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: bactrim attending: chief complaint: found unresponsive, cardiac arrest (pea) major surgical or invasive procedure: 1. intubation 2. mechanical ventilation 3. central line 4. femoral arterial line history of present illness: 88 year old woman with dementia (a&ox2), congestive heart failure (ef50%), coronary artery disease with stent to rca and otherwise three-vessel disease, mild-moderate mr/ar, complete heart block s/p pacemaker, h/o uti with mdr e. coli, recent admission for nstemi (2/8-9/), who was in her usual state of health until found unresponsive this morning at her nursing home (), at 7am. per the patient's family, she had "not been feeling well" the day prior and had been complaining of left thigh pain. . when ems arrived at the nursing home, patient had coma score of 3. she was intubated. patient reportedly had spontaneous movements and faint carotid pulse en route to the hospital. . upon arrival to the ed, the patient became pulseless upon transfer from stretcher to bed. the initial rhythm was pea. chest compressions were started and 1 mg of epinephrine given. patient had return of spontaneous circulation, although pressures were systolic 50-60. rij central line was placed and levophed gtt started. patient was bolused 1l normal saline. patient's pressure remained labile, from 50-60 to 140s intermittently over a course of 20 minutes before pulse was lost again, with the rhythm being pea. patient received an additional 1 mg of epinephrine. femoral arterial line was placed. her pulse returned and her pressures have been systolic 130s since. she was started on phenylephrine as well as the levophed gtt after the second pea arrest. . stat labs returned with lactate 13.7 and hct initially 18 (baseline from was 30), troponin 0.54. given the hematocrit, patient had fast done at bedside which was negative, guaiac positive (brown stool), received 2 units of uncrossed prbc. she received 2mg versed for sedation but was not started on a drip. also empirically given vancomycin/zosyn. . the patient was sent for ct head and torso. the ct torso showed a left sided retroperitoneal bleed in the setting of ptt of 150 (possibly secondary to heparin flushes for her picc line). the patient received 50mg iv protamine to reverse the ptt prior to transfer to ccu. also had received a total of 2.5l normal saline iv. surgery evaluated patient briefly in the ed following rp bleed seen on ct and did not recommended operative therapy. upon transfer, patient hr78, bp164/64, vent settings (assist control, fio2100%, rr 28, tv 450) but satting 100%. . on review of systems, patient intubated/sedated and unable to provide history. past medical history: 1. cardiac risk factors: -diabetes, +dyslipidemia, +hypertension 2. cardiac history: hypertension hyperlipidemia cad s/p nstemi in -9/, in with bms, and another mi in with stent to proximal rca complete heart block status post pacemaker in 03/. 3. other past medical history: - asthma - s/p thyroidectomy in - osteopenia, osteoarthritis, and chronic pain - gerd - chronic diaphoresis: tsh and ppd normal - glaucoma - shoulder bursitis - mdr e. coli uti with bacteremia: sensitive only to meropenem, zosyn, amikacin social history: retired, worked as a . currently living in senior living home. has 3 children (, , and ) who live nearby and are very involved in her care. she also has a granddaughter, , who is also involved. -tobacco history: denies -etoh: denies -illicit drugs: denies family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. mother with mi at age 70. no other cardiac hx, dm, or cancer. physical exam: admission physical exam: general: intubated. synchronous with vent. responds to commands. heent: ncat. sclera anicteric. left pupil round and reactive. right pupils appears post-surgical. neck: right ij in place. cardiac: rrr, normal s1, s2. no m/r/g. lungs: ventillated breath sounds. clear to auscultation anteriorly. abdomen: soft, mildly tender. no rebound or guarding. extremities: 2+ bilateral pitting edema. neuro: oriented x 2. responds to commands. moves upper extremities but not lower extremities. says she can sense light touch in lower extremities. toes downgoing bilaterally. . discharge physical: n/a pertinent results: pertinent laboratories results 05:39pm wbc-10.1 rbc-2.71*# hgb-8.5*# hct-24.4* mcv-90 mch-31.2 mchc-34.8 rdw-16.7* plt ct-72* 11:00am wbc-7.2 rbc-2.02* hgb-5.7* hct-18.9* mcv-94 mch-28.4 mchc-30.3* rdw-20.9* plt ct-173 04:44pm pt-15.2* ptt-48.1* inr(pt)-1.3* 11:00am pt-15.9* ptt-150* inr(pt)-1.4* 11:09am fibrino-138* 03:01am fibrino-149* 01:59pm fibrino-124* 04:44pm creat-1.3* na-132* k-4.3 cl-107 11:00am glucose-93 urean-21* creat-1.1 na-141 k-5.1 cl-104 hco3-8.0* angap-34* 04:44pm ck(cpk)-951* 03:01am alt-112* ast-458* ld(ldh)-910* ck(cpk)-727* alkphos-77 totbili-1.2 11:00am alt-51* ast-154* ck(cpk)-336* alkphos-99 totbili-0.3 04:44pm ck-mb-14* mb indx-1.5 ctropnt-0.60* 01:59pm ck-mb-7 ctropnt-0.49* 04:44pm calcium-7.2* mg-2.2 11:00am albumin-1.4* calcium-6.5* phos-6.1* mg-2.1 05:22pm type-art temp-33.8 po2-181* pco2-29* ph-7.20* caltco2-12* base xs--15 11:27am type-art tidal v-350 peep-5 fio2-50 po2-84* pco2-28* ph-7.33* caltco2-15* base xs--9 -assist/con intubat-intubated 03:22pm type-art po2-174* pco2-27* ph-7.30* caltco2-14* base xs--11 intubat-intubated 01:57pm type-art po2-444* pco2-22* ph-7.36 caltco2-13* base xs--10 05:22pm lactate-7.6* 03:12am lactate-3.7* 01:57pm glucose-181* lactate-8.3* na-133* k-3.9 cl-109 11:49am lactate-13.7* 11:07am glucose-89 lactate-14.1* na-136 k-4.8 cl-111 06:49am freeca-1.14 01:57pm freeca-0.93* . studies: cxr : impression: 1. et tube ending 3.1 cm above the carina. 