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: patient recorded as having no known allergies to drugs attending: chief complaint: hypokalemia, weakness. major surgical or invasive procedure: none. history of present illness: 74 year old female with metastatic breast cancer on chemo (cmf, last tx ) x3 wks with mucositis since presents with increasing fatigue/weakness and hypokalemia to 2.1. of note, the patient was treated for atn due to port-a-cath infection with sepsis and she has been on lasix at home since discharge in . she reports poor po's due to mucositis and thrush over the past several weeks. routine blood work revealed the hypokalemia and she was referred into the ed this afternoon for further treatment. . in the ed, initial vitals were 97.8, hr 96, bp 96/60, rr 16, o2sat 100%. electrolyte abnormalities included k 2.1 and mg 2.0 for which she received 40 meq iv kcl and 2 gm iv magnesium sulfate as well as an additional 3l iv nss. ekg was without qtc or u waves. sbp's were 85-low 90's. of note, one lumen of her power picc was clotted so tpn was instilled prior to transfer. vitals on transfer were t 98.0 hr 90 bp 90/60 rr 16 sats 100% on ra. . the patient reports persistent fatigue. she denies fever or chills, nausea, vomiting or diarrhea. past medical history: past oncologic history: her breast cancer was first diagnosed in . she has undergone lumpectomy in both breasts with xrt. she has been on zometa for several years. chemotherapies included arimidex, then faslodex, then xeloda, then navelbine, then taxotere, then gemzar, then doxil x11 cycles, then abraxane/avastin, which she continues currently. c9 was completed in . . other past medical history: mild asthma- cough variant htn hyperlipidemia social history: lives with daughter in . - tobacco: none - etoh: very rare - illicits: none family history: father - chf, copd mother - mesenteric cancer physical exam: tmax: 35.3 ??????c (95.5 ??????f), tcurrent: 35.3 ??????c (95.5 ??????f), hr: 90 (90 - 91) bpm, bp: 111/11(39) {111/11(39) - 111/11(39)} mmhg, rr: 14 (14 - 15) insp/min, spo2: 98% general appearance: well nourished, no acute distress, non-toxic eyes / conjunctiva: perrl, pupils dilated, mucous membranes tacky head, ears, nose, throat: normocephalic cardiovascular: (s1: normal), (s2: normal) peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (expansion: symmetric), (breath sounds: clear : b/l) abdominal: soft, non-tender, bowel sounds present extremities: right lower extremity edema: 1+, left lower extremity edema: 1+ skin: not assessed neurologic: responds to: not assessed, movement: not assessed, tone: not assessed pertinent results: admission labs: 06:32pm blood wbc-2.1* rbc-3.49* hgb-10.4* hct-31.5* mcv-90 mch-29.8 mchc-33.0 rdw-19.7* plt ct-299# 06:32pm blood neuts-35* bands-3 lymphs-37 monos-15* eos-7* baso-0 atyps-3* metas-0 myelos-0 11:30am blood urean-33* creat-1.7* na-130* k-2.1* cl-92* hco3-21* angap-19 11:30am blood alt-26 ast-61* alkphos-288* totbili-1.2 03:11am blood ld(ldh)-204 11:30am blood calcium-8.7 phos-3.7 mg-2.0 03:35am blood lactate-1.8 . potassium trend: 11:30am k-2.1* 06:32pm k-2.5* 03:11am k-2.9* cxr: 1. unchanged course of the left picc catheter with tip projecting over distal svc. 2. persistent small pleural effusions with associated atelectasis. 3. diffuse osseous metastasis and old rib fractures. tte: the left atrium is mildly dilated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 70%). the right ventricular cavity is dilated the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. there is a trivial/physiologic pericardial effusion. there is an anterior space which most likely represents a prominent fat pad. compared with the findings of the prior study (images reviewed) of , probably no major change but the technically suboptimal nature of the present study precludes definitive comparison. brief hospital course: ms. is a 74 year old female with metastatic breast cancer on chemo (cmf, last tx ) x3 wks with mucositis presents with increasing fatigue/weakness and hypokalemia to 2.1 in the setting of dehydration and diuretic use. * pt hypotensive to 80s-low 90s in ed, down from baseline of 90s to low 100s. thought most likely dehydration, although given her positive picc line culture, there may have been a component of sepsis. pt does have a history of a small pericardial effusion and low voltage on ekg in the ed, although no other overt signs of tamponade. tte was obtained and showed a small pericardial effusion and no signs of tamponade. ivf resuscitation was continued overnight with an additional 2l overnight in addition to the 3l the patient received in the ed, with improvement in her blood pressures to 100's to 110's systolic, which remained stable during her hospitalization. * bacteremia - on the day of admission, had blood culture drawn that returned positive for enterococcus and gnr, which were later identified as enterobacteria. additionally, the tip of the catheter was "tortuous" as seen in her cxrs. given these two factors, her picc line was pulled and was given a 48 hour line holiday. the picc was replaced on . she was started empirically on vanco/cefepime. once sensitivities returned, she was transitioned to ampicillin and cefepime. while enterobacteria was sensitive to cipro, cefepime will be continued since it is cheaper, is once a day, and patient is paying out