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 attending: chief complaint: diarrhea major surgical or invasive procedure: r-ij placement in ed history of present illness: 80 y.o woman with history of recurrent lung pneumonia and empyema, hep c cirrhosis and c-diff colitis who presents to the hospital with a 3 day history of diarrhea, malaise, poor po intake and fevers. the patient had recently finished a course of ceftriaxone and ciprofloxacin for treatment of her recurrent empyema, and had been taking po vancomycin for prophylaxis which she had finished only recently on . . the patient reports that over the past several days she has been feeling increasingly tired, and had noticed some increased diarrhea as well which she initially self treated with immodium with good effect. however, on tuesday she noticed that her stool was becoming more watery with her having to empty her colostomy twice a day rather than once a day. on the day of admission (friday), she felt nauseous and also felt that she had a fever. her son, who had come up to see her from found her to be lethargic with a poor appetite, and as such was concerned and brought her to the ed. . in the ed, initial vs were 102.3, hr 101 bp 91/49. the patient however subsequently triggered for a blood pressure of 70/50, for which she was given 2l of normal saline with only slight improvement to 85/60. she was also started on iv flagyl for empiric treatment of clostridium difficile colitis. a central line was placed, and a 3rd litre of ns was started. . once in the icu, she reported feeling much better and complained of being hungry. she stated that her blood pressures have tended to run low in the 80s-90s. she denied any current fevers or chills, no nausea, abdominal pain, chest pain, shortness of breath, black stools or bloody stools. . review of systems: (+) per hpi (-) as above past medical history: 1) empyema from id note, admitted " with a large right-sided empyema requiring chest tube and pigtail catheter drainage. she received antibiotics with vancomycin and ceftriaxone. bacteria grew a pansensitive e. coli and a penicillin sensitive enterococcus. she stopped her antibiotics on ." 2) hcv cirrhosis obtained via blood transfusion during colon surgery in 's, h/o nodule with work-up underway by dr. 3) htn 4) remote history of rectal cancer s/p colectomy and ostomy in 5) h/o lacunar infarcts 6) anxiety/depression 7) gerd 8) h/o multiple parastomal hernias with revisions and repositions from rlq to llq to luq 9) s/p ccy in social history: lives alone in with a nurse her daily. independent in adls, and most iadls. she is a lifelong non-smoker. no alcohol consumption since at least and was never a heavy drinker. worked in a bank for years, retired. divorced. family history: mother with uterine cancer. sister with . sister with lung cancer. physical exam: admission exam: vs: t 98.8, bp 99/55, hr 86, rr 25, spo2 99% on 2l gen: nad. alert and oriented x3. mood and affect appropriate. pleasant and cooperative. resting in bed eating dinner. heent: ncat. perrl, eomi, anicteric sclera. mmm, op benign. neck: supple. jvp not elevated. no cervical lymphadenopathy. cv: rrr. normal s1, s2. systolic murmur at llsb. chest: respiration unlabored. decreased breath sounds and crackles at right base. no wheezes or rhonchi. abd: bs present. soft, nt, nd. ostomy in luq with soft stool and gas in bag. no surrounding erythema. large hernia at ostomy site. ext: wwp. no le edema. digital cap refill <2 sec. distal pulses radial 2+, dp 2+, pt 2+. neuro: moving all four limbs. discharge exam: t98.7 tm 98.7 bp 98/52 (98-108) p87 rr18 sa02 95ra general: well appearing nad heent: mmm, op clear pulm: crackles at the bases bilaterally, otherwise clear and unlabored cards: rrr, normal s1 s2 3/6 sem at the rusb abd: soft, nontender, nondistended. luq ostomy with soft stool in bag, no surrounding erythema, +hernia at site ext: wwp, 2+dp pt pulses. pertinent results: admission labs: 07:58pm glucose-100 urea n-22* creat-0.8 sodium-134 potassium-4.2 chloride-106 total co2-20* anion gap-12 07:58pm alt(sgpt)-16 ast(sgot)-26 alk phos-74 tot bili-1.1 07:58pm lipase-13 08:22pm lactate-1.9 07:58pm albumin-2.3* 09:20pm wbc-8.4 rbc-2.97* hgb-9.9* hct-29.6* mcv-100* mch-33.4* mchc-33.5 rdw-14.7 09:20pm plt count-66* 09:20pm neuts-88.4* lymphs-5.4* monos-4.9 eos-1.0 basos-0.3 09:48pm urine