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: fevers, hypotension major surgical or invasive procedure: esophagastroduodenoscopy history of present illness: the patient opcabg x 4 on . post-op course was lengthy and complicated. he initially was hemodynamically unstable, requiring vasopressor support. ep saw the patient for ventricular ectopy. ppm/aicd was not recommended. he continued to be bradycardic, and would receive a temporary pacer. this was removed, ep did not feel a ppm was indicated. he developed a sternal wound infection and was taken to the operating room by plastic and reconstructive surgery for sternal plating and bilateral pectoralis flaps. the patient required re-intubation several times during the hospital course, and eventually received a trach and peg on . evh site was debrided, and he received a 10 day course of vancomycin. he was transferred to rehab on pod 45, . he returned on with fever and hypotension. during this hospitalization he was found to have cdiff in the stool and was placed on appropriate antibiotics. his hypotension resolved past medical history: coronary artery disease s/p off pump coronary artery bypass grafts respiratory failure- s/p tracheostomy/peg loculated left sided pleural effusion s/p pigtail toracentesis sternal dehiscence s/p sternal debridement,plating,pectoral flap advancement endoscopic vein harvest infection decubitus ulcer ischemic cardiomyopathy chronic atrial fibrillation peripheral vascular disease hypertension chronic obstructive pulmonary disease hypercholesterolemia social history: family history: race: caucasian last dental exam: edentulous lives with: wife (in-law apartment- daughter +fam live nearby) uses canadian crutches for ambulation ( oa of knees) occupation: retired tobacco: 1ppd x 64yrs. etoh: occasional family history: there is no family history of premature coronary artery disease or sudden death. physical exam: vs - t 102.6, 93/50, hr 70's (atrial fibrillation, vent - simv tv 500, fio2 50% rate 14 peep 10 gen: eldery male, ill appearing heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: no clear jvd cv: pmi located in 5th intercostal space, midclavicular line. irregularly irregular. normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: wheezing b/l. sternum stable abd: distended, patient does not react to deep palpation ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: gj tube check. one view of the abdomen. there is motion artifact. contrast material has been injected via a gastrostomy tube. contrast has accumulated in a small area in the left upper quadrant, presumably within the gastric lumen. the bowel gas pattern is not remarkable. there are degenerative changes in the lumbar spine. impression: limited study demonstrating findings consistent with placement of the gastrostomy tube in the stomach. see procedure note. admission: 08:45pm urine rbc-* wbc-0-2 bacteria-few yeast-none epi- 08:45pm urine blood-lg nitrite-neg protein-25 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-tr 08:45pm pt-13.4 ptt-26.7 inr(pt)-1.1 08:45pm plt count-345 08:45pm wbc-14.3*# rbc-3.46* hgb-10.5* hct-32.3* mcv-93 mch-30.3 mchc-32.5 rdw-16.5* 08:45pm calcium-9.3 phosphate-4.9* magnesium-2.5 08:45pm ctropnt-0.11* 08:45pm lipase-107* 08:45pm alt(sgpt)-67* ast(sgot)-158* ld(ldh)-327* alk phos-241* amylase-97 tot bili-1.2 08:45pm glucose-135* urea n-74* creat-1.3* sodium-142 potassium-4.2 chloride-109* total co2-22 anion gap-15 08:51pm lactate-1.2 k+-4.1 discharge: 02:54am blood wbc-8.8 rbc-2.86* hgb-8.6* hct-26.4* mcv-93 mch-30.1 mchc-32.5 rdw-17.6* plt ct-228 02:54am blood plt ct-228 03:17am blood pt-14.1* ptt-29.8 inr(pt)-1.2* 02:54am blood glucose-86 urean-36* creat-1.0 na-144 k-4.4 cl-112* hco3-22 angap-14 03:59am blood alt-24 ast-23 alkphos-124 amylase-53 totbili-1.3 01:36am blood lipase-38 5:00 am stool consistency: watery source: stool. **final report ** clostridium difficile toxin a & b test (final ): reported by phone to ,d @ 16:19, . clostridium difficile. feces positive for c. difficile toxin by eia. (reference range-negative). radiology report chest (portable ap) study date of 10:34 am medical condition: 83 year old man s/p cabg reason for this examination: eval for pleural effusions final report reason for examination: evaluation of the patient after cabg for pleural effusions. portable ap chest radiograph was compared to . tracheostomy tube is in the midline, approximately 7.5 cm above the carina. there is no change in the sternal fixation devices appearance. cardiomegaly is severe. retrocardiac consolidations are bilateral, accompanied by bilateral pleural effusions. there is no interval worsening of the overall appearance of the chest. dr. brief hospital course: the patient was admitted for workup and management of fever and hypotension. he was empirically treated with vancomycin and zosyn. there was question of malposition of g-tube on ct scan, so urgent egd was performed. tube was re-positioned without complication. contrast study was negative for extravasation. tube feeds were resumed. wound care was consulted for evaluation of pressure ulcer (present prior to admission). pan cultured for fever workup, sputum culture would grow gram negative rods and stool was positive for c-diff. the patient was treated with flagyl and zosyn. after several days on flagyl the patient continue to have watery stool and po vancomycin was added for treatment of cdiff infection. pulmonary status remains tenuous, attempts to wean ventilator to pressure support ventilation with 5 peep and 5 pressure support were unsucessful. the patient would quickly have an episode of tachypnea requiring increased pressure support. interventional pulmonary was consulted, an ultrasound of pleural space showed small loculated effusion that was not amendable to drainage. on hospital day 10 the patient was transferred to rehabilitation at -. medications on admission: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for temperature >38.0. 