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: no known allergies / adverse drug reactions attending: chief complaint: altered mental status, somnolent, hypotensive major surgical or invasive procedure: none history of present illness: 87 yo f with a history of hypertension, gerd, atrial fibrillation (not anticoagulated), and advanced alzheimers dementia who was noted to be more somnolent this am and was subsequently referred to the emergency department. she is apparently aaox1 at baseline. in the ed, initial vs were: t98.1 p116 bp93/57 r18 o2 sat 99%4lnc. she appeared diaphoretic, tachycardic, and flushed. her temp was later found to be 102.4 rectally. lactate noted to by 5.5 with a left-shifted wbc to 15. cxr concerning for left sided pnuemonia though urinalysis showed heavy leukocytes concerning for uti. she received vancomycin 1000mg iv, and pip/tazo, along with 3l of ns which dropped her heart rate to the 90s, her lactate to 3.1, and bolstered her systolics to the 100s. of note, code status was clarfied with the daughter hcp, and stands as full code despite a previous dnr order. prior to transfer, vs were hr92 bp100/57 rr25 sat98ra. on admission to the icu, her vs were t96.6 bp105/63 r24 sat 97%ra. her english is very limited and could not recount the details. her primary nurse was not available at rehab, but coverage mentions that she was recently treated for a uti on with cefpodoxime. she developed cough on , with a negative cxr on . she was tired and weak yesterday with decreased po intake. she had increased somnolence this morning with inability to feed herself or communicate with staff. revealing a wbc to 16. she had a witnessed generalized tonic colonic seizure (no previous seizure history) with convulsions of the upper and lower extremity. she was subsequently referred to the ed. ros could not be ascertained. past medical history: - gerd - htn - atrial fibrillation (not on coumadin) - hyperlipidemia - advanced alzheimer's dementia (aaox1 at baseline?) - hypothyroidism - parkinsons disease - history of recurrent uti? - diabetes mellitus, type 2 social history: lives at rehab, daughter highly involved in care and speak daily. family history: noncontributory physical exam: vitals: t96.6 bp105/63 r24 sat 97%ra general: alert and answering questions, though prominent language barrier heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: coarse breath sounds anteriorly with left sided posterior crackles cv: iregular rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: moving all extremities pertinent results: 1. on admission: 06:25pm blood wbc-15.1* rbc-4.30 hgb-13.1 hct-39.3 mcv-91 mch-30.4 mchc-33.2 rdw-13.7 plt ct-299 06:25pm blood neuts-89.7* lymphs-4.6* monos-5.2 eos-0.3 baso-0.3 06:25pm blood pt-14.2* ptt-23.6 inr(pt)-1.2* 06:25pm blood glucose-293* urean-28* creat-1.2* na-134 k-4.2 cl-96 hco3-21* angap-21* 06:25pm blood calcium-10.2 phos-1.6* mg-1.5* 06:32pm blood lactate-5.5* k-4.1 2. on discharge: 07:40am blood wbc-8.3 rbc-3.74* hgb-11.6* hct-33.9* mcv-91 mch-31.0 mchc-34.3 rdw-13.3 plt ct-314 07:40am blood neuts-77.9* lymphs-11.7* monos-9.0 eos-0.9 baso-0.5 07:47am blood glucose-149* urean-17 creat-0.7 na-139 k-3.2* cl-105 hco3-26 angap-11 07:47am blood calcium-9.2 phos-2.3* mg-1.7 3. imaging/diagnostics: - cxr (): markedly limited study. there is suggestion of extensive patchy foci throughout the left lung, which may indicate an underlying pneumonia. if clinically feasible, consider pa and lateral views in the radiology suite for more sensitive and specific evaluation. - cxr (): portable compared with one day earlier, a picc line has been placed. the tip overlies the right atrium. please see wet read from radiology resident, dr. , recommending pullback by approximately 3 cm. otherwise, i doubt significant interval change. no pneumothorax is detected. 4. microbiology 6:25 pm blood culture x 2 blood culture, routine (pending): 6:57 pm urine site: clean catch **final report ** urine culture (final ): <10,000 organisms/ml. brief hospital course: 87 year old russian speaking woman with dementia who presented with fever, hypotension, altered mental status, and elevated lactate in the setting of possible pneumonia and uti. she was hypotensive to the 80s, tachycardic, febrile, diaphoretic with leukocytosis. all of these raised suspicion for sepsis. potential sources included left sided pneumonia (limited chest x-ray and no respiratory symptoms) versus uti based on abnormal ua. urine culture was negative. she was fluid responsive with aggressive hydration in the ed with improvement of the lactate. she was treated with vancomycin and cefepime for hcap and uti. day 8 of 8 will be on . she remained hemodynamically stable with appropriate urine output for the remainder of the hospitalization. she was noted to be somnolent prior to admission with a possible generalized grand mal seizure. her sepsis offered an explanation of a toxic-metabolic encephalopathy. she had no focal neurologic deficits and mental status remained improved and stabilized at what seemed to be her baseline. she had an acute kidney injury on admission with creatinine of 1.2 with unknown baseline, this improved to 0.7 at the time of discharge. metformin held initially and restarted at the time of discharge. antihypertensives held initially, all restarted with the exception of hctz. her potassium was continued as her k was 3.2 on discharge (given 60meq x 1 on then will continue 20meq daily). her potassium should be checked in a few days (friday ) and potassium supplementation should be adjusted as necessary. if her bp remains stable and becomes elevated her hctz can be restarted. medications on admission: -cefpodoxime 100mg since ? -aspirin 325mg daily -acetaminophen 650mg q4hr prn -vitamin d2 50,000iu q3wks -alendronate 70mg qsunday -losartan 50mg daily -hydrochlorothiazide 25mg daily -metoprolol tartrate 50mg -senna 2 tabs qhs -omeprazole 20mg daily -simvastatin 10mg qhs -levothyroxine 100mcg daily -potassium chloride 20meq daily -metformin 750mg daily -fluticasone nasal spray 1 s discharge medications: 1. vancomycin 1,000 mg recon soln sig: one (1) gram intravenous once a day for 4 days: last dose . 2. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain or fever. 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. vitamin d-3 oral 5. alendronate 70 mg tablet sig: one (1) tablet po once a week. 6. losartan 50 mg tablet sig: one (1) tablet po daily (daily). 7. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 8. senna 8.6 mg tablet sig: two (2) tablet po hs (at bedtime) as needed for constipation. 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 10. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 11. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 12. potassium chloride 20 meq packet sig: one (1) packet po once a day. 13. metformin 750 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. 14. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal daily (daily). 15. cefepime 2 gram recon soln sig: two (2) grams injection every twenty-four(24) hours for 4 days: continue until . discharge disposition: extended care facility: rehab discharge diagnosis: pneumonia sepsis discharge condition: mental status: confused - always. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you presented with delirium (confusion), fever, and hypotension. you were treated in the icu for pneumonia with antibiotics, vancomycin and cefepime. there was a question of seizure prior to your arrival to but that could not be confirmed. followup instructions: , i. procedure: venous catheterization, not elsewhere classified diagnoses: pneumonia, organism unspecified esophageal reflux pure hypercholesterolemia acute kidney failure, unspecified unspecified septicemia atrial fibrillation sepsis paralysis agitans diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled alzheimer's disease dementia in conditions classified elsewhere with behavioral disturbance 

Answer: The patient is high likely exposed to