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: morphine sulfate / iodine-iodine containing / oxycodone / minocycline / erythromycin base / dust & pollen filter mask / water, dove soap, seasonal allergies / water attending: chief complaint: nausea and vomitting major surgical or invasive procedure: central line placment diagnostic paracentesis picc line nasogastric tube history of present illness: history of presenting illness this patient is a 78 year old female who complains of vomiting. this patient is one-week status post right hemicolectomy for a cecal volvulus. she's been having vomiting and retching for the last several days. she went to the campus where she had a kub which showed: a 12 cm colon. she has no real abdominal pain but is complaining of some "heartburn". she was given cipro and flagyl and sent. they also put a foley catheter in and found 500 cc of urine. no fevers or chills. she actually denies abdominal pain. she has been having difficulty urinating but denies any dysuria or any hematuria. timing: sudden onset, intermittent quality: mostly retching, severity: 5 times in the last 24 hours duration: several days, context/circumstances: see above associated signs/symptoms: decreased p.o. intake past medical history: pmh: - rectocele and rectal prolapse s/p multiple surgeries (see below) - colonic adenomas s/p sigmoid colectomy (last colonoscopy , sigmoidoscopy ) - diverticulosis - hemorrhoids - severe anxiety / depression - osteopenia - degenerative joint disease, planned for l hip surgery with dr. - lumbar spondylosis - chronic pain - chronic constipation - asthma - syncope / vasovagal episodes psh: - cholecystectomy - sigmoid colectomy for tubobillous adenoma - rectopexy and rectocele repair ( ) - posterior colporraphy ( ) - removal of retained sigmoid suture ( ) social history: former smoker, quit 25 years ago; no etoh, no ivdu; lives with husband. pcp is . (). family history: - father: deceased of colon cancer (age unknown), mother: cva and endometrial cancer, brother: lung cancer, dm and mi, son: lung cancer physical exam: physical examination: upon admission: temp:99.2 hr:90 bp:132/83 resp:16 o(2)sat:95 normal constitutional: comfortable heent: extraocular muscles intact mucous membranes moist chest: clear to auscultation cardiovascular: normal first and second heart sounds without murmur abdominal: soft, nontender without distention and with clean-looking staple line gu/flank: no costovertebral angle tenderness a foley catheter is in a draining clear yellow urine. extr/back: mild edema on both sides neuro: speech fluent psych: normal mood physical examination upon discharge: general: sitting in chair, alert and oriented, skin warm, dry, pink vital signs: t=98.6, hr=88, bp=130/90, resp. rate=20, oxygen saturation room air=96% cv: ns1, s2, -s3, -s4 lungs: diminished bases ( left >right) abdomen: suture line clean and dry, no exudate, non-tender, soft ext: mild edema lower ext., + dp bil. pertinent results: 05:18am blood wbc-11.2* rbc-3.00* hgb-8.8* hct-25.4* mcv-85 mch-29.2 mchc-34.4 rdw-14.0 plt ct-519* 05:10am blood wbc-12.6* rbc-3.22* hgb-8.9* hct-27.3* mcv-85 mch-27.6 mchc-32.6 rdw-14.0 plt ct-567* 05:22am blood wbc-10.7 rbc-3.19* hgb-9.0* hct-27.1* mcv-85 mch-28.3 mchc-33.4 rdw-13.9 plt ct-582* 05:55pm blood wbc-17.9*# rbc-4.53# hgb-12.9# hct-38.0# mcv-84 mch-28.5 mchc-34.0 rdw-13.6 plt ct-590*# 05:58am blood neuts-80.3* lymphs-13.0* monos-4.3 eos-2.0 baso-0.5 05:18am blood plt ct-519* 05:33am blood pt-11.7 ptt-26.3 inr(pt)-1.0 02:10am blood fibrino-313 05:32pm blood fibrino-385 05:18am blood glucose-149* urean-21* creat-0.5 na-138 k-3.5 cl-107 hco3-25 angap-10 05:10am blood glucose-128* urean-16 creat-0.5 na-136 k-3.4 cl-103 hco3-25 angap-11 05:22am blood glucose-186* urean-15 creat-0.5 na-137 k-4.2 cl-106 hco3-26 angap-9 05:32pm blood glucose-240* urean-26* creat-0.9 na-137 k-3.8 cl-100 hco3-24 angap-17 04:58am blood glucose-163* urean-22* creat-0.8 na-130* k-3.8 cl-93* hco3-30 angap-11 01:30am blood glucose-227* urean-19 creat-0.8 na-131* k-3.5 cl-94* hco3-29 angap-12 05:49am blood alt-30 ast-19 alkphos-65 amylase-9 totbili-0.2 02:10am blood alt-183* ast-137* ck(cpk)-203* alkphos-69 totbili-0.2 05:32pm blood alt-211* ast-248* ck(cpk)-60 alkphos-76 totbili-0.3 09:04am blood ck-mb-6 ctropnt-0.02* 02:10am blood ck-mb-8 ctropnt-0.03* 05:32pm blood ck-mb-3 ctropnt-0.01 07:25am blood ctropnt-<0.01 05:18am blood calcium-8.0* phos-3.2 mg-2.1 05:49am blood caltibc-159* trf-122* 10:23am blood d-dimer-* 05:11pm blood type-art po2-92 pco2-34* ph-7.48* caltco2-26 base xs-2 09:21am blood type-art po2-142* pco2-34* ph-7.48* caltco2-26 base xs-3 09:21am blood glucose-91 lactate-0.6 03:33am blood lactate-0.8 06:14pm blood hgb-10.2* calchct-31 : ekg: sinus rhythm. low voltage. mild q-t interval prolongation. st-t wave abnormalities. since the previous tracing of precordial st-t wave abnormalities are more prominent. clinical correlation is suggested. tracing #1 : abdominal cat scan: impression: 1. mild dilation of the proximal and mid small bowel loops measuring up to a maximum of 3.5 cm in diameter. there is no definite discrete transition point in small bowel although proximal bowel is somewhat more dilated than distal residual small bowel. however, noting marked colonic dilatation on the recent prior radiographs, which has improved, this evolution is suggestive of an ileus. small bowel obstruction is not entirely excluded, however, and if it were confirmed, then ascites could suggest considerable congestion or even potentially ischemia in the appropriate clinical setting, although there is no bowel wall thickening. 