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: femur fracture s/p fall major surgical or invasive procedure: : s/p open reduction internal fixation, left hip. history of present illness: y.o. russian speaking m with htn, cri, dementia from rehab who was brought by ambulance to the ed s/p witnessed mechanical fall (backed into chair and fell after getting up without walker). reportedly did not strike his head strike and no loc. was noted to have left leg pain/deformity. per report, patient a & o x 0 at baseline. was seen by staff physician and given morphine. initial ed vs 96.9, 112 irregular, 118/82, 18, 100/ra. exam with left hip deformity, lle shortening and internal rotation, 1+ palpable distal pulses. baseline hct 35.8 (). given morpine 2mg iv, morphine 4mg x 1, ns 2l, haldol 5mg, 1u prbc. foley placed. fast negative per report but not in ed documentation. ortho consulted, consented patient for surgery and placed pin, currently in traction. given unclear source of bleeding and hypotension on arrival, patient admitted to micu for closer monitoring. vs on transfer 97.3, 100, 136/86, 22, 100/2l. upon admission to micu, patient appears in pain. . while in ed patient denied chest pain, pressure, fever, chills/rigors, sob, cough. past medical history: 1. hypertension. 2. chronic renal insufficiency. 3. benign prostate hypertrophy. 4. dementia 5. depression 6. peptic ulcer disease 7. s/p hernia repair social history: lives in behavioral unit at rehab. no tobacco, 'may have up to one glass of wine per day'. family history: non-contributory physical exam: on admission: vitals: 97.3, 100, 136/86, 22, 100/2l general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: labs: 12:00pm blood wbc-12.8*# rbc-3.62* hgb-11.4* hct-34.9* mcv-97 mch-31.5 mchc-32.6 rdw-12.8 plt ct-258 12:00pm blood neuts-86.3* lymphs-9.2* monos-3.9 eos-0.5 baso-0.1 02:32pm blood pt-13.8* ptt-22.0 inr(pt)-1.2* 03:00pm blood esr-16* 12:00pm blood glucose-205* urean-40* creat-1.9* na-140 k-4.6 cl-105 hco3-23 angap-17 12:00pm blood alt-25 ast-33 ck(cpk)-90 alkphos-105 totbili-0.5 12:00pm blood ctropnt-0.07* 12:00pm blood lipase-40 05:10am blood wbc-9.4 rbc-3.28* hgb-10.1* hct-30.5* mcv-93 mch-30.8 mchc-33.1 rdw-16.3* plt ct-208 05:10am blood pt-14.0* ptt-27.9 inr(pt)-1.2* 05:10am blood glucose-141* urean-37* creat-1.2 na-135 k-4.0 cl-105 hco3-28 angap-6* 04:23am blood ck-mb-9 ctropnt-0.08* 12:00pm blood alt-25 ast-33 ck(cpk)-90 alkphos-105 totbili-0.5 05:10am blood calcium-8.1* phos-3.8 mg-2.2 . admission imaging: hip x-ray impression: comminuted fracture proximal femur. . ct pelvis / pelvis w/o contrast -- ** preliminary ** comminuted left intertrochanteric femoral fracture. no acute intra-abdominal findings: no free air or fluid, no hematoma. no bowel obstruction, although rectum is distended with stool. 3mm nonobstructing renal calculus (versus vascular calcification). fluid-filled gallbladder without wall thickening, pericholecystic fluid or other evidence of cholecystitis. . ct c-spine w/o contrast -- ** preliminary ** no fracture. marked degenerative changes with reversal of lordosis in the mid c-spine resulting in moderate canal narrowing. . ct head w/o contrast -- ** preliminary ** no ich or acute abnormality . chest x-ray ** preliminary ** low lung volumes, marked deviation of trachea to the right, otherwise lungs are normally aerated. prior cxr with tracheal deviation. . ekg: 120 bpm, ?sinus tachy cardia but very poor baseline, slight lad, no clear st/tw changes but poor study. compared to , similar axis. abdomen, history: colonic pseudo-obstruction. please measure colonic diameter. impression: three views of the abdomen show no appreciable change in the diameter of the widest part of the colon, the ascending, 84 mm yesterday and 88 mm today. there is no appreciable wall thickening or intramural emphysema to suggest ischemia. generalized gaseous distention is moderate throughout the gi tract except for the stomach which is decompressed by a nasogastric tube. kub () 1. interval improvement in patient's colonic dilatation, with scattered air-filled loops of small and large bowel without evidence of significant dilatation. air-fluid levels are identified on the decubitus view. brief hospital course: yo m, russian speaking only, with dementia, ckd, bph presented after witnessed mechanical fall at rehab and found to have a comminuted left intertrochanteric femoral fracture . # left femur fracture: ortho was consulted in the ed and consented patient for surgery and placed pin