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: vasotec / iodine; iodine containing / nifedipine / lipitor / norvasc / ranitidine / lovastatin / protonix attending: chief complaint: abdominal pain major surgical or invasive procedure: central line placement history of present illness: this is an 89 y/o cantonese-speaking female with h/o constipation s/p negative c-scope , distant ovarian ca w/positive peritoneal washings refusing to f/u since , niddm, who presented on to the ed with diffuse, colicky abdominal pain x 24 hours, non-radiating w/o aggravating/alleviating factors, with nausea but no vomiting. last bm 3 days pta, but pt was able to pass gas earlier on the day of admit. no dysuria, urinary c/o on admission. she was noted to be febrile to 102 in the ed, lactate of 5.5, elevated lfts, wbc 7.6, with negative imaging and benign abdominal exam. given labs, code sepsis was initiated and the patient was started on early goal-directed therapy, receiving a cvl, ivf resuscitation, foley, broad-spectrum abx (levo, flagyl, amp), and transferred to the micu for further management. . in the micu, general surgery consulted on the pt, and thought her clinical picture to be more c/w with hepatitis than cholecystitis. hep panel was negative for hep a/b/c. no acute infection with ebv, cmv, and hsv. ruq u/s showed non-specific gb wall thickening (either related to edema or known ovarian ca). ct abd/pelvis demonstrated a small amount of ascites, slightly heterogenous appearance of the liver raising the possibility of hepatitis, and slight gb wall edema likely hepatitis. a hida scan on demonstrated normal gb filling. patient's abdominal pain improved with a standing bowel regimen and now is tolerating a regular diet. in the micu, blood cx drawn on admission grew out gnr, specifically pan-sensitive e.coli. pt was switched from broad-spectrum abx to po levoflox. she has remained afebrile with a normal wbc. source of infection is unknown, with negative u/a's, no further positive blood cx, and negative abdominal imaging. lfts have been trending down during her course. past medical history: 1. tachybrady syndrome, status post ddd implant . 2. moderate mr in , with left atrium 4 x 1 cm and normal lv at that time. 3. ett thallium , at which time she went three minutes on protocol and reached 75% of maximum predicted heart rate and did not have any wall-motion abnormalities or reversible defects. 4. ovarian cancer diagnosed in . status post tah/bso. papillary serous type status post oral melphalan treatment. the patient had positive peritoneal washing. the patient refused follow up since . 5. adult-onset diabetes mellitus which is insulin requiring. 6. constipation. 7. peptic ulcer disease, status post h. pylori treatment . 8. peripheral neuropathy secondary to diabetes mellitus. 9. chronic headaches. 10. mild lower extremity edema/venous insufficiency. 11. concentric lvh, h/o flash pulmonary edema 12. hypothyroid amiodarone social history: sh - lives at home with family. no tobacco/etoh/illicits. family history: nc physical exam: vitals: t 97.3, bp 144/72, hr 74, rr 18, sao2 94%/ra gen: elderly well-appearing asian woman lying in bed, nad, pleasant heent: nc/at, perrl, eomi, mmm, op clear neck: supple, no lad or jvd noted cv: rrr, s1 s2 normal, syst murmur at apex lungs: cta-b, no w/r/r abd: mildly distended, soft, nt, nabs, no hsm, no rectal: guaiac neg per ed resident exam ext: no edema, 2+ dp pulses bilaterally skin: warm and dry pertinent results: 12:20pm blood alt-188* ast-400* alkphos-270* amylase-56 totbili-2.1* 04:30pm blood ld(ldh)-256* ck(cpk)-26 dirbili-1.2* 02:21am blood alt-140* ast-170* alkphos-206* totbili-1.2 04:08am blood alt-78* ast-64* ld(ldh)-118 ck(cpk)-26 alkphos-153* totbili-0.8 07:49am blood alt-61* ast-55* alkphos-171* 03:09am blood alt-45* ast-43* ld(ldh)-153 alkphos-159* totbili-0.6 06:05am blood alt-38 ast-46* ld(ldh)-153 alkphos-152* amylase-47 totbili-0.6 tte - regional left ventricular systolic dysfunction c/w multivessel cad. mild aortic regurgititation. mild mitral regurgitation. compared with the prior report (images unavailable for review), regional left ventricular systolic function is more extensive. based on aha endocarditis prophylaxis recommendations, the findings indicate a moderate risk (prophylaxis recommended). clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. . hida scan - normal gallbladder filling with no evidence of biliary obstruction. a rim of decreased tracer uptake surrounding the gallbladder is suggestive of gallbladder wall thickening. if consistent with clinical findings, this could be suggestive of gallbladder wall necrosis, but more likely reflects the effects of ascites and generalized tissue edema in this patient. . liver u/s - 1. no biliary ductal dilatation. 