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: ruptured aaa major surgical or invasive procedure: : endovascular stent graft exclusion of ruptured abdominal aortic aneurysm with a 31 x 14-1/2 x 130 main body endo prosthesis and right 20 x 9.5 iliac limb and 14-1/2 x 7 left iliac extension limb : permanent pacemaker generator exchange history of present illness: the patient is a year old woman with a history of cad s/p pacemaker placement, atrial fibrillation, and known aaa who presented to an osh today with abdominal and back pain, and was scanned demonstrating an 8.4 x 7.5 cm aaa with evidence of leak. she was therefore transferred to urgently for vascular surgery evaluation. past medical history: pmh: htn hypothyroidism s/p pacemaker atrial fibrillation chf h/o mrsa cellulitis in legs history of falls psh: s/p cholecystectomy s/p l cea social history: lives alone with daughter nearby family history: nc physical exam: on admission: pe: hr 61 bp 170/75 94% ra nad, awake/alert, responsive; poor historian rrr lungs clear abdomen soft, moderately distended, pulsatile mass with deep palpation bilateral lower extremities warm, no ulceration pulses: r femoral palpable, r dp palpable l femoral palpable, l dp palpable \ on discharge: vss afebrile wdwn in nad lungs - cta bilat card - rrr, paced at 60, strong pmi felt in the distal,external thoracic cavity, due to pts habitus can feel pmi in the extreme luq of the abd abd- soft +bs, no m/t/o ext- warm and dry, fem/dp/pt pulses all palpable bilat pertinent results: 11:31 pm mrsa screen source: nasal swab. **final report ** mrsa screen (final ): positive for methicillin resistant staph aureus. 12:17 am blood culture source: line-arterial. **final report ** blood culture, routine (final ): no growth. 12:17 am blood culture 2nd. **final report ** blood culture, routine (final ): no growth. 12:17 am urine source: catheter. **final report ** urine culture (final ): pseudomonas aeruginosa. 10,000-100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ pseudomonas aeruginosa | cefepime-------------- 8 s ceftazidime----------- 2 s ciprofloxacin---------<=0.25 s gentamicin------------ 4 s meropenem-------------<=0.25 s piperacillin/tazo----- 8 s tobramycin------------ <=1 s radiology report ct chest w/o contrast study date of 1:12 pm impression: extremely limited examination due to lack of intravenous contrast. 1. cardiomegaly. small bibasal effusions and pulmonary ground-glass opacities. the lung findings may represent infection, fluid overload or ards. 2. aaa with an aortofemoral bypass graft in situ. the appearances are suggestive of an endoleak as described above. 3. extensive atherosclerosis in the vasculature of the abdomen and pelvis including the coronary arteries. 4. striated appearance of both kidneys, most marked on the right. the appearances may represent acute tubular necrosis from prior contrast administration. radiology report cta chest w&w/o c&recons, non-coronary study date of 10:34 am reason: pe protocol. please eval for pe. impression: 1. unchanged multifocal bilateral ground-glass opacities consistent with multifocal pneumonia. 2. compared to increase of now large bilateral simple pleural effusion and partial atelectasis of the superior segments of the lower lobes bilaterally. 3. unchanged ascending aorta and aortic arch dilatation with focal aortic arch aneurysm. 4. unchanged cardiomegaly without significant pulmonary edema. 5. a central line ends in the distal left brachiocephalic vein. unilat up ext veins us right study date of 1:36 pm reason: r/o dvt in rue occlusive thrombus involving the right cephalic vein. no dvt in the right upper extremity. 4:13 pm unilat lower ext veins right reason: calf pain, please eval for dvt impression: no evidence of dvt in right lower extremity. 03:56am blood wbc-8.8 rbc-3.09* hgb-10.6* hct-31.9* mcv-103* mch-34.3* mchc-33.2 rdw-18.6* plt ct-249 03:56am blood glucose-81 urean-31* creat-1.3* na-137 k-3.2* cl-95* hco3-33* angap-12 03:56am blood calcium-8.4 phos-3.4 mg-1.9 12:17am urine rbc-* wbc-21-50* bacteri-mod yeast-none epi-0-2 05:46am urine rbc-0-2 wbc-0-2 bacteri-none yeast-few epi-0-2 12:17am urine blood-lg nitrite-neg protein-150 glucose-neg ketone-15 bilirub-neg urobiln-neg ph-5.0 leuks-sm 05:46am urine blood-mod nitrite-neg protein-25 glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.5 leuks-neg 12:17am urine color-yellow appear-clear sp -1.022 05:46am urine color-straw appear-clear sp -1.016 brief hospital course: patient was admitted from an osh with leaking aaa seen on osh imaging. she was emergently taken to the angio suite and her images were uploaded and reviewed. she underwent: 1. ultrasound-guided puncture of bilateral common femoral arteries. 2. bilateral introduction of catheter into aorta. 