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: synchronous rectal cancer and sigmoid colon cancer major surgical or invasive procedure: laparoscopic converted to open proctosigmoidectomy with partial colectomy and end colostomy with takedown of splenic flexure and prophylactic placement of surgisis preperitoneal patch to prevent parastomal hernia history of present illness: this is a 73 year-old male with locally advanced rectal cancer with and biopsy-proven liver metastasis who presented electively on for a laparoscopic converted to open proctosigmoidectomy with partial colectomy and end colostomy, takedown splenic flexure, and prophylactic placement of surgisis preperitoneal patch to prevent parastomal hernia. past medical history: pmh: locally advanced rectal cancer w/ liver mets, viral cardiomyopathy ef 30%, a.fib on coumadin, multiple episdoes of v.fib s/p icd firing psh: early stage urothelial carcinoma of the bladder status post cystoscopic resection on social history: primarily italian-speaking. he is married and lives at home with his wife. his son and daughter are local and he is close to them. he is originally from central and tries to spend time in yearly. he smoked two packs per day for 40 years, quitting in the past two years. he drinks two glasses of wine per day and denies recreational substance use. family history: father: died young of unknown causes. mother: lived to 94 and was healthy with no known cancers. other: no other known cancer history in his family. physical exam: vitals: t 98.2 hr 80 bp 133/64 rr 22 o2sat 99%ra heent: normocephalic, atraumatic. eomi. perrl. nares clear. mucous membranes moist. neck supple without lymphadenopathy. cvs: regular rate and rhythm, without murmurs, rubs or gallops. s1 and s2. resp: clear to auscultation bilaterally without adventitious sounds, minimally decreased breath sounds at bases bilaterally. no wheezing, rhonchi or crackles. abd: soft, non-tender, non-distended, with normoactive bowel sounds. no masses or peritoneal signs. left sided colostomy stoma is pink-purple, protuberant with mild friability and is healing well with liquid-brown/green stool output and gas in his ostomy appliance. extr: 2+ peripheral pulses, without cyanosis, clubbing or edema. incision/wound: midline abdominal incision has mild erythema extending 1-2 cm from the wound edge without fluctuance, purulence or induration. staples have been removed with granulating tissue and minimally serosanginous drainage underlying the exposed superficial fascia. the wound appears clean. pertinent results: 06:00am blood wbc-9.2 rbc-3.58* hgb-9.7* hct-31.4* mcv-88 mch-27.1 mchc-30.8* rdw-18.4* plt ct-650*# 07:55am blood pt-13.2 ptt-24.7 inr(pt)-1.1 06:00am blood pt-14.6* ptt-25.2 inr(pt)-1.3* 03:50am blood pt-17.1* ptt-27.3 inr(pt)-1.5* 06:00am blood glucose-97 urean-21* creat-1.2 na-135 k-3.8 cl-100 hco3-27 angap-12 cxr () - stable postoperative findings indicative of chf. fluid overload, as suggested in the requisition, may be a cause of these findings provided other cardiogenic factors are excluded. lue us () - no evidence of left upper extremity deep venous thrombus. cephalic vein not visualized. pathology () - rectum and sigmoid colon: two synchronous colonic adenocarcinomas. thirty-five lymph nodes; no malignancy identified. brief hospital course: neuro/pain: the patient was maintained on pca/iv morphine for pain medication in the immediate post-operative period and transitioned to po narcotic medication with adequate pain control on pod#. the patient remained neurologically intact and without change from baseline. the patient remained alert and oriented to person, location and place. cardiovascular: the patient experienced a single episode of what was suspected ventricular tachycardia and his aicd fired a single time intra-operatively, as previously mentioned. the event occurred soon after insufflation of the abdomen during attempted laparoscopy. in light of the rhythm concerns, the procedure was converted to an open approach. the procedure progressed without further hemodynamic or arrhythmic issues and he was transferred to icu in stable condition, intubated. the ep/cardiology service was consulted for further management, they recommended continuing his outpatient anti-arryhthmic (dofetilide) and initiating post-op beta-blockade with iv metoprolol. serial ekgs were closely monitored without issue. he was transitioned to oral metoprolol, continued his dofetilide, and started digoxin with resolve of cardiac issues by pod#4. vitals signs were closely monitored via telemetry. lopressor increased to provide better appropriate rate control. respiratory: the patient was extubated pod# 1 successfully. the patient had no episodes of desaturation. the patient denied cough or respiratory symptoms. pulse oximetry was monitored closely and the patient maintained adequate oxygenations. serial cxrs did reveal some evidence of atelectasis versus consolidation, along with pleural effusions (improved with diuresis) which was closely