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: aspirin attending: chief complaint: acute kidney injury major surgical or invasive procedure: cystoscopy with ureteral stent placement history of present illness: 79 year old female w/ chf, afib on coumadin who was transfered from due to acute renal failure due to a 7mm l ureteral stone complicated by a left forniceal rupture. she originally presented to for failure to thrive. she reported feeling "ill" for the past seven days with vague abdominal pain associated with nausea, and had an episode of falling out of bed on the friday prior to admission. she denies emesis, fevers, chills, or sweats. at , she was found to have left sided pleural effusions vs pneumonia and l-sided flank pain. she was hemodynamically stable, however had hhnk with fs 765, and metabolic abnormalities including cr 3.8, k 6.5, bicarb 17, bandemia 19%, and wbc 19. pan-scan showed left-sided ureteral stone, hydronephrosis, and forniceal rupture. her ekg at the time was stable in nsr with digoxin effect (dig 3.7). she received 3l ivf, 5u insulin, na-bicarb (for potassium), as well as 1g vanco/ 3.375g zosyn. urology at requested transfer to due to the complexity of her presentation. in the ed at , her vitals were: t 98.7, hr 68, bp 134/46, rr 20, o2 100% 2l. exam showed mild diaphoresis, llq and left cva tenderness, and an elderly woman in mild distress. labs were significant for fs > , na 129, k 5.5, hco3 15, cr 3.4, ca 7.5, wbc 19.7, hct 29.4, plt 397, inr 6.3. ekg showed afib @ 68 with digoxin effect. a ua showed many bacteria, > 182 wbcs, and 1000 glu. she was given 100 units of regular insulin x 2. she was seen in the ed by urology, who recommended admission to the icu for treatment of her hyperkalemia, hhnk, and super-therapeutic digitalis before ir-guided l percutaneous nephrostomy tube tomorrow. on arrival to the micu, patient's vs were t 97.8, hr 71, bp 115/50, rr 28, o2 99%/2l past medical history: - congestive heart failuire - atrial fibrillation, on coumadin - type 2 diabetes mellitus social history: lives at home with brother, who cares she cares for. has nieces who helps care for her. family history: non-contributory physical exam: admission exam: general: elderly woman, responsive to questions, no pain without movement, fatigued. neck: supple, jvp not elevated, no lad. cv: irregularly irregular, s1 + s2, 3/6 systolic murmur in left sternal border. lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: palpable mass in left upper quadrant with llq tenderness, l cva tenderness to palpation, bowel sounds present. gu: erythematous rash in perivaginal folds. foley. ext: diaphoretic, 1+ pulses, no clubbing, cyanosis or edema. neuro: cn ii-xii grossly intact. moves all four extremities ---- discharge condition: the patient expired. pertinent results: admission labs: 10:10pm blood wbc-19.7* rbc-2.99* hgb-9.2* hct-29.4* mcv-99* mch-30.9 mchc-31.3 rdw-14.4 plt ct-397 10:10pm blood neuts-89.5* lymphs-7.4* monos-2.9 eos-0.1 baso-0.1 10:10pm blood pt-62.8* ptt-48.1* inr(pt)-6.3* 02:00am blood glucose-453* urean-77* creat-3.3* na-135 k-4.5 cl-105 hco3-15* angap-20 10:10pm blood alt-27 ast-42* alkphos-90 totbili-0.5 10:10pm blood lipase-99* 10:10pm blood albumin-2.2* calcium-7.5* phos-3.8 mg-2.0 03:57pm blood %hba1c-11.1* eag-272* 02:00am blood digoxin-5.5* 02:14am blood type- temp-36.7 o2 flow-2 po2-43* pco2-41 ph-7.22* caltco2-18* base xs--10 intubat-not intuba comment-green top 09:43pm blood glucose-greater th lactate-1.7 na-129* k-5.5* cl-106 calhco3-15* 02:14am blood freeca-1.07* discharge labs: 02:59am blood wbc-17.5* rbc-2.45* hgb-7.4* hct-23.3* mcv-95 mch-30.2 mchc-31.7 rdw-15.5 plt ct-289 02:59am blood pt-15.6* ptt-25.8 inr(pt)-1.5* 03:52pm blood glucose-316* urean-71* creat-3.5* na-136 k-4.6 cl-107 hco3-17* angap-17 03:52pm blood calcium-8.2* phos-2.8 mg-2.2 05:00pm blood lactate-1.9 06:50am blood type- po2-33* pco2-28* ph-7.30* caltco2-14* base xs--11 urine studies: 10:10pm urine color-yellow appear-cloudy sp -1.013 10:10pm urine blood-sm nitrite-neg protein-30 glucose-1000 ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-lg 10:10pm urine rbc-5* wbc->182* bacteri-many yeast-none epi-3 10:10pm urine wbc clm-mod mucous-rare 03:57pm urine color-brown appear-cloudy sp -1.015 03:57pm urine blood-lg nitrite-neg protein-100 glucose-tr ketone-neg bilirub-neg urobiln-neg ph-5.5 leuks-lg 03:57pm urine rbc->182* wbc->182* bacteri-many yeast-none epi-0 03:57pm urine wbc clm-many 03:57pm urine hours-random urean-263 creat-38 na-87 k-14 cl-71 micro data: urine culture (final ): no growth. urine culture (final ): source: catheter gram positive bacteria. >100,000 organisms/ml.. alpha hemolytic colonies consistent with alpha streptococcus or lactobacillus sp. urine culture (final ): source: cystoscopy gram positive bacteria. >100,000 organisms/ml.. alpha hemolytic colonies consistent with alpha streptococcus or lactobacillus sp. urine culture (final ): no growth. blood culture : pending imaging: cxr : findings: as compared to the previous radiograph, patient has received a new internal jugular vein catheter on the right. the tip of the catheter projects over the mid-to-low svc. there is no evidence of complications, notably no pneumothorax. increasing left pleural effusion with substantial left lower lung atelectasis. retrograde urography : findings: 21 spot fluoroscopic images obtained without a radiologist present are submitted for review. images demonstrate poor filling of the upper collecting system. multiple filling defects are noted in the distal ureter and the upper pole. images also demonstrate the placement of a double-j stent. please consult the operative note in the online medical record for further details. cxr : conclusion: new