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: antihistamines attending: chief complaint: hypotension/ ms changes, diarrhea . pcp: . major surgical or invasive procedure: central line history of present illness: 86 year old man with pmhx of cad presented to the pcps office on with ms changes and 2 days of fevers/edema. he also endorsed diarrhea for last 2-3 weeks. patient presented from home. he was found to be hypotensive to 80/40 during the office visit and was subsequently sent to the ed. . on admission , patient also reported intermittent abdominal pain in the lower quadrants x 2 weeks. the pain was not present there upon rest, but only upon palpation. he was having diarrhea x hours, loose, non bloody. no dysuria/hematuria. no f/c, has chronic dizziness/lightheadedness, slightly worse x 2 months; did report nl po, including compliance with medication. no sob, no cp, no n/v, no diaphoresis. has chronic r flank pain. of note patient recently admited to in early where he was given a 7 day course of ceftriaxone for pna. he also had elevated inr at that time. . in ed, patient received 2 l ivf, he was started on peripheral dopamine. he had a r ij placed after several failed attempts b/l with a stick to the carotid (it was not cannulated). patient was subsequently found to have an inr of 12 and patient was given 10 mg vitamin k sq. patient also underwent ct head, ct neck that showed no evidence of bleed or hematoma. patient also had a cxr that did not reveal in infiltrate. a foley was placed. ua was negative. lactate was 1.8. he was started on vanco/zosyn for broad empirice coverage and on flagyl for c. diff. no recent abx. patient was not tachycardic in ed - 80s, sating 96% on 3l upon transfer. . in the micu, pt remained on pressors (levophed) for approximately 24 hours. the hypotension was attributed to diarrhea likely c diff versus sepsis, though pt remained afebrile, wbc was elevated to 21. his coagulopathy was reversed and may have been vit k loss with diarrhea. his repeat kub was unchanged and rate of diarreha decreased. . on transfer, the patient reports some diarrhea and denies n/v or abdominal pain. he denies or chills, denies dizzyness. he has new-onset bilat intesnse pain in his hands that he attributes to gout. otherwise he denies cough, chest pain, sob. he does report some weakness with walking. he denies any back pain, which is significant as outpatient. past medical history: 1. cad s/p inferior mi unknown date and no records here. he states that he had a stent placed in the past. - dr. 2. cva in the left putamen with ongoing right sided weakness on coumadin. 3. hypothyroidism 4. depression 5. chronic back pain 6. atrial fibrillation - on coumadin 7. inguinal hernia x4 8. sciatica 9. spinal stenosis- s/p surgery x2, dr. 10. sleep apnea . social history: lives at home with a day care nurse the meds. born in . italian in origin. no tobacco or etoh currently. has sons who are very involved in his care family history: nc physical exam: micu pe on presentation: vs: 97.1 71 afib 97/65 on levophed cvp 12-22 15 98% 2l rij gen: pleasant elder, pale male, nad, axox2, not alert to the date, but fully aware of his diagnosis and the reason he is here heent: expanding r neck hematoma, no jvd cv: irregular, no extra hs lungs: ctab/l, no focal rhonchi appreciate abd: + bs, soft, nondistended, mild guarding in b/l lower quadrants, no rebound, back: no cva ext: + 2 pitting edema, no cyanosis, + 1 dp bl, mild erythema/chronic . floor transfer pe: vs: t 95.4 bp109/79 hr80 97% ra gen: comfortable, nad, falls asleep at times heent: nc/at, small mucous thread r eye, conjunctivae slightly pale, sclera anicteric, op clear, mmm neck: tender r neck at prior ij site, some fluctuance but no clear hematoma ln: no cervical or supraclavicluar ln cvs: nr/rr, +s1/s2, no clear murmurs pul: ctab, no wheezes/ : obese, +bs, soft, non-tender, no rebound, no masses ext: + edema to shins, dp pulses difficult to palpate skin: venous stasis changes and erythema over bilat shins neuro: slightly sleepy, oriented to name, place, year, season, current events, moves all four extremities pertinent results: admission labs: lactate 2.8--> 1.0 . cr 2.6 . wbc 22.7 hct 32.3 plt 481 n 84%, no bands . inr 12.3 . labs on transfer: cbc: 10.1 > 29.2 < 332 bl hct 35-38 . 142 111 42 ==============< 95 3.7 23 1.7 . inr: 1.9 . uric acid 8.1 . xr : findings: two views of the abdomen are compared to ct abdomen and pelvis . right ijv catheter terminates at the cavoatrial junction. transverse colon is distended measuring up to 6.7 cm. bowel gas pattern is nonspecific. no definite free air present. there is s-shaped scoliosis, with levoscoliosis at thoracolumbar junction and dextroscoliosis at lower lumbar levels. the patient is status post laminectomy. there is severe degenerative change of the right humeral head with superior migration compatible chronic rotator cuff tear. impression: transverse colon distention, with nonspecific bowel gas . . ct head: 1. no acute intracranial abnormality is detected. 2. encephalomalacia and volume loss related to old left mca territorial infarct. . ekg offical read: baseline artifact. sinus rhythm with significant atrial ectopy. occasional ventricular premature beats. left axis deviation. right bundle-branch block. old inferolateral myocardial infaction. st-t wave abnormalities. compared to the previous tracing of there is probably no significant diagnostic change and multiple abnormalities persist. clinical correlation is suggested. . ct neck: soft tissue swelling and stranding in the bilateral neck without organized hematoma detected. . microbiology: stool: c diff neg x 2 blood: ngtd brief hospital course: 86 y.o. m with h/o cad, afib on coumadin, spinal stenosis and chronic pain, who presents to pcp with diarrhea, dehydration and hypotension attributed to likely c diff infection after recent hospitalization for pna and treatment with ceftriaxone. his stool cultures were negative x2 but suspicion was still high and his symptoms improved quickly with cipro and flagyl antibiotic therapy. his leukocytosis to a peak of 22 trended down to 10.1. he will finish a 2-week course. . the patient also presented with acute renal failure with a peak