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: cool and painful right lower extremity major surgical or invasive procedure: aorto-bifem thrombectomy flexible sigmoidoscopy history of present illness: 65 year old m with a pmh of left aka and cad s/p 4v cabg presents with a 6 hour history of a cool and painful rle. the patient notes that at 1pm, his right foot acutely became more pale and started hurting. he was taken to a local ed, where he was given a bolus of heparin. his pain resolved, but the foot remained cold and the osh was unable to doppler any distal pulses. therefore, the patient was transfered to ed for further care. at time of presentation, he denied any pain/parasthesias or difficulty moving his foot. he did state that it felt cold, however. he denies any trauma to that area. he is able to ambulate with a prosthesis on his left foot and a cane. of note, the patient is on coumadin for history of pe/dvt and inr was 1.4 at the osh. past medical history: htn cad s/p cabg l aka hypercholesterolemia pe/dvt on coumadin pvd s/p aortobifem 's social history: n/c family history: n/c physical exam: xx pertinent results: 04:15am blood wbc-15.7* rbc-3.25* hgb-9.3* hct-28.2* mcv-87 mch-28.7 mchc-33.1 rdw-15.6* plt ct-1353* 04:15am blood plt ct-1353* 04:15am blood pt-14.5* ptt-59.1* inr(pt)-1.3* 04:15am blood glucose-117* urean-17 creat-0.7 na-135 k-3.5 cl-107 hco3-24 angap-8 03:35am blood glucose-193* urean-16 creat-0.7 na-134 k-3.8 cl-102 hco3-20* angap-16 02:52am blood alt-37 ast-46* alkphos-187* amylase-146* totbili-1.6* 02:52am blood lipase-279* 04:15am blood calcium-8.0* phos-3.0 mg-2.0 mrcp (mr abd w&w/oc) study date of 1:18 pm there is no evidence of cholecystitis, although there is sludge in the gallbladder. there is no biliary dilatation. there are bilateral pleural effusions. there is evidence of previous retroperitoneal hemorrhage. there is ischemic abnormality of the spleen. chest (portable ap) study date of 7:39 am findings: as compared to the previous examination, there is no relevant overall change. minimal areas of hypoventilation at both lung bases, minimal right-sided pleural effusion limited to the very area of the costophrenic sinus. no newly appeared focal parenchymal opacity suggestive of pneumonia, normal size of the cardiac silhouette. liver or gallbladder us (single organ) study date of 8:09 am impression: 1. no intra- or extra-hepatic bile duct dilatation. 2. gallbladder sludge but no son evidence for acute cholecystitis. 3. small right pleural effusion. 4. mild splenomegaly. ct guidance drainage study date of 1:31 pm impression: successful ct-guided placement of an 8 french pigtail catheter in the pelvic fluid collection. 90 ml of clear brown fluid was aspirated. a sample was sent to the laboratory for gram stain, fungal smear and bacterial and fungal cultures. ct abdomen w/contrast study date of 1:16 pm impression: 1) markedly abnormal segment of sigmoid colon as described above suggestive of infarcted bowel. the portions of the sigmoid immediately proximal as well as the rectum appear re-perfused. 2) interval decrease in the right retroperitoneal hemorrhage with surgical drain in place. 3) unorganized intraperitoneal fluid in the deep pelvis adjacent to the sigmoid with thin peritoneal enhancement. 4) persistent abnormal perfusion pattern of the spleen suggestive of ischemic injury. 5) moderate bilateral pleural effusions with associated atelectasis. 6) this study was not tailored as an arterial phase study to evaluate the bypass graft, though there remains persisting high-grade stenosis of the distal aorta. the right sfa does appear re-perfused and there is some re- perfusion of the proximal portion of the left iliac graft. us abd limit, single organ port study date of 9:28 am impression: 1. unremarkable gallbladder containing an echogenic structure which may be a small polyp or adherent gallstone. otherwise, no signs of cholecystitis identified. no biliary dilatation. 2. ascites identified in the perihepatic space. portable tte (complete) done at 9:44:56 am final conclusions no atrial septal defect is seen by 2d or color doppler. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: normal global and regional biventricular systolic function. no significant valvular abnormality seen. moderate pulmonary artery systolic hypertension. cta abd w&w/o c & recons study date of 10:42 am impression: 1. high-grade distal aortic stenosis appears secondary to acute thrombosis in the proximal graft. clot begins just below the origin of the renal arteries, and extends inferiorly towards the bifurcation. right iliac graft is patent, but the left is completely occluded. 