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 attending: chief complaint: hyperglycemia . pcp: : major surgical or invasive procedure: femoral central venous line history of present illness: 54 yo f with history of type 1 dm, severe gastroparesis, htn, grave's ds and hep c, presents with dka for second time in 3 weeks. patient was admitted at the end of with hyperglycemia and an anion gap acidosis in the setting of a cough and fevers. she was discharged to home and in the last several days noticed her blood sugars running high, this time unaccompanied by fevers/coughing. she admits to +n/v and abdominal pain. before her electrolytes came back, she was treated in the ed with three doses of humalog. once it was evident that she had a gap acidosis, an insulin gtt was initiated. vitals in the ed were t 98.8, hr 125, bp 130/66, rr 16, sats 100% ra. although she had no obvious focus of infection, blood cultures and ua were sent and cxr ordered. she was sent to the micu for further management of dka while on an insulin gtt. . in the micu, the patient is currently non-bloody bilious emesis, requiring a dose of zofran iv. she denies sob/cp, cough, dysuria, f/c's. no diarrhea. she admits to abdominal pain, similar to her chronic gastroparesis pain, but more severe. patient claims she was taking all of her insulin as directed. past medical history: 1. dm type 1: years w/ dm: 5 age of diag: 48 year diag: several episodes of dka (last one in ), managed on 36u lantus plus hiss 2. diabetic polyneuropathy 3. hypertension 4. grave's disease s/p rai 5. reactive airway disease 6. seronegative arthritis, followed in rheumatology 7. hepatitis c, genotype 1a, biopsy with grade 1 inflammation, never been on antiviral therapy, acquired via blood transfusion during surgery in 8. gerd 9. migraines 10.bilateral knee arthroscopy in 11.s/p tah and pelvic floor surgery with bladder lift 12.depression 13. obesity 14. bone spurs in feet social history: no smoking/etoh/drugs. lives at home with 2 daughters. lives downstairs family history: mother: died of colon cancer long h/o dm-2 physical exam: vs: temp: 98.3 bp: 174/91 hr: 120 rr: 18 o2sat 100% ra gen: pleasant, fatigued but nad : , eomi, anicteric, dry mm, op without lesions neck: flat jvd, supple resp: cta b/l with good air movement throughout cv: tachy but regular, s1 and s2 wnl, no m/r/g abd: nd, +b/s, soft, diffusely tender but no rebound or guarding, no masses. neg . ext: no c/c/e, warm, good pulses skin: no rashes/no jaundice neuro: aaox3. moves all extremities. pertinent results: 09:21pm glucose-83 urea n-12 creat-1.1 sodium-133 potassium-4.0 chloride-105 total co2-23 anion gap-9 09:21pm calcium-9.4 phosphate-1.3* magnesium-2.3 01:10pm glucose-265* urea n-11 creat-0.8 sodium-136 potassium-3.6 chloride-103 total co2-22 anion gap-15 01:10pm calcium-9.5 phosphate-1.8* magnesium-1.5* 08:03am glucose-296* urea n-15 creat-0.8 sodium-134 potassium-4.8 chloride-102 total co2-21* anion gap-16 08:03am alt(sgpt)-16 ast(sgot)-17 ld(ldh)-149 alk phos-97 amylase-49 tot bili-0.5 08:03am lipase-39 08:03am albumin-4.2 calcium-10.0 phosphate-2.6*# magnesium-1.7 08:03am tsh-less than 03:49am type-art po2-109* pco2-32* ph-7.31* total co2-17* base xs--9 intubated-not intuba 03:49am lactate-2.1* 03:38am urine hours-random 03:38am urine uhold-hold 03:38am urine blood-neg nitrite-neg protein-neg glucose-1000 ketone-150 bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 01:09am glucose-608* urea n-19 creat-1.4* sodium-134 potassium-4.8 chloride-95* total co2-10* anion gap-34* 01:09am estgfr-using this 01:09am calcium-10.8* phosphate-4.2 magnesium-2.1 01:09am acetone-large 01:09am wbc-5.4 rbc-4.43# hgb-13.1# hct-40.2# mcv-91 mch-29.6 mchc-32.7 rdw-13.7 01:09am neuts-79.0* lymphs-19.2 monos-1.5* eos-0.1 basos-0.1 01:09am plt count-381 . cxr: impression: no acute cardiopulmonary abnormality. brief hospital course: 54 yo woman h/o type 1 dm w/ gastroparesis and neuropathy, htn, hep c presents with dka (initial glc 777, ag 33) and fevers, nausea, (nonbloody), worsening gastroparesis pain and nonproductive cough. in the micu, patient was placed on insulin drip. she was restarted on lower dose lantus and placed on her outpatient sliding scale. she was tolerating meals well and her abdominal pain was improved. . 1. diabetes melitus: on admission she was in dka based on ag of 29, ketones in urine and glc of 608 in ed. she reported compliance w/ home insulin. ecg was unchanged from previous. she had no f/c or leukocytosis. alternatively worsened gastroparesis with nausea, vomitting and abdominal pain also possible. initial ua and blood cultures were negative. initial urine culture grew gardnerella vaginalis. subsequent ua equivocal with < gnr's on culture. final ua also equivocal but culture grew >100,000 e.coli (pan-sensitive) which developed with catheter in place so treated with 1 week of ciprofloxacin. cxr unremarkable. one set of blood cultures grew coag neg staph but subsequent cultures were negative at the time of discharge so this was thought to be a contaminant. last a1c in was 6.0, markedly elevated on last admission to 10. in the micu she was treated with an insulin drip and electrolyte repletion. she was stabilized on this, gap was closed, she was transferred to the floor, and initially started on less than normal dose lantus with sliding scale. she had fair glycemic control and was tolerating food. she was discharged to resume her home dose of insulin (20 units glargine twice daily, with humalog sliding scale. followed her in house and she will follow-up with them as an outpatient. she was continued on reglan for gastroparesis. 2 gastroparesis: she had nausea, and abdominal pain on presentation thought secondary to her diabetic gastroparesis with no clear infectious process presenting itself. this was controlled and she resumed home reglan. 