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: nitrofurantoin attending: chief complaint: abdominal distention major surgical or invasive procedure: exploratory laparotomy and lysis of adhesions history of present illness: 32f with pmh of cerebral palsy p/w abdominal distention. patient is non-verbal at baseline and is reported to develop abdominal distention with abdominal girth approaching 90cm while at her nursing facility one day prior to presentation. patient had been receiving tf of fibersource 185 cc 5xdaily. tf were stopped and patient was started on pedialyte without much improvement in abdominal girth. per nursing facility last bm was within 24 hours of presentation. patient reportedly had hypoactive bs but they denied chills or night sweats. there was no n/v/d. at baseline patient generally non-verbal per nursing home patient but will either flinch, or cough with pain. patient was subsequently taken to where ct scan was concerning for sbo. patient was subsequently transferred to for further management. in our ed patient developed low grade temperature to 100.8 and tachycardia to 120. hr responded to fluid (down to 102 with 3 l) and patient was started on empiric antibiotics of vanc/ceftriaxone. also received levofloxacin/flagyl at osh. past medical history: cerebral palsy, encephalopathy (unknown etiology), gerd, seizures, chronic lung disease (due to chronic aspiration), mental retardation, siadh (stable) social history: resids at nursing home. mother (primary language cambodian, but speaks some english) makes medical decisions for patient (c ), sister in law - lives with pt's mother () family history: nc physical exam: vital signs upon admission: vitals @ triage: 98.9 121 114/77 16 100% trach mask. vitals @ h&p: 100.6 106 105/70 22 100 4ltm gen: not interactive, awake, eyes open, blinks to threat, otherwise unresponsive cor: rrr, tachycardic lungs: clear on r, coarse rhonchi on left abd: tense, difficult to assess for tenderness as patient unable to report pain ext: contracted, dwarfed pertinent results: 10:46pm type-art temp-35.7 po2-81* pco2-46* ph-7.32* total co2-25 base xs--2 08:43pm type-art po2-217* pco2-49* ph-7.33* total co2-27 base xs-0 intubated-intubated vent-controlled 08:43pm glucose-89 lactate-0.8 na+-139 k+-2.7* cl--107 08:43pm hgb-11.0* calchct-33 o2 sat-99 carboxyhb-1 met hgb-0 08:43pm freeca-1.17 04:54pm glucose-89 urea n-8 creat-0.1* sodium-141 potassium-3.1* chloride-107 total co2-24 anion gap-13 04:54pm calcium-8.6 phosphate-2.8 magnesium-2.0 07:05am urine hours-random 06:25am lactate-1.3 07:05am urine ucg-negative 06:15am glucose-139* urea n-18 creat-0.4 sodium-126* potassium-4.6 chloride-85* total co2-28 anion gap-18 06:15am estgfr-using this 06:15am alt(sgpt)-25 ast(sgot)-37 alk phos-197* tot bili-0.3 06:15am lipase-100* 06:15am albumin-4.6 06:15am carbamzpn-8.6 06:15am wbc-17.2*# rbc-4.73 hgb-14.5 hct-42.5 mcv-90 mch-30.7 mchc-34.1 rdw-12.9 06:15am neuts-86* bands-0 lymphs-9* monos-4 eos-0 basos-0 atyps-0 metas-1* myelos-0 06:15am hypochrom-occasional anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 06:15am plt count-296 06:15am pt-11.8 ptt-21.6* inr(pt)-1.0 06:15am urine color-yellow appear-cloudy sp -1.014 06:15am urine blood-lg nitrite-pos protein-25 glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-8.0 leuk-tr 06:15am urine rbc-* wbc-0-2 bacteria-mod yeast-none epi-0-2 06:15am urine amorph-many 05:36am blood wbc-6.5 rbc-3.38* hgb-10.3* hct-30.4* mcv-90 mch-30.5 mchc-33.9 rdw-12.9 plt ct-326 04:50am blood wbc-4.5 rbc-3.31* hgb-10.0* hct-30.4* mcv-92 mch-30.0 mchc-32.8 rdw-12.9 plt ct-319 06:50am blood wbc-4.3 rbc-3.18* hgb-9.7* hct-29.5* mcv-93 mch-30.4 mchc-32.7 rdw-12.6 plt ct-305 06:15am blood neuts-86* bands-0 lymphs-9* monos-4 eos-0 baso-0 atyps-0 metas-1* myelos-0 05:36am blood plt ct-326 02:23am blood pt-12.3 ptt-23.1 inr(pt)-1.0 05:36am blood glucose-103* urean-4* creat-0.1* na-139 k-4.4 cl-97 hco3-34* angap-12 04:50am blood glucose-94 urean-4* creat-0.1* na-136 k-4.2 cl-98 hco3-31 angap-11 02:23am blood alt-30 ast-57* alkphos-121* amylase-39 totbili-0.4 05:36am blood calcium-9.7 phos-4.6* mg-1.9 05:36am blood carbamz-7.1 : eeg impression: this extended routine eeg showed no electrographic seizures. it continued to show a disorganized likely encephalopathic background and frequent episodes of focal slowing and sharp waves seen bilaterally and independently in the two temporal regions or more broadly over each hemisphere. there were no electrographic seizures. : eeg impression: this telemetry continued to show