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: dka major surgical or invasive procedure: flexible sigmoidoscopy history of present illness: 52 yo woman with type 1 dm and htn who presents in dka in the setting of a recent c.diff infection and worsening n/v/d over the past 1 week. she states that her symptoms initally started at the end of with n/v/d (non-bloody) and crampy abdominal pain. she was admitted to from , was treated for c. diff with flagyl but experienced excessive nausea so she was switched to oral vancomycin. her bss were well controlled during this admission. she is currently employed in a nursing home facility and feels that she may have contracted c. diff at work. . after being discharged from she felt better for several weeks but continued to have loose bms but was better than before. she was seen by in the clinic on , referred to him by her pcp. was thought that she may have had recurrent c. diff or a post-infectious ibs like syndrome at the time. on she underwent a flexible sigmoidoscopy with biopsy, which was unremarkable. . for the past week she has had non-bloody diarrhea, abdominal discomfort, weakness, nausea, and vomiting which have all progressively gotten worse. she was initally having 10+ loose bms each day but has not had any in the past day since she has not eaten anything. she states that her appetite has been very poor since last monday. whenever she tries to eat something she feels nauseous and vomits what she eats. she localizes her abdominal discomfort to the rlq. . she states that her sugars have been extremely high on the day of admission in the 400's and denies stopping or missing any of her insulin she takes at home. she denies any recent fevers, chills, cough, sob, or chest pain. denies any recent travel or sick contacts. had some polydipsia but denies polyuria. . in the ed her vitals were t 95.1 bp 127/74 ar 140-150's rr 24 o2 sat 98% ra. her bs>500 and she had an anion gap of 29. she was started on continuous ivfs and was started on insulin drip past medical history: 1. diabetes mellitus type i x38 years, followed by @ . mild peripheral neuropathy 2. hypertension. 3. hypercholesterolemia. 4. mild copd. social history: social history: the patient recently quit tobacco use approximately 2 years ago. she has a 25-pack year history. she denies alcohol use. she works as a secretory in the physical therapy rehab center. she is married with two children. her daughter has fibromyalgia syndrome and irritable bowel syndrome. family history: family history: sister has juvenile rheumatoid arthritis. aunt has rheumatoid arthritis. there is no known psoriasis, osteoarthritis, thyroid disease or inflammatory bowel disease known in the family. no family hx of bowel problems, ibd. physical exam: on admission - vitals: t 97.3 bp 152/67 ar 106 rr 22 o2 sat 96% ra gen: pt awake but extremely tired and lethargic heent: dry mucous membranes neck: no lymphadenopathy, thyromegaly heart: nl s1/s2, no s3/s4, no m,r,g lungs: ctab, no crackles abdomen: soft, nt/nd, +bs extremities: 2+ dp/pt pulses, no edema rectal: heme negative pertinent results: 06:30am blood wbc-3.8* rbc-3.20* hgb-8.9* hct-27.5* mcv-86 mch-27.8 mchc-32.3 rdw-16.4* plt ct-569* 01:30pm blood wbc-15.8*# rbc-4.39 hgb-12.7 hct-38.2 mcv-87 mch-29.0 mchc-33.4 rdw-14.4 plt ct-656* 03:53am blood neuts-79* bands-1 lymphs-10* monos-7 eos-1 baso-0 atyps-0 metas-0 myelos-2* 01:30pm blood neuts-71* bands-6* lymphs-13* monos-7 eos-0 baso-0 atyps-0 metas-0 myelos-2* promyel-1* 04:10pm blood pt-12.5 ptt-50.4* inr(pt)-1.1 06:30am blood urean-4* creat-0.4 k-3.7 06:52am blood urean-5* creat-0.4 na-139 k-3.3 cl-103 hco3-26 angap-13 01:30pm blood glucose-521* urean-18 creat-1.3* na-138 k-4.1 cl-93* hco3-16* angap-33* 06:10am blood alt-10 ast-15 alkphos-81 totbili-0.3 05:45am blood caltibc-144* vitb12-779 ferritn-284* trf-111* 01:30pm blood acetone-large 04:10pm blood tsh-3.9 pleural fluid: 02:12pm pleural wbc-396* rbc-194* polys-10* lymphs-44* monos-36* eos-1* meso-2* other-7* 02:12pm pleural totprot-1.9 glucose-137 ld(ldh)-70 amylase-21 albumin-1.2 cholest-32 cytology - negative for malignant cells cxr comparison: pa and lateral radiograph . most of right pleural effusion has been removed. minimal parenchymal changes are identified within the right lung base, presumably related to residual atelectasis. no pneumothorax identified. cardiomediastinal silhouette is normal in appearance. echo the left atrium is elongated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is a trivial/physiologic pericardial effusion. ct chest - impression: 1. no evidence of pulmonary embolus. 2. moderate-sized right pleural effusion findings: grayscale and color doppler son of the bilateral lower extremities including the common femoral veins, superficial femoral veins, and popliteal veins was performed. normal flow, augmentation, compressibility, and waveforms was demonstrated bilaterally. intraluminal thrombus was not identified. impression: no dvt. cxr impression: 1. a new moderately sized right pleural effusion. 2. new lingular atelectasis vs. early pneumonia. us abdomen - impression: no evidence of megacolon. cecum measures approximately 7 cm in diameter. 