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: abd pain major surgical or invasive procedure: selective celiac arteriogram, celiac stenting, abdominal and pelvic arteriogram (cpt codes , , and ). failed attempt to cross sma occlusion exploratory laparotomy. procedure: 1. exploratory laparotomy. 2. small bowel resection. 3. small bowel anastomosis x2. 4. ileocolic anastomosis. 5. gastrostomy. 6. patch abdominal closure. procedure: 1. reopening of abdomen. 2. resection of small bowel anastomoses x3. procedure: 1. exploratory laparotomy. 2. small bowel resection. 3. tube jejunostomy. 4. abdominal closure. procedure: hickman catheter insertion. history of present illness: patient is intubated and is therefore unable to communicate verbally. history is based on medical records provided by and dr. exploratory laparoscopy notes. this 63 yo female had a laparoscopic cholecystectomy on and was discharged home on the same day symptomatic (symptoms not mentioned). on the morning of , the patient began to experience severe abdominal pain, which became worse and she was seen at / in , ma where a ct scan showed an ileus with no evidence of any other abnormality and a small amount of fluid in the gallbladder fossa, consistent with the previous surgery. she has a past medical history of vascular disease with a carotid artery stenosis and coronary artery disease. she had an ercp because of stones in the bile duct and had been referred for a semi-urgent cholecystectomy and had undergone an uneventful laparoscopic cholecystectomy. the findings at surgery upon opening the patient's abdomen, the small bowel in the superior mesenteric distribution was considered "dusky", although completely and not frankly gangrenous. the operative site appeared with no evidence of any bile leak and all staples in place. there was no free fluid in the peritoneal cavity. it was elected to close the patient, start the patient on heparin, and refer her to vascular service. the superior mesenteric artery has a non-dopplerable pulse, but there is a palpable pulse in the splenic and the common hepatic artery. the aorta is considered markedly stenosed past medical history: pmh: pvd, l subclavian stenosis s/p bypass, htn, ^chol, copd, s/p appy, s/p tonsillectomy, seizure d/o, cva ', bilateral cea social history: married female living with husband. unknown occupation status. smokes cigarettes: unknown amount, denies alcohol/illicit drug use family history: n/c physical exam: fragile female a/o nad cta rrr abd j / g tube sites inact, clean pulses: fem dp pt rt 2+ mono mono lt 2+ mono mono pertinent results: 09:52pm blood wbc-10.7 rbc-3.57* hgb-10.8* hct-32.9* mcv-92 mch-30.3 mchc-32.9 rdw-15.0 plt ct-341 03:06am blood pt-16.2* ptt-45.8* inr(pt)-1.5* 05:45am blood glucose-82 urean-23* creat-0.6 na-133 k-4.4 cl-105 hco3-23 angap-9 06:01am blood alt-7 ast-10 alkphos-105 totbili-0.5 05:45am blood calcium-8.6 phos-4.3 mg-2.0 09:40am urine color-straw appear-clear sp -1.011 urine blood-tr nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-7.0 leuks-neg urine rbc-* wbc-0-2 bacteri-0 yeast-none epi-0 11:52 am stool site: stool consistency: loose clostridium difficile toxin assay (final ): feces negative for c. difficile toxin by eia. 9:17 pm chest (single view); chest fluoro without radiologi reason: insertion hickman line under fluoro findings: two fluoroscopic spot films are obtained in the or during placement of a central venous line. these limited films reveal right subclavian and right internal jugular venous catheters extending to the cavoatrial junction. no pneumothorax is visualized. 3:26 pm bilat up ext veins us reason: please do a formal study of bilat. ue - look for dvt upper extremity ultrasound: grayscale and color doppler ultrasound examinations of bilateral internal jugular, subclavian, axillary, brachial, basilic, and cephalic veins was performed. there is an occlusive thrombus of the right cephalic, which extends into the right subclavian although this vessel is not occluded. the extension of the subclavian exhibits echogenicity suggestive of organization. remaining veins demonstrate normal wall-to-wall color flow, compressibility, and waveforms. impression: occlusive thrombus in the right cephalic vein which extends into the right subclavian vein without causing occlusion. brief hospital course: : pt admitted taken stat to the or: selective celiac arteriogram, celiac stenting, abdominal and pelvic arteriogram (cpt codes , , and ). failed attempt to cross sma occlusion. selective celiac arteriogram, celiac stenting, abdominal and pelvic arteriogram (cpt codes , , and ). failed attempt to cross sma occlusion exploratory laparotomy. there was no evidence of soilage of bowel contents in the abdomen. - the patient was taken for a planned second look operation by dr. , she had been hemodynamically stable during the interim period. there were several areas of small bowel requiring resection procedure: 1. exploratory laparotomy. 2. small bowel resection. 3. small bowel anastomosis x2. 4. ileocolic anastomosis. 5. gastrostomy. 6. patch abdominal closure. transfered back to the cvicu - intubated / pt required resusitation by meds and fluid - patient did begin spiking fevers, reexploration, washout and closure were indicated. bilious ascites with some fecalized material was encountered. inspection revealed that the two small bowel anastomoses had broken down with the beginning of leakage of intestinal contents. vascular surgery was notified intraoperatively and did come into the or. all potentially viable lengths of small bowel were preserved. procedure: 1. reopening of abdomen. 2. resection of small bowel anastomoses x3. - pt spiked fevers again, upon entering the abdomen, there was a sulcus free within the intestinal cavity from a perforation of 1 of the closed loops of small bowel. anadditional 18 cm of small bowel was identified and found to be nonviable. procedure: 1. exploratory laparotomy. 