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: penicillins / oxycodone attending: chief complaint: bright red blood in stool x 3 days major surgical or invasive procedure: findings: colonoscopy protruding lesions a single 8mm non-bleeding polyp was found in the rectosigmoid junction. impressions: polyp in the rectosigmoid junction recommendations: will need repeat colonoscopy tomorrow with full golytely preparation (+/- polyp excision). ok to anticoagulate with heparin tonight; please contact gi fellow to determine time of procedure tomorrow. egd findings: esophagus: lumen: a schatzki's ring was found in the lower third of the esophagus at the top of the patient's hiatal hernia. a medium size hiatal hernia was seen. stomach: normal stomach duodenum: other bile noted in the duodenum: no blood observed. impressions: medium hiatal hernia schatzki''s ring otherwise normal egd to second part of the duodenum history of present illness: 52 year old woman with h/o aortic valve endocarditis s/p replacement with embolic cva, hepatitis c, chronic venous stasis ulcers, and multiple gi bleeds in past with negative work up who came to the ed on with 3 days of bright red blood per rectum with bowel movements. she reported bms per day. pt was tolerating pos but noted mild decrease in appetite. she denied melena, abdominal pain, hemoptysis, hematemesis. she denied chest pain, palpitations but did note one episode of shortness of breath. the patient has a history of gib in past while on coumadin for anticoagulation and has had an extensive negative workup for a source of the bleed. labs have revealed an iron deficiency anemia and intermittent guaic positive stools but egd x2(98/99) have revealed only gastritis and a single non-bleeding diverticulum in middle third of esophagus. the patient has also had negative colonoscopy x2 and a negative angiogram in . bleeding thought to be secondary to small avm (although never visualized) and empiric estrogen, ex-lap/intraop enteroscopy have also been entertained in the past. past medical history: past medical history: 1. st. aortic valve replacement in . 2. history of endocarditis (staph, strep, candidal) 3. history of hepatitis c. 4. peripheral vascular disease with nonhealing le ulcers. 5. cerebrovascular disease. 6. hypertension. 7. reflux disease. 8. anemia. 9. coronary artery bypass graft in . 10. history of gastrointestinal bleed (-) colonoscopy x2; (-) angio in . brief hospital course: in the ed, the patients hct was 21, she was given 6u prbc and a right cordis was placed. she was hemodynamically stable and transferred to the icu where she was hemodynamically stable and her hematocrit remained stable x 1 d before she was transferred to the floor. a/p 52 yo female with h/o aortic valve endocarditis s/p replacemnet, cva, hep c, chronic leg ulcers, and history of multiple gi bleeds with (-) workup presents with brbrp. hct found to be 21.2 on admission. 1. gi bleed pt with hct of 21.2 on admission. in ed received 1 u prbcs and patient received another unit when transferred to the . on the floors, hct was initially checked tid, then ; it was stable (33-36) from . she was treated with pantoprazole 40 mg po and remained npo and on maintenance intravenous fluids. she was maintained on heparin during this time for her prosthetic valve. on she was given subcutaneous vitamin k to reverse her coumadin induced anticoagulated state. on , she was given 4 u ffp before undergoing an egd which showed a hiatal hernia and schatski's ring, but no source of bleeding. she also had a colonoscopy which was limited by the patient having stool throughout her colon. during the limited study, a sigmoid polyp was found but no removal was completed secondary to the excessive stool. she refused to drink more go-lytely for a repeat colonoscopy so she underwent a pill endoscopy on which showed bright red blood and clots in stomach; no active bleeding site was found from esophagus to cecum. on , she had a repeat egd to reevaluate for the source of bleeding. it showed a single non-bleeding diverticulum in the middle third of the esophagus and erythema associated with gastritis. no source of bleeding was identified. her hematocrit remained stable during this time and she had no bloody stools after . 2. heart valve pt has a aortic valve. she is on coumadin 2.5 mg qhs at home.her therapeutic inr is 2.5-3.5. on admission, the patient was actively bleeding. the risks of further gi bleeding versus the need for anticoagulation were weighed and it was decided that she needed anticoagulation so her coumadin was held and she was started on heparin. on , her coumadin was restarted at 3 mg qhs for 3 doses. her inr was 2.5 on discharge and she was sent home on her home dose of coumadin 2.5 mg qhs. she will follow up with for anticoagulation and inr on . 