2. nonspecific gallbladder wall edema, which may be related to known ovarian cancer or liver disease. brief hospital course: this is an 89 y/o cantanese-speaking woman with h/o constipation, neg cspy , distant ovarian ca, p/w abd pain x 24h, found to have elevated lactate and fever, elevated lfts, now with 1/4 e. coli bacteremia. . 1. e coli bacteremia - no clear source. likely gi related given abdominal pain and pathogen. given elevated lfts, possible that patient passed a stone and subsequent transient bacteremia. bottles . ucx negative. hida negative. pan sensitive. being treated with levofloxacin for 14-day course. afebrile and normal wbc throughout course. given pt has a pacer, a tte was done to evaluate the pacer and wires for vegetation though unlikely as it was a low-grade bacteria and rare pathogen to affect heart valves. the tte was negative for any vegetations, however, it did show further decline of her lv function, for which she should f/u with her cardiologist. no acute ischemic symptoms. surveillance cultures were sent on , which were pending on the day of discharhe. . 2. hepatitis - hep serologies negative. have been to shock though no documented hypotensive event. lfts normalized by the time of discharge. no symptoms, including abdominal pain, n/v/diarrhea. . 3. abd pain - likely constipation vs. hepatitis nos. all abdominal imaging negative for any acute process. resolved with standing bowel regimen and pt was tolerating full diet for last several days of her stay. . 4. elevated lactate on admission - normalized with ivf. likely e.coli bacteremia and septicemia. . 5. cv a) tachybrady syndrome s/p ddd pacer; stable b) moderate mr, lvh with h/o flash pe; gently with ivf if needed c) coronaries: no known cad with ett (-) in 4/99; continue amio, atenolol, aspirin, losartan. . 6. ovarian cancer - no acute issues, outpt f/u . 7. niddm - continue insulin regimen, titrate as needed . 8. pud - continue zanatc . 9. hypothyroidism - continue synthroid . 10. anemia - stable hct, baseline in-house 30-33; iron studies c/w iron-deficiency anemia -hold on fe supplements given h/o constipation and current abdominal pain -recent c-scope w/ small adenoma otherwise wnl, may need a repeat given new baseline . medications on admission: meds (at home) - 1. amiodarone 200 mg qd 2. asa 325 mg qd 3. atenolol 50 mg qd 4. nortriptyline 10 mg qd 5. nph 25/16, regular 8 units 6. synthroid 50 mcg qd 7. losartan 50 mg qd 8. zantac 150 mg . meds (on transfer) - 1. amiodarone 200 mg qd 2. asa 325 mg qd 3. atenolol 50 mg qd 4. nortriptyline 10 mg qd 5. insulin nph 12 units/8 units w/riss 6. synthroid 50 mcg qd 7. levofloxacin 250 mg qd 8. losartan 50 mg qd 9. bowel regimen 10. hep sc discharge medications: 1. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed. 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. nortriptyline 10 mg capsule sig: one (1) capsule po daily (daily). 4. losartan 50 mg tablet sig: one (1) tablet po daily (daily). 5. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 6. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 10. atenolol 50 mg tablet sig: one (1) tablet po daily (daily). 11. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. disp:*60 tablet, delayed release (e.c.)(s)* refills:*0* 12. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 9 days. disp:*9 tablet(s)* refills:*0* 13. insulin regimen continue with 12 units of nph at breakfast and 8 units of nph at dinner. cover with regular insulin as needed per sliding scale. please see attached sheet. you may titrate up to prior home regimen slowly. discharge disposition: home discharge diagnosis: primary - low-grade e.coli bacteremia, abdominal pain, hepatitis nos secondary - niddm (insulin requiring), pud, peripheral neuropathy, hypothyroidism, chronic constipation, h/o ovarian ca discharge condition: good, afebrile with stable vs, asymptomatic discharge instructions: -continue with all medications as prescribed -you will need to complete a total of 14 days of antibiotics, you currently are on day # 5 -please follow-up with appointments as listed below -if you have any symptoms of fevers, chills, sweats, chest pain, increasing abdominal pain, or any other concerning symptoms please seek medical attention immediately followup instructions: provider: , m.d. date/time: 8:00 provider: clinic phone: date/time: 10:30 provider: clinic phone: date/time: 1:00 procedure: venous catheterization, not elsewhere classified diagnoses: thrombocytopenia, unspecified mitral valve disorders acute and subacute necrosis of liver diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes sepsis personal history of other malignant neoplasm of skin long-term (current) use of insulin iron deficiency anemia, unspecified cardiac pacemaker in situ sinoatrial node dysfunction septicemia due to escherichia coli [e. coli] cardiac rhythm regulators causing adverse effects in therapeutic use other iatrogenic hypothyroidism 

Answer: The patient is high likely exposed to