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: bright red blood per rectum major surgical or invasive procedure: colonoscopy ir embolization history of present illness: 65 yo m with multiple medical problems presented to on thursday with bright red blood per rectum. he had a colonoscopy on friday which showed multiple diverticuli but he is not sure where in the colon the diverticuli were located. no intervention was performed. his bleeding stopped and he was discharged on sunday. he began experiencing copious amounts of bright red blood per rectum again the afternoon of admission. he went to and was given 2 units of prbc and transferred to . he has minimal lower abdominal crampy pain. he has not had any fever, chills, shortness of breath, chest pain. he does have fatigue. in our ed, initial vs 98.7 100 117/62 16 100. initial pe notable for pallor and bright red blood per rectum. ng lavage reportedly negative. given an additional 2u prbc in our ed. briefly with sbp 60s. given 1u ffp and 2u with approximately 3l ns. no other medications given. on aspirin, . no chest pain. upon transfer from ed, sbp 90s, hr 80s and 100/2l. his access includes three pivs 16g, 18g, 20g. gi consult was contact and thought with diffuse bleeding from below and minimal role for egd or colonoscopy given poor visualization. at the soonest, would plan for colonoscpy . discussed with surgical team. has aaa s/p repair with graft so increased risk of aorto-enteric fistula. cta would be used to rule-out fistula but gi fellow thinks this unlikely at this time unless significantly worsens. per discussion with ed resident, ir paged about tagged rbc scan. past medical history: diverticulosis aaa cad s/p cabg and stenting, ef 25% to 30% () cva htn hld gerd obsessive compulsive disorder psh: sigmoid colectomy for perforated colectomy in s/p ostomy reversal () s/p triple vessel cabg s/p multiple cardiac stents (, , - dr ; lastly with stenting of the mid-lcx with a 3.5 x 23mm promus drug eluting stent s/p endovascular aneurysm repair () social history: on disability since his cva in . divorced with 2 children. non smoker, 2 drinks/week family history: mother - deceased at y/o, cad. father - 83 y/o, cad s/p cardiac catheterization. 1 brother - 61 y/o a&w. denies any fhx of melanoma, breast or colon cancer. physical exam: vitals: 97.6, 75, 108/71, 15 and 100/ra gen: alert and oriented, nad, with pallor and diaphoresis heent: scleral pallor, mmm cv: tachycardic, sinus rythmn pulm: cta b/l anteriorly abd: soft, active bowel sounds, mildly tender in lower abdomen ext: but mildly diminished pulses in radial pulses bilaterally pertinent results: cbcs: 06:07pm blood wbc-12.3*# rbc-4.10* hgb-13.4*# hct-37.8* mcv-92 mch-32.7* mchc-35.5* rdw-13.3 plt ct-241# 12:04am blood wbc-11.5* rbc-2.77*# hgb-8.5*# hct-24.0*# mcv-87 mch-30.6 mchc-35.2* rdw-14.8 plt ct-216 05:59am blood wbc-10.4 rbc-4.26*# hgb-12.7*# hct-36.5*# mcv-86 mch-29.9 mchc-34.9 rdw-15.1 plt ct-140* 09:14pm blood wbc-9.6 rbc-3.56* hgb-11.5* hct-31.0* mcv-87 mch-32.3* mchc-37.1* rdw-15.9* plt ct-115* 08:40am blood hct-27.7* 04:39am blood wbc-7.8 rbc-3.97* hgb-12.0* hct-34.8* mcv-88 mch-30.2 mchc-34.5 rdw-15.8* plt ct-150 06:06am blood wbc-3.8* rbc-3.68* hgb-11.1* hct-33.2* mcv-90 mch-30.0 mchc-33.3 rdw-15.9* plt ct-200 05:59am blood wbc-5.3 rbc-3.59* hgb-10.6* hct-31.8* mcv-89 mch-29.6 mchc-33.4 rdw-15.6* plt ct-332 . coags: 06:07pm blood pt-13.5* ptt-27.4 inr(pt)-1.2* 11:22pm blood pt-13.2 ptt-24.8 inr(pt)-1.1 . fibronigen: 12:04am blood fibrino-248 05:59am blood fibrino-253 09:48am blood fibrino-265 . chemistries: 06:07pm blood glucose-129* urean-21* creat-1.0 na-139 k-4.7 cl-109* hco3-20* angap-15 06:11pm blood glucose-85 urean-18 creat-0.8 na-142 k-4.3 cl-108 hco3-22 angap-16 . cardiac enzymes: 08:10pm blood ck-mb-3 ctropnt-<0.01 08:10pm blood ck(cpk)-73 04:39am blood ck-mb-3 ctropnt-less than 04:39am blood ck(cpk)-39* . micro: 9:47 pm mrsa screen source: nasal swab. **final report ** mrsa screen (final ): no mrsa isolated. . imaging/procedures: ct-a abd/pel: impression: 1. evidence of active bleeding site in the mid transverse colon. 2. soft tissue nodule adjacent to pancreatic tail is unchanged since the prior ct. 3. patent aortobiiliac stent graft without evidence of endoleak. . kub : there is dilatation of small bowel loops up to 4.8 cm with a few air-fluid levels. there is air in the colon including the sigmoid and probably the rectum. the dilatation has increased from ct. this is nonspecific and could be ileus or early obstruction and follow-up is recommended. . ct a/p: provisional report: fluid filled loops of bowel with no definate transition point. mild inflammatory changes at the distal anatomosis site in the left lower quadrant be sequlae of recent anatomosis versus fat necrosis. no drainable abscess or collection. trace free fluid in the abdomen and pelvis. brief hospital course: 65m with history of diverticular bleeding and profuse bleeding per rectum. 1. gi bleed: with known diverticuli and brbpr, suspicion was for a large diverticular bleed and patient was admitted to the micu for stabilization. however, given h/o aaa repair, a ae fistula was ruled out first with ct-a. no graft leak was identified, but active extravasation was seen in the mid-colon. the patient went emergently to ir for angioembolization of the mid transverse colon. he required 14 units of prbcs for stabilization, plus 5 ffp, 3 platelets. after this intervention, he continued to have occasional maroon stools, and hct drifted down to 27. 1 additional unit prbcs transfused, with stabilization of hcts. gi performed colonoscopy which showed pan-colonic diverticulosis with some pseudomembranes, but no active bleeding. patient was transferred to medical floor where serial monitoring of hct was continued, initially and then daily. patient did have 1 episode of bright red blood requiring 1 additional uprbc but subsequent stools were guiac negative. at time of discharge, hct had stabilized at 30 - 31. follow up was arranged with gastroenterology. of note, patient may need referral to general surgeon for semi-elective hemicolectomy in several months. if possible, patient should wait until at least 1 year from last (see below) so that he can safely stop . 