of pocket for iv antibiotics. tte was negative for vegetations. she refused a ct scan in the hospital for further work up her bacteremia. * the pt received 40 meq iv kcl in the ed then an additional 40 meq iv kcl immediately on arrival to the micu. she then received 2l of d5ns with 40 meq kcl/l and an additional 20 meq iv kcl, with improvement in her potassium to. she was given 50meq kcl to take daily, and lasix moved to 40mg (8am & 1pm). outpatient labs to be checked mon and sent to dr. office. it was thought that admission hypokalemia was due to non-compliance with potassium supplements. * hypomagnesemia- received 2g magnesium repletion in the ed with resolution. * chronic renal insuffiency (stage 3) - lasix was initially held, but restarted on , and adjusted to 40mg on discharge. she will go home with potassium supplements. she will need chem panels checked at home on monday by vna after discharge to ensure stability. * port a cath wound infection - she suffered from this wound infection in , but the wound remains open. wound care was consulted and they had made recommendations to obtaining a surgical consultation. surgery was called and felt no need for debridement, but recommeded plastics consult and breast consult in future given wound and h/o breast cancer. this can be done as an outpatient. she will need continued vna care of her wound after discharge. medications on admission: 1. advair 100/50 one inhalation b.i.d. 2. pravastatin 40 mg once at night. 3. compazine 10 mg every six hours as needed for nausea. 4. metolazone 5 mg once daily. 5. furosemide 40 mg once daily. (reduced from 120 mg daily for decreased po's) 6. potassium 120 meq daily. 7. nystatin 5 ml four times a day swish and swallow. 8. colace 100 mg b.i.d. 9. spironolactone 12.5 mg daily discharge medications: 1. nystatin 100,000 unit/ml suspension sig: one (1) po q8h (every 8 hours). :*30 ml* refills:*2* 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. pravastatin 20 mg tablet sig: two (2) tablet po hs (at bedtime). 4. fluticasone-salmeterol 100-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 5. ampicillin sodium 1 gram recon soln sig: one (1) grams (recon soln(s)) injection q6h (every 6 hours): through . :*50 doses* refills:*0* 6. cefepime 2 gram recon soln sig: two (2) grams (recon soln(s)) injection q24h (every 24 hours): give through unless otherwise specified by primary md. :*15 doses* refills:*0* 7. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 8. potassium chloride 10 meq tab sust.rel. particle/crystal sig: five (5) tab sust.rel. particle/crystal po once a day. :*180 tab sust.rel. particle/crystal(s)* refills:*0* 9. furosemide 40 mg tablet sig: one (1) tablet po twice daily: take at 8am and 1pm. :*60 tablet(s)* refills:*2* 10. sodium chloride 0.9 % 0.9 % parenteral solution sig: three (3) ml intravenous q8h (every 8 hours) as needed for line flush. :*500 ml(s)* refills:*0* discharge disposition: home with service facility: critical care systems discharge diagnosis: bacteremia hypokalemia mucositis breast cancer asthma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the hospital with low blood pressures and low potassium. you were initially sent to the icu and had your potassium repleted. your blood cultures returned positive for bacteria and you were started on 2 iv anitbioics. the picc line was removed and replaced. your oncologist will need to follow the culture data and adjust your antibiotics as needed. you will need your potassium checked, and this will be arranged for tomorrow by vna, and results sent to dr. office. your chest wound was evaluated by the wound nurse and general surgical service. recommendation was made to have this evaluated by breast and plastics surgical services. this recommendation has been relayed to dr. who can arrange to have this done as an outpatient. the vna will continue to care for your wound. the following medication changes were made: 1. potassium 40meq daily 2. lasix 40mg twice a day (8am, 1pm) 2. addition of two antibiotics followup instructions: please follow up with your primary care provider. below (dr. office administrator) said she is going to call you at home on monday with a follow up appointment for when dr. would like to see you. if you have any questions or haven't heard by tuesday please call the office at . procedure: venous catheterization, not elsewhere classified injection or infusion of thrombolytic agent diagnoses: hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified asthma, unspecified type, unspecified personal history of malignant neoplasm of breast hypopotassemia other and unspecified hyperlipidemia chronic kidney disease, stage iii (moderate) other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure unspecified disease of pericardium bacteremia streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] dehydration other and unspecified infection due to central venous catheter other malignant neoplasm without specification of site disorders of magnesium metabolism other specified bacterial infections in conditions classified elsewhere and of unspecified site, other gram-negative organisms other diuretics causing adverse effects in therapeutic use non-healing surgical wound family history of other specified malignant neoplasm mucositis (ulcerative) due to antineoplastic therapy 

Answer: The patient is high likely exposed to