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: no known allergies / adverse drug reactions attending: chief complaint: perforated sigmoid colon major surgical or invasive procedure: diagnostic laparoscopy, exploratory laparotomy, sigmoid colectomy with end colostomy history of present illness: mr. is a very pleasant 87 y/o gentleman with comorbidities including cad s/p cabg, rheumatoid arthritis on methotrexate, and chronic renal insufficiency, who suddenly developed pain at his left flank and abdomen approximately 4 days ago while doing yardwork. the pain has been constant and relatively since then. he denies any n/v, diarrhea or constipation, and last passed flatus yesterday. he has been eating and drinking without difficulty though his appetite is decreased. trying to get up from sitting or standing makes the pain worse. he denies any fevers/chills. he has no hematochezia or changes in his urinary habits. he denies cp/sob. at baseline he is quite active and can walk many blocks without getting tired. past medical history: pmh: rheumatoid arthritis on methotrexate cad b/l carotid stenosis, s/p cea and stent on r, 60-70% on l prostate ca s/p radiation microcytic anemia cri (bl 1.5-1.6) psh: cabgx4 15-20 yrs ago @ r cea r carotid stent back surgery yrs ago social history: smoked 1ppd x 20 yrs but quit 20 yrs ago. no etoh or rda. retired, lives with wife. family history: noncontributory physical exam: physical examination upon admission: pe: t 97.6, hr 72, bp 152/84, rr 17, 100% on ra gen: nad. a&ox2, not oriented to time heent: anicteric. dry mucosal membranes. neck: no jvd. no lad. no tm. faint bruit on l. cv: rrr no m/g/r pulm: ctab. abd: soft, mildly distended. ttp b/l lower quadrants with involuntary guarding and rebound also quite tender at l flank and cva. b/l inguinal hernias, l > r, reducible, tender to palp over l without overlying skin changes dre: normal tone. no masses. no gross or occult blood. ext: warm and well perfused. no peripheral edema. neuro: motor and sensation grossly intact. on discharge: vitals: 96.6 79 142/84 20 96% ra gen: nad. alert but intermittently confused. heentl mucous membranes pink, dry. cv: irreg rhythm, normal rate. pulm: cta bilaterally abd: slightly distended, soft, nontender. stoma pink with liquid dark brown stool. ext: warm and well perfused. trace pedal edema. pertinent results: 05:25am blood wbc-10.7 rbc-2.80* hgb-8.8* hct-26.8* mcv-96 mch-31.4 mchc-32.8 rdw-15.6* plt ct-289 11:30am blood wbc-14.7* rbc-3.14* hgb-9.5* hct-30.0* mcv-96 mch-30.1 mchc-31.5 rdw-15.6* plt ct-278 09:10am blood wbc-15.4* rbc-3.45* hgb-10.7* hct-32.7* mcv-95 mch-30.9 mchc-32.6 rdw-15.7* plt ct-218# 05:05am blood wbc-11.8* rbc-3.14* hgb-9.7* hct-29.9* mcv-95 mch-31.1 mchc-32.7 rdw-15.6* plt ct-137*# 06:30pm blood wbc-9.2# rbc-3.84* hgb-12.0* hct-36.0* mcv-94 mch-31.3 mchc-33.4 rdw-15.1 plt ct-82*# 06:30pm blood neuts-88.9* lymphs-8.2* monos-2.7 eos-0.2 baso-0.1 05:25am blood plt ct-289 11:30am blood plt ct-278 11:30am blood pt-18.2* ptt-31.7 inr(pt)-1.6* 06:30pm blood pt-13.1 ptt-24.2 inr(pt)-1.1 05:25am blood glucose-118* urean-42* creat-1.2 na-138 k-4.0 cl-108 hco3-23 angap-11 11:30am blood glucose-146* urean-49* creat-1.2 na-139 k-3.8 cl-107 hco3-25 angap-11 06:30pm blood glucose-129* urean-47* creat-1.4* na-135 k-3.5 cl-100 hco3-22 angap-17 11:30am blood alt-17 ast-20 alkphos-71 amylase-49 totbili-0.6 11:30am blood calcium-7.9* phos-4.1 mg-2.1 09:10am blood calcium-8.7 phos-4.0 mg-2.1 04:03pm blood type-art temp-36.7 o2 flow-3 po2-81* pco2-29* ph-7.35 caltco2-17* base xs--7 intubat-not intuba 02:34pm blood glucose-114* lactate-1.3 08:13am blood lactate-1.2 02:34pm blood freeca-1.28 05:33am blood freeca-1.08* : ekg atrial fibrillation, average ventricular rate 104. non-specific st-t wave changes diffusely. onthe previous tracing of the patient was in sinus bradycardia, rate 51. the non-specific st segment changes were also present at that time. otherwise, no diagnostic interval change. tracing #1 : chest x-ray: impression: free intraperitoneal air, as seen on outside hospital ct abd/pelvis from earlier today. : ekg: atrial fibrillation, average ventricular rate 92. compared to tracing #1 the patient remains in atrial fibrillation but the ventricular rate has slowed. in addition, the non-specific st-t wave changes noted in the lateral precordial leads are no longer seen on the current tracing. consider rate related myocardial ischemia on tracing #1 which is no longer seen on tracing #2. tracing #2 : chest x-ray: impression: ap chest compared to . previous pneumoperitoneum is resolved. increasing bibasilar opacification is probably a combination of worsening atelectasis and dependent pulmonary edema, mild elsewhere in the lungs. heart size is normal. pleural effusions are minimal. no pneumothorax. et tube in standard placement. nasogastric tube passes below the diaphragm and out of view. : us of left upper ext: occlusive thrombus in the left cephalic vein and in the proximal part of the left basilic vein : x-ray of abdomen: single portable ap view of the abdomen demonstrates air-filled loops of large and small bowel consistent with an ileus. there is no evidence for obstruction or free intra-abdominal air. brief hospital course: 87 year old gentleman admitted to