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: hypoglycemia, hypoxemia, hypothermia major surgical or invasive procedure: endotracheal intubation arterial line placement central venous line placement peripherally-inserted venous catheter history of present illness: ms. is a 62 yo wheelchair bound f with iddm c/b peripheral neuropathy with chf 20%, s/p right bka, daughter nurse, picked her up at adult day care, noticed somnolence, checked glu - 25. went to local er. gave amp d50 and gave her zosyn, but there is no documented temperature. she was noted to desat to the 70s on ra, but she was asymptomatic. she was put on nonrebreather. she was also noted to be bradycardic in 40s. she was tx here for further management. upon arrival, she was again without complaints. she was noted to desat to 82 without nrb. vitals in the ed: hr 60s. t 92-93 rectal. hr 60, bp 160/63, rr 19, 98%nrb. no other antibiotics. 1 blood and urine here. 2 bloods at outside ed. lactate 1.5. cr 1.4 there, 1.8 here. no cta done, but she was placed on heparin out of concern for pe. she was put on a warming blanket. in the icu, she endorsed cough x 2 days, atypical chest pain. she denies abd pain, dysuria or increased frequency, diarrhea, n/v. she subsequently developed hypotension with sbp 70s to 80s. given her evolving sepsis picture, pulmonary edema, possible benefit of better monitoring, and possible need for pressors, an arterial line was placed and she was intubated. past medical history: #. chronic systolic chf ef 20%: - h/o hospitalizations for chf exacerbation - echo : moderate symmetric lvh with severe global left ventricular dysfunction (ef 20-25%) moderate tricuspid regurgitation. moderate pulmonary hypertension. small pericardial effusion. - mibi with normal perfusion #. dm ii x 15 years - complicated by peripheral neuropathy; retinopathy #. htn #. cad - h/o distant mi per family report, no pci or cabg #. history of pancreatitis - s/p pancreatic duct stent #. ckd (baseline 1.1-1.3 per report, but was 0.7-0.9 in ) #. anemia - mixed iron deficient and anemia of chronic disease #. thrombocytopenia #. h/o thickened endometrium per us #. osteopenia #. history of stroke #. dementia #. ? seizure disorder social history: the patient was previously living in with her other daughter. she recently returned to to live with her daughter who is employed at as a coworker : quit 1 year ago, previously ppd x 50 years etoh: rare illicits: none family history: mother with dm, breast cancer, mi in her 70's. brother has dm. sister with heart disease. physical exam: vitals: 92 axillary, hr 67 83/35-->121/84 rr20 o2 83-94% nrb heent: ncat, mmm, eomi neck: no lad pulm: ctab, no w/r/r cv: hrrr, no m/r/g abd: s/nd, mild diffuse ttp, hypoactive bs extr: s/p right bka, multiple ulcers on left foot without erythema. exudate between 3rd and 4th toes where there is an ulcer. neuro: ao x 1 (self) pertinent results: 11:06pm po2-67* pco2-35 ph-7.32* total co2-19* base xs--7 11:06pm lactate-1.5 10:55pm glucose-266* urea n-23* creat-1.8* sodium-144 potassium-5.6* chloride-118* total co2-19* anion gap-13 10:55pm ck(cpk)-51 10:55pm ctropnt-0.03* 10:55pm calcium-8.6 phosphate-3.5 magnesium-2.0 10:55pm tsh-11* 10:55pm tsh-11* 10:55pm t4-8.7 10:55pm plt smr-normal plt count-122* lplt-3+ 10:55pm plt smr-normal plt count-122* lplt-3+ 10:55pm pt-11.6 ptt-31.3 inr(pt)-1.0 cxr : findings: in comparison with the study of , there is persistence of diffuse bilateral pulmonary opacifications. again, this is consistent with ards, though vascular congestion or diffuse pneumonia can certainly not be excluded radiographically. various monitoring and support devices remain in place. the left hemidiaphragm is not sharply seen on the current study. this could reflect some pleural fluid, atelectatic change, or even focal consolidation at the left base. abd/pelvis ct : 1. significantly limited ct examination without intravenous contrast with no source of infection identified. if there remains a high clinical concern for an occult infection, can consider correlation with a dedicated tagged white cell scan. 2. ground glass and interstitial opacities within visualized lung bases in conjunction with small bilateral pleural effusions, small pericardial effusion, and probable compression atelectasis. these all likely relate to fluid overload/chf with no discrete pneumonia noted. 3. diffuse anasarca. 4. unchanged pancreatic parenchymal calcifications again suggestive of prior episodes of pancreatitis. brief hospital course: 62 yo female with dm, htn, cad, dementia, who presented with hypothermia, hypoxia, and hypotension. # sepsis: the patient's clinical picture was consistent with sepsis, initially concerning for urosepsis based on her ua in the ed. early goal-directed therapy was initiated, with prompt transfer to the icu. however, no bacteria grew from the urine, and nothing was grown from blood and sputum cultures. she was covered broadly with vancomycin, zosyn, and levofloxacin and she improved clinically. she was ruled out for respiratory viruses. podiatry was consulted and did not feel that her left foot was infected, only colonized. bronchoscopy was also not revealing. ct abd & pelvis were also unremarkable for source. given no clear source and clinical improvement she was given a 10-day course of empiric antibiotics with the last doses on . she remained afebrile during the latter portion of her hospital course. # hypotension/hypertension: the patient was hypotensive on admission requiring agressive fluid resuscitation (11l in the first 24 hours) and pressors. she became hypertensive after the second or third day of her icu stay and was gradually started back on some of her home medications, metoprolol and amlodipine. hydralazine was started due to hypertension and wanting to hold enalapril and hctz given her acute renal failure. as kidney function improved enalapril was started and gradually titrated upward, while hydralazine was discontinued. her anti-hypertensive