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 attending: chief complaint: abdominal pain major surgical or invasive procedure: s/p exploratory laparoscopy, open cholecystectomy with jp drain placement history of present illness: ms. is an 88-year-old indian female with a long history of hypertension and chronic renal insufficiency who presented to the with at least 3 days of worsening right upper quadrant abdominal pain. she underwent a ct scan of the abdomen there that demonstrated a distended gallbladder with wall thickening. a right upper quadrant ultrasound was then obtained that confirmed acute cholecystitis with a large gallstone in the fundus and another large gallstone impacted in the neck of the gallbladder. her liver function tests were within normal limits. given her significant medical comorbidities, i advised transfer into where she arrived late last night and early this morning she was given intravenous antibiotics and was hydrated overnight. given relative hypotension and low urine output likely secondary to the systemic inflammatory response from this septic gallbladder, i advised urgent cholecystectomy past medical history: small bowel lymphoma chronic renal insufficiency (cr 2.0) hypertension physical exam: afebrile, vital signs within normal range nad, talking small amounts of english neck supple chest clear heart regular, no mrg abdomen soft, non distended, appropriately tender around the ruq incision, which is opened at the lateral aspect and packed with saline gauze. no drains or hernia. no erythema. nabs. le warm, well-perfused with minimal edema pertinent results: 05:10am blood wbc-14.4* rbc-3.72* hgb-11.1* hct-33.6* mcv-90 mch-29.8 mchc-33.1 rdw-13.3 plt ct-152 12:56pm blood wbc-8.9 rbc-3.21* hgb-9.5* hct-28.6* mcv-89 mch-29.5 mchc-33.1 rdw-13.4 plt ct-128* 02:55am blood wbc-9.6 rbc-3.12* hgb-9.3* hct-28.1* mcv-90 mch-29.9 mchc-33.2 rdw-13.4 plt ct-152 02:00am blood wbc-12.3* rbc-3.23* hgb-9.6* hct-29.4* mcv-91 mch-29.8 mchc-32.7 rdw-13.6 plt ct-173 12:15am blood wbc-10.2 rbc-3.12* hgb-9.5* hct-28.1* mcv-90 mch-30.3 mchc-33.7 rdw-13.6 plt ct-150 02:21am blood wbc-9.0 rbc-3.20* hgb-9.6* hct-30.0* mcv-94 mch-30.0 mchc-31.9 rdw-13.6 plt ct-166 06:25am blood wbc-8.2 rbc-3.07* hgb-9.2* hct-28.6* mcv-93 mch-30.1 mchc-32.3 rdw-13.7 plt ct-206 10:50am ascites totbili-3.1 ------------ 11:15 am swab bile. a swab is not the optimal specimen collection to evaluate body fluids. **final report ** gram stain (final ): no polymorphonuclear leukocytes seen. 1+ (<1 per 1000x field): gram positive cocci. in pairs and chains. 1+ (<1 per 1000x field): gram negative rod(s). fluid culture (final ): due to mixed bacterial types ( >= 3 colony types) an abbreviated workup is performed appropriate to the isolates recovered from the site (including a screen for pseudomonas aeruginosa, staphylococcus aureus and beta streptococcus). susceptibility will be performed on p. aeruginosa and s. aureus if sparse growth or greater. anaerobic culture (final ): no anaerobes isolated. ------------ 11:10 am swab site: peritoneal a swab is not the optimal specimen collection to evaluate body fluids. fluid should not be sent in swab transport media. submit fluids in a capped syringe (no needle), red top tube, or sterile cup. **final report ** gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. fluid culture (final ): no growth. anaerobic culture (final ): no growth. ---------- 12:18 pm swab site: abdomen source: ruq incision. gram stain (final ): 2+ (1-5 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. wound culture (preliminary): results pending. anaerobic culture (pending): medical condition: 88 year old woman with cholecystitis reason for this examination: pre-op chest xray history: pre-operative chest. findings: no previous images. poor inspiration may account for some of the prominence of the transverse diameter of the heart. however, some enlargement of the cardiac silhouette is seen with elevation of pulmonary venous pressure. no evidence of acute pneumonia. ------------ the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. mild mitral regurgitation. electronically signed by , md, interpreting physician 15:15 --------------- dr. approved: mon 12:56 pm ------ sinus rhythm with atrial premature beats. intraventricular conduction delay with left axis deviation. left atrial abnormality. probable left ventricular hypertrophy. compared to the previous tracing of no diagnostic change. brief hospital course: id: admitted and taken to the or on hospital day 1, with diagnosis of cholecystitis from osh - . intraoperatively, a decision was made to perform an open procedure, based on the laparoscopic findings of purulent fluid intraperitoneally. postoperatively, the pt was taken to the icu intubated for monitoring of her fluid status given the diagnosis of necrotic gallbladder and sepsis. she was placed on cipro and flagyl emperically. on pod1, cultures returned with gpc on gram stain so ampicillin was started then changed to vancomycin as well. the pt remained afebrile throughout her hospital course, and on pod4, the vanc and flagyl were held. she will be discharged on po ciprofloxacin for a total of 14 days of antibiotics. cv: troponin leak postoperatively. cardiology was consulted and interpreted this as being a troponin leak secondary to demand ischemia. ekg as noted above. she was started on aspirin and a statin postoperatively and will continue these upon discharge along with her beta blocker. pulm: extubated on pod1 and given lasix for pulmonary edema, she did not have any additional respiratory events throughout her course. renal: postoperatively, pt was oliguric, making 315cc the day of operation and only 77cc postoperatively over 12 hours. she was resuscitated agressively on pod1 and was over 6l positive; her urine responded the following day with 900cc. creatinine bumped from 2.0 to 3.0 on pod2, but subsequently trended down off her home hctz. nephrology was consulted and recommended continued hydration for prerenal azotemia and atn. upon discharge her cr was 1.9 and urine output adequate. she will have follow up with nephrology upon discharge. gi: her diet was advanced upon return of bowel function and upon discharge she was tolerating a regular diet with tid supplements without nausea. pt: ambulated with pt once she was on the floor. recommendations included continued physical therapy work to improve strength and conditioning. wound: opened slightly postoperatively on the lateral aspect (about 15% of its length) and packed with wet-to-dry dressings twice daily. should continue upon discharge. medications on admission: cardura 1.5 lopressor 50 hctz 25 qd prilosec 20 qd piroxican neurontin 100 xanax 0.5 qhs discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection (2 times a day). 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* 3. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. prilosec 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 6. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 5 days. disp:*5 tablet(s)* refills:*0* 7. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed. disp:*30 tablet(s)* refills:*0* 8. gabapentin 100 mg capsule sig: one (1) capsule po daily (daily). 9. acetaminophen 160 mg/5 ml solution sig: one (1) po q6h (every 6 hours) as needed. 10. alprazolam 0.25 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)) as needed. discharge disposition: extended care facility: of discharge diagnosis: acute cholecystitis acute renal failure demand cardiac ischemia discharge condition: good discharge instructions: please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomiting, diarrhea or other reasons. signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. *avoid driving or operating heavy machinery while taking pain medications. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered. * continue to ambulate several times per day. . incision care: -your steri-strips will fall off on their own. please remove any remaining strips 7-10 days after surgery. -you may shower, and wash surgical incisions. -avoid swimming and baths until your follow-up appointment. -please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. followup instructions: call to arrange an appointment to see your primary care physician weeks to adjust your diuretics and cardiac medications. call to arrange an appointment to see dr. in weeks. (. call to arrange to see nephrology at in the next weeks. procedure: venous catheterization, not elsewhere classified cholecystectomy open biopsy of liver diagnoses: acute kidney failure with lesion of tubular necrosis cirrhosis of liver without mention of alcohol unspecified septicemia severe sepsis cardiac complications, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, unspecified other malignant lymphomas, unspecified site, extranodal and solid organ sites septic shock acute myocardial infarction of unspecified site, initial episode of care calculus of gallbladder with acute cholecystitis, without mention of obstruction laparoscopic surgical procedure converted to open procedure 

Answer: The patient is high likely exposed to