2. moderate amount of ascites, new since the prior study, and could be secondary to fluid resuscitation/ cardiac / hepatic dysfunction. peritoneal inflammation with secondary ileus and ascites could also be considered in the differential, noting substantial ascites and ileus, which together could be seen with peritonitis although the findings are non-specific. although ascites does not appear loculated, if clinical concern persists, then an examination with intravenous contrast would be more sensitive for the possibility of any potential early abscess formation. 3. malpositioned nasogastric tube with a retrograde turn and terminating in the distal esophagus. 4. small exophytic left renal lesion; suggest follow-up ultrasound evaluation : diagnostic paracentesis: impression: successful, ultrasound-guided diagnostic and therapeutic paracentesis yielding 2.2 liters of reddish fluid : liver/gallbladder ultrasound: impression: 1. patent hepatic vasculature, note is made that the midline vessels are obscured from view by overlying bowel. 2. minimal ascites and a small right pleural effusion. 3. no liver lesion and no biliary dilatation. : chest x-ray: impression: evidence for pulmonary vascular congestion. left pleural fluid. bilateral subsegmental atelectasis and possibly focal consolidation. the right internal jugular catheter terminates at the level of the right atrium. there is distended colon below the level of the diaphragm (see accompanying report) : ekg: artifact is present. sinus rhythm. low voltage in the precordial leads. compared to the previous tracing of limb lead voltage has improved marginally : kub: findings: moderate-to-severe intestinal distention with multiple air-fluid levels but no evidence of wall thickening. given the multiple overlays of gas-filled bowel loops no change in caliber can be clearly determined. therefore, ct is recommended. no evidence of free air. no safe evidence of pathological calcifications. contrast material in the rectum : chest x-ray: findings: the nasogastric tube that has newly been placed is in the stomach. a right internal jugular vein catheter projects into the basal parts of the right atrium, the device should be pulled back by approximately 7 cm. unchanged moderately distended segments of the colon. subtle bilateral areas of atelectasis at the lung base. borderline size of the cardiac silhouette without pulmonary edema. : chest x-ray: findings: the patient has received a new picc line. the line can be followed over its entire course, the tip projects over the right atrium, the line should be pulled back by approximately 4 cm to ensure position within the mid-to-low svc. no evidence of pneumothorax, the other monitoring and support devices are unchanged. mildly increasing colonic distention. brief hospital course: 78 year old female s/p right hemi-colectomy re-admitted to the acute care service with vomitting. upon admission, she was made npo, given intravenous fluids, and had imaging studies of her abdomen which showed an ileus and ascites. because of her abdominal distention and nausea, she had -gastric tube placed. a diagnostic paracentesis was done for the fluid collection in her abdomen. it did not grow any bacteria. her fluid status was tenuous during this time and she did require additional fluid to maintain an adequate urine output. in order to maintain her nutritional staus, she was started on tpn on after a nutrition consult. on , she was transported to the intensive care unit after she sustained a pea arrest vs. vaso-vagal event. she was intubated and her cardiac enzymes were cycled. her ekg did not show any evidence of a myocardial infarction. an echocardiogram showed possible antero-septal hypokinesis with an ef> 50%. she was bronched with no evidence of aspiration. ultrasound was negative for dvt. she was extubated within 24 hours and discharged from the intensive care unit. upon return to the floor, she had a follow-up gi consult who recommended a bowel regimen to alleviate her constipation and reduce her abdominal distention. her -gastric tube was discontinued on after she tolerated it being clamped. she was started on clear liquids with the gradual advancement to a regular diet. she did continue to have an elevated white blood cell count and was found to have a urinary tract infection for which she is currently on ampicillin until . because of her colonic inertia, her narcotics were