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: aldactone attending: chief complaint: guaiac positive stools major surgical or invasive procedure: colonoscopy history of present illness: this is a 56 year old man with a history of congenital heart disease s/p recent admission for mvr/pvr, and paroxysml afib previously on coumadin, recently d/c'd from for gib who returns with ?melena and ?hypotension to 80's. patient was seen by gi on last admission and egd showed generalized gastritis without ulcer. they recommmended c-scope outpt. . the patient was unaware of having had melena or brbpr until he was told by staff at his rehab that he had black stools. he has felt well. he denies abdominal pain, n/v, diarrhea, constipation. he also denies cp, sob. he had been working with pt until instructed that he needed to go to ed. transfer note from rehab shows vs with bp of 98/59 and hr of 95. . in the ed, vs: 96.7, 85, 99/55, 94% on 6l tm. his stool guaiac +. hct noted to be 27.1 (range 23-24 on last admission, 24.4 at time of discharge). he received 1u prbcs. inr 1.0. patient was given 40mg protonix iv. gi saw him aware and planning on colonoscopy in am. past medical history: #congenital heart disease -s/p pulmonic valvulotomy in -s/p vsd repair -: redo sternotomy, pvr (porcine), mvr (porcine), vsd closure, pfo closure #chf #s/p trach, open j-tube in #dm #anxiety #depression #a fib #rbbb #rle varicosities #s/p r hernia repair #s/p appy social history: disabled never used tobacco occasional etoh family history: father had mi at age 55 physical exam: t: 97.2 bp: 111/60 p: 82 rr: 22 o2 sats: 100% on 6l trach mask gen: nad heent: perrl, mmm, op clear neck: trach cv: regular with frequent ectopy, harsh systolic murmur best heard at usb resp: ctab abd: +bs, j tube in place, small surgical wound, closing by secondary intention. guaiac: positive in ed ext: hyperpigmentation c/w chronic venous insufficiency, 3+ pitting edema to knees neuro: aao x3, cn 2-12 intact, sensation to light touch intact, upper ext strength, 4+/5 trunk strength, proximal lower body, 4+/5 in distal lower extremities pertinent results: 02:30pm wbc-7.2 rbc-2.94* hgb-8.6* hct-27.1* mcv-92 mch-29.2 mchc-31.6 rdw-15.2 02:30pm neuts-79.4* lymphs-12.9* monos-5.4 eos-2.3 basos-0.1 02:30pm plt count-203 02:30pm glucose-41* urea n-17 creat-0.6 sodium-139 potassium-3.7 chloride-98 total co2-35* anion gap-10 03:33pm pt-12.4 ptt-28.5 inr(pt)-1.0 08:49pm hct-25.0* hct : 29.6 hct : 28.1, 28.1 brief hospital course: a/p: 56m with congenital heart disease s/p complicated valve repair/vsd/pfo repair with recent trach/peg and very recent admission to icu for gib with negative egd p/w dark stool and baseline hct. . # anemia/black stools: patient recently had an upper egd which showed mild gastritis but was otherwise unremarkable. he underwent colonoscopy and egd with small bowel enteroscopy without identification of a bleeding lesion to the level of his j-tube. he subsequently underwent capsule endoscopy on . results will be available in days. the report can be obtained by calling dr. office at in 10 days. his hematocrit at transfer was 27, higher than his baseline at 24. he subsequently drifted to 24 and was transfused a total of 2 units, last on . his hematocrit has subsequently stayed between 27-29.9 and was 28.5 at discharge. the patient's iron supplementation was held at discharge. for the procedures he was given ampicillin and gentamicin for endocarditis prophylaxis. last bowel movement was immediately prior to transfer and was brown. . # chronic respiratory failure: the patient was stable on trach collar during the day, each day, and the patient was oob in the chair. at night the patient asked to be placed on the ventilator. the night prior to transfer he was on pressure support ventilation overnight and tolerated well. per abg, it is likely the patient has a component of contraction alkalosis which may be contributing to his need for ventilatory support at night. he was restarted on his outpatient lasix dose for his primary providers to adjust as they deem necessary. . # paf: