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: sulfa (sulfonamides) / penicillins attending: chief complaint: 48yow with h/o esld etoh cirrhosis, crohn's disease, chronic kidney disease, transfered from on for persistent mrsa bacteremia major surgical or invasive procedure: admitted with picc femoral hd catheter placement history of present illness: 48yow with h/o esld etoh cirrhosis, crohn's disease, chronic kidney disease, who was admitted to hospital with liver failure, acute renal failure and hyponatremia, and is transferred now to with persistant mrsa bacteremia. . the patient was initially referred to ed from her primary care physician's office for evaluation of elevated lfts, confusion, arf (cr 3.4), and hyponatremia (na+ 124). at that time she complained of sob and productive cough. she was transferred to the icu with hypotension (bp 65/40) and treated for urosepsis after e.coli grew in her urine. she was treated with initially ceftriaxone and then aztreonam. hypotension was treated initially with neosynephrine, and then levophed. baseline sbp 80s. hospital course also complicated by lll pneumonia. she then developed a mrsa bacteremia. exam was significant for pericardial rub, and echo showed a small-moderate effusion. no vegetations were seen on tte , but she was treated for endocarditis with vancomycin/gentamicin. a tee was not done due to concern for causing a variceal bleed. ef was 60-65%. on the gentamicin her creatinine rose from 1.0 to 3.8. on she had a single burst of non-sustained afib. hospital course was also complicated by hypokalemia requiring repletion. surveillance blood cultures were persistantly positive for mrsa, most recently , despite therapeutic doses of vancomycin. additionally the lll infiltrate enlarged on cxr. abdominal u/s on showed hepatosplenomegaly, ascites, and reversed flow in the portal vein. on she had a urine culture that grew enterococcus. she was transferred on levophed via picc line in left a/c vein. . hospital course also complicated by indecision regarding code status. she was initially dnr/dni, then full code, then reverted to dnr/dni status prior to transfer. . on presentation now she complains of chest pain when coughing, and cough productive of brown sputum. she denies sob. she c/o midepigastric abdominal pain and low back pain, which is her baseline. she denies headache, dizziness, confusion, vision changes, nausea, vomiting, diarrhea, constipation. past medical history: copd crohn's disease liver failure d/t alcoholic cirrhosis c/b portal htn, esophageal varices sciatica osteoarthritis chronic kidney disease social history: lives with her son. daughter serves as her hcp. on disability +tob use; +etoh use; denies illicit drug use most recent drink was the day prior to hospitalization. she denies having a h/o withdrawals. drinks 1pint vodka daily. family history: father - h/o etoh abuse, d. alzheimer' dz at 64yrs mother - alive, had stroke at 67yrs brother - etoh abuse mgm - etoh abuse physical exam: t 97.2 hr 69 bp 93/36 rr 33 95%3lnc wt 94kg pulsus <10 gen: alert, speaking full sentences, appropriate, nad heent: icteric sclera, perrl (2->1mm), conjunctiva pale, op clear, mmdry neck: supple, no lad, jvp 11cm cv: pmi nondisplaced, regular rate, murmer vs rub, ii/vi supine, iii/vi sitting resp: left basilar crackles, no rhonchi, no wheeze. no egophany. abd: +bs, soft, ttp ruq, +fluid wave, +caput ext: 3+pitting edema ble to thigh, 2+ dps and radial pulses, no splinter hemorrhage, or osler lesions, fingers clubbed neuro: a&ox3, cn ii-xii intact, no asterixis, strength 5/5 throughout, sensation intact to touch, coordination intact ftn skin: jaundiced pertinent results: admission labs: 09:57pm glucose-143* urea n-59* creat-3.6* sodium-130* potassium-3.4 chloride-99 total co2-18* anion gap-16 09:57pm estgfr-using this 09:57pm alt(sgpt)-31 ast(sgot)-75* ld(ldh)-225 alk phos-214* amylase-78 tot bili-28.1* dir bili-21.0* indir bil-7.1 09:57pm lipase-100* 09:57pm albumin-2.2* calcium-8.0* phosphate-5.1* magnesium-2.3 09:57pm urine hours-random urea n-424 creat-61 sodium-18 tot prot-33 prot/crea-0.5* 09:57pm urine osmolal-316 09:57pm wbc-16.1*# rbc-3.04* hgb-11.1* hct-30.8* mcv-101*# mch-36.5*# mchc-36.0*# rdw-16.7* 09:57pm neuts-82.7* lymphs-8.6* monos-3.7 eos-4.6* basos-0.4 09:57pm anisocyt-1+ macrocyt-3+ 09:57pm plt count-115*# 09:57pm pt-15.7* ptt-37.9* inr(pt)-1.4* 09:57pm urine color-amber