2. small bowel resection. 3. tube jejunostomy. 4. abdominal closure. since that time, the patient has been stable. transfered to the vicu, then the floor. pt required pain consult to wean of pca. pca was removed and pain control was maintained using a fentanyl patch with percocet elixir for breakthrough. the patient has had copious output from her gtube and jtube, managed with a variety of colostomy-style appliances. - she requires agressive fluid and electrolyte repletion, it was decided to put a permanent line in procedure: hickman catheter insertion. pt had multiple cx's taken during this hospital sty. her ab were broad coverage. prior to discharge her antibiotics were stopped. the morning after she spiked a temperature. no obvious sources of infection. ct abdomen done which showed small collection in the abdomen, decreased in size from previously. however, no ring enhancing with air. patient was transferred to the general surgery team for continued management of this problem. peritoneal fluid {neg} escherichia coli, ciprofloxacin - <=0.25 s anaerobic culture: no anaerobes isolated. albicans, fluconazole sensitive. during her last week in the hospital she was afebrile and without complaint. her tpn and fluids were titrated with her urine output and her g and j tube output to maintain her net fluid balence as neutral. medications on admission: : dilantin, aggrenox, lorazepam, albuterol,, advair, lovastatin discharge medications: 1. acetaminophen 650 mg suppository : one (1) suppository rectal q6h (every 6 hours) as needed. 2. cyclobenzaprine 10 mg tablet : one (1) tablet po tid (3 times a day) as needed. 3. oxycodone-acetaminophen 5-325 mg/5 ml solution : 5-10 mls po q4h (every 4 hours) as needed. 4. fentanyl 100 mcg/hr patch 72 hr : one (1) patch 72 hr transdermal q72h (every 72 hours). 5. clopidogrel 75 mg tablet : one (1) tablet po daily (daily). 6. nystatin 100,000 unit/ml suspension : five (5) ml po qid (4 times a day): thrush / dc when thrush is gone. 7. miconazole nitrate 2 % powder : one (1) appl topical prn (as needed). 8. prochlorperazine edisylate 5 mg/ml solution : one (1) injection q6h (every 6 hours) as needed. 9. hickman catheter heparin flush hickman (100 units/ml) 2 ml iv daily:prn 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. 10. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 11. enoxaparin 80 mg/0.8 ml syringe : one (1) subcutaneous q 24h (every 24 hours). 12. levetiracetam 500 mg/5 ml solution : one (1) intravenous q12h (every 12 hours). 13. ipratropium bromide 0.02 % solution : one (1) inhalation q6h (every 6 hours) as needed for sob, wheeze. 14. albuterol sulfate 0.083 % (0.83 mg/ml) solution : one (1) inhalation q6h (every 6 hours) as needed for sob, wheeze. 15. lorazepam 2 mg/ml syringe : 0.5 mg 0.5 mg injection q4h (every 4 hours) as needed. discharge disposition: extended care facility: northeast - discharge diagnosis: small bowel ischemia discharge condition: good discharge instructions: call or go to the er if signs and symptoms although there are different types of intestinal ischemia, signs and symptoms are most often perceived as having a sudden (acute) or gradual (chronic) onset. signs and symptoms of acute intestinal ischemia typically include: sudden abdominal pain that may range from mild to severe an urgent need to move your bowels frequent, forceful bowel movements abdominal tenderness or distention blood in your stool nausea, vomiting fever chronic intestinal ischemia, in which blood flow to the intestines is reduced over time, is characterized by: abdominal cramps or fullness, beginning within 30 minutes after eating and lasting for one to three hours abdominal pain that gets progressively worse over weeks or months fear of eating because of subsequent pain unintended weight loss diarrhea nausea, vomiting bloating call or come to the er if: wound care: please call us immediately for any of the following problems: redness in or drainage from your wound(s). new pain, numbness or discoloration of your lower or upper extremities (notably on the side of the incision). watch for signs and symptoms of infection. these are: a fever greater than 101 degrees, chills, increased redness, or pus draining from the incision site. if you experience any of these or bleeding at the incision site, call the doctor. followup instructions: provider: , md phone: date/time: 10:45 follow-up with dr. @ 2pm telephone # procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances other enterostomy other partial resection of small intestine diagnostic ultrasound of heart angioplasty of other non-coronary vessel(s) percutaneous abdominal drainage arteriography of other intra-abdominal arteries open and other right hemicolectomy other small-to-large intestinal anastomosis insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) transfusion of packed cells other gastrostomy small-to-small intestinal anastomosis multiple segmental resection of small intestine multiple segmental resection of small intestine multiple segmental resection of small intestine open and other cecectomy other suture of abdominal wall transposition of cranial and peripheral nerves insertion of two vascular stents procedure on single vessel diagnoses: thrombocytopenia, unspecified anemia, unspecified pure hypercholesterolemia other postoperative infection unspecified essential hypertension chronic airway obstruction, not elsewhere classified other convulsions other ascites acute vascular insufficiency of intestine other and unspecified postsurgical nonabsorption peritoneal abscess surgical operation with formation of external stoma causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other chronic postoperative pain 

Answer: The patient is high likely exposed to