a disorganized but fast background throughout, with some prominent focal slowing seen bilaterally and independently in posterior areas of the two hemispheres. there were also very frequent isolated sharp wave discharges, on this day's recording more frequent broadly over the left hemisphere, but there were frequent discharges on the right, as well. finally, there were infrequent and brief (five to ten second) rhythmic runs of delta slowing in the left temporal area suggestive of brief electrographic seizures : eeg impression: this eeg telemetry showed a low voltage fast record with plentiful muscle artifact throughout. it did not change appreciably over the recording. there was an absence of normal sleep patterns. sharp waves persisted on both sides, more on the left and more posteriorly on both sides. they could indicate independent areas of cortical hypersynchrony, but they were not definitely epileptiform in appearance. multifocal vascular or other problems are one possible explanation. there were no electrographic seizures : kub impression: nonspecific small bowel gas pattern not suggestive of obstruction. improvement in bowel gas pattern compared to prior imaging. air and stool are seen within the distal colon. no other significant change compared to the prior. brief hospital course: mrs. was admitted to the acute care surgery service and moved to the trauma sicu due to her tachycardia and need for frequent suctioning. because of her concerning exam, she underwent exploratory laparotomy with lysis of adhesions during which the transition point was found and released. no bowel resection was performed. she was moved back to the tsicu until she was able to be weaned from the ventilator back to trach collar. subsequently, she was transferred to the floor where she remained until discharge back to her nursing home facility. her complicated hospital course is summarized by systems below: neuro: throughout her hospital stay, the patient remained minimally interactive, and non-verbal. on her mother's suspicion for seizures, a neurology consult was obtained who recommended continuous eeg monitoring which revealed that the patient was having seizures activity. she sleeps in naps, but opens her eyes to tactile stimulation. she was treated with extra doses of tegretol and standing ativan for her seizure control. her last tegretol level was 7.1. she will be discharged on ativan but may be weaned off over 1 week as per neurology. ativan wean can begin when ms back at the nursing home facility. she will need a follow-up visit in weeks with her neurologist, dr. , at . cv: the patient was tachycardic between 105-125 for the majority of her hospitalization. nevertheless, her hematocrit and blood pressure remained stable and urine output adequate. thus, this was believed to be secondary to pain and anxiety and was treated with narcotics with some effect. current heart rate continues to range between 110-130 despite ativan, for this reason, she was started on lopessor. she continues to have bouts of increased heart rate 118-125 especially with stimulation. pulmonary: chronic aspiration. permanent trach to collar mask. strong cough and expectorates white secretions out trach tube. trach site clean. copious white secretions via trach site. portex trach tube, #8 with inner cannula, cuff inflated 7cc. coarse breath sides bilaterally. her oxygen saturation has been 98%. gi: replete with fiber at 30cc/hr, changed to fibersource at 80cc/hr with re-cycling via g-tube. mild abdominal distention continues. hypoactive bowel sounds. ducolax suppository given with no results. miralex and mineral oil instilled via g-tube with no results. no bowel movement with lactulose. x-ray of abdomen done which showed air and stool in distal colon with no signs of obstruction. sse given last evening, rectal exam this am noted to have soft stool. starting to pass small amount of soft stool. repeat sse to be given today with passage of soft formed brown stool. gu: foley to gravity drainage with dark yellow urine. she had a urine culture done which showed enterococcus for which she was started on a 3 day course of ampicillin. she will complete ampicillin on at midnight. skin: warm, pink, abdominal wound with staples, mild erythema along staple line, no discharge. abdominal incision open to air. dry dressing to g-tube site. id: blood cultures from showed no growth. sputum culture from showed extensive contamination with upper respiratory secretions. urine culture showed enterococcus which is sensitive to ampicillin. she will