appear-hazy sp -1.008 09:57pm urine blood-tr nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-mod urobilngn-neg ph-5.0 leuk-mod 09:57pm urine rbc-* wbc-* bacteria-few yeast-mod epi- 09:57pm urine eos-negative . labs closest to time of death: 03:45am blood wbc-14.8* rbc-2.34* hgb-8.5* hct-24.6* mcv-105* mch-36.3* mchc-34.5 rdw-17.9* plt ct-106* 09:46am blood glucose-342* urean-22* creat-1.6* na-128* k-3.9 cl-95* hco3-20* angap-17 09:46am blood ck-mb-notdone ctropnt-0.03* 09:46am blood calcium-8.8 phos-2.4* mg-2.2 03:58am blood type- po2-48* pco2-44 ph-7.38 caltco2-27 base xs-0 . micro: urine culture with yeast. blood cultures negative . imaging: cxr: ap upright portable chest x-ray: there is a ill-defined opacity within the left lower lobe consistent with patient's known pneumonia in this region. the cardiac silhouette is difficult to evaluate. the mediastinal and hilar contours appear within normal limits. there is a small right pleural effusion. a left picc catheter terminates in the upper svc. cholecystectomy clips in the right upper quadrant. impression: left lower lobe consolidation consistent with patient's known pneumonia. small right pleural effusion. . abd ultrasound: findings: this was a technically difficult examination and was performed portably. the liver is heterogenous in echotexture and is of increased echogenicity. it is shrunken and the appearances are consistent with cirrhosis. there is evidence of ascites. the flow in the main portal vein is reversed and is centrifugal. the flow in the main hepatic artery reaches velocities of 80 cm/sec, but there is a normal waveform and the resistive index is 0.77. the flow in the right anterior portal vein is centripetal and the flow in the right posterior portal vein is centrifugal. the left portal vein is not well visualized. normal waveforms are seen in the right and left hepatic arteries. the flow in the left hepatic vein, right hepatic vein and middle hepatic vein is normal. no intrahepatic bile duct dilatation. the cbd measures 0.48 cm. impression: technically difficult examination in a patient with cirrhotic liver with ascites with reversed flow seen in the portal veins. ascites . echo: conclusions: the left atrium is moderately dilated. the right atrium is moderately dilated. left ventricular wall thicknesses are normal. 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 are mildly thickened. there is moderate aortic valve stenosis (area 0.8-1.19cm2) mild to moderate (+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is a small pericardial effusion. . mri abdomen: findings: the liver is shrunken and nodular, consistent with the given history of cirrhosis. within the limits of the examination, no focal mass lesion is seen. a mild-moderate amount of ascites fluid is seen, primarily adjacent to the liver. the pancreas is diffusely atrophic. adrenal glands are unremarkable. the spleen and kidneys also appear unremarkable. a serpiginous structure showing flow voids is seen in the right paraaortic/retroperitoneal region, with suggestion of communication between the superior mesenteric vein and the renal vein, probably representing a porto-systemic shunt. impression: right-sided vascular structure, probably representing a porto- systemic shunt between the smv and the right renal vein. no renal mass seen within the limits of this noncontrast examination. brief hospital course: 48 y/o female with h/o end stage liver disease, etoh abuse, copd, crohn's disease, and chronic kidney disease, transferred from osh with mrsa bacteremia, liver failure, acute renal failure, lll pneumonia, enterococcus uti, and hypotension. her hospital course is as follows: . cirrhosis w/acute hepatitis: patient was admitted with likely etoh cirrhosis given her known history and lab data (discriminate score >32). liver service cwas consulted. she remained coagulopathic with elevated lfts and hyperbilirubinemia. she was also encephalopathic. we treated her supportively with lactulose, rifamixin. we held her propranolol given her hypotnesion requiring pressors. us was negative for pv thrombosis, though there was reversal of flow. a diagnostic paracentesis was unsuccessfully attempted. she was also started on pentoxyfylline for presumed etoh hepatitis, as well as octreotide and midodrine for possible hrs. nevertheless, given her multiple issues, she continued to decompensate. she was transferred to the liver