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: rectal bleeding, hypotension major surgical or invasive procedure: r femoral arterial sheath l femoral central venous line history of present illness: 58f w/ metastatic non-small lung cancer recent d/c'd from on following cervical/thoracic decompression (for presumed mets) complicated by lgib now returning for bleeding per rectum and hypotension. . to or on for spinal decompression and post op course complicated by lgib requiring 6 units prbc and sicu transfer. did have a bleeding scan that was unrevealing on and underwent colonscopy on which demonstrated small internal hemorrhoids and multiple diverticuli w/ mixed openings in sigmoid and descending colon. pt ultimately transferred to medicine but review of omr indicates that crit stabilized at 28-30 after w/ last transfusion on . also worked up for hyponatremia and found to have siadh. discharged to rehab on . . now returns to ed w/ bleeding per rectum. apparently, had crit checked at 3/24 am w/ crit of 31. on evening of admission, noted at rehab to pass large amounts of bright red blood per rectum. reported no abdominal pain. initially noted to be tachy to 120's but w/ systolic blood pressures in 110's. arrangements made for transfer to and upon ed arrival, noted to hypotensive to sytolic blood pressure of 60's and labs notable for crit of 22 (28.3 on ) and sodium of 123. had 3 large peripheral iv's placed and has received total of 6l ivf and 4 units prbc. ng lavage reported negative. systolic blood pressures running in 90's-100's. urine output noted to be 40cc over last hour. surgery consulted, suggested potential colectomy if bleeding persisted and pt hemodynmically unstable. patient then transported to ir and plans made for urgent angio. . angio failed to demonstrate evidence of active bleeding within the sma and system. apparently, clinical bleeding had also stopped. recommendations were made for nuclear tagged scan. past medical history: -metastatic non-small lung cancer w/ known spinal mets (based upon pathology from surgery) s/p cervical/thoracic decompression -s/p rul lobectomy of pancoast tumor w/ xrt, chemo in ' c/b bronchopleural fistula -s/p recurrent/?new non-small lul cancer in ' for which received chemo and xrt (etoposide/cisplatin in ' via dr. -s/p scapular osteomylitis -hyponatremia thought secondary to siadh -lower gi bleed as above (thought diverticular) social history: former tobacco history (40 pack years), no etoh, ivda family history: mother died from ovarian cancer. father alive with htn. has 6 children. physical exam: 152/72 92 16 96%ra gen: chronically ill appearing female lying in bed flat, somewhat anxious heent: dry mm, mild scleral icterus cv: s1, s2 regular w/ no mrg appreciated pulm: ctab abd: positive bs, soft, mild diffuse tender, worse on the ruq, pool of bright red blood in rectum extr: no edema, right groin w/ femoral arterial sheath, palpable dp pulses in both le pertinent results: ekg sr at 92, nl axis/interval, borderline low limb voltage, no definite ischemic changes . tagged rbc scan- blood flow images show increased tracer activity beginning at approximately 40 minutes in the pelvis just right of midline projecting superior to the bladder. there is an indentation of the superior bladder contour that may be secondary to the adjacent uterus. . impression: findings suggestive of slow bleeding of the sigmoid colon. . arteriogram- selective arteriograms of the superior mesenteric and inferior mesenteric arteries and superselective arteriograms of the superior hemorrhoidal and sigmoidal arteries did not demonstrate any active contrast extravasation, focal vascular lesion or other potential source of bleeding. as such, embolization was not performed. . brief hospital course: 58f w/ recurrent metastatic non-small lung cancer and recent lower gi bleed who was admitted to micu for recurrent large volume gi bleed. it initially appeared by nuclear scan that bleeding was localized to the sigmoid colon. however clinically bleeding had subsided, therefore no intervention was undertaken. unfortunately, clinical course was also complicated by the development of high-grade mssa bacteremia. suspected source was infection at her spinal surgery site. she underwent washout of her r shoulder and cervical spine with post-op course requiring monitoring in the icu for hypotension and persistent hypoxia (secondary to volume overload) requiring venitlatory support. she was weaned off the ventilator but continued to require bipap to maintain oxygenation despite diuresis. she did not tolerate the bipap and expressed wishes to her family to be made comfortable. she did not wish to be intubated or kept on bipap, and she did not want to continue with any further aggressive measures. discussion with patient, family (husband, ), with palliative care, and social work on with plan made to transition care to dnr/dni with goals geared towards comfort. she was taken off bipap and given dilaudid and ativan for pain control and respiratory distress. she passed away shortly after this time. . . a brief review of her hospital course by problem is outlined below: . # respiratory distress: required intubation initially in setting of volume overload and then again post-operatively. she was weaned off ventilator but still required bipap. she did not tolerate the bipap and made wishes clear that she wished to be taken completely off respiratory support. after discussion with the patient, family, and palliative care services, her goals of care were changed to comfort measures only and she was taken off bipap support. she was kept comfortable with pain control and sedation and passed away shortly after this time. . 