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 / cefazolin / cipro / shellfish / keflex attending: chief complaint: abd pain, hypotension major surgical or invasive procedure: ercp history of present illness: 83 year old female with h/o cbd stones, h/o ccy, afib, htn, and t2dm who presented to an osh ed with nausea and vomiting and was found to have an impacted cbd stone, transferred to for ercp. . she reports feeling unwell over the past 1 month. she was reportedly admitted to another hospital for a urinary tract infection but her symptoms never truly improved. she has been taking bactrim for the last several weeks for a uti (unclear when course finished as not on nursing home list). she reports nausea and vomiting x 10-14 days which acutely worsened last evening when she had multiple episodes of nonbloodly nonbilious vomiting. denies abdominal pain, diarrhea, constipation or bloody stools. does endorse some dizziness of the last few days. . she was sent from her nursing home to where she had a ct scan that showed a 9x6mm common bile duct stone associated with dilation. she was given gentamicin and flagyl (due to pcn and fluoroquinolone allergy) and 1l ivf. had leukocytosis to 20. also was found to have a uti and foley was placed. . in the ed, initial vs were 97.8 102 101/52 18 100% ra. she started to become hypotensive to sbp 70's, given 500cc bolus and sbp increased to 100's. has 18g and 20g for access. given another 500cc bolus for bp in the 80's. ercp saw her in the ed and plans to take her for ercp tonight. she was given a dose of vancomycin. started on peripheral levophed prior to transfer. most recent vitals 104 (afib) 88/48 26 99%ra. . on the floor, she complains of feeling very anxious. also has some nausea, but denies abdominal pain. requests that the team leave her alone "even if it means i die." past medical history: lung cancer resected 15 years ago spinal stenosis pancreatitis hypertension anxiety depression reflux hypothyroid diabetes type 2 s/p appendectomy s/p hysterectomy r hip replacement social history: retired, formerly worked in high school cafeteria serving food. former smoker (many years ago), no alcohol use. denies drug use. currently lives at bay skilled nursing center. family history: non-contributory physical exam: vitals: 97.2 121 123/41 20 97%2l general: alert, oriented, but very anxious appearing heent: sclera anicteric, dry mucous membranes but oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: irregularly irregular with normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, grimaces to deep palpation of right upper quadrant, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly palpable ext: warm extremities above the pneumoboots with 1+ peripheral pulses, 1+ peripheral edema pertinent results: 06:45pm blood wbc-15.3* rbc-3.57* hgb-10.8* hct-32.1* mcv-90# mch-30.1# mchc-33.6 rdw-15.7* plt ct-350 02:54am blood wbc-27.6*# rbc-3.20* hgb-9.2* hct-30.4* mcv-95 mch-28.8 mchc-30.3* rdw-15.6* plt ct-482* 04:06am blood wbc-9.9 rbc-2.91* hgb-8.4* hct-26.4* mcv-91 mch-28.9 mchc-31.9 rdw-16.0* plt ct-225 06:45pm blood neuts-85.3* lymphs-11.0* monos-2.4 eos-1.0 baso-0.3 . 06:45pm blood pt-14.9* ptt-29.5 inr(pt)-1.3* 02:54am blood pt-16.1* ptt-38.5* inr(pt)-1.4* . 06:45pm blood glucose-110* urean-41* creat-2.5*# na-136 k-4.1 cl-97 hco3-25 angap-18 02:54am blood glucose-380* urean-38* creat-2.6* na-136 k-4.8 cl-104 hco3-12* angap-25* 02:07pm blood glucose-279* urean-34* creat-2.3* na-137 k-3.8 cl-103 hco3-23 angap-15 09:48pm blood glucose-137* urean-29* creat-1.8* na-139 k-3.4 cl-111* hco3-20* angap-11 03:46am blood glucose-140* urean-30* creat-1.9* na-138 k-3.6 cl-109* hco3-21* angap-12 04:05pm blood glucose-192* urean-28* creat-1.6* na-140 k-4.8 cl-112* hco3-16* angap-17 . 02:54am blood alt-89* ast-101* ck(cpk)-109 alkphos-445* amylase-21 totbili-0.5 03:46am blood alt-57* ast-52* ck(cpk)-86 alkphos-360* totbili-0.4 . 02:54am blood ck-mb-14* mb indx-12.8* ctropnt-0.67* 11:04am blood ck-mb-18* mb indx-17.8* ctropnt-0.73* 03:46am blood ck-mb-18* mb indx-20.9* 07:08am blood ctropnt-0.98* . 