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: addendum: this is the replacement d/c summary chief complaint: hypernatremia major surgical or invasive procedure: none history of present illness: yo wheelchair-bound female nursing home resident with a history of a large right hemispheric stroke,dementia, multiple aspiration pneumonias, recurrent utis presents with decreaseing oral intake, lethargy and hypernatremia (na 168. per , pt was treated since for uti (cx data not available) w/ levofloxacin and vancomycin. nh noted progressive lethargy for the last 3 days; the patient has not been eating/taking medications for the last 3 days. labs were obtained today, and pt transported to the ed for na 168. in ed, hr 86, bpc 138/76, resp 18, 87% 5l -> 99% nrb. she received ceftriaxone and levofloxacin for presumed pneumonia and was started on 1l ns. cxr and ct head negative. 02 rapidly weaned to 2l nc and patient sent to icu for sodium correction and neurologic monitoring. course c/b decreased ms, somewhat improved with ivf depletion. had episodes of sinus bradycardia thought metabolic derangements. was empirically started on meropenem for history of esbl resistant organisms for uti and transferred to the floor once ms/hypernatremia improved. past medical history: 1) right hemorrhagic ca w/ residual left-sided paralysis 2) multiple prior aspiration pneumonias on pureeed solids at nursing home 3) ugi bleed , managed conservatively 4) h/o rectal bleeding 5) h/o c. diff colitis 6) h/o diverticulitis 7) dementia 8) severe constipation requiring multiple admissions for lbo/disimpaction 9) chf: tte: hyperdynamic lv, mild-mod mr 10) gerd 11) atrial fibrillation ?? 12) eye implant social history: lives at health and rehab center; wheelchair bound. no etoh, tobacco, or other drug use. pcp . . family history: nc physical exam: tc 99.8, pc 74, bpc 134/80, resp 16 97% 100% nrb gen: elderly, cachectic female, lethargic, does not follow commands heent: perrl, thick discharge from eyes bilaterally, mild conjunctival injection, omm very dry, poor dentition, neck supple, no lad, no jvd, normocephalic, atraumatic cardiac: rrr, ii/vi sm at apex pulm: coarse breath sounds w/ occasional ronchi abd: nabs, soft, nt/nd, no masses ext: no c/c/e, warm with 2+ dp bilaterally neuro: face symmetrical, perrl, resists eyes opening, weak gag, moves rue and rle >lle in response to painful stimulus; does not move lue in response to pain. increased tone left side. 1+ dtr throughout, does downgoing right, withdrawal on left. pertinent results: ekg: ed sinus? @ 75 bpm, downsloping depressions v4-v6 (new from prior. old prwp. in : afib at approx. 70 bpm * cxr: ? minimal, patchy rll infiltrate . pt-13.7* ptt-27.2 inr(pt)-1.2 plt count-135* neuts-62.6 lymphs-31.4 monos-2.8 eos-0.7 basos-2.4* wbc-4.9 rbc-5.57*# hgb-17.1*# hct-53.4*# mcv-96# mch-30.7 mchc-32.0 rdw-15.3 tsh-2.0 albumin-4.1 calcium-10.2 phosphate-3.0 magnesium-3.2* alt(sgpt)-59* ast(sgot)-73* ck(cpk)-33 alk phos-241* amylase-40 tot bili-1.8* glucose-109* urea n-50* creat-1.0 sodium-169* potassium-3.9 chloride-126* total co2-31* anion gap-16 urine rbc-0-2 wbc-* bacteria-mod yeast-none epi- urine blood-sm nitrite-pos protein-tr glucose-neg ketone-tr bilirubin-sm urobilngn-neg ph-5.0 leuk-sm urine color-amber appear-hazy sp -1.022 brief hospital course: yof w/ h/o mult aspiration pneumonias, recently dx uti, dementia, prior stroke admit with decreasing oral intake, lethargy and hypernatremia. . 1) hypernatremia: initial na 168. presentation consistent with loss of hypotonic fluid with decreased free h20 intake/access due to being non-ambulatory (wheelchair bound, and an overall decreased interest in food and fluids. patient was aggressively hydrated with slow correction of sodium to within normal limits, with improvement in mental status. at time of her discharge, her sodium was back to baseline 140. . 2) decreased ms: thought to be multifactorial including hypernatremia and urinary infection. had head ct on admission, negative for acute bleed. pt also with underlying dementia, which is unchanged. her medications for dementia (donepizil and memantine) were discontinued during her hospitalization. at this time, we did not feel we should restart these meds; this can be discussed with her nursing home physician. . 