2. no acute radiographic cardiac or pulmonary process. . cta torso : 1. large left retroperitoneal hematoma extending from the left hemidiaphragm into the left pelvis. no areas of active extravasation are identified, although this study was not optimized for evaluation of the distal aorta and iliac vessels. given the patient's history of recent heparinization, this hematoma could be consistent with a spontaneous retroperitoneal hemorrhage. 2. nonspecific peripancreatic fat stranding could be due to third spacing or pancreatic trauma. recommend clinical correlation. 3. transverse lucency through part of the superior aspect of the l3 vertebral body could represent a fracture of uncertain chronicity. recommend correlation with physical examination and recent history of trauma. also recommend further evaluation with mr for ligamentous injury following resolution of patient's acute illness. 4. moderate bilateral pleural effusions. 5. exophytic hypodense left renal lesion is not fully assessed on this study and could be further evaluated with non-emergent ultrasound. 6. no evidence of pulmonary embolism or aortic dissection/aneurysm. 7. bilateral rib fractures as above, possibly related to recent cpr. . ct head w/o : impression: no acute intracranial process. . micro: cx : pending brief hospital course: hospital course: 88 year old woman with history of coronary artery disease (three vessels) status post three mis (two nstemis, one unknown), complete heart block status post dual chamber pacemaker, chf (ef 50%), mild dementia, mild-moderate mr/ar and recent functional decline who presented in hypovolemic shock, pea arrest two times in setting of severe anemia from large left sided retroperitoneal bleed. pt was intubated and made full-code initially, with subsequent change to cmo as code status below. . goals of care: on the day following admission, the patient's condition continued to deteriorate as she developed multiorgan failure in the setting of retroperitoneal bleed, hypovolemic shock and pea arrest. multiple family meetings were held on admission indicating full code, despite the patient's prior dnr status during recent hospitalization. on hd 2, a family meeting was held, with two of her daughters, one son and multiple grandaughters were present. the social worker, attending, resident, intern and two nurses were present. the patient was made comfort measures only. the endotracheal tube remained in place at room oxygen. levophed was discontinued. all non-comfort medications were discontinued. she expired shortly thereafter. . active issues: # retroperitoneal bleed /acute loss anemia: the patient came in with a hematocrit of 18.9, elevated ptt. a cta of her torse revealed a large left retroperitoneal hematoma extending from the left hemidiaphragm into the left pelvis, without obvious extravasation. she had been on heparin sc and flushes with picc at outside facility. no evidence of trauma on history or exam. surgery was , and recommended reversal of coaugulopathy, serial hematocrits and repeat imaging when the patient was stabilized. her coagulopathy was reversed with protamine and 2 units of ffp. hct and coags were monitored. she was transfused 5 total units of prbc's, with stabilization of hct. . # pea arrest: two pea arrests in the ed in the setting of hypovolemic shock from large retroperitoneal hemorrhage. she was not placed on cooling protocol given risk of coagulopathy. . # hypovolemic shock: likely secondary to retroperitoneal bleed with two pea arrests. she initially required 2 pressors and transfusions as outlined above. she was bolused with 500cc to 1 liter normal saline bolues regularly for pressure support receiving nearly 9 liters of volume rescussitation in the ccu. despite aggressive rescusitation, and ventilatory support, the patient developed multiorgan failure; she was anuric, with evidence of shock liver. an abg on the afternoon following admission was ph 7.2/29/181/15. her lactate rose to 7.8 after improvement ovenight from initial insult to 14.1 hematocrit continued to drop and require transfusion support and her extremities were cool and mottled as her condition continued to deteriorate. a family meeting was held to discuss the patient's condition and goals of care. as above, pt was made cmo, and pressors were discontinued. . # respiratory distress: pt required intubation due to inability to protect her airway in setting of pea arrest. she was monitored on the ventilator with frequent abg's. pt was oxygenating well, with respiratory alkalosis due to correcting for metabolic acidosis from lactate. when pt was made cmo, vent settings were maintained at current settings. she expired after pressors were discontinued. . # guaiac positive gastric lavage: not grossly bloody. as above, coagulopathy reversed with protamine and ffp. aspirin and plavix were held. she was started on protonix iv bid. . # coronary artery disease with recent nstemi: known 3vd. she was status post bare metal stent over 12 months ago. and recent admission for medical management of an nstemi one week prior. ekg without significant changes although difficult to interpret in setting of demand with bleed. held aspirin and plavix in setting of retroperitoneal