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: penicillins / shellfish attending: chief complaint: 1. obesity with body mass index of 52. 2. fatty liver. 3. gallstones. 4. sleep apnea. 5. gastroesophageal reflux. 6. polycystic ovary syndrome. major surgical or invasive procedure: 1.laparoscopic cholecystectomy converted to open; open roux-en-y gastric bypass. 2.exploratory laparotomy for removal of foreign body. history of present illness: has class iii morbid obesity with weight of 303.7 pounds as of with her initial screen weight on as 304.6 pounds, height 64 inches and bmi of 52.1. her previous weight loss efforts have included 3 months of prescription weight loss medication orlistat (xenical) in losing 10 pounds that she gained back in two months, 4 months of slim-fast in without results and she also took over-the-counter herbal preparation green tea for weight loss in but achieved no results. she has not taken over-the-counter ephedra-containing appetite suppressants. her weight at age 21 was 260 pounds her lowest adult weight with her highest weight being 307.8 pounds on . she weighed 220 pounds one year ago. she states she developed a significant weight problems since her teenage years and cites as factors contributing to her excess weight genetics, late night eating, large portions, too many carbohydrates in saturated fats as well as lack of exercise. she denies history of eating disorders or depression. she has not been seen by a therapist nor has she been hospitalized for mental health issues and she is not on any psychotropic medications. past medical history: gastroesophageal reflux, hyperlipidemia with elevated triglycerides, obstructive sleep apnea testing use cpap, vitamin d deficiency, polycystic ovary syndrome, fatty liver and cholelithiasis social history: she has been smoking two cigarettes a day for 6 years and quit one month ago and has been using chantix for smoking cessation. she denied recreational drug usage and has alcoholic beverage on rare occasion, does drink both caffeinated and carbonated beverages. she is a student at community college studying hospitality. she is single and has no children. she lives with her sister at age 34 and 3 nieces. family history: father living age 54 with obesity and sister living age 27 with asthma. physical exam: vitals on discharge: temp-97.8 bp-120/77 p-104 rr-20 o2 100% room air constitutional: no acute distress; comfortable appearing neuro: alert and oriented to person, place and time cardiac: regular, rate and rhythm, nl s1,s2 lungs: cta bilaterally, no respiratory distress abd: soft, nd, + peri-incisional tenderness, no rebound tenderness/ guarding wounds: abdominal midline incision superior aspect intact. inferior aspect open: wound bed- 100% red granulation tissue, drainage- serosanguinous, periwound edges- no erythema, no edema. ext: no edema pertinent results: laboratory results: 06:32pm blood hct-33.6* 09:05am blood wbc-12.4* rbc-4.34 hgb-11.8* hct-34.3* mcv-79* mch-27.2 mchc-34.5 rdw-15.0 plt ct-338 neuts-88.7* lymphs-6.9* monos-4.2 eos-0.1 baso-0.1 glucose-125* urean-7 creat-0.7 na-139 k-4.1 cl-105 hco3-27 angap-11 alt-141* ast-122* alkphos-44 amylase-27 totbili-0.9 albumin-3.5 calcium-8.3* phos-2.7 mg-1.5* 08:00pm blood type-art po2-74* pco2-46* ph-7.40 caltco2-30 base xs-2 03:30am blood wbc-13.0* rbc-3.81* hgb-10.5* hct-30.2* mcv-79* mch-27.5 mchc-34.7 rdw-14.9 plt ct-329 glucose-105* urean-6 creat-0.7 na-137 k-4.1 cl-103 hco3-29 angap-9 alt-119* ast-103* alkphos-41 amylase-23 02:06pm blood calcium-8.6 phos-1.8* mg-1.9 03:09pm blood type-art rates-/20 peep-5 po2-81* pco2-54* ph-7.38 caltco2-33* base xs-4 intubat-not intuba 01:59am blood wbc-11.5* rbc-3.50* hgb-9.7* hct-28.4* mcv-81* mch-27.7 mchc-34.2 rdw-14.8 plt ct-298 glucose-78 urean-7 creat-0.6 na-139 k-3.8 cl-100 hco3-31 angap-12 calcium-7.9* phos-2.6* mg-1.9 01:46am blood wbc-11.4* rbc-3.40* hgb-9.4* hct-27.1* mcv-80* mch-27.8 mchc-34.8 rdw-15.0 plt ct-347 glucose-81 urean-6 creat-0.5 na-134 k-3.5 cl-95* hco3-28 angap-15 calcium-8.2* phos-2.5* mg-1.8 06:40am blood wbc-13.7* rbc-3.49* hgb-9.7* hct-28.2* mcv-81* mch-27.9 mchc-34.5 rdw-14.8 plt ct-365 chest (portable ap): impression: findings concerning for retained sponge within the right upper quadrant of the abdomen abdomen (supine & erect): impression: apparent interval removal of a retained sponge chest (portable ap): the lung volumes are low. the heart size is top normal, probably exaggerated by the presence of low lung volumes and portable character of the study. there is a right perihilar opacity that might represent infectious process or may be a combination of infection and asymmetric pulmonary edema. left lung demonstrates mild interstitial pulmonary edema. bilateral pleural effusions cannot be excluded. no appreciable pneumothorax is seen. cta chest w&w/o c&recon: impression: 1. no evidence of pulmonary emboli. bilateral moderate atelectasis. 