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: coumadin attending: chief complaint: gi bleed major surgical or invasive procedure: egd colonoscopy history of present illness: 80m w pmh of recent bioprosthetic mvr 6 weeks ago presents with painless rectal bleeding x1. at 12am overnight, pt got up to urinate. he felt a sudden urge to have bm. he had large loose stool followed by bright red blood. pt filled toilet with blood and some on the floor. he felt weak and his wife lowered him to the floor. he was unable to clean himself. his wife called ems. during this time he denied having abdominal pain, cp, sob. in the ed, vs t97.4, bp 136/80 hr 86 rr 18 99%ra. he had no abdominal tenderness on exam. small clots noted on rectal exam with no evidence of hemorrhoids. hct was 31.7. stool guaiac positive red, purplish color. 2 large bore pivs were placed. patient was type and crossmatched for 2 units and given 1l ivfs. past medical history: hypertension hyperlipidemia diverticulosis gastroesophageal reflux disease thyromegaly raynaud's phenomenon prostate cancer s/p prostatectomy osteoarthritis s/p right total hip replacement s/p left shoulder replacement s/p tonsillectomy s/p cataract surgery s/p mvr with bioprosthetic valve social history: lives with:wife occupation:retired investment manager tobacco:quit ; 1 ppd x 25 yrs etoh:couple of drinks/day; no history of withdrawal including last admission active walking, working out daily family history: n/c physical exam: vitals: t:afebrile bp: 152/94 p:95 r: 18 o2: 100ra general: alert, oriented, no acute distress lying in bed heent: sclera anicteric, dry mm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops; midline sternotomy scar well healed abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or pertinent results: 01:15am pt-12.1 ptt-23.2 inr(pt)-1.0 01:15am plt count-385# 01:15am neuts-65.2 lymphs-20.3 monos-5.7 eos-8.0* basos-0.8 01:15am wbc-4.9 rbc-3.89* hgb-10.1* hct-31.7* mcv-82 mch-26.1* mchc-32.0 rdw-16.3* 01:15am glucose-114* urea n-11 creat-0.7 sodium-137 potassium-4.2 chloride-102 total co2-24 anion gap-15 04:36pm hct-26.3* 07:10am blood wbc-6.4 rbc-3.63* hgb-10.7* hct-30.3* mcv-83 mch-29.5 mchc-35.3* rdw-16.0* plt ct-267 brief hospital course: 80 year old male with pmh of htn and s/p bioprosthetic mvr who initially presented with acute blood loss anemia. 1. gi bleed: admitted after an episode of painless hematochezia at home. initially, the patient was treated with fluid resuscitation and iv ppi. the patient's b-blocker and aspirin were stopped and serial hematocrit was monitored every 6 hours, pending stabilization of bleed. on first day of hospitalization, patient developed frank hematochezia and became hypotensive with sbp in 70s-80s. transferred to the micu for further stabilization in consultation with ir and general surgery. in total, the patient received 8 uprbc, 5 units ns and 2 units ffp. serum electrolytes, especially calcium were monitored carefully and repleted as necessary with massive transfusion requirement. hct stabilized in the 27s. the patient was taken to angiography on the evening of but celiac, sma and arteriograms were within normal limits. endoscopy was within normal limits on . colonoscopy on showed diverticulosis in the entire colon, blood in the mid ascending colon through sigmoid colon and no evidence of active bleed. on the morning of , patient had another drop in hct to 24 and was transfused another uprbcs. he remained hemodynamically stable without further melena or hematochezia and was transferred to floor for further management. on the medicine floor, the patient was observed for an additional 48 hours with serial hematocrits every 12 hours. aspirin was held indefinitely and his b-blocker was restarted (initially at a lower dose). he had no evidence of active bleed (guiac negative stool) or symptoms of anemia. prior to discharge, hct was 30.3. follow up with gi for presumed diverticular bleed was arranged as outpatient. 2. s/p mvr: stable 3. htn: as above, the patient's b-blocker was initially held in the setting of his acute bleed. once hematocrit had stabilized and the patient had no further evidence of active diverticular bleeding, metoprolol was started at a reduced dose of 12.5mg . by time of discharge, patient was on home medication regimen of metoprolol 25mg 4. hyperlipidemia: stable, continued on statin throughout hospitalization 5. gerd: stable, not on medications at home medications on admission: 1. aspirin 325 mg (e.c.) po daily 2. lovastatin 20 mg po daily 3. metoprolol tartrate 25 mg po bid 4. metamucil prn 5. centrum silver 6. n acetylcysteine (supplement) discharge medications: 1. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 2. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 3. metamucil powder sig: one (1) po once a day as needed for constipation. discharge disposition: home discharge diagnosis: primary diagnosis: lower gastrointestinal bleed secondary diagnosis: status post mitral valve replacement hyperlipidemia htn discharge condition: hemodynamically stable, hematocrit 29- 30 discharge instructions: you were admitted after having a bloody bowel movement. at first, we treated you only with intravenous fluids, however the bleeding worsened. you were transferred to the intensive care unit for closer monitoring. you received 8 units of red blood cells. the gastroenterologists performed an endoscopy and colonoscopy but could not localize the source of bleeding although there was extensive diverticulosis, or sac-like protrusions within your large intestine. most likely the bleeding was caused by a small artery located within a diverticulum that broke through the skin into the colon. the bleeding stopped spontaneously and your blood cell counts remained stable. you do not need to make any special modifications to your diet, although some physicians recommend increasing fiber intake to increase the bulk of your stool. also, please avoid foods that cause your stool to appear red, such as beets. please make the following changes to your medication regimen: 1. stop aspirin: ask your cardiologist if you should take this medication in the future please call your physician or return to the emergency room if you develop any further bloody bowel movements, fever, abdominal pain, lightheadedness, shortness of breath, palpitations, chest pain or any other concerning symptoms. followup instructions: please follow up with your gastroenterologist, , m.d. phone: date/time: 4:30 please follow up with your primary care physician, , m.d. date/time: 3:30. phone number: provider , md phone: date/time: 9:40 provider: phone: date/time: 9:00 procedure: diagnostic ultrasound of heart other esophagoscopy colonoscopy arteriography of other intra-abdominal arteries diagnoses: esophageal reflux acute posthemorrhagic anemia other and unspecified hyperlipidemia hypotension, unspecified iron deficiency anemia, unspecified heart valve replaced by transplant diverticulosis of colon with hemorrhage raynaud's syndrome leukocytosis, unspecified benign essential hypertension 

Answer: The patient is high likely exposed to