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: no known allergies / adverse drug reactions attending: chief complaint: weakness major surgical or invasive procedure: intubation history of present illness: 49 year-old male with mental retardation, intractable seizures, non-verbal at baseline, recurrent subclinical seizures presenting with weakness, gait instability, and decreased engagement with staff at group home. noticed over past 2-3 days by staff. requiring assistance with ambulation, whereas usually independent. no falls. he was not having fevers, chills, cough. appetite at baseline. . of note, he was admitted and /11 for similar complaint. during both admissions he had increased seizure activity (described as subclinical tonic seizures, suspected left temporal lobe in origin) due to infection - pneumonia during the first admission, uti during the second. he was discharged on vimpat, but due to difficulty tolerating medication stopped on . . in the ed, 85.5/90 axillary 52 103/62 18 99%__. systolic blood pressure dropped to 80s, initially fluid responsive. physical examination notable for recurrent seizures with lateral gaze deviation. laboratory data significant for platelet count 64, wbc 4.1 with left shift, transaminitis, lipase 1438, and chem10 within normal limits; ua with trace leukocyte esterase, nitrite positive, moderate bacteria. lactate 1.4. cxr 1v "acutely worsening right lower lobe opacification." ruq ultrasound with patent portal vein, gallbladder sludge, liver cysts, cbd 0.4cm; note of poor study quality. ct head without contrast without acute hemorrhage, stable periventricular leukomalacia. seen by neurology - concerning for seizures due to underlying infection; recommended restart vimpat 100 mg qam and ordering 24 hour bedside eeg. he was intubated for airway protection. rij placed, sterile position; levophed initiated. received ativan 1mg iv x4-5 for seizures; 5l ivf; vancomycin, zosyn for suspected uti, pneumonia; midazolam for sedation. on transfer to micu, 109, 131/60, 99% ac 500x16 , peep 10, fio2 100%. . in the micu, patient is intubated and sedated. past medical history: - static encephalopathy after prolonged status epilepticus, possible anoxic injury at age 7 or 8 years. - intractable epilepsy. - per neurology note "he had mild developmental delay as a child, and then at age 7 or 8 years had prolonged (greater than 24 hours) status epilepticus with probable anoxic brain injury in the setting of a febrile illness. subsequently, he had severe static encephalopathy and intractable epilepsy. he currently resides in a group home. he is nonverbal, but does understand some language. he requires assistance with most activities of daily living. he has some obstinate behavior, but no aggression or agitated behavior recently. his typical seizures are of 2 types: #1) episodes of rapid eye blinking, staring, and urinary incontinence, unclear frequency, and #2) episodes of facial grimacing, stiffening of his limbs, some lip smacking, and incontinence of urine and stool, occurring 3-4 times pack-year." social history: lives in group home. does not use tobacco, alcohol, or illicit drugs. family history: noncontributory physical exam: on admission: 97.7, 105, 116/67, 24, 99% ac 500x24, peep10, fio2 100% general: intubated, sedated; not responsive to verbal stimuli heent: sclera anicteric, moist mucous membranes neck: supple lungs: anterior auscultation, clear to auscultation bilaterally without wheezes, rales, or rhonchi cv: tachycardic; regular rhythm; normal s1/s2, no murmurs appreciated abdomen: hypoactive bowel sounds; soft, nontender (sedated), not distended; no guarding gu: foley in place ext: warm, well-perfused; radial, dp pulses 2+, symmetric; no lower extremity edema neuro: pupils equally round and reactive to light; does not respond to verbal stimuli; withdraws to painful stimuli; biceps, patellar reflexes 2+, symmetric . on discharge: tm 97.6, 108/62 54 12 98% ra gen: awake, alert, no acute distress heent: sclera anicteric, eomi cv: rrr, s1/s2, no murmurs or extra sounds appreciated pulm: anterior fields cta bilaterally abd: + bs, soft, non-tender, non-distended ext: warm, no edema, moves all extremities spontaneously pertinent results: ========= labs (updated through micu course) ========= 12:30pm blood lipase-1438* 04:27am blood lipase-566* 03:49am blood lipase-98* 05:34am blood lipase-98* 04:40am blood lipase-389* 03:24am blood lipase-397* 03:42am blood lipase-297* 04:11am blood lipase-241* 04:02am blood lipase-282* 03:00am blood lipase-279* 04:06am blood lipase-298* 02:24am blood lipase-262* 03:12am blood lipase-250* . 