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: penicillins attending: chief complaint: resp distress, copd, rapid atrial fibrillation major surgical or invasive procedure: exploratory laparotomy, right colectomy and wash out, ileal transverse anastomosis central line placement arterial line history of present illness: 78 yo female with copd, afib on coumadin, chf presents with 2-3 day history of sob, cough, and chest congestion along with some fever and chills and decrease po appetite. denies any other associated symptoms and did receive the flu shot couple of weeks ago. in the ed, patient did not get her ca channel and b blocker and so went into rapid afib with rvr and so being ruled out. had some ekg changes. back to normal rate after meds. past medical history: pmhx: 1. chronic afib 2. htn 3. copd 4. chf (dx'd in setting of rvr) 5. mibi : negative 6. tte : 55%, 2+mr social history: long, heavy smoking history. quit 9 years ago. no etoh, drugs. lives at home alone retired lawyer family history: nc physical exam: 100.0 71 113/88 18 96% ra gen: nad, sleeping but easily arousable heent: perrl, eomi neck: no jvd cv: irreg, irreg, no m/r/g lungs: expiratory wheezes abd: soft, nt/nd, nabs ext: warm, no edema pertinent results: 08:44pm glucose-110* urea n-18 creat-1.3* sodium-140 potassium-3.1* chloride-96 total co2-30* anion gap-17 08:44pm pt-20.6* ptt-42.0* inr(pt)-2.7 08:44pm plt count-162 08:44pm neuts-75.1* lymphs-16.5* monos-8.0 eos-0.1 basos-0.3 08:44pm wbc-6.6 rbc-5.09 hgb-15.3 hct-45.9 mcv-90 mch-30.2 mchc-33.4 rdw-14.4 08:44pm ck-mb-2 ctropnt-<0.01 08:44pm glucose-110* urea n-18 creat-1.3* sodium-140 potassium-3.1* chloride-96 total co2-30* anion gap-17 03:50am ck-mb-2 03:50am ctropnt-<0.01 03:50am ck(cpk)-115 07:40am blood wbc-9.3 rbc-3.52* hgb-10.9* hct-32.8* mcv-93 mch-31.0 mchc-33.2 rdw-16.5* plt ct-176 01:10pm blood neuts-91* bands-2 lymphs-3* monos-3 eos-0 baso-0 atyps-0 metas-0 myelos-0 hyperse-1* 07:55am blood pt-13.0 inr(pt)-1.1 07:55am blood glucose-121* urean-31* creat-0.7 na-140 k-4.0 cl-99 hco3-34* angap-11 07:55am blood calcium-8.1* phos-3.6 mg-2.1 09:00am blood vanco-32.0 04:48am blood vanco-20.5* 07:47am blood vanco-30.1 05:04am blood vanco-18.5* brief hospital course: the hospital course was significant for the following issues: in the emergency department, the patient's ekg revealed atrial fibrillation at a rate of 127 with 2.5mm st depressions in leads v3-v5, ii, avf. given the patient's history, she was placed on droplet precautions and a nasopharyngeal aspirate was performed to evaluate for influenza. her ekg changes were attributed to demand ischemia in the setting of a rapid rate. she was continued on metoprolol and diltiazem. on hospital day #2, the patient's heart rate increased to the 160s and she became increasingly short of breath and developed significant respiratory distress. an arterial blood gas was performed and revealed: 7.15/88/125. the patient was placed on mask ventilation and transferred to the intensive care unit where she was intubated. micu course: *respiratory failure: the patient's respiratory failure was likely secondary to influenza, copd exacerbation and flash pulmonary edema due to af with rapid ventricular rate. the patient had a direct influenza a antigen test which was positive for influenza a viral antigen. the viral culture revealed hemadsorption positive virus. she was treated with amantadine for a total of 5 days. the patient was treated aggressively for copd flare with solu-medrol and frequent nebulizer treatments. she was transitioned to 60mg po prednisone on . this should be tapered slowly over the course of weeks as tolerated. the patient developed a new cxr opacity while in the micu and was treated for a superimposed bacterial pneumonia with vancomycin and levofloxacin. the patient developed a rash on her trunk and extremities. the etiology of rash was not clear but the possibility that this was an adverse reaction to vancomycin or levaquin has been entertained. skin eruption responded to benadryl iv and resolved by the time of transfer out of the micu after abx were discontinued. she completed a course of levofloxacin. the patient was extubated on and o2 was weaned. *af with rvr: the patient was initially started on a diltiazem drip but continued to require boluses of iv metoprolol with sub-optimal rate control. she was loaded with digoxin on and continued on digoxin. her rate did decrease somewhat with this regimen. her coumadin was continued initially but then held for elevated inr likely from coumadin interaction with levofloxacin. *hypotension: the patient was transiently hypotensive in the micu and required pressor support and multiple ivf boluses. with treatment of her infection and weaning of sedation, the patient's blood pressure normalized. *colonic pseudo-obstruction: the patient had severe constipation while in the icu likely secondary to fentanyl effect on intestinal motility. she was given neostigmine with good result and then was continued on an aggressive bowel regimen and reglan. *hyperglycemia: the patient was started on an insulin gtt for tight glucose control. she was transitioned to a regular insulin sliding scale prior to transfer from the micu. *fen: the patient was started on tube feeds while intubated. after extubation, she underwent a swallowing study which revealed no signs of aspiration but swallowing was a respiratory demand for her and she could easily desat if feed to quickly. recommendations