcer over left lateral malleolus w/ small amount of purulent drainage, 3 cm ulcer over right heel with larger amt of purulent drainage and surrounding erythema. no cyanosis or edema noted. back: no tenderness to percussion over kidneys. neuro: bilateral facial weakness, symmetric bilaterally, othwerise cn ii-xii grossly intact and symmetric bilaterally, rue and rle strength, lue and lle strength, (+) spasticity of ue bilaterally r>l, sensation intact to light touch proximally and distally in upper and lower extremities bilaterally on transfer to floor tc 98.4, bp 138/82, hr: 89 rr: 20 , 96% room air gen: middle-aged caucasian woman in nad, resting comfortably heent: nc/at, perrl, eomi, mmm, op clear, neck supple w/o lad. cardiac: rrr, nl s1 and s2, no m/r/g pulm: cta b/l abd: obese, soft, nt/nd, catheter in place w/ minimal surrounding erythema, non-tender, no discharge noted ext: warm with 1+ dp bilaterally, 2 cm ulcer over left lateral malleolus w/ minimal serosanguionous drainage, 3 cm ulcer over right heel with serosanguinous drainage and surrounding erythema. right foot valgus deformity. darkened pigmentation right > left lower legs. no cyanosis or edema noted. back: no tenderness to percussion over kidneys. neuro: bilateral facial weakness, symmetric bilaterally, othwerise cn ii-xii grossly intact and symmetric bilaterally, rue and rle strength, lue and lle strength, (+) spasticity of ue bilaterally r>l, sensation intact to light touch proximally and distally in upper and lower extremities bilaterally pertinent results: admit labs: 08:40am wbc-18.4*# rbc-5.40# hgb-14.1 hct-42.2 mcv-78* mch-26.0* mchc-33.3 rdw-14.7 08:40am neuts-81.1* bands-0 lymphs-12.8* monos-4.9 eos-0.7 basos-0.5 08:40am plt count-332 08:40am glucose-90 urea n-15 creat-0.7 sodium-139 potassium-3.5 chloride-98 total co2-34* anion gap-11 lft's: 08:40am alt(sgpt)-21 ast(sgot)-25 alk phos-91 amylase-40 tot bili-0.5 08:40am lipase-21 urinalysis: 09:15am urine blood-lg nitrite-pos protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-mod 09:15am urine rbc-0-2 wbc->50 bacteria-many yeast-none epi-0 09:15am urine ca oxal-occ 09:15am urine color-straw appear-hazy sp -1.018 transfer labs: 05:01am blood wbc-12.1* rbc-4.69 hgb-12.2 hct-37.1 mcv-79* mch-26.1* mchc-33.0 rdw-14.8 plt ct-250 05:01am blood neuts-90.6* lymphs-7.3* monos-2.1 eos-0 baso-0 05:01am blood plt ct-250 05:01am blood glucose-115* urean-9 creat-0.3* na-146* k-3.3 cl-111* hco3-29 angap-9 05:01am blood calcium-8.2* phos-1.8*# mg-1.9 micro: blood: ngtd urine: pseudomonas, pending left foot: gram positive bacteria and gnr right foot: gram positive bacteria chest x-ray: portable ap chest radiograph. the comparison is made with a prior chest radiograph dated . findings: the cardiac and mediastinal contours are within normal limits. the patient is slightly rotated. bilateral lungs are clear. no consolidation noted. impression: no acute cardiopulmonary process. foot films: pending brief hospital course: this is a 49 year old woman with a history of multiple sclerosis and recurrent uti's with catheter who presented with fever and mental status change. patient was admitted to the intensive care unit. short stay for sepsis protocol involved rescucitation with ivf, no pressors and initiation of zosyn/vancomycin. the following issues were addressed on this admission: . 1) concerning fevers, mental status change: patient admitted with fevers to 102 and history of urinary tract infections ( catheter) from multi-drug resistant organisms including psuedomonas and mrsa. likely sources of infection included urine and or foot ulcers given history and exam. as per icu team, although patient with leukocytosis, tachycardia, and hyperthermia, she was never hypotensive and lactate was <4. history of multiple prior uti's however, did not notice her usual symptoms, no purulent drainage form tube which was due to be changed but urine grew both pseudomonas and mrsa. the patient also reported recent history of trauma to foot ulcers, swabs growing lots of bacteria but are of unclear value. reportedly with purulent drainage, fluctuance induration at home, but on exam here, no evidence of osteomyletis. foot films were