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 / tetracyclines / plaquenil / chloroquine / sulfonamides / floxin / heparin agents attending: chief complaint: fever, hypotension. major surgical or invasive procedure: removal of left subclavian line. placement of right internal jugular line. history of present illness: 49 year old female with h/o pulm htn dm lupus on flolan via hickman presenting for possible line infection. a new hickman line was placed 3 weeks ago after line became infected and she is s/p 14d vanco course for micococcus. micrococcus was grown out of cultures on and . subsequent cultures on were all negative. hickman line insertion (for flolan) was on and picc line (for vanco) insertion was on . . she comes in with 2 days sweats, chills, as well as tenderness, warmth and drainage from line. blood sugars 220, usually 100-200. it also has been draining a clear green fluid. she was apparently scheduled for a dental procedure tomorrow for ? infected tooth. no other ros positive. mult drug allergies. exam: crusting and purulence at site. . in the ed: her initial vitals were 98.1 103 145/82 12 94ra, she was started on vancomycin but developed itching and rash, benadryl given, -> continued vanco at slower rate -> got worse -> stopped. this is strange since she finished off a 14 day course of vancomycin dating from her recent visit. . on arrival to the floor she was noted be hypotensive 70s, 1l ns in ed, and received 500cc ns, and 2nd iv was placed. past medical history: -diabetes mellitus type 2 -pulmonary arterial hypertension on flolan -atrial septal defect of the secundum type (versus a stretched pfo) -obstructive sleep apnea on home oxygen -anticardiolipin antibody -type 1 heparin induced thrombocytopenia -systemic lupus erythematosus with history of pleuritis, glomerulonephritis () -obesity -restrictive pulmonary disease -migraines -history of sinusitis -fibromyalgia. social history: significant for the absence of current tobacco use. there is no history of alcohol abuse. family history: there is no family history of premature coronary artery disease or sudden death. physical exam: on admisison to floor: vs: t 95.5 bp 82/38 hr 104 rr27 o2 5lnc gen: wdwn middle aged male in mild distress heent: ncat. sclera anicteric. perrl, eomi. op clear, dry mm neck: supple, cv: s1 s2 no mrg chest: ant cta b/l no w/r/r, hickman 2cm erythema around site, no discharge abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, pertinent results: labwork on admission: 11:10pm wbc-4.0 rbc-4.60 hgb-14.3 hct-40.9 mcv-89 mch-31.0 mchc-34.9 rdw-16.1* 11:10pm plt count-198# 11:10pm neuts-64.6 lymphs-28.6 monos-5.3 eos-0.4 basos-1.1 11:10pm glucose-150* urea n-16 creat-0.7 sodium-141 potassium-4.0 chloride-102 total co2-24 anion gap-19 11:27pm pt-20.5* ptt-28.2 inr(pt)-2.0* 11:36pm lactate-2.6* 12:25am urine rbc-0 wbc-0-2 bacteria-rare yeast-none epi- 12:25am urine blood-neg nitrite-neg protein-500 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.0 leuk-neg 09:16am cortisol-39.3* 09:16am alt(sgpt)-25 ast(sgot)-51* ld(ldh)-262* alk phos-40 tot bili-0.2 . chest (pa & lat) impression: no evidence of pneumonia. . echo study date of conclusions: the left atrium is mildly dilated. the estimated right atrial pressure is >20 mmhg. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). the right ventricular cavity is markedly dilated. right ventricular systolic function appears depressed. there is abnormal septal motion/position consistent with right ventricular pressure/volume overload. the aortic root is moderately dilated athe sinus level. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is at least moderate to severe pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. no vegetations seen (cannot definitively exclude). compared with the prior study (images reviewed) of , the ivc is now more dilated. brief hospital course: 49 f pmh pulmonary htn on flolan, sle, apa syndrome, underwent recent hickman change due to line infection who returned with likely line sepsis. . #) sepsis: most likely due to hickman line infection. she was in the icu for sepsis for a few days where she received several liters of fluids, pressors which were quickly weaned, high dose antibiotics and stress dose steroids. she was subsequently transferred to the floor when off pressors x 48 hours. ua/culture remained negative. cxr negative for infection. of note, her hickman was removed and a rij placed. she was treated with gentamycin/linezolid since until when daptomycin replaced linezolod (see "headache" section below) and then on we switched gentamycin to levofloxacin to prevent gentamycin induced toxicity. all of the antibiotic regimens were per id recs. no blood or catheter tip cultures grew out any organisms during this admission. on the floor she remained hemodynamically stable and afebrile with no further signs of sepsis. she had a midline placed for 8 more days of home antibiotics (per id) to end and she had her hickman replaced by surgery without event on . . #) pulmonary htn: she had a right heart cath on which revealed pulmonary hypertension with mean pa pressure of 47mmhg with pa systolic of 70. the pvr was 513. there was elevation of ra pressure with mean ra of 15mmhg. the pcwp was near normal at 13mmhg. the cardiac index was preserved. based on this, and concersations with dr. (pulmonology) we will continue flolan at home for now via her hickman. she has follow up scheduled with dr. to discuss further management of her pulmonary htn. . #) tooth pain: pt with right questionable tooth infection prior to