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: this is an 80-year-old woman with history of chronic lower back pain status post multilevel laminectomy in the past. the patient underwent spinal nerve block on , and thereafter developed increasing pain in that area per her report. the patient was seen in pain clinic on , at which time, an mri was obtained of her spine due to the increased pain. this outpatient mri showed a question of osteomyelitis at t12/l1 disk level with possibility of an abscess versus degenerative joint disease. the patient was sent to the emergency room by her primary care physician due to these findings. in the emergency room, the patient was evaluated by neurosurgery. the patient also received dilaudid with the relief of pain. the patient denied fever, chills, or other complaints. the patient denied any bowel or bladder symptoms or numbness or tingling or weakness. the patient's only complaint was of chronic lower back pain predominantly in the right side radiating to her right groin, which was somewhat increased from her baseline. past medical history: lower back pain, chronic l12/l1 laminectomy in . l3-5 fusion, nerve block in . vancomycin-resistant enterococcus approximately 10 years ago. also history of helicobacter pylori. social history: denies alcohol or tobacco. lives with her husband. medications at home: 1. dilaudid p.r.n. 2. percocet p.r.n. 3. levoxyl 300 once a day. 4. folate 1 once a day. 5. naproxen. 6. labetalol, unknown dose. 7. protonix once a day. 8. ambien p.r.n. allergies: the patient reports allergies to sulfa medications as well as ciprofloxacin and macrobid. physical examination: on admission, temperature 96.6 degrees, blood pressure 137/70, heart rate 67, respirations are 20, saturating 100 percent on room air. generally, an elderly woman in no apparent distress. physical examination notable for normal heart and lung exam. benign abdomen. normal rectal tone. cranial nerves intact, 5/5 strength throughout. normal but somewhat guarded gait. no edema. sensation grossly intact throughout. diagnostic data: on admission, notable for bun and creatinine of 52/2.1 slightly above her baseline of 1.1-1.8 creatinine. hematocrit of 30, stable at her baseline. white blood count 7. concise summary and hospital course: an 80-year-old woman with chronic low back pain status post laminectomy in the past as well as nerve block to l3 on who presents with increasing low back pain. an outpatient mri concerning for possible osteomyelitis at t12-l1 and sent to the emergency room. the patient denied any symptoms, otherwise, however. question of osteomyelitis. outpatient mri concerning for osteomyelitis was discussed. the patient without any signs or symptoms of this, however. the patient's pain subjectively was worse than her baseline, however. the patient's crp was elevated and sedimentation rate was 50. the patient's white blood count remained normal. tagged white blood cell scan showed possible abscess or bone pathology. the patient, therefore, was consented for and underwent open neurosurgical biopsy by dr. . pathology and cultures from that has been unrevealing so far with gram stain showing only 2 plus polymorphoneutrophils. at the time of discharge, cultures were still no growth to date including afb and fungal. infectious disease followed the patient throughout her hospital stay and given the lack of signs or symptoms or definitive evidence of infection, antibiotics were not administered. the patient is to follow up with neurosurgery as well as her primary care physician for followup of culture data. if the culture continues to be negative, the plan is to continue to hold off antibiotics and radiologic finding was likely due to chronic degenerative disk changes. pain. the patient has chronic lower back pain as well as later on pain associated with the open nerve surgical biopsy. the patient was initially, prior to the open biopsy, treated with dilaudid p.r.n. her oxycontin was changed to methadone. pain consult followed the patient throughout her hospital stay. of note, the patient complained of excruciating pain even when she was quite somnolent and falling asleep easily. the patient likely with some narcotic dependence at this point due to her chronic narcotic use. the patient is to follow up with outpatient pain clinic. cardiovascular. the patient's cardiovascular status was stable with stable vital signs without signs or symptoms of ischemia. the patient is to continue on her beta-blocker. hypothyroidism. the patient is to continue on her synthroid and clinically euthyroid. prophylaxis. the patient is maintained on subcutaneous heparin and cardiopulmonary rehab throughout her hospital stay. condition on discharge: stable. discharge status: to home with services. discharge diagnoses: chronic lower back pain. hypothyroidism. discharge medications: 1. labetalol 100 b.i.d. 2. senna p.r.n. 3. synthroid 150 once a day. 4. folic acid 1 once a day. 5. alprazolam 1 q.h.s. 6. multivitamin q.d. 7. colace b.i.d. 8. bisacodyl p.r.n. 9. pantoprazole 40 once a day. 10. psyllium p.r.n. constipation as well as q.h.s. 11. gabapentin 100 t.i.d. 12. methadone 10 q.i.d. 13. cyclobenzaprine 10 t.i.d. 14. hydromorphone 2 mg tablet 1 tablet q.3-4h. p.r.n. followup plans: the patient is to follow up with her primary care physician, . within 2 weeks. the patient is to follow up with pain clinic within 1-2 weeks. the patient is to follow up with dr. of neurosurgery in 1 or 2 weeks. , procedure: excision of intervertebral disc transfusion of packed cells insertion of catheter into spinal canal for infusion of therapeutic or palliative substances systemic to pulmonary artery shunt diagnoses: unspecified essential hypertension acute posthemorrhagic anemia unspecified acquired hypothyroidism unspecified osteomyelitis, other specified sites other and unspecified disc disorder, thoracic region 

Answer: The patient is high likely exposed to