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: history of present illness: the patient is a 53 year old female with a past medical history significant for splenectomy after a motor vehicle accident twenty years ago, who had acute onset of headache approximately 36 hours prior to presentation. the headache was diffuse, severe and throbbing associated with mild photophobia but no neck rigidity. the day prior she awoke and went to work, still with the complaint of a headache, developed fever to 102.8, despite tylenol and finally presented to an outside hospital once a rash developed. petechiae first noted on the face and then spread to bilateral upper extremities and chest, none below the waist. the lesions on the face since coalesced to a violaceous rash over the nose. the patient was initially tachycardia and hypertensive with systolic blood pressure in the 70s, heart rate at 110. she was transferred to the intensive care unit where infectious disease, hematology and cardiology were consulted. sepsis protocol was initiated and she received five to six liters of intravenous fluids. concern for meningitis prompted a lumbar puncture followed by empiric vancomycin, ceftriaxone, chloramphenicol and steroids. swan-ganz catheter was placed for management of volume status and the patient was transferred to on levophed and dopamine for further management. past medical history: 1. status post splenectomy twenty years ago. 2. hypertension. allergies: penicillin causes a rash. sulfa causes a rash. intravenous dye causes a rash. outpatient medications: 1. diovan 80 mg. 2. hydrochlorothiazide 25 mg. 3. a cox2 inhibitor p.r.n. medications on transfer: 1. levophed 4 mcg/kg. 2. dopamine 5 mcg/kg. 3. ceftriaxone 2 grams. 4. vancomycin 500 mg. 5. chloramphenicol one gram. 6. activated protein c 25 mcg/kg/hour. 7. protonix. 8. solu-medrol 100 mg q8hours. social history: the patient works as a registered nurse. previously worked at . she denied tobacco use. occasional alcohol. she lives with her partner and two children. family history: positive for coronary artery disease, cerebrovascular accident, no cancer or diabetes mellitus. physical examination: at admission, temperature was 100.0, pulse 113, blood pressure 110/77, oxygen saturation 100% in room air. the patient appeared critically ill. the heart was tachycardic, s1, split s2, no murmurs. the lungs were clear to auscultation bilaterally. the abdomen was soft, nontender, nondistended, positive bowel sounds. extremities - no cyanosis, clubbing or edema. neurologic - no kernig or brudzinski signs. dermatology revealed numerous petechiae in the bilateral upper extremities and some on the chest. lesions on her face coalesced to form violaceous patches over the nose and maxilla bilaterally. laboratory data: from the outside hospital, white blood cell count was 12.1, 32% bands, 67% neutrophils, hematocrit 33.1, platelet count 77,000. inr 1.5, partial thromboplastin time 70, fibrinogen low at 164. d-dimer greater than 1.0. blood urea nitrogen 34, creatinine 3.0. albumin 3.1, alt 67, ast 58, amylase 47, ast 440, total bilirubin 135, lipase 106. cerebrospinal fluid was 186 red cells and white cells, 85% polys, glucose 68, protein 320. crypto antigen negative, gram stain negative. data from , white blood cell count 13.9 with 72% neutrophils, 24% bands, hematocrit 34.0, platelet count 81,000. inr 1.6. d-dimer greater than 10,000. fibrinogen 184. blood urea nitrogen 22, creatinine 1.0. alt 70, ast 311, alkaline phosphatase 45, ldh 545, albumin 3.2, amylase 46, total bilirubin 2.0. hospital course: 1. infectious disease - the patient was initially admitted to the medical intensive care unit where she was treated with neo-synephrine for blood pressure support and aggressive fluid hydration was continued. she was treated initially with empiric therapy for meningitis with vancomycin, ceftriaxone and briefly with acyclovir as well. the blood cultures from the outside hospital eventually grew out streptococcal pneumoniae and it was therefore felt that the patient had pneumococcal sepsis and meningitis. the gram stain and culture from the cerebrospinal fluid, however, did not grow any organisms. the patient was also continued briefly on the intravenous steroids but this was weaned off. the patient was quickly able to be weaned off the pressor support and improved nicely on antibiotic therapy. she was eventually transferred to the medical floor where she continued to spike low grade fevers, prompting a further fever workup which included further blood cultures and a ct of the chest which revealed evidence of a resolving pneumonia but no further sources. the sensitivities came back sensitive to ceftriaxone and penicillin. as the patient was allergic to penicillin, the patient was continued on ceftriaxone to finish a twenty-one day course as directed. at the time of discharge, the patient was afebrile for greater than 24 hours and her white blood cell count had returned to . 2. hematologic - the patient was in dic at the time of admission. she was treated with activated protein c started at the outside hospital and continued at . she had activated protein c for a total of eighty hours and was stopped early as her platelet count dropped to 39,000. there was no evidence of bleeding and subsequent to the discontinuation of the activated protein c, the patient's platelet count rebounded nicely to the high normal range. 3. gastrointestinal - near the end of her hospital course, the patient developed abdominal pain and nausea postprandially. an amylase and lipase were checked and showed evidence of pancreatitis. a ct scan was performed although intravenous contrast could not be used because of an allergy. ct scan showed no evidence of a large abscess in the pancreas or other pathology. it was felt the pancreatitis was due to sepsis and resulting inflammation. the patient's enzymes titrated down nicely after one day of npo and intravenous fluids and her diet was advanced and tolerated well. discharge status: the patient was discharged home with services. final diagnoses: 1. pneumococcal meningitis and sepsis. 2. pancreatitis. 3. disseminated intravascular coagulopathy. recommended follow-up: primary care physician, . , as well as dr. of infectious disease. medications on discharge: 1. percocet one to two tablets p.o. q4-6hours p.r.n. pain. 2. ceftriaxone two grams intravenously q12hours times ten days. the patient was instructed to follow-up with her primary care physician in regard to restarting her blood pressure medications and hormone replacement. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified infusion of drotrecogin alfa (activated) diagnoses: congestive heart failure, unspecified unspecified essential hypertension severe sepsis defibrination syndrome septic shock other acquired absence of organ pneumococcal septicemia [streptococcus pneumoniae septicemia] acute pancreatitis pneumococcal meningitis 

Answer: The patient is high likely exposed to