admission. she had considerable pain and headaches off amitriptyline. based on this we got panorex films of her jaw and a dental consult. per dental recs, there was no obvious source of infection/abscess and she was recommended for outpatient dental workup. . #) sle: stable throughout admission. we continued steroid taper for a few days after stress dose steroids. as she has had recurrent infections in the past few months, we consulted dr. (rheum) re: tapering her home prednisone which may be contributing to her susceptibility to infections. per dr. recs, we will discharge ms. on 9mg daily prednisone and she will follow in the outpatient setting and consider a further taper. . #) migraine ha: patient was off amytriptilline for migraine prophylaxis while on linezolid (due to increased risk of seratonin syndrome). her headaches were significantly worse off her home meds. we temporized with toradol, and dilaudid prn and eventually switched from linezolid to daptomycin per id so we could resume amytriptilline which we did a few days prior to discharge. her headaches subsequently improved significantly. . #) apa syndrome/history of hit: stable. coumadin was held for procedures/line placements and she remained off heparin products without event. we resumed coumadin on day of discharge which she is on for line patentcy. she will follow inrs in the outpatient setting. . #) dm: stable. fs qid, ssi while in house. we resumed oral agents prior to discharge. . #) osa: stable. on home oxygen during admission with stable o2 sats. . medications on admission: 1. allopurinol 100 mg daily 2. amitriptyline 50 mg qhs 3. estrogens conjugated 0.625 mg po daily 4. fexofenadine 60 mg 5. fluticasone 50 mcg spray daily 6. furosemide 20 mg daily 7. gabapentin 300 mg po daily 8. gabapentin 600 mg po hs 9. metformin 850 mg 10. prednisone 10 mg daily 11. warfarin 1 mg daily 12. zolpidem tartrate 10 mg po hs discharge medications: 1. daptomycin 500 mg recon soln sig: one (1) recon soln intravenous q24h (every 24 hours) for 8 days: last dose 5/18. disp:*8 recon soln(s)* refills:*0* 2. warfarin 1 mg tablet sig: one (1) tablet po daily (daily). 3. prednisone 1 mg tablet sig: four (4) tablet po daily (daily). disp:*120 tablet(s)* refills:*2* 4. prednisone 5 mg tablet sig: one (1) tablet po once a day: take with four 1mg tablets for a total of 9mg a day. disp:*30 tablet(s)* refills:*2* 5. epoprostenol 0.5 mg recon soln sig: one (1) recon soln intravenous infusion (continuous infusion). 6. allopurinol 100 mg tablet sig: one (1) tablet po once a day. 7. fluticasone 50 mcg/actuation aerosol, spray sig: one (1) nasal once a day. 8. gabapentin 300 mg capsule sig: two (2) capsule po hs (at bedtime). 9. gabapentin 300 mg capsule sig: one (1) capsule po daily (daily). 10. fexofenadine 60 mg tablet sig: one (1) tablet po twice a day. 11. zolpidem 5 mg tablet sig: two (2) tablet po hs (at bedtime). 12. conjugated estrogens 0.625 mg tablet sig: one (1) tablet po daily (daily). 13. amitriptyline 50 mg tablet sig: four (4) tablet po hs (at bedtime). 14. metformin 850 mg tablet sig: one (1) tablet po twice a day. 15. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 8 days: last dose 5/18. disp:*8 tablet(s)* refills:*0* 16. potassium chloride 10 meq capsule, sustained release sig: four (4) capsule, sustained release po once a day. disp:*120 capsule, sustained release(s)* refills:*2* 17. lasix 20 mg tablet sig: one (1) tablet po once a day. 18. flush please flush midline catheter with saline flushes before and after antibiotics daily 19. saline flush 0.9 % syringe sig: one (1) injection twice a day for 8 days: before and after antibiotics. disp:*8 days* refills:*0* discharge disposition: home with service facility: vna assoc. of discharge diagnosis: sepsis -diabetes mellitus type 2 -pulmonary arterial hypertension -obstructive sleep apnea -systemic lupus erythematosus -migraines discharge condition: fair discharge instructions: you were admitted for sepsis secondary to a presumed hickman line infection. the line was pulled and you were placed on antibiotics and did quite well. you had the hickman replaced and are now ready for discharge on antibiotics through . . seek medical attention immediately if you experience new symptoms including shortness of breath, chest pain, fainting, arm/jaw pain or numbness, coughing, blood in sputum, worsening diarrhea or other concerning symptoms. . follow up as per below. have your potassium checked by your doctor this week as well as your inr (to assess coumadin level). . take all medications as prescribed. followup instructions: -, l. call today for an appointment within 1 week. have your inr and potassium checked this week provider: , m.d. phone: date/time: 10:00 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified pulmonary artery pressure monitoring diagnoses: systemic lupus erythematosus obstructive sleep apnea (adult)(pediatric) anemia, unspecified cellulitis and abscess of trunk diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia asthma, unspecified type, unspecified sepsis other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure hypotension, unspecified ostium secundum type atrial septal defect long-term (current) use of insulin diarrhea infection and inflammatory reaction due to other vascular device, implant, and graft obesity, unspecified myalgia and myositis, unspecified home accidents chronic pulmonary heart disease, unspecified other forms of migraine, without mention of intractable migraine without mention of status migrainosus 

Answer: The patient is high likely exposed to