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: melena major surgical or invasive procedure: celiac, sma, common/proper hepatic angiogram, ptc cholangiogram & exchange celiac & sma angiogram ptc exchange gj tube exchange percutaneous tracheostomy history of present illness: this is a 76m with h/o gallstone pancreatitis c/b necrotizing pancreatitis and prolonged icu course (), during which he had an open tracheostomy (), open g/j tube placement (), and percutaneous cholecystostomy tube placement (). his cholecystostomy tube fell out on , leaving him with an uncontrolled cholecystocutaneous fistula. he underwent subtotal cholecystectomy (), internal-external biliary drain placement (), upsizing of drain (), and replacement of ptbd with stent/pigtail (). he was discharged to rehab on . he was was readmitted on , treated for pneumonia, and discharged on . he returned on for guiaic positivity. in the ed, melena was discovered. past medical history: pmh: gallstone pancreatitis, necrotizing pancreatitis, cad s/p mi (15 years ago), htn, hyperlipidemia, obesity, oa, bph, duodenal ulcer, dm, atrial fibrillation, recent pneumonia psh: open trach (), open g/j tube placement (, percutaneous cholecystostomy tube (), open subtotal cholecystectomy (), internal-external biliary drain placement (), drain upsizing (), replacement of ptbd with biliary stent/pigtail (), b/l tkr (most recently r ) social history: being admitted from rehab. previously lived with 2nd wife. a daughter and 4 sons. quit smoking 15 yrs ago. no history of alcohol or ivdu. retired contractor. family history: parents - htn mother - cva physical exam: on admission: 96.8 80 118/68 18 94%2l ms/neuro: a/o heent: perrla, eomi cvs: rrr, no mrg pulm: cta b/l, no rrw abd: soft, nt, nd, +bs, incision c/d, r sided wtd gauze packing, ptc drain on r with no erythema, gj tube capped ext: 1+ edema, pulses present b/l on discharge: 98.2 69 125/74 18 99% cpap & ps 0.4/360x26/5/5 gen: nad, trached cvs: rrr pulm: cta b/l, no resp distress abd: soft, distended, nt, incision c/d/i ext: no c/c/e pertinent results: on admission: 06:45am blood wbc-9.9 rbc-2.80* hgb-8.3* hct-25.5* mcv-91 mch-29.4 mchc-32.4 rdw-15.7* plt ct-229 06:45am blood glucose-74 urean-11 creat-0.7 na-137 k-3.8 cl-103 hco3-29 angap-9 06:45am blood calcium-7.8* phos-3.7 mg-1.9 06:25am blood alt-14 ast-15 alkphos-90 amylase-31 totbili-0.8 06:25am blood lipase-13 egd: gj tube and internal biliary drain noted. erosion in the second part of the duodenum. otherwise normal egd to third part of the duodenum. there was no source of bleeding noted on this exam to the 3rd portion of the duodenum. the procedure was done by the attending and gi fellow. egd gj tube entering stomach body with adherent clot attached near the bumper but no source of bleeding noted. biliary drain entering duodenum through ampulla. no fresh or old blood in the duodenum. non-bleeding erosion in the second part of the duodenum. otherwise normal egd to third part of the duodenum. additional notes: after extensive exploration, no source of bleeding could be identified in the esophagus, stomach or duodenum to the 3rd portion. a dieulafoy could have bled and stopped or the patient could have hemosuccus which also stopped spontaneously. recommend angiography. if no source identified, would proceed to colonoscopy as planned on monday. the procedure was done by the attending and gi fellow. cultures: 11:30 am swab source: rectal swab. r/o vancomycin resistant enterococcus (final ): enterococcus sp.. moderate growth. sensitivities: mic expressed in mcg/ml _________________________________________________________ enterococcus sp. | vancomycin------------ >256 r 8:00 pm sputum site: endotracheal gram stain (final ): pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): gram negative rod(s). respiratory culture (final ): oropharyngeal flora absent. escherichia coli. heavy growth. sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | ampicillin------------ =>32 r ampicillin/sulbactam-- =>32 r cefazolin------------- 8 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 4 s ciprofloxacin--------- =>4 r gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin---------- 32 i piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s 4:09 pm urine source: catheter. urine culture (final ): yeast. >100,000 organisms/ml.. 7:07 am urine site: clean catch urine culture (final ): enterococcus sp.. 10,000-100,000 organisms/ml.. yeast. 