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: penicillins attending: chief complaint: year old female admitted with abdominal pain and no bm x 8 days. major surgical or invasive procedure: status post exploratory laparotomy with lysis of adhesions. history of present illness: ms. is a -year-old woman who presents from an outside institution () with a several-day history of increasing constipation, nausea without vomiting. she has noted that her abdomen has been increasingly distended over the last several days. her most recent bowel movement was days ago. she has received a number of enemas in an effort to relieve this. she has had no flatus in the last day or so. per her recollection, no change in stool caliber or hematochezia. she has had diminished oral intake and at this point is n.p.o. she denies any abdominal pain or cramping. past medical history: depression shortness of breath associated with pectus carinatum and age appropriate obstructive ventilatory deficit - seen in pulmonary clinic colon ca and small bowel ca/resected in past history of falls hypothyroidism glaucoma cataracts ? some short term memory loss social history: smoking: 60 pack year no alcohol use. lives at home iwth a 24 hr aide family history: patient denies any med issues in family physical exam: vital signs: temperature is 97.3, pulse is 82. blood pressure 124/68, respirations 21, saturation on 2 liters is 97. general: she is alert, oriented, and in no acute distress. heent: sclerae are anicteric. oropharynx is clear. there is a plaque on the soft palate of a whitish hue. neck: supple. trachea midline. no lymphadenopathy. no bruits. lungs: clear with few wheezes bilaterally. heart: regular. abdomen: markedly distended. there are no obvious hernias, no organomegaly. she does have active high pitched bowel sounds. she has some discomfort to palpation. no peritoneal signs. extremities: without edema. feet are warm. no ulcers. pertinent results: admission labs --------------- 08:15pm wbc-15.5* rbc-4.61 hgb-14.6 hct-41.4 mcv-90 mch-31.8 mchc-35.4* rdw-13.4 plt ct-417 neuts-85.6* lymphs-8.2* monos-5.6 eos-0.2 baso-0.4 plt ct-417 glucose-125* urean-16 creat-0.7 na-122* k-4.9 cl-86* hco3-30 angap-11 . 05:55am blood wbc-26.2*# rbc-3.55* hgb-10.7* hct-32.4* mcv-91 mch-30.2 mchc-33.1 rdw-14.3 plt ct-387 . 09:15am blood neuts-90.0* lymphs-5.6* monos-3.5 eos-0.8 baso-0.1 . 05:25am blood wbc-14.2* rbc-3.19* hgb-9.6* hct-30.1* mcv-94 mch-30.1 mchc-32.0 rdw-14.3 plt ct-412 glucose-112* urean-28* creat-0.4 na-139 k-4.1 cl-107 hco3-28 angap-8 09:15am blood ck-mb-notdone ctropnt-0.03* . radiology --------- 9:22 pm ~ abdomen (supine & erect) indication: -year-old female with possible small-bowel obstruction on outside film. impression: multiple, relatively proportionately gas-distended loops of large and small bowel extending to the rectum, without free intraperitoneal air. appearance is suggestive of adynamic ileus, though early or incomplete sbo cannot be completely excluded; correlate clinically, with imaging follow- up as indicated. . 9:46 pm ~chest port. line placement history: right ij line. assess placement, evaluate for pneumothorax. impression: tube and line placement as described. . 4:50 am ~ ct abdomen w/contrast; ct pelvis w/contrast indication: -year-old female with history of colon ca status post resection, presenting with abdominal distention and nausea. impression: 1. multiple dilated loops of fluid-filled small bowel with fecalized material in the distal ileum extending to the ileocolonic anastomosis in the mid abdomen. findings are consistent with partial small- bowel obstruction. no evidence for free intraperitoneal fluid or air. 2. cystic mass in the right adnexa and fluid filled endometrial cavity are both concerning findings given the patient's age. further characterization with pelvic ultrasound is recommended on a non-emergent basis if additional followup is warranted. 3. small bilateral pleural effusions and bibasilar atelectasis. 4. dilatation of the aortic root to 4.5 cm. coronary artery calcifications and enlargement of the pulmonary artery suggestive of pulmonary arterial hypertension. 5. left adrenal adenoma. 6. severe degenerative changes in the thoracolumbar spine with numerous wedge compression deformities of unknown chronicity. . 6:29 pm ~foot 2 views right medical condition:r foot pain and bruising findings: no previous images. frontal and lateral view show no definite fracture. there is apparent dislocation of the third pip and subluxed fourth pip. question of a well-corticated bone fragment at the distal fourth proximal phalanx. this could be a sequela of previous injury, though an acute fracture cannot be unequivocally excluded. . 