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: morphine / lipitor / welchol / percocet / tape "x10yd / synvisc / codeine attending: chief complaint: weakness, fatigue major surgical or invasive procedure: none. history of present illness: the patient is a 76f who presents with approximately one week of generalized weakness and fatigue. she reports that her symptoms initially begane about 2 weeks ago, with weakness, poor appetite and frequent urination. over the past several days she has been so weak that she could barely walk. she also felt dizzy, had subjective chills and back pain. at home she has had increased urination and urinary incontinence (unusual for her), as well as some episodes of hematuria last week that have since resolved. she denies any frank dysuria, fevers, cp, sob. she felt so terrible today that she and her husband decided to come to the . initial vs in the ed were : 97.4 77 78/52 20 97%. her labs were notable for a leukocytosis to 14.9, hct 35.5 (last baseline 31 ), hyponatremia to 127, a dirty u/a. a cxr was performed and showed cardiomegaly and ppm, but no acute process. she was given ctx, ampicillin and 2.5 l ivf by report (only 1 l recorded in records). a right ij was placed and the patient sent to the micu for further management. on arrival to the micu, the patient complained of feeling cold and fatigued. she otherwise denied any dizziness, cp, sob or other complaints. review of systems: (+) per hpi. also reported headaches and nausea. (-) denies sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations. denies vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. past medical history: aortic valve stenosis and insufficiency, congestive heart failure, hypertension, hyperlipidemia, congenital complete heart block s/p ppm , apical lv thrombus, peptic ulcer disease, osteopenia, s/p hysterectomy, s/p appendectomy, s/p cholecystectomy, s/p repair of right rotator cuff tear x 3, s/p cataract surgery social history: denies tobacco use. per her husband, she drinks ~ 2.5 glasses of wine every night for several years. lives with her husband, . family history: there is no family history of premature coronary artery disease or sudden death. physical exam: on admission: vs t97.5 p74 bp102/105 rr19 spo2 99%ra general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred, finger-to-nose intact on discharge: general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: aox3, 5/5 strength upper/lower extremities, grossly normal sensation, gait deferred pertinent results: 01:30pm blood wbc-14.9*# rbc-3.50* hgb-12.1 hct-35.5* mcv-101* mch-34.5* mchc-34.0 rdw-12.2 plt ct-201 01:30pm blood neuts-89.4* lymphs-5.4* monos-4.4 eos-0.6 baso-0.1 04:50am blood wbc-11.6* rbc-2.85* hgb-9.8* hct-29.7* mcv-104* mch-34.2* mchc-32.8 rdw-12.5 plt ct-139* 01:30pm blood pt-12.1 ptt-26.8 inr(pt)-1.1 01:30pm blood glucose-156* urean-24* creat-1.1 na-127* k-4.1 cl-95* hco3-19* angap-17 04:50am blood glucose-127* urean-17 creat-0.7 na-134 k-3.5 cl-105 hco3-21* angap-12 01:30pm blood alt-29 ast-43* alkphos-121* totbili-1.1 01:30pm blood albumin-3.6 calcium-8.6 phos-1.9*# mg-1.4* 04:50am blood calcium-7.1* phos-3.0 mg-2.7* 01:59pm blood lactate-2.0 02:45pm urine color-yellow appear-hazy sp -1.017 02:45pm urine blood-sm nitrite-neg protein-100 glucose-neg ketone-neg bilirub-sm urobiln-4* ph-6.0 leuks-lg 02:45pm urine rbc-6* wbc-178* bacteri-mod yeast-none epi-0 renalep-1 02:45pm urine castgr-1* casthy-28* 02:45pm urine wbc clm-mod mucous-rare micro: 1:30 pm blood culture #1. blood culture, routine (preliminary): gram negative rod(s). anaerobic bottle gram stain (final ): reported to and read back by dr. @ 0655, . gram negative rod(s). 1:48 pm blood culture #2. blood culture, routine (preliminary): gram negative rod(s). anaerobic bottle gram stain (final ): reported to and read back by dr. @ 0655, . gram negative rod(s). 2:45 pm urine urine culture (preliminary): escherichia coli. >100,000 organisms/ml.. presumptive identification. 