2. cad s/p cabg and des 1 month prior to admission: and asa were initially held given his active bleeding. once this issue was stabilized, his and asa were restarted asap. however, since the pt developed an ileus (see below), and was npo, his asa was changed to pr, and instead of , integrillin drip was recommended by cardiology, who followed closely during his admission. he did occasionally complain of chest pain, but this was usually in the setting of anxiety, and there was never any ekg changes, and serial cardiac enzymes were always flat. once ileus had resolved and patient had no further signs of rebleeding, oral aspirin 81mg was resumed and restarted. additionally patient was restarted on his bblocker and 1/2 dose of acei. as patient had no symptoms of angina and blood pressure was still low, imdur was held on discharge. 3. n/v ileus - after his colonoscopy, for which he was electively briefly intubated, he developed profound nausea and bilious vomiting. a kub showed air in colon and possible dilated sb loops. a repeat ct abdomen pelvis did not show sbo. surgery was consulted and also did not think there was an sbo. an ng tube was placed, and over the course of 2 days over 2 liters of bilious material was suctioned. on , the tube was clamped successfully and diet advanced. after patient began to have bowel movements, ngt was removed (see below regarding subsequent diarrhea) 4. colonic pseudomembrane/ diarrhea - on colonoscopy, gi reported small pseudomembranes adherent to the mucosa in the ascending colon, possibly compatible with pseudomembranous colitis. once patient's ileus resolved he also began to have profuse watery diarrhea with some abdominal cramping. differential dx included infection (especially c.diff), ischemia (in setting of prior partial colectomy plus recent embolization), vs physiologic/ diet related. infectious evaluation was negative including c. diff x 3 and lactate was normal. with advancement of diet from clears, diarrhea improved. 5. hypertension: initially, home medications were held in setting of acute bleeding. following embolization with stabilization of bleed antiypertensives were slowly added back to medication regimen, beginning with bblocker and 1/2 dose of home acei. by time of discharge, blood pressure was still well controlled with sbp from 100- 110s, so imdur was not restarted. 6. hyperlipidemia: severe coronary history. continued home statin when not npo medications on admission: - lipitor 80 mg qday - 75 mg qday - isordil dinitrate 40 mg qday - lisinopril 10 mg qday - metoprolol 25 mg qday - asa 325 mg qday - mvi - fish oil 1,200 mg-144 mg daily - vit e discharge medications: 1. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 2. zolpidem 5 mg tablet sig: 0.5 tablet po hs (at bedtime) as needed for insomnia. disp:*10 tablet(s)* refills:*0* 3. vitamin e 400 unit capsule sig: one (1) capsule po daily (daily). 4. omega-3 fatty acids capsule sig: one (1) capsule po daily (daily). 5. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 7. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 8. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain: please do not exceed more than 4 grams tyelenol per day. disp:*15 tablet(s)* refills:*0* 9. multivitamin tablet sig: one (1) tablet po daily (daily). 10. lisinopril 5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: diverticular bleed ileus hypotension secondary diagnosis: coronary artery disease s/p recent systolic heart failure discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital with rectal bleeding from a diverticular bleed. you required a large amount of blood products- in total 15 units of red blood cells through your hospital stay. the interventional radiologists embolized the vessel causing the bleed. during your hospitalization, you also developed severe constipation caused by an ileus. you were treated conservatively with bowel rest and a nasogastric tube. your symptoms improved; you started having bowel movements and you tolerated a normal diet. please make the following changes to your medication regimen: 1. please stop your imdur until seeing your cardiologist or primary care physician 2. please reduce your lisinopril to 5mg until you see your primary care physician 3. when you have abdominal pain, take tyelenol first. if that does not relieve your symptoms you make take a percocet (please do not drink or drive while taking this medication as it can make you sleepy). 4. you may take ambien as needed for sleep followup instructions: department: radiology when: monday at 11:45 am with: cat scan building: cc clinical center campus: west best parking: garage department: adult specialties when: tuesday at 2:20 pm with: , md building: (, ma) campus: off campus best parking: free parking on site md procedure: venous catheterization, not elsewhere classified arterial catheterization colonoscopy other endovascular procedures on other vessels diagnoses: esophageal reflux congestive heart failure, unspecified unspecified essential hypertension intestinal bypass or anastomosis status acute posthemorrhagic anemia aortocoronary bypass status percutaneous transluminal coronary angioplasty status other specified forms of chronic ischemic heart disease other and unspecified hyperlipidemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure hypotension, unspecified chronic systolic heart failure paralytic ileus personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits diarrhea diverticulosis of colon with hemorrhage chest pain, unspecified intestinal infection due to other organism, not elsewhere classified obsessive-compulsive disorders 

Answer: The patient is high likely exposed to