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: dilaudid / morphine / flagyl / latex / percocet attending: chief complaint: she was discharged home on following a sigmoidectomy. while at home she noticed gradually increasing abdominal distension, and persistent abdominal pain, worse on the right. she continued to tolerate regular diet though her appetite decreased. she had a normal bowel movement 2 days after discharge but subsequently had no bms until she had 2 watery bowel movements this evening. she presented to the ed at an outside hospital in this evening, where her wbc was found to be 27. a kub was done which revealed diffuse free air, and she had a ct scan with po contrast which revealed a very large diffuse fluid collection with contrast layering. major surgical or invasive procedure: exploratory laparotomy, washout and loop colostomy - pleural tap history of present illness: ms. is a 75 year old woman who recently underwent sigmoid colectomy for a sigmoid stricture on . her hospital course was prolonged by diarrhea and esophagitis. repeated cdiffs were negative and she was started on imodium, and she underwent an egd which revealed esophageal candidiasis. she was discharged home on . while at home she noticed gradually increasing abdominal distension, and persistent abdominal pain, worse on the right. she continued to tolerate regular diet though her appetite decreased. she had a normal bowel movement 2 days after discharge but subsequently had no bms until she had 2 watery bowel movements this evening. she presented to the ed at an outside hospital in this evening, where her wbc was found to be 27. a kub was done which revealed diffuse free air, and she had a ct scan with po contrast which revealed a very large diffuse fluid collection with contrast layering. she denied any nausea/vomiting prior to today but has had some nausea after the ct scan. she was never febrile at home. she denies any chest pain, but does complain of mild shortness of breath starting this am. past medical history: pmh: diverticulitis, htn, hypothyroid, hyperchol, gerd, esophagitis, panic d/o, hemorrhoids, osteo, b12 def psh: hemmorhoid, urethral sling, bladder suspension ,tah, cholecystectomy, lumbar fusion, l rotator cuff social history: married. lives with supportive husband and son. denies use if tobacco products, illicit drugs, and etoh. family history: noncontributory physical exam: on admission vs: 98.4 97 140/p 22 98% on 2l, 170 lbs gen: nad, aaox3 heent: perrla, eomi, oropharynx pink/moist chest: cta b/l, no crackles, wheezes, ronchi heart: s1s2 rrr, 2/6 sem loudest at aortic abd: soft, distended, + bs, midline incision intact. tender to palpation diffusely but especially right upper and lower quadrants. no rebound, guarding, or tenderness to percussion. no hernias/masses. ext: no c/c/e . at discharge: vitals: gen: cv: resp: abd: incision: extrem: pertinent results: 04:53am blood wbc-12.5* rbc-2.57* hgb-7.9* hct-23.7* mcv-92 mch-30.6 mchc-33.2 rdw-15.6* plt ct-315 04:44am blood wbc-19.3* rbc-3.14* hgb-9.5* hct-28.0* mcv-89 mch-30.2 mchc-33.9 rdw-16.9* plt ct-300 06:50am blood wbc-21.8* rbc-3.33*# hgb-10.2*# hct-28.4* mcv-85 mch-30.6 mchc-36.0* rdw-17.0* plt ct-239 05:35am blood wbc-20.3* rbc-1.60*# hgb-4.8*# hct-14.6*# mcv-91 mch-29.8 mchc-32.8 rdw-15.2 plt ct-498* 06:25am blood wbc-15.6* rbc-3.27* hgb-9.9* hct-30.2* mcv-92 mch-30.3 mchc-32.8 rdw-15.5 plt ct-522* 02:09am blood wbc-32.4* rbc-3.41* hgb-10.3* hct-30.6* mcv-90 mch-30.2 mchc-33.6 rdw-17.1* plt ct-634* 01:13am blood wbc-28.7*# rbc-2.77* hgb-8.6* hct-26.0* mcv-94 mch-31.1 mchc-33.1 rdw-14.7 plt ct-678*# 06:50am blood pt-12.3 ptt-31.7 inr(pt)-1.0 09:47am blood pt-14.5* ptt-43.6* inr(pt)-1.3* 04:53am blood glucose-104 urean-34* creat-1.1 na-143 k-4.7 cl-112* hco3-23 angap-13 08:00am blood glucose-105 urean-11 creat-1.3* na-143 k-3.5 cl-113* hco3-25 angap-9 01:13am blood glucose-108* urean-42* creat-0.8 na-146* k-3.6 cl-110* hco3-20* angap-20 06:49am blood alt-6 ast-11 ld(ldh)-248 alkphos-40 totbili-0.3 04:53am blood calcium-8.5 phos-4.1 mg-2.1 06:49am blood albumin-2.2* calcium-7.5* phos-3.2 mg-1.9 01:13am blood calcium-7.6* phos-4.3# mg-2.6 04:55pm blood caltibc-134* ferritn-317* trf-103* 04:55pm blood triglyc-114 04:55pm blood triglyc-114 11:29am blood vanco-16.6 05:51am blood vanco-51.8* 08:15am blood vanco-7.2* . 10:45 am pleural fluid n. gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. fluid culture (final ): no growth. anaerobic culture (preliminary): no growth. . time taken not noted log-in date/time: 8:05 am serology/blood chem # 00899i- 8:04am. **final report ** helicobacter pylori antibody test (final ): negative by eia. (reference range-negative). . 