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: haldol attending: chief complaint: n/v/cp with concern for dissecting aaa and ischemic colitis major surgical or invasive procedure: none history of present illness: 85 y/o f, pvd, cva x 2, dm2, htn, s/p l fem distal bypass, l ij thrombus being treated with lovenox 50mg sc bid, coumadin, and aspirin. also with recent aspiration pna on , now transfered from an outside hospital with n,v and cp on with troponin increease. has known aaa, and on osh imaging, found to have 4.4 x 4 cm infrarenal aaa with concern for new blood within the intima. also with abdominal pain and colitis concerning initially for ischemic colitis associated with dissecting aneurysm. in ed: bp 146/71 hr 95; hypoxia to 89%, that was 98% on 4l, 100.3 and c/o cp. admitted to the micu. supratherapuetic on admit with inr to 7 after being anticoagulated for lij thrombosis in setting of picc line. inr was reversed with vitamin k. upon admit surgery was called to evaluate her and thought her to be a poor surgical candidate. additionally, despite her ams & dementia, was thought that patient had refused surgery although she remains full code. hcp agreed with conservative management given her high risk of perioperative mortality. while in the micu she was not hypotensive but had average bp of 140/90s and never required pressors. clinically ill-appearing and delirious with pain. has been afebrile but is c.dif positive. initially thought to be septic so treated with vanc for gp bacteria and iv cipro/flagyl for gi bacteria. once c.dif positive, cipro was discontinued given negative repeat ua and po vanc/flagyl were continued for severe c.dif colitis. . upon transfer to the floor, vss with mild tachycardia to 100. confirms pain in lue, abdomen and . denies any n/v, cp/sob. aphasic and speaking only few words including 'yes/no' but appears agitated. past medical history: 1. left leg ischemia. 2. peripheral vascular disease, status post left fem- in with thrombectomy. 3. history of cerebrovascular accident x2, ischemic and hemorrhagic strokes with residual dysphagia and aspiration. 4. asymptomatic abdominal aortic aneurysm of 4.3 cm. 5. history of type 2 diabetes, controlled. 6. history of hypertension, controlled. 7. haldol allergy 8. preoperative delirium, multifactorial, resolved. 9. preoperative anemia, transfused x2. 10.picc line thrombus x3, treated. 11.postoperative blood loss anemia, transfused. 12.left axillary-femoral bypass with a left femoral to distal bypass on . social history: previously living in rehab. negative for tobacco use and negative for alcohol use. family history: noncontributory. physical exam: pe: 96/62 101 20 t 100.3 gen: somnolente, not following commands heent: pt non cooperative difficult to assess pupils. neck: right ij, supple, no bruits, no lymphadenopathy. cv: rrr s1, s2, no m/g/r resp: ctab abd: bowel soudns audible, guarding with diffuse abdominal tenderness buttocks: erythema diffusely but no pressure ulcers. ext: left foot with medial thigh ulcer with granulation tissue about 4cm by 2cm. multiple necrotic lesions in the left lower extremity with no pulses on l extremity. right extremity with 1 plus distal pulses. no edema lower and upper extremities bilaterally. pertinent results: 08:00am urine color-yellow appear-hazy sp ->1.035 urine blood-lg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-mod rbc-* wbc->50 bacteria-few yeast-many epi-0 . 08:00am wbc-23.1*# rbc-4.50# hgb-13.8# hct-43.3# mcv-96 mch-30.6 mchc-31.8 rdw-15.1 neuts-93.1* bands-0 lymphs-4.4* monos-2.1 eos-0.1 basos-0.3 hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal . 08:00am plt smr-high plt count-524* . 08:00am glucose-148* urea n-72* creat-1.8* sodium-144 potassium-4.0 chloride-101 total co2-28 anion gap-19 alt(sgpt)-62* ast(sgot)-25 ld(ldh)-361* ck(cpk)-78 alk phos-80 amylase-114* tot bili-0.5 lipase-82* . 08:00am ctropnt-0.05* . 02:05pm lactate-4.3* . 03:00pm pt-49.2* ptt-41.1* inr(pt)-5.8* 07:27pm fibrinoge-752* d-dimer-4040* . 10:00 pm stool consistency: not applicable **final report ** fecal culture (final ): no salmonella or shigella found. campylobacter culture (final ): no campylobacter found. clostridium difficile toxin assay (final ): reported by phone to p. , r.n. on at 0520. clostridium difficile. feces positive for c. difficile toxin by eia. (reference range-negative). a positive result in a recently treated patient is of uncertain significance unless the patient is currently symptomatic (relapse). brief hospital course: assessment and plan: 85 yo female with pvd, dm2, s/p multiple bypasses who presents with n/v/cp, found to have aaa with possible dissection and c. difficile colitis. . # pain: patient was tachypneic and tachycardic at times. concerning for possibility of pe but o2 sat is 95%. abdominal exam significant for wincing pain to palpation, concerning for toxic megacolon given c. diff infection. thought to be pain causing increased respiratory rate. cxr revealed mod pulm. edema->congested on exam, given 20mg iv lasix x1, with good output. restarted