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: sulfa (sulfonamide antibiotics) attending: addendum: events: : cipro started empirically for uti. patient resuscitated with boluses of ns x 750 cc, and lr 100 cc/hr. patient was still hypotensive and tachycardic at 21:00; vanc/zosyn started in place of cipro in view of empiric treatment for sepsis. ir on for replacement of j-tube. a-line inserted in right axilla, patient continues to be tachy and hypotensive, neo 1 mcg/kg/min started to maintain pressure despite adequate fluid resuscitation. : j-tube replaced in ir; started peptamen for tf. changed fluids to maintenance. cdiff sent. cipro added per id recs for additional gram negative coverage - given organisms noted on prior bile cx on previous admission. given 25/100 sinemet x 1 to assess for response - mild improvement per neuro team, thus started tx. on neo gtt. alb 5% 12.5g x1 overnight for low uop. off pressors : d/c'ed r. axillary a-line; d/c'ed antibiotics given absence of growth on cultures and likely contamination in jp (grew multiple organisms previously and at the time id had recommended watchful waiting); 1u prbcs for hct 23.4. : improved rigidity and finger tapping on 25/100 sinemet, increased to tid. decrease in urine production, bolused 500 cc ns. : transferred on the floor. speech and swallow evaluation recommended npo. refeed with bile from t-tube started. fluid balance with boluses. : continued tf, 2l lr for fluid balance. : ptbd and t-tube capped, received 1l bolus. was fluid possitive. mental status improving. : increased output from , slightly increase in wbc, ptbd and t-tube unclamped. bile refeed with tf from ptbd. required 500cc bolus to stay even. : clamped t-tube and , refeeding 300cc of bile per day from ptbd by mixing with tf. required 500cc bolus to stay even. : clamped ptbd, unclamped occasionally to allow accumulation of bile, continued to refeed 300cc of bile per day from ptbd by mixing with tf. required 500cc bolus to stay even. : clamped t-tube; clamped ptbd x4hrs, unclamped for 2hours, refed bile 100cc q8h by mixing with tfs. due to an episode of tachycardia, hypotension, and tachypnea, the patient was transferred to the icu. please refer to full icu notes for further reference. : patient transferred to icu, intubated, a-line placed, phenylephrine drip, albumin 500cc x 2, ns->lr, initially c/w pe, ct a/p was obtained : lll pna was diagnosed. sputum cultures were sent. the patient was transitioned from a phenelephrine drip to norepinephrine drip on this day. on this day, tubefeeds were also administered started. 2 units of prbcs were given for hematocrit of 19. : tf were stopped as the patient was noted to have increased output upon administration of feeds. from this point onwards, it was determined that the patient was to be strictly npo, with no tube feeds. nothing to be administrered by j tube, with the exception of crushed cinemet. this was the day that tpn was started, and began weaning patient off the vent. stool studies were obtained, which were negative. sputum cultures revealed e.coli, for which the patient was started on a course of iv zosyn, to be complete on . due to rsbi 103 and persist acidosis, were unable to extubate. cardiovascular status continued to improve, however, and the patient was weaned off pressor support. : on this day, the patient was weaned off propofol, and was awake following commands, on cpap, with iv tylenol for pain : patient was noted to be "wet" on pulmonary exam, +10 liters during hospital stay. he was given 10 mg iv lasix, still intubated pending further diuresis. family updated, raised the possibility of tracheostomy. : lasix drip restarted, goal -130 to 150 cc per hour, albumin given with lasix- ir reanchored . : on this day, patient was extubated without incident. 1 u prbc given, ng removed, cinemet administered via j-tube, and patient was out of bed throughout the day. he would expereince occasional desat to high 80's which improved with suctioning : waxing/ mental status this morning. and : patient continues to be stable in terms of cardiovascular and respiratory status. is the day of completion of zosyn treatment for lll pneumonia. the patient requires tpn for nutrition, and is to be strict npo, with no tube feeds. nothing is to be administered by j tube except for crushed cinemet. the patient and family is informed and aware of upcoming transfer to an extended care facility for further care. chief complaint: dehydration, hypotension major surgical or invasive procedure: none history of present illness: 79ym s/p laparoscopic cholecystectomy @ with intraoperative placement for bleeding and mild bile spillage who developed bilious drainage on pod1. he was sent to from for ercp and was found to have a duct of luschka leak. he was subsequently worked up and found to have jejunal and duodenal enterotomies. jejunal enterotomy was repaired, and a t-tube was placed in the duodenal enterotomy. he now has ptbd, t-tube, and drains in place, in addition to a feeding j-tube. at in , he became febrile and hypotensive and was transferred to medical center, where he continued to be hypotensive and tachycardic with a positive uti, and was subsequently transferred to . upon