bleed. continued on atorvastatin. as above, metoprolol and losartan were initially held. ce's were cycled and showed elevated cardiac enzymes in the setting of likely demand ischemia that continued to trend upwards as the patient decompensated. . # congestive heart failyre: chronic, systolic and diastolic with ef 50%. on admission, she appeared intravascularly depleted (anemic/hemorrhage) but extravascularly volume up with lower extremity edema. home regimen of furosemide, hctz, losartan, and metoprolol were held in setting of hypontension. . # anion gap metabolic acidiosis: likely lactic acidosis in the setting of hypovolemic shock and pea arrest. culture date negative at time of patient's death. . inactive issues: . # hypertension: home regimen of furosemide, hctz, losartan, and metoprolol were held in setting of hypontension. . # asthma: patient was ventilated on admission. her lungs were without wheezes. she was continued on albuterol mdi. . # severe oa and cppd disease: she was followed by rheumatology as an outpatient and has been on prednisone 10mg to 7.5mg daily. she was placed initially on stress dose steroids. . # gerd: patient on omeprazole at home. she was started on pantoprazole. . # history of falls/presyncope: per rheumatology, recent orthostasis and loss of consciousness with question of history of adrenal insufficiency given ongoing prednisone use. stress-dose steroids were givenin setting of shock and prednisone use at home were started as above. . # dyslipidemia: last lipid panel in showing chol 195 tg 63 hdl 65 ldl 117. her simvastatin was changed to atorvastatin 80 mg daily given nstemi during last admission. continued on same dose of home atorvastatin 80mg daily. . # hypothyroidism: recent tsh 0.36 with free t4 1.4. continued on home dose of levothyroxine. . # elevated ldh: during previous admission and since . etiology remains unknown but were trending downward as outpatient. elevated on admission. . # stage iii sacral decubitus ucler: ulcers noted during last admission. routine wound care continued per prior recommendations. wound consult nurse and evaluated patient prior to her death. . # glaucoma: continued latanoprost and brimonidine eye drops. . # deression: home regimen of mirtazapine, fluoxetine were held on admission. . transitional issues: the patient was made comfort measures only. patient expired. autopsy was requested by the family to determine cause of death. medications on admission: * heparin, porcine (pf) 5,000 unit/0.5 ml syringe sig: 5000 (5000) units injection three times a day. * levothyroxine 125 mcg tablet sig: one (1) tablet po daily (daily). * hydrochlorothiazide 12.5 mg capsule sig: one (1) capsule po once a day. * metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. * clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). * vitamin d-3 400 unit capsule sig: one (1) capsule po once a day. * omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). * albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation every 4-6 hours as needed for shortness of breath or wheezing. * alum-mag hydroxide-simeth 200-200-20 mg/5 ml suspension sig: 15-30 ml po four times a day as needed for nausea. * latanoprost 0.005 % drops sig: one (1) drop ophthalmic qhs. * senna 8.6 mg tablet sig: one (1) tablet po at bedtime. * acetaminophen 650 mg tablet sig: one (1) tablet po three times a day. * calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po three times a day. * docusate sodium 100 mg capsule sig: one (1) capsule po twice a day. * brimonidine 0.15 % drops sig: one (1) drop ophthalmic twice a day. * mirtazapine 15 mg tablet sig: one (1) tablet po at bedtime. * fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal nasal twice a day. * aspirin 325 mg tablet sig: one (1) tablet po once a day. * fluticasone 110 mcg/actuation aerosol sig: two (2) puffs inhalation twice a day. * fluoxetine 20 mg capsule sig: two (2) capsule po once a day. * losartan 25 mg tablet sig: one (1) tablet po once a day. * potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. * ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po once a day. * miralax 17 gram/dose powder sig: one (1) packet po once a day. * bisacodyl 5 mg tablet sig: 1-2 tablets po once a day as needed for constipation. * heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. * meropenem 500 mg iv q6h duration: 6 days end date: * prednisone 10 mg tablet sig: one (1) tablet po once a day: end date: change to prednisone 7.5 mg on . * prednisone 1 mg tablet sig: 7.5 tablets po once a day: start date: . * atorvastatin 80 mg tablet sig: one (1) tablet po once a day. * furosemide 40 mg tablet sig: one (1) tablet po once a day. 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: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified arterial catheterization insertion of oropharyngeal airway diagnoses: acidosis coronary atherosclerosis of native coronary artery esophageal reflux mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia aortic valve disorders unspecified glaucoma other persistent mental disorders due to conditions classified elsewhere other and unspecified hyperlipidemia cardiac arrest other shock without mention of trauma pressure ulcer, lower back cardiac pacemaker in situ subendocardial infarction, subsequent episode of care hemorrhage, unspecified pressure ulcer, stage iii chronic combined systolic and diastolic heart failure 

Answer: The patient is high likely exposed to