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: codeine / sulfa (sulfonamides) attending: chief complaint: febrile, bacteremic due to picc major surgical or invasive procedure: none history of present illness: 68 yo woman w/hx ventral hernia repair c/b enterocut fistula, abdom wall abscess, more recently w/picc-associated enterococcus and coag neg staph bacteremia, now admitted on with gpc bacteremia and klebs uti. past medical history: sbo s/p surgery complicated by ventral heria repair and wound infection requiring vancomycin and pigtail placement in ; s/p hysterectomy, s/p lap chole, s/p loa, epilepsy, anxiety, tremors, depression, hypothyroid, sz d/o social history: currently living at ne siani since . no tobacco or etoh family history: noncontributory physical exam: t: 98.2 p: 86 r: 20 bp: 136/84, o2sat 99% ra general: alert, oriented, follows commands, watching tv heent: ncat, perrl, op clear without exudates/lesions neck: no lad/jvd lungs: cta b heart: rrr, 2/6 systolic murmur abdom: midline 10 x 10cm wound with ostomy bag over top, and j-tube entering the middle of such wound. llq mildly tender extrem: *lue ac w/3x3cm tender nodule over former site of picc line *rue new picc c/d/i, no erythema gu: foley intact neuro: mae, perrl skin: no rash pertinent results: 02:55pm plt count-222 02:55pm neuts-68.8 lymphs-13.5* monos-8.6 eos-9.0* basos-0.1 02:55pm wbc-9.3 rbc-3.26* hgb-8.6* hct-26.7* mcv-82# mch-26.4* mchc-32.2 rdw-13.2 02:55pm estgfr-using this 02:55pm glucose-103 urea n-68* creat-2.1*# sodium-138 potassium-4.9 chloride-102 total co2-27 anion gap-14 04:23pm lactate-1.5 03:50pm urine hours-random 03:50pm urine uhold-hold 03:50pm urine color-red appear-cloudy sp -1.014 03:50pm urine blood-lg nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-mod 03:50pm urine rbc->50 wbc-21-50* bacteria-few yeast-none epi-0 06:31am blood wbc-13.5* rbc-3.25* hgb-8.7* hct-26.1* mcv-80* mch-26.7* mchc-33.3 rdw-14.2 plt ct-358 05:44am blood wbc-11.1* rbc-3.13* hgb-8.2* hct-25.3* mcv-81* mch-26.3* mchc-32.6 rdw-13.6 plt ct-324 04:10am blood wbc-10.6 rbc-3.05* hgb-8.2* hct-24.7* mcv-81* mch-26.8* mchc-33.1 rdw-13.4 plt ct-308 09:10pm blood neuts-80.1* lymphs-9.8* monos-5.5 eos-4.5* baso-0.1 06:31am blood plt ct-358 06:31am blood pt-40.9* inr(pt)-4.5* 05:44am blood plt ct-324 05:44am blood pt-30.1* ptt-36.5* inr(pt)-3.1* 04:10am blood plt ct-308 04:10am blood pt-22.6* ptt-38.8* inr(pt)-2.2* 06:31am blood glucose-93 urean-48* creat-3.4* na-139 k-4.4 cl-104 hco3-25 angap-14 05:44am blood glucose-89 urean-48* creat-3.4* na-140 k-4.1 cl-106 hco3-23 angap-15 04:10am blood glucose-96 urean-50* creat-3.4* na-140 k-3.4 cl-109* hco3-21* angap-13 04:44am blood glucose-101 urean-59* creat-3.5* na-142 k-3.2* cl-111* hco3-22 angap-12 06:19pm blood ck(cpk)-12* 01:07pm blood ck(cpk)-15* 09:10pm blood alt-27 ast-26 ck(cpk)-18* alkphos-272* totbili-0.4 06:19pm blood ck-mb-notdone ctropnt-0.04* 01:07pm blood ck-mb-notdone ctropnt-0.03* 09:10pm blood ck-mb-notdone ctropnt-0.03* 06:31am blood calcium-8.7 phos-6.7* mg-2.2 05:44am blood calcium-8.5 phos-6.1* mg-2.4 04:10am blood calcium-8.7 phos-5.5* mg-1.8 04:44am blood calcium-9.0 phos-4.8*# mg-1.9 01:54am blood calcium-9.1 phos-6.5* mg-2.2 06:52pm blood caltibc-194* ferritn-1898* trf-149* 10:50am blood caltibc-209* ferritn-greater th trf-161* 06:52pm blood triglyc-90 hdl-26 chol/hd-3.3 ldlcalc-41 05:44am blood vanco-19.0 07:56pm blood vanco-14.9 06:52pm blood vanco-29.3* 02:55pm blood holdblu-hold 02:14am blood type-art po2-170* pco2-39 ph-7.41 caltco2-26 base xs-0 03:04pm blood type-art po2-171* pco2-31* ph-7.44 caltco2-22 base xs--1 09:25pm blood type-art po2-160* pco2-40 ph-7.38 caltco2-25 base xs-0 06:53pm blood type-art po2-448* pco2-41 ph-7.38 caltco2-25 base xs-0 