color-amber appear-clear sp -1.022 09:48pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-sm urobilngn-4* ph-6.0 leuk-neg discharge labs: 06:05am blood wbc-3.5* rbc-2.92* hgb-9.6* hct-29.3* mcv-101* mch-32.9* mchc-32.7 rdw-14.4 plt ct-64* 07:00am blood neuts-72.3* lymphs-15.3* monos-5.9 eos-6.1* baso-0.5 06:05am blood glucose-96 urean-14 creat-0.6 na-137 k-4.1 cl-112* hco3-22 angap-7* 06:05am blood calcium-7.6* phos-2.7 mg-1.6 micro: blood cultures x2 - negative stool: fecal culture (final ): no salmonella or shigella found. campylobacter culture (final ): no campylobacter found. clostridium difficile toxin a & b test (final ): reported by phone to @ 0323 on cc7a . clostridium difficile. feces positive for c. difficile toxin by eia. studies: ekg : sinus rhythm with an aberrantly conducted atrial premature beat with borderline p-r interval prolongation. diffuse non-specific st segment flattening throughout. there is anterior r wave regression, raising the possibility of prior anterior wall myocardial infarction. compared to the previous tracing of limb lead voltage is lower. t waves are actually slightly higher in lead avl. other abnormalities are largely unchanged. cxr : findings: the pigtail catheter has been removed. there is prominence of the interstitial markings and engorgement of the pulmonary vasculature compatible with interstitial pulmonary edema. there are no pleural effusions. there is no evidence of pneumothorax. the cardiomediastinal and hilar contours are normal. there are no focal consolidations concerning for pneumonia. clips overlie the right upper quadrant. impression: mild interstitial pulmonary edema. brief hospital course: the patient is an 80 y.o woman with recent history of pneumonia complicated by e. coli empyema and clostridium difficile infection who presents to the hospital with hypotension, fever and diarrhea, found to have recurrent c. difficile infection. 1. hypotension: she presented with hypotension to the 70s that was slow to respond to fluids. she was admitted to the micu for management, and was further resuscitated with 3 liters ns with stabilization of her bp. she did not need pressor support. she was started on empiric treatment for c. diff colitis with po vancomycin 125 mg q6hr and iv flagyl. given her recent complicated pneumonia and empyema, she was also covered for hcap with vancomycin and cefepime. she was called out to the floor in stable condition. she maintained her oxygen saturations on room air. hcap coverage was discontinued once her c dif titer returned positive. her blood pressures ranged in the 90s for the remainder of the hospitalization. 2. c difficile infection: her diarrhea was secondary to c. dif infection, related to recent antibiosis. she was treated empirically with po vancomycin and iv flagyl. her diarrhea subsided over the following 4-5 days. because she received broad spectrum antibiotics, id recommended a long vancomycin taper over 6 weeks. she was tolerating a regular diet without abdominal pain or diarrhea at the time of discharge. 3. hepatitis c cirrhosis: her spironolactone was initially held given her hypotension, but was restarted prior to discharge as her pressures became stable. 4. vaginal candidiasis: she received fluconazole in the micu with resolution of symptoms pending tests at discharge: none transitional care issues: - has id followup in place for management of her empyema/c. dif infection medications on admission: albuterol sulfate - 90 mcg hfa aerosol inhaler - 2 puffs po every 4 to 6 hrs as needed for wheezing ceftriaxone - (not taking as prescribed: states was d/c'd in rehab 2/1or ) - 2 gram recon soln - 2 gms every twenty-four(24) hours please continue for at least 4-6 weeks. further recommendation will be given from infectious disease doctor at the follow-up appointment. ciprofloxacin - (prescribed by other provider) - 500 mg tablet - one tablet(s) by mouth twice a day till folic acid - 1 mg tablet - one tablet(s) by mouth once a day omeprazole - 20 mg capsule, delayed release(e.c.) - one capsule(s) by mouth once a day spironolactone - 50 mg tablet - 1 tablet(s) by mouth twice a day tramadol - (prescribed by other provider) - 50 mg tablet - tablet(s) by mouth every six (6) hours as needed for pain trazodone - (prescribed by other provider) - 50 mg tablet - tablet(s) by mouth at bedtime as needed for insomnia