acs service after presenting to with abdominal pain and free air on ct scan. he was made npo, given intravenous fluids, and underwent radiographic imaging. he was reported to have perforated diverticuliti. he was taken emergently to the operating room and underwent an ex-lap, sigmoid colectomy, and colostomy. he required neosynephrine intra-op for blood pressure support. he was transported to the intensive care unit after the procedure. he was extubated on pod #1 without difficulty. after his vital signs stabilized, his beta-blockers were resumed. he did have an episode of rigors, not associated with temperature elevation, but accompanined by hypertension. he was given a dose of intravenous lopressor with effective results. he self discontinued his -gastric tube. on pod #2, he was transferred to the surgical floor. he was started on clear liquids with advancement to a mechanical soft diet. he has 1 day left of his course of ciprofloxacin and flagyl. his heart rate continued to be irregular, likely atrial fibrillation, but the rate was controlled with metoprolol. his foley catheter was discontinued on pod #3 and he has been voiding without difficulty. he was evaluated by physical therapy to assess his level of mobility. recommendations were made for discharge to an extended care facility where he can further regain his strength. he was also evaluated by the ostomy nurse who provided ostomy instruction. on pod #6, he was noted to have left arm swelling and underwent an ultrasound of his left arm which showed an occlusive thrombus in the left cephalic vein and in the proximal part of the left basilic vein. no intervention indicated. he is preparing for discharge on to an extended care facility with recommendations to follow up with his primary care provider who will assess his cardiac status with new onset of atrial fibrillation. his pcp was prior to discharge and notified re: afib and addition of lopressor to his medication regimen. he also has follow up scheduled in the clinic on . he remains afebrile and hemodynamically stable, without evidence of infection and a normal wbc count of 10.7. of note: his home dose of methotrexate was held perioperatively for optimal healing, and can be restarted . medications on admission: : methotrexate 15 , 325', folate discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day): hold for loose stool. 4. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day): hold for systolic blood pressure <110, hr <60. 5. acetaminophen 325 mg tablet sig: two (2) tablet po tid (3 times a day). 6. heparin (porcine) 5,000 unit/ml solution sig: 5000 (5000) units injection tid (3 times a day). 7. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 8. tramadol 50 mg tablet sig: 0.5 tablet po q6h (every 6 hours) as needed for pain. 9. oxycodone 5 mg tablet sig: 0.5 tablet po q4h (every 4 hours) as needed for pain: hold for increased sedation, resp. rate <10. 10. methotrexate sodium 15 mg tablet sig: one (1) tablet po weekly: please resume . 11. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 1 days. 12. metronidazole 500 mg tablet sig: one (1) tablet po q8h (every 8 hours) for 1 days. discharge disposition: extended care facility: at discharge diagnosis: perforated diverticulitis discharge condition: mental status: clear,coherent, alteranating with episodes of disorientation level of consciousness: interactive, disoriented at times activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the hospital with left flank and abdominal pain. imaging studies were done and you were found to have a perforated diverticulitis. you were taken to the operating room where you had an exploratory laparotomy, sigmoid colectomy, and colostomy. you have made good progress since your surgery. you were seen by physical therapy and recommendations made for you to go to a rehabiltation facility where you can further regain your strength. followup instructions: name: , md specialty: family practice location: family practice address: , , phone: please discuss with the staff at the facility about making a follow up appointment to see dr. once you are discharged from the facility. the staff can call the number listed above. department: general surgery/ when: thursday at 3:45 pm with: acute care clinic with: , md building: lm bldg () campus: west best parking: garage procedure: colostomy, not otherwise specified other appendectomy open and other sigmoidectomy diagnoses: acidosis other iatrogenic hypotension thrombocytopenia, unspecified urinary tract infection, site not specified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation personal history of malignant neoplasm of prostate coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status personal history of tobacco use chronic kidney disease, unspecified occlusion and stenosis of carotid artery without mention of cerebral infarction other and unspecified hyperlipidemia long-term (current) use of other medications rheumatoid arthritis oliguria and anuria diverticulitis of colon (without mention of hemorrhage) laparoscopic surgical procedure converted to open procedure acute appendicitis with generalized peritonitis acute venous embolism and thrombosis of superficial veins of upper extremity 

Answer: The patient is high likely exposed to