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: vancocin hcl attending: chief complaint: cc: major surgical or invasive procedure: permenant pacemaker l picc line history of present illness: hpi: 30 year old female recently discharged () from trauma service s/p multiple gunshot wounds with resultant spinal cord injury and quadriplegia resulting in tracheostomy and peg tube placement, who was at where she was noted on the day of admission to have desaturation and bradycardia with trach tube suctioning, as well as a seizure. per their report, on the day prior to admission her hr went into the 20s while being suctioned. her sao2 at the time was mid-70% and while bagging her she reportedly had a seizure with a post-ictal period following. prior to these events the patient had been repositioned by the aide. . of note, during her long recent hospitalization she underwent a lengthy fever workup for frequent fevers as high as 103. id was involved, and ultimately no etiology was found. . past medical history: pmh: 1) adjustment disorder 2) c6 spinal cord injury resulting in paraplegia in : c6-t1 burst injury. . psh: ant&post fixation of cervical vertebra, trach, g-tube, ivc filter social history: soc hx: living at since shooting, for trach care, etc. family history: non-contributory physical exam: pe: 99.5, 92, 108/59, 24, 100% on ac 600x12, 50%, 10 peep gen: comfortable appearing african american female, with trach in place, responding to questions by mouthing words and nodding yes and no. heent: pearl, anicteric sclerae, moist mm. cor: rr, normal rate, no m/r/g. lungs: difficult to evaluate over coarse sounds of trach. abd: nabs, soft, nt/nd, g-tube with dressing in place, non-tender. extr: trace bipedal edema. neuro: able to move upper extremities against gravity but not force. grasp very weak. pertinent results: 04:09am blood wbc-10.4 rbc-3.23* hgb-9.8* hct-29.2* mcv-91 mch-30.3 mchc-33.5 rdw-15.6* plt ct-356 01:43pm blood wbc-13.0*# rbc-3.10* hgb-9.6* hct-28.1* mcv-91 mch-30.9 mchc-34.1 rdw-15.7* plt ct-342 01:30am blood wbc-8.4 rbc-3.37* hgb-10.0* hct-30.0* mcv-89 mch-29.6 mchc-33.2 rdw-14.7 plt ct-316 01:43pm blood neuts-76.4* lymphs-17.3* monos-3.4 eos-2.6 baso-0.3 01:30am blood neuts-75.2* lymphs-18.1 monos-3.0 eos-3.5 baso-0.3 01:30am blood esr-100* 04:09am blood glucose-100 urean-12 creat-0.3* na-136 k-4.8 cl-103 hco3-24 angap-14 01:30am blood glucose-139* urean-12 creat-0.3* na-141 k-3.9 cl-104 hco3-23 angap-18 01:43pm blood alt-132* ast-36 ld(ldh)-225 ck(cpk)-49 alkphos-103 amylase-249* totbili-0.2 01:43pm blood lipase-270* 06:27pm blood ck-mb-5 ctropnt-0.03* 01:43pm blood ck-mb-5 ctropnt-0.03* 01:43pm blood albumin-3.2* calcium-8.9 phos-4.2 mg-2.3 01:04am blood lactate-1.5 k-4.3 _____________________________________ ____________________________________ complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 04:10am 9.7 3.40* 10.2* 30.1* 89 30.0 33.8 14.1 237 renal & glucose glucose urean creat na k cl hco3 angap 04:10am 144* 10 0.2* 136 4.2 99 25 16 _ _ _ _ _ _ _ _ _ _ ________________________________________________________________ radiology final report chest (portable ap) 5:03 am chest (portable ap) reason: please eval for lead position and ptx. medical condition: 30 year old woman vent dependent, s/p trauma s/p c spine fixation now s/p perm pacer placement. reason for this examination: please eval for lead position and ptx. indication: 30-year-old woman with vent dependent. status post permanent pacemaker placement. evaluate for lead position and pneumothorax. comparison: . semi-erect ap portable chest: the lung apices are partially excluded from examination. the tip of the tracheostomy tube remains in similar position. the leads of the pacemaker again project over the expected locations of the right atrium and right ventricle in this single view. sternal wire sutures are again noted. a picc entering from the left upper extremity ends just beyond the left axilla. the heart size is unchanged. the left retrocardiac opacity persists. the visualized portions of the right lung remain clear. no pneumothorax is seen. impression: 1. unchanged pacemaker lead position in this single projection . a conventional two-view chest examination could confirm their positions. 2. persistent left retrocardiac opacity probably representing atelectasis. 