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: ceclor / cephalexin / codeine / sulfonamides / alprazolam attending: chief complaint: hypotension major surgical or invasive procedure: picc placement history of present illness: 61 yo woman with extensive pmhx (including severe ischemic cm, ef 25-30%, on home dopamine gtt) admitted with hypotension. she went to after she fell twice at home (per husband). her first fall was not witnessed and the 2nd was witnessed by her husband. she had no head trauma. clinic notes state that she has been gaining weight over the past week and has not been takin gher perscribed lasix dose. + dietary non-compliance past medical history: 1. cad s/p cabg 2. ischemic cardiomyopathy s/p icd 3.chf 30% on chronic dopamine pump at 8mg/kg/min since 4. afib/aflutter s/p ablation s/p ppm 5. h/o gib + avm 6. pud 7. s/p mvr on coumadin (inr goal 2.0-2.5 since has multiple gib with higher inr) 8. h/o bacteremia with septic emboli 9. h/o anemia social history: no etoh, still smoking. lives with husband, has service family history: noncontrib physical exam: vitals: t= 96.6, hr = 80 av paced, bp = 66/44 (dopa 19.7, levo 0.015) - 102/43 (dopa 19.7, levo 0.086), rr = 13 , sao2 = 100% on 3l. general: pleasant female, appears chronically ill, sleepy heent: normocephalic and atraumatic head, no nuchal rigidity, anicteric sclera, moist mucous membranes. neck: no thyromegaly, no lymphadenopathy, no carotid bruits. jvd to jaw. chest: her chest rose and fell with equal size, shape and symmetry, lungs with bibasalier crackles. no erythema around picc line, non tender. cv: pmi appreciated in the fifth ics in the midclavicular line without heaves or thrills, rrr, normal s1 and s1 hsm. abd: normoactive bs, nt and nd. no masses or organomegaly back: no spinal or cva tenderness. ext: no cyanosis, no clubbing, 1+ edema with 2+ dorsalis pedis pulses bilaterally integument: no rash neuro: cn ii-xii symmetrically intact, perrla. pertinent results: 07:43am blood wbc-5.2 rbc-3.75* hgb-10.8* hct-31.9* mcv-85 mch-28.8 mchc-33.9 rdw-17.3* plt ct-157 11:38pm glucose-149* urea n-100* creat-2.4* sodium-131* potassium-4.1 chloride-98 total co2-21* anion gap-16 11:38pm hct-28.8* 11:38pm pt-26.9* ptt-33.6 inr(pt)-4.5 11:38pm fibrinoge-580* 04:15pm glucose-170* urea n-108* creat-2.9* sodium-127* potassium-5.4* chloride-95* total co2-17* anion gap-20 04:15pm ck(cpk)-75 04:15pm ck-mb-notdone ctropnt-<0.01 04:15pm wbc-10.2# rbc-3.35* hgb-10.1* hct-29.4* mcv-88 mch-30.2 mchc-34.4 rdw-17.3* 04:15pm plt count-99* 10:20am urine color-yellow appear-clear sp -1.018 10:20am urine blood-neg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-sm urobilngn-neg ph-6.5 leuk-neg 10:20am urine rbc-<1 wbc-<1 bacteria-none yeast-none epi-<1 09:37am lactate-2.2* 08:45am glucose-84 urea n-115* creat-3.5*# sodium-127* potassium-5.7* chloride-93* total co2-15* anion gap-25* 08:45am alt(sgpt)-107* ast(sgot)-83* ck(cpk)-70 alk phos-119* amylase-60 tot bili-1.2 08:45am lipase-33 08:45am ck-mb-6 08:45am ctropnt-0.02* 08:45am calcium-8.3* phosphate-7.3*# magnesium-2.7* 08:45am wbc-3.2* rbc-3.08* hgb-8.9* hct-27.0* mcv-88 mch-28.8 mchc-32.8# rdw-18.0* 08:45am neuts-78* bands-11* lymphs-9* monos-0 eos-2 basos-0 atyps-0 metas-0 myelos-0 08:45am hypochrom-normal anisocyt-1+ poikilocy-2+ macrocyt-1+ microcyt-3+ polychrom-2+ ovalocyt-2+ burr-1+ teardrop-occasional 08:45am plt smr-low plt count-113* 08:45am pt-21.9* ptt-34.1 inr(pt)-3.0 chest (portable ap) 8:35 am chest (portable ap) reason: r/o chf medical condition: 61 year old woman with hypotension, low ef reason for this examination: r/o chf history: hypotension. low ejection fraction. portable ap chest, 1 view: findings: comparison is made to . the patient is status post sternotomy. there is a left-sided pacemaker with lead tips in the region of the ra and rv. there is a prosthetic mitral valve. the heart is enlarged with slight increase in size compared to the prior exam. there is new vascular congestion and indistinctness consistent with chf, although there is no interstitial or alveolar edema. there are no large pleural effusions and there are no focal areas of consolidation. impression: cardiomegaly with chf. echo: general comments: suboptimal image quality - poor echo