12:30pm blood wbc-4.1 rbc-3.61* hgb-11.8* hct-35.4* mcv-98 mch-32.7* mchc-33.3 rdw-15.8* plt ct-64*# 04:27am blood wbc-8.4# rbc-3.14* hgb-10.2* hct-30.8* mcv-98 mch-32.5* mchc-33.1 rdw-15.9* plt ct-54* 03:49am blood wbc-13.3*# rbc-2.93* hgb-9.5* hct-28.3* mcv-97 mch-32.6* mchc-33.7 rdw-16.0* plt ct-46* 05:23am blood wbc-12.6* rbc-3.01* hgb-9.9* hct-28.8* mcv-96 mch-33.0* mchc-34.5 rdw-16.0* plt ct-44* 05:34am blood wbc-9.7 rbc-2.76* hgb-9.1* hct-26.5* mcv-96 mch-32.8* mchc-34.2 rdw-15.8* plt ct-51* 04:40am blood wbc-3.9*# rbc-3.20* hgb-10.5* hct-30.9* mcv-97 mch-32.7* mchc-33.9 rdw-15.6* plt ct-55* 03:24am blood wbc-1.5*# rbc-2.63* hgb-8.6* hct-25.6* mcv-97 mch-32.8* mchc-33.8 rdw-15.4 plt ct-72* 03:24am blood wbc-1.5*# rbc-2.63* hgb-8.6* hct-25.6* mcv-97 mch-32.8* mchc-33.8 rdw-15.4 plt ct-72* 03:42am blood wbc-3.0*# rbc-2.57* hgb-8.4* hct-24.8* mcv-97 mch-32.6* mchc-33.8 rdw-15.3 plt ct-117*# 03:45pm blood wbc-3.8* rbc-2.70* hgb-8.8* hct-26.2* mcv-97 mch-32.6* mchc-33.6 rdw-15.2 plt ct-198# 04:11am blood wbc-4.2 rbc-2.12* hgb-6.9* hct-20.7* mcv-98 mch-32.4* mchc-33.2 rdw-14.9 plt ct-233 05:48am blood wbc-4.4 rbc-2.51* hgb-8.1* hct-24.6* mcv-98 mch-32.1* mchc-32.8 rdw-14.8 plt ct-244 04:02am blood wbc-5.0 rbc-2.70* hgb-8.7* hct-26.6* mcv-98 mch-32.2* mchc-32.7 rdw-14.6 plt ct-332 03:53pm blood wbc-4.9 rbc-2.60* hgb-8.2* hct-25.4* mcv-98 mch-31.5 mchc-32.3 rdw-14.5 plt ct-435 04:14am blood wbc-4.7 rbc-2.41* hgb-7.8* hct-23.5* mcv-98 mch-32.3* mchc-33.2 rdw-14.7 plt ct-448* 03:00am blood wbc-5.2 rbc-2.51* hgb-8.0* hct-24.5* mcv-98 mch-31.9 mchc-32.7 rdw-14.7 plt ct-600* 04:06am blood wbc-6.8 rbc-2.21* hgb-7.0* hct-21.5* mcv-97 mch-31.6 mchc-32.5 rdw-14.6 plt ct-661* 02:24am blood wbc-5.5 rbc-2.55* hgb-8.3* hct-24.7* mcv-97 mch-32.5* mchc-33.5 rdw-14.7 plt ct-688* 03:12am blood wbc-5.2 rbc-2.56* hgb-8.3* hct-24.7* mcv-96 mch-32.3* mchc-33.5 rdw-14.9 plt ct-657* . 04:27am blood pt-14.1* ptt-37.2* inr(pt)-1.2* 03:49am blood pt-15.9* ptt-42.2* inr(pt)-1.4* 05:34am blood pt-15.2* ptt-41.4* inr(pt)-1.3* 04:11am blood pt-16.0* ptt-34.1 inr(pt)-1.4* 04:02am blood pt-16.9* ptt-34.7 inr(pt)-1.5* 04:06am blood pt-16.7* ptt-33.8 inr(pt)-1.5* 02:24am blood pt-16.3* ptt-30.7 inr(pt)-1.4* 03:12am blood pt-14.5* ptt-21.2* inr(pt)-1.3* . glucose-104* urean-20 creat-0.8 na-141 k-3.9 cl-105 hco3-27 glucose-69* urean-17 creat-0.8 na-142 k-3.9 cl-114* hco3-21* glucose-75 urean-16 creat-0.8 na-141 k-3.5 cl-113* hco3-22 glucose-86 urean-15 creat-0.8 na-142 k-3.1* cl-110* hco3-24 glucose-86 urean-16 creat-0.9 na-143 k-3.4 cl-109* hco3-24 glucose-100 urean-17 creat-0.9 na-139 k-3.2* cl-107 hco3-28 glucose-122* urean-20 creat-0.8 na-142 k-3.6 cl-110* hco3-30 glucose-99 urean-19 creat-0.7 na-142 k-3.7 cl-107 hco3-28 angap-11 glucose-118* urean-22* creat-0.8 na-144 k-3.5 cl-107 hco3-30 glucose-123* urean-24* creat-0.7 na-142 k-3.6 cl-105 hco3-31 glucose-96 urean-27* creat-0.7 na-144 k-4.0 cl-106 hco3-31 glucose-85 urean-28* creat-0.6 na-145 k-3.7 cl-107 hco3-30 glucose-106* urean-28* creat-0.7 na-144 k-3.5 cl-106 hco3-31 glucose-93 urean-24* creat-0.6 na-145 k-3.2* cl-111* hco3-28 glucose-98 urean-26* creat-0.6 na-142 k-3.7 cl-106 hco3-29 glucose-105* urean-27* creat-0.6 na-144 k-4.0 cl-107 hco3-28 glucose-89 urean-26* creat-0.6 na-144 k-4.1 cl-105 hco3-31 glucose-116* urean-25* creat-0.6 na-144 k-3.4 cl-103 hco3-35* glucose-125* urean-26* creat-0.7 na-141 k-4.5 cl-104 hco3-35* glucose-107* urean-25* creat-0.6 na-141 k-3.9 cl-104 hco3-32 glucose-98 urean-25* creat-0.5 na-143 k-4.1 cl-108 hco3-30 glucose-104* urean-27* creat-0.6 na-142 k-4.6 cl-109* hco3-27 . alt-53* ast-52* ld(ldh)-274* alkphos-147* totbili-0.1 alt-34 ast-67* alkphos-101 totbili-0.4 alt-40 