the patient is anticoagulated for the atrial fibrillation, not the bioprosthetic valves. therefore, the coumadin had been held prior to admission and will continue to be held until the results of the capsule endoscopy are available. . # congenital heart disease: s/p recent surgery. no cad on cath in . patient was restarted on aspirin, statin, and lower dose of beta blocker as his blood pressures ran lower during this hospitalization. at discharge his blood pressures running 90s/50s on metoprolol 12.5 mg with holding parameters, and he was tolerating this well. . # anxiety/depression: continued home meds (fluoxetine, klonopin) . # dm/glucose control/hypoglycemia: initially hypoglycemic at admission, then hyperglycemic on d5. the patient was restarted on lower amount of tf than he had been receiving at his facility, thus his long acting insulin was restarted at 1/2 dose and ssi at discharge. . medications on admission: 1. atorvastatin 20 mg daily 2. ascorbic acid 500 mg 3. fluoxetine 20 mg daily 4. docusate sodium 50 mg/5 ml 5. miconazole nitrate 2 % powder qid 6. albuterol sulfate 2.5 mg/3 ml inhalation q6h prn 7. ipratropium bromide 0.02 % solution q6 prn 8. nystatin (5) ml po qid 9. acetaminophen ml po q6h prn 10. clonazepam 0.5 mg tablet po bid prn 11. lansoprazole 30 mg tablet daily 12. aspirin 81 mg tabletdaily 13. ferrous sulfate 300 mg/5 ml daily 14. metoprolol tartrate 25 mg tablet po twice a day. 15. insulin glargine twenty (20) units subcutaneous at bedtime. 16. insulin lispro 100 unit/ml solution : sliding scale coverage subcutaneous four times a day. 17. nutrition tube feeds glucerna tube feeds 90cc/hour 18. lasix 20mg pgt -coumadin 4mg on 250cc free water q shift discharge medications: 1. atorvastatin 20 mg tablet : one (1) tablet po hs (at bedtime). 2. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 3. clonazepam 0.5 mg tablet : one (1) tablet po bid (2 times a day). 4. fluoxetine 10 mg capsule : two (2) capsule po daily (daily). 5. ascorbic acid 500 mg tablet : one (1) tablet po bid (2 times a day). 6. docusate sodium 50 mg/5 ml liquid : five (5) ml po bid (2 times a day). 7. albuterol 90 mcg/actuation aerosol : 1-2 puffs inhalation q6h (every 6 hours) as needed. 8. ipratropium bromide 17 mcg/actuation aerosol : two (2) puff inhalation qid (4 times a day). 9. nystatin 100,000 unit/ml suspension : five (5) ml po qid (4 times a day) as needed. 10. acetaminophen 160 mg/5 ml solution : one (1) po q6h (every 6 hours) as needed. 11. aspirin 81 mg tablet : one (1) tablet po once a day. 12. metoprolol tartrate 25 mg tablet : 0.5 tablet po bid (2 times a day): hold for sbp <100, hr <60. 13. insulin glargine 300 unit/3 ml insulin pen : ten (10) units subcutaneous at bedtime. 14. insulin lispro 100 unit/ml solution : variable units subcutaneous four times a day: per outpatient facility sliding scale. 15. furosemide 20 mg tablet : one (1) tablet po bid (2 times a day). 16. miconazole nitrate 2 % powder : one (1) appl topical tid (3 times a day) as needed. discharge disposition: extended care facility: - discharge diagnosis: gib (guaiac positive stools) . congenital heart disease diabetes mellitus discharge condition: stable. requiring intermittent ventilation via trach. hct stable for more than 24 hours. discharge instructions: you were admitted with guaiac positive stools. followup instructions: you are going back to rehab. you should follow up with your doctors as previously planned. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours other endoscopy of small intestine colonoscopy transfusion of packed cells diagnoses: anemia, unspecified congestive heart failure, unspecified atrial fibrillation dysthymic disorder diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled heart valve replaced by transplant hemorrhage of gastrointestinal tract, unspecified unspecified gastritis and gastroduodenitis, without mention of hemorrhage diverticulosis of colon (without mention of hemorrhage) gastrostomy status chronic respiratory failure tracheostomy status 

Answer: The patient is high likely exposed to