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: patient recorded as having no known allergies to drugs attending: chief complaint: abdominal pain, constipation major surgical or invasive procedure: s/p exlap/segmental sigmoid resection/hartmann's procedure history of present illness: hpi: 68 yo woman with history of constipation controlled on colace per day with 1-3bms per day, who was doing well until she returned from 2 wks ago. since then she has been extremely constipated. she was taking mom at increasing doses and 2 senna yesterday with minimal stool output. she also reports cramping abdominal pain intermittently in her lower abdomen, which worsened with taking senna last night. she also noticed some mild lh last night which since resolved. she currently also reports nausea and vomited non-bloody vomitus twice earlier. she denies any fever, chills, dysuria. she denies any weight loss or any change in the color of her urine or stool prior. she does report a sick contact, her husband, who is suffering from a pna currently. past medical history: pneumococcal pericarditis 4 yrs ago treated with vats procedure and pericardial decortication. residual atrial arrhythmias since. s/p iud perforation of the uterus. social history: married, supportive husband and family. writes and puts on plays for students. no tobacco, 1 glass of wine/day. family history: father died of heart disease at 56. mother died at 84 and had breast cancer. maternal uncle colon cancer. family history of malignant hyperthermia. physical exam: physical exam: vs t 99.1 bp 96/54 hr 100 rr 18 o2sat 99ra gen: nad, aaox3 heent: perrla, mmm neck: no lad, no jvd cor: distant heart sounds, s1s2, regular rhythm, no m/r/g pulm: cta b/l, no wheezing or rhonchi abd: + bowel sounds, soft, nd, tender throughout but primarily in llq, no guarding, mild rebound skin: warm extremities, no rash ext: 2+ dp, no edema/c/c, no cva tenderness pertinent results: 04:50pm glucose-94 urea n-14 creat-0.7 sodium-136 potassium-4.0 chloride-94* total co2-27 anion gap-19 04:50pm wbc-16.2*# rbc-4.13* hgb-12.6 hct-37.8 mcv-92 mch-30.6 mchc-33.5 rdw-12.8 04:50pm neuts-84.7* lymphs-9.5* monos-3.7 eos-1.9 basos-0.2 04:50pm plt count-371 11:00am urine blood-tr nitrite-neg protein-tr glucose-neg ketone-150 bilirubin-neg urobilngn-neg ph-6.5 leuk-tr 11:00am urine rbc-0 wbc-0-2 bacteria-occ yeast-none epi-0-2 05:55am blood wbc-13.0* rbc-3.26* hgb-10.1* hct-29.3* mcv-90 mch-30.9 mchc-34.3 rdw-12.7 plt ct-293 09:38am blood hct-31.0* 08:14pm blood wbc-16.4* rbc-3.23* hgb-10.1* hct-29.3* mcv-91 mch-31.3 mchc-34.6 rdw-12.7 plt ct-349 05:20am blood wbc-13.6* rbc-3.18* hgb-9.8* hct-28.5* mcv-90 mch-30.9 mchc-34.5 rdw-12.4 plt ct-316 11:00 am urine site: clean catch urine culture (final ): presumptive gardnerella vaginalis. >100,000 organisms/ml.. . radiology final report ct pelvis w/contrast 11:07 am 1. sigmoid colitis. differential for this includes diverticulitis, however other etiologies including inflammatory/ischemic causes cannot be excluded. inability to completely opacify a segment of the bowel with rectal contrast and luminal caliber change in its proximal and distal aspects raises concern for stricture and possible underlying iniltrative neoplasm although impacted stool in this region may cause similar appearance. loops proximal to this region filled normally. appropriate treatment and followup with colonoscopy is recommended. 2. multiple air- filled diverticula with questionable small region of microperforation. no evidence of abscess or drainable fluid collections. . portable abdomen 9:23 pm indication: 68-year-old female with worsening abdominal pain. assess for volvulus, obstruction. impression: retained contrast material within the colon, likely from two recent ct examinations. given the lack of air within the rectum, an element of obstruction is suggested, probably related to the ongoing inflammatory process within the pelvis. no volvulus. . pathology examination specimen submitted: sigmoid colon w sts at distal margin, proximal sigmoid colon. procedure date diagnosis: i. sigmoid colon segment (a-g): 1. localized area of ulceration, marked dilation and perforation, with acute peritonitis (see note). 2. multiple small intact diverticula. 3. resection margins are viable. ii. proximal sigmoid colon (h-j): colonic segment, within normal limits. . radiology final report cta chest w&w/o c&recons, non-coronary 2:38 pm indication: lower abdominal pain, worsening over two weeks. suspected pulmonary embolus. impression: 1. no evidence of pulmonary embolism. 2. bilateral pleural effusions that track along the major fissures bilaterally with some areas of loculation. 3. opacity in the lower lobes bilaterally, likely at least in part represents compressive atelectasis given the effusions. 4. small amount of opacity in the right main stem bronchus posteriorly in a dependant location at the carina may represent debris. 5. trace ascites. 6. bilateral mild breast edema in the lower lateral breasts, correlate clinically. . ct abdomen w/contrast 11:21 am ct abdomen w/contrast; ct pelvis w/contrast reason for this examination: please evaluate for collection, leak contraindications for iv contrast: none. impression: 1. three distinct rim-enhancing pelvic fluid collections are suspicious for small postoperative abscesses though post-op seroma is also possible. no definite evidence of bowel injury/leak, although dehiscence of the rectal pouch cannot be definitively excluded. given the small size, pelvic fluid collections would not be amenable to persutaneous drainage. if clinically warranted, aspiration may be performed percutaneously by ct guidance. 2. interval increase in amount of intraabdominal/intrapelvic free fluid. new body wall edema and small bilateral pleural effusions. 