3. no pneumothorax seen, although this examination is somewhat limited, as above. the study and the report were reviewed by the staff radiologist. dr. dr. approved: 11:43 am _ _ _ _ _ _ _ _ _ ________________________________________________________________ radiology final report ct abdomen w/o contrast 10:47 am ct abdomen w/o contrast; ct pelvis w/o contrast reason: please evaluate for abscess, pseudocyst, evidence of pancrea field of view: 46 medical condition: 30 year old woman with fevers and elevated amylase and lipase reason for this examination: please evaluate for abscess, pseudocyst, evidence of pancreatitis contraindications for iv contrast: none. indication: 30-year-old with fever, elevated amylase and lipase, assess for abscess or pancreatitis. technique: ct of the abdomen and pelvis without iv contrast. the patient did not receive iv contrast due to lack of iv access. no prior abdominal cts for comparison. ct of the abdomen without iv contrast: there are atelectatic changes at both lung bases, somewhat more focal at the left lung base. there is a small pericardial effusion. evaluation of the superior part of the liver is somewhat limited due to streak artifact from the patient's arms. the remainder of the liver, gallbladder, spleen, pancreas, adrenals, and kidneys are unremarkable in appearance allowing for the lack of iv contrast. a minimal amount of stranding is seen just inferior to the pancreas in the mid abdomen. there is no focal fluid collection. a percutaneous gastrostomy tube is present. an inferior vena cava filter is present. no free fluid, free air, or pathologic lymphadenopathy is seen. the intra-abdominal large and small bowel are unremarkable. ct of the pelvis without iv contrast: the rectum, sigmoid, bladder, uterus, and ovaries are normal in appearance. a foley catheter is present with a small amount of resultant air within the bladder. a few small non- pathologically enlarged lymph nodes are seen within both inguinal regions. there is no free fluid or lymphadenopathy in the pelvis. osseous structures are unremarkable. the soft tissues are normal. impression: 1. bibasilar atelectasis. more focal consolidation at the left base is not excluded. 2. no evidence of pancreatitis or intra-abdominal abscess. _ _ _ _ _ _ _ ________________________________________________________________ object: evaluate for seizures. referring doctor: dr. findings: background: the background remained in the 9 hz frequency range throughout the majority of the recording. at times, overlying beta activity could be seen. hyperventilation: could not be performed. intermittent photic stimulation: could not be performed. sleep: the patient progressed from wakefulness to drowsiness but did not enter stage ii sleep. cardiac monitor: showed a generally regular rate and rhythm. impression: this is a normal eeg in the awake and drowsy states. no focal or epileptiform activity was seen. note is made of overlying muscle activity over both temporal regions. no epileptiform activity was observed. interpreted by: , s. (f) _ _ _ _ _ _ _ ________________________________________________________________ 8:25 pm urine **final report ** urine culture (final ): acinetobacter baumannii. >100,000 organisms/ml.. sensitivities: mic expressed in mcg/ml _________________________________________________________ acinetobacter baumannii | cefepime-------------- <=1 s ceftazidime----------- 4 s gentamicin------------ <=1 s imipenem-------------- <=1 s levofloxacin----------<=0.25 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s 5:48 am urine **final report ** urine culture (final ): no growth. _ _ _ _ _ _ _ _ _ ________________________________________________________________ 12:45 am sputum site: endotracheal **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 4+ (>10 per 1000x field): multiple organisms consistent with oropharyngeal flora. respiratory culture (final ): moderate growth oropharyngeal flora. staph aureus coag +. moderate growth. of two colonial morphologies. oxacillin resistant staphylococci must be reported as also resistant to other penicillins, cephalosporins, carbacephems, carbapenems, and beta-lactamase inhibitor combinations. rifampin should not be used alone for therapy. gram negative rod(s). rare growth. sensitivities: mic expressed in mcg/ml _________________________________________________________ staph aureus coag + | clindamycin----------- =>8 r erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- =>8 r oxacillin------------- =>4 r penicillin------------ =>0.5 r rifampin-------------- <=0.5 s tetracycline---------- <=1 s vancomycin------------ <=1 s brief hospital course: a/p: 30 year old female with recent c6 spinal injury secondary to gunshot wounds and resultant paraplegia, tracheostomy, g-tube, and ivc filter placement, sent from rehab for bradycardia with suctioning and associated desaturation and questionable seizure. . #) bradycardia and asystolic episode at rehab: be secondary to vagal response to mucous plugging or suctioning. no further events during hospital stay . ep does not think patient has underlying conduction problem and some of this may be related to prior anoxic brain injury which could have