intubat-intubated 06:53pm blood lactate-1.8 04:23pm blood lactate-1.5 06:52pm blood prealbumin-test 10:50am blood prealbumin-test brief hospital course: mrs was admitted to the surgery service with a klebsiella uti and coagulase negative staph positive blood cultures at her rehab. she was started on cefriaxone and vancomycin and her picc line was pulled and the tip cultured and blood and urine cultures were also sent. all cultures were negative. on , she became anxious and then developed respiratory distress, hyopoxia, and acidosis that required emergent intubation. she was transfered to the icu where her respiratory distress was attributed to chf as a tte showed a ef of 40% whereas she had previously had a normal ef. she was diuresed and extubated. renal was consulted for worsening renal funciton that they believed was secondary to atn. a renul ultrasound showed only mild left pelvocaliectasis and no signs of obstruction or hydronephrosis. upper extremity ultrasound revealed left ij occluding thrombus and and left upper extremety non-occlusive thrombus. the patient was started on heparin drip and bridged to coumadin. a repeat echo on showed improved ef of >55% and no vegetations. mrs was transferred back to the regular floor and did well. infectious disease was consulted and recommended continuing the vancomycin and stopping the ceftriaxone as a 10 day course of treatment had been completed. repeat blood and urine cultures were negative. a new picc line was placed on for antibiotics and tpn, but given her recent bacteremia and her tolerating tube feeds well, tpn was not restarted. she remained afebrile and was tolerating her tube feeds well, and was advanced slowly to a regular diet in addition to her tube feeds. a left upper extremity ultrasound of the old picc site showed findings suggestive of left antecubital thrombosed pseudoaneurysm. due to the presence of multiple thrombi, infectious disease recommended continuing the iv vancomycin for 4 weeks and will continue to follow her laboratory and micro data at rehab. her abdominal wound/ostomy/fistula continued to require daily care by wound/ostomy nurses. recommendations for wound care and nutrition were included in the page one. . heme: pt was found to have left ij and left upper extremety thrombi. given her respiratory distress early in her admission a chest ct-angiogram was considered but not performed secondary to her worsening renal function. she was started on therapeutic dosing of heparin and bridged to coumdin. her inr was therapeutic on , but her daily coumdain dose was not stable and will need to be monitored closely at rehab. . renal: mrs presented in acute renal failure, which worsened somewhat during her hospital course, despite adequate hydration and consistently good urine output. renal was consulted and felt was atn and recommended renal ultrasound and monitoring urine output. the renal ultrasound showed no obstruction or hydronephrosis. her creatinine and urine output should be followed at rehab. . cardiac/respiratory: pt had episode of respiratory distress/hypoxia as described above, that appeared to be a combination of anxiety and new chf with reduced ef on echo. ekg was unchanged and troponin 0.03, 0.03, 0.04, which was considered to be negative in the context of her worsening renal failure. she was stabilized in the icu, diuresed and easily extubated. repeat echo was normal and her respiratory status remained stable after returning to the floor. she has had no chest/respiratory complaints and is satting 97-100% on room air. . infectious disease: pt presented with klebsiella uti and co-ag neg staph bacteremia likely secondary to a line infection. for her uti she completed a 10 day course of ceftriaxone. for her bacteremia, her picc