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: patient is a 63-year-old female with a history of metastatic carcinoid tumor to the liver status post radiofrequency ablation in , who presented to the hospital complaining of three to five week history of productive cough and dehydration. patient's carcinoid tumor was first diagnosed seven years ago during a small bowel resection for a small bowel obstruction. patient has failed treatment with thalidomide and temodar, and she underwent radiofrequency ablation in and as recently as . she has had persisting diarrhea, which is being treated with sandostatin and cutaneous flushing. approximately 3-5 weeks prior to admission, patient started developing a productive cough, and initially presented to hospital. she had an extensive workup at the hospital including ct scan, hida scan, bronchoscopy. sputum culture at hospital showed a mrsa. bronchoscopy demonstrated no tracheal lesions. she is started on vancomycin and was improving in her symptoms. the ct scan at hospital showed an area of necrosis in the right lower lobe of the lung and hida scan was performed to assess for a possible biliary bronchial fistula. patient was transferred to , for further treatment. past medical history: 1. hypertension. 2. carcinoid syndrome. medications at home: 1. advair one puff b.i.d. 2. combivent mdi. 3. vancomycin 1 gram q.12. 4. norvasc 10 mg p.o. q.d. 5. prednisone 20 mg p.o. q.d. 6. patient had been taking sandostatin for diarrhea. allergies: patient reports no known drug allergies. social history: patient denies using alcohol. she reports 5- 10 pack year history of smoking. laboratory studies on admission: white count of 6.0, hematocrit of 30.1, platelets of 176. chemistries: sodium 142, potassium 3.3, chloride 101, co2 35, bun 13, creatinine 0.5, and glucose of 119. calcium 9.0, magnesium 2.2, phosphate 3.3. pt 13.3, ptt 24.4, and inr of 1.2. hospital course: upon her transfer to the , the report on the hida scan appeared to suggest biliary bronchial fistula. thoracic surgery consult was obtained and patient was evaluated by dr. . initially on admission, patient was doing well, therefore, the control of the fistula was the primary concern, and the patient underwent an ercp on , with dr. . at the ercp, there was a suggestion of extravasation of contrast in the biliary tree to the surface of the dome of the liver. there was no visualized bronchial fistula seen on the exam. however, patient was having bilious sputum during the procedure. patient developed respiratory difficulty and was transferred to the surgical intensive care unit on , where she was started on broad-spectrum antibiotics. patient underwent a ct-guided drainage of the right pleural effusion on , with return of approximately 200 cc of bilious fluid in chest tube one and 100 cc in chest tube two. patient subjectively reported feeling better, and patient was supported in our care. patient continued on broad-spectrum antibiotic coverage with zosyn and fluconazole, and infectious disease consult was obtained and was recommended that patient be started on meropenem instead of zosyn. patient continued on meropenem and fluconazole for positive pleural fluid gram stain and sparse c. albicans. patient also developed a urinary tract infection with enterococcus and was being treated appropriately. patient underwent a flexible bronchoscopy on , which showed a persistent small fistula in the right lower lobe bronchus with bile spilling into the airway. after extensive discussion and evaluation, patient elected to undergo surgical repair and went to the or on for right thoracotomy and diaphragmatic repair and lung debridement. please see the operative report for further details. postoperatively, patient received an epidural for pain control and was started on vancomycin in addition to meropenem for broad-spectrum antimicrobial coverage until the operative cultures came back. the intraoperative culture came back with c. albicans and vancomycin-resistant enterococcus, and patient was started on linezolid. patient was improving in her condition slowly. she had persistent leak in her chest tube, which required a prolonged treatment, and on discharge patient has one chest tube which is connected to a heimlich valve. patient is supported by total parenteral nutrition in addition to her p.o. intake to supplement her nutritional status, and is discharged with tpn being cycled at nighttime. patient was also evaluated by physical therapy for deconditioning and is found to be in need of rehab, and the patient is discharged on , in stable condition. discharge status: discharged to rehab hospital. discharge condition: good. discharge diagnoses: 1. metastatic carcinoid disease status post radiofrequency ablation with right lower lobe methicillin-resistant staphylococcus aureus pneumonia complicated by biliary bronchial fistula. 2. status post right thoracotomy and diaphragmatic repair, and lung debridement with confirmation of vancomycin- resistant enterococcus. 3. right lower lobe pneumonia/necrosis with persisting air leak. 4. hypertension. discharge medications: 1. tylenol 325-650 mg p.o. q.4-6h. prn pain. 2. pepcid 20 mg p.o. b.i.d. 3. linezolid 600 mg p.o. q12. 4. levaquin 500 mg p.o. q.24. 5. dilaudid 2 mg q.3-4h. prn pain. 6. heparin 5000 units subq q.8h. 7. pyridoxine 50 mg p.o. q.d. 8. insulin-sliding scale as per sliding scale. 9. lomotil 2.5/0.025 mg p.o. q.6h. prn. 10. megace 40 mg p.o. q.i.d. 11. patient is also prescribed tpn to be cycled overnight to supplement her p.o. intake. follow up: patient is to followup with dr. at his office within one week and is to call the office for appointment time. patient is to followup with dr. in 1- 2 weeks and is to call the transplant center for follow-up appointment. patient has a follow-up appointment with dr. with infectious disease on at 10:30 a.m., telephone number . patient needs chemistry laboratories drawn every other day for adjustment of tpn and then every week as she is stable on tpn, and needs cbcs drawn every week. , m.d. procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances injection or infusion of thrombolytic agent endoscopic sphincterotomy and papillotomy decortication of lung closed [endoscopic] biopsy of bronchus endoscopic insertion of stent (tube) into bile duct puncture of lung transfusion of packed cells closure of other fistula of thorax removal of other device from thorax plication of the diaphragm diagnoses: malignant neoplasm of liver, secondary urinary tract infection, site not specified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other complications due to other vascular device, implant, and graft abscess of lung methicillin susceptible pneumonia due to staphylococcus aureus mechanical complication due to other implant and internal device, not elsewhere classified streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] empyema with fistula 

Answer: The patient is high likely exposed to