2:57 pm ~ chest (portable ap) medical condition: rales and crackles findings: in comparison with the study of , there has been the development of substantial pleural effusions bilaterally. the pulmonary vessels are less sharply seen, consistent with increasing pulmonary venous pressure. the endotracheal tube has been removed and the right ij catheter remains. . 2:21 pm ~foot ap,lat & obl right indication: pain in the third and fourth right toes. impression: overall unchanged appearance when compared to . dislocation of the third and fourth proximal interphalangeal joint. subluxation/dislocation of the second and fifth metatarsophalangeal joint. a fracture at the base of the fourth middle phalanx cannot reliably be excluded. . 11:28 am ~chest (portable ap) reason: increased white count, please eval for acute pulmonary proce findings: again noted are large bilateral pleural effusions and right ij line with tip in the svc. the upper lungs are clear. the lower lungs cannot be assessed due to the overlying effusions. . 7:47 pm ~portable abdomen indication: recent small bowel obstruction status post loa, presenting with nausea and vomiting. impression: limited examination. recommend upright and supine views to further assess bowel as indicated. no definite evidence of obstruction. dense material of the colon is probably from ct evaluation nine days prior. . 9:00 pm ~chest port. line placement procedure: chest portable for line placement on . impression: 1. right picc line in a fairly satisfactory location at the svc/atrial junction. 2. new bilateral mild interstitial pulmonary edema. . 11:52 am ~ct abdomen w/contrast; ct pelvis w/contrast indication: status post exploratory laparotomy, , now with elevated white blood cell count. evaluate for abscess. impression: 1. dilated loops of small bowel and moderate amount of stool in the colon. findings are most suggestive of ileus. 2. focal area of peripheral circumferential gas within the colon, just adjacent to the ileocolic anastomosis, most likely represents gas trapped around luminal contents, as no other signs to suggest bowel ischemia are present. 3. increased bilateral pleural effusions and atelectasis. 4. small amount of fluid in the pelvis without evidence of abscess. 5. left adrenal gland prominence could relate to adenoma as previously suggested, although a focal nodule is not definitely visualized on today's examination. . 10:00 am ~chest (portable ap) reason: pulm edema, ? increasing effusions indication: followup. impression: no relevant changes as compared to . . . cardiology ---------- tte (complete) done at 11:48:15 am final impression: mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. moderate aortic stenosis. mild-moderate aortic regurgitation. moderate mitral regurgitation. moderate pulmonary hypertension. dilated thoracic aorta. . pathology --------- specimen submitted: right ovary. procedure date tissue received report date diagnosed by dr. . /cma?????? previous biopsies: egd (2). diagnosis: right ovary, exploratory laparotomy: 1. fallopian tube with paratubal cyst and reactive mesothelial cells. 2. ovary with simple cyst. dr. reviewed slide b. clinical: small bowel obstruction. gross: the specimen is received fresh labeled with ", " the medical record number and "right ovary." it consists of a fallopian tube and ovary. the fallopian tube measures 5.5 cm in length and 0.3 cm in diameter and the ovary measures 2.5 x 2.0 x 1.5 cm. at the junction of the fallopian tube and the ovary is what appears to be a paratubal cyst which measures 3.5 x 3.0 x 2.0 cm. the surface of the specimen is inked in black and the specimen is serially sectioned to reveal a biloculated cyst with a smooth lining and contains approximately 15 cc of clear fluid. the ovary is also serially sectioned to reveal a simple cyst with approximately 5 cc of yellow fluid. the cyst wall has a smooth lining and measures 0.1 cm in thickness. no solid component is identified. representative sections are submitted as follows: a = fallopian tube, b-c = paratubal cysts. d-e = ovary with cyst. . brief hospital course: this is a year old female admitted on with small bowel obstruction. underwent exploratory laparotomy. postoperative issues: 1. cardiac - has been tachycardic intermittently. ekg confirms sinus rhythm to sinus tach. troponin checked with normal to slight elevations. : impression: mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. moderate aortic stenosis. mild-moderate aortic regurgitation. moderate mitral regurgitation. moderate pulmonary hypertension. dilated thoracic aorta. acute on chronic heart failure. 