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: fall major surgical or invasive procedure: : hemiarthroplasty, right hip. history of present illness: 71 year old male s/p fall on resulting in a right hip fracture requiring surgical management. past medical history: niddm2, htn, hi chol, h/o tia (r hemiparesis), prostate ca s/p rads, carotid stenoses (70-79% l, 60-69% r), 1ppd smoker social history: lives with son, daughter-in-law, and three grandchildren. able to ambulate with prosthesis and cane at baseline. former smoker, quit 2 years ago, previously smoked 1 ppd x40 years. occasional beer, about once per week. no illicit drug use. family history: no family history of diabetes mellitus, hypertension, hyperlipidemia, or cancer. per reports mother deceased secondary to mi. physical exam: bp: 132/80 hr: 78 rr: 18 97%2l temp: 97.5 general evaluation exam sensorium: awake (x) awake impaired () unconscious () airway: intubated () not intubated (x) breathing: stable (x) unstable () circulation: stable (x) unstable () musculoskeletal exam neck normal (x) abnormal () comments: no tenderness over posterior scalp where pt recalls hitting it during the fall spine normal (x) abnormal () comments: clavicle r normal (x) abnormal () comments: l normal (x) abnormal () comments: shoulder r normal (x) abnormal () comments: l normal (x) abnormal () comments: arm r normal (x) abnormal () comments: l normal (x) abnormal () comments: elbow r normal (x) abnormal () comments: l normal (x) abnormal () comments: forearm r normal (x) abnormal () comments: l normal (x) abnormal () comments: wrist r normal (x) abnormal () comments: l normal (x) abnormal () comments: hand r normal (x) abnormal () comments: l normal (x) abnormal () comments: pelvis r normal (x) abnormal () comments: l normal (x) abnormal () comments: hip r normal () abnormal (x) comments: minimal tenderness with palpation over the greater trochanter. severe tenderness with internal/external rotation of the hip. no obvious brusing or skin discoloration l normal (x) abnormal () comments: thigh r normal (x) abnormal () comments: l normal (x) abnormal () comments: knee r normal (x) abnormal () comments: pt able to flex/extend knee without difficulty, minimal pain experienced in the r hip. small amount of serosang oozing from an open sore (5mm diameter) at the distal tip of rle stump l normal (x) abnormal () comments: leg l normal (x) abnormal () comments: ankle l normal (x) abnormal () comments: foot l normal (x) abnormal () comments: vascular: radial r palpable (x) non-palpable () doppler () l palpable (x) non-palpable () doppler () palpable graft pulse in lle prox and distal neuro: quad r (x) l (x) ant tib l (x) l (x) peroneal l (x) gs l (x) pertinent results: admission labs: 11:35am blood wbc-8.6# rbc-4.01* hgb-12.8* hct-36.0*# mcv-90 mch-32.0 mchc-35.5* rdw-13.6 plt ct-214 11:35am blood neuts-77.1* lymphs-16.4* monos-5.5 eos-0.6 baso-0.4 11:35am blood pt-29.7* ptt-30.0 inr(pt)-2.9* 11:35am blood glucose-189* urean-16 creat-0.8 na-140 k-4.0 cl-104 hco3-28 angap-12 ua: 11:47am urine color-yellow appear-clear sp -1.029 11:47am urine blood-tr nitrite-neg protein-75 glucose-250 ketone-tr bilirub-neg urobiln-neg ph-5.0 leuks-neg 11:47am urine rbc-0-2 wbc- bacteri-0 yeast-none epi-0-2 11:47am urine mucous-many micro: urine culture: negative blood cultures: pending imaging: brief hospital course: 71yo male with h/o pvd, htn, dmii, hl, distant prostate cancer s/p radiation who initially presented from osh on with right displaced femoral neck fracture, s/p right hip hemiarthroplasty on and was subsequently transferred to micu on pod #2 in setting of somnolence, tachycardia, and desaturations most likely to narcotic pain medication administration and aspiration pneumonia. . #. pneumonia: cxr showed rll opacity concerning for pneumonia, and cta chest confirmed widespread patchy opacities throughout the right upper lobe and both lower lobes c/w bronchopneumonia. most likely hap vs. aspiration pna in setting of somnolence after receiving increased doses of narcotic pain medication. started on broad spectrum antibiotics with vanc/cefepime and flagyl added on . blood cultures were negative. pt will resume antibiotics for a total 8 day course, to be continued through: friday, . . #. r displaced femoral neck fracture s/p r hip hemiarthroplasty: patient sustained right displaced femoral neck fracture, and underwent r hip hemiarthroplasty on . pain controlled on low dose narcotics given his sensitivity to narcotics. he was given acetaminophen 1gm q 6hrs, oxycodone 2.5mg q 