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 the present illness: the patient is a 74-year-old female with complicated past medical history significant for squamous cell lung cancer status post left upper lobe resection in , multiple pneumonia, ischemic colitis. the patient presents with nausea, vomiting, and abdominal distention. the patient has been discontinued to rehabilitation late in , on tpn and npo with exception to medications due to ischemic colitis for which the patient needs elective hemicolectomy. at the rehabilitation, she has been gradually weaned from the ventilator, but had recent fever spikes and the sputum grew methicillin resistant staphylococcus aureus and klebsiella. these were treated with cefotetan and vancomycin with mild improvement, however, the patient spiked a fever and at this time she only grew out klebsiella in her sputum. she was started on imipenem for her klebsiella pneumonia. the pic line was discontinued. once her blood cultures grew , at that time she was started on fluconazole with surveillance. blood culture were negative per report of the rehabilitation. over the last few days, prior to the admission, the patient required increased ventilatory support, and she was restarted assist control 500/20. over the last three to four days, the patient had increasing abdominal distention. she was complaining of nausea and had bilious emesis. per husband's report, vomiting had stopped approximately two days ago. the ng tube was placed on suction and the abdominal x-ray showed dilated loops of small bowel and air fluid levels. on admission, the patient denied abdominal pain, and nausea. on arrival, she had a moderate-sized, green bowel movement guaiac-positive. past medical history: 1. squamous cell lung cancer diagnosed in , status post left upper lobe resection on . 2. multiple pneumonias with pseudomonas klebsiella and methicillin resistant staphylococcus aureus. 3. status post tracheostomy on . 4. history of cmv colitis, status post ganciclovir treatment. 5. recurrent c. difficile colitis. 6. ischemic colitis. 7. lower gi bleed. 8. history of partial small bowel obstruction. 9. history of coronary artery disease status post catheterization with three-vessel disease and stenting times two. 10. status post non-q-wave mi in . 11. intermittent atrial fibrillation. 12. hypertension. 13. clot in the pulmonary vein, pouch-the patient is not currently on anticoagulation. 14. asthma and chronic obstructive pulmonary disease. 15. hypothyroid. 16. breast cancer status post right mastectomy. 17. heparin-induced thrombocytopenia. 18. history of diverticulectomy 22 years ago. allergies: ? hit, question benzodiazepine sensitivity. medications on admission: 1. captopril 50 mg q.8h. 2. diltiazem 30 mg q.6h. 3. protonix 40 mg iv q.d. 4. fluconazole 400 mg iv q.d. 5. combivent 4 puffs q.i.d.. 6. lasix 40 mg iv q.d. 7. imipenem 500 mg iv q.6h. 8. metoprolol 25 mg q.12. 9. solu-medrol 4 puffs q.12. 10. insulin sliding scale. 11. tamoxifen 20 mg q.d. 12. levothyroxine 0.075 mg q.d. 13. aspirin 81 mg q.d. 14. amiodarone 200 mg q.d. 15. paroxetine 20 mg p.o.q.d. 16. fluticasone 220 meq b.i.d. family history: mother deceased with cva, father died of mi, question of history of copd. social history: the patient is married. the patient has a 20 pack per year smoking history; quit 20 years ago. former social drinker. the patient's husband is her health-care proxy. physical examination: examination revealed the following: temperature 101.2, blood pressure 132/54, pulse 66, respiratory rate 20, oxygen saturation 98% on assist control 500 x 20; peep of 5 and fio2 40%. general: the patient is awake, trached, alert, and in no apparent distress. heent: right pupil is approximately 5-mm. left pupil is appropriate 2-mm. they are both sluggish to react. oropharynx with upper dentures, clean and moist with poor lower dentition. neck: jvd difficult to assess, trach intact. chest: inspiratory wheezes bilaterally, coarse at lower base. heart: regular rate and rhythm, s1 and s2, no murmur, rub, or gallop. abdomen: soft, but distended with good bowel sounds, nontender, no guarding or rebound. stool is green, guaiac-positive stool. extremities: no clubbing, cyanosis or edema with difficult to palpate distal pulses. neurological: the patient is awake, alert, and follows commands. she answers yes or no questions appropriately. she moves all four extremities with strength being 5 out of 5 in all four extremities. laboratory data: findings on admission revealed the white count of 5.1, hematocrit 27.7, platelet count 176,000, differential on the white count 67 neutrophils, 26 lymphs, 5 monocytes, 0.6 eosinophils. sodium 135, potassium 4.3, chloride 92, bicarbonate 34, bun 35, creatinine 1.0, glucose 68, calcium 8.1, magnesium 2.1, phosphate 4.4, albumin 2.3, alt 10, ast 25, alkaline phosphatase 53, total bilirubin 0.5. chest x-ray revealed probable left pleural effusion, left sided mild