negative for evidence of bone infection. patient had ultrasound for suspicious looking area of fluctuance of fifth left toe. ultrasound showed no evidence of abcess. exam consistent with possible cellulitis. there were no other localizing sources of infection on history/exam. no evidence pneumonia, abdominal or other source at this time. no evidence of meningismus to suggest meningitis/encephalitis. chest x-ray was without acute process. blood cultures remained negative as of date of discharge. patient maintained on zosyn/vancomycin. she will be treated with 14 day course of each to cover urinary tract infection secondary to pseudomonas and mrsa and possible cellulitis. final blood culture results pending at time of discharge. altered mental status returned to baseline over course with treatment of infection and iv fluids. 2)concerning multiple sclerosis: patient was maintained on baclofen, gabapentin, glatiramer; prednisone (got stress dose in er given relative hypotension). acute issues. on alendronate given long-term steroids, dosing q thursday. * 3) prophylaxis: patient maintained on subcutaneous heparin for dvt prophylaxis and famotidine (given steroids) for gi prophylaxis. 4) pain: percocet was maintained on her home dosing for foot pain. * 5) code: patient full code throughout admission. patient was a candidate for rehabilitation but did not desire rehab at this time, wanted to be discharged to home. * medications on admission: 1) baclofen 20 mg po qid 2) gabapentin 200 mg po tid 3) prednisone 10 mg po daily 4) glatiramer 30 mg sc daily 5) fexofenadine 60 mg po bid 6) colace 100 mg po bid 7) ranitidine 150 mg po bid 8) modafinil 100 mg po bid 9) aledronate 70 mg po qth 10) combivent q6h prn 11) ibuprofen 40 mg po q8h 12) hctz 25 mg po daily 13) escitalopram 10 mg po daily 14) ambien 10mg qhs 15) lipitor 20 mg po daily discharge medications: 1. vancomycin hcl 10 g recon soln sig: one (1) gram recon soln intravenous q12h (every 12 hours) for 10 days. disp:*20 gram recon soln(s)* refills:*0* 2. piperacillin-tazobactam 4.5 g recon soln sig: one (1) recon soln intravenous q8h (every 8 hours) for 10 days. disp:*30 recon soln(s)* refills:*0* 3. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po daily (daily). 4. prednisone 10 mg tablet sig: one (1) tablet po daily (daily). 5. glatiramer acetate 20 mg kit sig: one (1) kit subcutaneous qd (). 6. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). 7. escitalopram oxalate 10 mg tablet sig: one (1) tablet po daily (daily). 8. modafinil 100 mg tablet sig: one (1) tablet po bid (2 times a day). 9. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed: for pain. disp:*20 tablet(s)* refills:*0* 10. baclofen 10 mg tablet sig: two (2) tablet po qid (4 times a day). 11. gabapentin 100 mg capsule sig: two (2) capsule po q8h (every 8 hours). 12. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 13. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: puffs inhalation q6h (every 6 hours) as needed. 14. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 15. zolpidem tartrate 5 mg tablet sig: two (2) tablet po hs (at bedtime) as needed. discharge disposition: home with service facility: multicultural vna discharge diagnosis: pseudomonal and mrsa urinary tract infection, multiple sclerosis discharge condition: stable discharge instructions: contact md if you experience any fevers, change in your urine, develop any foot pain, redness or swelling or if you develop any new concerning symptoms. take all your medications as prescribed. follow-up as below. followup instructions: you must call to set up an appointment with dr. at for next week as we discussed. procedure: venous catheterization, not elsewhere classified diagnoses: urinary tract infection, site not specified unspecified essential hypertension long-term (current) use of steroids unspecified septicemia sepsis multiple sclerosis urinary incontinence, unspecified cellulitis and abscess of foot, except toes ulcer of heel and midfoot infection and inflammatory reaction due to indwelling urinary catheter ulcer of ankle neurogenic bladder nos fall from (nonmotorized) scooter 

Answer: The patient is high likely exposed to