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: codeine / ultram attending: chief complaint: strep (group g) sepsis likely related to cellulitis of lle major surgical or invasive procedure: central line placement picc line placement history of present illness: yo russian speaking woman with pmhx significant for diastolic chf (ef>55%), afib, cml, admitted 10 days ago from hematology/oncology clinic for chf exacerbation. she was diuresed well and gleevec was d/c'd as it was thought to be a culprit in her chf exacerbation. she returned to the hospital 3 days post-discharge with a cough and nausea w/ a small amt of emesis. no f/c, abd pain, c/d, no cp, stable bilat pedal edema, stable 2 pillow orthopnea, no pnd. initially on presentation to ed on she was febrile to 103.7f, she had a negative u/a and was started on vanc levo for cellulitis / possible pna, her lle duplex u/s was negative, sbp dropped to 70s and lactate was 2.1 initially and dropped to 1.8 w/ fluids. central line placed and patient transferred to micu. micu course: fluid responsive hypotension although temporarily on levophed. tx initially w/ vanc / levo, transitioned to penicillin g. today patient states that she feels well and initially presented to the hospital with extreme fatigue as her main complaint as well as left lower extremity pain and swelling, with no known traumatic event preceeding. +n and small amt emesis and a ha w/o any visual changes. she has no pnd, no chest pain, no sob, and has not exerted herself lately but @ home can walk 1 block w/o any doe or fatigue. reproducible orthopnea @ 30 degrees now, @ baseline sleeps w/ 2 pillows although has no orthopnea. past medical history: 1. chronic myelogenous leukemia, on gleevec, followed by dr. . gleevec held, dr. aware and will follow as outpt. 2. paf - rate control, no anticoag by pt's choice 3. chf- chronic diastolic 4. spinal stenosis with chronic low back pain - s/p epidural steroid injections in clinic 5. chronic r shoulder pain 6. s/p r total knee replacement 7. s/p r total hip replacement 8. s/p l comminuted tibial fx repair 9. unsteady gait 10. h/o dizziness, on meclizine 11. hypercholesterolemia 12. h/o dyspepsia 13. s/p cataract surgery bilaterally 14. oa social history: pt lives alone in a senior community. she has a caregiver that see her on a daily basis. she denies any tobacco, etoh, or ivdu. family history: noncontributory. physical exam: vs: temp: 97 bp: 146/70 hr: 93 rr: 20 o2sat: 100% gen: a&ox3, interactive, comfortable. nad heent: jvp to earlobe @ 45 degrees. eomi, mmm, op clear. lungs: r sided rales to way up, l sided rales @ base only. cardiac: irregularly irregular, no m/r/g, able to induce orthopnea @ 30 degrees abd: +bs, soft, nt, nd, no masses, no hepatosplenomegaly. ext: 1+ pedal edema on l to knee, circumferential erythema from knee distally, warmth, edema and induration, tenderness to palpation but not to manipulation of joint. no cords, no cyanosis or clubbing. +tinea pedis between digits on le. neuro: cn 2-12 intact, moving all 4 extremities. pertinent results: admission cbc : wbc 11.5, hct 28.7, plt 208 discharge cbc: wbc 8.3, hct 25.2, plt 434 admission chemistry : na 138, k 4.1, cl 99, hco3 29, bun 17, cr 0.9, glucose 138. cpk 97, tnt 0.04, dig level 0.6. lactate 2.1. alt 16, ast 31, ldh 245. alkphos 71, t bili 0.8. discharge chemistry: na 140, k 4.1, cl 102, hco3 31, bun 23, cr 1.3, glucose 89, mg 2.3 micro data: : 4/4 bottles beta strep group g. mrsa screen negative blood cultures from , , ngtd ucx: 10k-100k enterococcus, cipro sensitive guiac stool echo - conclusions: the left atrium is moderately dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (lvef>55%). regional left ventricular wall motion is normal. the right ventricular cavity size is normal. right ventricular systolic function is normal. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild to moderate (+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is a small (0.9 cm) circumferential pericardial effusion. there are no echocardiographic signs of tamponade. compared with the prior study (images reviewed) of , the severity of mitral regurgitation has increased slightly. the other findings are similar. repeat echo : no evidence of endocarditis. symmetric lvh with preserved global and regional biventricular systolic function. moderate aortic, mitral, and tricuspid regurgitation. moderate pulmonary hypertension. small-to-moderate sized pericardial effusion without evidence of tamponade. cxr port ap : findings consistent with interstitial and alveolar edema, with bilateral pleural effusions. early pneumonia cannot be excluded and repeat imaging following diuresis could be helpful for further evaluation. cxr port ap : single portable radiograph of the chest demonstrates no change in the cardiomediastinal contour. left internal jugular central venous catheter is again seen with its tip in the svc. assessment is limited by patient positioning but there is likely a small right-sided pleural effusion. no pneumothorax. the appearance of the lungs is unchanged. lle duplex u/s : no evidence of left lower extremity deep vein thrombosis u/a : wbc, 0-2 epi, neg leuk es, neg nitrites, 0-2 rbc, few bacteria ekg: afib nml axis, nl intervals, tw flattening in all leads except leads v4-6; unchanged from . brief hospital course: sepsis- transiently on pressors, fluid resuscitated and transferred from icu to floor. sepsis likely related to her rle cellulitis as blood cx grew 4/4 bottles group g beta strep. treated initially with vancomycin, switched to penicillin g iv and continued to improve. hemodynamically stable. 