8:01 pm stool consistency: not applicable source: stool. **final report ** clostridium difficile toxin assay (final ): feces negative for c. difficile toxin by eia. (reference range-negative). . 6:00 am swab site: abdomen **final report ** gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. 2+ (1-5 per 1000x field): gram negative rod(s). . 1:47 am blood culture **final report ** blood culture, routine (final ): bacteroides fragilis group. beta lactamase positive. anaerobic bottle gram stain (final ): reported by phone to @ 7:05a . gram negative rods. . radiology final report pleural asp by radiologist left 9:24 am pleural asp by radiologist lef reason: please tap left pleural effusion - please send fluid for gr medical condition: 75 year old woman with left pleural effusion reason for this examination: please tap left pleural effusion - please send fluid for gram stain, culture, ldh, ph, glucose, albumin, amylase, creatinine, protein pleural aspirate by radiologist: indication: 75-year-old woman with left pleural effusion. procedure: informed and signed written consent was obtained from the patient. a preprocedure timeout was performed with two patient identifiers. under ultrasound guidance, distance and trajectory to a fluid collection in the right hemithorax was performed. the area was cleansed, local anesthesia was administered and subsequently a 16-gauge catheter was placed within the fluid with approximately 700 cc of clear fluid removed. there is no evidence of residual effusion on ultrasound after the procedure. the patient tolerated the procedure well. post-procedure chest x-ray did not show evidence of pneumothorax. samples were sent for microbiology and chemistry evaluation. brief hospital course: on admission the patient was prepared for surgery and started empirically on vanc/zosyn. following surgery she was kept intubated, sedated, with an ng tube, jp drain and foley catheter in place. she was transferred to the icu for intense, continued monitoring. - vasopressors weaned down as tolerated to minimal volumes. - patient extubated, vasopressors weaned off, levofloxacin, flagyl added to antibiotic coverage. - - d/c levofloxacin and flagyl, started cipro, oxygen requirements weaned down, oob to chair - transferred to the floor for continued monitoring, central line removed - picc line placed, diet advanced to a regular diet - nutrition supplements added tid, continued work with physical therapy - ct scan performed demonstrating interval development of four loculated fluid collections within the peritoneal cavity, which are located anterior to the stomach, near the anterior abdominal wall on the right side, in the right lower quadrant area and within the pelvis. - ir percutaneous drainage of fluid collections. lasix started prn for lower extremity edema continued gentle diuresis, regular diet with supplements, transfused 2 units of rbc for hct of 24.3. id consulted - recommended continued therapy on zosyn only picc line removed due to clot formation, placed on pre-mixed peripheral nutrition. - picc line placed, resumed on tpn. - transfused a total of 4 units of rbc for a hematocrit of 18. gi consulted for guiaic positive output. egd demonstrated a shallow cratered ulcer with a visible vessel was seen on the superior wall of the duodenal bulb. -cap electrocautery was applied at the visible vessel for hemostasis successfully. the patient was treated with a proton pump inhibitor . - continued tpn, gentle diuresis, monitor hct - rising white cell count, ct scan demonstrated decreasing fluid collections, no need for drainage - interventional radiology tapped right sided pleural effusion for 700cc, no drain left in place. fluid was negative for pmns, microorganisms. continued abx, tpn, encourage po intake - cont abx, reg diet, tpn , - cont abx, reg diet, cycled tpn overnight : hct decreasing slightly, 2 units of rbc given : egd performed demonstrating a shallow ulcer but no visible bleeding. gi recommends h.pylori treatment empirically including po protonix indefinitely, and clarithromycin & amoxicillin for 2 weeks. - continues to require encouragement with po intake. continue strict calorie counts. tolerating regular diet and ensure drinks three times per day. tpn weaned, blood sugar 114 at 2:45pm. continue to monitor blood sugars closely. treat accordingly. continue with empiric h. pylori treatment for 2 weeks. vitals stable. urine output adequate. stoma viable with loose brown stool. continue with rehabilitation. follow-up with dr. in weeks for both staple and tension suture removal. medications on admission: sucralfate 1g''''; synthroid 125', metoprolol 25'', lotrel ', sertraline 100', torsemide 5', loperamide 2'''prn, tylenol 325 prn, nystatin 5ml'''', pantoprazole 40', ', temazepam 15'prn, crestor 5', fioricet prn, mvi, os-cal 500'', ocuvite 1tab'', vitamin b12 250' discharge medications: 1. sertraline 100 mg tablet sig: one (1) tablet po daily (daily). 2. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day) as needed for groin for 2 weeks. 3. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day): hold sbp<100, hr<60. 4. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) for 2 weeks. 5. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily): hold sbp<100, hr<60. 6. levothyroxine 125 mcg tablet sig: one (1) tablet po daily (daily). 7. enalapril maleate 10 mg tablet sig: two (2) tablet po daily (daily): hold sbp<100, hr<60. 8. torsemide 5 mg tablet sig: two (2) tablet po daily (daily). 9. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 10. acetaminophen 500 mg tablet sig: two (2) tablet po q8h (every 8 hours) as needed for pain: do not exceed 4000mg/24hour. 11. rosuvastatin 5 mg tablet sig: one (1) tablet po daily (daily). 12. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 13. heparin, porcine (pf) 10 unit/ml syringe sig: one (1) ml intravenous prn (as needed) as needed for line flush. 14. megestrol 400 mg/10 ml suspension sig: one (1) po bid (2 times a day). 15. normal saline flush 0.9 % syringe sig: one (1) 10ml injection every eight (8) hours: via picc. 16. clarithromycin 250 mg tablet sig: two (2) tablet po tid (3 times a day) for 2 weeks: started on . 17. amoxicillin 250 mg capsule sig: four (4) capsule po q12h (every 12 hours) for 2 weeks: started on . 18. reglan 10 mg tablet sig: one (1) tablet po qid and hs. 19. insulin regular human 100 unit/ml solution sig: one (1) injection before meals and bedtime for 1 weeks: refer to sliding scale. 20. regular insulin sliding scale insulin sc (per insulin flowsheet) sliding scale fingerstick q6insulin sc sliding scale q6h regular glucose insulin dose 0-60 mg/dl amp d50 61-120 mg/dl 0 units 121-160 mg/dl 2 units 161-200 mg/dl 4 units 201-240 mg/dl 6 units 241-280 mg/dl 8 units 281-320 mg/dl 10 units 321-360 mg/dl 12 units > 361 mg/dl notify m.d. discharge disposition: extended care facility: - discharge diagnosis: primary: splenic flexure colonic perforation malnutrition post-op anemia post-op low urine output post-op multiple abdominal abscesses right brachial venous blood clot . secondary: diverticulitis, htn, hypothyroid, hyperchol, gerd, esophagitis, panic d/o, hemorrhoids, osteo, b12 def discharge condition: stable tolerating a regular diet adequate pain control with oral medication discharge instructions: please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * if you are vomiting and 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. * you see blood or dark/black material when you vomit or have a bowel movement. * your skin, or the whites of your eyes become yellow. * 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. * any serious change in your symptoms, or any new symptoms that concern you. . incision care: * your retention sutures and staples will be removed at your follow-up appointment with dr. . *you may shower. pat incision dry. *avoid swimming and baths until further instruction at your followup appointment. *please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. . monitoring ostomy output / prevention of dehydration: *keep well hydrated. *replace fluid loss from ostomy daily. *avoid only drinking plain water. include gatorade and/or other vitamin drinks to replace fluid. *try to maintain ostomy output between 1000ml per day. *if ostomy output exceeds 1 liter, take 4mg of imodium, repeat 2mg with each episode of loose stool. do not exceed 16mg in 24 hours. followup instructions: 1. please call the office of dr. to make a follow up appointment in weeks at . 2. please call pcp, . for a follow-up in 1 week. this summary neither dictated nor read by me procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances other endoscopy of small intestine thoracentesis percutaneous abdominal drainage endoscopic excision or destruction of lesion of duodenum exteriorization of large intestine other laparotomy diagnoses: anemia, unspecified pure hypercholesterolemia unspecified essential hypertension unspecified protein-calorie malnutrition unspecified acquired hypothyroidism perforation of intestine sepsis chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction septicemia due to anaerobes other vascular complications of medical care, not elsewhere classified peritoneal abscess edema essential thrombocythemia 

Answer: The patient is high likely exposed to