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: brief history of present illness: this is a 50 year old female who is status post cadaveric renal transplant on , for a history of diabetes mellitus and hypertension. she had been admitted briefly prior to this admission for complaints of right breast and facial swelling that was diagnosed as a right axillary vein thrombosis as well as a wound seroma which was opened and treated with vac dressing changes. she was readmitted then on , with a hematocrit of 23 and a wound infection which progressed to septic shock and respiratory arrest requiring intubation. she also had acute on chronic renal failure. she was admitted and her anti-coagulation which she was taking for her vein thrombosis was stopped in the face of hematuria and rectal bleeding. she was transfused and given quite a bit of fluids. the first half of her stay was in the intensive care unit and over the last month she has been recovering. her renal function has slowly improved and she started off loading her peripheral fluid overload. she was extubated in early and has been on the floor continuing to rehabilitate. past medical history: 1. diabetes mellitus. 2. diabetic neuropathy. 3. diabetic retinopathy, blindness. 4. hypertension. 5. cervical cancer status post radiation. 6. depression. 7. status post appendectomy. 8. status post cholecystectomy. 9. constipation. 10. right upper extremity av fistula. allergies: raloxifene and vancomycin. medications on admission: 1. bactrim ss one tablet p.o. q. day. 2. valcyte 450 mg p.o. q. day. 3. colace 100 mg p.o. twice a day. 4. paroxetine 20 mg p.o. twice a day. 5. cellcept mg p.o. four times a day. 6. rosiglitazone 8 mg p.o. q. day. 7. nystatin swish and swallow. 8. protonix 40 mg p.o. q. day. 9. gabapentin 100 mg p.o. q. a.m. and another 200 mg p.o. q. p.m. 10. percocet one to two tablets p.o. q. four hours p.r.n. pain. 11. prednisone 7.5 mg p.o. q. day. 12. tacrolimus 6 mg p.o. twice a day. 13. insulin sliding scale. 14. coumadin 3 mg p.o. q. day. 15. lovenox 100 mg per cc q. 12 hours. hospital course by systems: 1. neurologic: she has had intermittent confusion and was seen by psychiatry who deemed her confusion and at times lethargy as electrolyte related. at times she has required haldol although she last used haldol on . she is requiring only tylenol for pain medication. 2. cardiovascular: from a cardiovascular standpoint, she has had no issues. an echocardiogram on , showed a normal ejection fraction with no valve dysfunction. 3. respiratory: she had respiratory failure with the onset of her sepsis and was intubated for over two weeks. she was extubated on , and since then has been managed purely with intermittent albuterol nebulizers. she has no respiratory complaints and chest x-rays have been clear. 4. gastrointestinal: from a gi standpoint, she initially had some bright red blood per rectum as she has known radiation proctitis and the bleeding stopped. gi consultation deferred colonoscopy secondary to the risk. due to her obesity, any colonoscopy would need to be done in the operating room at significant risk. on , a tube feed was placed for poor p.o. intake. her oral intake and appetite has improved dramatically and this feeding tube may be removed some time in the next few days when she has proven consistent adequate p.o. intake. she has been on pepcid 30 mg p.o. q. day for gi prophylaxis. 5. genitourinary: from a genitourinary standpoint, initial ct scan revealed an indwelling stent in her bladder and ultrasound showed hydronephrosis which required a nephrostomy tube. that nephrostomy tube is now capped and all urine that she is making is coming through the foley catheter. she has had persistent hematuria that clears intermittently with bladder irrigation but tends to recur. urology has seen her and she should have a follow-up appointment with dr. for a cystoscopy some time in the next few weeks. her hematocrit, despite her hematuria, has been stable. in terms of her transplanted kidney, her bun and creatinine have been 14 and 1.0 most recently. her renal function has been stellar since mid , although prior to that point she did have acute renal failure with a maximum creatinine of 3.7 in early . a biopsy on of her transplanted kidney shows minimal interstitial fibrosis. she has been maintained on lasix q. day to help even her fluid balance. she has a right lower quadrant wound at the site of her transplant. this is being treated with a vac dressing that needs to be changed every three days. the wound is a large one, approximately 6 inches across and at least 6 inches in depth. it is granulating nicely but extends to the fascia. 6. infectious disease: from an id perspective, she is on unasyn for enterococcal urinary tract infection as well as an enterococcal bacteremia. she has also been treated with miconazole powder to her groin region for yeast infection. 7. hematology: from a hematology standpoint, she does have svc syndrome from an axillary vein thrombosis. ultrasound has revealed that the remaining right upper vessels are patent. there was some clot within them. the patient has refused recanalization by interventional radiology and the initial right arm, face and breast swelling that she came in with has improved dramatically. 8. endocrine: from an endocrine standpoint, she has been maintained on insulin for her diabetes mellitus. 9. prophylaxis: she has been on bactrim ss once per day, subcutaneous heparin, and pepcid. 10. immunologic: from an immunologic standpoint, she is being maintained on prednisone 5 mg p.o. q. day, tacrolimus 4 mg p.o. twice a day, with a goal tacrolimus level of 9.0 to 10.0. her third is valcyte, 450 mg p.o. q. day. discharge medications: 1. insulin sliding scale. 2. tacrolimus 4 mg p.o. twice a day. 3. valcyte 450 mg p.o. q. day. 4. lasix 80 mg p.o. q. day. 5. unasyn 3 grams intravenously q. eight hours. her unasyn should be continued for a total of 14 days; she is currently day eight. 6. pepcid 30 mg p.o. q. day. 7. heparin 5000 units subcutaneously q. eight hours. 8. prednisone 5 mg p.o. q. day. 9. bactrim ss one tablet p.o. q. day. 10. tylenol 325 to 650 mg p.o. q. six hours p.r.n. she is also on tube feeds. her tube feed is promod with fiber full strength at a goal rate of 60 cc per hour. the feeding tube should be flushed with 30 cc of water q. six hours. discharge instructions: 1. the patient is to be followed up with the renal transplant center. their telephone number is . 2. she should have appointments with dr. as well as with dr. at some point in the next week. 3. she requires laboratory draws twice weekly, mondays and thursdays at least, which include cbc, chem-7, tacrolimus level. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances closed [percutaneous] [needle] biopsy of kidney injection or infusion of oxazolidinone class of antibiotics nephrostomy percutaneous pyelogram percutaneous pyelogram percutaneous pyelogram replacement of nephrostomy tube phlebography of other intra-abdominal veins using contrast material diagnoses: other postoperative infection acute kidney failure, unspecified septic shock hydronephrosis streptococcal septicemia other and unspecified coagulation defects complications of transplanted kidney 

Answer: The patient is high likely exposed to