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 / motrin / vioxx / colchicine / optiray 320 / iodine containing agents classifier / levofloxacin attending: chief complaint: leg pain major surgical or invasive procedure: picc line placement history of present illness: ms. is a 88 year old female per omr with cad, af, dchf, dm2, dvt/pe , end-colostomy for perforated diverticulitis, recurrent multi-drug resistant uti who is admitted for uti,hypotension and dvt. . patient has previous hx of left femur fracture in . she has been living at nursing home since where she has remained farely immobile and spends most of her time in a wheelchair requiring full help in adl's. at nursing home she was on prophylactic enoxaparin. . patient's most recent admission at was for uti. urine cultures at the time however grew mixed flora and patient was treated based on her previous cultures of which grew e.coli resistant to cipro, bactrim, pseudomonas resistant to cephalosporin and vre. she received daptomycin and meropenem and was discharged on meropenem and fosfomycin to rehab for completion of 10 day course. per phone converstioon with nursing home nurse patient was treated again with meronepem from for another episode of uti. . earlier today patient presnted to pre-scheduled appointment at orthopedic's office from her nursing home, she has reported several days of left leg pain starting around her toes or ankles radiating up to her hip. pain was intemitent with no relation to position or other triggers. patient also reports that she has had some increased dyspnea for the same time period. she denied chest pain. she has subjective chills. denies any recent falls or trauma. no cough. denies any abd pain. patient has also been increasingly fatigued and lethargic. she reports continous urinary symptoms but can't say whether those were more prominent over the past few days. . ortho obtained x-rays of her left femur which showed no major change from previous. also obtained ultrasound of her left lower extremity which showed a partial dvt. she was sent to the ed for management of dvt. . . ed course - initial vitals: 100.9 122/66 89 20 100% - patient had trigger at 17:45 for hypotension to 87/40. labs showed leukocytosis to 12,000 with 84% neu, hct 33 at baseline, lactate 1.9, ua positive she had some llq tenderness: ct abd was unremarkable. recieved pain control: acetaminophen + iv morphine ivf - 4l abx - meropenum . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: - diabetes - dyslipidemia - hypertension - coronary artery disease s/p cardiac cath with 50% mid-lad lesion -a-fib -congestive heart failure with diastolic dysfunction (ef 60%) -diabetes mellitus type 2 -hyperlipidemia -pulmonary embolism (did not tolerate coumadin due to gi bleed) -polymyalgia rheumatica -temporal arteritis -diverticulitis with perforation in s/p colostomy -rotator cuff injury -glaucoma -gout -hemorrhoids -neuropathy -depression -s/p fall with left femur, left humeral and right fifth metacarpal fracture social history: widowed. patient has previous hx of left femur fracture with assoicated dvt/pe in . she has been living at nursing home in since where she has remained farely immobile and spends most of her time in a wheelchair requiring full help in adl's. had been living with daughter with services prior.she has 3 daughters and 2 sons all living in the area, she can also boast of 16 grandchildren and 4 great grandchildren. no tobacco, etoh, illicits. family history: father died of colon cancer, mother had , died of breast cancer, brother died of colon cancer, two sons with prostate cancer. physical exam: general - nad, comfortable, appropriate, a+ox3, cheerful heent - nc/at, arcus senilis, perrla, eomi, sclerae anicteric, dry mm, op clear neck - supple, no thyromegaly, no jvd, no carotid bruits lungs - good bil air movement, -basilar crackles, no wh unlabored, no accessory muscle use heart - rrr, sm at lsb, no carotid bruits abdomen - surgical scars, ostomy bag at llq, soft/nt/nd, bs++, no masses or hsm, no rebound/guarding gu: foley in place with thick viscous urinary secretion extremities - wwp, left shin skin discoloration, tenderness along calf and medial thigh, no drainage or erythema around area of left femur fracture, pain with movement along all lle, left drop foot, no dorsal flexion beyond neutral position, motor strength foot . some tenderness along rle too but less. no le edema. +1 peripheral pulses (radials, dps) skin - no rashes or lesions neuro - awake, a&ox3, cns grossly intact, muscle strength, except lle, sensation grossly intact throughout . pertinent results: admission 03:40pm blood wbc-12.3*# rbc-3.70* hgb-10.7* hct-33.3* mcv-90 mch-29.0 mchc-32.2 rdw-16.2* plt ct-284 03:40pm blood neuts-84.5* lymphs-11.7* monos-2.9 eos-0.6 baso-0.3 03:40pm blood pt-11.9 ptt-30.8 inr(pt)-1.1 03:40pm blood glucose-101* urean-16 creat-0.9 na-138 k-3.8 cl-101 hco3-26 angap-15 calcium-7.5* phos-3.2 mg-1.5* 03:40pm blood alt-31 ast-40 alkphos-328* totbili-0.6 04:10am blood 03:40pm blood cortsol-18.0 04:04pm blood lactate-1.9 discharge: 06:10am blood wbc-5.8 rbc-3.26* hgb-9.6* hct-29.3* mcv-90 mch-29.5 mchc-32.8 rdw-16.1* plt ct-224 06:10am blood pt-13.1* ptt-116.4* inr(pt)-1.2* 06:10am blood glucose-101* urean-11 creat-0.6 na-140 k-3.8 cl-105 hco3-29 angap-10 calcium-9.5 phos-4.2 mg-1.8 microbiology: 3:55 pm blood culture #2 peripheral. **final report ** blood culture, routine (final ): staphylococcus, coagulase negative. isolated from only one set in the previous five days. sensitivities performed on request.. sensitivities requested by #. final sensitivities. ceftriaxone sensitivity requested by . ceftriaxone sensitivity testing performed by etest. sensitivities: mic expressed in mcg/ml _________________________________________________________ staphylococcus, coagulase negative | ceftriaxone----------- 4 s clindamycin-----------<=0.25 s erythromycin----------<=0.25 s gentamicin------------ <=0.5 s levofloxacin---------- 4 r oxacillin-------------<=0.25 s tetracycline---------- =>16 r vancomycin------------ 1 s aerobic bottle gram stain (final ): gram positive cocci in clusters. reported to and read back by 3:15pm. 4:29 pm urine site: catheter **final report ** urine culture (final ): proteus mirabilis. 10,000-100,000 organisms/ml.. piperacillin/tazobactam sensitivity testing available on request. sensitivities: mic expressed in mcg/ml _________________________________________________________ proteus mirabilis | ampicillin------------ =>32 r ampicillin/sulbactam-- =>32 r cefazolin------------- 16 r cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin--------- =>4 r gentamicin------------ 8 i meropenem------------- 0.5 s tobramycin------------ 2 s trimethoprim/sulfa---- =>16 r blood culture blood culture, routine-pending inpatient blood culture blood culture, routine-pending inpatient reports: radiology chest port. line placem white, of the new right pic line projects over the mid-to-low svc. the patient is rotated to the right, distorting the mediastinal anatomy, but the moderate cardiomegaly appears grossly unchanged. aside from mild left basal scarring or atelectasis, lungs are clear and there is no appreciable pleural abnormality. a row of suture reflects previous right upper lobe lung resection. radiology chest (pa & lat) , impression: interval vascular congestion with mild interstitial edema, new since . radiology ct abd & pelvis w/o con , impression: 1. no acute intra-abdominal or intrapelvic process. 2. foley catheter terminates within the collapsed bladder, with coiled extra foley tubing distorting the bladder wall. consider retraction of the foley catheter by at least 10 centimeters. radiology knee (2 views) left , a. approved the patient is status post orif distal femur fracture, transfixed by buttress plate and screws, in overall anatomic alignment, with slight medial and posterior displacement of the distal fragment and minimal posterior apex angulation. compared with , alignment is unchanged. the fracture line remains visible, with minimal if any interval callus formation and sclerosis. no hardware loosening or failure is detected. the medial femorotibial joint is narrower on today's examination -- this could reflect either worsening oa or differences in positioning. again seen is severe osteopenia, severe knee osteoarthritis, and dense vascular calcification. radiology unilat lower ext veins , a. impression: partial thrombosis of the left superficial femoral and popliteal vein, new since . findings were discussed with dr. at by dr. over the phone at 10:45 a.m. on . cardiovascular ecg white, w. sinus rhythm. left anterior fascicular block. possible left ventricular hypertrophy. compared to the previous tracing of no diagnostic change. brief hospital course: micu course: ms. is a 88 year old female per omr with cad, af, dchf, dm2, dvt/pe , end-colostomy for perforated diverticulitis, recurrent multi-drug resistant uti who presented to the ed from nursing home with recurrent