windows. emergency study performed by the cardiology fellow on call. conclusions: the left ventricular cavity is dilated. overall left ventricular systolic function is severely depressed. the right ventricular cavity is dilated. right ventricular free wall motion appears grossly preserved. the aortic valve leaflets are mildly thickened. no aortic regurgitation is seen. a bileaflet mitral valve prosthesis is present and appears well-seated. leaflet motion is probably preserved (views suboptimal). mitral regurgitation is present but cannot be quantified. the tricuspid valve leaflets are mildly thickened with moderate to severe tricuspid regurgitation. there is no pericardial effusion. compared to the prior study of , the basal septum now appears slightly less vigorous; overall left ventricular systolic function appears slightly more depressed. peak transmitral velocity appears similar. brief hospital course: 1. septic shock: the patient had gnr bacterima likely from picc line. she was placed on zosyn and levo and continued levo as an outpatient. she was weaned off the levophed and her dopamine was dropped down to her home infusion dose. her picc line was changed. 2. chf excerbation: the patient has end-stage chf and is on home dopamine infusion. a bedside echo showed ef 20 - 25 % and no effusion. she was diuresed 8lbs overweight with lasix. 3. mechanical valve: her coumadin was brefily held when she was admiited for a inr 3.3. this was restarted prior to dc. 4. arf: cr 3.5 from baseline of 1.2 most likely from hypoperfusion. this resolved with correction of her failure and hypotension. 5. cad: her asa and acei were titrated up. she was ruled out for an mi 6. hyperkalemia: got kayexalate in the ed. resolved medications on admission: asa, amio 200mcg, coreg 6.5 mg , lasix 80 mg , lipitor 10mg, vasotec 5mg , trazodone 100mg qpm, zoloft 100mg , ativan 1mg tid, rantidine 150mg , coumadin 6mg, metamusil, colace discharge medications: 1. atorvastatin calcium 20 mg tablet sig: one (1) tablet po daily (daily). 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. epoetin alfa 4,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-). 4. amiodarone hcl 200 mg tablet sig: one (1) tablet po daily (daily). 5. sertraline hcl 50 mg tablet sig: one (1) tablet po bid (2 times a day). 6. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. trazodone hcl 50 mg tablet sig: two (2) tablet po hs (at bedtime) as needed. 8. lorazepam 1 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for anxiety. 9. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). 10. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 11. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 14 days. disp:*14 tablet(s)* refills:*0* 12. enalapril maleate 5 mg tablet sig: one (1) tablet po bid (2 times a day). 13. insulin regular human subcutaneous 14. lasix 40 mg tablet sig: three (3) tablet po qam. 15. lasix 40 mg tablet sig: two (2) tablet po qpm: take 120mg at night if your weight is above 150 lbs. 16. coumadin 3 mg tablet sig: one (1) tablet po at bedtime. disp:*30 tablet(s)* refills:*1* 17. dopamine in d5w 3.2 mg/ml solution sig: eight (8) mcg/kg/m iv infusion intravenous continuous infusion: weight = 67.9 kg. disp:*30 bags* refills:*2* discharge disposition: home with service facility: discharge diagnosis: gnr sepsis congestive heart failure discharge condition: good discharge instructions: weigh yourself every morning, call dr. if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 2 l always wash your hands before handling your picc line. followup instructions: provider: , m.d. where: cardiac services phone: date/time: 2:30 please have check inr on and send results to mr. at clinic. very important! procedure: venous catheterization, not elsewhere classified transfusion of packed cells infusion of vasopressor agent diagnoses: other primary cardiomyopathies congestive heart failure, unspecified acute kidney failure, unspecified severe sepsis aortocoronary bypass status heart valve replaced by other means septic shock long-term (current) use of anticoagulants other septicemia due to gram-negative organisms infection and inflammatory reaction due to other vascular device, implant, and graft 

Answer: The patient is high likely exposed to