3. unchanged gallbladder luminal distention without any secondary signs of acute cholecystitis. findings are most likely related to fasting state. . brief hospital course: a/p: 68 yo f with longstanding constipation now p/w abdominal cramping and acute constipation. . in the ed: vs: 96.6, 42 > later 80-110, 139/59, 18, 98ra. pt was found to have a fullness in her llq w/ mild tenderness (non-surgical, no rebound). kub: with lots of stool, no evidence of obstruction. a rectal p kub showed no stool ball, guaic neg. enema x 2, mag citrate, polyethylene glycol w/ mild effect. gi consulted by pcp w/ increase llq ttp, guaiac + (after enemas) --> recommended ct. a ct was not diagnostic as due to presence of stool, contrast did not pass into the colon. cipro/flagyl was started for ?diverticulitis. blood cultures were sent. pt also received 1l ns as well as zofran for nausea. surgery was also consulted and did not feel there was evidence for an acute abdomen. no further recommendations. . # abdominal pain/constipation: though the patient was afebrile, given her pain and elevated white count, there was concern on presentation for diverticulitis superimposed on constipation. surgery and gi were consulted in the ed, and a kub showed extensive stool-filled colon with no evidence of obstruction or free air. a rectal post jub showed no stool ball and was guaiac negative. enemas x2, magnesium citrate and polyethylene glycol had only mild effect, and the oral regimen was associated with increased nausea and an episode of vomiting. an initial ct was non-diagnostic in that contrast had not advanced into the colon. a repeat ct later on the night of presentation showed contrast in the colon but not yet to the sigmoid. surgery felt that there was no evidence of acute abdomen and that diverticulitis was unlikely, but the read on the scan was that it could not rule out sigmoid pathology. cipro and flagyl were started, and blood cultures sent. lactate was trended and was normal. the patient was made npo and iv fluid were continued. following admission, pain increased somewhat and was associated with moderate rebound tenderness in the lower quadrants, but no guarding or other peritoneal signs. she was followed with serial abdominal exams. pain control was initially managed with morphine but was transitioned to tylenol given concern for worsening constipation. tsh and ca studies were normal. fleets enema was performed x1 on the afternoon of with production of only a small stool ball. further enema were deferred per gi recs given concern about potential microperforations. cipro/flagyl were continued and the wct trended down. . # anemia/guaiac positive stool-- at presentation hct was 37.8, and a drop to 29.3 on the morning following admission was concerning for acute blood loss. the patient was initially guaiac negative, but had a positive exam following the multiple enemas in the ed. hct was rechecked on and was stable in the 29-31 range. per medical records, the patient has had anemia to low 30s since her early 20s, though her recent baseline mid-to-upper 30s. peripheral ivs x2 were established, and 2 units blood typed and matched. iron studies were rechecked and were essentially normal. a repeat guaiac on stool post-enema on was negative. hct was trended and remained stable at discharge. . # leukocytosis: this raised concern for diverticulitis. cxr was clear, there were no external signs of infection, and the patient remained hemodynamically stable. urine grew out >100,000 colonies of gardnerella, which was already being covered by the flagyl. wct decreased to 13.0 on abx. id was consulted. she was discharged home on iv vancomycin & ertapenem x 2 weeks. . # gardnerella in urine: a h/o perforated uterus s/p iud many years ago may predispose to risk of gardnerella infection. patient being treated w/ flagyl for possible diveritculitis which also covers gardnerella. this was discontinued prior to discharge. . # frequent apb: dilt held initially ( ? abdominal process), then held for hypotension. husband will bring off formularly home med (60 once/day sustained release) to start in am. . # nut: she was tolerating small amounts regular food, and required encouragement to eat. medications on admission: diltiazem cr 60mg qday colace 100mg /day advil 2/day for hand pain (arthritis) calcium vitamins discharge medications: 1. vancomycin in dextrose 1 gram/200 ml piggyback sig: one (1) intravenous q 24h (every 24 hours) for 14 days. disp:*qs qs* refills:*0* 2. ertapenem 1 gram recon soln sig: one (1) intravenous once a day for 14 days. disp:*qs qs* refills:*0* 3. outpatient lab work please have blood drawn on for the following lab tests (please fax results to @ ): bun,creatinine,lfts,cbc,vancomycin trough 4. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po q6h prn as needed for pain: each tablet contains 500 mg acetaminophen. please do not exceed 4 g of acetaminophen per day. disp:*30 tablet(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: stercoral perforation of the colon. discharge condition: stable tolerating a regular diet adequate pain control with oral medication discharge instructions: please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomitting 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. * your skin, or the whites of your eyes become yellow. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * 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. * continue to amubulate several times per day. . please have the following lab tests performed in 1 week: bun,cr,lfts,cbc,vancomycin trough (please fax results to @ ) followup instructions: 1. please make a follow-up appointment with dr. ( in weeks. 2. please follow-up with your pcp, . , in 1 week or as needed. provider: . 1 radiology phone: date/time: 1:00 procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances temporary colostomy open and other sigmoidectomy anastomosis to anus diagnoses: urinary tract infection, site not specified cardiac complications, not elsewhere classified atrial fibrillation perforation of intestine other specified cardiac dysrhythmias other specified bacterial infections in conditions classified elsewhere and of unspecified site, other specified bacteria peritonitis (acute) generalized 

Answer: The patient is high likely exposed to