2. no evidence of intra-abdominal fluid collection with close attention paid to the region of the hepatic fossa of the gallbladder as well as at the jejunostomy and gastrojejunostomy site. chest (portable ap): impression: 1. stable bibasilar atelectasis and right upper lung zone linear atelectasis. 2. no focal consolidation, pneumothorax or pulmonary edema. chest (pa & lat): impression: findings concerning for developing pneumonia and possibly mild fluid overload. abdomen (supine & erect): air in the colon and scattered small bowel segments, nonspecific bowel gas pattern. no frank obstruction.no radiopaque foreign body is identified. clips are present in the right upper quadrant. chest (pa & lat): impression: developing pneumonia. dup extext bil (map/dvt): no evidence of deep vein thrombosis either right or left lower extremity microbilogy results: urine culture (final ): escherichia coli.>100,000 org/ml blood culture, routine (final ): no growth. mrsa screen (final ): no mrsa isolated. blood culture: urine culture: no growth sputum gram stain (final ): pmns and >10 epithelial cells/100x field. gram stain indicates extensive contamination with upper respiratory secretions. bacterial culture results are invalid. abdominal wound: no growth brief hospital course: pt was evaluated by anaesthesia and taken to the operating room for laparoscopoic converted to open cholecystectomy and roux-en-y gastric bypass. there were no adverse events in the operating room; please see the operative note for details. pt was extubated, taken to the pacu until stable, then transferred to the for observation. pod 0 (): the patient was tachycardic (hr 120-130's)and was given a bolus of 1 litre of intravenous fluids. pod 1 (): the patient continued to be tachycardic during the early morning hours. she was afebrile and had no pain. she was scheduled for an urgent ugi of the abdomen to rule out any leak. an abdominal film done at this time showed evidence of a retained foreign body possibly a sponge in the right upper quadrant of the abdomen. she was then taken to the or for an emergent exploratory laparotomy to remove the sponge. please see the operative note for details. she was not extubated and transferred to the pacu where she was extubated after a few hours. she was kept on bipap overnight on which she stayed very stable. pod 2 (): she was transferred to the trauma icu where she had a brief episode of desaturation to 80% on 4 l of o2. she was tachycardic and hemodynamically stable through out this period. a ct angiogram of the chest was performed and ruled out any pulmonary embolism. she required 15 l of o2/min during the day and this was further weaned down to 10 l/min overnight. her diet was advanced to stage 1 which was tolerated very well. she also recieved intravenous lasix 20 mg twice since she was thought to be fluid overloaded. pod 3 (): she continued to do well on the 10l/min of o2 which was further weaned down to 4l/min. she had a fever spike to 102 f when she was pan cultured. her urine culture grew e.coli and she was then started on ciprofloxacin. she recieved a few hous of cpap overnight. pod 4 (): she was transferred to the floor and her diet was advanced to stage ii. this was tolerated well. pod 5 (): diet was advanced to stage iii which was tolerated well. there was an increase in the wbc count from 11.4 to 13.7. a chest x-ray was done given her persistent o2 requirement, which was concerning for a possible developing pneumonia. pod 6 (): she had a fever spike to 101.9f when she was pan cultured again. a chest x-ray was done that showed developing pneumonia. also there was an increase in the wbc count noted. pod 7 (): she did well during the day except for being tachycardic to 130's & occasionally 140's with activity. she stayed completely asymptomatic throught this period. in view of her rising white count and recent chest x-ray, intavenous vancomycin and cefepime were started empirically. pod 8(): the lower part of abdominal wound appeared erythematous and was hence opened. wound swabs were sent for gram stain & culture. the gram stain did not show any organisms. she had a fever spike to 101.7f during the day. otherwise, she conitnued to do well on stage iii. her tachycardia was better than the day before and her hr stayed in the 120's and occasionally in 130's with activity. pod 9(): the jp was removed and an infectious disease consult was sought. a repeat chest x-ray was done and blood and urine cultures were sent following their recommendations. she stayed afebrile through out the day. pod 10 (): the abdominal wound was examined and a wound vac dressing was placed. her white cell count was down from 14.7 to 11.7. pod 11 (): she remained afebrile with continued intravenous antibiotics; a wound vac remained in place; her tachycardia had resolved and vital signs remained stable. pod 12 (): no