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: hypotension major surgical or invasive procedure: r femoral tlc history of present illness: pt is a 68 yo m with esrd on hd s/p failed renal transplant (access through l ij non-tunneled catheter placed ) admitted from ed after being snet in from dialysis. prior to starting dialysis today, noted to have bp 60/40s, asymptomatic. in ed received 1.5 l ns with increase bp to 80s-100s. he also received 1 gm vanco for empiric coverage of possible line sources of infection. denies any recent cp/sob/abd pain/ fever/chills/cough/melena. there was a question of some recent cocaine use but patient denies. . seen by renal in ed, no urgent need for hd on day of admission. past medical history: #status post failed cadaver renal transplant in with explantation in (path acute and chronic rejection). complicated by wound infection with enterococcus and bacteroides fragilis . #hypertension #diastolic dysfunction #congestive heart failure (echo ef 60%, 2+mr, 2+tr, moderate pulmonary artery hypertension) #diabetes type 2 #hepatitis c virus #chronic anemia #status post mitral valve replacement in #history of iv drug abuse with recent cocaine and heroin #h/o ptx #h/o depression #positive ppd s/p inh #s/p l eye loss after accident #cervical radiculitis #reports hiv negative. social history: retired water meter reader, now disabled +etoh/tobacco ivda, cocaine lives alone on methadone maintenance program, but still using cocaine and iv heroin. family history: father -- cva (50's),mother -- cad,sister -- sle (deceased @ 60 due to renal/cardiac complications) physical exam: vs - t 100.7, bp 92/56, hr 100, rr 20, o2 sat 96% ra gen - somnolent, but responsive heent - op clr, mmm, l ij site c/d/i cv - irreg irreg, tachy, syst mur at apex chest - ctab anteriorly abd - nabs, soft, nt ext - no edema, 2+ distal pulses r groin - open ~1 cm wound, no exudate or surrounding erythema pertinent results: 05:30pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 04:40pm lactate-1.6 04:15pm potassium-5.1 12:45pm glucose-189* urea n-57* creat-9.9*# sodium-142 potassium-5.8* chloride-100 total co2-25 anion gap-23* 12:45pm ck(cpk)-24* 12:45pm ck-mb-notdone ctropnt-0.15* 12:45pm wbc-5.1 rbc-3.67* hgb-11.1* hct-34.3*# mcv-93# mch-30.2 mchc-32.4# rdw-17.0* 12:45pm neuts-65.0 lymphs-23.5 monos-8.8 eos-2.2 basos-0.6 12:45pm hypochrom-2+ anisocyt-1+ macrocyt-1+ 12:45pm plt count-221# 12:45pm pt-13.0 ptt-27.3 inr(pt)-1.1. . chest - portable ap (): comparison is made to , . the patient is status post sternotomy. the tip of the central venous line terminates at the cavoatrial junction in a similar location. cardiac and mediastinal contours are unchanged. the lungs are clear. however, there is evidence of a small right subpulmonic effusion, new since the prior study. there is also similar fullness of the pulmonary vessels bilaterally, consistent with pulmonary venous hypertension. . ecg: atrial fibrillation with somewhat rapid ventricular response. since the previous tracing of atrial fibrillation is a new rhythm. the rate is somewhat faster. otherwise, no significant change. . femoral vascular us right port (): scale, color, and pulse doppler examination of the right femoral vessels was performed. markedly turbulent, increased flow is seen in the right femoral vein with arterialization of the venous waveform demonstrated on pulse doppler examination. there is a large groin hematoma measuring at least 18.5 x 7.9 x 8.3 cm. . femoral vascular us right (): grayscale, color, and doppler son of the right common femoral artery and vein were performed. again demonstrated is pulsatility of the right common femoral venous waveform with markedly elevated velocities of 180 cm/s consistent with an arteriovenous fistula. redemonstrated within the right medial groin is a heterogeneous collection measuring at least 8.9 x 6.0 x 3.0 cm. these findings are consistent with a hematoma which appears more organized than on prior exam. brief hospital course: the patient was admitted to the micu service for close observation. at the time of admission to the icu, the patient's sbp was stable ~100. there was concern for sepsis, to an indwelling dialysis line, and the patient was covered with vancomycin. he had a h/o of gib in the past but his hct remained stable and no evidence of active bleeding on exam. his bp responded to a 500cc