was pulled, she was started on iv vancomycin, and will have a 4 week course given her thrombi. micro blood cxr at osh: gpc () urine cxr at osh: klebsiella to bactrim, aztreo, cefaz, ceftaz, ceftriaxone, resistant to cipro amp levo nitrofurantoin urine cxr: contam final : blood cxr: ng final : picc tip cxr: ng final urine: ng final /: mrsa screen neg medications on admission: . nystatin 5ml po q6 2. ferrous sulfate 300mg po bid 3. metoprolol 100mg po tid 4. mirtazapine 15mg po qhs 5. citalopram 40mg 6. heparin sodium 50units iv q8 7. primidone 50mg qhs 8. olanzapine 5mg daily 9. lipids 250ml iv mon/we/fri 10. esomeprazole 40mg iv bid 11. ascorbic acid 500mg 12. levetiracetam 500mg iv bid 13. ergocalciferol units po mon, thurs 14. tpn 15. fentanyl patch 75mcg td q72 hours 16. ceftazidine 1gm iv q8h 17. vancomycin 1gm iv q8h 18. tylenol 650mg po q4 prn 19. albuterol 2.5mg neb prn 20. zofran 4mg iv prn - last dose 2/14 21. hydromorphone 6mg iv q4h prn - last dose 2/15 22. nutren with replete at 20cc/hr 23. quetiapine 200mg po bid medications: 1. acetaminophen 325 mg tablet : one (1) tablet po q6h (every 6 hours) as needed. 2. insulin regular human 100 unit/ml solution : ssi injection asdir (as directed). 3. olanzapine 5 mg tablet, rapid dissolve : one (1) tablet, rapid dissolve po daily (daily). disp:*30 tablet, rapid dissolve(s)* refills:*2* 4. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 5. fentanyl 100 mcg/hr patch 72 hr : one (1) patch 72 hr transdermal q72h (every 72 hours). 6. citalopram 20 mg tablet : two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 7. quetiapine 200 mg tablet : one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. primidone 50 mg tablet : one (1) tablet po hs (at bedtime). 9. mirtazapine 15 mg tablet : one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 10. levothyroxine 100 mcg tablet : two (2) tablet po daily (daily). 11. metoprolol tartrate 50 mg tablet : two (2) tablet po tid (3 times a day). 12. hydralazine 25 mg tablet : one (1) tablet po q6h (every 6 hours) as needed for sbp > 150. 13. sevelamer hcl 400 mg tablet : two (2) tablet po tid w/meals (3 times a day with meals). 14. warfarin 2 mg tablet : 1.5 tablets po days (,mo,tu,we,th,fr,sa). disposition: extended care facility: - diagnosis: s/p component release and mesh repair of ventral hernia, enterocutaneous fistula, klebsiella uti, acute renal failure, bacteremia. condition: good instructions: mrs. will require 4 weeks of vancomycin iv (end date ). she will need weekly labs: cbc/diff, bun/cr, lft, vanco trough faxed to infectious disease r.ns. at (. her vancomycin should be held until a vanc level is below 20, then restarted at 750mg q48 hours. vanc troughs should be checked and reviewed before each dose until stable. if questions please call infectious disease. dr (. continue tube feeds per nutrition recommendations and wound/ostomy care. please return to if you have increasing pain, drainage, or fever, shaking chills, shortness of breath. followup instructions: md phone: date/time: 1:30 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified diagnostic ultrasound of heart insertion of endotracheal tube diagnoses: acidosis anemia of other chronic disease mitral valve disorders acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified congestive heart failure, unspecified friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site other pulmonary insufficiency, not elsewhere classified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure bacteremia other complications due to other vascular device, implant, and graft epilepsy, unspecified, without mention of intractable epilepsy other and unspecified infection due to central venous catheter 

Answer: The patient is high likely exposed to