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: no known allergies / adverse drug reactions attending: chief complaint: abnormal labs major surgical or invasive procedure: none history of present illness: 82 year-old woman w/ pmh significant for htn, cutaneous lupus, recent diagnosis of metastatic colon cancer to peritoneal and liver who was admitted last week for bacteremia wiht gp rods (clostridium septicum) and has been on vancomycin and flagyl iv treatment at home. the pt was originally admitted to hospital in (was there on vacation) with back pain and found on ct to have bowel wall thickening and numerous intraperitoneal and hepatic lesions consistent with metastatic disease. she was then transferred to our hospital and had colonoscopy with biopsy of the cecal lesion that showed adenocarcinoma. she had elevated wbc at presentation on at 19k, she had blood culture from the and from that grew clostritium. this was thought to be related to colon ca, she was started on flagyl and vancomycin iv for a total of 14 days on . pt was discharge home with a picc and on iv antibiotics. as per patient's daughters she developed a few days after her last discharge and she had very poor po intake. she also states that flagyl made her very nauseous. in addition she has been taking oxycodone for pain 10mg around twice daily and has increase lethargy and weakness. she denies having any fever, chills, dysuria, hematuria, diarrhea, abd pain. she has daily bm with no blood or melena. she continues to have low back pain which is unchanged from prior. she came today to see dr. and was found to have electrolyte abnormalities with increase in her k, creatine to 1.4 from baseline of (0.4-0.5), and elevated transaminitis with increase t.bili to 2.6. she was then instructed to come to the ed for further evaluation. . in the ed her vitals were 97.2, 88/57, 86, 18, 99% on ra. pt appeared dry on exam and she was given 1l of iv fluids and flagyl. her sbp responded to iv fluids and improved to 110s her vanco level was 34 and it was held. she was found to have new small pleural effusion on her left lung base on cxray and was started on levoquin. she denies having cough, sob, cp or other respiratory symptoms. she was also given oxycodone 2.5mg and tylenol 1gm for pain. . on arrival to the floor, pt appears comfortable. she was afebrile and her vitals were stable with sbp 110s-120s/50s-60s, hr in 60s. she denies having any complains at this time. her foley is to bsd with dark yellow/brown urine. . of note during her last admission on she was found to have psvt, for which she was treaded with adenosine 6mg, and tachycardia resolved. within 24 hours she had two more episodes of svts, again requiring adenosine, so cardiology was consulted who recommended increasing her dose of metoprolol from 50 mg a day to 100 mg a day. her heart rate has been controlled on this medication. . review of systems is negative also for fevers, chills, nightsweats, headache, neck pain, chest pain, sob, palpitations, abd pain, diarrhea, constipation, or changes in her bowel or bladder pattern. she denies joint pain, myalgias, confusion, or depression. past medical history: past medical history: - metastatic colon ca to liver and malignancy, - hypertension - cutaneous lupus, not active (per daughter) - setting of hospitalization social history: has one glass of wine several nights per week. smoked one pack of cigarettes per week until 20 years ago. lives in with her daughter. four daughters and a son, husband died 13 years ago. overall very active up to recent diagnosis family history: mother with breast cancer. sister with cancer but unsure of type, possibly pancreatic. physical exam: admission: vs: 95.6, 68, 130/74, 24, 100% on ra. gen: nad heent: eomi, mmdry with white patches consistant with yeast, mild scleral icterus neck: supple, no jvp noted chest: ctab, except for bil diminished bs at bases cv: rrr, normal s1 and s2, no murmurs abd: soft, nontender, nondistended, bowel sounds present skin: facial splotchy red spots (cutaneous lupus) ext: bil le +1 pitting edema up to ankles neuro: alert, oriented x3, cn 2-12 intact, sensory intact throughout, strength 5/5 bue/ble, fluent speech, normal coordination psych: calm, appropriate pertinent results: imaging: cxr: new small bilateral pleural effusions, with left retrocardiac opacities, may reflect atelectasis. an early superimposed consolidation is not excluded. abd/pelvis u/s 1. patent portal venous system. 2. redemonstration of masses in the liver and porta hepatis, which were characterized to better effect on the comparison ct. 3. no hydronephrosis or nephrolithiasis. 