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 sulfate attending: chief complaint: subdural hematoma s/p fall and neutropenic fever (osh transfer) major surgical or invasive procedure: removal or port placement of picc line history of present illness: history of present illness: 83f with metastatic breast ca s/p mechanical fall at 1am on after losing balance while getting up to use commode. she fell on her left side, and hit her l knee and her head anteriorly on hardwood floor. she denies loc, dizziness, visual changes or hearing changes. she was feeling okay and went back to sleep. later that day she developed fever up to 100.6 and presented to ohs. she had a head ct and was found to have a 5mm l frontal subdural hematoma. she was also found to be neutropenic. she recent chemo treatement with doxorubicin on . her primary oncologist was notified and per recs she was started on ceftazidime, levofloxacin, and neupogen. she was then transferred here for further evaluation of her subdural hematoma. on arrival to the ed her vitals were, t97.4, bp 102/60, r 18, hr 60, o2sat 96% her pe was noted for no neurologic findings. neurosurgery was consulted and recommended repeating ct of head in am and frequent neuro checks. neck ct was done and showed no fracture or traumatic malalignment. she also had cxr that showed 3.6 cm rll pulmonary opacity/mass and patchy left costal phrenic angle opacity, that could represent atelectasis vs consolidation. she spiked to 101 and received vancomycin. she denies respiratory symptoms. her wbc 0.6 w/( n:20 band:0 l:54 m:10 e:6 bas:0 atyps: 10), hct 28.5, plts 212. bicarb at 19, creatine at 1.5 w/ bun of 29 uncertain about her baseline. she was given 1l of iv fluids and then transferred to the for further observation for her subdural hematoma. on arrival to the , pt appears comfortable. she has no neurologic symptoms, except for minor ha on the site of the trauma. her left leg has an open woun/excoriation. she denies having any other complains. past medical history: -breast cancer metastatic to bone: initially diagnosed in with a l axilla mass. pt then had radiation and chemo. she improved, however her left arm has lymphedema. most recently in - she developed a lump on her left rib and was found to have mets. she was then started on doxirubicin -type 2 diabetes social history: she used to work as a waitress and in a shoe shop. she has 8 children and she currently lives with her daughter. she uses a walker to ambulate due to "worsening balance" for the last year. her daughter helps her take her meds. she smoked 1ppd for ~50 years and quit over 18 years ago. she does not drink alcohol family history: 2 paternal aunts had breast ca 1 sister died of breast ca physical exam: vs: 99.9 146/56 77 10 97%ra, 188 glu general: alert & oriented fully, no acute distress heent: sclera anicteric, mmm, left periorbital ecchymoses, left conjunctiva injected neck: supple, no jvd, no lad, normal rom lungs: cta b, no wheezes, rales, ronchi cv: rrr, + systolic ejection murmur ii/vi heard through out, no rubs/gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema lle: with ecchymosis on the left knee area and skin excoriation neuro: speech is fluent, 5/5 strength bil le, lue sl weaker w/limited rom due to lymphedema and decrease rom due to injury and wrap; sensation is grossly intact throughout; patellar and brachioradialis reflexes 2+ and symmetric pertinent results: admission labs: 08:50pm blood wbc-0.6* rbc-2.98* hgb-9.6* hct-28.5* mcv-96 mch-32.1* mchc-33.6 rdw-19.4* plt ct-212 08:50pm blood neuts-20* bands-0 lymphs-54* monos-10 eos-6* baso-0 atyps-10* metas-0 myelos-0 nrbc-6* 08:50pm blood hypochr-1+ anisocy-1+ poiklo-normal macrocy-1+ microcy-normal polychr-1+ stipple-occasional 08:50pm blood pt-12.9 ptt-22.9 inr(pt)-1.1 08:50pm blood glucose-70 urean-29* creat-1.5* na-136 k-5.1 cl-101 hco3-19* angap-21* ct spine with contrast (): impression: 1. no evidence of acute fracture or traumatic malalignment. multilevel degenerative changes may predispose to traumatic cord injury. if the clinical exam is suspicious for this entity, consider evaluation with mri. 2. sclerotic and lytic vertebrae in the cervical spine, most notably involving c2 and c6. in the presence of malignancy, these could conceivably be neoplastic/metastatic. would recommend comparison to previous imaging if available. otherwise, consider outpatient mri or bone scan as clinically warranted. head ct (): impression: interval evolution of previously seen subdural hematoma. no evidence of new hemorrhage. blood cultures: _________________________________________________________ enterococcus faecalis | staphylococcus, coagulase negative | | ampicillin------------ <=2 s clindamycin----------- s daptomycin------------ s erythromycin---------- <=0.25 s gentamicin------------ <=2 s levofloxacin---------- 0.5 s oxacillin------------- =>16 r penicillin g---------- 8 s rifampin-------------- <=0.5 s tetracycline---------- =>16 r s vancomycin------------ 2 s <=1 s tte the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). there is no ventricular septal defect. the right ventricular cavity is dilated with normal free wall contractility. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no masses or vegetations are seen on the aortic valve. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. no mass or vegetation is seen on the mitral valve. mild to moderate (+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. brief hospital course: 1. bacteremia: blood cultures drawn during the patient's hospitalization returned positive with high-grade enterococcal bacteremia and coagulase negative staph bacteremia. after initial treatment with vancomycin, switch to ampicillin was made with return of sensitivities. id was consulted and felt the coag negative staph need not be treated. tte showed no vegetations; tee was refused by patient, therefore, 6 week course was recommended with day 1 and final day . port was removed. 2. subdural hematoma: small with no focal neurologic defecit. neurosurgery evaluated and recommended repeat head ct which showed normal progression of bleed; neurosurgery recommended follow-up in 4 weeks. 3. neutropenic fever. most likely source bacteremia from her indwelling port. cxr demonstrated a rll opacity felt to be most consistent with metastatic disease (seen on cxr at oncologists office). while neutropenic, received ceftazadine and neupogen. after seven day course of former, this was stopped; neupogen was stopped after wbc normalized. will need to follow-up with primary oncologist regarding lung mass. 4. anemia with thrombocytopenia: likely related to chemo regimen. hct of 28.5 on admission down to hct of 22.3 by am of . likely hemodilutional as plts also dropped from 212 to 132 with no signs of active bleeding. due to overall poor status and unclear relation to timing for chemo count nadir, transfused 1 unit prbc on am of with post transfusion hct of 27.0. 5. renal failure: creatine peaked at 1.5 and was 1.2 at time of last check. possible prerenal component with underlying ckd. medications on admission: doxorubicin once a month, last carbidopa/levodopa 25/100 daily atenolol 100mg daily gabapentin 400mg tid amitrtiptylline 10mg daily glimepiride 1mg daily omeprazole 20mg daily loratidine 10mg as needed multivitamin daily k dur 20meq viactiv calcium daily magnesium 400mg daily senakot 8.6 mg, 1 tab qam, 2 tabs qpm tylenol 325mg, 1-2 tabs q4h prn oxycodone 5/325 prn pain discharge medications: 1. carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po daily (daily). 2. glimepiride 1 mg tablet sig: one (1) tablet po once a day. 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 4. loratadine 10 mg tablet sig: one (1) tablet po once a day as needed for allergy symptoms. 5. multivitamin tablet sig: one (1) tablet po daily (daily). 6. viactiv oral 7. magnesium oral 8. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 9. ampicillin sodium 2 gram recon soln sig: two (2) grams intravenous every six (6) hours for 5 weeks: last dose 10/17. disp:*qs grams* refills:*0* 10. atenolol 50 mg tablet sig: two (2) tablet po daily (daily). discharge disposition: home with service facility: vna discharge diagnosis: enterococcal bacteremia subdural hematoma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted with a subdural bleed and found to have bacteria in the blood. six weeks of antibiotics will be needed to treat this infection. for the head bleed, you have an appointment scheduled with the neurosurgeons to follow-up. followup instructions: department: primary care name: dr. when: monday at 11:30 am location: address: , , phone: department: radiology when: wednesday at 10:15 am. please arrive at 10 am for registration. with: cat scan building: cc clinical center campus: west best parking: garage department: neurosurgery when: wednesday at 11:00 am with: , md building: lm , campus: west best parking: garage oncologist: please schedule a follow-up with your primary oncologist : dr. ; phone: ( procedure: venous catheterization, not elsewhere classified incision with removal of foreign body or device from skin and subcutaneous tissue diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled personal history of malignant neoplasm of breast bacteremia antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] other and unspecified infection due to central venous catheter drug induced neutropenia subdural hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness fall from other slipping, tripping, or stumbling secondary malignant neoplasm of bone and bone marrow postmastectomy lymphedema syndrome anemia in neoplastic disease 

Answer: The patient is high likely exposed to