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: sulfa (sulfonamides) / bactrim attending: chief complaint: weakness major surgical or invasive procedure: none history of present illness: year old female presents with gi bleed in setting of elevated inr, and hypothermia/hypotension. patient with h/o of recent pneumonia treated with levofloxacin and on coumadin 1mg qday for afib. she was found at her rehab facility weak, slumped on bathroom floor. noted to have loose heme positive stool over several days. wbc 18, inr >11. treated with vitamin k 10mg po and levoflox 750mg po x1. of note patient also with recent seizures since . seen by neurologist who ordered mri and eeg. eeg nl. recent swall eval with micro aspirations with thin liquids, and the patient has been on nectar thick liquids. in the ed the patient was noted to be hypothermic (temp 33c) and mildly hypotensive 70's-90's. guiac+ stool. given 10mg vitamin k. given 1u prbc and 2u ffp. ct head neg for mass/bleed. ct torso with multilobar pna but without evidence of retroperitoneal bleed. she was admitted to the intensive care unit, at which time she denied fevers, chills, chest pain, shortness of breath, abdominal pain, dysuria. no cough but niece noted that patient was "gurgling" and that food sometimes "gets stuck" when she swallows past medical history: chf h/o bradycardia afib on low dose coumadin critical as h/o breast ca s/p mastectomy in 's h/o zoster with post-herpetic neuralgia on r ribs htn hypothyroidism h/o mrsa uti chronic diarrhea h/o aspiration s/p pneumovax social history: lives at nursing home; grand-niece is health proxy family history: nc physical exam: in ed: pe: vs t 93.0 p 96 bp 102/42 r 15 o2 98% on ra gen - a+ox3, nad heent - op clear, eomi, perrl neck - supple, no lad chest - crackles at bases, scrape on r side of chest, mild bleeding, no erythema or pus cor - rrr, sys murmur abd - s/nt/nd +bs ext - w/wp, no edema rectal - guaic neg per ed transfer to icu: pe: vs 94.2 129/77 80 18 o2 95on 2l gen - a+ox3, nad heent - op clear, eomi, perrl; drymm neck - supple, no lad chest - crackles at right base cor - rrr, sys murmur abd - s/nt/nd +bs ext - w/wp, no edema pertinent results: admission: wbc-17.0 hgb-12.3 hct-38.5 mcv-96 rdw-15.9 neuts-93.7 bands-0 lymphs-4.5* monos-1.4* eos-0.2 basos-0.2 pt-150* ptt-131.9* inr(pt)->22.8 glucose-83 urea n-60* creat-2.2* sodium-145 potassium-5.7* chloride-113* total co2-17* lactate-2.4* u/a: nitrite-neg protein-30 glucose-neg ketone-tr bilirubin-sm urobilngn-neg ph-5.0 leuk-neg rbc-* wbc-0-2 bacteria-few yeast-none epi- discharge: wbc-11.3 hgb-12.1 hct-34.5 mcv-87 rdw-15.8 plt ct-62 neuts-93.7* bands-0 lymphs-4.5* monos-1.4* eos-0.2 baso-0.2 pt-13.4* ptt-30.1 inr(pt)-1.2* glucose-87 urean-26* creat-1.3* na-144 k-4.6 cl-103 hco3-34 radiology: ct torso w/o contrast: patchy tree-in- opacities in the right upper lobe. there are more dense mixed consolidative and ground glass opacities in the lower lobes and within the right middle lobe. trace pleural effusions. there are multiple prominent but relatively small mediastinal lymph nodes up to 7 mm in shortest dimension. mild prominence of the central hepatic bile ducts without definite intrahepatic biliary ductal dilatation. the extrahepatic common duct measures up to 6 mm. the gallbladder is massively distended, measuring up to 13 cm in length. there is no definite surrounding inflammatory change, however, and no radiopaque stones are visualized. particularly without intravenous contrast administration, further evaluation, however, is highly limited. the pancreatic head is poorly visualized but appears perhaps slightly enlarged and may have a double duct sign raising at least the suspicion of an underlying mass. the spleen and adrenal glands are unremarkable. particularly the right kidney is highly atrophic, but there is also left renal cortical thinning. there are vascular calcifications noted but no aortic aneurysm. there is extensive involvement of the left ischium with paget's disease and lesser involvement of the left ilium. the bones are diffusely demineralization. there is leftward convex scoliosis of the lumbar spine with degenerative changes, including intervertebral disc space narrowing and osteophytes throughout the lumbar spine, extending from the t11-t12 through the l5-s1 interspaces. there are posterior osteophytes from the level of t12- l1 through l3-l4. ct head w/o contrast: there is no intracranial hemorrhage. there is no midline shift, mass effect or hydrocephalus. there are periventricular white matter hypodensities most consistent with chronic microvascular ischemic changes. there are small lacunes within the right cerebellar hemisphere. there is an air-fluid level in the right maxillary sinus with adjacent mucosal thickening. this fluid is of high density and could represent inspissated secretions vs. blood. no facial fractures are identified on these limited images. cxr: : bibasilar opacities concerning for pneumonia. right lung base atelectasis. no congestive heart failure. no pleural effusion. ct c spine: no acute fractures or dislocations. multilevel degenerative changes with at least moderate spinal canal narrowing at c4-5 due to osteophytes and a central disc protrusion. u/s: : dilated gallbladder with stones in its lumen. no ericholecystic fluid, gallbladder wall thickening, or son sign. intra- or extra-hepatic biliary ductal dilation. the pancreas and pancreatic duct are not well assessed. cxr: moderate right and small-to-moderate left pleural effusions are unchanged. bibasilar consolidation is present and slightly worse on the left in the interval. multifocal poorly defined upper lobe opacities have slightly worsened and likely correspond to areas of bronchocentric opacification on recent ct torso. the constellation of findings is most consistent with a multifocal infection. tte: the left atrium is normal in size. the estimated right atrial pressure is 11-15mmhg. there is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (lvef>55%). regional left ventricular wall motion is normal. