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 an 82 year old white female with a history of severe scoliosis, osteoporosis, hypertension, status post t3-t12 fusion on , status post compression fracture one to two years ago. the patient was doing well after her operation on the orthopedic service, apart from self-extubating herself on , requiring increasing amounts of oxygen on the floor. on , the patient had a fever of 101.4 and chest x-ray showed left lower lobe collapse with a right greater than left effusion. blood cultures, one out of four, were positive for gram positive rods, thought to be a contaminant, and gram positive cocci. on , overnight, the patient had acute onset shortness of breath with an increase in oxygen requirement with an oxygen saturation of 93% on a 40% face mask. arterial blood gases at that point were 7.45, 50 and 65 at 1:00 a.m. and then later, at 5:00 a.m., 7.41, 57 and 128 on 40% to 50% face mask. electrocardiogram was read as stable. a chest x-ray showed no congestive heart failure, with right sided effusion and left lower lobe collapse, unchanged from prior. ct was negative for pulmonary embolus but also saw bilateral effusions. the patient's mental status was deemed stable, as she was alert and oriented times three, with some inappropriateness. a medicine consult was called for this desaturation at 1:00 a.m. on and then on for falling. for the fall, she possibly hit her head and fell on her right side and also had a transient desaturation, for which were arterial blood gases were 7.41, 57 and 124. she had a ct of her chest and head which showed no bleed and no fracture. she was put in a collar until she was cleared and, at that point, because a urinalysis was found to be positive for 46 white blood cells and greater than 1,000 red blood cells on at 9:00 a.m. the patient was started on ciprofloxacin and then transferred to the medical service. past medical history: 1. osteoporosis, status post compression fracture in last one to two years, here with t3-t12 fusion done on . 2. severe scoliosis. 3. echocardiogram, concentric left ventricular hypertrophy, left atrial enlargement, 1+ mitral regurgitation, no wall motion abnormalities, normal left ventricular ejection fraction. 4. hypertension times two years. 5. hiatal hernia/gastroesophageal reflux disease. 6. question of mitral valve prolapse but negative on echocardiogram. allergies: the patient has no known drug allergies except for morphine, which causes her to get very sick, nausea apparently. medications on admission: iron supplements, zantac 150 mg p.o.q.d., tenormin 25 mg p.o.q.d., os-cal 500 mg p.o.b.i.d.; on transfer, albuterol and atrovent nebulizers, zantac 150 mg p.o.b.i.d., lopressor 12.5 mg p.o.t.i.d., colace 100 mg p.o.t.i.d., and p.r.n. lasix, zofran, codeine, haldol and tylenol. physical examination: on physical examination on transfer, the patient's vital signs were 96.1, 66 to 80, 160 to 174/63 to 72 and 96% on 50% shovel mask, 84% in room air. overnight ins and outs were 760 and 1,553, and urine output was 300 cc over the last eight hours. general: in no acute distress. head, eyes, ears, nose and throat: moist mucous membranes, oropharynx clear, no jugular venous distention, no point tenderness. chest: clear to auscultation bilaterally, slight crackles at right base, scattered. cardiovascular: regular rate, s1 and s2 normal, ii/vi systolic murmur at left upper sternal border, no gallops or rubs. abdomen: soft, nontender, nondistended, positive bowel sounds, no masses. extremities: no cyanosis, clubbing or edema. neurologic examination: alert and oriented times three, recall immediately and in five minutes, strength 5/5 throughout, sensation to light touch intact throughout, finger-to-nose bilaterally intact, gait not tested, reflexes 1+ throughout bilaterally. laboratory data: white blood cell count was 11.7, hematocrit 37.7, down from 39.6, platelet count 256,000, and coagulation profile normal. urinalysis showed specific gravity of 1.040, large blood, positive nitrite, greater than 300 protein, greater than 1,000 red blood cells, 46 white blood cells, many bacterial and no epithelial cells. chem-7: sodium 144, potassium 3.8, chloride 101, bicarbonate 32, bun 22, creatinine 0.4 and glucose 127. the patient