2. respiratory - pulmonary consult called for management of chf, copd and pectus carinatum. chest x-rays have showed bilateral pleural effusions with some chf. diuresised with lasix multiple times. albuterol nebulizers given for expiratory wheezes. currently respiratory status stable. daily advair and spiriva. 3. infectious disease - wbc up to 26 on pancultured with negative cultures for blood, urine, sputum. stool sent for c. diff. negative times four. central line discontinued, negative growth of culture tip. started on vancomycin and flagyl. white count trending down to 11.6 on . flagyl discontinued. will continue oral vancomycin for 14 more days per infectious disease. 4. abdomen/gi - patient has been getting a fleets enema daily with colace. her abdomen is now soft, positive bowel sounds, slightly distended. incision line dry and intact without erythema. has been tolerating a soft diet with fluid intake approx. 1 liter a day. as oral intake good will discontinue tpn today. 5. gu - foley discontinued on . incontinent at times. baseline bun 15-20, creatinine .3 -.8. 6. mobility - out of bed with assistance. she has been ambulating with physical therapy with walker with much assistance. 7. discharge plans - she will be discharged to rehab. at today. she is to follow up with dr. in 2 weeks. medications on admission: advair spiriva asa levoxyl 75' diltiazem xl 180' remeron 7.5 mg daily and 15 mg qhs lisinopril 7.5' trosopt eye drops tid rt eye centrum silver discharge medications: 1. dorzolamide 2 % drops sig: one (1) drop ophthalmic tid (3 times a day). 2. albuterol sulfate 2.5 mg/3 ml solution for nebulization sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 3. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 4. mirtazapine 15 mg tablet sig: 0.5 tablet po qam (once a day (in the morning)). 5. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for fever or pain. 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 8. diltiazem hcl 180 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). 9. lisinopril 5 mg tablet sig: 1.5 tablets po daily (daily). 10. vancomycin 125 mg capsule sig: one (1) capsule po q6h (every 6 hours): continue until . 11. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 12. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). discharge disposition: extended care facility: senior care - discharge diagnosis: high grade small bowel obstruction post-operative ileus post-operative leukocytosis discharge condition: stable discharge instructions: please call dr. or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * if you are nauseous and vomiting; cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomiting, diarrhea or other reasons. signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * your pain is not improving within 8-12 hours or becoming progressively worse, or inadequately controlled with the prescribed pain medication. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * abdominal pain and/or tenderness * abdominal fullness * abdominal distention * increase in cramping and/or bloating sensation * failure to pass gas or stool (constipation) * changes in bowel habits ?????? such as constipation or diarrhea * any serious change in your symptoms, or any new symptoms that concerns you. followup instructions: please follow-up with dr. in clinic on at 1:15. procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances exploratory laparotomy other lysis of peritoneal adhesions other unilateral salpingo-oophorectomy diagnoses: unspecified pleural effusion urinary tract infection, site not specified congestive heart failure, unspecified unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified other chronic pulmonary heart diseases pulmonary collapse intestinal infection due to clostridium difficile paralytic ileus personal history of malignant neoplasm of large intestine multiple involvement of mitral and aortic valves personal history of malignant neoplasm of other gastrointestinal tract chronic diastolic heart failure intestinal or peritoneal adhesions with obstruction (postoperative) (postinfection) pelvic peritoneal adhesions, female (postoperative) (postinfection) other and unspecified ovarian cyst pectus carinatum 

Answer: The patient is high likely exposed to