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: ceftriaxone attending: chief complaint: saddle pulmonary embolus major surgical or invasive procedure: ivc filter placement by interventional radiology history of present illness: pt is a 79 y/o f with unknown pmhx, who presented to the ed with generalized weakness and doe for the past week. she presented earlier this week to her pcp, was planning ot see her in follow-up on friday. however, her symptoms progressed, and she ultimately presented to an osh ed today, where she was found to have a large saddle pulmonary embolus. while at the osh, she received 100 mg tpa. she was hypoxic to the 80's on nc and was placed on nrb. on arrival to the ed, she was started on a heparin gtt after her tpa was completed. labs were significant for troponin 0.11, bnp 3456, lactate 4.8. per report, k was low at osh; repeat here was 5.2 but was hemolyzed. wbc 18.7. cxr was unremarkable. bedside ultrasound was performed and "generous" rv with some septal bowing during systole. ecg showed twi in v1-v4. bp's were borderline in the ed; she received a total of 1 l ns. vs prior to transfer bp 98/50, hr 75, 100% on nc. on arrival to the micu, the patient endorsed some mild sscp that was non-radiating. she reports chronic ble swelling and tightness, which has been worse recently (r>l). no other complaints. past medical history: - lower extremity edema - htn - "phlebitis" vs. dvt during her pregnancies - gerd - insomnia social history: tobacco: denies. alcohol: denies. illicits: denies. lives alone in a senior complex. son recently died etoh; daughter attempted suicide as a result. family history: many family members with depression. mother with ovarian cancer (at 35) and colon cancer (at 75). father with throat cancer, alzheimer's. 2 brothers with skin cancer, one with ?lymphoma. physical exam: admission: vitals: t: 99.1 bp: 136/68 p: 74 r: 16 o2: 995 nc general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, ble edema, increased warmth erythema of medial distal rle neuro: cnii-xii intact, 5/5 strength upper/lower extremities discharge: vs: 98.4 116/57 79 18 99% ra skin: back, buttocks and thighs with pruritic maculopapular rashes. no ulcerations or skin openings. otherwise essentially unchanged. pertinent results: admission labs: 05:30pm ctropnt-0.11* 05:30pm probnp-3456* 05:33pm lactate-4.8* 05:30pm glucose-132* urea n-32* creat-1.2* sodium-137 potassium-5.2* chloride-104 total co2-20* anion gap-18 05:30pm wbc-18.7* rbc-4.26 hgb-12.9 hct-38.2 mcv-90 mch-30.3 mchc-33.8 rdw-13.6 discharge labs: 06:10am blood wbc-7.6 rbc-3.87* hgb-11.6* hct-34.9* mcv-90 mch-29.9 mchc-33.2 rdw-14.2 plt ct-222 06:10am blood pt-18.7* ptt-110.4* inr(pt)-1.8* 06:10am blood glucose-98 urean-10 creat-0.7 na-143 k-4.5 cl-108 hco3-29 angap-11 06:10am blood calcium-8.6 phos-3.8 mg-2.3 chest x-ray (): single ap portable chest radiograph was provided. subtle hazy opacity at the right base which may represent atelectasis; however, early infection cannot be excluded. the lungs are otherwise clear. there is no pleural effusion or pneumothorax. heart size is top normal; however, this may be due to ap projection. there are no acute skeletal abnormalities. impression: subtle hazy opacity right base is most likely atelectasis but cannot exclude early infectious process. lower extremity doppler : impression: 1. deep venous thrombosis involving the right mid femoral vein extending into the popliteal vein. no evidence of below-knee dvt on the right side. 2. on the left side there is non-occlusive thrombus in the popliteal vein extending into the left peroneal vein. echocardiogram : the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef 65%). the right ventricular free wall is hypertrophied. the right ventricular cavity is mildly dilated with depressed free wall contractility. there are focal calcifications in the aortic arch. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. there is no pericardial effusion. ivc filter placement : impression: 1. placement of a bard eclipse ivc filter into the infrarenal inferior vena cava via a femoral approach. 2. no evidence of ivc thrombus or ivc duplication anomalies on ivc venogram which preceded ivc filter placement. microbiology: ucx : klebsiella pneumoniae. >100,000 organisms/ml.. cefazolin interpretative criteria are based on a dosage regimen of 2g every 8h. piperacillin/tazobactam sensitivity testing available on request. klebsiella pneumoniae. 10,000-100,000 organisms/ml.. 2nd morphology. cefazolin interpretative criteria are based on a dosage regimen of 2g every 8h. piperacillin/tazobactam sensitivity testing available on request. sensitivities: mic expressed in mcg/ml _________________________________________________________ klebsiella pneumoniae | klebsiella pneumoniae | | ampicillin/sulbactam-- 4 s <=2 s cefazolin------------- <=4 s <=4 s cefepime-------------- <=1 s <=1 s ceftazidime----------- <=1 s <=1 s ceftriaxone----------- <=1 s <=1 s ciprofloxacin---------<=0.25 s <=0.25 s gentamicin------------ <=1 s <=1 s meropenem-------------<=0.25 s <=0.25 s nitrofurantoin-------- 128 r <=16 s tobramycin------------ <=1 s <=1 s trimethoprim/sulfa---- <=1 s <=1 s brief hospital course: transitional issues: restarting home antihypertensives as patient's clinical status stabilizes. pt was restarted on 5 mg of lisinopril (20 mg daily at home). her metoprolol was held as we did not want to interfere with compensatory tachycardia if pt needed it (home dose 50 mg metoprolol succinate daily). she had recently been started on diltiazem, which was stopped. lasix was also held as we did not want to decrease her preload, and the recently increased swelling were thought to be due to dvt. it can be restarted in the future if lower extremity swelling does not improve with treatment of dvt. patient will need to make sure that her cancer screening is up to date as an outpatient to rule out hypercoagulable state. hypercoagulable work up is not recommended during this acute episode of clot, but can be considered in the future. patient will also need an appointment with interventional radiology to remove the retrievable ivc filter in about weeks. ir is aware and will be contacting the patient to make the appointment. ============================ 79 yo f with pmh of chronic lower