3 urinary tract infection: noted after foley catheter placed in micu. she was started on cipro for pan-sensitive e.coli for a 7 day course, started . she should have a repeat ua and culture once she has completed the antibiotics. 4 coag negative staph in blood cultures: not present on initial cultures or subquent surveillance cultures. thought to be a contaminant given lack of signs or symptoms of infection. 5 acute renal failure: normal on arrival creatinine was elevated to 1.4. this improved to 0.9 with hydration so was thought to be prerenal given dehydration. this did not recur during her hospital course. 6 headache: she has a history of migraine headaches and developed unilateral pain typical of her usual migraine pain in house. this was treated with morphine and tylenol in house and resolved. 7 leukopenia: she develped mild leukopenia, with a wbc count of 3.7 on discharge. she has had leukopenia to this level in the past and will need follow-up with her pcp to have this repeated and further evaluated as an outpatient. 8 hypertension: she was noted to develop hypertension in the micu so was restarted on her losartan with excellent hemodynamic control by the time of discharge. 9 history of anemia: baseline high 20's, normocytic, iron studies suggestive of aocd. at baseline on discharge. 10 asthma: she was continuted on inhalers in house but no evidence of asthma exacerbation. 11 polyneuropathy: she was conintinued on neurontin for this in house. 12 grave's disease: she was continued on methimazole in house at home doses. her tsh returned suppressed in the micu and free t4 at that time was 2.7, which is mildly elevated. these should be repeated as an outpatient and she may need her regimen re-addressed. she was asymptomatic at these values. . 13 seronegative arthritis: no active issues in house, she was restarted on sulfasalazine and prn naprosyn. 14 depression: she was continued on amitriptylline. medications on admission: trazodone 100 mg po hs (at bedtime) as needed for insomnia. albuterol 90 mcg/actuation aerosol sig: two (2) puff inhalation q6h (every 6 hours) as needed for sob, wheezing. amitriptyline 25 mg po hs (at bedtime). gabapentin 300 mg qp q12h aspirin 81 mg tablet, po daily (daily). methimazole 10 mg po tid metoclopramide 10 mg po qidachs montelukast 10 mg po daily hexavitamin po daily pantoprazole 40 mg po q24h salmeterol 50 mcg/dose disk q12h simvastatin 10 mg po daily sulfasalazine 500 mg po 3 tabs oxycodone-acetaminophen 5-325 mg 1-2 tablets po q6h prn hyoscyamine sulfate 0.125 mg tablet, sl losartan 50 mg po daily lantus 20 units hiss flexeril zelnorm 6mg 1 tab po tid discharge medications: 1. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 5. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 6. gabapentin 300 mg capsule sig: one (1) capsule po q12h (every 12 hours). 7. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). 8. methimazole 10 mg tablet sig: one (1) tablet po tid (3 times a day). 9. losartan 50 mg tablet sig: one (1) tablet po daily (daily). 10. sulfasalazine 500 mg tablet sig: one (1) tablet po tid (3 times a day). 11. amitriptyline 25 mg tablet sig: one (1) tablet po hs (at bedtime). 12. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 6 days. disp:*12 tablet(s)* refills:*0* 13. insulin glargine 100 unit/ml solution sig: twenty (20) units subcutaneous twice a day. 14. trazodone 100 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. 15. hexavitamin tablet sig: one (1) tablet po once a day. 16. salmeterol 50 mcg/dose disk with device sig: one (1) inhalation inhalation twice a day. disp:*qs 1 month * refills:*2* 17. percocet 5-325 mg tablet sig: one (1) tablet po every hours as needed for pain. 18. levsin 0.125 mg tablet sig: one (1) tablet po once a day. 19. insulin lispro 100 unit/ml solution sig: per sliding scale units subcutaneous four times a day. 20. flexeril 10 mg tablet sig: one (1) tablet po three times a day as needed for pain. 21. zelnorm sig: six (6) mg po three times a day. 22. flovent hfa 220 mcg/actuation aerosol sig: one (1) inhalation inhalation twice a day. disp:*qs 1 month * refills:*2* discharge disposition: home with service facility: discharge diagnosis: primary: diabetic ketoacidosis / type 2 diabetes mellitus with complications and uncontrolled . secondary: urinary tract infection, hypertension, polyneuropathy, depression, seronegative arthritis, asthma. discharge condition: tolerating food, improved blood glucose control, hemodynamically stable without fever. discharge instructions: please take all medications as prescribed. please keep all follow-up appointments. please call your primary care doctor, your doctor, or return to the ed if you experience fevers, chills, nausea, vomitting, diarrhea, pain with passing your urine, back pain, or any symptoms that concern you. followup instructions: please call to schedule follow-up with your primary care physician, . within the next week. you should have a repeat urinalysis and culture after you finish your ciprofloxicin for your urinry tract infection. . please also call to schedule follow-up this week. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified diagnoses: anemia of other chronic disease urinary tract infection, site not specified unspecified essential hypertension acute kidney failure, unspecified unspecified viral hepatitis c without hepatic coma asthma, unspecified type, unspecified polyneuropathy in diabetes depressive disorder, not elsewhere classified dehydration toxic diffuse goiter without mention of thyrotoxic crisis or storm diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with ketoacidosis, type i [juvenile type], uncontrolled gastroparesis leukocytopenia, unspecified arthropathy, unspecified, site unspecified 

Answer: The patient is high likely exposed to