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: sulfa (sulfonamide antibiotics) attending: chief complaint: sbp major surgical or invasive procedure: paracentesis x 2, left ij, right temp hd line, a-line x 3, left picc history of present illness: 53-year-old female with a history of alcohol abuse and cirrhosis status post liver and kidney transplant in who presented to with abdominal pain, vomiting and diarrhea, found to have sbp, and transferred to for further management. she states the non-bloody/non-billous vomiting started monday evening as well as the diarrhea. she states she drank a boost that exacerbated this. no fevers. she continued to have this intermittently overnight and awoke tuesday morning with severe lower and left sided abdominal pain, 15/10, and constant and releived with dilaudid. in the osh, her blood pressures were noted to be in the 80s with a lactate of 2.4. she was started on ceftriaxone and given 1.5 grams/kg of albumin. on day of transfer, other notable lab findings include a wbc of 19,900, inr: 1.7, and cr of 2.0 (baseline around 1.5). . of note, the patient was recently admitted to on for acute renal failure due to volume overload, as well as an e. coli uti. her cr prior to d/c was 1.4. with the question of outflow obstruction vs. rejection in the outpatient a transjugular liver biopsy was attempted, but failed due to diminutive right hepatic vein. there is also speculation from her hepatologist that her worsening liver failure is due to recurrent etoh use, and she admits to resuming etoh use in the fall. . on arrival to the micu, the patient is complaining of abdominal pain that has somewhat improved from initial presentation. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies constipation. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes past medical history: - alcoholic cirrhosis c/b hrs. dialysis dependent prior to transplant. - status post orthotopic deceased liver-kidney transplant and splenectomy on , c/b jejunostomy leak requiring exploratory laparotomy and small bowel resection. - right hepatic artery stent placement on asa/plavix - hypothyroidism - dyslipidemia - history of two enteroenterostomies and a small bowel obstruction s/p exploratory laparotomy with lysis of adhesions in 03/. - osteoporosis liver history: - previously been on azathioprine, prednisone, and tacrolimus immunosuppresion. azathioprine, previously dc'd due to hair loss in early and patient was, maintained on prednisone and tacrolimus, before switching to, tacro sole therapy. patient recently restarted on azathioprine again in . azathioprine dose decreased in mid for apparent concern of peripheral edema. given concern of diarrhea, azathioprine was discontinued, and patient was maintained on tacrolimus sole therapy. due to sole therapy, would target slightly higher goal of . continued atovaquone for pcp . . social history: - tobacco: denies - etoh: hx of heavy etoh use. - drugs: denies - home: lives alone. independent in adl's. 2 grown children. - work: quit job at convenience store due to health issues. - she has two children ages 21 and 18, who live near her family history: are alive at ages 79 and 80 and in good health. she has four siblings, none of whom have any chronic illnesses physical exam: physical exam: vitals: t:96.6 bp:89/53 p: 97 r: 15 o2: 95% 3l general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp mid neck, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, rales at the bases abdomen: multiple surgical scars, distended, tender to deep palpation of llq, bowel sounds present, no organomegaly, no rebound gu: foley ext: warm, well perfused, 2+ pulses, 1 + anasarca neuro: 5/5 strength upper/lower extremities, grossly normal sensation, gait deferred, no asterixis pertinent results: admission labs: 03:46pm blood wbc-15.6* rbc-2.28*# hgb-6.7*# hct-21.2*# mcv-93 mch-29.5 mchc-31.8 rdw-14.7 plt ct-266# 03:46pm blood neuts-86.2* lymphs-10.2* monos-2.6 eos-0.6 baso-0.4 03:46pm blood hypochr-2+ anisocy-2+ poiklo-2+ macrocy-2+ microcy-1+ polychr-1+ ovalocy-1+ target-2+ schisto-1+ burr-1+ stipple-1+ 03:46pm blood pt-23.5* ptt-48.4* inr(pt)-2.2* 03:46pm blood fibrino-173*# 03:46pm blood glucose-101* urean-31* creat-2.0* na-132* k-4.3 cl-101 hco3-21* angap-14 03:46pm blood alt-15 ast-32 alkphos-75 totbili-0.3 03:46pm blood albumin-3.0* calcium-7.2* phos-4.8*# mg-1.3* iron-30 03:46pm blood caltibc-31* vitb12-1797* folate-14.9 hapto-70 ferritn-296* trf-24* 09:44am blood tsh-2.9 02:29pm blood cortsol-36.2* 03:46pm blood hbsag-negative hbsab-negative hbcab-negative 07:00pm blood vanco-14.8 03:46pm blood tacrofk-7.4 04:26pm blood type- po2-27* pco2-50* ph-7.25* caltco2-23 base xs--6 04:26pm blood lactate-1.4 03:25am blood freeca-1.00* imaging: cxr: findings: in comparison with the study of , there are lower lung volumes. there is enlargement of the cardiac silhouette with diffuse bilateral pulmonary opacifications, most prominent in the central region, consistent with pulmonary edema. poor definition of the left hemidiaphragm could reflect atelectasis and effusion. although the radiographic abnormalities are most consistent with pulmonary edema, the possibility of supervening pneumonia would have to be considered in the appropriate clinical setting. . cxr: chf with pulmonary edema and bilateral effusions, together with bibasilar collapse and/or consolidation, similar in appearance to . -/orogastric tube as described. . 