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: history of present illness: this is a 33 year old female with the sudden onset of headache at 1 p.m. on the day of admission. the patient had vomiting and coma scale of 14. she was able to follow commands but became more lethargic gradually. she was transferred from an outside hospital. she stated that when she arrived there, her headache was getting worse. past medical history: hypothyroidism. medications were levothyroxine sodium 75 mcg p.o. q. day. social history: the patient is divorced and lives with her kids. she does not smoke. she does not drink alcohol. family history: no family history of subarachnoid hemorrhages. physical examination: vital signs temperature of 97.1; heart rate 96; blood pressure 138/96; respirations 26. oxygen saturation 100% on two liters. constitutional: arousable but lethargic, oriented times one. pupils were 1 mm and reactive bilaterally. extraocular movements intact. neck: range of motion was decreased due to pain. lungs were clear to auscultation. regular rate and rhythm. abdomen soft, nondistended. back: nontender, no edema. skin was warm and dry. neurologic: she answers questions appropriately, is awake and oriented to being in the hospital and the year of . language is fluent but slow. the patient was not cooperative with examination. she complains of severe headache and nausea. pupils were pinpoint bilaterally. hard to assess reactivity. visual fields were full but hard to interpret. no droop, no nystagmus. tongue was midline but very slow to protrude. hearing was intact. motor: moves all extremities; upper extremities against gravity but lower extremities barely. difficult to assess whether she was cooperative or not. drift was hard to examine. sensory: she had positive response to noxious stimuli with all extremities. hospital course: the patient was admitted to the neurosurgery service. a head ct showed subarachnoid hemorrhage. . her blood pressure was controlled for less than 150. she did have a witnessed seizure according to her parents when she initially complained of a headache so she was loaded with dilantin. nimodipine was started 60 mg p.o.q. 4 hours. a ventriculostomy drain was placed. the patient was brought to the angiography suite on where she was found to have a right anterior choroidal aneurysm, size 3 by 7 mm. this was coiled successfully with a small remnant at the origin. good flow through right inferior choroidal artery. she was brought to the intensive care unit extubated. postoperatively, her vital signs were 98.2; pulse of 89; blood pressure 107/64; respirations 28. sa02 98%. icp was 10. white count was 12.8; hematocrit was 32.9. pt1 was 13.4. ptt was 35. inr was 1.2. sodium of 140; potassium of 3.9. the patient was awake, alert and oriented to the date and year. speech was fluent. she followed commands and attended examiner. visual fields were intact. pupils 4 to 2 bilaterally. no drift. groin sheath was left in place. the evd had some bloody drainage. she was kept in the intensive care unit to keep her blood pressure less than 140. she was receiving dilantin. on , on subarachnoid day number 3, she remained awake and alert times two to person and time. face is symmetric, no drift. her sheath was discontinued. her blood pressure was kept between 140 and 160. central line was asked to be placed. she was on subcutaneous heparin. on the , the patient was awake and alert, without complaints. extraocular movements were full. face was symmetric. she had no drift. ip's were full bilaterally. her dilantin level was 11.8. her drain was currently raised to 12 cm. she continued to receive dilantin and amlodipine. on the , the patient remained neurologically intact. she was started on albumin 25% q. eight hours to keep cvp between the 6 to 8. amlodipine was changed to 30 mg q. 2 hours in order to keep her blood pressure in the 130 to 160 range. the patient did complain of increased headache during the day. she had a head ct which was normal, no change and no new blood. on the 25th, her drain was raised to 15. she tolerated this. on the , the patient spiked a temperature to 103.3. her icp's were 9 to 16; cvp 3 to 10; blood pressure 140 over 78. she was awake and alert. she continued to complain of a headache. she was oriented to hospital, date . extraocular movements were full. no drift. face was symmetric. the patient was pan cultured. on the , it showed that her blood cultures were positive 3 out of 4 bottles. cerebrospinal fluid showed staph coagulase negative. at that time, levaquin was started intravenously. her central line was changed out. cerebrospinal fluid cultures were sent again on the 29th as cerebrospinal fluid showed gram positive cocci in pairs and clusters. on , her ventriculostomy drain was removed. the patient was neurologically intact. fevers were at 100.3. she was being treated with levaquin