3. abdominal aortogram and selective iliac arteriogram. 4. endovascular stent graft exclusion of ruptured abdominal aortic aneurysm with a 31 x 14-1/2 x 130 main body endo prosthesis and right 20 x 9.5 iliac limb and 14-1/2 x 7 left iliac extension limb. 5. perclose closure of bilateral common femoral arteriotomies. 6. left common femoral endarterectomy with vein patch angioplasty. the patient tolerated the procedure well. of note, she was not intubated for the procedure given her age and co-morbidities. neuro: no active issues, patient is alert and interactive cardiopulmonary: post-operatively she was closely monitored in the cvicu. initally her ppm was pacing her appropriately, however, overnight she had an episode of asystole, lasting less than 30 seconds. compression were started, and the pt almost immediately began pacing appropriately again. these episodes recurred a few more times the evening of pod 0 and electrophysiology was urgently consulted. the ep fellow interrogated the device and found the rv lead to be dislodged. he adjusted the settings, and the pacer functioned properly. he recommended repleting electrolytes and discontinuing digoxin as well. these interventions resolved her arrythmias. on the patient went into atrial fibrillation with rapid ventricular response and required iv lopressor and then a diltiazem drip for rate control. ep and cardiology were asked to advise on treatment. soltalol 80mg and diltiazem 30mg qid were started and the diltiazem gtt weaned off. the pt returned to a paced sinus rhythm within 24hrs of the atrial fibrillation and had no further episodes throughout her stay. anticoagulation was initally recommended, however given the pts age and comorbidities it was decided that heparin/coumadin benefit would not outway the risk, and thus asprin 325mg was initiated. on the morning of the patient began to c/o sob, required increased o2 and was hypoxemic on her abg. there was concern for chf exacerbation as well as pe. she urgently underwent cta which ruled out pulmonary embolism. the ct did reveal pulmonary edema and bilateral pleural effusions. interventional pulmonology was consulted and felt these effusions were not large enough to drain. there was some concern the pt may have developed pneumonia as well given her previous emesis and immobility. the patient was put on broad spectrum antibiotic coverage and put on a fluid restriction and aggressively diuresed with lasix over the next several days with close monitoring and repletion of her electrolytes. the diureses significantly improved her symptoms and her o2 requirements were subsequently minimal. on she was thought to be quite stable from a medical and surgical standpoint and ep took her to the procedure lab where they exchanged her ppm for a new device. she tolerated the procedure well and her. gi/nutrition: the patient vomitted twice on pod 0 during chest compressions, after which an ng tube placed. the tube was removed a few days later when her bowel function returned. speech and swallow was consulted to evaluate for aspiration risk prior to advancing the patients diet. on preliminary examination she passed her swallow evaluation and she was started on a ground puree diet which was later advanced to regular diet with thin liquids which she tolerated well. gu: patient was found to have a uti on urinalysis and she was started on antibiotics. the culture grew moderate amt of pseudomonas and she was started on cirpo. her foley was exchanged. it was not removed as she was being aggressively diuresed and her i/o's required close monitoring. a second ua/cx was sent on and was negative with no bacterial growth. at the time of discharge her foley was removed and she was voiding without difficulty. id: post-operatively patient received 3 days of kefzol for perioperative coverage. given her uti, she was started on ciprofloxacin on , but this was switched to ceftriaxone and doxyclycline given concern for pna after episodes of vomitting and consolidation seen on cxr and ct. heme: patient received sqh throughout her stay for dvt prophylaxis. there was concern for a dvt in her rue and rle during her stay, however both were ruled out. she did work with physical therapy but given her deconditioned state only ambulated minimally. she is discharged on sqh to continue at rehabilitation facility until she is ambulating at her baseline state. medications on admission: potassium 20 meq daily lasix 40 mg po qd digoxin .125 mg daily cardizem er 240 mg po qd asa 81 mg po qd miralax clonidine 0.1 mg po bid discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day): until pt fully ambulatory and low risk for dvt. 2. aspirin 325 mg tablet sig: one (1) tablet po once a day. 3. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 4. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inh inhalation q6h (every 6 hours) as needed for wheezing. 5. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 6. acetaminophen 325 mg tablet sig: two (2) tablet po tid (3 times a day). 7. sotalol 80 mg tablet sig: one (1) tablet po bid (2 times a day). 8. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 9. ipratropium bromide 0.02 % solution sig: one (1) neb inh inhalation q6h (every 6 hours) as needed for sob. 10. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 11. keflex 500 mg capsule sig: one (1) capsule po four times a day for 7 days. 12. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day: when on lasix. discharge disposition: extended care facility: manor nursing & rehab center - discharge diagnosis: 8.4 x 7.5cm ruptured aaa discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: medications: ?????? take aspirin 325mg (enteric coated) once daily ?????? do not stop aspirin unless your vascular surgeon instructs you to do so. ?????? continue all other medications you were taking before surgery, except for the following changes: we have stopped your digoxin and diltiazem and you are now on sotalol. you should take aspirin of your previous 81mg. ?????? you make take tylenol or prescribed pain medications for any post procedure pain or discomfort what to expect when you go to rehab: it is normal to have slight swelling of the legs: ?????? elevate your leg above the level of your heart (use pillows or a recliner) every 2-3 hours throughout the day and at night ?????? avoid prolonged periods of standing or sitting without your legs elevated it is normal to feel tired and have a decreased appetite, your appetite will return with time ?????? drink plenty of fluids and eat small frequent meals ?????? it is important to eat nutritious food options (high fiber, lean meats, vegetables/fruits, low fat, low cholesterol) to maintain your strength and assist in wound healing ?????? to avoid constipation: eat a high fiber diet and use stool softener while taking pain medication what activities you can and cannot do: ?????? when you go home, you may walk and go up and down stairs ?????? do not shower x 1 week, you may have sponge baths. after 1 week you may shoewer, but no soaking tubs ?????? your right chest/shoulder dressing covering the incision from the pacemaker exchange should stay on for three days, it may be removed on thursday . the groin and leg incisions may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing or band aid over the area that is draining, as needed ?????? no heavy lifting, pushing or pulling (greater than 5 lbs) for 1 week (to allow groin puncture to heal) ?????? after 1 week, you may resume sexual activity ?????? after 1 week, gradually increase your activities and distance walked as you can tolerate ?????? no driving until you are no longer taking pain medications ?????? keep your f/u appointment to be seen for post procedure check and cta what to report to office: ?????? numbness, coldness or pain in lower extremities ?????? temperature greater than 101.5f for 24 hours ?????? new or increased drainage from incision or white, yellow or green drainage from incisions ?????? bleeding from groin puncture site sudden, severe bleeding or swelling (groin puncture site or incision) ?????? lie down, keep leg straight and have someone apply firm pressure to area for 10 minutes. if bleeding stops, call vascular office. if bleeding does not stop, call 911 for transfer to closest emergency room. followup instructions: provider: clinic phone: date/time: 1:00 (pacemaker follow up and wound check) provider: scan phone: date/time: 11:30 provider: , md phone: date/time: 12:00 (vascular surgery f/u, imaging of aorta and see surgeon) procedure: endovascular implantation of other graft in abdominal aorta other endovascular procedures on other vessels cardiopulmonary resuscitation, not otherwise specified repair of blood vessel with tissue patch graft endarterectomy, lower limb arteries replacement of any type pacemaker device with dual-chamber device procedure on single vessel diagnoses: pneumonia, organism unspecified anemia, unspecified urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension unspecified acquired hypothyroidism atrial fibrillation acute on chronic diastolic heart failure other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure cardiac arrest carrier or suspected carrier of methicillin resistant staphylococcus aureus sinoatrial node dysfunction fitting and adjustment of cardiac pacemaker abdominal aneurysm, ruptured mechanical complication of other vascular device, implant, and graft pseudomonas infection in conditions classified elsewhere and of unspecified site dissection of iliac artery 

Answer: The patient is high likely exposed to