creatinine at 3.0, bl < 1.0. likely prerenal in setting of hypotension and diarrhea. creatinine trended down and was 1.3 on discharge. his uop remained slightly low and he received ns ivf boluses (gentle at 250cc) and patient was encouraged to take plenty of po fluids which was difficult for him secondary to his hand stiffness from an acute gout flare. he will follow up with his primary care physician. . on admission the patient was hypotensive in setting of acute infection and diarrhea and was placed on levophed in micu for 24 hours, now stable. patient did not have cardiac symptoms to suggest cardiac etiology, minimal oxygenation. no neurological symptoms were identified to suggest neurological compromise. patient has a h/o stroke with slurred speech and slight weakness but this was unchanged from his baseleine. his antihypertensives were held and he is instructed to restart them under the guidance of his pcp as an outpatient. . the patient had an elevated inr to 12 while on coumadin for a-fib. incr inr appears to be recurrent, may be colitis/infection and subsequent vit k deficiency. lfts wnl, inr trended down s/p vitamin k. he sustained a hematoma at the r ij puncture site (arterial) but the hematoma did not increase in size. he did have persistent anemia but did not require transfusions. his stool guaiacs were negative. his coumadin was restarted adn he will need to have his inr checked as an outpatient. . the patient developed bilateral hand pain which he attributed to gout, uric acid 8. with normalized pressures, patient was restarted on his outpatient doses of morphine. prednisone was not started given current infection. he was started on colchicine daily and nsaids while in the micu which were held given potential for bleeding and gi distress. his pain was greatly improved on discharge and he was able to use his hands. . for his chronic low back pain/sciatica s/p laminectomy, outpatient doeses of morphine sr 30mg were restarted once his blood pressure normalized. pt does have h/o withdrawal after abrupt stopping of opioids and has /sweats/diarrhea and family was concerned he was not receiving in-house. he also takes gabapentin . . during his hospitalization the patient and family voiced interest in home care and possible "do not hospitalize" status. a social worker will visit the family to discuss this. the patient is dnr/dni. he will receive home pt and on discharge. . # communication - is hcp ; other son (laboratory hematologist in nh); there is family discussion re change of hcp but was not part of discussion; daughter works with /hospice and would like to be contact for long-term care plans ; (home); (work) medications on admission: medications on admission: atenolol 12.5mg daily ranitidine 150mg levothyroxine 175mcg daily coumadin 3mg daily imdur 30mg daily vitamin b12 1000mcg daily morphine sulfate cr 30mg po bid colace nitroglycerin prn lasix 20-40mg daily hydroxyzine 50mg qpm norvasc 2.5mg gabapentin 300mg tid senna percocet medications on transfer: morphine iv prn (1mg) bisacodyl cipro 500mg daily levothyroxine magnesium oxide x 1 flagyl 500mg tid protonix senna coumadin 2mg hs hep subq colchicine 0.6mg daily discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. levothyroxine 175 mcg tablet sig: one (1) tablet po daily (daily). 4. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 11 days. disp:*33 tablet(s)* refills:*0* 5. ciprofloxacin 250 mg tablet sig: two (2) tablet po q24h (every 24 hours) for 11 days. disp:*22 tablet(s)* refills:*0* 6. warfarin 2 mg tablet sig: one (1) tablet po hs (at bedtime). 7. colchicine 0.6 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed. 9. gabapentin 300 mg capsule sig: one (1) capsule po q12h (every 12 hours). 10. morphine 30 mg tablet sustained release sig: one (1) tablet sustained release po q12h (every 12 hours). 11. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed. 12. hydroxyzine hcl 25 mg tablet sig: 1-2 tablets po qhs (once a day (at bedtime)). 13. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). discharge disposition: home with service facility: discharge diagnosis: primary: diarrhea likely secondary to c. diff colitis sepsis secondary: coronary artery disease stroke hypothyroidism depression chronic back pain atrial fibrillation - on coumadin sciatica and low back pain sleep apnea discharge condition: good discharge instructions: you were admitted with low blood pressure and diarrhea thought to be all related to a likely infection by c. diff which can be a complication from antibiotic use. your diarrhea resolved and you will finish a 2 week course of antibiotics. . your blood pressure medications were held during this hospitalization. please discuss with dr. at your next visit if you should restart the norvasc (amlodipine), atenolol, imdur, and lasix. . your coumadin levels (inr) were very high and it is unclear if this was secondary to your infection. you were restarted on a lower dose of your coumadin at 2mg at bedtime. you will have your blood work done by the visiting nurse and your coumadin dose adjusted as needed . you were started on colchicine 0.6 mg daily for your gout flair. please discuss with dr. if you should continue this. . your kidney function was slightly impaired on admission, likely secondary to dehydration from your diarrhea. it returned to closer to your baseline on discharge. . if you develop any concerning symptoms please contact your physician or proceed to the emergency room. followup instructions: please call your primary care physician to schedule follow-up appointment in weeks: dr. , d. . you had an appointment scheduled previously with neurology. provider: , m.d. phone: date/time: 1:30 procedure: venous catheterization, not elsewhere classified diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery acute kidney failure, unspecified unspecified septicemia unspecified acquired hypothyroidism gout, unspecified atrial fibrillation depressive disorder, not elsewhere classified hypotension, unspecified unspecified sleep apnea intestinal infection due to clostridium difficile long-term (current) use of anticoagulants dehydration lumbago other and unspecified coagulation defects 

Answer: The patient is high likely exposed to