mild right-sided pleural effusion. stability of the left moderate pleural effusion. renal u/s : impression: there is mild bilateral pelvocaliectasis without evidence of frank hydronephrosis. ekg : atrial fibrillation with controlled ventricular response. left ventricular hypertrophy. no previous tracing available for comparison. ekg : atrial fibrillation. left ventricular hypertrophy. probable digitalis effect. no major change from previous tracing. ekg : atrial fibrillation with rapid ventricular response and occasional ventricular ectopy. q-t interval prolongation. diffuse non-specific st segment changes. compared to the previous tracing of ventricular ectopy has appeared. otherwise, no diagnostic interim change. brief hospital course: 79 year old female with congestive heart failure, atrial fibrillation on coumadin who was transfered from due to acute renal failure due to a left ureteral stone, complicated by urinary tract infection, hyperosmolar hyperglycemic non-ketotic syndrome, supratherapeutic inr, and digitalis toxicity. active issues: # acute kidney failure: left ureterolithiasis and associated hydroureter, hydronephrosis, perinephric stranding consistent with forniceal rupture. cr at 3.4 on admission. urine output on admission low at 10-15cc/hr. there was also a superimposed urinary tract infection and acute tubular necrosis. the patient was seen by urology who placed a stent and frank pus passed through the urinary catheter. the patient was also seen by renal who recommended continued treatment of her infection and fluid boluses as needed for her acidosis (see below). the patient was treated with vancomycin and zosyn for her urinary tract infection. her cr remained elevated until the time of her death. her urine output had improved to 50-100cc/hr. # hyperosmolar hyperglycemic nonketotic syndrome: the patient has a history of non-insulin dependent diabetes mellitus and takes metformin and glipizide at home. she does not have ketones in her urine. her abg was 7.22/41/43. hco3 15. this represents a metabolic (anion gap 15) acidosis, with concomitant respiratory acidosis. the metabolic acidosis is likely secondary to renal failure (not producing ammonia), and her respiratory acidosis likely represents inadequate ventilation due to her lll effusion. the patient was maintained on an insulin drip and the diabetes team was consulted to help in managing her. her electrolytes were normalized with iv fluids and appropriate repletions. after a day on the insulin drip, she was transitioned to nightime lantus and an insulin sliding scale with meals. her electrolyte abnormalities resolved. however, her blood sugars remained challenging to control and had risen back to the 300s at the time of her death. # left lower lobe opacity: cxr showed opacities over the left lower lobe without visualization of the left hemidiaphragm. this was most consistent with a left pleural effusion, related to her l forniceal rupture. # digitalis toxicity: the patient was admitted with a high dig level of 5.5 and had some changes consistent with elevated levels of digitalis on her ekg. digibind was initially held as patient was stable and serial ekgs showed no continued changes. pt was given digibind when her digitalis level remained elevated. # atrial fibrillation: currently asymptomatic. held coumadin due to supratherapeutic inr and for ureteral stent placement. # sudden death: unexpectedly, approx 17:10 , patient's monitor alarmed for ventricular tachycardia and nurses and physicians rushed to the room. her rhythm quickly degenerated to ventricular fibrillation and then asystole and she became unresponsive. chest compressions and bag ventilation were initiated immediately and a code blue was called. iv fluids were bolused via her central line. she was given 1mg of epinephrine at 17:12. anesthesia arrived and intubated the patient at 17:15. she was given a total of 4 mg epinephrine, an amp of bicarb and 4mg of magnesium. at 17:26 during a rhythm check, she was found to be in vtach without a pulse and cardioversion was attempted. cpr was resumed. subsequent rhythm and pulse checks confirmed asystole. perfusing rhythm was not achieved. cpr was discontinued and she was confirmed dead at 17:35. her niece was notified and declined autopsy. patient??????s next of is her brother, but given his dementia it was decided that notification should occur in person via patient??????s niece. transitional issues: pt expired. medications on admission: - digoxin 0.25mg daily - coumadin 2mg daily - lasix 40mg daily (for leg swelling) - k-dur 20mg daily (with lasix) - metformin - glipizide discharge medications: patient expired. discharge disposition: expired discharge diagnosis: renal failure uti sudden cardiac death discharge condition: expired discharge instructions: n/a followup instructions: n/a md procedure: insertion of endotracheal tube ureteral catheterization retrograde pyelogram cardiopulmonary resuscitation, not otherwise specified central venous catheter placement with guidance diagnoses: anemia, unspecified acute kidney failure with lesion of tubular necrosis unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension unspecified septicemia atrial fibrillation sepsis paroxysmal ventricular tachycardia long-term (current) use of anticoagulants hydronephrosis calculus of ureter cardiotonic glycosides and drugs of similar action causing adverse effects in therapeutic use mixed acid-base balance disorder pyelonephritis, unspecified other specified disorders of kidney and ureter unspecified adverse effect of other drug, medicinal and biological substance physical restraints status diabetes with hyperosmolarity, type ii or unspecified type, uncontrolled 

Answer: The patient is high likely exposed to