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: prochlorperazine attending: chief complaint: fever and tenderness at r tunneled catheter site major surgical or invasive procedure: placement of right femoral temporary dialysis line. removal of right subclavian dialysis line. placement of right femoral permanent dialysis catheter history of present illness: 39 y/o f with h/o dm, esrd, cva, history of multiple line infections most recently mrsa line infection treated with 2 wks vancomycin and catheter was removed at that time (course finished on ) presents w/ chief complaint of tenderness around r catheter site and fever for 100.3 at nh. patient denies any h/o trauma. denies cp, sob. she does have mild cough. denies fever, chills. no changes in bowel habits. her current r subclavian tunneled catheter was placed on . . ed course: cta done because patient provided h/o pleuritic right shoulder pain and that showed pulmonary nodules. also received vanco 1 gram, benadryl 25 mg po twice, ns 1 liter. past medical history: 1. esrd due secondary to diabetes, on hemodialysis three times weekly. she had a failed renal transplant () 2. diabetes mellitus type i with retinopathy, nephropathy and peripheral vascular disease, diagnosed as a child, brittle 3. cva (, ) with hydrocephalus status post vp shunt (removed in as csf grew out coag negative staph), right basal ganglia hemorrhage 4. hypercholesterolemia 5. hypertension 6. unclear history of grand mal seizure during dialysis 7. mrsa line tip infection with right atrial thrombus (line tip pulled ) 8. diffuse lymphadenopathy of unknown etiology. 9. chronically elevated alkaline phophatase 10. history of naphthelene induced coma from inhaling moth balls 11. h.o vre bacteremia (completed linezolid in 11/). 12. status post parathyroidectomy 13. status post multiple amputations (right bka, left digit, left metatarsal) 14. exploratory laparotomy and appendectomy for appendicitis in 15. prior history of tracheostomy social history: ms usually lives in jp with her daughter and granddaughter, although she came from rehab. her sister-in-law, , helps her with management of her multiple medications. no tobacco or alcohol use. her baseline is such that she can feed herself, knows when to take medicines and when to go to dialysis. family history: family history of diabetes mellitus in children. physical exam: 103.6 hr=116 bp=168/94 rr24 94% ra gen: aa female; ill appearing but non-toxic heent: perrla/eomi. poor dentition. membranes moist neck: supple, no jvd. pulm: cta, no wheezes cv: tachy; reg rythm. +systolic murmur abd: +bs, soft, mild diffuse tenderness, nd, no ruq pain, no quarding ext: left bka; r metatarsal amp. no edema neuro: alert, oriented to name, place and year only, follow simple commands, cn ii-xii intact, no gross neuro deficits. line: no signs of infection, no discharge, no fluctuance pertinent results: 11:15am wbc-8.5 rbc-4.92 hgb-13.1 hct-45.2 mcv-92 mch-26.6* mchc-29.0* rdw-19.7* 11:15am neuts-79.3* lymphs-12.0* monos-5.1 eos-3.2 basos-0.5 11:15am plt count-411 11:15am pt-14.6* ptt-28.7 inr(pt)-1.4 11:15am d-dimer-1613* 11:15am glucose-178* urea n-49* creat-5.7* sodium-134 potassium-5.3* chloride-96 total co2-28 anion gap-15 11:38am lactate-2.0 03:49pm lactate-2.4* cxr : no evidence of pneumonia. no interval change. cta : 1) no evidence of pe. 2) multifocal, nonspecific, vague small patchy opacities with a tiny nodular density in the left lower lobe. no comparison studies are currently available on pacs for comparison. 3) extensive atherosclerotic disease. brief hospital course: 1. e. coli bacteremia. 39 yo w with h/o esrd, dmi, htn, cva, multiple line infections who was admitted to general medicine service with fevers and c/o tenderness at the right subclavian catheter site. blood cultures grew e. coli in bottles from and then in bottles on . the patient was initially covered broadly with vancomycin and zosyn. when culture and sensitivity results returned vancomycin was discontinued and then zosyn was changed to levaquin. initially right subclavian line was not removed per nephrology request because the patient has very difficult access. however, after the work up of potential sources of infection was unrevealing, the r subclavian line was removed on and the tip culture grew e coli and citrobacter. temporary femoral line placed for hd. overnight of , patient spike to 105, became tachy to 140's, wbc went up to 37 and cooling blanket started on floor. she received iv lopressor, tylenol on floor, then became hypothermic to 91 w/ sbp 70's and was tranferred to micu for hypotension. she was given fluids, one dose of gentamycin was given and levaquin was changed back to zosyn. she required dopa briefly but was quickly weaned off pressors. she remained hemodynamically stable. the patient was transferred back to the general floor on . she defervesced and her leukocytosis quickly resolved. the patient was doing well and being screened for transfer back to . she underwent permanent hemodialysis line placement by ir on . she had a new fever of 102 later that day and was changed from levaquin back to zosyn. on she was started on higher dose of levaquin with good effect. she is to complete a 2 week course of levoquin. 