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 / ceftriaxone / keflex attending: chief complaint: hematemesis major surgical or invasive procedure: none history of present illness: pt is yo f with htn, dm ii, oa, and h/o klebsiella uti (multi-drug resistant), who reportedly had episode of hematemesis this am. pt lives at , and vomited 80cc of bright red blood this am, and was also found to be tachycardic and diaphoretic. she had sob and abdominal pain as well. per pt's son, she was "sharp as a tack" 2 days ago for a birthday party (her birthday is today), and now has worsened mental status. no hx of diarrhea, hematochezia, hematuria, or dysuria. per pt's son, pt may have had course of for uti several months ago. . in the , pt had temp 101.6, bp 200/108, hr in the 140's, was diaphoretic, and c/o abdominal pain. ng lavage was attempted x 2, but was unsuccessful due to pt's inability to cooperate. the pt also refused central line placement. pt was found to have a dirty ua, and a ct abd showed pan-colitis. she was given 2l ns, levoflox 500mg iv, vanc 1g iv, morphine 2mg x 2, protonix 40mg iv, metoprolol 5mg iv x 1, anzemet 12.5mg x 1, and tylenol 650mg pr. . past medical history: - dm type ii - ? steroid induced (per notes) -> no meds - hypertension - osteoarthritis - rheumatoid arthritis on prednisone - cri - baseline creatinine is 0.9 to 1.3. - neurogenic bladder - dementia - s/p total right hip replacement in - pmr with chronic pain on prednisone, fentanyl - depression - h/o klebsiella uti (multi-drug resistant)/urosepsis - h/o hyperkalemia - stage ii sacral decub on r buttock social history: has lived at nursing home x several years. is bedbound and needs assistance w/ adls like eating/dressing/toileting because of her contractures and pain. she is dnr/dni. family history: nc physical exam: vitals: t 96.3 bp 168/109 hr 118 rr 31 o2 98% ra gen: elderly female, moaning occasionally heent: perrl neck: supple. jvd flat cardio: tachycardic, no m/r/g appreciated resp: crackles way up on r, crackles way up on l abd: soft, nd, diffusely tender, +bs, no rebound/guarding ext: le contractures. no c/c/e neuro: a&ox1 (knows only name) rectal (per ed): brown stool, guaiac negative pertinent results: ct abd: pancolitis. the appearance is nonspecific and could be secondary to infection, an inflammatory process, or ischemia. severe atherosclerotic disease; however, the mesenteric vessels appear patent. gallbladder fundal adenomyosis. low attenuation splenic foci, which are incompletely characterized on this exam. . cxr: cardiomegaly with a tortuous aorta is again seen and unchanged. pulmonary vascularity is unremarkable. no infiltrate or consolidation is identified within the lung. no pleural effusion is seen. no intraperitoneal free air is identified. gas-distended fundus of the stomach is noted. . ekg: sinus tach @ 126, lad, nl intervals, <1mm std in v5-v6 brief hospital course: a/p: yo f with htn, dm ii, oa, h/o uti's, who now presents with hematemesis, uti, and pan-colitis. . #) hematemesis: upon admission, the patient was reported to have approximately 50cc of hematemsis. she was admitted to in hemodynamically stable condition. her hct upon admission was 50.0, thought to represent hemoconcentration severe dehydration in the setting of pan-colitis. this returned to her baseline around 28-30 after ivf hydration and then remained stable. gi was made aware of pt, however plan for egd was deferred as pt/family wish to avoid aggressive invasive measures. the patient had no further episodes of hematemesis and her hct remained stable. asa, nsaids were avoided and she was put on protonix. . #) pan-colitis: an abdominal ct scan with contrast upon admission showed a pan-colitis. the differential included infectious (? c dif), inflammatory, or ischemic causes. an infectious etiology was thought to be most likely given fever, elevated wbc count, and was guaiac negative. ischemia was thought to be less likely given pan colitis distribution. stool cultures were sent and were negative (c dif x 3 was negative as well as campylobacter, o&p and stool culture. she was treated with flagyl, and meropenem for 6 days. pain control acheived with fentanyl patch + prn morphine. after three negative c difs and clinical improvement in her abdominal exam, her antibiotics were discontinued. . #) respiratory distress/hypoxia: while in the icu, the patient was noted to have one episode of mild respiratory distress with pulmonary edema after getting ivf hydration. she was approximately +7 liters at the time after aggressive ivf hydration for pan-colitis. her respiratory distress was volume overload and mild chf from diastolic dysfunction. she was gently diuresed with excellent response to lasix 10mg iv and got daily lasix. she will be discharged on daily po lasix which will need to be titrated based on daily weights, monitoring cr and uop (this was discussed with patient's pcp before discharge). . #) acute renal failure: upon admission, the patient's