service after a final decision was made to make her comfort measures only. . arf on ckd: her baseline creatinine was unknown but per report creatinine was 1.0 prior to initiation of gentamicin. she had no h/o large volume paracentesis. she had been hypotensive requiring pressors, including vasopressin, raising the concern for pre-renal azotemia vs atn. hrs was also considered given her decompensated liver failure. renal was consulted and initiated cvvh after placing a femoral hd cath. however, after she was made cmo all interventions were withdrawn. . mrsa bacteremia: her source was unknown but was being treated for endocarditis given persistant bacteremia despite therapeutic doses of vancomycin at osh. id was consulted. she was started on gent in addition to vanco. there were no positive cultures here. tee was not done given concern for causing variceal bleed; however, egd did not demonstrate varices. worsening lll pneumonia on cxr at osh could have been source of infection. there was also a concern that her pericardial effusion might be infected/purulent pericarditis. spinal abscess or thrombophlebitis was also considered. multiple imaging studies were performed without clear source of infection (see above). her antibiotics were stopped once the patient was made cmo. . hypotension: it was unclear what degree of hypotension this represented as patient's baseline sbp reported to be in the 80s. however she was clearly septic at osh. sepsis, severe infection, esld were thought involved. she was maintained on levophed, neosynephrine, and vasopressin during her micu stay. octreotide and midodrine were also started (see above). however, these interventions were stopped once she was made cmo. . tachycardia/chest pain: patient had an episode of a fib w/ rvr ; likely to fluid shifts w/ cvvhd and cardiac irritation from levophed. echo at osh showed normal ef, la slightly enlarged. she was asymptomatic during event, cardiac enzymes were flat. levophed was changed to neo and pt bolused fluid. she converted to nsr after 1-2hrs. she remained tachycardic but looked to be in mat. . ms changes: patient was not oriented, and she was unclear that she understood who made decisions for her. psych evaluated her and determined that she did not have capacity to make her own decisions. there were multiple family meetings to discuss goals of care. palliative care also helped faciliate this decision making process. she remained disoriented, likely secondary to hepatic encephalopathy, infection, hyponatremia, and arf. . hyponatremia: it was thought to be hypervolemic hyponatremia given her esld. it improved with fluid restriction . code/end of life issues: her code status continually fluctuated during her admission, between full code and dnr/dni. however, after extensive family meetings and palliative care involvement, the decision was made to make her cmo . once the patient was cmo, she was transferred to the - service. there were no lab draws. she was put on a morphine drip and appeared comfortable. she was pronounced dead at 7am on . cause of death likely end stage liver disease and infection. the family was notified. they did not request an autopsy. medications on admission: percocet 1-2tabs q4hr prn protonix 40mg loratadine 10mg daily singulair 10mg dialy vistaril 25mg tid prn lomotil 2mg tid prn actos 15mg daily discharge medications: expired discharge disposition: expired discharge diagnosis: cardiopulmonary arrest end stage liver disease crohn's disease discharge condition: expired discharge instructions: expired followup instructions: expired md, procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis transfusion of other serum infusion of vasopressor agent diagnoses: pneumonia, organism unspecified tobacco use disorder acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified acute and subacute necrosis of liver alcoholic cirrhosis of liver hepatorenal syndrome hyposmolality and/or hyponatremia severe sepsis portal hypertension chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation infection with microorganisms resistant to penicillins methicillin susceptible staphylococcus aureus septicemia candidiasis of mouth regional enteritis of unspecified site hepatic encephalopathy other and unspecified alcohol dependence, unspecified acute alcoholic hepatitis endocarditis, valve unspecified, unspecified cause 

Answer: The patient is high likely exposed to