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: demerol / compazine / reglan / betadine surgi-prep / tape / iodine; iodine containing / vancomycin attending: chief complaint: back pain major surgical or invasive procedure: none history of present illness: 47f h/ syndrome s/p colectomy and short gut syndrome, on tpn for many years who comes in frequently with recurrent line infections, and has had multiple other infectious complications. presenting evening to the ed with fever, hypotension to 80s/40s, and low back pain. reportedly treated for a uti last week, and with clear urine at outside ed. also has a h/o l4-5 discitis in . in the , pt was febrile and hypotensive, received 6lns with sbp persistently in the 70s. levophed started at 0.06 through femoral hickman. seen by nsgy in the ed who recommended ct guided bx of disc. id consulted; she is well-known to their service and per their review of her prior infections and sensitivities, they recommended cefepime and dapto which were started in the ed. per id, she has presented several times with identical symptoms and found to have a line infection with bacteremia presenting as back pain. . review of systems: (+) per hpi, some urinary incontinence assocatitaed with recent uti (-) denies recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel habits. no dysuria. denied arthralgias or myalgias. past medical history: ++ syndrome - diagnosed age 23 - total colectomy, end ileostomy - small bowel resection (multiple) secondary to recurrent polyposis - subsequent short gut syndrome - on tpn since , ++ benign cystadenoma - partial hepatectomy, ++ line-associated blood stream infections - her cvl in her l leg has been in place for at least 5 years, when she has had infections the line has been changed over a wire - mssa, - - c. parapsilosis + coag neg staph, - non-albicans, - c.parapsilosis, - k. pneumoniae, --> resistant to cipro, cefuroxime, tmp/smx --> treated with meropenem /08 - line change due to positive blood cultures (?) --> had an echocardiogram that was abnormal as noted below coag neg staph --> line changed over wire --> linezolid ++ venous thrombosis/occlusion - failed access in r ij, r brachiocephalic - reconstructed ivc w/ kissing stent extensions into high ivc - stenting to r femoral, external iliac ++ gi bleed ++ hsv-1 ++ fibromyalgia ++ osteoporosis ++ scoliosis; h/o surgical repair ++ right hip fracture; orif ++ meniscal tears of knee; 4 prior surgeries, ++ total abdominal hysterectomy; bilateral salpingo-oophorectomy ++ dermoid cyst removal (small bowel, ovaries) ++ hepatic cyst adenoma; resected ++ cholecystectomy, social history: the patient lives with her mother in , mass; mother helps her with her medical needs. denies alcohol or tobacco. family history: father and 6 of 8 siblings with syndrome. mother and relatives with htn and resulting cva. sister with breast cancer. her father's parents died of cancer. physical exam: general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: admit labs wbc-4.7 rbc-3.81* hgb-11.4* hct-33.4* mcv-88 mch-29.8 mchc-34.0 rdw-13.9 plt ct-193# neuts-89.2* lymphs-5.6* monos-3.6 eos-1.2 baso-0.3 pt-12.9 ptt-39.2* inr(pt)-1.1 glucose-117* urean-20 creat-0.9 na-138 k-3.9 cl-105 hco3-23 angap-14 alt-120* ast-83* alkphos-436* totbili-1.3 lipase-17 calcium-7.4* phos-2.8 mg-1.5* lactate-1.7 k-4.0 crp-61.1* ct lumbar spinr () - impression: 1. erosive endplate changes at the l4-5 level consistent with known chronic discitis. assessment for any acute foci of infection si limited. 2. no evidence of acute fracture or malalignment. 3. bilateral atelectasis, right greater than left, unchanged. 4. multiple mesenteric and retroperitoneal lymph nodes, which are enlarged and measure up to 1 cm. these are relatively stable. please note that mri is more sensitive in the detection of intrathecal abnormalitites and should be considered if there is concern for ongoing/ recurrent infection in the disk, vertebrae or spinal soft tissues. ruq ultrasound () - impression: 1. no pathology identified to account for the patient's presentation. exam is unchanged from , with unchanged dilatation of the extrahepatic common bile duct which is within normal limits for post- cholecystectomy. no choledocholithiasis seen. 2. unchanged splenomegaly. 