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: codeine, intravenous contrast and phenothiazine, although she tolerated intravenous contrast well during her stay. past medical/surgical history: as outlined above. her previous history is also significant for exploratory laparotomy with hysterectomy, depression, gastroenteritis, fibromyalgia, irritable bowel syndrome, hypertension, chronic fatigue syndrome, chronic back pain, morbid obesity, suicidal attempts on several occasions, interstitial cystitis, chronic utis, basal cell carcinoma status post excision, hypertension. there is no known history of coronary artery disease or diabetes and no history of known thyroid disease. medications: medication at home is toprol xl 50 once a day. she denied taking any of her other medications. social history: the patient is baseline confused. she is a retired nurse who lives alone and is estranged from all her four sons. she has no known history of alcohol abuse or smoking, however, her past psychiatric history is quite significant as noted above. family history: unknown because the patient is an extremely poor historian. physical examination: physical examination on presentation to the emergency room at was temperature 102.6, blood pressure 163/68, heart rate 88. she was breathing 20 times a minute and her o2 saturation was about 100 percent. at that time she appeared ill, confused and distressed. pupils were equal and reactive to light and anicteric. she had some strabismus. heart was regular rate and rhythm without evidence of jugular venous distention nor was there evidence of systolic murmur. lungs revealed poor inspiration and decreased breath sounds at the bases with some diffuse rhonchi. abdomen was extremely obese with a well healed, infraumbilical, midline incision without evidence of hernia. she had left lower quadrant focal rigidity and tenderness without rebound upon presentation. she had some mild left sided costovertebral angle tenderness. right lower quadrant was benign as were the upper quadrants. she did not have a sign. she was nontender over mcburney point. there was yeast present between her inguinal folds. rectal revealed no masses and a posterior anal fissure, no evidence of hemorrhoids, no stool was felt on digital inspection within the lower rectal vault. vascular exam revealed palpable, 1 plus femorals and palpable dps. there were no carotid bruits. there was no evidence of lymphadenopathy, no thyromegaly. laboratory data: laboratory data on admission to were white count 9.8, hematocrit 42, platelets 294. sodium 140, potassium 3.3, chloride 101, bicarb 28, bun 12, creatinine 0.9, glucose 121. amylase 114, lipase 212. lfts were within normal limits. urinalysis sent off after placement of foley catheter was extremely positive, essentially draining pus which was positive for nitrites and white cells. hospital course: hospital course for the combined and is now as follows. the patient was initially diagnosed with the suspicion of pyelonephritis and given wide spectrum antibiotics. however, there was no way to rule out diverticulitis and the decision was made to conduct a ct scan that evening. cat scan demonstrated that she had significant sigmoid diverticulitis which appeared uncomplicated and without an abscess. there was no evidence of extensive free air. she had been admitted to the medical service with us consulting and we followed very carefully. she was made npo and fluid resuscitated. foley catheter was carefully monitored for fluid output. she received serial abdominal exams as well as intravenous antibiotics. during the course of the next 12 hours and the following morning, it was noted that her abdominal exam had worsened and she now had diffuse peritonitis and rebound in all four quadrants of the abdomen. based on this, the decision was made that she needed emergency exploration and she went to the operating room. see op report for details on this. her postoperative course remained extremely and is dictated by system for the combined hospitals. neurologically, the patient was initially on propofol, ativan and morphine. she was intubated and extubated postoperatively on the third postoperative day and she did well. baseline she was confused and demented according to our notes in the computer pre-incident. her pain was controlled once she was extubated and able to take clears and p.o. medications. however, on she suffered acute respiratory distress and required reintubation. at this point we used propofol for sedation and comfort as well as morphine and ativan. after extubation at , she was eventually put back on iv dilaudid and now p.o. medications for pain control. her neurologic status at this point reveals that she is confused, but she is coherent and able to communicate with us. from a cardiovascular point of view, throughout all incidents the patient remained hemodynamically stable without evidence of loss of blood pressure throughout her hospital stay. we continued her on a beta blocker and she did not have any ischemic changes or episodes that we could tell. on she suffered an episode of hypertension and tachycardia which were unexplained and presumed due to pe until workup could be conducted. she was also checked for cardiac enzymes times three which were negative over the next few hours. she was increased on lopressor to 20 mg iv every six hours. hemodynamically remaining stable and she has continued on her beta blocker of lopressor now 50 b.i.d. with thickened nectar. from a respiratory point of view, the patient remained morbidly obese and incentive spirometry and out of bed were vigorously encouraged and helped with the patient. a ct scan was performed emergently on revealing no evidence of pulmonary embolism. heparin was started empirically and continued. due to our concern which had to be stopped, please