2. very large right retroperitoneal hemorrhage, with areas of active extravasation of contrast in right groin. foci of active extravasation in the right groin cannot be directly connected to the external iliac graft, and may be arising from a bleeding superficial or subcutaneous muscular branch vessel in the right groin deep to the staple line. 3. multiple wedge-shaped perfusion defects in the left kidney, most consistent with infarcts, acuity uncertain. 4. findings consistent with hypoperfusion complex in the visceral organs, including splenic hypoperfusion, adrenal hyperenhancement, and heterogeneous perfusion of the liver. 5. relative hypoperfusion of the sigmoid colon may be secondary to shock as the sigmoid and superior rectal arteries are patent but clamped down in appearance. 6. occluded right superficial femoral artery. ecg study date of 7:43:22 pm sinus tachycardia with a decrease in voltage as compared with prior tracing of . there are new downsloping st segment depressions and t wave inversions in leads i and avl with st-t wave flattening in the inferior leads and new st segment depression and t wave inversion in leads v5-v6. these findings are consistent with active inferolateral ischemia. followup and clinical correlation are suggested. ecg study date of 8:31:38 pm sinus rhythm with intraventricular conduction delay. left bundle-branch block pattern. peaking of the t waves is present in leads v2-v6 which is consisent with hyperkalemia or anterior myocardial infarction. a q wave is also present in lead v1 consistent with anteroseptal myocardial infarction, age undetermined. no previous tracing available for comparison. brief hospital course: transferred from osh for threatened rle. started heparin drip. patient had a cta abdomen-very large right retroperitoneal hemorrhage, with areas of active extravasation of contrast in right groin. high-grade distal aortic stenosis appears secondary to acute thrombosis in the proximal graft. clot begins just below the origin of the renal arteries, and extends inferiorly towards the bifurcation. right iliac graft is patent, but the left is completely occluded. taken to or for thrombectomy of right limb of aortobifemoral, resection of pseudoaneurysm with interposition graft. patient tolerated procedure, intubated, l bracila arterial line, foley, ngt, and r ij central line placed. patient remained intubated and sedate post-operatively, transferred to the cvicu. on heparin drip. pulses of rle w/ signals popletieal, and pt, absent dp. riss for glycemic control. fluid resuscitation and pressors for hypotention. transfused with 2 units packed red blood cells. follow up cta done-with persistent right groin bleeding and retroperitoneal hematoma. taken back to or for exploration of right groin with ligation of bleeding vessel, evacuation of retroperitoneal hematoma. jp drians placed. postoperatively- fluid resuscitated. remains on pressors, heparin drip and intubated. 12/29-31/08 cvicu days # 2, 3. intubated on pressors, and heparin gtt. continue riss. hct stable. wbc rising- started on levaquin emperically. pan cultured. cardiach echo done- lvef >55 %. cvicu day # 4, intubated-weaning to cpap, sedate, riss, vanco an metronidazole added to abx. off pressors. wbc peristently elevated with low grade temp. abdominal ct done-unorganized intraperitoneal fluid in the deep pelvis adjacent to the sigmoid with thin peritoneal enhancement. cvicu day # 5. now w/ generalized anasarca. still febrile. remain intubated. hypertensive managed w/ metoprolol and hydralazine iv. underwent successful ct-guided placement of an 8 french pigtail catheter in the pelvic fluid collection. 90 ml of clear brown fluid was aspirated. sample was sent to the laboratory for gram stain, fungal smear and bacterial and fungal cultures. continue abx. added fluconazole-prelin cx came back w/ yeast. started tpn. cvicu day # 6. still febrile t maxed 101.8. remain intubated-cpaping. axillary arterial line placed at bedside. hydralazine and metoprolol for hypertension. remains on vanco, zosyn, flagyl and fluconazole. levaquin d/c'd. id consulted- recs to continue w/ current abx. started lasix . patient started having diarrhea negative c-diff, abdomenn also distended. general surgery consulted-will follow. cvicu day # 7 remains febrile (t amx 101.6)-became confused. weaned and extubated. remains on abx (vanc/zosyn/fluconazole). tube feeds started, stooling bloody. general surgery following- no scope for now. getting diuresed. r ij changed to l subclavian cl. cvicu day # 8 afebrile. wbc continue to rise. id following-continue w/ abx (vanc/zosyn/fluc). tube feeds on hold-speech and swallow eval-swallowing