ast-78* alkphos-122 amylase-360* totbili-0.4 amylase-378* alt-55* ast-92* alkphos-106 totbili-0.3 alt-43* ast-50* alkphos-126 totbili-0.4 . ========= radiology ========= ct head: no acute hemorrhage. no significant change in appearance compared with the mri of . . cxr: persistent patchy opacification in the right lower lobe is nonspecific, may represent atelectasis, though acute infection/aspiration is not excluded. . ruq u/s: sludge within the gallbladder, but no evidence of cholecystitis or cholelithiasis. . cxr : in comparison with the study of , the monitoring and support devices are essentially unchanged. diffuse bilateral pulmonary opacifications persist. this apparently is consistent with bilateral pneumonia combined with congestive failure and bilateral pleural effusions, and is again more prominent on the right. . ct head : no acute intracranial hemorrhage or mass effect. persistent moderate dilation of the lateral ventricles along with evidence of volume loss as on the prior study. 2. no large obvious hypodense area to suggest acute infarct. however, assessment is somewhat limited due to artifacts from the leads. if there is continued concern for small acute infarcts, consider mr if not contraindicated. . ct abd : no evidence of complications related to pancreatitis. dense consolidative and patchy opacity at the bilateral lung bases, right slightly greater than left, most likely represents aspiration but infection cannot be excluded. . cxr : current study demonstrates unchanged appearance of the et tube and ng tube. widespread parenchymal consolidations are unchanged except for right lower lung where they appear to be progressed and they might be accompanied by bilateral pleural effusion. no interval development of pneumothorax or other new findings have been demonstrated. . cxr : in comparison with the studies of and , there is little overall change in the diffuse bilateral pulmonary opacifications involving almost all of the right lung and much of the left lung. this represents some undetermined combination of pneumonia, pulmonary edema, hemorrhage, and possibly even ards. . ========== micro ========== urine culture (final ): escherichia coli. >100,000 organisms/ml.. presumptive identification. piperacillin/tazobactam sensitivity testing performed by . warning! this isolate is an extended-spectrum beta-lactamase (esbl) producer and should be considered resistant to all penicillins, cephalosporins, and aztreonam. consider infectious disease consultation for serious infections caused by esbl-producing species. sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | amikacin-------------- 4 s ampicillin------------ =>32 r ampicillin/sulbactam-- =>32 r cefazolin------------- =>64 r cefepime-------------- r ceftazidime----------- r ceftriaxone----------- =>64 r ciprofloxacin--------- =>4 r gentamicin------------ =>16 r meropenem-------------<=0.25 s nitrofurantoin-------- 64 i piperacillin/tazo----- s tobramycin------------ =>16 r trimethoprim/sulfa---- =>16 r . clostridium difficile toxin a & b test (final ): feces positive for c. difficile toxin by eia. . clostridium difficile toxin a & b test (final ): feces positive for c. difficile toxin by eia. . blood cultures , no growth on final cultures. ========== cards ========== tte : the left atrium is elongated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 70%). right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic valve is not well seen. there is no aortic valve stenosis. there is mild posterior leaflet mitral valve prolapse. trivial mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. . ========= neuro ========= eeg : this is an abnormal continuous eeg due to the presence of 14 electrographic seizures characterized by a generalized electrodecrement, followed by a higher amplitude rhythmic hz activity beginning over the bifrontocentral regions with secondary generalization, usually lasting between 40-50 seconds. there was an extended seizure which lasted for 15 minutes occuring at 00:21 am. in addition, the hz theta rhythm background with bursts of generalized theta slowing is consistent with a mild diffuse encephalopathy, commonly