arrival, he was tachycardic and hypotensive. he also had a clogged j-tube. the family was not satisfied with the care at hospital. past medical history: past medical history: htn, prostate ca, duodenal ulcer past surgical history: partial gastrectomy with bii reconstruction, prostatectomy with bilateral inguinal node dissection, laparoscopic cholecystectomy social history: he lives in a long term care facility. he does not drink alcohol, and has not smoked for 20 years. family history: non-contributory physical exam: vs:98.0 97.5 78 131/56 26 96%1l gen: limited responsiveness but , follow commands cv: rrr, systolic ejection murmur pulm: coarse breath sounds, mild/minimal basilar crackles on l abd: soft, non-tender to palpation, non-distended, inc c/d/i, t-tube, , and ptbd all bilious output ext: no le edema pertinent results: ucx- no growth 02:24am blood wbc-10.1 rbc-3.01* hgb-9.1* hct-28.4* mcv-94 mch-30.1 mchc-32.0 rdw-17.2* plt ct-620* 02:24am blood glucose-131* urean-74* creat-2.8* na-147* k-3.5 cl-110* 02:24am blood alt-7 ast-24 alkphos-173* totbili-0.6 02:24am blood albumin-2.8* calcium-9.5 phos-3.3 mg-2.3 03:27am blood type-art po2-99 pco2-45 ph-7.47* caltco2-34* base xs-7 brief hospital course: events: : cipro started empirically for uti. patient resuscitated with boluses of ns x 750 cc, and lr 100 cc/hr. patient was still hypotensive and tachycardic at 21:00; vanc/zosyn started in place of cipro in view of empiric treatment for sepsis. ir on for replacement of j-tube. a-line inserted in right axilla, patient continues to be tachy and hypotensive, neo 1 mcg/kg/min started to maintain pressure despite adequate fluid resuscitation. : j-tube replaced in ir; started peptamen for tf. changed fluids to maintenance. cdiff sent. cipro added per id recs for additional gram negative coverage - given organisms noted on prior bile cx on previous admission. given 25/100 sinemet x 1 to assess for response - mild improvement per neuro team, thus started tx. on neo gtt. alb 5% 12.5g x1 overnight for low uop. off pressors : d/c'ed r. axillary a-line; d/c'ed antibiotics given absence of growth on cultures and likely contamination in jp (grew multiple organisms previously and at the time id had recommended watchful waiting); 1u prbcs for hct 23.4. : improved rigidity and finger tapping on 25/100 sinemet, increased to tid. decrease in urine production, bolused 500 cc ns. : transferred on the floor. speech and swallow evaluation recommended npo. refeed with bile from t-tube started. fluid balance with boluses. : continued tf, 2l lr for fluid balance. : ptbd and t-tube capped, received 1l bolus. was fluid possitive. mental status improving. : increased output from , slightly increase in wbc, ptbd and t-tube unclamped. bile refeed with tf from ptbd. required 500cc bolus to stay even. : clamped t-tube and , refeeding 300cc of bile per day from ptbd by mixing with tf. required 500cc bolus to stay even. : clamped ptbd, unclamped occasionally to allow accumulation of bile, continued to refeed 300cc of bile per day fro ptbd by mixing with tf. required 500cc bolus to stay even. : clamped t-tube; clamped ptbd x4hrs, unclamped for 2hours, refed bile 100cc q8h by mixing with tfs. due to an episode of tachycardia, hypotension, and tachypnea, the patient was transferred to the icu. please refer to full icu notes for further reference. : patient transferred to icu, intubated, a-line placed, phenylephrine drip, albumin 500cc x 2, ns->lr, initially c/w pe, ct a/p was obtained : lll pna was diagnosed. sputum cultures were sent. the patient was transitioned from a phenelephrine drip to norepinephrine drip on this day. on this day, tubefeeds were also administered started. 2 units of prbcs were given for hematocrit of 19. : tf were stopped as the patient was noted to have increased output upon administration of feeds. from this point onwards, it was determined that the patient was to be strictly npo, with no tube feeds. nothing to be administrered by j tube, with the exception of crushed cinemet. this was the day that tpn was started, and began weaning patient off the vent. stool studies were obtained, which were negative. sputum cultures revealed e.coli, for which the patient was started on a course of iv zosyn, to be complete on . due to rsbi 103 and persist acidosis, were unable to extubate. cardiovascular status continued to improve, however, and the patient was weaned off pressor support. : on this day, the patient was weaned off propofol, and was awake following commands, on cpap, with iv tylenol for pain : patient was noted to be "wet" on pulmonary exam, +10 liters during hospital stay. he was given 10 mg iv lasix, still intubated pending further diuresis. family updated, raised the possibility of tracheostomy. : lasix drip restarted, goal -130 to 150 cc per hour, albumin given with lasix- ir reanchored . : on this day, patient was extubated without incident. 