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: past medical history: significant for atrial fibrillation, coronary artery disease status post non q wave myocardial infarction in , hypercholesterolemia, congestive heart failure, mitral regurgitation, tricuspid regurgitation, hypothyroidism, gout and blindness. medications on transfer: the patient was on prevacid 30 q day, timolol drops ou, tolamide drops ou, topical hydrocortisone, ensure plus, colchicine .6 q day, levothyroxine .05 mg q day, oxybutynin 2.5 b.i.d., prednisone eye drops, dulcolax prn, digoxin .5 q day, lopressor 50 t.i.d., lovenox 30 subq b.i.d., magnesium oxide 400 b.i.d., tequin 400 intravenous q day and albuterol and atrovent nebulizers. after transfer to the patient was placed on aspirin 325 mg q day, lopressor 5 intravenous q 6, levaquin 250 q day, vancomycin 500, morphine prn, digoxin .125 intravenous q day, flagyl 500 intravenous t.i.d., albuterol and atrovent nebulizers, subq heparin, diltiazem 10 mg intravenous times one, protonix 40 q day intravenous, levothyroxine 25 intravenous q day, brimonidine eye drops and latanoprost eye drops. allergies: no known drug allergies. physical examination: temperature 101.8. 97.0. pulse 107 and irregular. blood pressure 110/59. respirations 20. saturations 92%. she is on normal saline at 75 cc an hour. on examination in general the patient was unresponsive. heart was irregular and tachy. lungs showed decreased breath sounds bilaterally. abdomen soft, distended. the patient winces to deep palpation in the left lower quadrant. extremities without edema and perfused. lines include a left picc line, left femoral triple lumen catheter, nasogastric tube, foley and rectal tube. laboratory: white blood cell count 11.9, hematocrit 28.7, platelets 313, pt 17, ptt 29.7, inr 2.0, sodium 146, potassium 5.3, chloride 116, co2 22, bun 38, creatinine 1.3, glucose 127, calcium 7.9, magnesium 1.5, phos 2.6, lipase 7, albumin 2.5, alt 363, ast 593, alkaline phosphatase 193 and total bilirubin is 0.8, amylase is 91, lactate 3.0, troponin was 13.9, cpk 65.33 and mb was not done. urinalysis showed moderate leukocyte esterase, moderate blood, few bacteria, 3 to 5 red cells and 6 to 10 white blood cells. arterial blood gas was 7.34, 45, 188, 25, and negative 1. ct of her head was unchanged showing a left parietal lobe infarct, unchanged right thalamic lacunar infarct. ct of her abdomen showed bilateral pleural effusions. no small bowel thickening, descending and sigmoid bowel thickening with fat stranding and minimal free fluid. no pneumatosis, questionable colonic polyp in the descending colon and mild dilatation of the small bowel. kub showed the cecum not very dilated, no free air, no evidence of obstruction and air throughout the colon. assessment: the patient is an 87 year-old female with likely ischemic colitis of the descending and sigmoid colon. the plan was to take the patient emergently to the operating room for exploratory laparotomy. in preparation for surgery the patient was given fresh frozen platelets and a left subclavian port was placed along with the swan-ganz catheter. the patient's son was available for discussion about the patient's prognosis and they were made aware that the patient's chances of survival were slim even with surgery and they chose to proceed with surgery and informed consent was obtained from the family. she was taken to the operating room and underwent exploratory laparotomy where a ischemic left colon was encountered. she underwent a left hemicolectomy, pouch and colostomy, j tube placement and the splenic flexure was taken down. she required 2 units of packed red blood cells and 2 units of fresh frozen platelets during the surgery. she also had cc of crystalloid and she was transferred to the in critical condition. postoperatively the patient remained intubated. refer to operative dictation for more details. initially out of the operating room the patient was on an epinephrine drip, which was weaned off. additionally she was taken off her amiodarone and a nitro drip was added initially for after load reduction. she is also put on dobutamine to increase her bowel function and remained antibiotic coverage of flagyl, levaquin and vancomycin initially. for prophylaxis she was placed on protonix. she is also on a beta blocker, metoprolol 5 mg intravenous q 6 hours. for deep venous thrombosis prophylaxis as well as coagulation given her atrial fibrillation she was placed on lovenox 40 mg subq q day. she remained on her levothyroxine, digoxin and aspirin. she did require fluid boluses aggressively throughout postoperative day one to support her urine output. postoperative day two the patient remained on a dobutamine drip of 5 micrograms per kilogram per minute and nitro .5 micrograms per kilogram per minute. she had received a total of 10 liters over the previous 24 hours and had no fevers or desaturations. initially the inferior portion of the patient's colostomy was dusky, however, this improved by postoperative day three. the plan for the day was to slow down the patient's hydration and to continue broad antibiotic coverage. she was kept on the lovenox initially, however, she was showing a downward trend in her platelets. by postoperative day three the patient's dobutamine had been weaned to 2 micrograms per kilogram per minute and she remained on nitro and trophic tube feeds