3) uti: pt w/ h/o recurrent utis, with u/a on admission consistent with uti; however, urine culture taken the same day was contaminated. given patient's past h/o infections with esbl resistant organisms was placed on meropenem x 5 days. f/u u/a, urine cultures showed clearance of infection, so antibiotics were d/c after 5 days. (there was concern that meropenem was contributing to her lft abnormalities/thrombocytopenia, so a prolonged course was not favored. given a nl u/a/urine culture, we felt comfortable d/c her antibiotics). . 4) ekg changes/afib: patient had ekg changes, new from baseline. was r/o for mi in the ; had mild troponin "leak" thought to be due to demand ischemia from dehydration/infection. aspirin was held in setting of low platelets. no further work-up was pursued. . 5) thrombocytopenia: pt with low nl platelets in the past, with decreased platelets during her hospitalization. meropenem was implicated, and d/c as soon as f/u u/a, urine cultures were negative. hit ab was negative. on day of discharge, platelets were back to her baseline, low 100s. . 6) abnl lfts: had transaminitis w/elevated ldh/alk phos and nl bilirubin. ruq u/s showed sludge but no stones/cholecystitis. abnormalities were thought to be secondary to meds (meropenem), but not entirely clear. still following with slow resolution of abnormalities; patient asymptomatic. . 7) f/e/n: pt w/ recurrent aspirations on pureed solids at nursing home. had bedside speech/swallow evaluation which confirmed this propensity. recommended nectar thickened liquids/aspiration precautions. it is anticipated that recurrent dehydration and hypernatremia will be a problem if mrs. refused to eat. if she is not eating, she will need d5 1/2ns maintenance ivf to avoid dehydration and hypernatremia. a picc line was inserted prior to transfer to facilitate this approach in the coming week. if patient is not eating for several days, may need to re-discuss the issue of a feeding tube with patient's health care proxy/son, (. . 8) proph: pneumoboots; no heparin/h2 blockers/ppi in setting of low platelets. ***aggressive bowel regimen (daily colace/senna unless patient has diarrhea; add bisacodyl/lactulose if patient not having bm x 2 days) as has needed disimpaction in past. . 9) dnr/dni: hcp (son) . 10) access-patient was not eating well during her hospitalization and required ivf. she had a picc line placed on day of discharge for ivf as needed medications on admission: 1) duoneb q6h prn 2) trazodone 25 mg po qhs prn 3) tylenol prn 4) colace 100 mg po bid 5) senna 1 tab po bid prn 6) glycolax 17g po prn 7) protonix 40 mg po daily 8) mom prn 9) aricept 10 mg po daily 10) namendal 10 mg po bid 11) mucinex 600 mg po bid 12) levoquin 250 mg po daily 13) ?vancomycin discharge medications: 1. docusate sodium 150 mg/15 ml liquid sig: one (1) dose po bid (2 times a day): hold for diarrhea. 2. senna 8.6 mg tablet sig: two (2) tablet po bid (2 times a day): hold for diarrhea. 3. trazodone hcl 50 mg tablet sig: 0.5 tablet po tid (3 times a day) as needed for agitation. 4. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation: patient has history of impaction; if no bm x 2 days, please be aggressive with bowel regimen. discharge disposition: extended care facility: - discharge diagnosis: hypernatremia urinary tract infection discharge condition: patient is urinating, having bowel movements and tolerating pos (aspiration precautions). she is wheel-chair bound at baseline but is working with physical therapy to assist in transfers. discharge instructions: patient should take her medications as prescribed. it is imperative that she eats/drinks to avoid getting dehydrated. if she is not eating, please give her maintenance ivf d5 1/2ns at 75cc/hr. this can be stopped if she is eating. followup instructions: patient should call her primary care provider, . ( and make an appointment to see him next week. md procedure: venous catheterization, not elsewhere classified diagnoses: thrombocytopenia, unspecified urinary tract infection, site not specified chronic airway obstruction, not elsewhere classified atrial fibrillation other persistent mental disorders due to conditions classified elsewhere other specified cardiac dysrhythmias cachexia late effects of cerebrovascular disease, hemiplegia affecting unspecified side hyperosmolality and/or hypernatremia delirium due to conditions classified elsewhere other drugs and medicinal substances causing adverse effects in therapeutic use nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] glycosuria 

Answer: The patient is high likely exposed to