monitored. a sputum sample revealed h. influenzae (non type-b) that was sensitive to ampicillin. given diurnal temperature spikes and the respiratory source of infection, empiric vancomycin and zosyn iv were started on pod#2. he completed a course of zosyn and his respiratory status was stable. gastrointestinal: the patient was npo following their procedure and transitioned to sips and a clear liquid diet on pod#. the patient experienced no nausea or vomiting. his ostomy site began functioning with liquid stool output and gas in the appliance on pod# . his stoma site appeared dusky and friable with some edema that progressed post-op, but was cloesly monitored and deemed clinically stable. the patient was transitioned to a regular diet on pod#9 and iv fluids were discontinued once adequate po intake was established. genitourinary: the patient's urine output was closely monitored in the immediate post-operative period. a foley catheter was placed intra-operatively and removed on pod#6, at which time the patient was able to successfully void without issue. the patient's intake and output was closely monitored for > 30 ml per hour output. the patient's creatinine was stable, his baseline being above normal. heme: the patient remained hemodynamically stable and only required transfusion of 2 units of packed red blood cells. the patient's coagulation profile remained normal. the patient had no evidence of bleeding from their incision. id: the patient was febrile immediately post-op and displayed a nearly diurnal fever curve, the source likely being a sputum sample which revealed h. influenzae (non type-b) that was sensitive to ampicillin. given diurnal temperature spikes and the respiratory source of infection, empiric vancomycin and zosyn iv were started on pod#2. their white count was stable post-operatively and their incision was closely monitored for any evidence of infection or erythema. staples were removed from the superior aspect of the incision on pod#5 given some spreading peri-incisional erythema, and green-brown purulence was expressed and cultured. dry dressing were changed daily following the staple removal. there was no induration, fluctuance. wound cultures demonstrated pan-sensitive pseudomonas and he has been on oral ciprofloxacin, which will continue until . endocrine: the patient's blood glucose was closely monitored in the post-op period with q6 hour glucose checks. blood glucose levels greater than 120 mg/dl were addressed with an insulin sliding scale. prophylaxis: the patient was maintained on heparin 5000 units sq tid for dvt/pe prophylaxis and encouraged to ambulate immediately post-op. the patient also had sequential compression boot devices in place during immobilization to promote circulation. gi prophylaxis was sustained with protonix/famotidine. the patient was encouraged to utilize incentive spirometry, ambulate early and was discharged in stable condition. medications on admission: 1. dofetilide 250 mcg capsule sig: two (2) capsule po bid. 2. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 3. pradaxa 150 mg tablet sig: one (1) tablet, po bid. 5. furosemide 80 mg tablet sig: 1.5 tablets po daily (daily). 6. metoprolol er 50mg tablet sig: one (1) tablet po qday. 7. warfarin 5 mg tablet sig: one (1) tablet po once (once): dose to be adjusted based on inr. 8. colchicine 0.6mg tablet sig: one (1) tablet po daily. 9. simvastatin 40mg tablet sig: one (1) tablet po daily. 10. diovan 80mg tablet sig: one (1) tablet po daily. discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for fever, pain. 2. dofetilide 250 mcg capsule sig: two (2) capsule po q12h (every 12 hours). 3. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. furosemide 80 mg tablet sig: 1.5 tablets po daily (daily). 6. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 7. warfarin 5 mg tablet sig: one (1) tablet po once (once): dose to be adjusted based on inr. 8. cipro 500 mg tablet sig: one (1) tablet po twice a day for 5 days: five more days of antibiotics - course to end on . 9. oxycodone 5 mg capsule sig: capsules po every 4-6 hours as needed for pain. discharge disposition: extended care facility: at discharge diagnosis: synchronous sigmoid colon and rectal cancers 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 after a laparoscopic converted to open proctosigmoidectomy with partial colectomy and end colostomy for surgical treatment of your colorectal cancer. during this procedure a patch was also placed to prevent you from developing a hernia near your colostomy site. you have recovered from this procedure well and you are now ready to return home. samples from your colon were taken and this tissue has been sent to the pathology department for analysis. you developed pneumonia during your hospitalization and this has been treated with broad spectrum antibiotics. you will continue antibiotics by mouth as an outpatient for the wound on your abdomen. this antibiotic is called ciprofloxacin which will end on . you have tolerated a regular