continue with ampicillin for 3 days. no mrsa was isolated in the nasal swab. she has been afebrile. her last white blood cell count was normal. musculoskeletal: contractures upper and lower extremities medications on admission: mvi 1tab daily omeprazole 20mg po bid pedialyte 400ml po bid miralax 100'prn constipation albuterol neb prn calcionate 115mg/5ml debrox 6.5mg fibersource 185mg 5x daily apap 325mg q4prn pain artificial tears 1 drop q4h dulcolax 10mg pr q48h budesonide susp 1unit inh carbamazepine 300mg tid prempro .625/2.5mg 1tab daily premarin .625 mg daily levothyroxine 87.5 mcg' medroxyprogesterone (provera) 10mg (give for 14 days each month starting on the 15th of each month) montelukast 10mgqhs discharge medications: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler : six (6) puff inhalation q4h (every 4 hours) as needed for wheezing. 2. acetaminophen 650 mg suppository : one (1) suppository rectal q6h (every 6 hours) as needed for fever. 3. bisacodyl 10 mg suppository : one (1) suppository rectal daily (daily) as needed for constipation. 4. polyethylene glycol 3350 17 gram/dose powder : 17 gm powder po daily (daily) as needed for constipation. 5. montelukast 10 mg tablet : one (1) tablet po once a day: via g tube. 6. provera 10 mg tablet : one (1) tablet po once a day for 14 days days: give via g tube ( 14 days each month starting on the 15th of each month. 7. prempro 0.625-2.5 mg tablet : one (1) tablet po once a day: via g tube. 8. carbamazepine 100 mg/5 ml suspension : fifteen (15) ml po three times a day: please check levels daily. 9. levothyroxine 175 mcg tablet : tablet tablet po once a day: via feeding tube. 10. ampicillin 500 mg capsule : one (1) capsule po every six (6) hours for 3 days: via g tube...continue up to midnight. 11. lorazepam 0.5 mg tablet : one (1) tablet po every six (6) hours: taper: 0.5 mg every 6 hours for2days, then 0.5 mg every 8 hours for 2 days, then 0.5 mg every 12 hours for 2 days, then discontinue. 12. colace 60 mg/15 ml syrup : 25ml ml po twice a day as needed for constipation. 13. insulin regular human 100 unit/ml solution : as per sliding scale injection asdir (as directed). 14. ipratropium bromide 0.02 % solution : one (1) nebulizer inhalation every eight (8) hours. 15. pulmicort 0.5 mg/2 ml suspension for nebulization : one (1) nebulizer inhalation twice a day. 16. metoprolol tartrate 25 mg tablet : 1.5 tablets po bid (2 times a day): hold for systolic bp <100, hr <60. 17. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr once a day. discharge disposition: extended care facility: nursing home discharge diagnosis: small bowel obstruction discharge condition: mental status: encephalopathic level of consciousness: eyes open to stimuli, does not follow verbal commands, spontaneous cough bedbound mental status: encephalopathic level of consciousness: eyes open to stimuli, does not follow verbal commands, spontaneous cough bedbound discharge instructions: please call your doctor or nurse practitioner or return to the emergency department for any of the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down 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. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *your pain in not improving within 8-12 hours or is not gone within 24 hours. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon. avoid driving or operating heavy machinery while taking pain medications. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. *if you have staples, they will be removed at your follow-up appointment. *if you have steri-strips, they will fall off on their own. please remove any remaining strips 7-10 days after surgery. followup instructions: please follow up with acute care surgery clinic in weeks by calling for an appointment. mis will also need to follow up with her neurologist, dr. , at in weeks md procedure: venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances other lysis of peritoneal adhesions diagnoses: esophageal reflux urinary tract infection, site not specified unspecified acquired hypothyroidism pneumonitis due to inhalation of food or vomitus epilepsy, unspecified, without mention of intractable epilepsy streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] other disorders of neurohypophysis tachycardia, unspecified gastrostomy status tracheostomy status infantile cerebral palsy, unspecified unspecified intellectual disabilities intestinal or peritoneal adhesions with obstruction (postoperative) (postinfection) 

Answer: The patient is high likely exposed to