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 (sulfonamides) attending: chief complaint: fever and lethargy major surgical or invasive procedure: none history of present illness: ms. is a f with alzheimers who was admitted on following fever and lethargy at her nursing home. per the patient's daughter, ms. had been less interactive over the last week. at daughter's request, urinalysis was checked and was apparently positive. she was empirically started on levofloxacin on . patient developed fever to 101.8f on so was sent to ed for further evaluation. per daughter, no nausea, vomiting, abdominal pain, or diarrhea. apparently had recent uri symptoms as well and has had cough x weeks. . in the ed, vitals were t 101f p 102 bp 97/49 rr 19 o2 100% on room air. she received 5l of saline and was empirically given vancomycin and ceftazidime (micu note says ceftriaxone, but from ed says ceftazidime). given her confusion, she underwent ct of her head which revealed no bleed or acute process. her chest film showed no infiltrate suggestive of pneumonia. she was admitted to the micu for further management. . in the icu, her antibiotics were changed to ciprofloxacin, cefepime, and vancomycin both po and iv. ciprofloxacin was subsequently discontinued. she received additional fluid resuscitation, but did not require pressors. c. difficile toxin assay returned positive. past medical history: alzheimer dementia depression htn dm2 h/o subdural hematomas and hygromas, now resolved h/o r humerus fracture pulmonary fibrosis ? s/p g-tube placement social history: lives at in (). at baseline, ambulates with assistance doesn't use walker. oriented x1 at baseline recognizes her daughters but not other family members. gets feeds through g tube. first language is greek, speaks some english. her daughter is her hcp. family history: n/c physical exam: t 100.8 (tmax 102.9 5pm) 101 123/53 rr 29 o2 97% on 2l general: thin elderly woman in no acute distress heent: sclera white, conjunctiva pale, mmm neck: jvp 7cm pulm: occasional wheeze on anterior exam, no rales appreciated cv: regular rate s1 s2 no m/r/g abd: soft, nondistender, +bowel sounds, tender to deep palpation (esp llq) no rigidity or guarding. g tube in place without erythema or exudate. extrem: warm, pneumoboots in place, 2+ distal pulses neuro: opens eyes to voice, responds in greek to daughter, follows commands to squeeze hands pertinent results: 07:50pm neuts-92.1* bands-0 lymphs-4.3* monos-3.6 eos-0.1 basos-0.1 07:50pm plt smr-normal plt count-184 07:50pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 07:50pm pt-12.4 ptt-26.5 inr(pt)-1.0 07:50pm wbc-13.2*# rbc-3.41* hgb-10.6* hct-30.5* mcv-90 mch-31.0 mchc-34.6 rdw-14.2 07:50pm calcium-8.3* phosphate-3.2 magnesium-2.1 07:50pm ck-mb-7 ctropnt-<0.01 07:50pm ck(cpk)-157* 07:50pm glucose-109* urea n-32* creat-1.7* sodium-133 potassium-3.8 chloride-99 total co2-21* anion gap-17 08:03pm lactate-3.0* 08:30pm urine color-yellow appear-clear sp -1.021 08:30pm urine blood-neg nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-tr 08:30pm urine rbc-* wbc-* bacteria-occ yeast-none epi-0-2 12:12am lactate-1.8 . labs wbc 14.5, hb/hct 10.1/30.3, plts 332 chem 137/4.2/110/17/18/0.9<98 ca 7.7 mag 1.9 phos 2.5 . micro stool c diff positive blood cx negative , blood cx *** pending *** urine cx negative urine legionella ag negative respiratory viral ag negative, cx *** pending *** at nursing home urine >100,000 klebsiella pneumoniae r to ampicillin, nitrofurantoin; s to augmentin, ceftriaxone, cephalothin, ciprofloxacin, gentamicin, levofloxacin, tetacycline, bactrim . imaging . ct head: 1. no acute intracranial pathology including no hemorrhage. . cxr findings: no consolidation or edema is evident. a tortuous aorta is again identified. the cardiac silhouette is within normal limits for size. no definite effusion or pneumothorax is evident. the bones are severely osteopenic with an exaggerated kyphosis in the midthoracic spine again evident. there is a chronic fracture deformity involving the proximal right humerus. impression: bony changes as above. no acute pulmonary process. . ekg sinus tachycardia. non-specific st-t wave changes. compared to the previous tracing of rate has increased and st-t wave changes are more prominent. brief hospital course: 1. clostridium difficile colitis the patient was started on oral vancomycin in the icu, and iv flagyl was added on the floor. her wbc climbed to a peak of ~20 but was trending down following transfer from the icu. she should complete at least 14 days of oral vancomycin dating from the end of broad spectrum antibiotics (started at admission due to concern for pneumonia), day 14 is . she had multiple blood cultures pending at discharge, which should be followed up by her outpatient physicians. the patient's prognosis is guarded, as discussed in detail in family meeting coordinated by the geriatrics team. the family agreed that escalation of care (including icu transfer or surgery) would not be pursued if the patient decompensated. ms. was transferred back to for more intensive nursing care. 2. acute renal failure the patient's creatinine was elevated at admission, likely pre-renal in etiology in the setting of poor po intake. her creatinine improved with iv hydration and was trending back toward baseline at discharge. her cozaar was held. 3. hypotension she was hypotensive in the emergency room and was treated with aggressive iv fluid resuscitation. she did not require pressors. she remained normotensive on the floor. 