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: no known allergies / adverse drug reactions attending: chief complaint: brbpr, llq pain major surgical or invasive procedure: sigmoidoscopy, colonoscopy, esophagoduodenoscopy history of present illness: 56m w/ hx of mitral valve repair, diverticulitis, multiple episodes of lower and upper gib presenting with 2 days of llq pain and brbpr, presenting to osh with inr of 14 on morning of admission. 2 days ago began having llq pain, sharp as knife, constant, progressive. last normal stool 2-3 days ago and have been getting darker and darker until morning of admission when llq pain was and noticed bright red blood in stool, then second stool then greenish, diarrhea, foul smelling and "coffee groundish." denied having any dizziness when standing up. called ems when pain was . had one episode of small vomitus at who which was gastroocult positive. guiaic positive. at osh got 2u ffp + vit k 10 iv. ivf. 1g ceftriaxone, protonix 80 bolus, 8/h. no recent abx use or change in coumadin dose, no recent changes in diet. no headache, no shortness of breath or chest pain. in the ed, initial vitals/trigger: 18:40 6 116 151/79 16 95% getting cont ivf, 1 more units ffp (got 2u ffp and vit k iv 1o at ),1mg iv dilaudid for llq pain (morphine not working)40meq k po, 40meq k iv, 4mg zofran, 1mg lorazepam. ct abdomen and pelvis was done. past medical history: mitral valve repair-mechanical valve hypertension s/p appendectomy lower and upper gi bleeds diverticulitis social history: lives with and takes care of his mother. at in the parking/transportation department, works nights. no tobacco, occ social etoh, no illicit drug use. family history: noncontributory physical exam: admission physical exam: general: alert, oriented, uncomfortable appearing heent: sclera anicteric, bloodshot, mmm, oropharynx clear, eomi, perrl 1-2mm neck: supple, jvp not elevated, no lad cv: tachycaric, regular, s1 + s2, mv mechanical click audible without stethoscope, heard throughout chest and abdomen, holosystolic murmur heard at lsb lungs: few right basilar crackles, left lung clear to auscultation, no wheezes, rales, ronchi abdomen: tense, distended, tenderness to percussion at llq, tenderness to light palpation at llq, bowel sounds present, unable to appreciate organomegaly due to distension, no rebound appreciated, no guarding gu: foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, grossly normal sensation, gait deferred, discharge physical exam: vs: afebrile, stable gen: alert. cooperative. no acute distress. heent/neck: perrla. eomi. mucous membranes pink/moist. lungs: clear to auscultation b/l. no wheezes or crackles cv: s1, s2 with mechanical click audible throughout. pulses equal throughout. abdomen: bs present. soft. tender to palpation over llq. no rigidity, rebound, or guarding. extremities: no pitting edema, no gross deformities, clubbing, or cyanosis. pertinent results: admission: 07:00pm blood wbc-10.3 rbc-3.69* hgb-12.6* hct-33.9* mcv-92 mch-34.3* mchc-37.2* rdw-14.4 plt ct-183 07:00pm blood pt-32.1* ptt-47.0* inr(pt)-3.1* 01:49am blood pt-20.0* inr(pt)-1.9* 07:00pm blood glucose-131* urean-14 creat-1.2 na-137 k-2.8* cl-93* hco3-29 angap-18 07:00pm blood alt-30 ast-49* alkphos-81 totbili-0.6 07:00pm blood albumin-3.8 calcium-8.5 phos-2.1* mg-1.4* 07:15pm blood lactate-4.5* 07:00pm blood lipase-42 . imaging/studies: ct-angio abdomen/pelvis : impression: 1. no evidence of active gastrointestinal bleeding. 2. numerous colonic diverticula without associated inflammatory changes. 3. small hiatal hernia. 4. mural fatty replacement of the ascending colon, suggestive of sequela of a prior inflammatory process. 5. status post mitral valve replacement. . chest x-ray : cardiac size is top normal. bibasilar opacities, larger on the left side, could be due to atelectasis but superimposed infection cannot be excluded. if any, there is a small right pleural effusion. there is elevation of the right hemidiaphragm. there is mild vascular congestion. sternal wires are aligned. patient is status post mvr. . ct-abdomen/pelvis : impression: interval development of small right greater than left pleural effusions with bibasilar subsegmental atelectasis. no acute intra-abdominal pathology identified . micro: blood culture, routine (final ): no growth. mrsa screen (final ): no mrsa isolated. fecal culture (final ): no salmonella or shigella found. campylobacter culture (final ): no campylobacter found. fecal culture - r/o e.coli 0157:h7 (final ): no e.coli 0157:h7 found. blood culture, routine (final ): no growth. c. difficile dna amplification assay (final ): negative for toxigenic c. difficile by the illumigene dna amplification assay. . pre-discharge: 08:17am blood lactate-1.0 05:25am blood wbc-6.1 rbc-3.32* hgb-10.9* hct-32.0* mcv-96 mch-32.6* mchc-33.9 rdw-15.1 plt ct-218 05:25am blood calcium-8.7 phos-2.6* mg-1.9 07:00am blood urean-9 creat-1.1 na-136 k-4.2 cl-101 hco3-24 angap-15 06:55am blood pt-14.3* ptt-76.9* inr(pt)-1.3* brief hospital course: 56 yo m with pmh mvr on coumadin, hypertension, lbig and ugib, and recurrent diverticulitis presenting with persistent left lower quadrant pain and bright red blood per rectum. active issues: # lower gib: unclear precipitant. patient was supratherapeutic on warfarin (inr 14), which was held initially. lactate was initially elevated, but trended downward. flex sigmoidoscopy was unrevealing. cta and ct-abdomen/pelvis were unrevealing. gi performed egd and colonoscopy and found diverticuli but no definitive sources of bleeding. the patient reported no signs of bleeding or melenic stools since the evening of and thereafter, his hct was stable and had been trending