regimen will need further adjustment as an outpatient. # respiratory failure: while in the icu, she developed progressive respiratory distress requiring endotracheal intubation, the etiology of which proved unclear. serial cxrs appeared most consistent with ards, but lung compliance proved good on the ventilator. fluid overload was also postulated. she was diuresed with lasix, and successfully extubated on . her length of stay fluid balance was still +4 l at the time of discharge but she was autodiuresing well so no diuretics were initiated. # acute renal failure: creatinine was elevated to 1.8 on admission and peaked at 2.1 but returned to a baseline of 1.2. the patient likely had arf hypoperfusion. # question of dic: concering because of thrombocytopenia and coagulopathy. however, heme was consulted and did not think her presentation was consistent with dic. she also ruled out for hit. her platelet count was stable at the time of discharge. # chronic diastolic heart failure: pt. was found to have a normal ef on echo (>55%) and severe diastolic dysfunction. she was restarted on an acei as described above, a beta blocker, and aspirin. # history of seizure: patient has a history of a recent seizure of unclear etiology. it may be related to a past stroke, however. she was managed with keppra. # dm: patient was managed on an iss while inpatient. at the time of discharge, her daughter reported episodes of hypoglycemia as an outpatient and requested a script for glucagon pens, which were given. # foot ulcers/bullae: podiatry evaluated the patient's foot ulcers and made recommendations for wound care. her ulcers grew pan-resistant bacteria (including vre) but they felt that the ulcers were not the cause of her septic presentation, and that they were instead colonized. she additionally improved clinically in the abscence of directed antimicrobial therapy against vre. she was discharged with wound care recommendations for at-home wound care. # cad/hx of stroke: patient was discharged on asa and a beta blocker. medications on admission: per d/c summary : discharge medications: 1. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 4. levetiracetam 500mg po bid 5. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 6. enalapril maleate 10 mg tablet sig: one (1) tablet po daily (daily). 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 8. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. augmentin 875-125 mg tablet sig: one (1) tablet po twice a day for 2 weeks. disp:*28 tablet(s)* refills:*0* 10. silvadene 1 % cream sig: one (1) topical once a day: apply to the blister once dry and stops draining. disp:*1 * refills:*2* 13. glargine 7 units qam insulin sc sliding scale discharge medications: 1. metoprolol succinate 50 mg tablet sustained release 24 hr sig: 1.5 tablet sustained release 24 hrs po once a day. disp:*45 tablet sustained release 24 hr(s)* refills:*2* 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 5. levetiracetam 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 6. albuterol 90 mcg/actuation aerosol sig: four (4) puff inhalation q6h (every 6 hours) as needed. 7. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed. 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 10. enalapril maleate 5 mg tablet sig: two (2) tablet po twice a day. disp:*120 tablet(s)* refills:*2* 11. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 12. lantus 100 unit/ml cartridge sig: seven (7) u subcutaneous qam. 13. insulin lispro 100 unit/ml solution sig: as directed subcutaneous asdir (as directed). 14. imodium a-d 2 mg tablet sig: one (1) tablet po four times a day as needed for diarrhea. disp:*60 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: 1. sepsis 2. acute respiratory failure 3. acute renal failure, resolved 4. low-grade dic secondary diagnoses: 1. chronic diastolic heart failure, compensated 2. hypertension 3. diabetes mellitus type 2, controlled with complications 4. hypercholesterolemia discharge condition: good discharge instructions: you were admitted because you had a serious infection in your blood stream. we treated you with antibiotics to help clear the infection. we also had to assist your breathing with a breathing tube. your condition improved gradually and we discharged you home with physical therapy services. please take all of your medications as prescribed. please keep all of your follow-up appointments. please call your doctor or return to the hospital if you experience fevers, chills, sweats, chest pain, shortness of breath or anything else of concern. followup instructions: please schedule an appointment with your primary care doctor within the next one to two weeks: pcp: , we scheduled you for an appointment with a nurse practicioner at next week. to keep this appointment, you will need to call the office (the number is below). if you would rather see dr. , please call his office to schedule an appointment there. scheduled appointments : --provider , : date/time: 2:00 please schedule an appointment with the podiatry clinic within the next week: podiatry , office phone: ( md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube arterial catheterization diagnoses: thrombocytopenia, unspecified anemia in chronic kidney disease congestive heart failure, unspecified acute kidney failure, unspecified unspecified septicemia severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes other persistent mental disorders due to conditions classified elsewhere chronic kidney disease, unspecified ulcer of other part of foot other and unspecified hyperlipidemia acute respiratory failure defibrination syndrome long-term (current) use of insulin chronic systolic heart failure iron deficiency anemia, unspecified personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits below knee amputation status disorder of bone and cartilage, unspecified diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy wheelchair dependence 

Answer: The patient is high likely exposed to