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: patient recorded as having no known allergies to drugs attending: chief complaint: ruq pain major surgical or invasive procedure: ercp intubation and extubation picc line placement history of present illness: ms. is an 84 y/o female with h/o dementia, recently admitted and treated at the for urosepsis, who was referred to the from nursing home with abdominal pain, nausea, and abnormal labs. she had vomited twice yesterday, at least once today in provider's office, which was described as dark green with appearance of coffeegrounds. in ed, vitals were t99.2 102.2=tmax 114 128/56 33 94% 2l (96/52 lowest) lfts were remarkable for obstructive picture with elevated ast/alt and bilirubin. patient given vanc/levo/flagyl. she was given 4l of crystalloid with only 125cc of urine output. she underwent ng lavage for suspicion of ugib that showed no active bleeding, but perhaps suspicion of mw tear. her initial lactate was 4.0 that trented down to 2.9 with ivf. surgery and ercp teams were consulted with plan for urgent ercp. on arrival to the the patient complains of mouth dryness and mild abdominal pain. she denies dyspnea, chest pain, cough, nausea, subjective fever. her interview is limited by dementia. past medical history: vascular dementia htn hypothyroidism hyperlipidemia tia/cvas spinal stenosis s/p multiple surgeries gout depression gerd social history: currently resides at house. diet: ground with nectar thick liquids family history: non-contributory physical exam: vs - temp 99.5 f, bp 97/52 , 109 hr , r 31 , o2-sat 95% 3l general - uncomfortable appearing lady in nad heent - nc/at, limited cooperation with cn exam. mucous membranes profoundly dry. op with the appearance of dried blood neck - supple, no thyromegaly, no jvd, no carotid bruits lungs - bibasilar crackles/bowel sounds, no r/rh/wh, good air movement, resp unlabored but rapid heart - pmi non-displaced, s1 & s2 regular with occasional irregularity and ii/vi hsm heard best in llsb abdomen - bowel sounds present, diffusely tender but soft and non-distended, no masses or hsm, no rebound/guarding extremities - wwp, no edema, 1+ dp pulses skin - no rashes or lesions lymph - no cervical, axillary, or inguinal lad neuro - awake, oriented to self. cn exam limited by her cooperation. perrl. muscle strength 4-/5 throughout, sensation grossly intact throughout, gait deferred as patient is wheelchair bound pertinent results: liver u/s : impression: technically limited study demonstrating dilatation of the common duct with equivocal small stone in the mid duct. there are no gallstones within the gallbladder and no gallbladder wall thickening. liver is grossly normal with no intra-hepatic ductal dilatation. further evaluation with mrcp should be considered if clinically indicated. ct abd/pelvis : 1. dilated common bile duct measuring up to 1.5 cm, with suggestion of two hyperdense lesions in the distal cbd, which could reflect stones or blood clots. 2. mildly distended gallbladder, without definite evidence for cholecystitis. 3. large hiatal hernia. 4. diverticulosis without evidence of diverticulitis. 5. defect and irregularity along the right iliac , reflect a prior harvest, however, correlation with prior surgical history is recommended. 6. atelectasis of the lung bases. ercp : an erythematous patch without any evidence of active bleeding was seen in the proximal esophagus. a medium size hiatal hernia was seen. three stones ranging in size from 6mm to 10mm that were causing partial obstruction were seen at the lower third of the common bile duct. there was post-obstructive dilation. a detailed cholangiogram was not obtained due to history of cholangitis successful placement of a 10fr by 7 cm cotton biliary stent. some stone fragments/sludge and black bile mixed with pus was seen draining from the cbd stent. brief hospital course: an 84 year old lady with dementia presents from nursing home recent nausea and vomiting with a concern for cholangitis based on fever, white count and ruq pain. on arrival to the floor she appears profoundly dry despite aggressive fluid hydration in the ed. . #. cholangitis + sepsis: given the patient's fever, wbc count, ruq pain, lft abnormalities, imaging her primary process was cholangitis stemming from possible gallstones or ? clots based on ct. her fever curve trended down with initial antibiotics (vanc/levo/flagyl) and her pain improved. recent urosepsis hospital admission with change in diet likely contributed to biliary sludging predisposing her to cholangitis. she had of the pentad (unable to assess mental status changes without appreciating her baseline). the patient's elevated lactate was attributable to sepsis, and she demonstrated a mixed metabolic acidosis (lactic acidosis) and alkalosis from volume contraction. antibiotics were changed to cipro and flagyl iv renally dosed, she was initially npo with aggressive ns boluses and oral care. she underwent ercp with stent placement. she will need another ercp in 6 weeks for sphincterotomy and stent removal. blood cultures drawn in the ed grew pseudomonas, acinetobacter, and enterococcus, all pan-sensitive. her antibiotics were narrowed to nafcillin and cipro based on these senstivities and she will complete a 2-week course. subsequent blood cultures were negative. #. respiratory failure: after