6h and morphine 0.5mg iv as needed. pt will follow up with ortho outpatient. . #. tachycardia/a. fib: during hospital stay, pt had intermittent sinus tachycardia as well as intermittent afib with rvr to as high as 170s-190s. on bb and dilt which controlled his rate. was discharged on metoprolol succ 150 daily, diltiazem 120mg long acting, daily. pt was in nsr with hr in 80 at time of discharge. he was anticoagulated with coumadin. coumadin was initially held for surgery and was restarted on . he is also being anticoagulated with prophylactic dose of lovenox 40mg daily. pt should continue both lovenox 40mg daily and coumadin 2.5mg daily for goal inr 1.8-2.5. after pt completes his 30 day course of lovenox, his new inr goal should be (standard inr goal for a fib). pt should follow up with ortho to decide when to stop the lovenox (it will likely be 30 days). . #. anemia: hct noted to drop from 28.2 to 21.5 on likely in setting of gi lossess while on heparin drip. baseline hct was 36 prior to admission presentation. s/p transfusion 2 units prbcs on , with improvement and subsequent stabilization of hct. heparin drip was d/c-ed since neg ctpa for pe. patient's downward trend in hct also in setting of recent hip surgery. prior to discharge, he had stool guiac test which was negative. *will need gi workup outpatient for hct drop. needs colonoscopy and possibly endoscopy. per pt, he has not had any colonscopies. told pt to follow up with his pcp to organize this. . #. delirium: waxing and mental status while in icu. delirium likely multifactorial, in setting of infection, pain, narcotic pain medication administration, and hospitalization. also have been related to constipation. pt was given aggressive bowel regimen. had no further episodes of delerium after leaving the icu. rpr negative, ua showed no signs of infection, tsh and b12 wnl. . #. htn: continued metoprolol and diltiazem. . #. diabetes mellitus type 2: continued insulin s/s. diabetic diet. . #. hyperlipidemia: continued simvastatin 80mg daily. . #. h/o tia: continued asa, statin. . #fen: heart healthy/diabetic diet, replete electrolytes prn . #prophylaxis: dvt ppx with enoxaparin 40mg sc daily (per ortho protocol) as well as coumadin 2.5mg daily. goal inr 1.8-2.5. medications on admission: citalopram 20mg qd gabapentin 100mg tid xr 2.5mg metoprolol 25mg simvastatin 80mg qd warfarin 2.5mg qd asa 81mg discharge medications: 1. enoxaparin 40 mg/0.4 ml syringe sig: one (1) syringe subcutaneous qhs (once a day (at bedtime)) for 4 weeks. 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 4. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed): followed insuline sliding scale while in hospital. takes 12.5 at home. 5. acetaminophen 325 mg tablet sig: three (3) tablet po q6h (every 6 hours). 6. diltia xt 120 mg capsule,degradable cnt release sig: one (1) capsule,degradable cnt release po once a day. 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. oxycodone 5 mg tablet sig: 0.5 tablet po q6h (every 6 hours): wean as pt's pain improves. 10. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po daily (daily) as needed for constipation. 11. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 12. metronidazole 500 mg tablet sig: one (1) tablet po q8h (every 8 hours) for 3 days: continue through and then stop. 13. multivitamin tablet sig: one (1) tablet po daily (daily). 14. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 15. metoprolol succinate 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day: take total of 150mg daily. 16. metoprolol succinate 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day: take total of 150mg daily. 17. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 18. warfarin 2.5 mg tablet sig: one (1) tablet po once daily at 4 pm: goal inr 1.8-2.5 until lovenox is completed (30 days after surgery). then inr goal is . 19. enoxaparin 40 mg/0.4 ml syringe sig: one (1) subcutaneous daily (daily): continue for 30 days after surgery. 