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: lactose intolerance attending: chief complaint: ugib major surgical or invasive procedure: nasogastric tube placement, foley catheter placement (both removed prior to discharge) history of present illness: per micu: "84 yo f w/ hx of dementia, hx of gib, p/w ugib at . ng lavaged in ed cleared after 750cc, gi does not want to scope given comorbidities. also noted to have fever to 101.4 and u/a was positive so started on ctx in ed. got cta for mesenteric ischemia w/ and w/o contrast which was negative. rectal exam guiac + but not grossly positive. trop 0.04, ekg baseline: sinus, small depressions v4-v6. has been hd stable. complains of abd pain. mental status is at baseline per son. in the ed, initial vs: 97.6 108 172/87 16 97. pt got 3livf and hct dropped from 40->37. started on iv pantoprazole and a foley and ngt placed and pt admitted to micu for ? emergent egd." . in micu pt was seen by gi who felt pt was not a candidate for egd given comorbidities unless she was to become hemodynamically unstable. son is hcp and he agreed with no egd. micu team also discussed code status c son and he felt firmly that pt should be fc (though was dnr/dni several admissions ago in ). pt did not have any further vomiting. pt had one run of svt treated with 5 metop iv x1. pt was continued on ceftriaxone for her uti. past medical history: alzheimers diverticulosis (lgib) iddm, c/b diabetic nephropathy and neuropathy w/ some balance problems htn s/p tah/bso s/p cholecystectomy lt humerus fx shoulder tendonitis s/p breast cyst surgery osteoarthritis of knees l eye cataract repair svt in micu, paroxysmal afib social history: patient currently living at , a , where she has been for over the past year. her only living family is her son . she is in the because of court ordered protective services. she currently is unable to walk, or carry out any adl's. smoking, drinking, and drug history unable to be elicited. family history: signficant for alzheimer dementia : her father, sister. mother died of bone cancer. physical exam: vitals - 98.7 143/79 105 18 100%ra general: mumbling incoherently, responds, but does not follow commands. heent: no elevated jvp. no scleral icterus. mm dry cardiac: rrr, no mrg lung: cta anteriorly abdomen: soft, nt, nd, bs+ ext: 2+ pitting edema in l leg, l leg contracted neuro: unable to perform neuro exam, pt. moving all extremities spontaneously. derm: no rashes pertinent results: admission labs: 09:25am blood wbc-8.6 rbc-4.52# hgb-13.2# hct-40.8# mcv-90 mch-29.2 mchc-32.4 rdw-15.4 plt ct-153 09:25am blood neuts-88.0* lymphs-9.1* monos-2.7 eos-0.2 baso-0.1 09:25am blood pt-12.8 ptt-27.5 inr(pt)-1.1 09:25am blood glucose-314* urean-18 creat-1.0 na-138 k-8.2* cl-104 hco3-22 angap-20 09:25am blood alt-9 ast-54* ld(ldh)-1123*(hemolyzed, wnl on repeat) ck(cpk)-206* alkphos-73 totbili-0.4 09:25am blood lipase-26 09:25am blood ck-mb-4 09:25am blood ctropnt-0.04* 07:30pm blood ck-mb-5 ctropnt-0.05* 11:57pm blood ck-mb-6 ctropnt-0.05* 09:25am blood calcium-9.5 phos-3.8 mg-2.1 09:39am blood lactate-2.5* 03:32pm blood lactate-1.4 discharge labs: 07:40am blood wbc-5.4 rbc-3.50* hgb-10.3* hct-31.3* mcv-89 mch-29.4 mchc-32.9 rdw-15.6* plt ct-131* 07:40am blood plt ct-131* 07:40am blood glucose-146* urean-13 creat-0.8 na-144 k-4.1 cl114* hco3-26 angap-8 07:40am blood calcium-8.6 phos-3.0 mg-1.9 cholest-pnd cta abd/pelvis: impression: 1. mild wall thickening involving the rectosigmoid junction and rectum, compatible with mild proctocolitis, which is either inflammatory or infectious in etiology. clinical correlation with endoscopy is recommended. 2. patent mesenteric arteries with diffuse atherosclerotic disease within the celiac artery, sma artery,and bilateral renal arteries without significant stenosis. 3. bilateral renal cysts, stable in size and appearance when compared to prior study. 4. two enhancing lesions in the liver, one seen on the arterial phase, and the other in the portal venous phase. these were not seen previously, and may represent perfusion anomalies. if clinically indicated, an mr can be obtained for further evaluation. leni l leg: impression: limited study due to portable technique and decreased diameter of the left lower extremity veins as described above. however, no definite evidence of left lower extremity deep venous thrombosis. urine culture (final ): escherichia coli. >100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | ampicillin------------ =>32 r ampicillin/sulbactam-- 16 i cefazolin------------- 16 i cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin--------- =>4 r gentamicin------------ <=1 s meropenem-------------<=0.25 s nitrofurantoin-------- <=16 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s brief hospital course: # ugib: appeared stable in ed and on the floor though she did initially have coffee grounds in the ed which cleared from ng lavage after 750cc. gi was consulted and recommended no egd as pt hemodynamically stable. it was felt that risks outweighed the benefits. she was started on ppi and her diet advanced back to her home diet (purees and nectar thick liquids). . #uti: lactate initially elevated but wnl after fluid repletion. pt was treated with ceftriaxone