bolus and remained stable. he was noted to be in an atrial fibrillation/flutter with rvr, requiring max diltiazem gtt and iv lopressor at one time. he was transitioned over to diltiazem and lopressor po. with improvement in his rate, his blood pressure remained stable. the patient was noted to have a r groin hematoma, thought to be to line attempts on admission. u/s revealed an av fistula. vascular surgery was consulted and recommended holding pressure and repeating ultrasound. repeat u/s following day showed no flow. . he remained hemodynamically stable and was called out to a monitored telemetry bed on the medical floor. there, a history of preceding diarrhea was elicited. stool samples were sent for c diff toxin assay, which returned positive on . the remainder of his workup remained negative, including blood cultures, chest x-ray, and stim test. his presenting hypotension was presumed secondary to hypovolemia from c diff associated diarrhea. he was started on po flagyl, with good symptomatic response. he was discharged with plans to complete a 2 week course. . he continued to be followed by the renal dialysis team and received dialysis on a mwf schedule. he was continued on nephrocaps and received epogen at dialysis. a temporary left internal jugular dialysis catheter was placed on . this was changed to a permanent tunnelled line on . . he was continued on a proton pump inhibitor twice daily for a recent history of gastrointestinal bleed. for this reason, he was not anticoagulated for atrial fibrillation. he received subcutaneous heparin three times daily for dvt prophylaxis. medications on admission: -epo -zemplar -tums -diltiazem 120 qd -thiamine 100 qd -lopressor 100 tid -protonix 40 -seroquel 25 tid discharge medications: 1. metoprolol succinate 100 mg tablet sustained release 24hr sig: three (3) tablet sustained release 24hr po daily (daily). disp:*90 tablet sustained release 24hr(s)* refills:*2* 2. diltiazem hcl 120 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). disp:*30 capsule, sustained release(s)* refills:*2* 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 4. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed. disp:*120 tablet, chewable(s)* refills:*2* 6. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). disp:*30 capsule* refills:*2* 7. oxycodone 5 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for pain. disp:*20 tablet(s)* refills:*0* 8. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 7 days. disp:*21 tablet(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: c diff colitis dehydration atrial fibrillation with rapid ventricular response . diabetes end stage renal disease on hemodialysis history of recent gastrointestinal bleed discharge condition: stable, discharged to home of mr (health care proxy) discharge instructions: 1) continue your medications as prescribed. - you were started on an antibiotic called flagyl (metronidazole) for your diarrhea. take this medication until you run out (last dose ). - your lopressor was changed to a once daily formulation. - please continue taking protonix for your stomach. 2) weigh yourself daily. call your doctor if your weight changes by more than 3 lbs. please adhere to a 2 gm sodium diet, and 2 l fluid restriction. 3) follow up as directed below. 4) call if you have chest pain, shortness of breath, palpitations, lightheadedness, nausea, fevers, or any other concerns. followup instructions: continue with outpatient dialysis as scheduled follow up with dr on friday, at 11:40 am - if you have any questions, or need to reschedule, you may contact his office at . procedure: venous catheterization, not elsewhere classified hemodialysis venous catheterization for renal dialysis venous catheterization for renal dialysis transfusion of packed cells diagnoses: anemia of other chronic disease end stage renal disease unspecified viral hepatitis c without hepatic coma atrial fibrillation hematoma complicating a procedure hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hypotension, unspecified intestinal infection due to clostridium difficile infection and inflammatory reaction due to other vascular device, implant, and graft hypovolemia diastolic heart failure, unspecified delirium due to conditions classified elsewhere disruption of external operation (surgical) wound pain in limb 

Answer: The patient is high likely exposed to