ercp, she returned to the icu intubated and was kept on vent overnight but was extubated the following day. she required shovel mask o2 for 24 hours but she began to autodiurese and her oxygen requirements decreased. #. oliguric renal failure: uop the day of admission was 125 after 5l of hydration with an elevated cr of 2.4, 1.9 two days prior and baseline unclear. she was given aggressive volume hydration to goal uop. medications were renally dosed. her creatinine improved to 0.1-1.2 #. ugib/tear: according to recent lavage the patient was not actively bleeding, likely had a small tear from vomiting. hematocrit stable. home omeprazole was converted to protonix 40mg iv q12 while in-house. stool guaiac negative. #. dementia: returned to near baseline per family. depression component, held celexa and clonazepam while npo, then restarted celexa on discharge. clonazepam was tapered off. #. htn: patient restarted on labetalol and amlodipine. captopril was held given acute renal failure and may be restarted as an outpatient as bp tolerates. #. gout: continued allopurinol, renally dosed at 100mg po every day. #. spinal stenosis: continued lidoderm patch, held vicodin initially. received occasional morphine iv. #. hyperlipidemia: statin was held while npo but then restarted on discharge #. hypothyroidism: levoxyl was continued as 50mcg iv daily initially, then switched back to po. #. cad: asa, statin were initially held, then restarted once no longer npo and hematocrit remained stable. #. code: code status was initially dnr/dni. this was changed to do not resuscitate but may intubate for reversible cause. contact: (dgt and health care proxy), cell medications on admission: allopurinol 100 mg po daily amlodipine 5mg po daily labetalol 200 mg po bid omeprazole 20mg po daily levoxyl 100 mcg po daily colace 100 mg po bid compazine 5 mg po q6 hours prn celexa 20 mg po daily clonazepam 0.25 mg 1 tab(s) qhs taper off zocor 20 mg po daily captopril 25 mg po tid aspirin 81 mg 1 tab(s) once a day calcium 600mg/vitamin d3 200mg 1 tab po bid vicodin 5/500mg po bid lidoderm patch multivitamin 1 tab po daily discharge medications: 1. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 2. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 3. labetalol 200 mg tablet sig: one (1) tablet po bid (2 times a day). 4. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 5. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 6. colace 100 mg capsule sig: one (1) capsule po twice a day. 7. compazine 5 mg tablet sig: one (1) tablet po every six (6) hours as needed for nausea. 8. celexa 20 mg tablet sig: one (1) tablet po once a day. 9. zocor 20 mg tablet sig: one (1) tablet po once a day. 10. aspirin 81 mg tablet sig: one (1) tablet po once a day. 11. calcium 600 with vitamin d3 600 mg(1,500mg) -200 unit tablet sig: one (1) tablet po twice a day. 12. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical q24 (). 13. multivitamin capsule sig: one (1) capsule po once a day. 14. ciprofloxacin in d5w 400 mg/200 ml piggyback sig: four hundred (400) mg intravenous q24h (every 24 hours) for 1 weeks. 15. nafcillin in d2.4w 2 gram/100 ml piggyback sig: two (2) g intravenous q6h (every 6 hours) for 1 weeks. discharge disposition: extended care facility: nursing home - discharge diagnosis: primary: cholangitis, bacteremia, acute renal failure secondary: hypertension, dementia, gout, hyperlipidemia, spinal stenosis, hypothyroidism, coronary artery disease discharge condition: good, stable, alert and oriented x 3, on intermittent low-flow o2 discharge instructions: you were admitted for evaluation of abdominal pain and nausea and found to have an infection of the biliary tract. you were treated with an endoscopic procedure (ercp) by the gi service and a stent was placed. you were also found to have a bloodstream infection for which you will need to complete a course of iv antibiotics. if you have fevers, chills, lightheadedness, confusion, abdominal pain, nausea, vomiting, shortness of breath, or any other concerning symptoms, call your doctor. followup instructions: you will be followed by the doctors at your rehab facility. follow up with your primary care physician weeks after discharge from rehab. you will need a repeat ercp for stent evaluation and removal six weeks after the ercp done on admission. the ercp service will contact you to schedule this appointment. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube endoscopic insertion of stent (tube) into bile duct irrigation of nasal passages diagnoses: acidosis thrombocytopenia, unspecified esophageal reflux unspecified essential hypertension acute kidney failure, unspecified severe sepsis unspecified acquired hypothyroidism gout, unspecified coronary atherosclerosis of unspecified type of vessel, native or graft depressive disorder, not elsewhere classified other persistent mental disorders due to conditions classified elsewhere diaphragmatic hernia without mention of obstruction or gangrene other and unspecified hyperlipidemia acute respiratory failure alkalosis hemorrhage of gastrointestinal tract, unspecified dehydration streptococcal septicemia spinal stenosis, unspecified region cholangitis calculus of bile duct without mention of cholecystitis, without mention of obstruction septicemia due to pseudomonas 

Answer: The patient is high likely exposed to