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: past medical history: 1. cad: mi in , postinfarction angina in which resolved with medical therapy. 2. hypercholesterolemia. 3. osteoarthritis. 4. bronchopneumonia, hospitalized in . 5. copd. 6. nephrolithiasis. 7. vocal cord polyp. past surgical history: 1. removal of large benign polyp of the left glottis in the summer of . 2. kidney stone removal in . 3. d&c in . family history: the patient's family history is strongly positive for bowel and breast cancer, hodgkin's disease and cad. one brother died of an mi at age 61. another brother died at age 58 with an mi. one sister has undergone a cabg. social history: the patient is a retired medical secretary. she smokes one pack of cigarettes per day, although has been trying to quit. she does not drink alcohol. she ambulates independently. she lives alone. allergies: 1. amoxicillin. 2. niacin. admission medications: 1. nifedipine xl 60 mg p.o. q.d. 2. prevacid 15 mg p.o. q.d. 3. lipitor 40 mg p.o. q.d. 4. aspirin 81 mg p.o. q.d. 5. tylenol 500 mg p.r.n. pain. 6. albuterol inhaler q.i.d. p.r.n. 7. lorazepam 0.5 t.i.d. p.r.n. anxiety. physical examination on admission: vital signs: pulse 80, blood pressure 140/80, weight 160 pounds, height 5' 2". general: alert, cooperative white female in no acute distress. heent: sclerae anicteric. neck: range of motion within normal limits. no jvd. carotids palpable with a faint transmitted cardiac murmur. chest: lungs clear bilaterally. heart: regular rate and rhythm with a grade i/vi systolic ejection murmur heard along the left sternal border and at the cardiac base. abdomen: obese, bowel sounds present. aa not palpable. no abdominal bruit. extremities: feet equally warm. femoral, popliteal, and dorsalis pedis pulses all palpable. laboratory/radiologic data: admission laboratories from revealed a wbc 8.9, hemoglobin 15.4, hematocrit 45.8, platelets 299,000. pt 13.9, ptt 46.4, inr 1.3. sodium 138, potassium 4.2, chloride 107, c02 22, bun 17, creatinine 0.9, glucose 146. ekg on showed a sinus rhythm at a rate of 92 without ischemic changes. chest x-ray on postoperatively showed clear lung fields and no pneumothorax. no pleural effusions. hospital course: the patient was admitted to the hospital following an uneventful retroperitoneal repair of the abdominal aortic aneurysm with a dacron graft. at the end of surgery, the patient had equally warm feet, doppler signals at her right dorsalis pedis and her left posterior tibial artery. the patient was noted to have a mottling of the skin from the midabdomen to the feet in the pacu. the patient was transferred to the sicu. on postoperative day number one, the patient was noted to be hypotensive with a decreased urine output. she was treated with iv fluids and packed red blood cells which helped her blood pressure but did not increase her urine output significantly. the patient remained intubated because of acidosis. an epidural with bupivacaine and dilaudid was used for pain management. on postoperative day number two, her creatinine was noted to have risen from 0.9 to 2.6. the renal service was consulted. the patient's urine showed muddy casts which were consistent with acute tubular necrosis. her urine output remained 20-30 cc per hour in spite of having received 5 units of iv fluid and 3 units of packed red blood cells perioperatively along with additional iv fluid postoperatively to promote urine output. a renal ultrasound showed no hydronephrosis. the patient's creatinine peaked at 3.0. no emergent hemodialysis was necessary. the renal service followed the patient and made recommendations regarding maximizing renal perfusion and urine output. medication was renally dosed. at the time of discharge, the patient's creatinine had come down to 1.3. the patient remained intubated because of respiratory acidosis. she self-extubated herself on postoperative day number four but was in respiratory distress and required reintubation immediately. the patient was noted to have laryngeal edema secondary to fluid overload in the immediate postoperative period. the patient was noted to have copious secretions. she was treated with mucomyst and nebulizers. she had a temperature spike to 101.3 on . levofloxacin was started empirically after blood cultures, sputum cultures, catheter tip cultures, and urine cultures were done. vancomycin was added for a total of six days. the patient was extubated on . one out of four blood cultures grew staphylococcus coagulase-negative. sputum culture from grew moderate hemophilus influenzae, beta lactamase negative, presumptively sensitive to ampicillin. there was also sparse growth of gram-negative rods. sputum culture from grew moderate hemophilus influenzae, sparse pseudomonas aeruginosa, and sparse second gram-negative rod. urine culture from foley catheter from grew klebsiella pneumonia which was pansensitive. the culture of the catheter tip was negative. the levofloxacin was stopped and ceftazidime was started for the ciprofloxacin-resistant pseudomonas