4:48 pm urine source: catheter. **final report ** urine culture (final ): morganella morganii. >100,000 organisms/ml.. piperacillin/tazobactam sensitivity testing available on request. sensitivities: mic expressed in mcg/ml _________________________________________________________ morganella morganii | amikacin-------------- <=2 s cefepime-------------- <=1 s ceftazidime----------- 32 r ceftriaxone----------- =>64 r ciprofloxacin--------- =>4 r gentamicin------------ =>16 r meropenem------------- 0.5 s nitrofurantoin-------- 256 r tobramycin------------ =>16 r trimethoprim/sulfa---- =>16 r brief hospital course: 53-year-old female with a history of alcohol abuse and cirrhosis status post liver and kidney transplant in who presented to an outside hospital with abdominal pain and found to have sbp, and transferred to for further management. . the patient was on the medical service for the first 27 days in the hospital before being transferred to the liver service. she was continued on daptomycin for vre bacteremia, as well as ultrafiltration, lasix, and hemodialysis was continued to reduce volume as she remained oliguric. supportive nutrition was continued through dobhoff. on occasion she developed a rapid ventricular rate (atrial tachycardia) which responded to iv metoprolol. her standing po metoprolol was stopped, as her hypotension was limiting the amount of fluid removed at hd. she developed an increasing leukocytosis, and work-up revealed a uti. she was initially treated with ceftriaxone, however leukocytosis continued to trend up and other work-up was negative so she was broadened to cefepime, which covered morganella, the organism that eventually grew. she did not make any significant progress in her overall state, and a family meeting was planned given that she had been hospitalized for such a prolonged amount of time. however, on the 5th day of her time on the liver service, she triggered for tachypnea after returning from dialysis. over the next 2-3 hours her mental status declined, her vitals became unstable, and it became clear she was going into septic shock. this decline happened very acutely, and she was quickly transferred to the micu for further management. . in the micu, the patient required intubation for airway protection and was initiated on broad antibiotic and antifungal coverage. unfortunately, her septic shock was refractory to broad antibiotic/antifungal coverage and she required 2 pressors. she was also given a trial of cvvh to try to optimize her volume status. it became clear that her prognosis was grave as she was not able to wean off of her pressors over the week in the icu. after a goals of care discussion with her husband and multiple family members including her daughter and son, it was decided that her care would be transitioned to comfort measures only on the evening of . she was started on a morphine drip and extubated shortly thereafter. she passed away on at 9:05am with her husband, daughter, and son at bedside. an autopsy was offered and declined by her husband/hcp. medications on admission: medications: 1. atovaquone 1500 mg po daily 2. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily 4. boniva 3 mg/3 ml syringe sig: three (3) mg iv every 3 months. 5. levothyroxine 100 mcg tablet sig: 1.5 tablets po daily 6. simvastatin 10 mg tablet sig: two (2) tablet po daily 7. tacrolimus 1 mg capsule sig: two (2) capsule po q12h 8. ursodiol 300 mg capsule sig: two (2) capsule po bid 9. aspirin 81 mg tablet daily 10. calcium carbonate 500 mg calcium (1,250 mg) po twice a day. 11. cholecalciferol (vitamin d3) 400 unit tablet po daily 12. multivitamin tablet sig: one (1) tablet po daily 13. mirtazapine 15 mg tablet sig: 0.5 tablet po hs (at bedtime). 14. spironolactone 100 mg tablet sig: one (1) tablet po daily 15. gabapentin 300 mg capsule sig: one (1) capsule po q12h 18. lasix 40 mg tablet sig: one (1) tablet po twice a day. 19. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical tid (3 times a day) as needed for itchiness. 20. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily 21. levothyroxine 150 daily discharge medications: patient expired discharge disposition: extended care discharge diagnosis: patient expired discharge condition: patient expired discharge instructions: patient expired followup instructions: patient expired md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis percutaneous abdominal drainage percutaneous abdominal drainage arterial catheterization transjugular liver biopsy central venous catheter placement with guidance central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified anemia, unspecified acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified acute and subacute necrosis of liver alcoholic cirrhosis of liver unspecified septicemia unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia severe sepsis unspecified acquired hypothyroidism atrial fibrillation other and unspecified hyperlipidemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure osteoporosis, unspecified septic shock other complications due to other vascular device, implant, and graft paralytic ileus do not resuscitate status encephalopathy, unspecified complications of transplanted liver surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other and unspecified coagulation defects complications of transplanted kidney other and unspecified alcohol dependence, continuous mixed acid-base balance disorder spontaneous bacterial peritonitis edema acute venous embolism and thrombosis of internal jugular veins acute venous embolism and thrombosis of subclavian veins 

Answer: The patient is high likely exposed to