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: gi bleeding. major surgical or invasive procedure: endoscopy, upper; ileoscopy; push through upper endoscopy. history of present illness: 45 year old man with uc, status post total proctocolectomy with ileal pouch anal anastomosis with persistent diarrhea who presented to hospital with 4 days of loose stools, fatigue, lightheadedness with stools turning to bloody 2 days prior to admission (). on initial evaluation at outside hospital, he was noted to have "melanotic" stools, that turned to hematochezia. admission hct was 22. of note, he was taking ibuprofen for tendinitis, though only took 10 tablets over a period of a week. he was transfused 2u on with unclear result of on his hct. on he had an egd which showed normal esophagus, stomach and duodenum and then underwent a pouchoscopy/enetorscopy which showed large amount of fresh bright blood with blold clots, including j pouch and throughout the entire small bowel examined (~ 70cm). since the last scope, he was transufsed another 5u of prbcs and his hct remained at 22. he was reported to be hemodynamically "stable", bp 100/50 and hr in 120s. he has 2, 18g ivs at time of transfer. . on the floor, he is without of lightheadedness, but has no other symptoms. he denies recent changes in bm frequency or character until presentation. no abdominal pain, nausea or vomiting, cramping or tenesmus. no fevers, chills, malaise or weight loss. denies recent cp, but reports shortness of breath for 1 year, which comes and goes, currently reporting mild sx intensity. no infectious symptoms, no arthralgias or myalgias. no rashes or skin changes. he has been off all medications for ~ 2 years, as "nothing has worked" for his loose stools. . of note, ~ 1 month ago, had severe constipation and required an endocsopic treatment to relieve this. has not had bloody stools or melanotic stools since that time. past medical history: ulcerative colitis - - ileoanal pouch w/ ileostomy - - laparotomy, resection of small bowel including ileostomy, reanastomosis and dilatation of the anorectal stricture - aortic valve stenosis, mild per outside hospital records, no documentation at . - history of small bowel obstruction: one month prior had a lower egd which relieved obstruction. social history: the patient lives with wife and 3 kids who are healthy. he works as a construction worker. - tobacco: quit 10years ago. 30 ppy prior to that. - alcohol: 10 drinks on weekends, once per month - illicits: denies. family history: - prostate and stomach cancer - brother - breast cancer - sister - ulcerative colitis - brother. - no bleeding diseases - brother with coronary artery disease died in 60s - uncle died of myocardial infarction at 45 - no h/o sudden cardiac deaths or arryhthmia physical exam: vitals: t: 97f bp: 135/57 p:90s r: 22 o2: 95%ra general: alert, oriented, no acute distress heent: sclera pale, dmm, oropharynx clear neck: supple, flat jvp lungs: clear to auscultation bilaterally cv: rr, normal s1 + s2, syst. m loudest at 2nd rics, strong pmi. abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, dry, 2+ pulses, no edema neuro: a/ox3, dowb intact, frontal function intact. full strength in ues and les, toes down, normal tone. pertinent results: 08:16pm lactate-1.0 07:42pm glucose-89 urea n-11 creat-0.8 sodium-139 potassium-3.6 chloride-107 total co2-24 anion gap-12 07:42pm alt(sgpt)-22 ast(sgot)-32 ld(ldh)-229 alk phos-30* tot bili-2.9* 07:42pm albumin-3.3* calcium-8.3* phosphate-2.9 magnesium-1.8 07:42pm crp-3.1 07:42pm wbc-10.9 rbc-3.15*# hgb-9.7* hct-27.0*# mcv-86# mch-30.7# mchc-35.9*# rdw-15.6* 07:42pm neuts-74.0* lymphs-17.0* monos-6.4 eos-2.1 basos-0.5 07:42pm plt count-143*# 07:42pm sed rate-3 . : cta abd/pelvic per ir request. impression 1. no ct evidence of active extravasation of contrast. 2. most of small bowel is collapsed, without obstruction. 3. s/p total colectomy with a ileo-pounch creation. no evidence of surgical complication at the anastomosis. 4. no free fluid or air. . : transthoracic echo: impression: hyperdynamic left ventricle with severe left ventricular outflow tract obstruction due to systolic anterior motion of the anterior mitral leaflet; no vegetations seen . : cta abd/pelvic per ir request impression: 1. no evidence of acute gastrointestinal bleed in this study. 2. small amount of simple free fluid in the pelvis is minimally increased since prior study. . cxr: nasogastric tube ends in the stomach, with the most proximal side port just beyond the gastroesophageal junction. the degree of rightward displacement of the mid and lower trachea and length of trachea displaced that lies above the aortic arch is more than i would expect from the aortic arch alone. this raises the possibility of mass effect from adjacent goiter or adenopathy, less likely from an esophageal lesion. i suggest you obtain repeat conventional chest radiographs when feasible to see if this is a persistent finding. heart size is top normal, and the lungs are grossly clear. there is no appreciable pleural abnormality or indication of pneumothorax. . cxr: tracheal contour has returned to baseline with no evidence of mass effect. brief hospital course: 45 year old man with uc, status post total proctocolectomy with ileal pouch anal anastomosis with persistent diarrhea who presented to outside hospital with loose bloody stools, was found to have hemorrhage in the small bowel with a normal egd, status post 7 units prbcs and with out improvement in hcts. he was transferred to for further intervention. . # anemia. -intestinal bleed from small bowel. etiology unclear: may be secondary to an arteriovenous malformation, or to a mechanical injury from previous endoscopy (although no intermittant bleeding) or from a leaky anastamosis. alternatively may be uc flare, but wouldn??????t expect involvement of the small bowel, although there is a question of underlying crohns. patient reports recent nsaid use, however not significant amount ingested, but a bleeding ulcer was not completely ruled out. after recieving 7 units without adequate hct response at the outside hospital the patient was transfused 2 additional units of prbcs and 2 units of ffp on arrival to the micu. a ct??????a on admission demonstrated no active bleeding. on hd2 the patient began actively bleeding with several episodes of bloody diarrhea ~200 ccs per episode. 