1 u prbc given, ng removed, cinemet administered via j-tube, and patient was out of bed throughout the day. he would expereince occasional desat to high 80's which improved with suctioning : waxing/ mental status this morning. and : patient continues to be stable in terms of cardiovascular and respiratory status. is the day of completion of zosyn treatment for lll pneumonia. the patient requires tpn for nutrition, and is to be strict npo, with no tube feeds. nothing is to be administered by j tube except for crushed cinemet. the patient and family is informed and aware of upcoming transfer to an extended care facility for further care. medications on admission: aspirin 325 po qd, metoprolol tartrate 25 po tid, heparin 5,000 subq tid, insulin regular ssi qachs, esomeprazole magnesium 40 po qd, saccharomyces boulardii 250 po qid, ascorbic acid er 500 po bid, duoneb 0.5 mg-3 mg(2.5 mg base)/3 ml neb qid, guaifenesin 100 mg/5 ml syrup oral qid discharge medications: 1. acetaminophen iv 1000 mg iv q6h:prn pain 2. carbidopa-levodopa (25-100) 1 tab ng tid please crush and give via j-tube with 60cc water to avoid j-tube clogging 3. dextrose 50% 12.5 gm iv prn hypoglycemia protocol 4. glucagon 1 mg im q15min:prn hypoglycemia protocol 5. heparin 5000 unit sc tid 6. insulin sc sliding scale fingerstick qachs insulin sc sliding scale using reg insulin 7. ipratropium bromide neb 1 neb ih q6h:prn sob 8. pantoprazole 40 mg iv q24h 9. potassium chloride replacement (critical care and oncology) iv sliding scale only 1 dose is to be given per laboratory value. additional doses without new lab values require an additional order be placed. discharge disposition: extended care facility: hospital discharge diagnosis: dehydration discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: out of bed with assistance ( lift) to chair or wheelchair. discharge instructions: mr. and new care team, you were admitted to the general surgery service at because you were tachycardic and hypotensive. you have done well, and it is now safe for you to continue your recovery in a long term care facility. please provide all specified medications. please encourage patient to get plenty of rest, continue to assist patient with getting out of bed and into a chair, as tolerated. please follow-up with surgeon and primary care provider (pcp) as advised below. please follow-up with your surgeon and primary care provider (pcp) as advised below. care and t-tube care: *please look at the site every day for signs of infection (increased redness or pain, swelling, odor, yellow or bloody discharge, warm to touch, fever). *maintain suction of the bulb. *note color, consistency, and amount of fluid in the . call the doctor, nurse practitioner, or vna nurse if the amount increases significantly or changes in character. *be sure to empty the frequently. record the output, if instructed to do so. *you may shower; wash the area gently with warm, soapy water. *keep the insertion site clean and dry otherwise. *avoid swimming, baths, hot tubs; do not submerge yourself in water. *make sure to keep the attached securely to your body to prevent pulling or dislocation. . ptbd care: please keep to gravity drainage. *please look at the site every day for signs of infection (increased redness or pain, swelling, odor, yellow or bloody discharge, warm to touch, fever). *if the is connected to a collection container, please note color, consistency, and amount of fluid in the . call the doctor, nurse practitioner, or vna nurse if the amount increases significantly or changes in character. be sure to empty the frequently. record the output, if instructed to do so. *wash the area gently with warm, soapy water or 1/2 strength hydrogen peroxide followed by saline rinse, pat dry, and place a sponge. change daily and as needed. *keep the insertion site clean and dry otherwise. *avoid swimming, baths, hot tubs; do not submerge yourself in water. *make sure to keep the attached securely to your body to prevent pulling or dislocation. . j-tube care: please monitor for signs and symptoms of infection or dislocation. you may use this tube for administration of cinemet (crushed) only. do not give other medications by this route - please administer intravenously, as specified. do not give any tube feeds. patient is strict npo and nothing by tube (except cinemet). followup instructions: department: surgical specialties when: monday at 3:30 pm with: , md building: sc clinical ctr campus: east best parking: garage md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances arterial catheterization arterial catheterization irrigation of gastrostomy or enterostomy diagnoses: pneumonia, organism unspecified acidosis hyperpotassemia hypocalcemia anemia, unspecified acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified toxic encephalopathy unspecified essential hypertension other pulmonary insufficiency, not elsewhere classified unspecified septicemia severe sepsis personal history of malignant neoplasm of prostate personal history of tobacco use paralysis agitans alkalosis septic shock mechanical complication due to other implant and internal device, not elsewhere classified diarrhea personal history of urinary calculi dehydration tachycardia, unspecified personal history of peptic ulcer disease other and unspecified escherichia coli [e. coli] attention to other artificial opening of digestive tract personal history of allergy to sulfonamides other digestive system complications 

Answer: The patient is high likely exposed to