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: heparin agents attending: chief complaint: s/p fall, shortness of breath major surgical or invasive procedure: - open reduction and internal fixation, left acetabular fracture, with percutaneous technique - hemodialysis history of present illness: 73 year old man with esrd on hd, copd on 1l home o2, cad, chf, a fib on coumadin with pacemaker who was in his usual state of health until the day prior to admission when he had a mechanical fall (tripped over socks) at home and fell on his side. no loc, denies injury to head. was brought to , where initial vitals were t 97.7, hr 79, rr 20, bp 117/64, 88% on ra --> 92% on 4lnc. ct showed left pelvic fracture; he was given 6 mg iv morphine, 1 mg iv dilaudid x 2, and and 50 mcg fentanyl, as well as 20 mg kcl in d51/2ns x 1 l and sent to for orthopedic evaluation. in the ed, initial vitals were t 97.5, hr 105, bp 121/67, rr 16, he was hypoxic to 70s on ra, low 80s on 2l and low 90s on venti mask 8l. he underwent repeat ct with contrast (with plan to be dialyzed early), which showed comminuted left acetabular and pubic rami fractures, intrapelvic hemorrhage/hematoma with no active extravasation, cirrhosis, infrarenal 3.1 cm aaa, b/l pleural effusions, rll patchy infiltrate, and no pe. he was seen by orthopedics and trauma surgery, who recommended percutanous stabilization of the fracture. additionally, labs were significant for macrocytic anemia with hct 32.1 (unknown baseline), cr 3.2, inr 1.5, trop i 0.30 --> 0.32. ecg ventricularly paced and could not be interpreted. he was in significant pain and received 8 mg iv morphine, 200 mg iv fentanyl, and 600 cc ns. two units of blood were cross-matched. on transfer, vitals were t 98.6, hr 80, bp 117/54, (dropped to sbp 80s after morphine), rr 21, 91% on ventimask. he was admitted to the micu service for further management. past medical history: -copd on home o2 during day 2-3 l, at night 3 l, keeps him low 90s, high 80s -dm2 -esrd on hd -chf -prostate ca - s/p xrt at -atrial fibrillation on coumadin -s/p pacemaker -left arm av fistula on social history: former smoker, quit 15 years ago. denies current tobacco use. occasionally drinks one beer - not every day. used to be heavy drinker. denies ivdu. family history: noncontributory physical exam: vitals: tc/tm= 97.5, bp= 115/65, hr= 90(v-paced), rr= 20, spo2= 98%ra fs glucose: 131 <- 141 <- 135 <- 159 <- 109 <- 121 general: thin, elderly male, laying in bed, nad heent: ncat, perrl (2mm pupils minimally reactive to light), eomi, sclerae anicteric, oropharynx slightly erythematous, dry mm neck: supple, jvp not elevated, no lad lungs: clear to auscultation anteriorly cv: regular rate and rhythm, nl s1+s2, no m/r/g abdomen: soft, non-tender, non-distended, +bs, no hsm appreciated, llq with ecchymoses, mildly warm to touch, non-tender. ext: warm, well perfused, 1+ dp pulses, no clubbing, cyanosis or edema, small dark 2 cm ulcer over right medial foot. lue with av fistula, bandage removed -> healing well with improving ecchymosis. l hip with stable ecchymosis, no tenderness, mild warmth. skin: dry, tan skin with many ecchymoses neuro: a+ox3. cn ii-xii intact without any focal deficits. lle with marked decreased strength secondary to pain. rle 5+ strength. ue 5+ bilaterally. movement and sensation symmetric. gait not observed. pertinent results: discharge labs: 07:19am blood wbc-7.9 rbc-2.86* hgb-10.0* hct-30.4* mcv-106* mch-34.9* mchc-32.9 rdw-20.0* plt ct-183 08:15am blood pt-25.3* ptt-38.9* inr(pt)-2.4* 06:50am blood fibrino-390 07:19am blood glucose-114* urean-33* creat-3.7* na-132* k-4.4 cl-92* hco3-31 angap-13 06:50am blood alt-16 ast-55* ld(ldh)-398* alkphos-309* totbili-2.1* 06:15am blood ck-mb-10 mb indx-3.7 ctropnt-0.54* 06:22am blood ctropnt-0.81* 04:56pm blood ck-mb-6 ctropnt-0.79* 11:55am blood ck-mb-7 ctropnt-0.72* 04:42am blood ck-mb-7 ctropnt-0.61* 01:05pm blood ck-mb-6 ctropnt-0.32* 05:00am blood ck-mb-5 ctropnt-0.32* 11:50pm blood ctropnt-0.30* 07:19am blood albumin-2.8* calcium-8.4 phos-4.5 mg-2.0 11:50pm blood caltibc-191* vitb12-956* folate-12.4 ferritn-257 trf-147* 11:12am blood %hba1c-6.1* eag-128* imaging: tte (complete) done at 4:17:16 pm final the left atrium is elongated. the right atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity is mildly dilated. overall left ventricular systolic function is severely depressed (lvef= 20-25 %) with global hypokinesis and inferior akinesis. no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. the right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. there is a minimally increased gradient consistent with minimal aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is mild to moderate pulmonary artery systolic hypertension. there is no pericardial effusion. ct torso w/contrast study date of 3:21 am impression: 1. markedly comminuted left acetabular and superior and inferior pubic rami fractures as detailed above. associated extraperitoneal pelvic hemorrhage and hematoma extending into the perirenal space with no evidence of active extravasation. 