and vancomycin. the cultures from showed four out of four gram negative rods in her blood culture. her urine was negative. her cerebrospinal fluid on showed coagulase negative staph and the 29th as mentioned 2+ gram positive. also, methicillin resistant staphylococcus aureus out of the cerebrospinal fluid for . as mentioned, the patient was started on vancomycin one gram twice a day at that time. on , it was also found that the patient had clostridium difficile and flagyl was added to treat that organism. also noted on , the patient had what was thought to be a cerebrospinal fluid collection and some leaking from her former ventriculostomy site. this site was resutured and continued to be followed. on , the patient had a cat scan of her head done. there was no hydrocephalus or shift of normally midline structures. a lumbar puncture was performed. her opening pressure was 22. approximately 20 cc of cerebrospinal fluid was taken off and the closing pressure was 11. on the 4th, there was no sign of cerebrospinal fluid collection at the former drain site. the patient remained neurologically intact. on the , the patient had a repeat lumbar puncture. opening pressure was 21. closing pressure was 10. cerebrospinal fluid culture from grew gram positive bacteria. the patient needs additional 21 days of vancomycin from the . on the , the patient remained afebrile at 98.8. blood pressures were in the 120 to 150 range over 70 to 80's. that was on neo-synephrine. between the 7th and , the patient was unsuccessfully weaned off neo-synephrine. her blood pressure off neo-synephrine would drop to the high 80's systolically. she was given two units of packed red blood cells on the 10th with good effect. her blood pressure was in the 90 to 100 range. she was transferred to the floor. on the , she was neurologically intact. she was seen by case management and rehabilitation, physical therapy, to assist with her mobility, being on bed rest for the past three weeks. the patient complained of intolerance to vancomycin. she developed a rash in her right arm area. she complained of some generalized weakness after receiving vancomycin each dose and she also felt like her face was swelling from it. we spoke with infectious disease who advised us on the not to switch to linezolid because of the questionable efficacy of treatment in cerebrospinal fluid infections and made the direct recommendations to start on benadryl prior to each dose and to slow down the rate of each vancomycin dose. a medical consult was done for continued orthostatic hypotension. they recommended some cortisol testing which was 6.0 and at one hour 17.4. they did not recommend treating her hypotension with any medication at this time. her hypotension did seem to be improving over time. they advised us to follow her hematocrits. she had a picc line placed for long term antibiotic for administration for vancomycin until the . however, the patient continued to complain of intolerance to vancomycin and infectious disease was consulted once again, who stated that the patient could be started on linezolid 600 mg p.o. q. 12 hours but she should have a cbc checked weekly while on it. her vancomycin was discontinued at that time. she was cleared by physical therapy and occupational therapy to go home. she will be discharged most likely on the . she is to have a head ct prior to discharge. she will have a lumbar puncture performed prior to discharge. discharge medications: linezolid 600 mg p.o. q. 12 hours. levothyroxine 75 mcg p.o. q. day. percocet one to two tablets p.o. every four to six hours prn as needed for pain. colace 100 mg p.o. twice a day while on percocet. discharge instructions: follow-up with dr. in one month. she should have her cbc checked by a primary care physician one week from discharge. she should complete the linezolid on the . return if she develops any severe headaches. discharge diagnoses: subarachnoid hemorrhage with a right choroidal aneurysm. coagulase negative staph ventriculitis. hypotension. hyponatremia. clostridium difficile. bacteremia. the patient was discharged neurologically intact. , m.d. dictated by: medquist36 procedure: spinal tap incision of lung intravascular imaging of intrathoracic vessels arterial catheterization central venous pressure monitoring transfusion of packed cells endovascular (total) embolization or occlusion of head and neck vessels transfusion of other substance diagnoses: hyposmolality and/or hyponatremia other convulsions subarachnoid hemorrhage other nervous system complications bacteremia intestinal infection due to clostridium difficile other specified bacterial infections in conditions classified elsewhere and of unspecified site, other gram-negative organisms infection and inflammatory reaction due to nervous system device, implant, and graft staphylococcal meningitis 

Answer: The patient is high likely exposed to