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: betadine viscous gauze / iodine containing agents classifier / naprosyn / clindamycin / lactose attending: chief complaint: frequent dark stools, falling hematocrit major surgical or invasive procedure: egd history of present illness: ms. is a 36 year old female with a history of an aortic clot, retroperitoneal bleed, and duodenal ulcer bleed, who presents with melena and anemia. . she presented to hospital today with greater than 20 liquid black bm in 16 hrs. she had hgb 6, hct 18.1, vitals 99.2, hr 93, rr 16, 122/64, 98% ra. guaiac positive times two. . prior to admission to , nursing notes, at 0700 pt she was incontinent of liquid stool and urine, hypertensive 190/90, labetalol and nitropaste prior to dialysis. at 5pm, 3 large loose black bms, stat hct 22.5 hgb 7, 2 units of blood given. at 2300 pt continued to have black liquid stool about 8 per shift. 0800, 6 liquid black tarry stools, given 1 unit prbcs and transferred to . . she had a recent admission in for the workup of altered mental status, which was unrevealing with negative mri/mra head, ct head, mra neck, eeg. ultimately unclear what caused her ms changes. she also developed renal failure, mssa bacteremia, a-fib with rvr, gi bleed from duodenal ulcer, rp bleed, c. diff, hyponatremia and aortic clot. briefly her previous hospitalization was significant for the development of an aortic occlusion for which she was started on heparin. she then developed rp hematoma and heparin was stopped. she then had a gi bleed. endoscopy showed ulcer with stigmata of recent bleed. treated with injectible epi and bicap. unfortuantely she re-bled and as she has a potential allergy to dye and given her aortic occlusion she was felt to be a poor candidate for ir procedure; thus she was taken to the or for an ex-lap and oversewing of bleeding duodenal ulcer and 4 point ligation (on ). her hct then improved to her baseline on 38-40. on it dropped again to 31 from 39. a repeat egd on showed multiple erosions and ulcers in the duodenal bulb with bright red blood consistent with active recent bleeding. no intervention was done at that time. her hct then trended down slowly to 26. . in the ed, she was found to have a hematocrit of 20.4 (from 26.9 on ). she remained hemodynamically stable and without tachycardia. initial vitals there were 99.1, bp 186/94, hr 98, rr 16, sat 98% ra. . on the floor, she had no new complaints. she mentioned some non-specific abdominal cramping during her bowel movements. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomitingconstipation. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: h/o alcohol abuse htn sleep apnea copd s/p ankle fracture repair h/o tia s/p spinal fusion l5-s1 laminectomy s/p bilateral cataract surgery ? danlos syndrome aortic thrombus mssa bacteremia afib duodenal cap bleed ptsd, multiple personalities, bipolar, substance abuse social history: raised in . history of sexual abuse. history of 1 bottle of wine daily until 6 months ago. she smoked 2ppd for 40 yrs, quit in . denies h/o ivda. family history: family psych hx: sister with ; son with depression and suicide attempt when he was 9 years old. denies any other known psychiatric family history. physical exam: on admission: tmax: 36.9 ??????c (98.4 ??????f) tcurrent: 36.9 ??????c (98.4 ??????f) hr: 84 (84 - 84) bpm bp: 159/87(98) {159/87(98) - 159/87(98)} mmhg rr: 15 (15 - 15) insp/min spo2: 98% heart rhythm: sr (sinus rhythm) general appearance: no acute distress cardiovascular: (s1: normal), (s2: normal) peripheral vascular: 1+ to thready dp bilaterally but lower extremities warm abdominal: obese soft, non-tender, bowel sounds present, no organomegaly skin: not assessed neurologic: attentive, follows simple commands, responds to: not assessed, oriented (to): times three, movement: not assessed, tone: not assessed, moving all extremities pertinent results: admission labs -------------- 06:00pm glucose-90 urea n-47* creat-2.6* sodium-133 potassium-3.5 chloride-96 total co2-24 anion gap-17 06:00pm estgfr-using this 06:00pm alt(sgpt)-10 ast(sgot)-16 alk phos-60 tot bili-0.2 06:00pm lipase-65* 06:00pm albumin-2.8* calcium-8.3* 06:00pm wbc-8.8# rbc-2.08*# hgb-6.8* hct-20.4* mcv-98 mch-32.7* mchc-33.3 rdw-18.9* 06:00pm neuts-76.5* lymphs-14.7* monos-5.4 eos-2.9 basos-0.5 06:00pm plt count-302 06:00pm pt-12.7 ptt-22.8 inr(pt)-1.1 . discharge labs -------------- 05:08am blood wbc-5.7 rbc-3.05* hgb-9.7* hct-29.1* mcv-96 mch-31.9 mchc-33.4 rdw-17.0* plt ct-306 05:08am blood neuts-62.5 lymphs-11.5* monos-9.5 eos-16.0* baso-0.5 05:08am blood glucose-84 urean-29* creat-3.7* na-131* k-4.3 cl-97 hco3-20* angap-18 05:08am blood calcium-8.0* phos-5.8* mg-2.3 . microbiology ------------ mrsa screen: negative . imaging ------- ct abd/pelvis on admission: impression: 1. mild decrease in size of two right retroperitoneal/pelvic hematomas. no evidence of new bleed. 2. new small amount of simple appearing ascites. 3. severe suprarenal aortic stenosis, with resulting renal atrophy. 