8 days of antibiotics received in hospital, continue for 6 more days. continue to keep leg elevated and teds stockings in place. also fungal foot infection slightly on dorsum of feet bilaterally and between toes, continue clotrimazole cream until clear and then for an additional 1-2 weeks. diastolic chf- recent admission for chf in setting of gleevec, gleevec held and patient diuresed and improved. this admission for sepsis patient was agressively hydrated and then was in moderate chf and diursed to nearly the point of euvolemia. she was diuresing well upon discharge and was restarted on her home regimen of 20mg po bid of lasix. her weight was 71.8kg and she was sating in the mid/high. please continue to administer lasix and titrate up if needed to goal of even to negative 500cc as she is still mildly fluid overloaded. continue toprol xl 50mg for rate control, uptitrate prn. on dig in past but dig toxic so dig has been avoided. cml- on gleevec, thought to be cause of heart failure exacerbations as reportedly she goes into pulmonary edema whenever her gleevec is initiated. her hematologist / oncologist dr. has been notified via email regarding this change. she should follow up with dr. within 2-4 weeks of her discharge. arf- baseline creatinine 0.7 to 0.9, arf in icu in setting of sepsis thought to be related to atn, no improvement with diuresis of volume overload, cr peaked at 1.3 in micu and discharged with cr of 1.3, would trend over time. hopeful that her cr would recover overtime. a-fib- relatively well rate controlled. no anticoagulation per patient preference. anemia- chronic, baseline near hct 29. here down to 23, rec'd 1 uprbc, hct upon discharge was 27.4. her iron studies were borderline, would repeat outpatient when not in acute setting. stool guiac positive, plan was to start iron empirically and suggest outpatient colonoscopy however patient having difficulty with constipation. would defer iron supplementation to outpatient setting given current constipation. medications on admission: 1. metoprolol 12.5 po bid 2. allopurinol 100 mg po daily 3. trazodone 50 mg po hs prn 4. meclizine 25 mg po q8 prn 5. percocet 5-325 mg po q6hrs prn 6. pantoprazole 40 mg q24h 7. colace 100 mg po bid 8. senna 1-2 tabs po bid prn 9. mvi po daily 10. vitamin d3 400u po daily 11. lasix 20mg po bid 13. calcium carbonate 500 mg 14. aspirin 81 mg once a day 15. lisinopril 2.5 mg po daily medications upon transfer from micu: see attached discharge medications: 1. heparin flush picc (100 units/ml) 2 ml iv daily:prn 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. 2. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 3. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 4. clotrimazole 1 % cream sig: one (1) appl topical (2 times a day) for 30 days. disp:*2 tubes* refills:*4* 5. acetaminophen 325 mg tablet sig: two (2) tablet po tid (3 times a day). disp:*180 tablet(s)* refills:*2* 6. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime). tablet(s) 7. toprol xl 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 8. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 9. heparin (porcine) 5,000 unit/ml solution sig: as directed injection q8h (every 8 hours): 5000 units tid. 10. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 11. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 12. penicillin g potassium in d5w 2,000,000 unit/50 ml piggyback sig: as directed units/50 ml intravenous every six (6) hours for 6 days: give 2 million units. 13. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed. 14. docusate sodium 100 mg capsule sig: two (2) capsule po bid (2 times a day). 15. polyvinyl alcohol 1.4 % drops sig: 1-2 drops ophthalmic prn (as needed). 16. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed. 17. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed. discharge disposition: extended care facility: of discharge diagnosis: primary: lle cellulitis and beta streptococcus sepsis secondary: chf, arf, anemia, atrial fibrillation, cml discharge condition: stable, afebrile, hr well controlled, sating mid 90s on room air, weight 158 lbs upon discharge discharge instructions: weigh yourself every morning, md if weight > 3 lbs. your weight upon discharge was 158 pounds. adhere to 2 gm sodium diet (do not add any salt to your food) fluid restriction: 2 liters please call your doctor or go to the emergency if you have any increase the redness of your leg, increasing pain or swelling, chest pain, shortness of breath or any other concerning symptoms. followup instructions: follow up with dr. ( within 2 weeks for your leukemia. follow up with your pcp 4 weeks. recommend colonoscopy as outpatient. procedure: venous catheterization, not elsewhere classified diagnoses: anemia, unspecified congestive heart failure, unspecified acute kidney failure, unspecified gout, unspecified atrial fibrillation sepsis streptococcal septicemia chronic diastolic heart failure cellulitis and abscess of foot, except toes chronic myeloid leukemia, without mention of having achieved remission 

Answer: The patient is high likely exposed to