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 / iodine / levofloxacin attending: chief complaint: pubic pain, cellulitis and drainage major surgical or invasive procedure: - incision and drainage of debridement of perineum and lower left abdominal wall, remained intubated post-operatively - extubation - reintubation and extubation for upper endoscopy - upper endoscopy with visualization of non-bleeding duodenal ulcer history of present illness: the patient is an 84-year-old female with presents to the ed with a five day history of erythema and edema of the left labial and mons area. she reports she started having drainage from the area on the day of presentation. she also reported fevers to 101 and shortness of breath, though she stated this was chronic. past medical history: pmh: pulm htn, copd, hcv, asthma, htn, hemolytic anemia, hemorrhoids diverticulosis, chf psh: appy, tah - , open ccy, splenectomy (for hemolytic anemia), djd social history: former smoker, quit ~, roughly 60 pack years. no etoh. lives alone and is independent; used to work at youth organizations, is very active. family history: hx of cancers on both sides of family; dad with lung, aunt with breast, and sisters with lung physical exam: on admission: 100.9 72 155/65 18 100% aaox3 nad rrr ctab soft nt/nd, well healed midline and rlq scars erythematous mons - open lateral/left of labia - fatty cavity with no pus no edema, extrem warm stool in vault, no masses, no blood pertinent results: 10:00am blood wbc-21.7*# rbc-3.62* hgb-11.9* hct-36.5 mcv-101* mch-33.0* mchc-32.7 rdw-15.7* plt ct-142* 07:00am blood wbc-19.1* rbc-3.31* hgb-11.0* hct-33.5* mcv-101* mch-33.1* mchc-32.7 rdw-15.6* plt ct-152 07:20am blood wbc-21.9* rbc-3.49* hgb-11.2* hct-36.3 mcv-104* mch-31.9 mchc-30.7* rdw-15.3 plt ct-171 07:10am blood wbc-19.9* rbc-2.77* hgb-9.0* hct-28.5* mcv-103* mch-32.4* mchc-31.5 rdw-15.5 plt ct-156 02:46am blood wbc-18.4* rbc-2.53* hgb-8.4* hct-25.9* mcv-102* mch-33.1* mchc-32.3 rdw-15.5 plt ct-184 01:51am blood wbc-14.1* rbc-2.28* hgb-7.9* hct-22.8* mcv-100* mch-34.5* mchc-34.6 rdw-15.5 plt ct-179 03:15am blood wbc-12.6* rbc-2.44* hgb-8.0* hct-23.7* mcv-97 mch-33.0* mchc-34.0 rdw-15.7* plt ct-181 01:29am blood wbc-12.3* rbc-2.58* hgb-8.7* hct-25.5* mcv-99* mch-33.8* mchc-34.2 rdw-15.6* plt ct-251 01:36am blood wbc-14.1* rbc-2.61* hgb-8.5* hct-24.9* mcv-95 mch-32.5* mchc-34.0 rdw-15.7* plt ct-245 04:55am blood wbc-13.8* rbc-2.66* hgb-8.6* hct-26.3* mcv-99* mch-32.4* mchc-32.8 rdw-16.1* plt ct-254 06:00am blood wbc-12.6* rbc-2.39* hgb-7.8* hct-24.0* mcv-100* mch-32.7* mchc-32.6 rdw-16.1* plt ct-271 03:30pm blood hct-19.5* 12:09am blood hct-22.9* 05:04am blood wbc-11.0 rbc-3.14*# hgb-10.0*# hct-29.5*# mcv-94 mch-31.7 mchc-33.8 rdw-17.3* plt ct-202 01:36am blood wbc-14.8* rbc-2.88* hgb-9.2* hct-26.9* mcv-94 mch-31.9 mchc-34.1 rdw-17.9* plt ct-169 02:01am blood wbc-14.9* rbc-2.59* hgb-8.4* hct-24.9* mcv-96 mch-32.6* mchc-33.9 rdw-18.0* plt ct-175 10:00am blood glucose-117* urean-56* creat-1.5* na-141 k-4.5 cl-100 hco3-27 angap-19 07:00am blood glucose-102* urean-58* creat-1.6* na-140 k-4.6 cl-103 hco3-28 angap-14 07:20am blood glucose-97 urean-84* creat-2.3* na-142 k-5.7* cl-104 hco3-22 angap-22* 07:10am blood glucose-100 urean-116* creat-2.4* na-137 k-5.5* cl-99 hco3-25 angap-19 02:46am blood glucose-215* urean-123* creat-2.7* na-134 k-5.9* cl-99 hco3-22 angap-19 01:51am blood glucose-126* urean-107* creat-2.6* na-138 k-4.1 cl-102 hco3-24 angap-16 03:15am blood glucose-121* urean-82* creat-2.1* na-139 k-3.4 cl-104 hco3-27 angap-11 01:29am blood glucose-127* urean-73* creat-1.9* na-139 k-4.7 cl-105 hco3-25 angap-14 01:36am blood glucose-95 urean-70* creat-1.8* na-144 k-4.7 cl-108 hco3-29 angap-12 04:55am blood glucose-85 urean-58* creat-1.7* na-149* k-5.0 cl-111* hco3-28 angap-15 06:00am blood glucose-99 urean-58* creat-1.7* na-146* k-5.0 cl-110* hco3-32 angap-9 05:04am blood glucose-111* urean-55* creat-1.6* na-147* k-4.7 cl-111* hco3-33* angap-8 01:36am blood glucose-86 urean-54* creat-1.8* na-151* k-4.6 cl-113* hco3-36* angap-7* 02:01am blood glucose-102* urean-51* creat-1.9* na-147* k-4.1 cl-108 hco3-35* angap-8 ct pelvis () - long indurated track extending anteriorly from the posterior gluteal fold. foci of air in the most posterior aspect - likely corresponding to area of drainage seen on physical exam - correlate clinically. about 3.5 cm superior to above mentioned are -- fat stranding in the fascia and soft tissues of the left labia -- c/w cellulitis. no drainable