uti hypotension and a new left popliteal dvt + superficial themoral thrombosis. hypotension resolved with 4 l of ivf's in the ed. was in the icu overnight where she remained hemodynamiocally stable and was treated empirically with iv meropenem + linezolid for her uti based on mdr-polymicrobial uti's in the past. she was also treated with iv heparin for her dvt. home anti-hypertensive meds were held as was glipizide and furosamide in the icu. patient is dnr/dni and has expressed interest in exploring palliative care. icu team planned to contact pcp and get palliative care consult to help with plan for her continued care. patient transfered to the medical floor for continued care. active issues: # sepsis: suspected source was urinary tract infection and was continued emperically from until . on , the patient's urine culture grew proteus, sensitive to ceftriaxone. she was switched without issue and improved significantly on this. last dose will be . # bacteremia: she had one out of four blood culture bottles grew methicillin sensitive coag negative staph. repeat blood cultures were pending at time of discharge and catheter culture was no growth. fortunately her msse was sensitive to ceftriaxone and she needs to continue this anyway for her complicated uti per above. # dvt: patient with lle pain found to have a dvt. this was considered to be provoked given her relative immobility and her recent left hip fracture . she was continued on heparin gtt to be transitioned to warfarin with lovenox bridge. goal inr of for a 3 month course. she was informed of her risks of bleeding given her massive rp bleed in , and she agreed to pursue anticoaggulation despite the risks. she should have a weekly hematocrit checked for the first few weeks of anticoaggulation therapy. # goals of care: after much discussion with palliative care patient opted to continue dnr/dni but to pursue all other therapies including antibiotics, anticoaggulation knowing the risks, rehospitalization, and even micu stays. chief goals remain comfort. # sciatica: patient developed severe acute on chronic sciatic pain and with palliative care's help was started on oxycontin and oxycodone. her gabapentin was also increased to good effect. chronic issues . . # atrial fibrillation: currently in sinus rhythm. - continued aspirin, now also on heparin gtt - held home dilt and dysopyramide given hypotension, restarted upon discharge . # cad: - continued aspirin + statin . # dm2: - held glipizide in house - started sliding scale insulin. . # polymyalgia rheumatica/temporal arteritis: - continued prednisone 5 mg qd. . # gout: - continued allopurinol. . # dchf: some congestion on auscultation and cxr. - getting fluids given hypotension in the settng of sepsis, but low threshold to diurese. - restarted lasix - restarted dysopiramide . # neuropathy: - increased home gabapentin given her sciatic pain . # arthritis: - continued lidocaine patches - pain control as above . # glaucoma: - continued lantoprost eye drops . # hld: - continued statin . # gerd: - continued omeprazole medications on admission: medications - prescription allopurinol - 100 mg tablet - 1 tablet by mouth once a day atorvastatin - 20 mg tablet - 1 tablet by mouth at bedtime diltiazem hcl - 120 mg capsule,ext release degradable - 1 capsule by mouth at bedtime disopyramide - 100 mg capsule - 1 capsule by mouth every six (6) hours furosemide - 40 mg tablet - 2 tablets by mouth daily and as directed gabapentin - 300 mg capsule - 1 capsule(s) by mouth morning and noon, 2 tabs at night glipizide - 5 mg tablet - 1 tablet by mouth daily as needed for for elevated blood sugar glipizide - 10 mg tablet - 2 tablets by mouth daily hydrocodone-acetaminophen - 5 mg-325 mg tablet - 1 tablet by mouth q 6 hours as needed for severe pain latanoprost - (prescribed by other provider) - 0.005 % drops - 1 gtt in each eye at bedtime lidocaine - 5 % (700 mg/patch) adhesive patch, medicated - one patch to each knee up to 12hrs off for 12 hrs motorized wheel chair - - use as directed daily nitroglycerin - 0.1 mg/hour patch 24 hr - one patch on hs, off am omeprazole - 20 mg capsule, delayed release(e.c.) - 1 capsule by mouth twice a day oxycodone - 5 mg tablet - 1 tablet by mouth every four (4) hours as needed for pain prednisone - 5 mg tablet - 3 tablet(s) by mouth daily medications - otc acetaminophen - (prescribed by other provider) - 500 mg tablet - 2 tablet(s) by mouth every six (6) hours aspirin - (otc) - 81 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth daily (daily) calcium carbonate - (otc) - 500 mg tablet, chewable - 1 tablet(s) by mouth three times a day cholecalciferol (vitamin d3) - (otc) - 400 unit capsule - 2 capsule(s) by mouth daily --------------- --------------- --------------- --------------- . allergies: . penicillins colchicine iodine containing agents classifier levofloxacin motrin optiray 320 vioxx discharge medications: 1. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 2. acetaminophen 500 mg tablet sig: two (2) tablet po q8h (every 8 hours). 3. atorvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 4. furosemide 80 mg tablet sig: one (1) tablet po daily (daily). 5. gabapentin 300 mg capsule sig: one (1) capsule po bid (2 times a day): morning, noon. 6. gabapentin 300 mg capsule sig: two (2) capsule po hs (at bedtime). 7. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: two (2) adhesive patch, medicated topical daily (daily): to each knee. 8. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 10. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 11. glipizide 10 mg tablet extended rel 24 hr sig: two (2) tablet extended rel 24 hr po once a day. 12. glipizide 5 mg tablet extended rel 24 hr sig: one (1) tablet extended rel 24 hr po once a day. 13. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 14. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 15. ceftriaxone 1 gram recon soln sig: one (1) injection every twenty-four(24) hours: last dose on . 16. lovenox 60 mg/0.6 ml syringe sig: one (1) subcutaneous every twelve (12) hours: give until inr between . 17. warfarin 4 mg tablet sig: one (1) tablet po once a day: goal inr . 18. disopyramide 100 mg capsule sig: one (1) capsule po every six (6) hours. 19. diltiazem hcl 120 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po at bedtime. 20. prednisone 5mg po daily. called facility to also ask them to restart the prednisone 5mg po daily discharge disposition: extended care facility: for extended care - discharge diagnosis: severe sepsis urinary tract infection bacteremia hypotension deep venous thrombosis sciatica discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: it was a pleasure to take care of you here at . you were admitted for low blood pressure thought to be secondary to a urinary tract infection. fortunately you improved significantly on antibiotics and will complete a 14 day course of iv ceftriaxone. there was a question of a blood stream infection from your old picc line, and therefore this was pulled out. fortunately, the bacteria was most likely a contaminant (not a real infection) and was also covered by ceftriaxone anyway. you also developed a dvt or blood clot in your left leg and were started on iv heparin. the risks of bleeding were explained to you and your family given your history of bleeding and you accepted these risks. therefore, we started you on warfarin and you would continue bridging with lovenox while in rehab. we also increased your gabapentin and started you on oxycontin and oxycodone for your severe sciatica pain. we have made the following changes to your medications: 1) start warfarin 4mg by mouth daily (for goal inr of ) 2) start ceftriaxone 1gm iv daily (last dose ) 3) start lovenox 60mcg subcutaneous injection twice daily until inr is between for 48 hours. 4) start oxycontin 10mg by mouth twice daily 5) start oxycodone 5-10mg by mouth every 4 hours as needed for pain 6) increase gabapentin to 300mg by mouth every morning, 300mg by mouth every afternoon, and 600mg by mouth nightly please continue to take all of your other medications as prescribed. followup instructions: please follow up with your primary care doctor while at the . md, procedure: central venous catheter placement with guidance diagnoses: sciatica polymyalgia rheumatica esophageal reflux urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension unspecified septicemia severe sepsis gout, unspecified atrial fibrillation unspecified glaucoma other and unspecified hyperlipidemia diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled personal history of venous thrombosis and embolism do not resuscitate status acute venous embolism and thrombosis of deep vessels of proximal lower extremity hypovolemia proteus (mirabilis) (morganii) infection in conditions classified elsewhere and of unspecified site chronic diastolic heart failure colostomy status giant cell arteritis personal history of pulmonary embolism 

Answer: The patient is high likely exposed to