see below under heme. from a respiratory point of view, after her successful extubation initially, she required emergent reintubation on . however, she was eventually re-extubated at diuresis. there was no evidence of pneumonia. however, sputum did reveal mrsa as well as a line culture which grew out staph epi from the hospital which was mrsa as well. gi and nutrition. the patient was initially nothing by mouth and continued on tpn for nutrition. however, her ostomy started to function and she was allowed tube feeds which were stopped. we continued tpn during the time when she was reintubated. we then eventually were able to obtain a swallow study which demonstrated that she was cleared for bedside food as long as it was pureed and thickened honey nectar food. she was too large for us to conduct a video pharyngeal radiological swallow, but she had been cleared by the speech and swallow department here for pureed and honey thickened foods. her ostomy is functioning, slightly retracted, but viable with gas inside of it. she was receiving prevacid and converted over to protonix p.o. for gi prophylaxis. on the 18th the patient received gallbladder percutaneous catheter placement for a positive hida which concerned us for cholecystitis. this was placed by interventional radiology. fluids, electrolytes and nutrition, gu and renal. the patient received tpn until she was taking p.o. for nutrition. she was diuresed gently with lasix as needed and we are now holding her diuresis at this time on discharge for volume contraction with bicarb of 30. her electrolytes have been optimized and her creatinine is currently normal. hematology. the patient's hematocrit was stable at . however, upon arrival to , a lower gi bleed from the hartmann pouch was noted. heparin was stopped and her bleeding resolved. she was transfused and supported through this episode and her coags normalized. no evidence of bleeding at this time. heparin drip was not discontinued. the patient's hematocrit was stable. id. the patient has had an extremely complicated infectious disease course. initially she was given a combination of several medications, however, postoperatively after the first hospital day starting in the immediate postoperative period, she was placed on levaquin, amp, flagyl. on the 14th she was changed over to vanco and ampicillin was discontinued. she was on levo, flagyl for broader coverage. fluconazole was started on the morning of the 16th for a persistently elevated white count and the a line grew out yeast as did one of her urine samples at . urine sample since has been shown to be sterile. white count peaked at 24,000 and has now decreased to 8.7 as of the 24th with a stable hematocrit of 34. coags revealed inr 1.3. bun and creatinine are normal. peritoneal and urine cultures initially upon presentation at grew out e.coli which was pansensitive as did her urine. these were well covered by antibiotics she received at the time. vancomycin is being continued for presumed line infection at from an a line which was infected as well as a sputum sample sent off at on the 17th which grew out mrsa. she will receive a total of 14 days of these antibiotics and as of now she is on day 10 out of 14 with vanco and this should be discontinued on the 30th. she is receiving 1 gm q.12 hours of fluconazole. levaquin and flagyl have also been discontinued. she is c.diff negative times three. her gallbladder continues to drain through the percutaneous cholecystostomy tube. endocrine. the patient proved to be somewhat insulin resistant, receiving insulin sliding scale and monitoring her sugars for tight blood sugar control. tubes, lines and drains. the patient had a central line placed which was discontinued after a picc line was placed on . she will keep this picc line in until her antibiotics are done. at that time that should be discontinued at the discretion of physician at rehab. discharge diagnoses: hypertension. perforated diverticulitis requiring emergency surgery. fibromyalgia. depression. chronic fatigue syndrome. urinary tract infection. morbid obesity. insulin resistance. vent dependent respiratory failure, now extubated. cholecystitis. the patient upon discharge is afebrile with stable vital signs. physical exam reveals that she has an abdominal wound which was left open postoperatively on the skin with good, clean, granulating tissue. this should be packed wet to dry with normal saline b.i.d. her ostomy site, although retracted, is viable and has good flow of fluid. discharge medications: 1. dilaudid 2 to 4 mg p.o. q.4h. p.r.n. 2. protonix 40 mg p.o. q.24. 3. metoprolol 50 mg p.o. b.i.d. 4. miconazole powder p.r.n. to the affected groin areas. 5. heparin subcu 5000 units b.i.d. 6. insulin sliding scale as noted starting at 120, range from 120 to 160, 2 units; range from 161 to 199, 4 units; 200 to 240, she should get 6 units; over that she should be at the discretion of the house officer or rehab doctor regarding tighter sugar control. 7. vancomycin 1 gm q.12h., this should be off on . all her diet should be pureed and honey thickened fluids nectars as well as the rest of her medications. , procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours parenteral infusion of concentrated nutritional substances insertion of endotracheal tube arterial catheterization flexible sigmoidoscopy transfusion of packed cells transfusion of other serum percutaneous aspiration of gallbladder diagnoses: urinary tract infection, site not specified unspecified essential hypertension acute respiratory failure morbid obesity infection and inflammatory reaction due to other vascular device, implant, and graft hemorrhage of gastrointestinal tract, unspecified acute cholecystitis diverticulitis of colon (without mention of hemorrhage) 

Answer: The patient is high likely exposed to