2 additional prbcs were administered with target hct above 30. on hd3 after another episode of gi bleed, a repeat ct-a demonstrated again no active bleed - 2 more units of prbc were transfused after a hct drop below 30. an upper and lower endoscopy on hd 2 revealed mild duodenitis, old blood, some mild ulcerations of small bowel and mild proctitis. no source of bleeding was identified. a push through enteroscopy was performed on hd 3. the upper gi tract was visualized to the middle of the ileum and all appeared normal with no sign of active or prior bleed. it was felt the site of bleeding was either in the remaining part of the bowel not visualized or that the site of bleeding had healed. the patient was scheduled for an outpatient swallow endoscopy with gi, and observed for 24 more hours for active bleeding and hct drops below 30. pt's hct remained stable, and on hd4, pt was discharged home with close gi follow-up for small-bowel follow-through and capsule endoscopy. . # moderate resting left ventricular outflow tract obstruction: the patient presented with a systolic murmor thought to be a high flow murmur. an echo from an outside hosptial in reported a normal lv systolic function with high velocity flow consistent with mild aortic stenosis or high cardiac output and mild left ventricular hypertrophy. a transthoracic echo on hd 3--requested to investigate the patient's dyspnea on exertion and possible endocarditis with emboli to bowel--reported severe left ventricular outflow tract obstruction due to systolic anterior motion of the anterior mitral leaflet; no vegetations seen. cardiology was consulted and recommended outpatient followup. recommendations for future management, given the patient's symptoms at baseline and the physical nature of his work, included the addition of a betablocker or verapamil when stable from a bleeding perspective. the patient will follow up with dr. or in the cardiology clinic. . # uc. the patient reports his uc has been stable for years. esr of 3 and crp of 3.1 not concerning for active uc flare. . # anxiety. the patient expressed anxiety throughout the admission. ativan was given as a sleep aid. wellbutrin was held secondary to patient's unstable hct on hematocrit. pt can be re-started on wellbutrin as outpatient upon follow-up with pcp. . medications on admission: - ibuprofen prn - advair prn sob/wheezing, does not take regularly - wellbutrin, stopped 2 mo ago, he feels he did not need it (anxiety) discharge medications: 1. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* discharge disposition: home discharge diagnosis: primary: gastrointestinal bleed, unknown source; left ventricular outflow obstruction. secondary: ulcerative coilitis. discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. no signs of active bleeding, benign abdominal examination. cardiac exam notable for iii/vi holosystolic murmur loudest at 2 lics and lightheadedness with ambulation. discharge instructions: you were admitted to from hospital for further evaluation of your gastrointestinal (gi) bleeding. you underwent multiple investigations to determine the source of bleeding, which were negative (upper endoscopy, pouchoscopy, ileoscopy, pushtrhough endoscopy, cta abdomen/pelvis). you received multiple blood transfusions and your blood levels stabilized but you had significant amounts of blood in your stool. your bleeding from stool has stopped but you are still at a very high risk of bleeding. it was felt that your bleeding may have been due to a small injured blood vessel or an ulcer that had healed (you were on ibuprofen which increases risk of bleeding). you were discharged home with instructions to return to the hospital if you have bloody stools again. you must not take nsaids (aspirin, ibuprofen, naprosy or the like) drugs as this will increase your risk of bleeding. in addition, you were found to have a heart murmur and outflow obstruction from your ventricle. this was felt to be due to an abnormal valve in your heart. you will need to follow up with a cardiologist. you can call dr. ( to arrange a follow up appointment or alternatively please call the office of dr. at to make an appointment, you were provided with his contact information. will need to be on a medication for your heart, once your bleeding problem has resolved. should you develop any of the symptoms listed below, please call your doctor or go to the emergency room. please follow up with your pcp, , . within one week of discharge from the hospital. please follow up with your gastroenterologist, dr. at hospital, call ( to arrange an appointment. you were started on protonix 40mg twice daily by mouth. you do not need bacterial endocarditis prophylaxis. followup instructions: see above md procedure: other endoscopy of small intestine other endoscopy of small intestine colonoscopy diagnoses: mitral valve disorders acute posthemorrhagic anemia anxiety state, unspecified duodenitis, without mention of hemorrhage hemorrhage of gastrointestinal tract, unspecified ulcerative colitis, unspecified ileostomy status heart disease, unspecified 

Answer: The patient is high likely exposed to