were started. the plan was attempt to wean dobutamine to off and to restart the patient's beta blocker. for antibiotic coverage the plan was to initially continue for five days postoperatively. by postoperative day five the patient's dobutamine drip was off and her nitro drip was off. due to hypoglycemia following the institution of total parenteral nutrition an insulin drip was started. enalapril was attempted, however, blood pressure dropped so this was discontinued. she was restarted on lopresor 5 mg intravenous q 6 once the dobutamine was weaned off and began on gentle diuresis with prn loop diuretics. due to her thrombocytopenia her lovenox was dropped and all heparin was eliminated on her carrier fluids. the hip panel was sent, which ultimately returned negative. on postoperative day five the patient developed what appeared to be an embolic phenomenon to her fingers and toes. the concern was that the patient could possibly be embolizing from atrial clot given her atrial fibrillation and stopping of her anticoagulation. cardiology consult was obtained the recommendations of which were to anticoagulate the patient with guidance from hematology. hematology recommended a lepirudin drip, which was started on the . on postoperative day six the patient had been restarted on dobutamine due to low cardiac index and also begun on a lasix drip for diuresis. her lepirudin was on at 3 mg per hour. she had begun to show an upper trend in her fever curve to 100.8 for a temperature max. she was on vancomycin at this time. this was due to a positive sputum culture three days prior, which was positive for mrsa. the patient had cardiac enzymes sent, which were initially negative for an myocardial infarction. she began showing output from her ostomy with stool mixed with liquid. her cardiac index continued to be very marginal alone with marginal urine output. an echocardiogram was obtained on postoperative day six. this ultimately showed adequate pump function. a left femoral line, which was initially in place from transfer from the outside hospital and then discontinued after the patient was transferred from the operating room and cultures of this showed e-coli. by postoperative day seven the patient was febrile to 101.8 so she was begun on zosyn prophylactically. additionally she grew out yeast from her urine culture and was started on fluconazole. due to low cardiac indexes refractory to dobutamine as well as tachycardia the patient was changed to a milrinone with initial improvement in her cardiac index. additionally, she was started on a neo drip to support her blood pressure, which had been trending down. dopamine was attempted, which was accompanied by marked tachycardia, so this was discontinued. throughout the hospital stay her ostomy continued to be pink, viable and functioning. on postoperative day seven the patient continued to deteriorate. a cat scan was obtained to rule out further bowel ischemia and/or intraabdominal source of sepsis. this was negative. the cat scan did show some ascites for which a diagnostic tap was obtained the results of which are pending at the time of this dictation. the patient showed an upward trend in her white count as well. as of postoperative day seven it was 24,000. the patient was also started on oral flagyl for empiric treatment of possible c-diff colitis, however, these were not confirmed on her laboratory tests. on postoperative day eight the patient is on levophed, milrinone, vasopressor had been started at .8 units per minute and she was still given a lepirudin drip for anticoagulation. her index continued to be marginal and her urine output had slowly decreased throughout the night. her white count was 27.5. throughout the day the patient became oliguric and her blood pressure and cardiac index continued to decline despite the pressors previously mentioned. due to the patient's grave status the family was gathered and after discussion it was elected to make the patient dnr. the patient continued to worsen her acidosis throughout the day and night and she was found to be asystolic at 2:00 a.m. this morning on the . on examination with the mechanical ventilator turned off the patient had no heart sounds and no breath sounds. the patient was declared at 0200 on the . the attending was notified. the intern notified the family of the patient's death. the family had previously been asked regarding post mortem and declined. the family member was the patient's son. the admitting office was notified and the death certificate was completed. admission diagnosis: ischemic colitis. diagnosis at the time of expiration: immediate cause of death is cardiac arrest and secondary to cardiogenic shock, status post exploratory laparotomy, left hemicolectomy and end colostomy. , m.d. dictated by: medquist36 procedure: parenteral infusion of concentrated nutritional substances other enterostomy open and other left hemicolectomy temporary colostomy enteral infusion of concentrated nutritional substances percutaneous abdominal drainage other lysis of peritoneal adhesions pulmonary artery wedge monitoring anastomosis to anus diagnoses: atrial fibrillation anoxic brain damage cardiogenic shock methicillin susceptible pneumonia due to staphylococcus aureus acute vascular insufficiency of intestine arterial embolism and thrombosis of lower extremity 

Answer: The patient is high likely exposed to