while inpatient and transitioned to cefpodoxime to complete a 7 day course. . # severe dementia: remained near baseline per pt's son. she makes eye contact but does not respond to questions appropriately and does not know her name. she was continued on depakote and risperdal. . # tachycardia/lateral 1mm st depressions on ekg (variable throughout admission) and small troponin bump: trop felt to be most likely secondary to small amount of demand given tachycardia. pt was ruled out for mi with 3 sets of cardiac enzymes which did not show a rising troponin. pt was started on low dose metoprolol. a recent echo showed preserved ef so ace not started (pt not hypertensive). aspirin was deferred as pt admitted for gib. sinus tachycardia resolved with fluid repletion. pt was continued on simvastatin. . # ? paroxysmal atrial fibrillation: pt carries this diagnosis per paperwork from . did have one brief episode of svt ~100bpm on telemetry which resolved spontaneously. metoprolol 12. help with rate control during these episodes. . # dmi: pt's nph decreased to 11u and humalog sliding scale started. she required minimal sliding scale. . # contact/hcp: . communication was maintained c son throughout admission, though he was unable to come in recent rib injury. medications on admission: purreed diet colace 100mg caco3 500mg vitamin d 50k unitsqw risperdal 0.25mg depakote 250mg simvastatin 10mg qhs nph 22u sc qam riss : 200-250 4u, 250-300 6u, 300-350 8u, 351-400 10u discharge medications: 1. heparin (porcine) 5,000 unit/ml solution : one (1) injection three times a day: please continue if pt unable to ambulate. if continued, need to check ptt and platelets to confirm no rise in ptt and no drop in platelets twice weekly. next check on ! if ptt rising or plts dropping must md as pt may require adjustment in dose or perhaps require a test for heparin induced thrombocytopenia. 2. simvastatin 10 mg tablet : one (1) tablet po daily (daily). 3. risperidone 0.25 mg tablet : one (1) tablet po bid (2 times a day). 4. calcium carbonate 500 mg tablet, chewable : one (1) tablet, chewable po bid (2 times a day). 5. divalproex 125 mg capsule, sprinkle : two (2) capsule, sprinkle po bid (2 times a day). 6. metoprolol tartrate 25 mg tablet : 0.5 tablet po bid (2 times a day). 7. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr po bid (2 times a day). 8. cefpodoxime 100 mg tablet : one (1) tablet po twice a day for 6 doses. 9. colace 100 mg capsule : one (1) capsule po twice a day. 10. vitamin d 50,000 unit capsule : one (1) capsule po once a week. 11. nph insulin human recomb 100 unit/ml cartridge : eleven (11) units subcutaneous qam: titrate up as indicated. 12. humalog 100 unit/ml cartridge : one (1) subcutaneous three times a day: per sliding scale. discharge disposition: extended care facility: discharge diagnosis: uti, upper gi bleed discharge condition: able to speak and eat, not oriented to person, place or time. discharge instructions: ms was admitted to the hospital for upper gi bleed noted at her nsg home. she was found to have coffee grounds by gi lavage in the ed that cleared in the ed. she was admitted to the micu and had no further bleeding and was transferred to the floor. gi was consulted but felt that pt would be a poor egd candidate. she was also found to have a uti, for which she was treated with ceftriaxone and then transitioned to cefpodoxime to complete 7 day course. she was noted to have left>r lower extremity swelling, but no dvt was found on ultrasound. she was also noted to be very dehydrated and was treated with iv fluids on day 1 and 2 of hospitalization. on day 3 she was able to drink enough fluids (~1 liter). her nph was decreased from 22 qam to 11 qam as she had several low blood sugars. she was initially not eating, and recieved ivf, but on hd 3 began eating full pureed meals. she was also noted to have a small troponin leak but ruled out for mi and was started on low dose metoprolol . pt was observed overnight and was stable. medication changes: 1. nph decreased from 22u to 11u. this may need to be uptitrated as she continues to eat more. 2. pt was started on metoprolol 3. she was started on uti treatment with ceftriaxone and should finish 7 day course with cefpodoxime at skilled nsg facility 4. added lansoprazole followup instructions: -please monitor her vital signs and call physician for hr <60 or >100, sbp >160 or <90, rr >20 or <12, oxygen saturation <93%. -please monitor for signs of uti by follow up ua in 1 week as pt is poor historian, as pt has had multiple prior utis. -please continue her diet and aggressive po fluids as pt appeared very dry on admission. procedure: insertion of other (naso-)gastric tube gastric lavage diagnoses: nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere pure hypercholesterolemia urinary tract infection, site not specified unspecified essential hypertension diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes other persistent mental disorders due to conditions classified elsewhere long-term (current) use of insulin hemorrhage of gastrointestinal tract, unspecified diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled paroxysmal supraventricular tachycardia 

Answer: The patient is high likely exposed to