4. non-specific isoechoic projection into the ascites in the pelvis. this raises the possibility of carcinomatosis in this patient with disseminated neoplastic disease. blood counts: 11:45am blood wbc-19.8* rbc-4.38 hgb-13.0 hct-40.2 mcv-92 mch-29.8 mchc-32.4 rdw-14.5 plt ct-450* 05:03am blood wbc-22.4* rbc-3.57* hgb-10.7* hct-33.1* mcv-93 mch-29.9 mchc-32.2 rdw-15.4 plt ct-336 coags: 11:45am blood pt-18.1* ptt-37.1* inr(pt)-1.6* 10:48pm blood pt-23.1* ptt-41.6* inr(pt)-2.2* chemistry: 11:45am blood urean-40* creat-1.4* na-132* k-5.7* cl-100 hco3-18* angap-20 05:03am blood glucose-120* urean-50* creat-1.8* na-133 k-5.5* cl-104 hco3-18* angap-17 09:30am blood uricacd-8.1* 09:30am blood hapto-<5* 11:45am blood tsh-3.0 11:45am blood cea-7.3* 02:56pm blood glucose-146* lactate-5.6* k-greater th 03:41pm blood lactate-4.7* k-5.2 07:40pm blood lactate-3.4* 01:51am blood lactate-2.7* k-5.3 . lfts: 11:45am blood alt-70* ast-260* ld(ldh)-738* alkphos-1059* totbili-2.6* dirbili-2.0* indbili-0.6 02:50pm blood alt-155* ast-732* alkphos-946* totbili-2.4* 10:48pm blood alt-490* ast-3004* alkphos-978* totbili-2.7* 05:03am blood alt-606* ast-4030* ld(ldh)-* alkphos-1165* totbili-4.7* blood gas: 01:51am blood type-art temp-35.6 po2-71* pco2-25* ph-7.48* caltco2-19* base xs--2 intubat-not intuba micro: blood cx gpcs in pairs and clusters brief hospital course: 82 year-old woman w/ pmh significant for htn, cutaneous lupus, recent diagnosis of metastatic colon cancer to peritoneal and liver who was admitted 1 week prior for bacteremia with gp rods (clostridium septicum) and returned for abnormal labs found during outpatient visit. on the day of admission, mrs. came to see dr. and was found to have electrolyte abnormalities with increase in her k to 5.7, creatine to 1.4 from baseline of (0.4-0.5), and elevated transaminitis with increase t.bili to 2.6. given lab abnormalities, she was then instructed to come in to the ed for further evaluation. she also had an elevated wbc at 19.8 with left shift. during her initial presentation in in her wbc was 19k, she had blood culture from the and from that grew clostritium. this was thought to be related to colon ca, she was started on flagyl and vancomycin iv for a total of 14 days on . on her admission she was still on flagyl and her vanco level was in the 30s, so this was not given in the ed. she was afebrile and had only one episode of hypotension at 88/57 for which she responded appropriately to 1 l of iv fluids. her lactate was initially elevated at 5.6 and was trending down with iv fluids. she was found to have new small pleural effusion on her left lung base on cxray and was started on levoquin. she denies having cough, sob, cp or other respiratory symptoms. she was admitted to the icu for close monitoring and concern for sepsis. she remained afebrile and her vitals remained stable with sbp in 110s-120s/50s-60s, hr in 60s. overnight, her lfts continued to trend up (peaking alt at 606, ast at 4030, ld , alkphos 1165 and totbili-4.7). she also had increase in inr from 1.6->2.2. there was a concern for acute liver failure and/or portal obstruction. pt had known metastatic disease to the liver. a liver us w/ doppler was done in the middle of the night which showed patent portal venous system, redemonstration of masses in the liver and porta hepatis, no hydronephrosis or nephrolithiasis, non-specific isoechoic projection into the ascites in the pelvis. this raises the possibility of carcinomatosis in this patient with disseminated neoplastic disease. pt was afebrile and had no active signs of infection. she did not appear septic, she had one bp that was low 88/50s and she responded well to fluids. her lactate was elevated and this was thought to possibly be due to hypovolemia and dehydration, since it had been trending down with iv fluids. she also had been covered with vanco and flagyl for the last 9 days. last + blood culture was on prior to starting antibiotics. however given that pt had metastatic colon cancer to liver and peritoneum pt could have gn infection. she was continued on flagyl and then her abx were broadened to zosyn/clinda. even before receiving these antibiotics, on the morning after admission, she suddenly became bradycardic and pea arrested. she was coded by the icu team for ~15 minutes and then per patient's family's request, resuscitation efforts were stopped. the patient expired with daughter at the bedside. family requested post-mortem exam. medications on admission: not recorded prior to patient's death discharge medications: patient expired discharge disposition: expired discharge diagnosis: patient expired discharge condition: patient expired discharge instructions: patient expired followup instructions: patient expired md procedure: insertion of endotracheal tube cardiopulmonary resuscitation, not otherwise specified diagnoses: acidosis systemic lupus erythematosus hyperpotassemia malignant neoplasm of liver, secondary unspecified essential hypertension acute kidney failure, unspecified sepsis pulmonary collapse defibrination syndrome cardiac arrest iron deficiency anemia, unspecified dehydration septicemia due to anaerobes diverticulosis of colon (without mention of hemorrhage) internal hemorrhoids without mention of complication malignant neoplasm of other specified sites of large intestine secondary malignant neoplasm of adrenal gland other specified disorders of circulatory system 

Answer: The patient is high likely exposed to