improvement compared with prior film of 220. opacification of the left hemithorax, shift of mediastinum to the left. there was a slight right sided effusion. pic line was placed. kub: ng tube in stomach. dilated loops of bowel mainly on the left side, however, air is seen throughout to the rectum. abg on admission 7.57/40/128. hospital course: in summary, the patient is a 74-year-old female with complicated past medical history including squamous cell lung cancer, status post left upper lobe resection, ischemic colitis, cmv colitis, multiple pneumonias, coronary artery disease, presenting with three to four days of nausea and vomiting abdominal distention, as well as fungemia with . issues during this hospitalization included the following: #1. infectious disease: the patient has history of fungemia with , which was treated with fluconazole. during this hospitalization, the patient's blood was found to be positive for and the patient was started on amphotericin b on . she is to receive 28 days of amphotercin b. in addition, the patient was found to be bacteremia with staphylococcus, coagulase negative, which was resistant to methicillin, but sensitive to vancomycin. the patient completed a seven-day course of vancomycin. transesophageal echocardiogram was obtained, which showed no vegetations and a good ejection fraction. she had ophthalmological examination of her eyes, with no evidence of candidal ophthalmitis. in addition, the patient underwent ct scan of her abdomen, which did not reveal any abscesses or localized source of infection. #2. gi: the patient presented with nausea, vomiting, abdominal distention, suggestive of small-bowel obstruction base on her abdominal film showing gas all the way through to the rectum. she was judged to have partial small-bowel obstruction. the ng tube was placed to suction. over the course of her hospitalization the ng tube output has been progressively decreasing. she underwent colonoscopy, which revealed stricture at 25 cm from her rectum. ct scan of her abdomen was obtained, which had no evidence of small-bowel obstruction or ischemic colitis. the department of surgery followed the patient throughout the hospital and did not think that she would be a good candidate for the elective left-sided hemicolectomy for her history of ischemic bowel. #3. pulmonary: on admission, the patient was ventilating well on assist control. however, following a seizure on , she became increasingly difficult to ventilate and required sedation with propofol for good ventilation. she required cpap with pressor support of 26, which allowed her to pull tidal volumes of approximately 500, peep of 7.5, fio2 of 40%. over the course of a few days, the patient's propofol was weaned off and her pressure support was weaned from 26 to 16. #4. cardiovascular: on admission, she was in normal sinus rhythm and maintain this rhythm throughout the hospitalization. she was continued on the amiodarone once the ng tube output decreased. #5. neurological: on , the patient had generalized tonoclonic seizure. the blood gases, drawn at that time, showed an acute respiratory acidosis. the patient was loaded with ativan, as well as dilantin with resolution of her seizures. she was continued on her dilantin throughout the hospitalization. she had another seizure on , at which time the dilantin was subtherapeutic. with her first seizures, the patient underwent a head ct scan, which did not show any hemorrhage or new stroke. she does have some periventricular white matter disease indicative of prior strokes. an eeg was obtained, which did not reveal any epileptiform activity, however, it showed generalized slowing, indicative of severe encephalopathy. neurological consultation was obtained and followed the patient with the rest of her hospitalization. #6. hematology: throughout this hospitalization the patient had guaiac-positive stools and intermittently required transfusion when the hematocrit dipped below 30. #7. fluids, electrolytes, and nutrition: during this hospitalization, the patient was maintained on tpn with sliding-scale insulin to control her blood sugars. #8. on , discussion with the patient's husband, as well as her daughter, was undertaken regarding the patient's code status and the patient's code status was changed to dnr with no pressor, cpr, or shock. #9. on , the care of this patient was transferred to dr. , who will dictate an addendum this discharge summary. dr., 12-746 dictated by: medquist36 procedure: venous catheterization, not elsewhere classified spinal tap incision of lung closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of large intestine diagnoses: acidosis congestive heart failure, unspecified personal history of malignant neoplasm of bronchus and lung other specified intestinal obstruction other convulsions chronic vascular insufficiency of intestine pneumonia due to klebsiella pneumoniae tracheostomy status 

Answer: The patient is high likely exposed to