20. cefepime 2 g iv q12h 21. vancomycin 1000 mg iv q 12h 22. morphine sulfate 0.5 mg iv q2h:prn prior to moving please hold for sedation or rr <12 discharge disposition: extended care facility: rehabilitation and nursing of discharge diagnosis: 1. right hip fracture 2. aspiration pneumonia 3. anemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the hospital for a femur (hip bone) fracture. you had a procedure done to fix the bone. below are the reccomendations from the orthopedic doctors: wound care: -keep incision dry. -do not soak the incision in a bath or pool. activity: -continue to be non weight bearing on your right leg and full weight bearing on your left leg. other instructions - resume your regular diet. - avoid nicotine products to optimize healing. - resume your home medications. take all medications as instructed. - continue taking the lovenox to prevent blood clots. - you were found to be very sensitive to narcotic medications. please take as small a dose as you can tolerate. narcotic pain medication may cause drowsiness. do not drink alcohol while taking narcotic medications. do not operate any motor vehicle or machinery while taking narcotic pain medications. taking more than recommended may cause serious breathing problems. if you have questions, concerns or experience any of the below danger signs then please call your doctor at or go to your local emergency room. during this hospitalization, you were noted to have a drop on your hematocrit (anemia) that was thought initially to be due to a gut source. it is important to follow this up with your primary care doctor and a gastroenterologist. you say that you have never had a colonoscopy, it is very important to get one within the next few months. during this admission, you were also found to have a pneumonia, thought likely due to aspiration when you were on narcotics. you were treated with antibiotics. please continue to take antibiotics for a total 8 day course. after talking to the vascular surgeons, the decision was made to restart your coumadin to protect your body from clots. your goal inr is 1.8-2.5 while you are on the 30 day course of lovenox. after you complete the lovenox, resume the coumadin for a goal inr . you heart rate was found to be fast occasionally. we increased your medications to protect your heart and prevent it from going to fast. the following changes were made to your medications: stop gabapentin 100mg tid. you may resume this in rehab or with your primary care doctor. 12.5 twice a day. you may resume then in rehab or with your primary care doctor. while in the hospital or rehab you may get insulin sliding scale. it is very important to resume this after you leave rehab. the rehab facility may wish to start this while you are there. change: metoprolol 25mg twice a day--> metoprolol succinate 150mg daily. start: lovenox 40mg inject yourself once a day for an entire month. follow up with the orthopedic doctors to determine when to stop this. continue: couamdin 2.5mg daily. your new inr goal is 1.8-2.5 while you are also taking lovenox. when you stop the lovenox, you may resume your regular coumadin for the goal inr . start: diltiazem 120mg daily (long acting) start: vancomycin 1,000mg , cefepine 2g , flagyl 500mg tid, last day is on . start: pantoprazole 40mg daily start: thiamine 100 units daily start:oxycodone 2.5mg every 6 hrs start: morphine sulfate 0.5mg iv as needed every 2 hrs for pain followup instructions: you have an orthopedic appointment scheduled below. you may need to make another follow up after the below date. department: orthopedics when: thursday at 8:40 am with: ortho xray (scc 2) building: sc clinical ctr campus: east best parking: garage department: orthopedics when: thursday at 9:00 am with: , np building: campus: east best parking: garage we reccomend you follow up with a gastoenterologist to work up blood loss from the gut. you will likely need a colonoscopy or endoscopy. please discuss this with your primary care doctor to arrange this. department: vascular surgery when: thursday at 1 pm with: vascular lab building: lm campus: west best parking: garage department: vascular surgery when: thursday at 1:45 pm with: , md building: lm campus: west best parking: garage procedure: partial hip replacement diagnoses: unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation peripheral vascular disease, unspecified personal history of tobacco use occlusion and stenosis of carotid artery without mention of cerebral infarction other and unspecified hyperlipidemia acute respiratory failure pneumonitis due to inhalation of food or vomitus long-term (current) use of insulin personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits hypoxemia hemorrhage of gastrointestinal tract, unspecified accidents occurring in residential institution fall from other slipping, tripping, or stumbling below knee amputation status other alteration of consciousness closed fracture of unspecified part of neck of femur poisoning by other specified analgesics and antipyretics accidental poisoning by other specified analgesics and antipyretics 

Answer: The patient is high likely exposed to