10,000-100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ enterococcus sp. | ampicillin------------ =>32 r linezolid------------- 2 s nitrofurantoin-------- 128 r tetracycline---------- <=1 s vancomycin------------ =>32 r 7:08 am sputum source: endotracheal. gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 2+ (1-5 per 1000x field): gram negative rod(s). respiratory culture (final ): sparse growth oropharyngeal flora. escherichia coli. moderate growth. sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | ampicillin------------ =>32 r ampicillin/sulbactam-- =>32 r cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 4 s ciprofloxacin--------- =>4 r gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin---------- 64 i piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s 2:26 pm bronchoalveolar lavage gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. respiratory culture (final ): ~1000/ml oropharyngeal flora. escherichia coli. ~/ml. sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | ampicillin------------ =>32 r ampicillin/sulbactam-- =>32 r cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 4 s ciprofloxacin--------- =>4 r gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin---------- 32 i piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s 5:00 pm swab source: drainage around g-j tube. gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. 2+ (1-5 per 1000x field): gram negative rod(s). wound culture (preliminary): gram negative rod(s). sparse growth. of two colonial morphologies. enterococcus sp.. rare growth. anaerobic culture (final ): due to laboratory error, unable to process. test cancelled, patient credited. radiology: 4:37 pm angiography & ptc exchange: 1. normal sma and celiac trunk mesenteric angiograms with conventional anatomy and no evidence of active bleeding, pseudoaneurysm or vascular biliary fistulous connection. limited dedicated angiogram of the common/proper hepatic arteries as described above was also unremarkable. 2. replacement of right ptbd (double j) catheter with distal pigtail coiled in jejunum and proximal pigtail coiled within the biliary confluence. no hemobilia noted during examination. the catheter is capped for internal drainage. of note, the insertion site does appear slightly indurated and tender to touch, consistent with a mild local infection. 4:17 pm ue us: no evidence of bilateral upper extremity deep vein thrombosis. 8:31 am angiography: selective arteriograms were performed in the celiac and superior mesenteric arteries without signs of active bleeding. there are signs of occlusion of the gda since the original arteriogram a few days ago. because no obvious intervention was feasible, the procedure was terminated. 11:07 am echo: the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 70%) the right ventricular free wall is hypertrophied. the right ventricular cavity is dilated with depressed free wall contractility. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is a small sized pericardial effusion. the effusion appears loculated subtending the right atrial free wall. there is brief right atrial diastolic invagination but cardiac tamponade is not present. compared with the findings of the prior study (images reviewed) of , the findings are similar, but the technically suboptimal nature of both studies precludes definitive comparison. urine cytology: negative for malignant cells 1:09 pm ct chest: 1. no evidence of ards. multifocal peribronchial infiltrates are seen in the aerated portion of the right lung, likely infectious versus aspiration. 2. endotracheal tube tip is in the right main bronchus resulting in almost complete collapse of the left lung. this needs to be retracted by at least 3 cm. 3. worsening bilateral moderate-to-severe pleural effusion with adjacent atelectasis. 4. a new hypodense area in the liver worrisome for infection given the known pancreatitis. a dedicated study such as ultrasound or dedicated ct scan examination of the abdomen is recommended. 5. in the presence of extensive intrabdominal infection the possibility of bilateral empyema could not be excluded, although the effusion appears simple with no loculations or hyperdense material. this report was discussed with dr . 1:24 pm ct head: no acute abnormality. sinus opacification. 1:47 pm ptc exchange: 1. malpositioned and obstructed indwelling right percutaneous trans-hepatic biliary drain, which was successfully removed and replaced with a new 10 french 22 cm double-pigtail internal-external biliary drain. 