gentle fluid after to maintain hydration. kub revealed no dilation. morphine changed to standing with improved pain control. will discharge on morphine sulfate 1-2mg iv q6hours prn pain. of note, patient has been needing 2mg iv q6 for the last 2-3 days to maintain pain-free. expect this need to deminish as infection resolves. . # left groin ulcer: s/p left femoral bypass with continued ulceration at left groin. vascular was consulted and followed her throughout her hospitalization recommending wound dressing changes and duration of iv antiobiotics for wound infection. preliminary wound swab revealed gpc in pairs, still pending on discharge. prior to discharge picc was placed for continued antibiotic therapy. was instructed to continue iv vancomycin until seen by dr. on at which point he may discontinue or extend the duration of therapy. . # colitis: initially thought to be infectious vs. ischemic. as d/w radiology and surgery. involving ascending and transverse colon with possible involvement of the small intestine. initially evaluated for surgery given concern for ischemic colitis, but area of involvement thought to be too extensive. cultures then positive for c.dif within a few hours of collection so transitioned to both po vanc/flagyl for severe c.dif infection. antibiotics to be continued in rehabiliation facility for complete 14 day course. . # aaa dissection: after reviewing with radiologist in house and dr. , there is evidence of possible minor leakage into the intimal flap although no overt dissection at this time. repeat imaging studies would be ideal to better assess the osh images, but given the patient's family wishes of no surgical approach and the risk of iv contrast, no further imaging was pursued. additionally aaa is less likely to be the cause of her current symptoms. given no surgical intervention, patient was medically managed with blood pressure control and her hct was followed as an inpatient. . # septic shock: likely secondary to translocation of colonic bacteria in the areas of infection. c. diff toxin positive. did not require pressors while in the micu, and upon transfer is to the floor was hemodynamically stable. upon discharge, all blood cultures negative, campylobacter & samonella negative. c.dif the only positive culture, to be treated as described above. . # coagulopathy & left ij thrombus: previously being treated for left ij thrombus found on prior hospitalization to picc placement. on admit elevated inr initially thought to represent dic vs over administration of warfarin. warfarin held and dic panel ordered. dic panel: fibrinogen 752, fdp 10-40, d-dimer 4040. was given vitamin k 5 mg po x1, 5 mg sc x 1. anticoagulation was initially discussed in micu with the vascular team. given concern for dissection, anticoagulation was held. however, once it was determined that no surgical intervention was indicated, the plan was to re-anticoagulate for an additional 14 days for his left ij thrombus given risk for pe. on discharge, patient was therapeutic with inr = 2.5 despite held warfarin, thought to be due to poor diet. rehab instructed to monitor inr and add warfarin prn for goal inr . to be treated for an additional two weeks until . . # dm2: fsbg ranging 97-200 (). was continued on humalog iss and q6 hour fingersticks. hba1c 5.6. discharged with instruction to check q6hour fingersticks and continue iss. be modified in rehab per facility physician . . # elevated troponin: elevated troponin on admit from osh. no ekg changes. finding likely secondary to hypoperfusion from septic shock. trop t followed and found to be 0.05 -> 0.04 -> 0.05 -> 0.04. not indicative of acute ischemia. . # arf: baseline cr 1.0, cr elevated to 1.8 on admission. urine lytes evaluated and found to be urean:1145, creat:67, na:<10, osmolal:654. fena 0.12%, thus patient likely prerenal nausea/vomiting. treated with ivf, and now at baseline cr. to be monitored in rehabiliation facility and continued on tubefeeds with flushes to maintain hydration. . # hypernatremia: na up to 148 after multiple ns boluses. upon transfer to the floor is 145, so still free water deplete. resolved with 1/2 ns fluids to correct free water deficit. na 137 on discharge. . fen: tubefeeding per nutrition recs to be continued in rehab. . prophylaxis: ppi and anticoagulated. consider heparin sq once completed 2 week course of anticoagulation. . code status: full code, confirmed with hcp . contacts: hcp brother/hcp and /2nd hcp medications on admission: asa 325 mirtazapine 15mg qhs metoporolol 50mg po bid warfarin 1mg po qd duonebs q6hrs enoxaparin 50mg sc bid quetiapine 25mg po qhs ntg 0.4mg/hr patch 24hr transdermal lasix 20mg po bid bactrim ds 1 tab po bid percocet prn insulin lispro dose lansoprazole 30mg po qday discharge medications: 1. mirtazapine 15 mg tablet : one (1) tablet po hs (at bedtime). 2. metoprolol tartrate 50 mg tablet : one (1) tablet po bid (2 times a day): hold for sbp < 100 or hr < 60 . 3. furosemide 20 mg tablet : one (1) tablet po bid (2 times a day): hold for sbp < 100 . 4. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 5. vancomycin 125 mg capsule : one (1) capsule po q6h (every 6 hours) for 10 days. 6. heparin (porcine) 5,000 unit/ml solution : 5000 (5000) unit injection tid (3 times a day). 7. acetaminophen 325 mg tablet : two (2) tablet po q6h (every 6 hours) as needed for fever or pain. 8. metronidazole 500 mg tablet : one (1) tablet po tid (3 times a day) for 10 days. 9. albuterol sulfate 0.083 % (0.83 mg/ml) solution : one (1) nebulizer inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 10. morphine 2 mg/ml syringe : one (1) mg injection q6h (every 6 hours) as needed for pain not relieved by acetaminophen. 11. morphine 2 mg/ml syringe : one (1) injection q6h (every 6 hours) for 4 days. 12. insulin sliding scale see attached insulin sliding scale 13. insulin sliding scale please continue humalog insulin sliding scale per attached sheet. facility physician may titrate for improved glycemic control. 14. miconazole nitrate 2 % powder : one (1) appl topical tid (3 times a day) as needed. 15. vancomycin in dextrose 1 gram/200 ml piggyback : one (1) gram intravenous q48h (every 48 hours) for 3 weeks: to see dr. , who may prescribe a different course of therapy pending improvement in leg wound. 16. morphine 2 mg/ml syringe : 1-2 mg injection q6h (every 6 hours) as needed for pain: patient has required 2mg iv q6h to remain nonpainful last 48hours, may diminish as c.dif resolves. hold for rr< 12 or over sedation. 17. picc maintenance heparin flush picc (100 units/ml) 2 ml iv daily:prn 10 ml ns followed by 2 ml of 100 units/ml heparin (200 units heparin) each lumen daily and prn. inspect site every shift. 18. outpatient physical therapy to evaluate and treat at new facility 19. outpatient physical therapy to evaluate and treat at new facility 20. outpatient speech/swallowing therapy to evaluate and treat at new facility for goal of improved clarity of speech. 21. anticoagulation patient with known left internal jugular thrombus, needs to be treated with anticoagulation for 2 weeks, until . please check inr daily until on therapeutic regimen and then per facility protocol 22. warfarin 1 mg tablet : 1-2 tablets po once a day as needed for inr goal : likely very sensitive to coumadin; inr on transfer 2.5 without coumadin, likely secondary to recent poor nutrition. 23. outpatient lab work please check cbc and chemistry panel qod to monitor for renal function, adequacy of electrolyte repletion and stable hct. 24. rectal tube please discontinue once decrease diarrhea. projected discontinuation 2-3 days post transfer. 25. nutrition please see page 1 for nutrition recs for tubefeeding discharge disposition: extended care facility: - discharge diagnosis: primary: clostridium dificile colitis secondary: abdominal aortic anuerysm, left axillo-femoral bypass and a left femoral-to-distal bypass with thrombosis , peripheral vascular disease, history of stroke discharge condition: hemodynamically stable and afebrile with decreased stool output and tolerating tubefeedings. discharge instructions: you were admitted with abdominal pain and concern for an expanding aneurysm in your abdomen. you were found to have a severe infection of your colon and a skin infection around your surgical site at your left groin. you were treated with antibiotics and iv fluids. your diet was slowly advanced, and once improved you were discharged to an acute care facility for further recovery. . please continue taking all your medications as prescribed. you also need to continue taking antibiotics for a full two week course for your abdominal infection. you will also continue iv antibiotics until your meet with your vascular surgeon on . . please return to the ed or consult a physician if you notice worsening diarrhea, fevers/chills, abdominal pain, inability to tolerate enough liquid via your g-tube to maintain your weight or for any other symptom for which you are concerned. followup instructions: please follow-up with your primary care physician 2 weeks after discharge from your acute care facility. while in the facility you will be followed by the facility's physician. . additionally you have an appointment with dr. . , your vascular surgeon, on at 9:45am at . office phone: (. your facility will coordinate transportation to this appointment. procedure: venous catheterization, not elsewhere classified diagnoses: anemia, unspecified other postoperative infection urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia hyposmolality and/or hyponatremia severe sepsis peripheral vascular disease, unspecified hypopotassemia defibrination syndrome surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation septic shock intestinal infection due to clostridium difficile abdominal aneurysm without mention of rupture hyperosmolality and/or hypernatremia accidents occurring in residential institution late effects of cerebrovascular disease, aphasia chronic ulcer of other specified sites other late effects of cerebrovascular disease, dysphagia dysphagia, unspecified 

Answer: The patient is high likely exposed to