upward. the patient was treated with ivf and proton pump inhibitors and his bleeding remained stable for the rest of the admission. # llq pain, presumed diverticulitis: however avm vs ischemic colitis vs diverticular disease vs hemorrhoidal causes were all considered. lactate was initially elevated but was normal by time of discharge. pain was treated with dilaudid, first iv, then po. the patient had a single recorded fever during his stay, and he was started on ciprofloxacin and metronidazole for empiric treatment of a gi infection. however, c. diff and stool cultures were negative. his pain gradually improved and was at a bearable level by time of discharge. he remained afebrile the rest of his admission. # mechanical mitral valve replacment on warfarin with goal inr 2.5-3.5. given inr of 14 on admission, warfarin was held. unclear etiology for admission inr of 14 given no history of antibiotic use or changes in diet. be related to poor po intake since llq pain began. heparin drip started when inr decreased below 2, while coumadin was still being held. once the patient's gi workup was complete (as above) with no further bleeding, warfarin was restarted. the inr responded slowly so heparin drip bridging was switched to enoxaparin bridging on discharge. chronic issues: # htn: the patient's home metoprolol was initially held, but was restarted on . the patient remained clinically stable thereafter # anxiety: the patient's home diazepam was initially held and he remained clinically stable on lorazepam prn. transitional issues: 1) the patient will need follow-up of his inr to therapeutic range of 2.5-3.5 before discontinuing his enoxaparin bridging. medications on admission: warfarin 5 mg tab oral 1 tablet(s) m,w,f, warfarin 7.5 mg tab oral 1 tablet(s) tu,th,sa amlodipine 5 mg tab oral metoprolol tartrate 50 mg tab oral 1 tablet(s) twice daily diazepam 5 mg tab oral 1 tablet(s) once daily, at bedtime for sleep discharge medications: 1. enoxaparin sodium 100 mg sc q12h duration: 14 days rx *enoxaparin 100 mg/ml 1 injection every twelve (12) hours disp #*28 syringe refills:*0 2. amlodipine 5 mg po bid 3. metoprolol tartrate 50 mg po bid 4. warfarin 7.5 mg po 3x/week (tu,th,sa) 5. warfarin 5 mg po 4x/week (,mo,we,fr) 6. ciprofloxacin hcl 500 mg po q12h duration: 3 days rx *ciprofloxacin 500 mg 1 tablet(s) by mouth every twelve (12) hours disp #*7 tablet refills:*0 7. metronidazole (flagyl) 500 mg po q8h duration: 3 days rx *metronidazole 500 mg 1 tablet(s) by mouth every eight (8) hours disp #*10 tablet refills:*0 8. diazepam 5 mg po qhs 9. docusate sodium 100 mg po bid rx *docusate sodium 100 mg 1 tablet(s) by mouth twice a day disp #*60 tablet refills:*3 10. acetaminophen 1000 mg po tid rx *acetaminophen pain relief 500 mg tablet(s) by mouth q8h:prn disp #*100 tablet refills:*0 11. pantoprazole 40 mg po q24h rx *pantoprazole 40 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 12. oxycodone (immediate release) 5-10 mg po q4h:prn pain hold for rr<12 or somnolence rx *oxycodone 5 mg tablet(s) by mouth q4h:prn disp #*60 tablet refills:*0 discharge disposition: home discharge diagnosis: primary: gastrointestinal bleeding, abdominal pain secondary: diverticulosis, mechanical valve, discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , it was a pleasure to care for you at . you were transferred here because you were bleeding in your digestive tract and had abdominal pain, as well as an inr of 14. we treated you with blood products, iv fluids, pain medications, and agents to lower your inr. we also stopped your warfarin(coumadin) and started you on a heparin drip for your mechanical valve. your bleeding stopped during your admission. . to assess your bleeding and pain, we performed ct-scans of your abdomen and the gi team performed several endoscopies. unfortunately, we could not find a definitive source of your symptoms. most likely, the symptoms are related to your chronic diverticular disease (small outpouchings of your colon. it is likely these have become inflamed (diverticulitis) and bled. we are treating you for possible diverticulitis with antibiotics. we recommend that you eat a low-residue or low-fiber diet to help avoid future episodes of diverticulitis. . we restarted your warfarin (coumadin)and put you on heparin drip as we waited for your inr to return to its normal range. on your day of discharge, your inr was 1.3 and we switched you to an injectable blood thinner, called enoxaparin. it is important you take this injection every 12 hours until your inr is back within range. . please note the following changes to your medications: you should start taking ciprofloxacin (cipro) and metronidazole (flagyl) antibiotics until you finish the full course. you should start enoxaparin (lovenox) every 12 hours until your inr is between 2.5-3.5. you may continue the rest of your medications as previously prescribed. followup instructions: please followup with your pcp to check/adjust your inr and warfarin dosing: . department: primary care name: dr. monday: at 2:45 pm location: community physicians associates, inc. address: , , phone: procedure: other endoscopy of small intestine colonoscopy flexible sigmoidoscopy diagnoses: thrombocytopenia, unspecified abnormal coagulation profile unspecified essential hypertension acute posthemorrhagic anemia heart valve replaced by other means anxiety state, unspecified fever, unspecified hypoxemia esophagitis, unspecified hypovolemia unspecified gastritis and gastroduodenitis, without mention of hemorrhage diverticulitis of colon with hemorrhage internal hemorrhoids without mention of complication diverticulum of esophagus, acquired 

Answer: The patient is high likely exposed to