included: 1. diet of thin liquids and pureed solids. straws are okay. 2. please feed slowly with rest between bites/sips trying to keep sats in low 90's. pt was transferred to medical floor on . the remainder of her hospital course was significant for the following issues. af with rvr: the patient was transitioned to po diltiazem, metoprolol and digoxin. the patient's rate was consistently in the 105-120 range with occasional bursts to 150-160. she was asymptomatic and hemodynamically stable. she will need to follow up with cardiology as an outpatient and it might be worth consider whether she is a candidate for av node ablation with pm placement. the patient's inr was elevated upon transfer from the micu. this elevation was thought to be due to interaction of coumadin and levofloxacin. the patient's coumadin was held and should continue to be held until her inr reaches goal of . chf: the patient has a known ef of 50%. she had some evidence of diastolic dysfunction. she was total body overloaded (> 10 liter positive) upon transfer from the micu but diuresed well with lasix. she will need continued diuresis of 750-1l of fluid per day until euvolemic. copd: she was transitioned to 60mg po prednisone on . this should be tapered slowly over the course of weeks as tolerated. colonic pseudo-obstruction: the patient was continued on reglan and an aggressive bowel regimen. she had several bowel movements and her abdominal distention was improving. hyperglycemia: continued on riss fen: prior to discharge, speech and swallow were re-consulted for evaluation oral candidiasis: the patient received nystatin for mild oral thrush. patient taken to or diagnosis: perforated cecum with ileal necrosis with feculent perforation secondary to cecal necrosis secondary to dilatation with ischemia. procedure: exploratory laparotomy, right colectomy and wash out, ileal transverse ileocolostomy. there were no complications and patient was extubated without trouble. ebl 100cc post operatively she was kept npo, ivf, ng, foley, vanc, levo, flagyl pod 1 pain was well controlled. physical therapy was consulted. pod 2 she continued to do well and the ng was taken out. in the evening she felt worse and had one episode of emesis, so a ng was placed again. pod 3 the patient felt better again. cardiology continued to follow. pod 5 she was started on clears. pod 7 she was started on a regular diet. +flatus foley was placed secondary to retension. pod 8 foley was taken out at midnight. pod 9 patient was discharged in good condition to rehab. tolerating a regular diet and moving her bowels without difficulty medications on admission: see below discharge medications: 1. fluticasone propionate 110 mcg/actuation aerosol sig: six (6) puff inhalation (2 times a day). 2. levalbuterol hcl 0.63 mg/3 ml solution sig: one (1) ml inhalation q6h (every 6 hours). 3. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day). 4. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 5. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 6. diltiazem hcl 60 mg tablet sig: two (2) tablet po tid (3 times a day). 7. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 8. prednisone 5 mg tablet sig: 0.5 tablet po bid (2 times a day) for 3 days: is first day. 9. prednisone 5 mg tablet sig: 0.5 tablet po daily (daily) for 3 days. 10. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 11. terazosin hcl 2 mg capsule sig: one (1) capsule po hs (at bedtime). 12. acetaminophen 500 mg tablet sig: two (2) tablet po q8h (every 8 hours) as needed for pain control. 13. warfarin sodium 2 mg tablet sig: one (1) tablet po once (once) as needed for atrial fibrillation for 1 doses. 14. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 15. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed. 16. dolasetron mesylate 12.5 mg iv q8h:prn 17. metronidazole in nacl (iso-os) 500 mg/100 ml piggyback sig: one (1) intravenous q8 for 4 days. 18. levofloxacin in d5w 500 mg/100 ml piggyback sig: one (1) intravenous once a day for 4 days. discharge disposition: extended care facility: & rehab center - discharge diagnosis: perforated cecum with feculent perforation secondary to cecal necrosis secondary to dilatation with ischemia. chronic obstructive pulmonary disease influenza a bacterial pneumonia atrial fibrillation ileus hyperglycemia oral thrush diastolic heart failure discharge condition: good discharge instructions: 1. please monitor for the following: fever, chills, nausea, vomiting, inability to tolerate food/drink. if any of these occur, please contact your physician . 2. staples need to come out in about two weeks. followup instructions: please call dr. office for a follow up appointment. ( follow up with dr. within 1-2 weeks. follow up with dr. . call for appointment. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances arterial catheterization open and other right hemicolectomy other small-to-large intestinal anastomosis diagnoses: congestive heart failure, unspecified unspecified essential hypertension other specified disorders of pancreatic internal secretion adrenal cortical steroids causing adverse effects in therapeutic use atrial fibrillation perforation of intestine obstructive chronic bronchitis with (acute) exacerbation candidiasis of mouth acute respiratory failure paralytic ileus acute vascular insufficiency of intestine diastolic heart failure, unspecified influenza with pneumonia abscess of intestine 

Answer: The patient is high likely exposed to