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are severely thickened/deformed. at least mild aortic valve stenosis is present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. significant aortic valve stenosis - ?mild. mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. mild-moderate mitral regurgitation. pulmonary artery systolic hypertension. bilateral pleural effusions. brief hospital course: year old female presents with gi bleed in setting of elevated inr and hypothermia/hypotension, found to have a multilobar aspiration pneumonia.. 1) gi bleed/acute blood loss anemia: this was most likely an upper source, given melena, in the setting of markedly elevated inr 22. she was initially admitted to the intensive care unit, where her inr was reversed with ffp and vitamin k. the gastroenterology service was consulted, but the patient and her health care proxy declined further work-up (egd/colonoscopy). at time of discharge, her hematocrit was stable at 34.5. she was maintained off coumadin. 2) sepsis due to aspiration pneumonia: in the icu, the patient was fluid resuscitated and covered with zosyn/vancomycin with stabilization of blood pressure. she had a speech and swallow evaluation, which recommended soft diet/thin liquids with no mixed consistencies. at time of discharge, she was on oxygen for comfort, 100% 2l nc. she was transitioned to oral antibiotics (cefpodoxime/metronidazole) to complete a 14 day course. 3) bilateral pleural effusions/chf: the patient developed bilateral pleural effusions, noted on chest x-ray . given suspicion for fluid overload, she was gently diuresed with iv lasix without significant change in size of effusions. although these effusions could represent parapneumonic effusions, both the patient and her healthcare proxy declined thoracentesis, given their goal of comfort-oriented care (see below). at time of discharge, she was stable on 100% 2l nc; she will complete a 14 day antibiotic course as above. 4) thrombocytopenia: the patient's platelet count dropped from 165 on admission to 62 (stable since ). this may have been related to consumption from gi bleed versus sepsis-related bone-marrow suppression. the patient's fibrinogen was elevated, not consistent with dic. the patient does not desire further blood draws and has decided to pursue hospice at rehab. 5) atrial fibrillation: the patient was noted to have significant pauses on telemetry, however, she did not desire a pacemaker. she had a tte which showed ?mild as, 1+ ar, + mr, + tr, ef >55%. she was continued off coumadin given gi bleed (see above). 6) seizure disorder: the patient has not had a seizure in over 2 weeks and recent eeg was without epileptiform activity. there had been concern that, given her history of cancer, she could have a metastatic focus in the brain that may have triggered her prior seizures. however, the patient did not desire further testing (mri head, etc.) given her goal of comfort-oriented care. 7) hypothyroidism: the patient was continued on her home dose of synthroid. 8) acute renal failure: the patient's creatinine improved to 1.3 from 2.2 on admission with hydration. the acute renal failure was most likely due to atn in the setting of sepsis. 9) breast mass/pancreatic mass: these had been incidentally noted on prior imaging. the patient does not desire treatment or further diagnostic testing. 10) goals of care: extensive discussions were held with the patient and her health care proxy with regards to his goals of care. they would like to complete the planned course of antibiotics for her aspiration pneumonia, but do not desire further tests or invasive procedures (mris, thoracentesis, lab draws, biopsies). they decided to pursue hospice care, and the patient was discharged back to rehab with hospice nursing services. medications on admission: meds: tylenol prn atrificial tears fluticasone 110mcg 2puff qday flonase 1 spray neurontin 400mg tid lactobacillus synthroid 50mcg qday lidocaine patch 5% tp qday oxycodone 2.5mg prn kcl 20meq qday bacitracin ointment to chest clotrimazole 1% to rectum . discharge medications: 1. acetaminophen 325 mg tablet : 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 2. polyvinyl alcohol 1.4 % drops : 1-2 drops ophthalmic prn (as needed). 3. erythromycin 5 mg/g ointment : 0.5 inch ophthalmic qid (4 times a day) for 7 days. 4. fluticasone 110 mcg/actuation aerosol : two (2) puff inhalation (2 times a day). 5. levothyroxine 50 mcg tablet : one (1) tablet po daily (daily). 6. gabapentin 300 mg capsule : one (1) capsule po q48h (every 48 hours). 7. albuterol sulfate 0.083 % solution : one (1) neb inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 8. cefpodoxime 100 mg tablet : two (2) tablet po q12h (every 12 hours) for 6 days. 9. metronidazole 500 mg tablet : one (1) tablet po tid (3 times a day) for 6 days. 10. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr po bid (2 times a day). discharge disposition: extended care facility: for the aged - ltc discharge diagnosis: primary: aspiration pneumonia secondary: pleural effusions, blood loss anemia, gastrointestinal bleed, thrombocytopenia, congestive heart failure (left), acute renal failure discharge condition: stable discharge instructions: please follow-up as indicated below followup instructions: please follow-up with your primary care physician . () within 1-2 weeks following discharge md procedure: transfusion of packed cells transfusion of other serum diagnoses: thrombocytopenia, unspecified abnormal coagulation profile acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia unspecified septicemia severe sepsis unspecified acquired hypothyroidism atrial fibrillation aortic valve disorders personal history of malignant neoplasm of breast other convulsions unspecified fall pneumonitis due to inhalation of food or vomitus lump or mass in breast hemorrhage of gastrointestinal tract, unspecified unspecified disease of pancreas history of fall 

Answer: The patient is high likely exposed to