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: a 48-year-old woman with primary pulmonary hypertension who awoke on the day of admission with a fever of 101.6 accompanied with aches, chills which mildly improved upon taking tylenol. when the patient became more symptomatic however, the patient came to the emergency room. she did not have any localizing complaints except a generalized whole body achiness as well as flu-like symptoms. she denies shortness of breath, cough, sputum production. she denies dysuria, increased frequency, or urgency. she denies any neck pain, nausea, vomiting, diarrhea, constipation, or upper respiratory tract like symptoms. she denies any sick contacts and has not eaten any suspicious foods. she has not taken any new medications. she denies any joint pains or rash. past medical history: 1. primary pulmonary hypertension: the patient has been taking flolan which is a continuous prostacyclin infusion for the past 2.5 years (). the patient says that she has not had any history of line infection and sees dr. , who is on medical leave currently. the patient's baseline blood pressure is 80-110. she says she only gets shortness of breath with exertion. she is also on coumadin and sees dr. in cardiology for her primary pulmonary hypertension as well. 2. history of supraventricular tachycardia/ventricular tachycardia: the patient sees dr. and has had three ablations done in the past. the patient is currently on amiodarone for management of her arrhythmias. 3. glaucoma. 4. status post appendectomy. 5. status post cesarean section. medications: 1. coumadin 2.5 mg po q day except half a tablet on thursday and sunday. 2. prostacyclin 18 ng/kg/min. 3. multivitamin. 4. claritin. 5. cosopt one drop os . 6. xylatan one drop os q hs. allergies: vancomycin causes an itchiness/redness at the head and neck. family history: father died of a myocardial infarction at age 53. social history: patient is married and has two children. she lives at home. she denies any alcohol, or tobacco, or drug use. she manages her flolan infusion on her own. physical examination: general: patient is a thin woman in no acute distress. temperature is 99.3 f, blood pressure 80/40, heart rate 105, respiratory rate 16, oxygen saturation 97% on room air. heent: pupils are equal, round, and reactive to light. extraocular movements are intact. no scleral icterus. oropharynx clear. skin: no peripheral embolic signs, or rash, or splinter hemorrhages. chest: clear to auscultation bilaterally with faint fine and inspiratory crackles. cardiovascular: regular, rate, and rhythm with s1 and variable splitting s2, systolic murmur, visible carotid pulsations were present to the ear. abdomen: soft, nontender, and nondistended, positive bowel sounds. extremities: no clubbing, cyanosis, or edema. neurologic: grossly intact. laboratories: white count 6.6 with a differential of 77 neutrophils, 18 bands, 4 lymphocytes, hematocrit of 41.3, platelets of 141,000. pt of 23, inr of 3.7. sodium of 139, potassium 38, chloride 105, bicarb of 22, bun of 11, creatinine of 1.0, glucose of 107. urinalysis was negative. a tsh 3.3, free t4 1.2, alt 13, ast of 16, total bilirubin of 0.7. chest x-ray showed no evidence of pneumonia, prominent main pulmonary arteries consistent with primary pulmonary hypertension. no pleural effusions. blood cultures and urine cultures were drawn in the emergency room. in the emergency room the patient also received linezolid x1 dose. hospital course: 1. infectious disease: the patient has positive blood cultures growing pseudomonas aeruginosa, the source of which was likely to be from the line for the patient's flolan infusion. the line was removed and the catheter tip culture was positive for pseudomonas. the patient was started immediately on intravenous ceftazidime and tobramycin. a left subclavian line was placed on . the patient also had a further infectious disease workup to identify the source of bacteremia including a transthoracic echocardiogram and a transesophageal echocardiogram which showed no evidence of vegetations, but increased pulmonary artery pressures with new bidirectional flow across the patent foramen ovale. an abdominal ultrasound was performed because the patient complained of some lower abdominal pain which was negative, a urinalysis and urine culture were negative, and a renal ultrasound was also found to be negative. on , the patient became progressively more hypoxic and complained of severe right sided pleuritic chest pain with oxygen desaturation into 79%, which subsequently increased to 100% on 100% nonrebreather. a chest cta was performed to look for evidence of pulmonary emboli, which was negative, but did show evidence of a right lower lobe consolidation with effusion, as well as suspected early cavitation which was thought to be secondary from the patient's pseudomonal bacteremia. on repeat chest ct scan done on , there was a persistence of the right lower lobe consolidation with effusion as well as an increased fluid density opacity within the right lower lobe which was thought secondary to entrapped fluid or early abscess formation. the patient had an ultrasound guided diagnostic thoracentesis performed on , which revealed an exudative fluid, representative of an uncomplicated parapneumonic effusion. the pleural fluid gram stain was negative for any organisms or white cells, however, the fluid culture was positive for rare bacterial growth. it was thought however, that the effusion was still uncomplicated and that the tobramycin with ceftazidime antibiotic treatment, the pneumonia and effusion would resolve after a three week course. on , a picc line was placed for outpatient antibiotic and flolan treatment, and the subclavian line was removed and the tip was sent for culture. the patient is to continue a full three-week course of tobramycin and ceftazidime and if the patient remained afebrile and has no symptoms of infection after stopping the antibiotics for at least one week, the patient will be able to have a permanent central line placed for her continuous flolan infusion. 