2. dm, type i. the patient was continued on glargine and iss for tight glycemic control. 3. pulmonary nodules on ct chest. per discussion with radiology these are new and were not seen on ct back in . the appearance was not specific but consistent with infectious etiology. the patient had no pulmonary complaints. follow up ct to assess for resolution/interval change was recommended. she also has significant adenopathy on past cts and exam. workup has been limited thus far secondary to chronic infection. her low grade fevers may be attributed to this adenopathy as she is clinically without infection. 4. htn. continued lisinopril, metoprolol. amlodipine was discontinued to maximize cardiac regimen. blood pressure medications were briefly held while she was hypotensive. 5. hypercholesterolemia. lipitor was continued. 6. esrd secondary to dm s/p failed transplant. hd treatments and renal medications were continues per nephrology 8. elevated lfts. abdominal ct with liver hemangiomas. bili normal. patient on lipitor. hepatitis serologies negative. monitor. elevated alk phos and ggt. pth sent. 9. left shoulder pain. the patient developed left shoulder pain in left sternoclavicular area. ct was done to evaluate this further and showed no abnormalities. it was thought to be secondary do djd. 10. cardiomypathy. ef ~25-30%. the patient had a normal ef in . given significant decline in ef, the patient should have a follow up echo when she is recovered from acute event. if repeat echo is still with decreased ef, further work up may be indicated. the patient was continued on asa, beta-blocker, lisinopril, lipitor. medications on admission: 1. b complex-vitamin c-folic acid 1 mg capsule po daily (daily). 2. fluoxetine hcl 30 mg po daily 3. aspirin 325 mg po daily 4. docusate sodium 100 mg 5. folic acid 1 mg tablet po daily 6. pantoprazole sodium 40 mg daily 7. metoprolol tartrate 25 mg po bid 8. amlodipine besylate 2.5 mg po daily 9. lisinopril 20 mg po daily 10. atorvastatin calcium 40 mg po daily 11. sevelamer hcl 800 mg po tid 12. diphenhydramine hcl 25 mg po q6h 13. simethicone prn 14. insulin regular human subcutaneous 15. metoclopramide hcl 10 mg tablet 0.5 tablet po qidachs 16. glargine sig: eleven (11) units qhs: plus see sliding scale. discharge medications: 1. ibuprofen 600 mg tablet sig: one (1) tablet po q8h (every 8 hours) for 5 days: with meals. 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 5. fluoxetine 10 mg capsule sig: three (3) capsule po hs (at bedtime). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 7. sevelamer 800 mg tablet sig: two (2) tablet po bid (2 times a day). 8. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. atorvastatin calcium 40 mg tablet sig: one (1) tablet po daily (daily). 10. metoclopramide 10 mg tablet sig: 0.5 tablet po qidachs (4 times a day (before meals and at bedtime)). 11. diphenhydramine hcl 12.5 mg/5 ml liquid sig: one (1) po hs (at bedtime) as needed. 12. insulin glargine 100 unit/ml cartridge sig: eleven (11) units subcutaneous at bedtime: plus sliding scale. 13. insulin regular human 100 unit/ml cartridge sig: sliding scale units injection four times a day. 14. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 15. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 16. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 2 weeks: do not give within of two hours of other medications. disp:*7 tablet(s)* refills:*0* 17. amlodipine besylate 2.5 mg tablet sig: one (1) tablet po once a day. 18. simethicone 60 mg tablet sig: tablet po once a day as needed for gas pain. discharge disposition: extended care facility: - discharge diagnosis: primary diagnoses: 1. bacteremia, e. coli, presumably from dialysis line infection 2. degenerative joint disease of bilateral shoulder joints secondary diagnoses: 1. end stage renal disease 2. diabetes 3. lymphadenopathy 4. pulmonary nodules 5. hypertension 6. cardiomyopathy 7. proctitis 8. depression discharge condition: stable. discharge instructions: please take all medications as prescribed. please continue dialysis treatments. you next treatment will be saturday please call your doctor if you develop fever, chills, worse shoulder pain or any other concerns. followup instructions: dialysis: you will need to have a follow up ct for pulmonary nodules seen on ct chest. procedure: diagnostic ultrasound of heart hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis other incision with drainage of skin and subcutaneous tissue infusion of vasopressor agent diagnoses: other primary cardiomyopathies acute posthemorrhagic anemia severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease long-term (current) use of insulin other diseases of lung, not elsewhere classified infection and inflammatory reaction due to other vascular device, implant, and graft septicemia due to escherichia coli [e. coli] other and unspecified coagulation defects complications of transplanted kidney diabetes with renal manifestations, type i [juvenile type], not stated as uncontrolled pain in joint, shoulder region nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] 

Answer: The patient is high likely exposed to