for traction. the pt presented with hct 34 (baseline hct 35.8 ). he was given morpine 2mg iv, morphine 4mg x 1, ns 2l, haldol 5mg, and 1u prbc. his post transfusion hct dropped to 29 and he was transfused a second unit without appropriate bump (hct stayed at 29). foley was placed. given unclear source of bleeding and hypotension on arrival, the patient was admitted to micu for closer monitoring. vs on transfer were 97.3, 100, 136/86, 22, 100/2l. upon admission to micu, the patient appeared in pain. the patient's bp normalized after 2l. hypotension was thought secondary to morphine amdinistration in the ed. he was afebrile with negative cardiac enzymes. it was unclear where his source of bleeding was but the patient was guaiac negative. his thigh had been firm and it was suspected that he may a hematoma there. he remained hemodynamically stable and was thought appropriate for transfer to medicine. he was transferred to the medicine floor on and taken for surgery on , where he underwent orif of his left hip. he went to the sicu post-op to recover, as he was transiently hypotensive during the procedure. his sicu course included uti and post op ileus (see below). on he was called out to the medicine floor. he continued to have a large amount of serous fluid drain from the traction wounds in his knee. his hct remained stable in the low 30s. ortho recommendations were to continue weight beairng as tolerated, lovenox for dvt prophylaxis and tylenol for pain. he should follow up in two weeks in ortho clinic with , np. # abdominal distension/ileus: in the micu the patient was found to have a mildly distended abdomen that was soft and non tender, with an unclear baseline. it was noted in the records that the patient required agressive bowel regimen at rehab it was thought that he had chronic constipation and was given an aggressive bowel regimen. after the patient went to the or he developed a post op ileus confirmed by kub and had an ngt placed to suction. he had a rectal tube placed for decompression but this failed. on po d# 4 he was started on ppn for nutrition. gi was consulted and they felt this was a pseudoobstruction. they recommended continued ng suction, avoiding narcotics and anticholinergics, and changing his position every hour. he should have a daily kub and if his colon diameter is between 10-12 cm, surgery should be consulted because this is a surgical emergency. it was 8.8cm on , and unchanged on . ngt was taken off suction and patient had low residuals. ng was discontinued per general surgery recs on . receiving tpn. patient will need speech and swallow evaluation on admission to rehab. # uti: in the sicu the patient was found to have a proteus uti. his foley was changed and he was started on ceftriaxone on and should complete a 14 day course. # ckd: the patient presented with cr of 1.9. he had an unclear baseline. his most recent creatinine in omr was 2.1 on . the rest of his electrolytes were normal. urine lytes were consistent with pre-renal azotemia. over the course of hospitlaization the patient's creatinine improved to 1.2. it was 0.9 on discharge. # dementia with behavioural disturbances: the patient lives in the behavioural unit at rehab. he is oriented x 1 a baseline. prior to the surgery the patient was functioning below baseline per family members, taking to recognize them then normal. after the operation he remained verbally unresponsive to family members and would not follow commands. he was not given narcotics for worsening of his mental status. the patient was continued on his home dose quetiapine 150 mg . # depression / anxiety: unclear severity. the patient was continued on his citalopram 40 mg po daily. # elevated troponin: the patient was initially found to have an elevated troponin compared to his baseline, however it did not trend up and repeat ekg showed no changes so it was not thought to be from acs. # bph: the patient had a foley placed, his terazosin was initially held in the icu given concern for hypotension. # code status: dnr/dni (this was reversed temporarily for the operation then dnr/dni again) medications on admission: morphine 4mg po q4h prn acetaminophen 650 mg q4h prn milk of magnesia 30 ml po daily citalopram 40 mg po daily miralax 17gm po daily terazosin 2 mg po qpm quetiapine 150 mg po bid lorazepam 0.5 mg po bid prn eucerin 1 application daily ferrous sulfate 325 mg po daily cyanocobalamin 1000 mcg daily sodium fluoride 10 ml qhs swish bisacodyl suppository 10 mg daily senna 2 tabs mirtazapine 15 mg qhs omeprazole 20 mg daily discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. quetiapine 50 mg tablet sig: three (3) tablet po bid (2 times a day). 