seen with medication effect, metabolic disturbance, or infection. in addition, there were frequent interictal sharp discharges, greatest over the right frontocentral region (with phase reversal at c4/t4), but also seen over the left frontocentral region (with phase reversal at f3/c3), and rarely bifrontocentrally, consistent with multiple regions with epileptogenic potential. . eeg : this is an abnormal continuous eeg due to the presence of 10 electrographic seizures characterized by higher amplitude rhythmic hz activity beginning over the bifrontocentral regions with secondary generalization, usually lasting between 10-20 seconds. compared to the previous tracing, the electrographic seizures are fewer in frequency and shorter in duration. in addition, the hz theta rhythm background with bursts of generalized theta slowing is consistent with a mild diffuse encephalopathy, commonly seen with medication effect, metabolic disturbance, or infection. in addition, there were less frequent interictal sharp discharges, although still occasionally seen over the right frontocentral region (with phase reversal at c4/t4), left frontocentral region (with phase reversal at f3/c3), and rarely bifrontocentrally. compared to the previous tracing, there is a significant improvement in the frequency of seizures and epileptiform activity. . eeg : this is an abnormal continuous eeg due to the presence of 5 brief electrographic seizures characterized by higher amplitude rhythmic hz activity beginning over the bifrontocentral regions with secondary generalization, usually lasting between 5-20 seconds. compared to the previous tracing, the electrographic seizures are fewer in frequency and shorter in duration. in addition, the hz theta rhythm background seen during the most awake portions of the record is consistent with a mild diffuse encephalopathy, commonly seen with medication effect, metabolic disturbance, or infection. in addition, there were occasional low amplitude interictal sharp discharges, seen over the right frontocentral region (with phase reversal at c4/t4), left frontocentral region (with phase reversal at f3/c3), and rarely bifrontocentrally. compared to the previous tracing, there is a significant improvement in seizure frequency and background slowing. . eeg : this is an abnormal continuous eeg due to the presence of 3 brief electrographic seizures characterized by higher amplitude rhythmic hz activity beginning over the bifrontocentral regions with secondary generalization, usually lasting approximately 10 seconds. compared to the previous tracing, the electrographic seizures are fewer in frequency and shorter in duration. there are also multiple brief bursts of similar appearing activity, lasting between 3-5 seconds each, which likely constitute epileptiform bursts. in addition, the hz theta rhythm background seen during the most awake portions of the record is consistent with a mild diffuse encephalopathy, commonly seen with medication effect, metabolic disturbance, or infection. in addition, there were occasional low amplitude interictal sharp discharges, seen over the right frontocentral region (with phase reversal at c4/t4), left frontocentral region (with phase reversal at f3/c3), and rarely bifrontocentrally. compared to the previous tracing, there is no significant change. . eeg : this is an abnormal continuous eeg due to the presence of 3 brief electrographic seizures characterized by higher amplitude rhythmic hz activity beginning over the bifrontocentral regions with secondary generalization, usually lasting between 10-15 seconds. there are also multiple brief bursts of similar appearing activity, lasting between seconds each, which represent epileptiform bursts. in addition, the hz theta rhythm background seen during the most awake portions of the record is consistent with a mild diffuse encephalopathy, commonly seen with medication effect, metabolic disturbance, or infection. in addition, there were occasional low amplitude interictal sharp discharges, seen over the right frontocentral region (with phase reversal at c4/t4), left frontocentral region (with phase reversal at f3/c3), and rarely