affected brainstem. permenant pacemaker placed on . . #) ?seizure: per report from aide and rn at rehab. if indeed seizure, could possibly have been secondary to brief period of anoxia. bleed ruled out by non-contrast head ct. no signs of ongoing seizures, and patient doesn't seem to have had much of a post-ictal period (minutes by report, it seems). nevertheless, for completeness sake, will check eeg. --f/u eeg . #) fever: had uti with acinobacter treated with a 7 day course of ciprofloxacin and ceftazidime. follow up urine culture negative. has new lll infiltrate vs atelectasis on cxr and fever on . holding off antibiotics at this point. would watch her clinically and increase pulmonary toilet . if does not get better or has increased vent requirement would consider bronchoscopy to look for mucous plug. has history of mrsa pneumonia. also has history of redman syndrome with vancomycin. on ssri which will interact with linezolid. if is persistently febrile, has increased secretions, or increased radiographic evidence of pna would begin treatment. . #) ventilator dependence: stable settings during hospitalization. patient has been ventilator dependent for unclear reasons since her trauma. her spinal lesion is at c6 which should not affect diaphragm and she has no apparent lung parencyhmal process that would keep her from weaning off the vent. be secondary to brainstem dysfunction in the setting of possible anoxic brain injury after her gunshot trauma. had nif of 17 . . #) tachycardia - episode of tachycardia going as fast as 180 on . pt given adenosine which slowed down the rate. slow rhythm with clear p waves in leads 2, and vii with pr ~0.08, ?atrial tachycardia. - ep consult felt it was sinus tachcardia. -cont. metoprolol. . #) fen: on promote with fiber tf . goal rate 75 cc/hour. . #) ivc filter: seems to have been placed for prophylactic purposes as no documented le dvts or pe. medications on admission: meds: sqh percocet elixir gabapentin 300 ranitidine lorazepam mirtazapine iss flonase albuterol ipratropium discharge medications: 1. oxycodone 5 mg/5 ml solution sig: fifteen (15) mg po q3h (every 3 hours) as needed for pain. 2. mirtazapine 15 mg tablet sig: 1.5 tablets po hs (at bedtime). 3. buspirone 5 mg tablet sig: one (1) tablet po tid (3 times a day). 4. chlorhexidine gluconate 0.12 % mouthwash sig: fifteen (15) ml mucous membrane (2 times a day). 5. acetylcysteine 20 % (200 mg/ml) solution sig: 3-5 mls miscell. q4-6h (every 4 to 6 hours) as needed. 6. lorazepam 1 mg tablet sig: one (1) tablet po hs (at bedtime). 7. lorazepam 0.5 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed. 8. ibuprofen 100 mg/5 ml suspension sig: 200-400 mg po q6h (every 6 hours) as needed for fever or pain. mg 9. senna 8.6 mg tablet sig: two (2) tablet po hs (at bedtime). 10. docusate sodium 150 mg/15 ml liquid sig: one hundred (100) mg po bid (2 times a day). 11. bisacodyl 10 mg suppository sig: one (1) suppository rectal hs (at bedtime) as needed for constipation. 12. acetaminophen 160 mg/5 ml solution sig: six y (650) mg po q4-6h (every 4 to 6 hours) as needed for fever or pain. 13. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day): groin. 14. aluminum-magnesium hydroxide 225-200 mg/5 ml suspension sig: 15-30 mls po qid (4 times a day) as needed. 15. calcium carbonate 500 mg/5 ml suspension sig: five (5) ml po bid (2 times a day). 16. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 17. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 18. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 19. cephalexin 250 mg/5 ml suspension for reconstitution sig: five hundred (500) mg po q8h (every 8 hours) for 6 doses. discharge disposition: extended care facility: - discharge diagnosis: spinal cord injury respiratory failure urinary tract infection seizure disorder bradycardia discharge condition: good discharge instructions: please take medications as prescribed. . if you have questions please contact , md at followup instructions: please check cxr on please also check cbc on l picc line pulled back and is now a mid-line. if pt does not require antibiotics in the next week please remove picc line. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle insertion of temporary transvenous pacemaker system closed [endoscopic] biopsy of bronchus injection or infusion of oxazolidinone class of antibiotics diagnoses: urinary tract infection, site not specified other convulsions anoxic brain damage sinoatrial node dysfunction quadriplegia, unspecified chronic respiratory failure arthrodesis status dependence on respirator, status attention to tracheostomy late effect of spinal cord injury late effects of injury purposely inflicted by other person 

Answer: The patient is high likely exposed to