4. confusion and dementia the patient's lethargy was likely due to superimposed infection, with baseline severe dementia. she did not require any chemical sedation. her trazodone and mirtazapine were held due to concern for worsening her sedation. namenda may have minimal effect in this patient with advanced dementia, but can be restarted by outpatient providers if desired. 5. diabetes covered with insulin sliding scale in hospital. 7. anemia hematocrit stable during this hospitalization with iron studies consistent with inflammatory state; can repeat iron studies following discharge with resolution of infection. 8. acidosis the patient had a hyperchloremic non-gap acidosis at transfer from the icu likely due to aggressive resuscitation with normal saline, as well as diarrhea. she did develop an anion gap acidosis with elevated lactate, likely due to her infection. 9. depression patient can restart mirtazapine at discharge, although would consider alternative due to potential for worsening sedation. 10. history of klebsiella urinary tract infection patient's urinary cultures were negative in hospital, and her foley catheter was discontinued. 11. intertrigo patient receive dose of fluconazole 150mg once per geriatrics team. she should continue regular skin care at her nursing facility. code dnr/dni communication daughter and hcp medications on admission: levofloxacin 250mg po daily cozaar 25mg po daily namenda 10mg po bid mirtazipine 27.5 mg po qhs omeprazole 20mg po bid trazodone 12.5mg po tid, 25 mg po qhs fortical 1spray daily calcium 1500mg po daily vitamin d 800mg po daily ferrous sulfate colace 100mg po bid senna 2tabs po qhs dulcolax 10mg pr prn tylenol prn robitussin prn duonebs prn discharge medications: 1. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily): give per g tube. 2. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day): give per g tube. 3. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily): give per g tube. 4. omeprazole 20 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po once a day. 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever, pain: give per g tube no more than 4grams of acetaminophen in all forms daily. 6. vancomycin 250 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 10 days: give per g tube. 7. namenda 10 mg tablet sig: one (1) tablet po twice a day: give per g tube. 8. mirtazapine 30 mg tablet sig: one (1) tablet po at bedtime: give per g tube. 9. colace 50 mg/5 ml liquid sig: one hundred (100) mg po twice a day: give per g tube hold while treated c. difficile colitis. 10. senna 8.6 mg tablet sig: 1-2 tablets po twice a day as needed for constipation: give per g tube hold while treating c. difficile colitis. 11. duoneb 0.5-2.5 mg/3 ml solution for nebulization sig: one (1) neb inhalation four times a day as needed for shortness of breath or wheezing. 12. oxycodone 5 mg/5 ml solution sig: 2.5 mg po every four (4) hours as needed for pain: hold rr<12, excess sedation. discharge disposition: extended care facility: of discharge diagnosis: primary 1. c. difficile colitis 2. alzheimer's disease 3. acute renal failure secondary 1. diabetes 2. depression 3. anemia discharge condition: fair, hemodynamically stable discharge instructions: you came to the hospital because of fever and confusion at your nursing home. you had recently been treated with antibiotics for a bladder infection; this infection appeared to have resolved because your urine cultures here did not show evidence of infection. you were found to have a form of diarrhea called c. difficile colitis likely related to the antibiotics you were given recently. because your blood pressure was initially low in the emergency department, you were admitted to the medical intensive care unit for close monitoring. your blood pressure improved after receiving intravenous fluids. . please take all of your medications as directed. . call your doctors and medical attention if you develop: ** worsened abdominal pain or diarrhea, fevers (temperatures higher than 100.4 farenheit), shaking chills, sweats, or any other symptoms that worry you or your family followup instructions: please follow up with dr. at as needed. procedure: enteral infusion of concentrated nutritional substances diagnoses: acidosis anemia, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified depressive disorder, not elsewhere classified intestinal infection due to clostridium difficile alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance 

Answer: The patient is high likely exposed to