1. hematochezia: second icu admission in nearly one week for large lower gib. ngt lavage neg in the ed. transported to angiography from ed where pt had stopped bleeding and engagement of and sma territory failed to reveal site of bleeding. nuclear bleeding scan on suggestive of potential localized bleed in region of sigmoid colon. upon arrival to micu, pt had been aggressively resusicated with 6l ivf and 5 units prbc. her crit improved from 22 to 30. surgery was consulted and given 2 recent life-threatening bleeds, had low threshold for or for ?partial or total colectomy. pt's hematocrit did eventually drop further on second icu stay from 30 back to 22 for which she required 4 units of prbc. she was not taken for surgery however since she had no clinical evidence of bleeding per rectum. . 2. hypotension: pt initially presented to ed hypotensive to systolic 60's in the setting of massive lower gi bleed. she was aggressively resusicated with ivf and multiple units of prbc and her pulse improved to high 90's and low 100's. however, during her first icu stay, she remained hemodymically tenous. high suspicion was for recurrent bleed but crit did remain fairly stable. recheck of cbc demonstrated a new leukocytosis to 35k and pt was hypothermic later during hd1. empiric abx initiated including vanc, unasyn, and flagyl. 2 sets of blood cultures subsequently positive for mssa (4 out of bottles) and uc w/ ecoli. pt did undergo stim which was unrevealing. her lactate never rose substantially but she did have systolics in 70's and 80's on hd1 that did require pressors and further ivf. . 3. mssa bacteremia: blood cultures from have grown methicillin sensitive staph aureus in 4 out of 4 bottles. she did present with elevated wbc to 35k as mentioned above. subsequent blood cultures from and are no growth to date. given sensitivities she was transitioned from vancomycin to oxacillin. in order to evaluates source, tte was performed, which was negative for vegetations. ct of t&c spine was negative for epidural abscess. however, there was evidence of local infection at spinal surgery site. therefore she went for surgical washout on . culture data from this washout demonstrated mssa. . 4. e.coli uti: culture reveals ecoli that was pan-sensitive, however her initial ua was not suggestive of infection. initially treated with zosyn and this was changed to levofloxacing once sensitivity data returned for a complete course . 5. metastatic lung cancer: she has long history of non-small lung cancer dating to early 90's at which point she underwent rul resection followed by xrt, chemo for pancoast's tumor. apparently, she had recurrence vs. ?new cancer in left lung. she has received etoposide and cisplatin in '. dr. has been notified about her second hospitalization and to speak about overall prognosis. she does have metastatic dz (for which recent spinal surgery performed) but felt that would be reasonable to proceed with aggressive therapy for gib and sepsis since condition not believed to be immenintly terminal. however, the patient subsequently requested withdrawl of aggressive care and wished for goals of care to be directed towards comfort measures only. medications on admission: megace 40 qd, oxycontin 30 , vicodin prn, protonix 40 qd, ferrous sulfate. discharge medications: n/a discharge disposition: expired discharge diagnosis: metastatic lung cancer massive lower gi bleed staph aureus bacteremia respiratory failure discharge condition: dead discharge instructions: n/a followup instructions: none procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube arterial catheterization arteriography of other intra-abdominal arteries transfusion of packed cells other partial ostectomy, scapula, clavicle, and thorax [ribs and sternum] other partial ostectomy, other bones diagnoses: acidosis other postoperative infection cellulitis and abscess of trunk urinary tract infection, site not specified acute posthemorrhagic anemia personal history of malignant neoplasm of bronchus and lung acute respiratory failure bacteremia methicillin susceptible staphylococcus aureus in conditions classified elsewhere and of unspecified site diverticulosis of colon with hemorrhage secondary malignant neoplasm of bone and bone marrow chronic ulcer of other specified sites pellagra 

Answer: The patient is high likely exposed to