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: morphine / codeine attending: chief complaint: brbpr, hypotension major surgical or invasive procedure: colonoscopy history of present illness: 86f w/ hx of recent pelvic fx on lovenox, atrial fibrillation, htn, cad s/p ami, tia presenting with and transferred to micu for hypotension. . patient recently hospitalized at on after mechanical fall during which she incurred non-operative nondisplaced fractures of the r superior and inferior pubic rami. she was placed on lovenox 40mg qd and discharged to rehab. at rehab she was noted to have several heme positive stools yesterday, then today was noted to have gross blood at the rectum. she is taking lovenox for a recent pelvic fracture after a fall, and her dose was held this morning. patient herself is asymptomatic but does have pelvic pain intermittently. both patient, daughter and prior pcp deny any past history of rectal bleeding but does endorse a history of polyps. she denies additional complaints. . in the ed, initial vs: 97.7 94 105/62 16 98%. iv x 2. t&s gi consulted with plan to see her in the floor will see on floor. labs: 30.2 down from 40 in . +ua. patient placed on ceftriaxone for uti. at 2pm blood pressures: 95/45, 90/50 therefore decision made to admit to the micu. past medical history: -afib, not on anticoagulation -hypertension -hyperlipidemia -coronary artery disease, s/p mi in and , patient and family denies -?partial complex seizure or tia in , patient and family denies -lv outlet obstruction on echo from -nph s/p shunt, which was removed due to colitis at shunt insertion site requiring colectomy. she has since been unsteady when she ambulates. -abdominal hernias social history: patient lives alone; her friends and family visit often. she cooks her own meals. she ambulates with a wheeling walker. she has no vna services. tobacco: quit in , previously smoked like a chimney etoh: 1 glass of wine with dinner every night family history: sister with lung cancer. physical exam: admission physical exam general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, systolic ejection murmur heard thoughout the precordium, rubs, gallops lungs: to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly ext: warm, well perfused, 2+ pulses, +clubbing; no cyanosis or edema neuro: cnii-xii intact, moving all extremities with sensation intact discharge physical exam unchanged pertinent results: labs: on admission: 12:10pm blood wbc-11.1* rbc-3.42* hgb-10.7*# hct-30.2*# mcv-88 mch-31.2 mchc-35.3* rdw-14.1 plt ct-350 12:10pm blood neuts-79.3* lymphs-14.7* monos-3.3 eos-2.0 baso-0.7 11:40am blood pt-11.5 ptt-27.0 inr(pt)-1.1 10:43pm blood ret aut-4.7* 11:40am blood glucose-141* urean-17 creat-0.6 na-135 k-5.8* cl-101 hco3-25 angap-15 05:50pm blood ld(ldh)-156 05:50pm blood calcium-8.6 phos-3.6 mg-1.7 05:50pm blood hapto-217* on discharge: 07:54am blood wbc-7.2 rbc-3.43* hgb-10.8* hct-30.8* mcv-90 mch-31.4 mchc-35.0 rdw-14.3 plt ct-338 07:54am blood glucose-86 urean-12 creat-0.4 na-139 k-3.7 cl-105 hco3-25 angap-13 07:54am blood calcium-8.4 phos-3.5 mg-1.5* imaging: colonoscopy: three sessile non-bleeding polyps of benign appearance and ranging in size from 3 mm to 5 mm were found in the transverse colon and descending colon. a 1 cm polyp which looked like an adenoma was noticed at 15 cms from the anal verge. not removed in the setting of gi bleed. multiple non-bleeding diverticula with mixed openings were seen in the descending colon and sigmoid colon. diverticulosis appeared to be severe. a single irregular 2 cm ulcer with stigmata of recent bleed was found in the rectum. cold forceps biopsies were performed for histology at the rectal ulcer. the anastomotic site looked normal. no ulcers noted. brief hospital course: 86f w/ hx of recent pelvic fx on lovenox, atrial fibrillation, htn, cad s/p ami, tia who presented with bright red blood per rectum and hypotension, initially admitted to the micu for one day for close monitoring, then transferred to the medicine floor. active issues by problem: # gi bleed: had brbpr in ed, as well as report of maroon stool in rehab. given hypotension in the ed, she was admitted to the micu for frequent bp and hct checks. hct initially 30, then drifted down to 26 within the first the first day, so transfused 1 unit prbcs. her hematocrit remained stable at that point. pt responded well to limited fluid boluses, and a blood transfusion, and maintained her sbp >100 after coming to the icu. gi was consulted, recommended inpatient colonoscopy. colonoscopy showed multiple diverticuli and a rectal ulcer, both of which were possible sources of her bleeding. she also had multiple polyps that will need to be removed at a follow up colonoscopy. numerous biopsies were taken of the ulcer, pathology pending at discharge. she was monitored overnight after her procedure in case of bleeding from the biopsy sites, however she did not experience and further bleeding. hematocrit was stable at 30.8 on discharge. she will follow up with dr. later this month in clinic for follow up of biopsy results and repeat colonoscopy for polyp removal. # sterile pyuria: +ua on admission, however urine culture negative and patient asymptomatic. was given ceftriaxone in the ed, however this was not continued. # pelvic fracture: patient is ~4 weeks out from fracture at this time but is not not really mobile, so she was continued on subcutaneous heparin for dvt prophylaxis. she will need to continue this until she is ambulating at least 3x a day. chronic inactive issues: # cad s/p mi: continued asa # history of afib - sinus on tele and ekg. her metoprolol was initially held in the setting of gi bleed, however it was restarted after she was