2. unchanged appearance to mild-to-moderate distal cbd stricture and known variant biliary anatomy and remnant cystic duct/gallbladder. no definite leak noted on today's exam. 1:48 pm g/j tube exchange: obstructed native/indwelling gj tube with crack in the jejunal tubing exiting into the stomach lumen. successful replacement with new 18 french mic gj tube through the indwelling tract. the new gj tube is appropriately positioned and ready to use. 9:28 am ct torso: 1. multifocal pulmonary opacities particularly in the right middle lobe and left upper lobe may represent multifocal pneumonia or aspiration. moderate bilateral pleural effusions remain; pigtail catheters in place. bilateral lower lobes remain collapsed. 2. multiple rim-enhancing fluid collections in the abdomen are little changed. fluid collections along the right paracolic gutter and also anterior to the pancreatic head again contain foci of gas. infectious process cannot be excluded. increased ascites compared to . 3. peripheral and wedge-shaped hypodensities along right hepatic lobe and spleen, new compared to ct torso from , consistent with infarct. 4. percutaneous gastrostomy and percutaneous transhepatic catheter, again both terminate in proximal jejunum. 5. foley catheter with balloon and tip terminating in prostate, with fluid distended bladder. 6. non-occlusive thrombus in right jugular vein partially visualized. 12:51 pm r subclavian & ij us: non-occlusive thrombus in the right internal jugular vein. on discharge: 01:52am blood wbc-13.1* rbc-2.68* hgb-8.2* hct-24.2* mcv-91 mch-30.5 mchc-33.7 rdw-15.7* plt ct-436 01:52am blood glucose-120* urean-14 creat-0.4* na-138 k-4.6 cl-106 hco3-26 angap-11 01:52am blood calcium-8.2* phos-4.0 mg-1.9 brief hospital course: gi was consulted. egd on demonstrated a non-bleeding erosion in d2. on , he developed hypotension, hematochezia, and was transferred to the sicu. repeat egd demonstrated a clot adherent to the gj tube, but no active bleeding. angiogram was recommended, and was also negative. his ptc was exchanged at that time. on , pt developed hematemesis, hematochezia, hypotension, and desaturation. he was transferred to the sicu, intubated, and started on pressors. repeat angiogram demonstrated a thrombosed gda, but no source of bleed. vancomycin and zosyn were started for presumptive aspiration pneumonia. he was in ards and was oliguric. on , diltiazem gtt was started for a-fib. vanc was changed to linezolid on . on , antibiotics were changed to cefepime only, and tpn was started. diuresis was begun. he was gradually weaned off pressors. tube feeds were started on . tpn and antibiotics were d/c'd on . cxr on demonstrated complete l lung white-out. ct chest demonstrated r peribronchial infiltrates and b/l pleural effusions. fluc was started for yeast in urine. on , his gj tube was changed as the j tube was clogged. the ptc was also exchanged as the pigtail was cracked. lasix gtt was started. a ct head was performed as the ct chest had demonstrated infarcts in the liver; there were no infarcts in the brain. on , a l pigtail was placed in the chest. on , a pigtail was placed in the r chest. on , he was febrile to 102.2. ct torso demonstrated multifocal pulmonary opacities. he was started on vanc/zosyn/flagyl for presumptive pneumonia and c.diff prophylaxis. ct incidentally demonstrated a rij thrombus. bronchoscopy was performed on . all sputum and bal cultures eventually grew e.coli. id was consulted and recommending d/c'ing fluc. a rij u/s demonstrated a non-occlusive thrombus. vascular was consulted; anticoagulation was unnecessary. on , the r chest pigtail was d/c'd. on , id recommended d/c'ing vanc and flagyl. patient underwent percutaneous tracheostomy at the bedside by the red surgery team. on , the l chest tube was d/c'd. zosyn was d/c'd on , completing a 7 day course. he had persistent high stool output. c.diff was negative several times. on , pancreatic enzymes were started. g tube was capped on . for the remainder of the hospital stay, patient was diuresed to near baseline weight and his vent was weaned. lasix gtt was changed to po on . on discharge, he was tolerating trach collar intermittently. he was afebrile with stable vital signs, tolerating tube feeds, and getting out of bed to chair with pt. he is being discharged to vent rehab. medications on admission: medications on discharge : 1. albuterol 90 mcg/actuation aerosol : one (1) puff inhalation q6h (every 6 hours). 2. amiodarone 200 mg tablet : one (1) tablet po daily (daily). 3. miconazole nitrate 2 % powder : one (1) appl topical prn (as needed). 4. ipratropium bromide 17 mcg/actuation aerosol : two (2) puff inhalation qid (4 times a day). 5. paroxetine hcl 20 mg tablet : one (1) tablet po daily (daily). 6. simvastatin 40 mg tablet : 0.5 tablet po daily (daily). 7. acetaminophen 325 mg tablet : 1-2 tablets po q6h (every 6 hours) as needed. 8. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day). 9. levofloxacin 500 mg tablet : one (1) tablet po q24h (every 24 hours). 10. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed. 11. omeprazole 20 mg capsule, delayed release(e.c.) : one (1) capsule, delayed release(e.c.) po twice a day. 12. viokase 16 935 mg tablet : 1-2 tablets po four times a day. 13. terazosin 10 mg capsule : one (1) capsule po at bedtime. 14. finasteride 5 mg tablet : one (1) tablet po at bedtime. 15. ursodiol 300 mg capsule : one (1) capsule po twice a day. 16. insulin regular human 100 unit/ml solution : sliding scale injection asdir (as directed). discharge medications: 1. polyvinyl alcohol-povidone 1.4-0.6 % dropperette : drops ophthalmic prn (as needed). 2. heparin (porcine) 5,000 unit/ml solution : one (1) ml injection (2 times a day). 3. bisacodyl 10 mg suppository : one (1) suppository rectal daily (daily) as needed. 4. docusate sodium 50 mg/5 ml liquid : ten (10) ml po bid (2 times a day). 5. lactulose 10 gram/15 ml syrup : thirty (30) ml po q8h (every 8 hours) as needed for constipation. 6. albuterol 90 mcg/actuation aerosol : 4-6 puffs inhalation q4h (every 4 hours) as needed. 7. ipratropium bromide 17 mcg/actuation aerosol : 4-6 puffs inhalation qid (4 times a day). 8. miconazole nitrate 2 % powder : one (1) appl topical prn (as needed). 9. potassium & sodium phosphates mg powder in packet : one (1) powder in packet po tid (3 times a day). 10. acetaminophen 160 mg/5 ml solution : six y (650) mg po q6h (every 6 hours) as needed. 11. metoprolol tartrate 25 mg tablet : one (1) tablet po bid (2 times a day). 12. amylase-lipase-protease 20,000-4,500- 25,000 unit capsule, delayed release(e.c.) : two (2) cap po tid (3 times a day). 13. lorazepam 0.5 mg tablet : one (1) tablet po q6h (every 6 hours) as needed. 14. simvastatin 10 mg tablet : two (2) tablet po daily (daily). 15. furosemide 20 mg tablet : one (1) tablet po bid (2 times a day). 16. potassium chloride 20 meq packet : three (3) packet po bid (2 times a day): check k daily while on lasix and change kcl dose as needed. 17. heparin flush (10 units/ml) 1 ml iv prn line flush temporary central access-floor: flush with 10 ml normal saline followed by heparin as above daily and prn. 18. hydralazine 10-20 mg iv q3h:prn sbp>160 19. hydromorphone (dilaudid) 0.125-0.5 mg iv q4h:prn 20. protonix 40 mg recon soln : forty (40) mg intravenous once a day. 21. insulin sliding scale insulin sc sliding scale q6h glucose regular insulin dose 0-60 mg/dl amp d50 61-120 mg/dl 0 units 121-150 mg/dl 2 units 151-180 mg/dl 4 units 181-200 mg/dl 6 units 201-220 mg/dl 8 units 221-240 mg/dl 10 units 241-260 mg/dl 12 units > 260 mg/dl notify m.d. discharge disposition: extended care facility: medical center - discharge diagnosis: primary: gi bleed, ards, pneumonia, ventilator dependence . secondary: gallstone pancreatitis, necrotizing pancreatitis, cad s/p mi (15 years ago), htn, hyperlipidemia, obesity, oa, bph, duodenal ulcer, dm, atrial fibrillation, recent pneumonia; s/p open trach (), open g/j tube placement (, percutaneous cholecystostomy tube (), open subtotal cholecystectomy (), internal-external biliary drain placement (), drain upsizing (), replacement of ptbd with biliary stent/pigtail (), b/l tkr (most recently r ) discharge condition: afebrile, vital signs stable, tolerating trach mask intermittently, tolerating tube feeds at goal, out of bed to chair daily. discharge instructions: please call or return to ed with fevers >101.5, chills, vomiting, hematemesis, melena or hematochezia, obstipation, severe abdominal pain unresponsive to medication, incisional erythema or purulent drainage, . clamp g tube. all tube feeds via j tube. npo. physical therapy as tolerated. biliary drain capped. followup instructions: please call dr. office at ( to schedule a follow up appointment within 2-3 weeks. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other endoscopy of small intestine other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances temporary tracheostomy closed [endoscopic] biopsy of bronchus arteriography of other intra-abdominal arteries replacement of gastrostomy tube other cholangiogram percutaneous hepatic cholangiogram diagnoses: thrombocytopenia, unspecified acute kidney failure with lesion of tubular necrosis unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled other pulmonary insufficiency, not elsewhere classified atrial fibrillation blood in stool pneumonia due to escherichia coli [e. coli] embolism and thrombosis of other specified artery other and unspecified complications of medical care, not elsewhere classified acute pancreatitis attention to other artificial opening of digestive tract 

Answer: The patient is high likely exposed to