diet, passing gas and your pain is controlled with pain medications by mouth. you may be discharge to a rehabiliation facility to finish your recovery. monitor your bowel function closely, if you have any of the following symptoms please call the office for advice or go to the emergency room if severe: increasing abdominal distension, increasing abdominal pain, nausea, vomiting, inability to tolerate food or liquids, prolonges loose stool, or constipation. you have a new colostomy. it is important to monitor the output from this stoma. it is expected that the stool from this ostomy will be solid to semi-solid and formed similar to regular stool. you should have bowel movements daily. if you notice that you have not had any stool from your stoma in days, please call the office. you may take an over the counter stool softener such as colace if you find that you are becoming constipated from narcotic pain medications. please watch the appearance of the stoma, your stoma has become darker purple/bluish/slightly yellow which is from some compromised blood flow after your procedure, occationally this happens with stomas and we watch the stoma for improvement which yours has shown. the stoma will likely shed dead tissues which is ok, and the tissue underneath should be beefy red/pink. this is expected to happen however it is importnat that this is watched by the wound/ostomy nurses and surgery team for improvements. the skin around the ostomy site should be kept clean and intact. monitor the skin around the stoma for buldging or signs of infection listed above. please care for the ostomy as you have been instructed by the wound/ostomy nurses. you will be able to make an appointment with the ostomy nurse in the clinic 5-7 days after discharge, you will have a visiting nurse at home for the next few weeks helping to monitor your ostomy until you are comfortable caring for it on your own. you have a long vertical incision on your abdomen that is partially closed with staples. the incision had a small area of infection , and was opened at the bedside. this dressing must be cared for by yourself and visiting nurses with wet to dry dressing changes twice daily. it is important to monitor the wound for signs of infection listed below. you will take antibiotics that will help treat infection inthe area and allow the wound to heal. the staples will stay in place until your first post-operative visit at which time they can be removed in the clinic, most likely by the office nurse. please monitor the incision for signs and symptoms of infection including: increasing redness at the incision, opening of the incision, increased pain at the incision line, draining of white/green/yellow/foul smelling drainage, or if you develop a fever. please call the office if you develop these symptoms or go to the emergency room if the symptoms are severe. you may shower, let the warm water run over the incision line/ wound and pat the area dry with a towel, do not rub. reapply a new dressing after showering. no heavy lifting for at least 6 weeks after surgery unless instructed otherwise by dr. or dr. . you may gradually increase your activity as tolerated but clear heavy excersise dr. and dr. . you will be prescribed a small amount of the pain medication oxycodone. please take this medication exactly as prescribed. you may take tylenol as recommended for pain. please do not take more than 4000mg of tylenol daily. do not drink alcohol while taking narcotic pain medication or tylenol. please do not drive a car while taking narcotic pain medication. thank you for allowing us to participate in your care! our hope is that you will have a quick return to your life and usual activities. good luck! followup instructions: please see dr. in the colorectal surgery office on tuesday, at 10am. the phone number is . provider: clinic phone: date/time: 3:30 provider: , m.d. phone: date/time: 4:00 please make an appointment with your primary care provider to update them on your position. procedure: open and other left hemicolectomy permanent colostomy diagnoses: pneumonia, organism unspecified other primary cardiomyopathies malignant neoplasm of liver, secondary congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified cardiac complications, not elsewhere classified atrial fibrillation systolic heart failure, unspecified pulmonary collapse paroxysmal ventricular tachycardia alkalosis chronic systolic heart failure long-term (current) use of anticoagulants personal history of malignant neoplasm of bladder ventricular fibrillation automatic implantable cardiac defibrillator in situ dehydration benign neoplasm of colon diverticulosis of colon (without mention of hemorrhage) anemia in neoplastic disease laparoscopic surgical procedure converted to open procedure surgical operation with formation of external stoma causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation malignant neoplasm of other sites of rectum, rectosigmoid junction, and anus 

Answer: The patient is high likely exposed to