2. pulmonary: as noted, the patient became progressively more hypoxic during her hospital course with right sided severe pleuritic chest pain. as noted again, the chest cta performed at that time revealed no evidence of pulmonary emboli, but did show right lower lobe pneumonic consolidation and effusion secondary to septic emboli. the patient was transferred to the medical intensive care unit on for her worsening hypoxia. the patient was initially placed on nonrebreather mask ventilation, and then required bipap. because the patient's hypoxia did not improve, elective intubation occurred on . the patient was extubated on and developed post-extubation stridor which was successfully treated with a brief course of steroids. the patient was transferred out of the medical intensive care unit on . her breathing improved remarkably and the patient no longer required oxygen upon transfer out of the micu. her oxygen saturation remained excellent at 97-99% postextubation. additionally, a repeat chest x-ray which was performed on showed an improving right lower lobe consolidation. it terms of the patient's pulmonary hypertension, the patient was continued on her flolan infusion during her entire hospital stay. the patient had her coumadin stopped while in the hospital, and the plan is to restart the patient's coumadin for her primary pulmonary hypertension once the permanent tunnel catheter is placed approximately two weeks after discharge. the patient will follow up with dr. in approximately one month. 3. cardiovascular: the patient was continued on amiodarone throughout her hospital stay given her history of ventricular tachycardia and supraventricular tachycardia. her potassium was repleted to a level greater than or equal to 4.5 for prophylaxis against any arrhythmias. as noted above, a tte performed on revealed a patent foramen ovale with bidirectional shunt across the interatrial septum at rest. the overall left ventricular systolic function was mildly depressed, and the right ventricular cavity was markedly dilated. there was severe global right ventricular free wall hypokinesis. mild dilation of the aortic root. trivial mitral regurgitation was seen. a transesophageal echocardiogram was also performed which revealed similar findings as well as no evidence of endocarditis and presence of tricuspid regurgitation which could not be quantified. 4. gi: the patient complained of mild right upper quadrant tenderness during her hospitalization along with loose stools. the amylase and lipase levels were found to be elevated with peak levels of an amylase of 473 and a lipase of 513. patient's abdominal discomfort subsided with bowel rest, and the patient was placed on prevacid 30 mg po q day for gastrointestinal prophylaxis. the patient's amylase and lipase trended downwards, and the patient remained asymptomatic of pancreatitis. it was thought that the patient's pancreatitis was secondary to a brief use of flagyl which was empirically started on for diarrhea. clostridium difficile toxin studies were sent and were all negative. 5. disposition: the patient will be discharged home with nursing services for home antibiotic treatment as well as flolan. the patient will continue her full three-week course of intravenous antibiotics, and will require tobramycin trough and peak levels drawn during administration. if patient remains asymptomatic and well for one week after discontinuation of antibiotics, she will be eligible for surgical placement of a central catheter for flolan infusion. the patient will follow up with dr. in approximately one month, with dr. in approximately two weeks. the patient will schedule her own surgical appointment for placement of a central line. 6. dermatology: during the hospital course she experienced the development of painful, erythematous nodules on her arms and back as well as lower legs. dermatology was consulted and biopsies were obtained which showed evidence of panniculitis most consistent with erythema nodosum and no evidence of septic emboli. dermatology recommended symptomatic relief. upon discharge, these lesions had been improving. condition on discharge: good. discharge status: to home with services. diagnoses: 1. pseudomonal line sepsis with septic emboli to the lung. 2. right lower lobe pneumonia with fusion, secondary to septic emboli. 3. asymptomatic pancreatitis secondary to flagyl use. 4. primary pulmonary hypertension. 5. history of ventricular tachycardia, supraventricular tachycardia. 6. glaucoma. discharge medications: 1. ceftazidime 2 grams iv q8 hours for a total of 21 days (seven days more). 2. tobramycin 250 mg iv q day for 21 days total (seven days more). 3. flolan 18 ng/kg/min iv continuous infusion. 4. loratadine 10 mg po q day. 5. amiodarone 100 mg po q day. 6. dorzolamide 2%/timolol 0.5% ophthalmic solution one drop ou q hs. 7. lansoprazole 30 mg po q day. 8. latanoprost 0.005% one drop ou q day. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more other esophagoscopy insertion of endotracheal tube pulmonary artery wedge monitoring closed biopsy of skin and subcutaneous tissue diagnoses: pneumonia, organism unspecified unspecified pleural effusion paroxysmal ventricular tachycardia primary pulmonary hypertension infection and inflammatory reaction due to other vascular device, implant, and graft septicemia due to pseudomonas 

Answer: The patient is high likely exposed to