in the patient's sputum. following extubation, the patient became very combative, confused, kicking and pinching staff. all sedatives and pain medications were stopped. the patient remained confused and combative and required a one-to-one sitter. neurology service was consulted on . a head ct showed an old infarct versus a subacute process. no metabolic sources were found. confusion versus aphasia versus apraxia was considered. neurology recommended eeg and an mri of the head, although the mri would not change management of the situation. on , the patient was very much improved and the patient had somewhat normal conversations with the house staff. the mri of the head done on showed no acute process. neurology noted that the patient was much improved and no further studies were required. because of prolonged intubation, the patient was started on tube feedings via her postpyloric dobbhoff catheter. the patient was started on nepro and promod. the patient had some loose stools while on tube feedings and the formulation was adjusted. stool cultures were negative for c. difficile. the patient had a bedside swallow evaluation on which she failed. tube feedings were continued until the patient did well on bedside swallow evaluation on . the patient has done well eating soft solids and thin liquids, although her appetite is only fair. on , the patient's family noted that the patient's right eye appeared to be bulging. ophthalmology was consulted and felt that the right lid swelling and pseudoproptosis was secondary to fluid overload. no treatment was recommended. the patient was transferred from the sicu to the vicu on . the patient's confusion improved greatly on . physical therapy was consulted to see the patient and recommended a rehabilitation stay. at the time of dictation, the patient's abdominal incision is clean, dry, and intact, with steri-strips in place. ecchymosis of the left flank is almost resolved. the patient's femoral and dorsalis pedis pulses are strongly palpable bilaterally. the patient's right and left great toes are dusky. her right second toe has gangrene at the tip and a very long curved toenail which almost reaches the plantar surface of the toe. her left fifth toe tip also is gangrenous. the patient has intermittent mild pain of these toes. podiatry service has been consulted for toenail care prior to the patient's discharge to rehabilitation. the patient will be discharged to rehabilitation facility whenever a bed is available. her ceftazidime for her cipro-resistant pseudomonas pneumonia will be stopped at transfer to rehabilitation. the patient will follow-up with dr. in the office following discharge from rehabilitation to evaluate her surgical incision as well as her gangrenous toes. if the patient's toes become more painful, dr. office can be notified to set up an appointment sooner. addendum: during the patient's hospitalization, her platelets decreased from approximately 300,000 down to 60. the patient was negative for antibody to heparin. her platelets rebounded to 364,000 at discharge without intervention. discharge medications: 1. ceftazidime 1 gram iv q. 12 hours started on , to be stopped at the time of transfer from rehabilitation. 2. lopressor 50 mg p.o. b.i.d., hold for systolic blood pressure less than 110 or heart rate less than 55. 3. nicotine patch 14 mg p.o. q.d. 4. albuterol one to two puffs q. four hours p.r.n. 5. albuterol/ipratropium one to two puffs q. six hours p.r.n. 6. miconazole powder 2% applied to groins t.i.d. p.r.n. 7. mucomyst 20% 1-5 mils via nebulizer q. four to six hours p.r.n. 8. pepcid 20 mg p.o. q.d. 9. colace 100 mg p.o. b.i.d. 10. dulcolax 10 mg p.o./p.r. q.d. p.r.n. 11. lidocaine jelly 2% apply as directed to perianal area after loose stool. 12. tylenol 325 to 650 mg p.o. q. four to six hours p.r.n. 13. tylenol #3 one to two tablets q. four to six hours p.r.n. pain. condition on discharge: satisfactory. disposition: rehabilitation facility. primary diagnosis: 1. asymptomatic 5.5 cm abdominal aortic aneurysm. 2. retroperitoneal repair of abdominal aortic aneurysm with dacron graft on . secondary diagnosis: 1. respiratory failure with prolonged intubation. 2. acute tubular necrosis. 3. postoperative malnutrition requiring tube feedings. 4. hypovolemia. 5. blood loss anemia. 6. staphylococcus coagulase-negative bacteremia. 7. hemophilus influenzae pneumonia. 8. pseudomonas pneumonia. 9. klebsiella urinary tract infection. 10. yeast urinary tract infection. 11. thrombocytopenia. 12. coronary artery disease. 13. hypercholesterolemia. , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances monitoring of cardiac output by other technique resection of vessel with replacement, aorta, abdominal transfusion of packed cells diagnoses: thrombocytopenia, unspecified acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified chronic airway obstruction, not elsewhere classified pneumonia due to pseudomonas bacteremia abdominal aneurysm without mention of rupture 

Answer: The patient is high likely exposed to