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: history of present illness: the patient is an 83-year-old male with multiple medical problems, including congestive heart failure with an ejection fraction of 20%, end stage renal disease requiring hemodialysis, diabetes type 2, coronary artery disease status post coronary artery bypass graft, and status post replacement of left hip. the patient presented to the emergency department on the after being noted by his caretakers at rehabilitation home to have decreased mental status and lethargy per wife and per caregivers at the rehabilitation facility. the patient was also desaturating on room air into the 70% range, and was brought into the emergency department for evaluation. in the emergency department, the patient was found on examination to have grossly melanotic stools, which were guaiac positive. a hematocrit drop was also noted in the emergency department from 37.7, the patient's baseline, to 19.3. also of note, the patient had a supratherapeutic inr of 4.2. he was on deep venous thrombosis prophylaxis status post a left hip replacement. in the emergency department, the patient was transfused packed red blood cells, was given fresh frozen plasma, vitamin k, and ddavp. he was transferred to the medical intensive care unit for further management. physical examination: in the medical intensive care unit, the patient was noted to have vital signs of a temperature of 96.8, blood pressure 110/47, pulse 110, respiratory rate 18, oxygen saturation 96% on 6 liters by nasal cannula. he was found to be an elderly gentleman, chronically ill-appearing, with a flat affect. head, eyes, ears, nose and throat examination: pupils equal, round and reactive to light and accommodation. there was no lymphadenopathy, and the neck was supple. on heart examination, he was noted to have a systolic ejection murmur, ii/vi, at the right upper sternal border. lung examination: decreased breath sounds at the bases, with soft crackles. abdomen: soft, tender to deep palpation, with positive bowel sounds. extremities: there was no cyanosis, clubbing or edema. on neurological examination, the patient was irritable, but was alert and oriented x 3. he was unable to follow commands. rectal examination showed black stool that was guaiac positive. laboratory data: white count 8.3, hematocrit 19.3, platelets 459. chemistries: sodium 141, potassium 4.5, chloride 104, bicarbonate 24, bun 65, creatinine 4.7, with a blood sugar of 166. the patient's first troponin came back elevated at 26. electrocardiogram showed sinus tachycardia with a rate of 118, right axis, right bundle branch block, a q wave in the inferior leads, and st depressions in the anterior and lateral leads. a chest x-ray was done that showed a perihilar haziness and early signs of cardiac heart failure. assessment: the patient had a gastrointestinal bleed and was experiencing cardiac demand ischemia secondary to hypotension and anemia. hospital course: on the morning of the 28th, the patient required intubation for respiratory failure secondary to cardiac failure. 1. cardiovascular: the patient required pressors to maintain adequate blood pressure from the 27th until the 30th. the patient was first placed on dopamine, but became tachycardiac, so was switched to neo-synephrine, which was then switched to levophed. the patient did have active ischemia, however, after consulting with cardiology and discussing treatment options, it was decided not to anticoagulate the patient as he had an active gastrointestinal bleed. the patient was placed on aspirin as part of a cardiac regimen, however, he was not started on a beta blocker or an ace inhibitor with the issue of hypotension. as stated, the pressors were discontinued on the 30th, and the patient maintained adequate pressure with systolic pressures 100 and above, and was transferred to the floor with a stable cardiac status. his troponin level did continue to decline to a level of 12. it had risen to above 50. 2. renal: the patient was started on cvvh dialysis as it was felt by renal that he could not tolerate hemodialysis because of his hypotension and need for pressure support. he received cvvh on the 29th, and then he received hemodialysis on the 31st and again on the 2nd, prior to his discharge from the medical intensive care unit to the floor. he remained stable from a renal standpoint. 3. pulmonary: the patient was intubated, as stated previously, on the morning of the 28th. he was weaned and extubated on the , did very well from a pulmonary standpoint, maintaining saturations of 97 to 100% on 2 liters nasal cannula status post extubation. 4. gastrointestinal: the gastroenterology fellow was very involved in the patient's care. it was decided not to scope the patient during this acute illness, as he was unstable clinically. gastroenterology has already made plans to follow up with the patient on an outpatient basis. the patient's hematocrit remained stable throughout his stay in the medical intensive care unit. he still had guaiac positive stools, but was not actively bleeding. 5. infectious disease: the patient remained afebrile during his course. he never had an elevated white blood count. blood cultures did come back with bacterium diphtheroids, which was felt to be a contaminant. sputum cultures came back with methicillin resistant staphylococcus aureus, however, this was felt to be a colonization secondary to intubation, as the patient had no white count, again was afebrile, clinically showed no signs of pulmonary infection, and had no evidence of an infiltrate on chest x-ray. the patient was placed on methicillin resistant staphylococcus aureus precautions. 6. neurology: the patient was noticed to have decreased attention and a flat affect on initial presentation to the medical intensive care unit. after being intubated, this obviously could not be assessed. once the patient was extubated on the 31st, he had much improvement in his mental status. he was alert and oriented x 3, able to respond to commands appropriately, able to carry on abbreviated conversations. 7. endocrine: the patient is a known diabetic. he takes oral glyburide as an outpatient. while in the unit, he was maintained on a regular insulin sliding scale and did well on this. 8. nutrition: the patient was initially nothing by mouth. when the bleeding was stabilized, the patient was placed on tube feeds. after extubation, the patient tolerated oral intake very well, eating three meals a day before he was transferred to the floor. the patient was prophylaxed with protonix intravenously, and then prevacid per nasogastric tube. he was also given heparin subcutaneously. 9. code status: full. a discussion was held with the entire medical intensive care unit team, including the attending, myself, resident, and the patient's wife, regarding the patient's code status on the . also a social worker was present. the goal of this meeting was to make sure the wife understood the grave nature of the medical status and each medical issue was discussed in depth with the patient's wife so that she had a good understanding of his cardiovascular status, his renal status, his pulmonary status, etc. code status was addressed as to what the patient's wife thought the patient would want. the patient's wife believed that the patient would wish to remain full code, however, the patient's wife will discuss code status again with the social worker and with the rest of her extended family, including nieces and nephews who are involved in the patient's care along with the wife. disposition: the patient was transferred to cc7, , on the . the patient is to be discharged on the to facility in , . discharge status: stable. discharge diagnosis: 1. end stage renal disease requiring hemodialysis 2. heart failure 3. diabetes , m.d. dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis diagnoses: other primary cardiomyopathies congestive heart failure, unspecified acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute respiratory failure old myocardial infarction hemorrhage of gastrointestinal tract, unspecified acute myocardial infarction of unspecified site, initial episode of care 

Answer: The patient is high likely exposed to