cr was 1.0 (near her baseline 0.9-1.3). her cr climbed to as high as 1.4 after gentle diuresis for volume overload with lasix. her creatinine trended down and was 1.2 upon discharge. her volume status and creatinine will need to be monitored as an outpatient as she will be going home on daily lasix 10mg daily (this may need to be titrated, possibly qday or qod). . #) uti: the patient has a long history of multiple klebsiella utis that are multi-drug resistant (esbl, extended spectrum beta-lactamase producing). her urine culture upon admission showed klebsiella (again esbl but sensitive to meropenem, pt cannot take cephaloporins or pcn, klebsiella was resistant to cipro, bactrim, nitrofurantoin and levofloxacin). she completed a 6 day course of meropenem. . #) tachycardia: the patient was admitted with tachycardia to the 120s thought to be intravascular volume depletion/dehydration as well as from diffuse abdominal pain. after volume resuscitation upon admission and resolution of pain, the patient's hr improved. she appears to run between 90s-105 at baseline. . #) hypertension: pt has a h/o of htn, which was treated with metoprolol and initially with prn hydral and nitropaste. her blood pressure improved during her hospital stay and she required only metoprolol to control her bp during the remainder of her hospital stay. . #) fever: thought to be secondary to uti and colitis. she completed 6 days of meropenem for resistent klebsiella uti and flagyl for colitis of unclear etiology (c dif x 3 negative). her fevers trended down during this admission and she was afebrile before discharge. . #) mental status change: thought to be likely secondary to infection and hypovolemia superimposed on mild dementia. on hd #2, her ms improved significantly after ivfs. she was restarted on remeron and neurontin after her mental status returned to baseline. . #) arthritis: stable. she was continued on her outpatient low-dose prednisone, and fentanyl patch. . #) dm ii: her diabetes was reportedly diet controlled (thought possibly to be steroids). finger sticks were elevated on admission likely due to infection. she was maintained on an insulin sliding scale and required minimal coverage. . #) fen: patient was maintained on a regular diet with thickened liquids. . #) comm: son , hcp (cell: , office: , home: , admin assistant ms. ), grandson () . #) code: dnr/dni (discussed with son, ); son requesting no aggressive procedures preferring instead for medical management . medications on admission: meds (per last d/c summary): atenolol 25 mg qd prednisone 5 mg qd mirtazapine 15 mg qhs bisacodyl 10 mg qd prn acetaminophen 325 mg q4-6h prn gabapentin 300 mg qhs fentanyl 150 mcg/hr patch 72hr aspirin 325 mg qd pantoprazole 40 mg qd mvi polysaccharide iron complex 150 mg qd lidocaine hcl 2 % 1ml tid prn mouth discomfort nystatin 100,000 unit/ml suspension qid prn ipratropium bromide 0.02 % solution q6h prn hep sc tid colace prn prn insulin sliding scale oxycodone 5 mg q4-6h prn discharge disposition: extended care facility: of discharge diagnosis: primary: gi bleed pan-colitis uti . secondary: dm type ii htn osteoarthritis rheumatoid arthritis cri (baseline cr 0.9-1.3) neurogenic bladder dementia s/p total right hip replacement pmr with chronic pain on fentanyl, prednisone depression h/o klebsiella uti (multi-drug resistant) stage ii sacral decub on r buttock . discharge condition: . stable: taking good po intake, abdominal pain resolved, no further episodes of hematemesis . discharge instructions: . 1- please take all medications as prescribed. you were started on a new medication, lasix (furosemide), which will help to prevent congestive heart failure and fluid buildup in your lungs. this was discussed with your primary care physician, . . the patient should be followed with daily weights, o2 sat, and electrolytes should be monitored including creatinine and potassium to titrate lasix dosing. . 2- your aspirin and subq heparin were stopped because you had a gi bleed. please start pneumoboots for dvt prophylaxis as an outpatient. . 3- please call your doctor if you experience worsening shortness of breath, fevers, abdominal pain or worsening diarrhea. . followup instructions: . please followup with your physicians at and with your primary care physician, . . . md procedure: venous catheterization, not elsewhere classified diagnoses: polymyalgia rheumatica urinary tract infection, site not specified congestive heart failure, unspecified long-term (current) use of steroids other specified disorders of pancreatic internal secretion adrenal cortical steroids causing adverse effects in therapeutic use acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified other persistent mental disorders due to conditions classified elsewhere chronic kidney disease, unspecified pressure ulcer, lower back rheumatoid arthritis acute diastolic heart failure dehydration universal ulcerative (chronic) colitis 

Answer: The patient is high likely exposed to