new events pod 13 (): no new events pod 14 (): antibiotics were discontinued with completion of a 7 day course. the vac was removed and the wound was dressed with dry, sterile gauze. the patient's sister was given instruction and demonstrated efficiency in performing the dressing changes. the patient did not have a cpap machine at home, therefore, it was arranged to have one delivered to her home. at the time of discharge, the patient was doing well, afebrile with stable vital signs. the patient was tolerating a stage 3 diet, ambulating, voiding without assistance, and pain was well controlled. the patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. a cpap machine will be delivered to her home with mask fitting and instruction for machine operation. medications on admission: omeprazole 20mg od, mvi 1 tab od, vitd 5000u od discharge medications: 1. docusate sodium 50 mg/5 ml liquid sig: ten (10) ml po bid (2 times a day) as needed for constipation for 10 days. disp:*200 ml* refills:*0* 2. oxycodone 5 mg/5 ml solution sig: one (1) po every 4-6 hours as needed for pain for 10 days: please do not drive or operate heavy machinery while taking this medication. disp:*100 ml* refills:*0* 3. multivitamin,tx-minerals tablet sig: one (1) tablet po bid (2 times a day): chewable. 4. vitamin d 5,000 unit tablet sig: one (1) tablet po once a day: please crush. 5. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day: open capsule; do not chew beads. discharge disposition: home with service facility: caregroup vna discharge diagnosis: 1. obesity with body mass index of 52. 2. fatty liver. 3. gallstones. 4. sleep apnea. 5. gastroesophageal reflux. 6. polycystic ovary syndrome. discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: please call your surgeon or return to the emergency department if you develop a fever greater than 101.5, chest pain, shortness of breath, severe abdominal pain, pain unrelieved by your pain medication, severe nausea or vomiting, severe abdominal bloating, inability to eat or drink, foul smelling or colorful drainage from your incisions, redness or swelling around your incisions, or any other symptoms which are concerning to you. diet: stay on stage iii diet until your follow up appointment. do not self advance diet, do not drink out of a straw or chew gum. medication instructions: resume your home medications, crush all pills. you will be starting some new medications: 1. you are being discharged on medications to treat the pain from your operation. these medications will make you drowsy and impair your ability to drive a motor vehicle or operate machinery safely. you must refrain from such activities while taking these medications. 2. you should begin taking a chewable complete multivitamin with minerals. no gummy vitamins. 3. you will be taking zantac liquid 150 mg twice daily for one month. this medicine prevents gastric reflux. 4. you should take a stool softener, colace, twice daily for constipation as needed, or until you resume a normal bowel pattern. 5. you must not use nsaids (non-steroidal anti-inflammatory drugs) examples are ibuprofen, motrin, aleve, nuprin and naproxen. these agents will cause bleeding and ulcers in your digestive system. activity: no heavy lifting of items pounds for 6 weeks. you may resume moderate exercise at your discretion, no abdominal exercises. wound care: you may shower, no tub baths or swimming. if there is clear drainage from your incisions, cover with clean, dry gauze. your steri-strips will fall off on their own. please remove any remaining strips 7-10 days after surgery. please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. please perform dressing changes with dry, sterile gauze twice daily as instructed or more frequently as needed. please contact dr. office if you have increased drainage from the wound requiring more frequent changes. also, please call dr. if you develop redness surrounding the wound and/ or fevers greater than 101f. followup instructions: provider: , rd,ldn phone: date/time: 11:30 provider: , md phone: date/time: 12:00 procedure: non-invasive mechanical ventilation arterial catheterization cholecystectomy other gastroenterostomy without gastrectomy removal of foreign body from peritoneal cavity diagnoses: pneumonia, organism unspecified obstructive sleep apnea (adult)(pediatric) esophageal reflux other postoperative infection urinary tract infection, site not specified hemorrhage complicating a procedure morbid obesity foreign body accidentally left during a procedure calculus of gallbladder without mention of cholecystitis, without mention of obstruction other chronic nonalcoholic liver disease laparoscopic surgical procedure converted to open procedure other fluid overload body mass index 50.0-59.9, adult polycystic ovaries foreign object left in body during surgical operation 

Answer: The patient is high likely exposed to