4. citalopram 20 mg tablet sig: two (2) tablet po daily (daily). 5. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 6. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po daily (daily). 7. polyethylene glycol 3350 17 gram/dose powder sig: one (1) 17 grams/dose powder po daily (daily). 8. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 9. cyanocobalamin 500 mcg tablet sig: two (2) tablet po daily (daily). 10. white petrolatum-mineral oil cream sig: one (1) appl topical daily (daily). 11. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 12. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours). 13. enoxaparin 40 mg/0.4 ml syringe sig: one (1) syringe subcutaneous daily (daily) for 4 weeks. 14. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain. 15. ondansetron hcl (pf) 4 mg/2 ml solution sig: one (1) injection q8h (every 8 hours) as needed for nauesa. 16. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 17. ceftriaxone in dextrose,iso-os 1 gram/50 ml piggyback sig: one (1) gram intravenous q24h (every 24 hours) for 4 days: last dose . 18. white petrolatum-mineral oil cream sig: one (1) appl topical daily (daily). 19. terazosin 1 mg capsule sig: two (2) capsule po hs (at bedtime). 20. regular insulin sliding scale 21. radiology supine abdomen daily. if colon is over 10cm contact surgery. 22. pantoprazole 40 mg recon soln sig: forty (40) mg intravenous once a day. discharge disposition: extended care facility: for the aged - macu discharge diagnosis: 1. left hip fracture. 2. ileus/pseudopbstruction 3. urinary tract infection discharge condition: mental status:confused - always level of consciousness:lethargic but arousable activity status:ambulatory - requires assistance or aid (walker or cane) discharge instructions: you came to the hospital after you fell and were found to have a left hip fracture. you required several blood transfusions and went to the operating room to have your hip fixed. you remained in the surgical intensive care unit for 4 days after your operation. you developed a post operative ileus ( problem with your gut working) and you were not able to eat food for several days. we gave you iv fluids and nutrition through your vein. please go to your follow up appointment with the orthopedic doctors (see below). they have also provided the following special instructions after your surgery: wound care: -keep incision dry. -do not soak the incision in a bath or pool. activity: -continue to be full weight bearing on your left leg. -you should not lift anything greater than 5 pounds. other instructions - resume your regular diet. - avoid nicotine products to optimize healing. - resume your home medications. take all medications as instructed. - continue taking the lovenox to prevent blood clots. - narcotic pain medication may cause drowsiness. do not drink alcohol while taking narcotic medications. do not operate any motor vehicle or machinery while taking narcotic pain medications. taking more than recommended may cause serious breathing problems. if you have questions, concerns or experience any of the below danger signs then please call your doctor at or go to your local emergency room. followup instructions: 2 weeks (the week of ) in the clinic with , np. please call to make this appointment. procedure: parenteral infusion of concentrated nutritional substances insertion of other (naso-)gastric tube open reduction of fracture with internal fixation, femur transfusion of packed cells diagnoses: acidosis other iatrogenic hypotension anemia in chronic kidney disease esophageal reflux urinary tract infection, site not specified acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified other opiates and related narcotics causing adverse effects in therapeutic use hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) other persistent mental disorders due to conditions classified elsewhere chronic kidney disease, unspecified dysthymic disorder paralytic ileus surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation alzheimer's disease closed fracture of subtrochanteric section of neck of femur fall from other slipping, tripping, or stumbling proteus (mirabilis) (morganii) infection in conditions classified elsewhere and of unspecified site dementia in conditions classified elsewhere with behavioral disturbance 

Answer: The patient is high likely exposed to