discontinued and she was given mineral oil, reglan, and azithromycin with successful passage of stool. her abdominal distention has diminished and she is tolerating a regular diet. her tpn has been discontinued on . she has been evaluated by physical therapy and has been seen by the social worker for additional emotional support. she is preparing for discharge to a extended care facility where she will be able to increase her strength and stamina through physical therapy and adl's. her vital signs are stable and she is tolerating a regular diet without complaint of nausea, but her appetite is still diminished. her foley catheter is to gravity drainage. she has been followed by the nurtritionist who has made recommendations about her diet. she has been ambulating with assistance. follow-up visit is recommended with her primary care provider where she will need further investigation about the left renal lesion. in addition to this, she will need to follow up with her dr. , who will make recommendations about the length of time for azithromycin usage for colonic motility. she will need to schedule an appointment with the acute care service in 2 weeks. of note: mrsa + medications on admission: : albuterol 1-2 puffs inh qid prn, clonazepam 1mg po bid, compazine 5mg po prn, flovent 110 mcg 3 puffs inh tid, anusol ointment prn, lidocaine 2% prn, metrogel 1% prn, simvastatin 10mg discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) cc injection tid (3 times a day). 2. cepacol sore throat + coating 15-5 mg lozenge sig: one (1) lozenger mucous membrane every 4-6 hours as needed for throat pain. 3. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q4h (every 4 hours) as needed for wheezing. 4. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: two (2) adhesive patch, medicated topical daily (daily) as needed for back and chest pain . 5. azithromycin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours). 6. mineral oil oil sig: thirty (30) ml po every other day (every other day). 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. senna 8.6 mg tablet sig: two (2) tablet po hs (at bedtime). 9. clonazepam 0.5 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for anxiety. 10. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 11. acetaminophen 500 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 12. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). 13. ampicillin 250 mg capsule sig: two (2) capsule po q6h (every 6 hours) for 1 days: 1 dose this pm, and 2 doses 1/28...then d/c. disp:*6 capsule(s)* refills:*0* 14. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po daily (daily). 15. calcium carbonate 250 mg tablet, chewable sig: tablet, chewables po three times a day: as needed for heartburn. discharge disposition: extended care facility: - discharge diagnosis: ileus post-operative ascites enterococcus urinary tract infection pea arrest discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were recently discharged from the hospital after you had a portion of your bowel removed for a cecal vovulus. you were discharged to a rehabilitation center but returned 3 days later with inability to tolerate food and nausea. since your re-admission, you have had -gastic tube placed to allerviate your nausea. you also were noted to have a collection of fluid in your abdomen which was cultured, did not show any bacteria. your bowels were slow to move, but since you have been off narcotics, and with laxatives, you have successfully moved your bowels. you have been able to tolerate a diet. you are now preparing for discharge to a rehabiltation facility with the following instructions: please call your doctor or return to the emergency room if you have any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomiting, diarrhea or other reasons. signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered, especially the bowel regimen which has been prescribed followup instructions: provider: , md phone: date/time: 1:20 provider: , m.d. date/time: 12:20 (please reschedule this appointment so that your visit will be withing the next 2-3 weeks. you will also need follow-up ultrasound for the kidney lesion. please follow up with the acute care service in 2 weeks, you can schedule this appointment by calling #. you will also need ultra-sound follow-up for the kidney lesion was was noted. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances insertion of endotracheal tube percutaneous abdominal drainage central venous catheter placement with guidance diagnoses: unspecified pleural effusion urinary tract infection, site not specified asthma, unspecified type, unspecified hypopotassemia dysthymic disorder cardiac arrest paralytic ileus pressure ulcer, lower back other constipation other ascites streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] disorder of bone and cartilage, unspecified lumbosacral spondylosis without myelopathy mixed acid-base balance disorder pressure ulcer, stage ii 

Answer: The patient is high likely exposed to