4. stable l5-s1 spondylolisthesis. . egd : erythema in the duodenal bulb compatible with mild duodenitis ulcer in the duodenal bulb otherwise normal egd to third part of the duodenum brief hospital course: 63 yo female with danlos syndrome, bipolar disorder, multiple personality disorder, ptsd, and seizure due to intracranial hematoma and recent hospital course complicated by suprarenal aortic clot, retroperitoneal bleed, and duodenal ulcer bleed presents with melena and falling hematocrit. . active issues ------------- # acute on chronic anemia: differential diagnosis included acute blood loss due to gastrointestinal bleed (with guaiac positive stools and recent history of duodenal ulcer bleed) versus retroperitoneal hematomas versus kidney dysfuction. patient received 4 units prbcs with inappropriate hematocrit response early in admission. gastroenterology was consulted and performed repeat egd on which showed a healing duodenal ulcer and no direct source of bleed was identified. patient also had ct of the back/abdomen that did not show evidence of an expanding hematoma, although old hematoma continued to show signs of resolution. she was initially on a proton pump inhibitor drip, then transitioned to intravenous route, and eventually to oral ppi. hematocrit remained stable after egd, with numerous guaiac negative stools noted. complete blood counts should be checked daily after the patient leaves the hospital to trend hematocrit levels, which have remained stable at 27-30 for days prior to discharge. . # chronic kidney disease: patient was initiated on hemodialysis during her last admission to . her renal disease was thought to be due to the large aortic thrombus. it was noted over the course of her admission that she was producing more urine, and 24 hour creatinine measurement was initiated. however, patient's creatinine uptrended while off hemodialysis, and it was determined that patient will possibly need to continue dialysis sessions as need at the outside facility, per the neprologist's discretion. her hemodialysis line will remain in and chem10 should be checked . patient is scheduled for follow-up with nephrology, where further determination will be made of dialysis need. patient's dialysis line should be flushed with heparin at the time of dialysis, if required. . # hypertension: patient was continued on labetalol 200 mg tid and amlodipine 10 mg daily during her admission for blood pressure control, which was deemed to be inadequate. her labetalol was increased to 600 mg tid for added control before discharge, and furosemide was also added, due to concern for fluid overload. twice daily chem10 should be performed upon discharge to trend electrolyte levels. if patient requires further blood pressure management, further uptitration of labetalol is recommended. recommended systolic blood pressure range should be 130s-160s due to patient's likely impaired kidney perfusion from her aortic thrombus. . # eosinophilia: patient was noted to have an eosinophilia of 16% on labs checked before discharge. this problem should be followed up at the discharge facility going forward. . inactive issues --------------- # retroperitoneal hematoma: per ct abdomen/pelvis, this was decreasing in size and no new retroperitoneal hematomas were noted compared to prior. . # aortic thrombus: patient had been on heparin when the clot was discovered during her admission in . she was taken off the heparin after developing retroperitoneal and gi bleeds. she is not anticoagulated at this time, because anticoagulation is contraindicated in the setting of a possible gi bleed. this should be reevaluated in the future. . # clostridium difficile colitis: patient was toxin positive on . she is currently receiving vancomycin 125 mg po q6hrs through , two weeks after cessation of nafcillin therapy. there was noted increased bowel movements prior to admission, which had slowed considerably on admission. patient will remain on oral vancomycin therapy upon discharge until the date noted above. patient was experiencing loose stools during her admission, likely due to osmotic mechanism from diet changes, and possible gi bleed on admission. there was no noted fever, leukocytosis or abdominal pain during her hospital course. at the time of discharge, she ranged from soft, loose bowel movements daily. . # mssa bacteremia: patient will be continuing nafcillin through , per infectious disease recommendations, which should continue upon discharge. she should also get weekly bun/creatinine, lfts, and cbc/differential going forward, with results to be faxed to the infectious disease clinic at at (. . # atrial fibrillation: patient was continued on labetalol 600 mg tid during admission for rate control, which she will continue upon discharge. she is currently not on anticoagulation given her recent history of gastrointestinal and retroperitoneal bleed. . # chronic hyponatremia: during her last admission, this was thought to be secondary to intrinsic renal disease. during most of this admission, patient had a normal sodium level. level was trended daily, and should continue to be trended regularly as noted elsewhere. . # dyslipidemia: patient was continued on simvastatin 40 mg daily during her admission. . # psychiatric conditions: patient was continued on divalproex 500 mg during her admission. patient will require psychiatry follow-up at health center or , which has not yet been scheduled, and should be initiated upon discharge from the ltac facility. the patient's family has been instructed to call and try to schedule an appointment at one of these two locations. . transition of care ------------------ # follow-up: patient is scheduled for follow-up appointments with vascular surgery, infectious disease, acute care surgery, nephrology and her primary care provider upon discharge. a psychiatry appointment has not yet been scheduled, but this will occur after discharge. there are pending blood cultures and wound cultures which will need to be followed up after discharge. she