02:54am blood triglyc-360* hdl-20 chol/hd-12.3 ldlcalc-153* 11:04am blood vanco-10.9 07:08am blood vanco-8.2* . 03:47am blood type-art po2-111* pco2-54* ph-6.98* caltco2-14* base xs--20 intubat-not intuba 04:34am blood type-art po2-307* pco2-38 ph-7.17* caltco2-15* base xs--13 03:01pm blood type-art po2-92 pco2-39 ph-7.30* caltco2-20* base xs--6 06:54pm blood lactate-2.2* 04:34am blood lactate-5.3* 03:01pm blood lactate-1.4 tte the left atrium is normal in size. left ventricular wall thicknesses and cavity size are normal. there is moderate to severe regional left ventricular systolic dysfunction with global severe hypokinesis of the distal of the ventricle and preservation of basal function (lvef is 30-35%). no intraventricular thrombus is identified. right ventricular chamber size and free wall motion are normal. the mitral valve leaflets are mildly thickened. significant mitral regurgitation is seen. there is an anterior space which most likely represents a prominent fat pad. impression: normal left ventricular cavity size with severe global dysfunction of the distal of the ventricle c/w lesion of the mid lad (wrap around) or takotsubo cardiomyopathy. significant mitral regurgitatino. compared with the prior study (images reviewed) of , left ventricular systolic dysfunction is now identified. the severity of mitral regurgitation is also likely increased. tte the left atrium is mildly dilated. the estimated right atrial pressure is 10-20mmhg. lv systolic function appears depressed (ejection fraction ? 30%) secondary to akinesis of the apical of the left ventricle with focal dyskinesis. no masses or thrombi are seen in the left ventricle. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. there is a minimally increased gradient consistent with minimal aortic valve stenosis. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. severe (4+) mitral regurgitation is seen. there is a moderate sized pericardial effusion. the effusion appears circumferential. the effusion is echo dense, consistent with blood, inflammation or other cellular elements. there are no echocardiographic signs of tamponade. compared with the findings of the prior study (images reviewed) of , severe mitral regurgitation is now demonstrated. chest xr the et tube tip is approximately 5.5 cm above the carina, impinging the left tracheal wall and should be repositioned. the ng tube tip is in the stomach. biliary stent is in place. there is no change in cardiomegaly, mediastinal contours. the patient is in mild interstitial engorgement, most likely related to fluid overload but overall improved since radiograph obtained at 04:32 a.m. left retrocardiac atelectasis and right retrocardiac atelectasis as well as bilateral small pleural effusions are unchanged. brief hospital course: 83 year old female with h/o cholangitis and cbd stones, afib, htn, and t2dm who presents with sepsis secondary to cholangitis. . #. septic shock: most likely from cholangitis given impacted common bile duct seen on osh ct, lfts and ruq tenderness on exam. could also be urosepsis as source as has positive ua and history of recent uti. has only received 2l of iv fluids prior to admission to icu and may certainly be more volume responsive. started on peripheral levophed as refused central line in the ed. likely had developing cholangitis over last several days-weeks untreated with her recent uti treatment. on presentation pt felt to be in sepsis and started on meropenem for her mult abx allergies(given dose of vancomycin in ed). r-ij placed. urgent ercp performed wo visualization of stone, stent was placed. she continued to appear unwell and was given ~5 liters overnight for volume resuscitation. she worsened and around 0300 was obtunded, diaphoretic, hypotensive, tachycardic and unable to protect her airway. she was intubated at 0400 with abg 6.98/111/54/14. noted to be cold, clammy. family was notified and present. ekg unchanged and still notable for t wave inversions present on admission ekg. she was given flumazenil 0.2mg for benzo reversal but no improvement. repeat abg on vent 7.17/307/38/15, lactate 5.3, o2sat 