2. distended gallbladder with cholelithiasis. in addition, extra-hepatic biliary dilatation with the common bile duct measuring up to 10 mm with a rounded intraluminal density, that may represent a possible stone in its distal aspect (near the ampulla). 3. cirrhotic liver with large recanalized umbilical vein. 4. infrarenal abdominal aortic aneurysm measuring up to 3.1 cm. 5. left greater than right simple pleural effusions. right lower lobe patchy opacification, for which differential includes aspiration/atelectasis, though infection is not excluded. 6. dilation of the main pulmonary trunk which may be seen in pulmonary hypertension. 7. emphysematous change. microbiology: urine culture (final ): no growth. mrsa screen (final ): no mrsa isolated. brief hospital course: 73 year old man with esrd on hd, copd on 2l home o2, cad, chf, h/o borderline hit antibody, afib on coumadin with pacemaker who was admitted for a left acetabular fracture, s/p orif percutaneous pinning procedure on c/b associated extraperitoneal pelvic hemorrhage and hematoma extending into the perirenal space with no evidence of active extravasation. required micu admission for hypoxia likely secondary to chf given post-op fluid resuscitation. # left pelvic fracture: the patient had a ct which showed a comminuted fracture of the left acetabulum and the inferior and superior rami. he underwent a successful percutaneous open reduction and internal fixation on c/b associated extraperitoneal pelvic hemorrhage and hematoma extending into the perirenal space with no evidence of active extravasation. hematocrit remained stable. touchdown weight bearing, no range of motion restrictions per orthopedics. pain was managed with oxycodone and acetaminophen. # hypoxia: the patient's hypoxia on admission was thought to be secondary to fluid overload after resuscitation in the ed. he was dialyzed and his respiratory status improved. he did not require emergent dialysis post surgery and was able to be quickly extubated afterwards and transitioned to a shovel mask, nasal cannula, then room air. # systolic chf: an echo was obtained which showed severely depressed ef of 20-25% and global hypokinesis but little in the way of valvular disease. ekg changes were interpreted by cardiology as not concerning for acute process requiring intervention. his troponins were elevated on admission, thought to be secondary to renal failure. these continued to increase after his hip surgery and peaked at 0.81 before trending down. switched patient to rosuvastatin 5mg qd from simvastatin 20mg qd for as the former is less hepatotoxic. # hit: on , records from showed that the patient has had two borderline hit antibodies this year; he was started on an argatroban drip with a bridge to coumadin after surgery with close monitoring of his hematocrit. he received two doses of heparin while in the micu. argatroban wa stopped on . inr peaked at 12.5 on pm; patient received a total of 5mg vit k po. inr on discharge was 2.4. # delirium: patient alert & oriented x 3; very clear on discharge. after transfer from the micu initially patient's mental status waxed and waned, likely secondary to pain. his mental status was monitored with the confusion assessment method and lactulose and thiamine were started. # hyponatremia: patient had an episode of hyponatremia for a few days which resolved with 1l ns given over two days (in the context of his chf). likely secondary to decreased fluid intake. # esrd on hd: hd on t/th/sat. patient received hd per schedule through left hd tunnelled catheter and was followed by the renal team. l av fistula in place is new and not yet matured. continued phoslo & nephrocaps. # hypertension: patient's furosemide and amlodipine were held during admission in the setting of his bleed. he was normotensive throughout admission. # dm: continued lantus 5mg qhs and humalog ss. # macrocytic anemia: hct stable. likely anemia of chronic inflammation from esrd. # atrial fibrillation: patient restarted coumadin 2.5mg po qd on . was therapeutically anticoagulated throughout admission. # cirrhosis: likely secondary to prior alcohol abuse. per patient and family, no significant alcohol use currently. lactulose started and titrated to bowel movements daily. # prophylaxis: despite history of borderline hit antibody, patient did receive two doses of heparin subcutaneously in the micu. his platelets did not drop below 100,000 and were closely monitored. # code: full code. medications on admission: amlodipine 5 mg daily coumadin 2.5 mg daily (stopped on ) lasix 40 mg daily ranitidine 150 mg allopurinol 100 mg daily simvastatin 20 mg daily phos-lo 667 mg tid insulin - lantus 5 units qhs, sliding scale aspirin 325mg vicodin prn for fistula pain amoxicillin 125 mg daily (post-op from fistula)- finished course qvar inhaler 2 puffs combivent 2 puffs tid or prn discharge medications: 1. calcium acetate 667 mg capsule sig: one (1) capsule po tid w/meals (3 times a day with meals). 2. allopurinol 100 mg tablet sig: one (1) tablet po daily (daily). 3. ranitidine hcl 150 mg tablet sig: 0.5 tablet po q24h (every 24 hours). 4. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 5. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical tid (3 times a day) as needed for itching. disp:*1 bottle* refills:*0* 6. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 7. warfarin 2.5 mg tablet sig: one (1) tablet po daily (daily). 8. rosuvastatin 5 mg tablet sig: one (1) tablet po daily (daily). 9. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 10. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for sob or wheeze. 11. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 12. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po bid (2 times a day). 13. acetaminophen 325 mg tablet sig: two (2) tablet po tid (3 times a day). 14. insulin glargine 100 unit/ml solution sig: five (5) units subcutaneous at bedtime. 15. humalog 100 unit/ml solution sig: per sliding scale subcutaneous qachs. 16. humalog insulin sliding scale 0-70 mg/dl proceed with hypoglycemia protocol proceed with hypoglycemia protocol proceed with hypoglycemia protocol proceed with hypoglycemia protocol breakfast lunch dinner bedtime 71-150 mg/dl 0 units 0 units 0 units 0 151-200 mg/dl 2 units 2 units 2 units 0 201-250 mg/dl 4 units 4 units 4 units 2 251-300 mg/dl 6 units 6 units 6 units 4 301-350 mg/dl 8 units 8 units 8 units 6 351-400 mg/dl 10 units 10 units 10 units 8 17. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 18. coumadin / inr management please have the results of your inr lab checks faxed to attn: dr. while you are at rehabilitation facility over the next few weeks. dr. ' phone# and fax #. inr goal . please resume your usual inr checks as an outpatient with dr. (through the clinic). discharge disposition: extended care facility: cape heritage, a healthcare center - discharge diagnosis: primary diagnoses: 1. left acetabular fracture 2. extraperitoneal pelvic hemorrhage and hematoma 3. congestive heart failure exacerbation from volume overload 4. chronic obstructive pulmonary disease 5. delirium 6. demand myocardial ischemia 7. coronary artery disease 8. history of borderline heparin-induced thrombocytopenia antibody 9. end-stage renal disease 10. anemia 11. cirrhosis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: 1. you were admitted to the hospital for a fall and found to have a fractured left hip. you had surgery to stabilize your hip, which was complicated by bleeding into your pelvis. your blood counts remained stable. you will need to follow-up in clinic as an outpatient as outlined below. 2. in order to decrease the likelihood of developing a clot, you were on blood thinners during your hospitalization (anticoagulation). you received 2 doses of heparin products during this admission. although you have a history of borderline heparin-induced thrombocytopenia (hit) antibodies, your platelet count did not go below 100,000. you were switched to argatroban and bridged to coumadin, which you will need to continue as an outpatient. 3. you were found to have cirrhosis of your liver based on cat scan. you should follow with the liver center as outlined below. 4. we made the following changes to your medications: - stopped simvastatin - stopped furosemide (lasix) - stopped amlodipine - started rosuvastatin - started thiamine - started oxycodone 5. it is important that you take all of your medications as prescribed. 6. it is important that you keep all of your follow-up appointments. 7. please have the results of your inr lab checks faxed to attn: dr. while you are at rehabilitation facility over the next few weeks. dr. ' phone# and fax #. inr goal . please resume your usual inr checks as an outpatient with dr. (through the clinic). followup instructions: pcp with dr. at ma location date: at 9:30am phone: # department: orthopedics / dr. when: tuesday at 11:20 am with: ortho appointment and xray (scc 2) building: sc clinical ctr campus: east best parking: garage department: orthopedics when: tuesday at 11:40 am with: , np building: campus: east best parking: garage department: liver center when: thursday at 11:45 am with: , md building: lm campus: west best parking: garage procedure: hemodialysis closed reduction of fracture with internal fixation, other specified bone diagnoses: anemia in chronic kidney disease end stage renal disease renal dialysis status coronary atherosclerosis of native coronary artery congestive heart failure, unspecified alcoholic cirrhosis of liver hyposmolality and/or hyponatremia chronic airway obstruction, not elsewhere classified atrial fibrillation hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease long-term (current) use of anticoagulants cardiac pacemaker in situ unspecified accident injury to bladder and urethra, without mention of open wound into cavity abdominal aneurysm without mention of rupture acute on chronic systolic heart failure other and unspecified coagulation defects other and unspecified alcohol dependence, unspecified fall from other slipping, tripping, or stumbling delirium due to conditions classified elsewhere hemoperitoneum (nontraumatic) closed fracture of pubis heparin-induced thrombocytopenia (hit) closed fracture of acetabulum other dependence on machines, supplemental oxygen renal osteodystrophy 

Answer: The patient is high likely exposed to