bifrontocentrally. compared to the previous tracing, there is no significant change. brief hospital course: 49m with mental retardation, intractable seizures admitted with lethargy and gait instability in context of hypothermia and hypotension, and found to have pancreatitis, pneumonia, uti and ongoing seizure activity. he improved and remained clinically stable, but stayed on the medical floor for 4 weeks awaiting guardianship for discharge to a rehabilitation facility. . #. sepsis: defined based on hypothermia and tachycardia on admission, in setting of pulmonary and urinary infectious processes. patient was initially managed on vanco and zosyn for uti given a history of resistant pathogens, and urine eventually grew out esbl e coli. zosyn was transitioned to meropenem, and patient completed a 10 day course of vanco and meropenem. cxr showed bilateral consolidations, which may have been due to pneumonia or chemical pneumonitis. sputum culture was unremarkable, and patient completed 10 day course of broad antibiotics for uti. patient received fluid resusication during his septic physiology state, and was later diuresed to help with his respiratory status (see below). after coming to the floor, he was hemodynamically stable and afebrile. his blood cultures from did not have any growth. he had no leukocytosis of localizing symptoms or signs of infection for the remainder of the hospitalization. . #. respiratory failure: initial cxr concerning for bilateral pneumonia, which may have developed in setting of aspiration event during seizure. imaging also consistent with fluid overload from aggressive resuscitation. sputum cultures have been negative. patient has completed course of meropenem, and was extubated successfully on . vancomycin was initially on board for hcap, but was stopped for concerns of worsening thrombocytopenia. patient aggressively diuresed, and diuresis continued after extubation with iv lasix 20 mg because cxr was still consistent with edema and patient was over 8 liters positive for length of stay. on transfer from the icu, patient was saturating well on 3l nc. he was able to be weaned off oxygen quickly without additional diuresis. he was maintaining normal oxygen saturations on room air at time of discharge. . #. acute pancreatitis: lipase 1438 on admission, and downtrended rapidly. he met 0/5 criteria on admission. no choledolcholithiasis found on ultrasound. ct abdomen without signs of complications from pancreatitis. patient was initially fed via postpyloric dobhoff, which was discontinued upon transfer to the floor. he was transitioned to a low fat regular diet, which he tolerated well. . #. seizure disorder: patient had presumed seizure activity in the ed, and multiple seizures on 24 hour eeg monitoring. patient is well known to have increased seizure activity with infection. in addition, patient had recently been tapered off of vimpat, possibly in error. vimpat was restarted, and other home antiepileptic meds were continued. seizure activity improved with new regimen and treatment of infections as above. he was discharged on gabapentin (1200 mg daily, 2400 mg nightly), oxcarbazepine (600 mg tid), lacosamide (vimpat) (100 mg qhs), and zonisamide (300 mg daily, 400 mg nightly). . #. urinary tract infection: urine culture on positive for esbl e. coli. patient completed 10-day course of meropenem, though repeat urine culture positive for yeast. foley changed and patient started on fluconazole, as unable to assess whether patient symptomatic. treated with fluconazole to complete 3 day course (). foley was removed and patient had successful voiding trial. . #. clostridium difficile infection: no complications of colitis seen on abdominal ct. given leukocytosis, c diff. specimen was sent on and was positive. patient was started on po vanco and iv flagyl through . he had resolution of symptoms but began to have increased frequency of stool on with 4/5 assay positive for c diff. he was treated for recurrence with a 2-week course of vancomycin which he completed on . he did not have any recurrence of symptoms, fevers, or abdominal pain and was having 1 formed stool daily at time