99. given concern for cardiogenic shock cv o2 sat = 66 (cardiogenic) and chest xray obtained showing increased pulmonary edema. she was started on heparin gtt with concern for pe but too unstable for cta. hosp was called but did not have updated culture data to support changing her abx regimen. bladder pressure was 9. cardiac enzymes showed leak but attributed to evolving nstemi vs demand ischemia. stat tte performed at bedside by cards fellow who reported takostumbo physiology. the next day she was bolused 6l ivns with uop increaseing to 30cc/hr with concern for under-resuscitated septic shock. lactate trended down to 1.1. noted to be in a. fib to 95-110, map in 60. repeated tte (lvef 30-35) normal left ventricular cavity size with severe global dysfunction of the distal of the ventricle c/w lesion of the mid lad (wrap around) or takotsubo cardiomyopathy. significant mitral regurgitatinon (not quantified). urine lytes suggested pre-renal volume status. she was temporarily weaned off pressors but worsening cvp (nonresponsive to fluids) and new effusion on echo was concerning for tamponade vs ace. ekg showed ste in inferior leads and family wanted no aggressive interventions. she was made cmo and expired within minutes of pressor withdrawal. . #. uti (with possible urosepsis): has grossly positive ua in setting of sepsis and end organ damage. previously treated with bactrim but unclear if organism was sensitive. continued on vanco and meropenem. it is possible that pt had urosepsis (rather than cholangitis/biliary sepsis) as postulated however pt was covered broadly. . #. acute kidney injury: likely prerenal in setting of sepsis and volume depletion, although could also be related to bactrim use vs atn given hypotension. low urine output currently. she was bolused with ivf to adequate urine output on hd-1. . #. atrial fibrillation: in sinus rhythm on admission and noted to be in afib w rvr during decompensation however pt too untable for rate control. . #. hypothyroidism: continued on levothyroxine . #. chronic diastolic chf: presumed diagnosis based on history but not clear. ramipril and lasix held overnight. she was continued on home dose baby asa. . #. anemia: on procrit and ferrous sulfate, likely hemoconcentrated on current labs. will continue home meds. . #. depression and anxiety: home sertraline and trazodone . #. diabetes type 2: regulated on humalog iss. . #. constipation: home dulcolax, miralax . #. gerd: home ranitidine medications on admission: procrit 40,000 units/ml q2weeks levothyroxine 50mcg po daily asa 81mg po daily brimonidine 0.15% once daily to both eyes cetirizine 10mg po daily diltiazem er 180mg po daily famotidine 20mg po daily ferrous sulfate 325mg po daily mvi 1 tab po daily nasacort aq 55mcg each nostril daily potassium chloride 40meq po daily sertraline 100mg po daily lasix 40mg po daily ramipril 5mg po daily acetaminophen 1000mg po tid artificial tears 1.4% po daily qhs both eyes polyethylene glycol 17g po daily at bedtime mirtazapine 15mg qhs trazodone 50mg po qhs compazine 10mg q4-6h prn reglan 5mg po tid prn azithromycin 500mg 1hr prior to dental procedures teargen 1.4% drops tid prn both eyes bisacodyl 10mg pr or po prn fleet enema prn meclizine 12.5mg tid prn dizziness guaifenesin 10ml q6 prn cough proair 90mcg inhaler q6 discharge medications: none discharge disposition: expired discharge diagnosis: septic shock cardiogenic shock discharge condition: deceased discharge instructions: none md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube endoscopic insertion of stent (tube) into bile duct diagnoses: subendocardial infarction, initial episode of care anemia, unspecified esophageal reflux urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia severe sepsis atrial fibrillation personal history of malignant neoplasm of bronchus and lung constipation, unspecified dysthymic disorder acute respiratory failure cardiac arrest cardiogenic shock septic shock chronic diastolic heart failure calculus of bile duct without mention of cholecystitis, with obstruction 

Answer: The patient is high likely exposed to