extremity swelling and htn who presented to the ed with generalized weakness and doe for the past week, found to have saddle pe and bilateral dvt, now s/p tpa and on heparin gtt/coumadin. pt also had troponin leak to 0.11 and evidence of right heart strain on bedside echocardiogram so underwent ivc filter placement to prevent further clot burden. she was continued on heparin gtt/coumadin until her inr was therapeutic. # pe/bilateral dvt: pt is now s/p tpa and on heparin gtt/coumadin. given a bedside echo with reported evidence of right heart strain and troponin leak to 0.11, underwent placement of ivc filter. patient stable in terms of respiratory status. unclear etiology for pt's pe, ?history of "phlebitis" with her 9 pregnancies, but no obvious clotting history. patient also reports normal mammogram 1 year ago, and had colonoscopy 5 years ago but does not know the result, as she did not follow up. patient received 100 mg tpa at osh prior to admission to the micu. bedside ultrasound showed large rv with some septal bowing during systole. ecg showed twi in v1-v4. the patient's respiratory status improved and the patient was weaned from nrb to nc. she was put on a heparin gtt and lenis showed bilateral dvts (rle femoral to popliteal occlusive thrombus, lle popliteal nonocclusive thrombus). she had ivc filter placed given the extent of her saddle emboli and bilateral dvt. it was thought that risk of further clot burden would be of significance. after the ivc filter was placed, she was started on coumadin with goal inr of . echocardiogram was also obtained to evaluate for evidence of right heart strain, given the report of septal bowing seen on bedside echocardiogram in the icu. the formal echocardiogram showed mild rv dilation but no bowing or other evidence of strain/failure. patient was seen by pt and was recommended discharge to rehab for conditioning/strengthening. # hypertension: patient's antihypertensives were held initially given that her bp was borderline low on admission. as her treatment for pe continued, her blood pressure improved, likely due to decreased strain on rv. as we did not want to beta-block the patient to allow her compensatory tachycardia if needed, she was started on low dose lisinopril only and her blood pressure remained within normotensive range. her metoprolol was not restarted on discharge, but can be restarted as an outpatient if needed. # insomnia/anxiety: patient with anxiety over her pe/dvt and ivc filter placement. she also has had recent loss of her son, suicide of her son's gf and overdose of her daughter. social work and pastoral care were consulted and patient appreciated their care. # : unclear baseline. with treatment of her pe, her creatinine improved. # uti: patient had fevers, found to have urinary tract infection. she was treated with iv ceftriaxone for 3 days. patient developed rash that was thought to be due to allergic reaction to ceftriaxone, so it was stopped. medications on admission: lisinopril 20 mg 1 tab qd toprol xl 50 mg 24 hr, 1 tab qd lasix 20 mg 1 tab qd zolpidem 10 mg 1 tab qd discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 4. acetaminophen 325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for fever or pain. 5. ambien 5 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. 6. hydrocortisone 0.5 % cream sig: one (1) appl topical (2 times a day) as needed for itching for 5 days. 7. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed for itching. 8. diphenhydramine hcl 12.5 mg tablet, chewable sig: one (1) tablet, chewable po q6h (every 6 hours) as needed for itching/pruritus. discharge disposition: extended care facility: nursing and rehab centre discharge diagnosis: primary diagnosis: saddle pulmonary embolus, deep vein thrombosis secondary diagnosis: hypertension, lower extremity swelling, drug rash discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear ms. , thank you for allowing us to participate in your care at . you were admitted because you had large blood clots in your lungs (saddle pulmonary embolus). we also found that you had blood clots in your legs, and we treated the blood clots in your lungs and legs with a blood thinner called heparin. you will also have placement of a filter (ivc filter) in one of your blood vessels to help prevent future clots in your lungs. these changes were made to your medications: stop diltiazem stop lasix for now, this can be restarted in the future if you have worsening lower extremity swelling decrease lisinopril to 5 mg daily decrease ambien to 5 mg at bedtime as needed for sleep. given your age, it is recommended that you take the smaller dose. start warfarin 2 mg daily (please follow directions from your facility and from your pcp to change the warfarin doses) start colace/senna twice daily for constipation start acetaminophen (tylenol) 325-650 mg every 6 hours as needed for pain/fever. do not take more than 3000 mg daily. start hydrocortisone 0.5 % cream. apply to skin twice a day as needed for itching/rashes for up to 5 days. please avoid face/armpit/groin areas. start camphor-menthol (sarna) lotion. apply to skin up to 4 times a day as needed for itching/rashes. start diphenhydramine (benadryl) 12.5 mg every 6 hours as needed for itching/pruritus. followup instructions: please call and make an appointment with your primary care physician once you are discharged from the long term acute care facility. please follow up with your doctor regarding your cancer screening. interventional radiologists will be calling you to schedule a removal of your ivc filter. please make this appointment in about 4-6 weeks from . procedure: interruption of the vena cava angiocardiography of venae cavae diagnoses: esophageal reflux urinary tract infection, site not specified unspecified essential hypertension friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site anxiety state, unspecified unspecified disorder of kidney and ureter dermatitis due to drugs and medicines taken internally acute venous embolism and thrombosis of deep vessels of proximal lower extremity insomnia, unspecified heart disease, unspecified cephalosporin group causing adverse effects in therapeutic use family history of malignant neoplasm of ovary saddle embolus of pulmonary artery 

Answer: The patient is high likely exposed to