of discharge. . #. thrombocytopenia/thrombocytosis: platelet count in has ranged between 60 and 600. concern for dic given infection/pancreatitis, although coags within normal limits. platelets improved with infection treatment and even rose to thrombocytotic range (likely reactive in nature), which trended down at time of discharge. . #. fever: patient had temperature of 103 rectal on and was pan-cultured. urinalysis and culture were negative for infection. blood cultures (anaerobic bottle) grew coagulase-negative staph, likely a skin contaminant. surveillance blood cultures are pending, no growth to date. the patient remained afebrile and developed no other signs or symptoms localizing infection. his lfts were normal, lipase was trending down, and abdominal exam benign. the exact etiology of his one fever is unclear; however, he clinically appeared well for 4 days after and was thought suitable for discharge. he remained in the hospital for several weeks awaiting guardianship paperwork and was afebrile for the remainder of the stay with no signs/symptoms of infection (other than c diff recurrence as above). . # disposition: evaluated by physical therapy and thought appropriate for discharge to rehabilitative center for continued strength training. . transition of care: =================== # patient will return to his group home after rehabilitation stay. he will have an appointment with his pcp scheduled after discharge. medications on admission: gabapentin 1200mg po am; 2400mg po qhs clonazepam 5mg po qhs zonisamide 300mg po qam; 400mg po qhs peridex oral rinse cap oxcarbazepine 600mg po tid mvi vimpat was discontinued on discharge medications: 1. acetaminophen 650 mg/20.3 ml solution sig: six y (650) mg po q6h (every 6 hours) as needed for pain, fever. 2. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) nebulizer inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 3. ipratropium bromide 0.02 % solution sig: one (1) nebulizer inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 4. clonazepam 1 mg tablet sig: five (5) tablet po qhs (once a day (at bedtime)). 5. gabapentin 250 mg/5 ml solution sig: 2400 (2400) mg po hs (at bedtime). 6. gabapentin 250 mg/5 ml solution sig: 1200 (1200) mg po daily (daily). 7. oxcarbazepine 300 mg/5 ml suspension sig: six hundred (600) mg po tid (3 times a day). 8. lacosamide 100 mg tablet sig: one (1) tablet po at bedtime. 9. zonisamide 100 mg capsule sig: three (3) capsule po qam. 10. zonisamide 100 mg capsule sig: four (4) capsule po qhs (once a day (at bedtime)). 11. multivitamin capsule sig: one (1) capsule po once a day. 12. peridex 0.12 % mouthwash sig: 0.5 cap full mucous membrane twice a day. discharge disposition: extended care facility: livingcenter - - discharge diagnosis: respiratory failure pneumonia clostridium difficile colitis urinary tract infection acute pancreatitis seizures discharge condition: mental status: non-verbal. level of consciousness: alert. minimally interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear mr. , you were recently admitted to where you were treated for pneumonia, a colon infection, seizures, and a urinary tract infection. you first spent time in the intensive care unit, then were transferred to the floor. you were evaluated by physical therapy, who felt you would benefit by going to a rehab center for more strength building. . we have made some changes to your medication regimen, which are listed in detail in your discharge packet. . it was a pleasure taking care of you during this admission. followup instructions: please schedule a follow up appointment with your primary care physician . () after discharge. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances diagnoses: pneumonia, organism unspecified thrombocytopenia, unspecified urinary tract infection, site not specified severe sepsis acute respiratory failure septic shock intestinal infection due to clostridium difficile encephalopathy, unspecified septicemia due to escherichia coli [e. coli] acute pancreatitis unspecified intellectual disabilities epilepsy, unspecified, with intractable epilepsy 

Answer: The patient is high likely exposed to