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po daily (daily) as needed for constipation. 4. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 5. dorzolamide 2 % drops sig: one (1) drop ophthalmic (2 times a day). 6. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po daily (daily) as needed for constipation. 7. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 8. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 9. simvastatin 10 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)). 10. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 11. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 12. chlorhexidine gluconate 0.12 % mouthwash sig: one (1) ml mucous membrane (2 times a day). 13. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: puffs inhalation q4h (every 4 hours). 14. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 4-8 puffs inhalation q4h (every 4 hours) as needed for wheezing. 15. ranitidine hcl 15 mg/ml syrup sig: one (1) po daily (daily). 16. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 17. hydralazine 50 mg tablet sig: one (1) tablet po q6h (every 6 hours). 18. clonidine 0.3 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qtues (every tuesday). 19. hydralazine 20 mg/ml solution sig: one (1) injection q6h (every 6 hours) as needed for sbp>130. 20. heparin, porcine (pf) 10 unit/ml syringe sig: one (1) ml intravenous prn (as needed) as needed for line flush. 21. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). 22. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed for thrush. 23. beclomethasone dipropionate 80 mcg/actuation aerosol sig: four (4) puff inhalation (2 times a day) as needed for copd. 24. vancomycin 1,000 mg recon soln sig: one (1) intravenous twice a day for 10 days. discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day) as needed for prophylaxis. 2. dorzolamide 2 % drops sig: one (1) drop ophthalmic (2 times a day) as needed for ----. 3. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day) as needed for prevent thrush. 4. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 6-10 puffs inhalation q4h (every 4 hours). 5. ipratropium bromide 17 mcg/actuation hfa aerosol inhaler sig: six (6) puff inhalation q4h (every 4 hours). 6. beclomethasone dipropionate 80 mcg/actuation aerosol sig: one (1) inhalation (). 7. collagenase clostridium hist. 250 unit/g ointment sig: one (1) appl topical daily (daily): to decub. 8. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 9. acetaminophen 650 mg/20.3 ml solution sig: one (1) po q 8h (every 8 hours). 10. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day): hold sbp<100 hr<60. 11. metronidazole 500 mg tablet sig: one (1) tablet po q8h (every 8 hours) for 14 days: end date . 12. vancomycin 125 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 14 days: end date . disp:*qs capsule(s)* refills:*0* 13. quetiapine 25 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). tablet(s) 14. pepcid 20 mg tablet sig: one (1) tablet po once a day. 15. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). 16. chlorhexidine gluconate 0.12 % mouthwash sig: fifteen (15) ml mucous membrane (2 times a day). 17. sodium chloride 0.9 % 0.9 % parenteral solution sig: sodium chloride 0.9% flush 10 ml iv prn line flush intravenous daily and prn: sodium chloride 0.9% flush 10 ml iv prn line flush temporary central access-icu: flush with 10ml normal saline daily and prn. . 18. furosemide 10 mg/ml solution sig: twenty (20) mg injection once a day. discharge disposition: extended care facility: tcu - discharge diagnosis: coronary artery disease s/p off pump coronary artery bypass grafts respiratory failure- s/p tracheostomy/peg loculated left sided pleural effusion s/p pigtail toracentesis sternal dehiscence s/p sternal debridement,plating,pectoral flap advancement endoscopic vein harvest infection decubitus ulcer ischemic cardiomyopathy chronic atrial fibrillation peripheral vascular disease hypertension chronic obstructive pulmonary disease hypercholesterolemia discharge condition: tracks, moves upper extremities incisional pain managed with tylenol incisions: sternal - healing well, no erythema or drainage left lower leg endoscopic vein site open->pack wet to dry discharge instructions: 1) please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage 2) please no lotions, cream, powder, or ointments to incisions 3) each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart 4) no driving for approximately one month until follow up with surgeon 5) no lifting more than 10 pounds for 10 weeks 6) please call with any questions or concerns **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments surgeon: dr. () on at 1:00pm please call to schedule appointments: primary care: dr. (in weeks cardiologist dr. () in weeks plastic surgery: dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** md procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more other gastroscopy arterial catheterization diagnoses: anemia, unspecified pure hypercholesterolemia unspecified pleural effusion unspecified essential hypertension chronic airway obstruction, not elsewhere classified atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status peripheral vascular disease, unspecified other specified forms of chronic ischemic heart disease acute respiratory failure intestinal infection due to clostridium difficile pressure ulcer, lower back tracheostomy status pressure ulcer, unstageable 

Answer: The patient is high likely exposed to