3. cad/chf on admission the patient was treated with intravenous fluids. her lasix was held secondary to her gi bleed and dehydrated state. on , she received ivfs plus iv antibiotics plus 4u ffp and developed some pulmonary edema and shortness of breath. she was treated with 20 mg iv lasix x 2 and the edema and shortness of breath resolved. she was restarted on her home dose of 40 mg lasix po and did not develop further shortness of breath or pulmonary edema with this dose. 4. endocarditis pt with history of fungal endocarditis, she was maintained on her fluconazole prophylaxis. 5. htn - on her enalapril was restarted at her home dose. her blood pressures were controlled on the enalapril. 6. leg ulcers - she was seen by vascular surgery who noted that there was no change in her previous left leg ulcer. she was continued with wet--> dry dressing changes qd and percoset as needed for the pain. 7. methadone maintainance - she was maintained on her home dose of 40 mg methadone po qd. she will be followed by the vna for her methadone dose as an o/p. 8. low magnesium - her magnesium was 1.5-1.7 throughout the admission. she was repleted as needed. she did not want any new medications to go home on, but as an outpatient a magnesium supplement should be considered. medications on admission: 4x 4 gauze 1--4" x 4" gauze for wound care-use as directed by skin care team acetaminophen 500mg-- by mouth every day as needed for pain compression stockings --use daily for peripheral edema. dx: venous stasis ulcer coumadin 2.5mg--as directed by md enalapril maleate 5mg--take one tablet every day ensure --as directed, 2 cans every day as tolerated flonase 50mcg--2 sprays each in the morning every day fluconazole 200 mg--one by mouth twice a day furosemide 40 mg--one tablet by mouth every morning kerlix 2.25"x108"--use as directed by skin care team methadone hcl 10mg--40mg per program normal saline 0.9%--use as directed by skin care team protonix 40mg--one every day roxicet 5-325mg--one by mouth twice a day as needed for pain tegretol xr 200mg--take one tablet by mouth twice a day discharge medications: 1. enalapril maleate 5 mg tablet sig: one (1) tablet po qd (once a day). 2. carbamazepine 200 mg tablet sustained release 12hr sig: one (1) tablet sustained release 12hr po bid (). 3. fluconazole 200 mg tablet sig: one (1) tablet po bid (2 times a day). 4. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. disp:*60 tablet(s)* refills:*0* 5. beclomethasone diprop monohyd 0.042 % aerosol, spray sig: two (2) spray nasal (2 times a day). 6. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po qid (4 times a day) as needed. 7. methadone hcl 40 mg tablet, soluble sig: one (1) tablet, soluble po qd (once a day). 8. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 9. furosemide 40 mg tablet sig: one (1) tablet po qd (once a day). 10. warfarin sodium 2.5 mg tablet sig: one (1) tablet po at bedtime for 1 doses. disp:*20 tablet(s)* refills:*0* discharge disposition: home with service facility: gentiva/ discharge diagnosis: acute gastrointestinal bleed congestive heart failure mitral regurgitation st. aortic valve discharge condition: good discharge instructions: please go to the emergency room if you have bloody stools, melena, increasing nausea, vomiting, abdominal pain, coughing up blood. you should have your inr checked at the on tuesday, . please follow up with dr. in gastroenterology for a colonoscopy and sigmoid polyp removal (appointment below). you should follow-up with the clinic for a colonoscopy and evaluation of sigmoid polyp removal. followup instructions: provider: , where: phone: date/time: 10:00 provider: , medical unit where: phone: date/time: 11:00 provider: , where: phone: date/time: 1:40 provider: where: medical specialties phone: date/time: 2:40 procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine colonoscopy transfusion of packed cells diagnoses: thrombocytopenia, unspecified congestive heart failure, unspecified chronic hepatitis c without mention of hepatic coma iron deficiency anemia secondary to blood loss (chronic) other convulsions cachexia hemorrhage of gastrointestinal tract, unspecified benign neoplasm of colon ulcer of other part of lower limb 

Answer: The patient is high likely exposed to