abscess collection. single foci of air in the anterior midline at the superficia labial fold. brief hospital course: the patient initially looked well and was admitted to the floor and treated with vanocmycin and clindamycin. her cellulitis initially improved but on the morning of it was noted to be worsened. she also developed oliguria with an increasing creatinine. she was taken to the operating room and underwent incision and drainage of debridement of perineum and lower left abdominal wall (see operative report for full details). she was admitted to the sicu post-operatively. she remained intubated an on pressors. aztreonam was initially added to her antibiotics regimen of vancomycin and clindamycin. she then underwent zosyn desensitization protocol as she is penicillin allergic. aztreonam was discontinued and replaced with zosyn. on the was transfused 1u prbc for a hct of 22.8. trophic tf were started and pressors were weaned to off. she underwent a bedside echo which was stable. on her antibiotics were narrowed to just zosyn for treatment of pan-sensitive pseudomonas which grew out of her wound. her tf were advanced. on she was stable for transfer to the floor. over the next few days dressing changes were continued and her cellulitis improved on zosyn. she remained stable and we had planned to send her to rehab on . however that morning she was noted to have increased melena and a hct from from 24.0 to 19.5. given this new issue and marked nursing concern she was transferred to the trauma icu. after transfer to the unit on she was given another 2u of prbc with lasix for increased respiratory distress. ng lavage was done with bloody output, with small clots and coffee grounds. she was seen by gi and intubated for an upper endoscopy. she developed hypotension after intubated and was briefly on pressors. another 2u prbc were transfused and she was weaned off pressors. upper endoscopy demonstrated a duodenal ulcer which was not bleeding. a left subclavian line was attempted which resulted in a pneumothorax, which was treated with a pigtail catheter. she was able to be extubated after endoscopy. she was maintained on a protonix drip. : she was transferred to the regular floor. her hct remained stable and she was bolused with lasix for fluid overload. her pigtail catheter was removed after cxr showed resolution of her pneumothorax. to further evaluate her decreasing hematocrit, she underwent an edg on which showed a small hiatal hernia, and the duodenal ulcer which was not actively bleeding. she was placed on intravenous ppi's for 72 hours. her hematocrit stabllized after the last unit packed red blood cells on . she resumed a regular diet and continued on oral ppi's. over the next 24-48 hours, her lab work was monitored. she was reported to have a elevation in her creatinine to 2.2. this was further evaluated with addional lab work, showing eosinophils in her blood and urine. the concern for antibiotic related nephritis vs. excess diuresis was raised. her zosyn was discontinued. her current creatinine is 2.2 and her lasix is being held. she has been evaluated by physical therapy and recommendations made for discharge to a exteneded care facility where she can regain physical strength. her vital signs are stable and she is afebrile. she did have her foley catheter removed and was unable to void. she was straight cathed for 400 cc. she did void on her own and post-voiding bladder scan did not show any residual urine in the bladder. she is tolerating a regular diet. the flexicel has been discontinued and she has not had any melena. she will need to follow up with the acute care service in 1 week. she will also need to follow-up with the gi service 4 weeks. medications on admission: albuterol sulfate - 90 mcg hfa aerosol inhaler - 1-2 puffs inh q 4 hr as needed for dyspnea allopurinol - 300 mg tablet - 1 tablet(s) by mouth once a day fluticasone - 50 mcg spray, suspension - 2 sprays nasal at bedtime folic acid - 1 mg tablet - 1 tablet(s) by mouth once a day furosemide - 40 mg tablet - 1 tablet(s) by mouth once a day hydralazine - 50 mg tablet - 1 tablet(s) by mouth every 8 hours hydrocodone-acetaminophen - 5 mg-500 mg tablet - tablet(s) by mouth three times a day as needed for pain ipratropium-albuterol - 18 mcg-103 mcg (90 mcg)/actuation aerosol - 1 puff(s) ih four times daily isosorbide mononitrate - 60 mg tablet extended release 24 hr - 1 tablet(s) by mouth qam medications - otc aspirin - (prescribed by other provider) - 81 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth once a day docusate sodium - (dose adjustment - no new rx) - 100 mg capsule - 1 capsule(s) by mouth three times a day multivitamin with iron-mineral - (prescribed by other provider) - 27 mg-0.4 mg tablet - tablet(s) by mouth --------------- --------------- --------------- --------------- discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 2. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain/fever. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 5. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q6h (every 6 hours) as needed for wheeze. 6. ipratropium bromide 17 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q6h (every 6 hours) as needed for wheeze. 7. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day: 8 weeks. 8. isosorbide mononitrate 60 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po daily (daily). 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 10. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 11. multivitamin tablet sig: one (1) tablet po daily (daily). 12. sucralfate 1 gram tablet sig: one (1) tablet po qid (4 times a day). 13. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 14. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day): wash abdominal folds and groin with soap and water, dry thoroughly and apply nystatin. 15. hydralazine 25 mg tablet sig: two (2) tablet po q8h (every 8 hours): hold for systolic blood pressure <110. 16. allopurinol 100 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: senior healthcare of discharge diagnosis: abscess left mons acute renal failure acute blood loss anemia acute respiratory failure 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: * you were admitted to the hospital with high fevers and an infection in the pubic area. you had the area drained in the operating room and now you will need to have frequent dressing changes to clean the wound and promote healing. * you spent some time in the icu due to your breathing problems but currently you are doing well. the pulmonary doctors have arranged some testing and a follow up appointment with them. see below. * your were anemic and required a blood transfusion. you also had some blood in your stool. when you are feeling better you will need to have a colonoscopy as an out patient. the number for the clinic is listed below. keep off of your aspirin for now. * your kidney function was poor during your acute illness but currently is slightly increased from your baseline * continue to eat well and stay hydrated. * you are being transferred to rehab to help increase your mobility as well as continue wound care. please follow up with the following: *any rectal bleeding, black, tarry stool *increasing heart rate *abdominal pain *fever, chills *increased yellow/green drainage from abdominal wounds *nausea/vomitting please follow up with any symptom which concerns you followup instructions: call the acute care clinic at for a follow up appointment in 1 week. provider: function lab phone: date/time: 3:10 provider: ,interpret w/lab no check-in intepretation billing date/time: 3:30 provider: /dr phone: date/time: 3:30 call the clinic at for a follow up appointment for a colonoscopy in about 4 weeks. md procedure: insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances incision of abdominal wall endoscopic control of gastric or duodenal bleeding other incision of vulva and perineum central venous catheter placement with guidance central venous catheter placement with guidance diagnoses: hyperpotassemia obstructive sleep apnea (adult)(pediatric) cellulitis and abscess of trunk congestive heart failure, unspecified chronic hepatitis c without mention of hepatic coma acute posthemorrhagic anemia acute kidney failure, unspecified unspecified septicemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified aortic valve disorders other chronic pulmonary heart diseases sepsis chronic kidney disease, unspecified diaphragmatic hernia without mention of obstruction or gangrene other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure iatrogenic pneumothorax alkalosis disorders of phosphorus metabolism morbid obesity acquired hemolytic anemia, unspecified chronic obstructive asthma, unspecified chronic diastolic heart failure pseudomonas infection in conditions classified elsewhere and of unspecified site acute duodenal ulcer with hemorrhage, without mention of obstruction other fluid overload 

Answer: The patient is high likely exposed to