was ruled out with cks of 252, 262 and 213 with negative mb, troponin less than 0.3. arterial blood gases: as above. ct scan of head and chest: negative for bleed and fracture respectively. cta: negative for pulmonary embolus and bilateral pleural effusions with question of left lower lobe loculation. chest x-ray: bilateral effusions as on . hospital course: 1. the patient was thought to have had flash pulmonary edema, possibly due to arrhythmia given her diastolic dysfunction by echocardiogram. the patient was given 20 mg of lasix. lopressor was increased, eventually to 50 mg twice a day. aspirin was given. the patient was put on telemetry. 2. pulmonary: the patient's effusions were thought likely due to her flash pulmonary edema and were considered stable. left lobe loculation was not considered accessible by ultrasound guided tap with risk of pneumothorax significant enough to cause her significant clinical deterioration. 3. infectious disease: the patient's urinary tract infection was treated with five days of ciprofloxacin. blood cultures were negative and urine culture was pending at this time. 4. hematology: the patient's hematocrit remained stable during her hospitalization, ranging from 33 to 39 and, on discharge, was 37.2. her white blood cell count continued to climb during her hospitalization, although she remained afebrile after transfer to medicine. it was thought possible that she could have a pneumonia given her effusions and difficult chest x-ray assessment based on her skeletal changes. ceftriaxone was started upon discharge for seven days, 1 gram daily. her wounds did not look infected. 5. fluids, electrolytes and nutrition: the patient initially had a bun to creatinine ratio that was elevated but, during her hospitalization, her creatinine remained stable at 0.4 to 0.5 and her bun fell from a peak of 23 on to 15 on discharge. the patient was intermittent getting intravenous fluids but mostly taking orals and, by the end of her hospitalization, the patient was taking adequate oral intake. 6. neurology: the patient's mental status fluctuated day to day and, as a result, she had a ct scan of her head initially on transfer that was negative, and then another one on that was also negative for a subdural hematoma. her mental status changes were thought possibly due to ciprofloxacin but, also, her family said that this was her baseline. she was off codeine and only on tylenol for her pain. 7. renal: as above, the patient's bun to creatinine ratio reduced over time. orthopedic surgery followed her after her transfer to the medicine service and after her fall. the patient had a thoracic spine film, read by orthopedic surgery who said that the alignment of the rods had shifted status post the fall and still was adequate in terms of stabilization of her spine. another read on the thoracic spine was a left eighth rib fracture, unclear when that occurred based on this one film. there were no management issues for that other than to heal spontaneously. discharge status: the patient was discharged to rehabilitation in stable condition. discharge diagnoses: thoracic compression fracture, status post t3 to t12 spinal fusion. acute desaturations secondary to possible congestive heart failure with diastolic dysfunction. hypertension. gastroesophageal reflux disease. scoliosis. concentric left ventricular hypertrophy. osteoporosis. discharge medications: ceftriaxone 1 gm i.v.q.24h. times seven days, until . lactulose 15 cc p.o.b.i.d.p.r.n. lopressor 50 mg p.o.b.i.d. multivitamins one p.o.q.d. zantac 150 mg p.o.b.i.d. tylenol p.r.n. colace 100 mg p.o.b.i.d. aspirin 81 mg p.o.q.d. dulcolax 10 mg p.r.n. haldol p.r.n. heparin 5,000 units s.c.b.i.d. follow-up: the patient is to follow up with orthopedic surgery as an outpatient and is to have her white blood cell count checked at rehabilitation to see if it resolves with the ceftriaxone. , m.d. dictated by: medquist36 procedure: dorsal and dorsolumbar fusion of the anterior column, anterior technique diagnoses: pneumonia, organism unspecified mitral valve disorders urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension pulmonary collapse scoliosis [and kyphoscoliosis], idiopathic kyphosis (acquired) (postural) 

Answer: The patient is high likely exposed to