07:31am stool na-49 k-63 brief hospital course: # dka: treated in the icu with insulin drip with eventual closure of anion gap and transfer to the medical floor. was consulted and sugars were controlled with an insulin sliding scale and glargine. . # c. difficile colitis diarrhea: positive stool c.diff. the patient had a very protracted course while in the hospital. gi followed her while in house. high doses of oral vancomycin was started with some improvement initially. a combination of iv flagyl and oral vanc was tried as well, with no improvement. rifaximin was started. the patient was advised a low-lactose diet. a flexible sigmoidoscopy was done by gi after 2 weeks of unremitting diarrhea - which revealed pseudomembranes. biopsies were done to r/o other processes the results of which are pending at this time and should be followed up in clinic. the overall appearance at flex. sig was more suggestive of a c. diff colitis than an ibd. after about a week of high dose vancomycin and rifaximin - the patient started having decreasing stools at night and more semi-formed stools. her appetite improved. all along, she was placed on contact precautions. she was observed for a few days after the stools had decreased to ensure resolution and then discharged home. the plan is to continue vancomycin 500 po q6h for atleast a 3 week course. then after a repeat stool c diff x 3, and if the patient's symptoms are consistantly improving - a very slow taper may be tried. the patient may need vancomycin for the next many months to a year. this plan was communicated to pcp and gi physician who will be following her - dr . the patient was also advised to take potassium tablets till diarrhea persists. she is advised not to return to work for the next few weeks and also strictly follow c diff precautions at home. . # hypoalbuminemia - likely from protein loss from diarrhea. this caused le edema. echo showed no significant findings and lft's were normal. small doses of lasix were tried with resolution of the edema. pleural effusion was noted on cxr which was tapped - was transudate and cytology was negative for cancer cells. the effusion could be due to hypoalbuminemia. # skin - the patient developed transient le erythematous lesions when getting diureses - derm was consulted who recommend f/u in clinic. their differential diagnosis for these lesions include resolving vesicles secondary to edema and mild stasis dermatitis. their recommendations include - topical moisturizer with aveeno and topical triamcinolone as needed for pruritus. however, there was spontaneous resolution of the rash # htn: metoprolol and lisinopril continued. . # hyperlipidemia: statin continued. # mild leucopenia was noted. they should be followed in primary care clinic. medications on admission: 1. atenolol 100mg po daily 2. lisinopril 40mg daily 3. pravastatin 20 mg daily 4.insulin regimen: a. levemir 6u b. humalog sliding scale 5.lorazepam 0.5 mg 1-2 tablets po every 4-6 hours discharge medications: 1. pravastatin 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 2. atenolol 100 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 3. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 4. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed. disp:*60 tablet, chewable(s)* refills:*0* 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 6. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 7. vancomycin 250 mg capsule sig: two (2) capsule po q6h (every 6 hours) for 4 weeks. disp:*224 capsule(s)* refills:*0* 8. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 9. potassium chloride 10 meq capsule, sustained release sig: four (4) capsule, sustained release po daily (daily): continuue to take as long as you have diarrhea. disp:*90 capsule, sustained release(s)* refills:*0* 10. rifaximin 200 mg tablet sig: two (2) tablet po bid (2 times a day) for 10 days. disp:*40 tablet(s)* refills:*0* 11. insulin glargine 100 unit/ml solution sig: one (1) 15 subcutaneous q am before breakfast. disp:*30 15* refills:*0* 12. insulin lispro (human) 100 unit/ml solution sig: one (1) as instructed subcutaneous as instructed. disp:*30 * refills:*0* discharge disposition: home discharge diagnosis: 1. recurrent c. difficile colitis 2. dka, resolved 3. hypoalbuminemia/ pleural effusion 4. anemia of chronic disease 5. mild leucopenia secondary diagnoses 1. hypertension 2. type i diabetes mellitus uncontrolled with complications 3. hyperlipidemia 4. mild copd discharge condition: stable discharge instructions: please return to the emergency room if you notice worsening diarrhea, abdominal pain or distension, fever, nausea, vomiting or any other unusual symptoms. please keep yur appointments. you should also have to get blood work done for potassium and magnesium levels at that time. discuss with your doctor about the continuing need for lasix and potassium. also discuss with her about anemia and low white blood cell counts as we had discussed. your anemia is likely due to loosing blood in stool bacause of c. diff infection. you will likely need iron tablets for the anemia. make an appointment at the clinic as well. your insulin doses have been changed for better control of sugars during this hospitalization. please continue monitoring the blood sugar levels at home 1-2 times a day before meals till you are seen at clinic. followup instructions: provider: , md phone: date/time: 2:15 provider: , rn, cs phone: date/time: 10:20 ( dr office) gi provider: , md phone: date/time: 10:00 - make an appointment with your doctor in the next 10 days procedure: thoracentesis closed [endoscopic] biopsy of large intestine diagnoses: anemia of other chronic disease unspecified pleural effusion unspecified essential hypertension iron deficiency anemia secondary to blood loss (chronic) chronic airway obstruction, not elsewhere classified polyneuropathy in diabetes hypopotassemia blood in stool intestinal infection due to clostridium difficile other disorders of plasma protein metabolism diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with ketoacidosis, type i [juvenile type], uncontrolled venous (peripheral) insufficiency, unspecified persistent vomiting 

Answer: The patient is high likely exposed to