should have daily complete blood counts and twice daily chemistry panels (chem10) for at least the first week after discharge to assure stability. she should also get weekly bun/creatinine, lfts, and cbc/differential going forward, with results to be faxed to the infectious disease clinic at at (. . # code status: patient is confirmed full code. . medications on admission: acetaminophen 325 mg tablet q6 prn pain amlodipine 10 mg tablet daily calcium carbonate 200 mg calcium (500 mg) tablet, tid divalproex 500 mg heparin 5,000 unit/ml sc tid labetalol 300 mg tablet tid montelukast 10 mg tablet qhs nafcillin 2 g iv q4h pantoprazole 40 mg simethicone 80 mg qid simvastatin 40 mg daily trazodone 100 mg qhs prn vancomycin 125 mg capsule q6 carboxymethylcellulose sodium 1.4-0.6% 1-2 drops prn dry eyes. discharge medications: 1. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain/fever. 2. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 3. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po three times a day. 4. divalproex 500 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po bid (2 times a day). 5. montelukast 10 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 6. nafcillin 2 g iv q4h end date 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. 8. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 9. trazodone 100 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. 10. vancomycin 125 mg capsule sig: one (1) capsule po q6h (every 6 hours). 11. outpatient lab work please perform cbc daily until , then every other day after that until hematocrit level stabilizes 12. outpatient lab work please perform chem10 twice a day, until electrolytes stabilize, specifically potassium and magnesium 13. outpatient lab work please perform weekly bun/creatinine, lfts, and cbc/differential going forward, with results to be faxed to the infectious disease clinic at at (. 14. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 15. labetalol 300 mg tablet sig: two (2) tablet po tid (3 times a day). 16. furosemide 40 mg iv bid discharge disposition: extended care facility: hospital transitional care unit - discharge diagnosis: primary diagnosis: acute on chronic anemia hypertension chronic kidney disease secondary diagnosis: retroperitoneal hematoma aortic thrombus clostridium difficile colitis mssa bacteremia atrial fibrillation chronic hyponatremia dyslipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , it was a pleasure taking care of you at . you came for further evaluation of anemia and increased bowel movements. tests showed that there was no evident source of bleeding in your stomach and the first part of your intestine. you are now being dischrged to a long-term acute care facility. you will also continue dialysis as needed at the outside facility. whether or not you need this in the future will continue to be determined. it is important that you continue to take your medications and follow up with the appointments that have been arranged for you. the following changes have been made to your medications: we increased your labetalol dose for added blood pressure control we added furosemide to take extra fluid off of your legs followup instructions: please call health center at to schedule a psychiatry appointment. department: vascular surgery when: thursday at 2:00 pm with: , md building: lm campus: west best parking: garage department: when: thursday at 2:35 pm with: , md building: sc clinical ctr campus: east best parking: garage department: general surgery/ when: thursday at 1:45 pm with: acute care clinic building: lm bldg () campus: west best parking: garage department: infectious disease when: thursday at 8:50 am with: , md building: lm bldg () campus: west best parking: garage department: west clinic when: tuesday at 9:30 am with: , md building: de building ( complex) campus: west best parking: garage procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung other endoscopy of small intestine other endoscopy of small intestine insertion of endotracheal tube hemodialysis venous catheterization for renal dialysis endoscopic control of gastric or duodenal bleeding suture of duodenal ulcer site central venous catheter placement with guidance diagnoses: end stage renal disease obstructive sleep apnea (adult)(pediatric) acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified acute posthemorrhagic anemia iron deficiency anemia secondary to blood loss (chronic) hyposmolality and/or hyponatremia atrial fibrillation hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure bacteremia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site intestinal infection due to clostridium difficile methicillin susceptible pneumonia due to staphylococcus aureus personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits methicillin resistant staphylococcus aureus in conditions classified elsewhere and of unspecified site chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction encephalopathy, unspecified other and unspecified infection due to central venous catheter bipolar disorder, unspecified precipitous drop in hematocrit vascular disorders of kidney hemoperitoneum (nontraumatic) other disorders of muscle, ligament, and fascia restless legs syndrome (rls) streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group b posttraumatic stress disorder abnormal involuntary movements eosinophilia dissociative identity disorder ehlers-danlos syndrome narcolepsy, without cataplexy 

Answer: The patient is high likely exposed to