deemed hemodynamically and clinically stable. transition of care issues: - please check complete blood count on given recent colonoscopy and biopsies. please fax the results to the medical director at the rehab center. - rectal ulcer: biopsy results pending at time of discharge, will follow up with gi in clinic on - colon polyps: needs to have polyps removed at repeat colonoscopy, as these could not be removed this time. coordination of this will be handled by dr. (gi) - pelvic fracture: continue subcutaneous heparin until ambulating 3x day, please be sure to call the orthopedic surgery, dr. office, to set up a follow up appointment given recent fracture. - patient was dnr/dni this admission, though this was reversed temporarily for colonoscopy procedure - please make sure the patient has a ride to her follow up appointment with gastroenterology and orthopedic surgery. medications on admission: 1. acetaminophen 500 mg tablet sig: two (2) tablet po tid (3 times a day). 2. tramadol 50 mg tablet sig: 0.5 tablet po q6h (every 6 hours) as needed for pain. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for loose stools. 4. senna 8.6 mg tablet sig: one (1) tablet po hs (at bedtime): hold for loose stools. 5. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 6. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 7. multivitamin tablet sig: one (1) tablet po daily (daily). 8. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily): to low back; please place for twelve hours and then remove for twelve hours. 9. polyethylene glycol 3350 17 gram/dose powder sig: one (1) dose po daily (daily) as needed for constipation. 10. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 11. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 12. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 13. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 14. cyclosporine 0.05 % dropperette sig: one (1) dropperette ophthalmic (). 15. heparin (porcine) 5,000 unit/ml solution sig: one (1) dose injection tid (3 times a day): can discontinue when patient consistently ambulating >3x per day. 16. calcitonin 200 units nasal spray - one spray alternating nostrils every day 17. quetiapine 25 mg qhs discharge medications: 1. acetaminophen 500 mg tablet sig: two (2) tablet po three times a day. 2. tramadol 50 mg tablet sig: 0.5 tablet po q6h (every 6 hours) as needed for pain. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for loose stools. 4. senna 8.6 mg tablet sig: one (1) tablet po at bedtime: hold for loose stools. 5. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 6. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po three times a day. 7. multivitamin tablet sig: one (1) tablet po daily (daily). 8. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) patch topical once a day: to low back; please place for twelve hours and then remove for twelve hours. 9. polyethylene glycol 3350 17 gram/dose powder sig: one (1) dose po once a day as needed for constipation. 10. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 11. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 12. metoprolol tartrate 25 mg tablet sig: one (1) tablet po twice a day. 13. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 14. calcitonin (salmon) 200 unit/actuation spray, non-aerosol sig: one (1) spray nasal daily (daily): alternate nares daily. 15. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection (5000 units) injection tid (3 times a day): can discontinue when patient consistently ambulating >3x per day. 16. quetiapine 25 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 17. cyclosporine 0.05 % dropperette sig: one (1) drop ophthalmic twice a day as needed for dry eyes. 18. outpatient lab work please check complete blood count on . please fax the result to the medical director at the rehabilitation center. discharge disposition: extended care facility: health care center - discharge diagnosis: primary diagnoses: hematochezia rectal ulcer diverticulosis secondary diagnoses: coronary artery disease atrial fibrillation discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear ms. , you were admitted to the hospital because of blood in your bowel movements. you were given a blood transfusion and monitored very closely, and you did not have any further episodes of bleeding. a colonoscopy was done and showed diverticuli (small benign outpouchings) and a rectal ulcer, which was sent for biopsies. either of these findings could have been the cause of your bleeding. they also saw some polyps that will need to be removed, so you will need to follow up with dr. in clinic to schedule this and follow up your biopsy results. changes to your medications: none it was a pleasure to take care of you at ! followup instructions: department: div. of gastroenterology when: wednesday at 2:00 pm with: , md building: ra (/ complex) campus: east best parking: main garage department: orthopedics physician: . telephone number: location: # 125, , time: please call dr. office and set up a follow up appointment within 1-2 weeks of your discharge from the hospital. your medical team in the hospital has been unable to reach the office because the phone line has been very busy. procedure: closed [endoscopic] biopsy of rectum diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension acute posthemorrhagic anemia atrial fibrillation unspecified fall old myocardial infarction retention of urine, unspecified hemorrhage of gastrointestinal tract, unspecified hyperosmolality and/or hypernatremia benign neoplasm of colon diverticulosis of colon (without mention of hemorrhage) ulcer of anus and rectum closed unspecified fracture of pelvis 

Answer: The patient is high likely exposed to