ok. rechecking c-diff cultures. continue to diurese. cvicu day # 9 spiked temp 101.7-pan cultured. elevated lft's. abdomenal us was done-negative extra-hepatic bile duct dilatation, or acute cholecystitis. has gallbladder sludge. continue abx (vanc/zosyn/fluc). ngt replaced to dobhoff. tube feeds resumed after abdominal us. hd cvicu day # afebrile. peritoneal pigtail d/c'd. abx continue(zosyn/fluconazole), vanco dicontinued. continue to diurese. lft's remain elevated- d/c'd statin. patient continue to have diarrhea. hd 14 cvicu day # 12 low grade temp, still confused. lfts still elevated-continued to monitor. transferred to 5 vicu. still stooling- flexiseal in rectum. taking po meds. hd 15-16 (vicu) vss, afebrile. wbc down, lfts's normalized. diffuse tenderness of mid abdomen. gen surgery resc- mrcp. a-line d/c'd. continues on tpn and heparin gtt. continues w/ zosyn. 1/12-13/09 hd 16-17 (vicu) vss, low grade temps. mrcp done-negative. continues on tpn and heparin drip. started regular diet. still having diarrhea. thigh drain d/c'd. started coumadin. continue zosyn. physical therapy consult for out of bed. hd 18 vicu vss, afebrile. continue w/ zosyn, tpn, heparin gtt. tpn d/c'd after bag is finished. coumadin dosed. groin staples removed. stool for c-diff sent again. continue to work w/ physical therapy. calorie count. hd# 19 vicu - episode of rectal bleeding noted in rectal bag. heparin dose decreased. repeat hct. stable @ 28.1. rectal tube removed and bleeding stopped. anticoagulation continued.patient not thearpeutic on coumadin inr 1.3 iv heparin bridge continued and coumadin dosed. hd#20 transfered to floor.inr 1.7 today will continue with iv heparin bridge. will dose with 7mg coumadin tonight. if inr on 2.0 or > will d/c heaprin and d/c to rehab. discharge dose should be 7.0mgm daily. will d/c iv antibiotics at discharge and continue a two week course of augmentin 875mg until seen in f/up with dr. . medications on admission: asa 81 mg qd lisinopril 10 mg qd hctz 12.5 mg qd omeprazole 20 mg qd metoprolol 50 mg qd lovastatin 20 mg qd coumadin 7 mg qd discharge medications: 1. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 4. outpatient lab work inr weekly 5. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours). 6. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed. 9. hydrochlorothiazide 12.5 mg capsule sig: one (1) capsule po daily (daily). 10. warfarin 1 mg tablet sig: seven (7) tablet po once daily at 4 pm. 11. augmentin 875-125 mg tablet sig: one (1) tablet po twice a day for 2 weeks. 12. lisinopril 10 mg tablet sig: one (1) tablet po once a day. 13. lovastatin 20 mg tablet sig: one (1) tablet po at bedtime. discharge disposition: extended care facility: country rehabilitation & nursing center - discharge diagnosis: thrombosed psuedoaneurysm right retroperitoneal hematoma with bleeding collateral vessel history of htn history of hyperlipedemia history of pe/dvt postoperative acute anemia secondary to blood loss -requiring blood transfusion postoperative pneumonia-yeast reactive thrombocytosis,annticoagulated psh: pvd s/p aortobifem 's history of cad s/p cabg history of l aka discharge condition: stable discharge instructions: - ambulate as tolerated fu with dr. - elevate leg when sitting - no driving till fu - may shower, no tub baths - keep wound dry and clean, call if noted to have redness, draining, swelling, or if temp is greater than 101.5 - continue all medications as directed - diet as tolerated - keep all fu appointments - call dr. office for fu appointment in 2 weeks - you will be on live long coumdain, take as directed, f/.up with your pcp for of your inr-goal 2.0-3.0 followup instructions: dr. phone: 2 weeks f/up, call for appointment. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other revision of vascular procedure insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous abdominal drainage flexible sigmoidoscopy transfusion of packed cells control of hemorrhage following vascular surgery transfusion of other serum diagnoses: acidosis pure hypercholesterolemia unspecified essential hypertension acute posthemorrhagic anemia aortocoronary bypass status hemorrhage complicating a procedure acute respiratory failure surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other complications due to other vascular device, implant, and graft long-term (current) use of anticoagulants candidiasis of lung personal history of venous thrombosis and embolism acute myocardial infarction of unspecified site, initial episode of care acute vascular insufficiency of intestine vascular disorders of kidney above knee amputation status 

Answer: The patient is high likely exposed to