vancomycin - (prescribed by other provider) - 125 mg capsule - one capsule(s) by mouth twice a day till medications - otc acetaminophen - (prescribed by other provider) - 650 mg tablet - tablet(s) by mouth every six (6) hours as needed for fever or pain calcium carbonate - (prescribed by other provider) (not taking as prescribed: pt has not been taking) - 500 mg (1,250 mg) tablet - tablet(s) by mouth three times a day cholecalciferol (vitamin d3) - (prescribed by other provider) - dosage uncertain cholecalciferol (vitamin d3) - 1,000 unit tablet, chewable - one tablet(s) by mouth once a day cyanocobalamin (vitamin b-12) - 250 mcg tablet - one tablet(s) by mouth once a day docusate sodium - (otc) - 100 mg capsule - one capsule(s) by mouth twice a day as needed for constipation miconazole nitrate - (prescribed by other provider) - 2 % powder - apply to affected areas in skinfolds twice a day as needed for rash discharge medications: 1. vancomycin 125 mg capsule sig: one (1) capsule po see below for 6 weeks: 1 tab q6hr for 1 wk. 1tab q12hr for 1wk. 1tab qd for 1wk. 1tab qod for 1wk. 1tab q3days for 2weeks. . disp:*57 capsule(s)* refills:*0* 2. spironolactone 50 mg tablet sig: one (1) tablet po twice a day. 3. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q6h (every 6 hours) as needed for wheeze. 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 5. colace 100 mg capsule sig: one (1) capsule po twice a day as needed for constipation. 6. acetaminophen 325 mg tablet sig: two (2) tablet po every six (6) hours as needed for pain. 7. tramadol 50 mg tablet sig: 0.25 tablet po every six (6) hours as needed for pain: may take additional 12.5mg qhs. 8. trazodone 50 mg tablet sig: 0.25 tablet po at bedtime as needed for insomnia. 9. calcium carbonate 500 mg (1,250 mg) tablet sig: one (1) tablet po three times a day. 10. cholecalciferol (vitamin d3) 1,000 unit tablet sig: one (1) tablet po once a day. 11. cyanocobalamin (vitamin b-12) 250 mcg tablet sig: one (1) tablet po once a day. 12. folic acid 1 mg tablet sig: one (1) tablet po once a day. 13. miconazole nitrate 2 % powder sig: one (1) application topical twice a day as needed for rash. discharge disposition: home with service facility: vna discharge diagnosis: 1. clostridium dificile infection 2. hepatitis c cirrhosis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , you came to the hospital with fevers, low blood pressure, and diarrhea. an infection called clostridium difficile colitis caused these symptoms, and was caused by antibiotic treatment of your lung infection. you were treated with several oral and iv antibiotics, and will continue to take oral vancomycin over the next 6 weeks according to a specific schedule that is attached. it is highly likely that this infection will recur if this regimen is not completed. if you require antibiotics for other problems in the future, please mention your multiple c. difficile infections to the prescribing providers. the following changes have been made to your medications: 1. start vancomycin 125mg tablets as follows over the next 6 weeks: - one tablet every six hours for one week - one tablet every twelve hours for one week - one tablet every day for one week - one tablet every other day for one week - one tablet every three days for two weeks please continue all other meds as previously prescribed. it was a pleasure taking care of you, ms. followup instructions: you have the following appointments available: department: when: thursday at 12:40 pm with: , m.d. building: sc clinical ctr campus: east best parking: garage department: infectious disease when: friday at 11:30 am with: , md building: lm bldg () campus: west best parking: garage department: liver center when: tuesday at 2:20 pm with: , md building: lm bldg () campus: west best parking: garage procedure: central venous catheter placement with guidance diagnoses: esophageal reflux unspecified essential hypertension cirrhosis of liver without mention of alcohol unspecified protein-calorie malnutrition unspecified viral hepatitis c without hepatic coma dysthymic disorder intestinal infection due to clostridium difficile other and unspecified coagulation defects candidiasis of vulva and vagina personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus other colostomy and enterostomy complication 

Answer: The patient is high likely exposed to