06:05am blood wbc-6.7 rbc-2.58* hgb-8.7* hct-27.5* mcv-107* mch-33.9* mchc-31.8 rdw-13.1 plt ct-318 brief hospital course: patient is a 76 yo f with multiple medical problems including cad, systolic chf who presented with urosepsis and pyelonephritis. she was admitted to the icu, where she was treated with fluid resuscitation and broad spectrum antibiotics for urosepsis. on the floor, she continued to improve. she was discharged on day 6 of hospital stay with followup with her primary care provider. . # e. coli urinary sepsis: urine culture and 2 blood cultures positive for e. coli, sensitive to both ceftriaxone and ciprofloxacin. she had a cvl which was never used, nor did she ever require pressors. tee was negative for valvular vegetations (patient has bioprosthetic aortic valve and multiple surgeries for pacemaker). id was consulted and recommended a 2 week course of antibiotics (one week iv ceftriaxone, one week po ciprofloxacin. #pyelonephritis: patient presented with cva tenderness and became febrile on icu day 2. ucx preliminarily identified as e. coli, on ceftriaxone. pt also complained of bladder pain with foley and pyridium was given to alleviate pain. according to records, she does not have a history of drug-resistant utis. pt left the icu on ceftriaxone, which was continued on the floor. #chf, ef35%: pt had no evidence of decompensation upon admission. she was given prn boluses to maintain map>64 and uop remained adequate. pt's home metoprolol was initially held but restarted on day 2 as bp continued to be stable throughout the day. pt's o2 saturations remained adequate while in the unit. tte was done, but image quality was inadequate to evaluate for valvular vegetation. of note, it showed lvef 30-35%. a follow-up tte was negative for any valvular or pacemaker vegetations. # / hyponatremia: initially found to be at 127. this was most consistent with hypovolemic hyponatremia as patient's bun/cr was more consistent with with prerenal azotemia . after receiving ns ivf, sodium normalized to 134 and creatine went to baseline. inactive issues # arthritis: continued home vicodin # htn: cont home metoprolol transitional issues: f/u compliance on home abx f/u resolution of urosepsis medications on admission: percocet 1-2 tabs/day ativan 1mg - 2 tabs at night metoprolol tartrate 50 mg omeprazole 20 mg daily asa 81 mg daily colace daily senna daily discharge medications: 1. oxycodone-acetaminophen (5mg-325mg) tab po daily:prn pain 2. senna 1 tab po daily 3. docusate sodium 100 mg po daily 4. aspirin 81 mg po daily 5. omeprazole 20 mg po daily 6. metoprolol tartrate 50 mg po bid 7. lorazepam 1-2 mg po hs 8. ciprofloxacin hcl 500 mg po q12h duration: 7 days rx *cipro 500 mg 1 tablet(s) by mouth twice a day disp #*17 tablet refills:*0 discharge disposition: home discharge diagnosis: sepsis with urinary origin pyelonephritis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , it was our pleasure taking care of you at the . you were admitted to the for fatigue and weakness which was discovered to be due to you having a urinary tract infection which led to bacteria to enter your bloodstream. your blood pressures in the intensive care unit were low but responded well to iv fluids. you were started on antibiotics to treat your infection. an ultrasound of your heart revealed no evidence of infection of your artificial heart valve. you were continued on 1 week of intravenous antibiotics and will be discharged on 1 additional week of oral antibiotics. we wish you all the best. the following changes were made to your medication list: 1. start ciprofloxacin 500mg twice daily for 7 days we made the following changes to your medications: please take all other medications as previously prescribed. weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: please call to schedule a follow-up appointment with your primary care physician in the following 1-2 weeks. name: , location: bldg, address: , , phone: procedure: diagnostic ultrasound of heart diagnoses: congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified hyposmolality and/or hyponatremia chronic systolic heart failure cardiac pacemaker in situ heart valve replaced by transplant septicemia due to escherichia coli [e. coli] examination of participant in clinical trial urinary incontinence, unspecified acute pyelonephritis without lesion of renal medullary necrosis systemic inflammatory response syndrome, unspecified arthropathy, unspecified, multiple sites 

Answer: The patient is high likely exposed to