3. left pleural effusion. wbc scan () - impression: no evidence of acute osteomyelitis, discitis or focal infection. brief hospital course: assessment and plan: this is a 47 yo f with recurrent admissions fot line associated bacterimia now presenting with severe back pain and sepsis requiring pressors. . # sepsis / hypotension / fevers - while the patient did have a downward-trending wbc on admission, her high fevers and hypotension requiring pressors made sepsis the likely cause of her symptoms. given her medical history, it was most likely that the source of her sepsis was a line infection. additionally, blood cultures from and outside hospital showed coag neg staph in multiple bottles. she was started on cefepime and daptomycin, based off of her medical history. neurosurgery and id were also consulted because of the possibility that the patient could have disciitis. a ct scan of the lumbar spine was performed and showed erosive changes at l4-5 that were consistent with known chronic discitis. however, acute infection could not be completely ruled out. it was noted, after the patient's admission to the micu, that her blood pressures normally run low and this was kept in mind as we weaned down her pressors. id added micofungin to the patient's regimen. neurosurgery recommended getting a crp and a tagged wbc scan, which showed no evidence of acute osteomyelitis, discitis or focal infection. also, the patient's venous access line was ethanol-locked, which is what she uses at home. three days after her admission, the patient was transferred out of the micu to the medicine service. at the time of transfer, all of her blood cultures from this hospital (including fungal cultures) were still pending. also, attempts were being made to obtain sensitivities from her cultures at the outside hospital. the bacteria was found to be sensitive to daptomycin. she will need 4 wks total of daptomycin (last dose 08/04) and to follow-up in id urgent care clinic in one week when vna can fax blood culture results to id doctor (name listed in follow-up instructions) she will need weekly cbc/ diff, ck, bun/cr as an outpatient on daptomycin. # leukopenia/thrombocytopenia: ddx includes medication induced (although no major medications which are likely culprits) vs. sepsis (although time course seems unusual). of note, her osh uti med was macrobid. - will trend values and watch for clinical improvement. # history of venous thrombosis and pulmonary embolism - the patient was taken off of coumadin in the past due to interactions with antibiotics and her history of frequent hospitalizations with antibiotic treatment. she was continued on her regimen of plavix during this admission for her stents. # pain control- pt has had chronic back pain and has been taking oxycodone and dilaudid in addition to having a fentanyl patch. upon consult from pain management team, we started tizanidine 20mg tid and liquid gabapentin 300mg tid on as well as a prn lidoderm patch. lido patch was changed to a standing order on the 14th and liquid oxycodone 5mg prn was also ordered at this time. pt continued to do well from a pain standpoint and was feeling relatively pain-free and using less dilaudid on . however, on the night of the 14th, pt reported increased back pain that did not respond go 5mg oxycodone. oxycodone was increased to 10mg prn on and pt reported increased relief with this dose. medications on admission: not on omr discharge medications: 1. outpatient lab work check creatinine kinase, please fax to pcp: _________ 2. daptomycin 275 mg iv q24h d1= 3. daptomycin 500 mg recon soln sig: two y five (275) mg intravenous every twenty-four(24) hours for 7 days. disp:*qs qs* refills:*0* discharge disposition: home with service facility: diversified vna and hospice discharge diagnosis: primary: sepsis secondary: pulmonary embolism, syndrome, chronic pain discharge condition: stable, afebrile. discharge instructions: you were admitted for a uti and back pain and were found to have a low blood pressure and sepsis. you grew out bacteria in your blood, for which you were treated with antibiotics. (daptomycin) you will need to continue this antibiotic until for a total of 4 weeks. your chronic pain was managed was pain medications, muscle relaxants and gabapentin. your meds were changed: daptomycin, tizanidine, gabapentin (please see discharge meds below). please come back to the hospital if you experience chest pain, shortness of breath, extreme back pain, hypotension please return to the hosp or call your doctor if x happens. followup instructions: please have vna obtain blood cultures in 1 week and fax the results back to dr. fax: ( then please follow up in infectious disease urgent care clinic that same week. they will need to check your cbc/diff, ck, bun/cr weekly while an outpatient on daptomycin. please f/u with your primary care doctor. procedure: parenteral infusion of concentrated nutritional substances diagnoses: thrombocytopenia, unspecified urinary tract infection, site not specified unspecified septicemia unspecified protein-calorie malnutrition sepsis long-term (current) use of anticoagulants personal history of venous thrombosis and embolism other and unspecified infection due to central venous catheter other and unspecified disc disorder, lumbar region other and unspecified postsurgical nonabsorption leukocytopenia, unspecified 

Answer: The patient is high likely exposed to