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: patient recorded as having no known allergies to drugs attending: chief complaint: melena major surgical or invasive procedure: esophagogastroduodenoscopy esophagogastroduodenoscopy history of present illness: 72 yo m with pmh of cad s/p cabg and pci to lcx, as, vt/vf arrest with biv pacer, chf (ef 20%), afib on coumadin, cri (bl cr 1.6-2), and diverticulosis admitted with abdominal pain and melena for two days. reported hypotension by vna to 96/p. the patient has a history of recurrent gib with most recent admission on to . during last hospital stay the patient was admitted to the micu for monitoring and serial hcts. a hct drop from 39 to 32 was noted, which then stabilized. gi saw the patient and deferred scope. his coumadin was discontinued at this time due to recurrent bleeding. he was also admitted on with melena and abd pain. egd showed barrett's esophagitis, gastritis, and duodenitis. he has a history of polyp removal in the cecum and one in the ascending colon in , histology was adenomatous. he also had a capsule study at that time, that did not show additional source of bleed in the small bowel. in ed, vitals t 98.2, hr 78, bp 111/61, rr 18, 100% 2l nc. ng lavage showed scant blood initially which cleared with lavage. hct stable. he was given morphine 4mg x3. no asa given. bolused with 40mg iv pantoprazole x1. on arrival to micu, pt is in no acute distress. reports black, tarry stools last pm with associated dizziness. pt has also had ongoing abdominal and back pain since discharge last week. his pain is constant and non-radiating located in his chest, abdomen and back. past medical history: cad status post cabg with simultaneous aortic aneurysm repair in , history of stenting of the left circumflex artery s/p vt/vf arrest, s/p icd placement in icmp (ef 20%) s/p biv pacer chest wall cellulitis over pacer site vs. icd pacer pocket infection afib ckd stage iii b/l cr. ~1.6 hyperlipidemia asthma anxiety alzheimer's dementia hypothyroidism diverticulosis gerd s/p ccy social history: patient originally from and moved to the united states in . father of five children. no history of smoking. patient was a heavy drinker until 20 years ago, when he stopped completely after attending aa and encountering marital difficulties. no history of illicit drug use. family history: non-contributory physical exam: discharge physical exam v/s: 99.1, 97.6, 120/70-102/62, 80s, 16, 94% ra gen - obese gentleman appears comfortable, nad heent- sclera anicteric, op clear with mmm neck: supple without jvd, delayed carotid upstroke no bruit cv: reg rate nl s1 no s2 iii/vi sem at lusb pulm: ctab no w/r/r abd: soft ntnd normoactive bs no organomegaly ext- warm, dry diminished distal pulses no c/c/e neuro: a&ox3 pertinent results: 08:20am blood wbc-7.0 rbc-3.95* hgb-11.7* hct-34.5* mcv-87 mch-29.5 mchc-33.8 rdw-14.2 plt ct-198 08:10am blood wbc-5.6 rbc-3.82* hgb-11.2* hct-33.2* mcv-87 mch-29.4 mchc-33.7 rdw-14.7 plt ct-186 07:35am blood wbc-5.8 rbc-3.60* hgb-10.5* hct-31.5* mcv-88 mch-29.1 mchc-33.2 rdw-14.2 plt ct-167 07:00am blood wbc-6.5 rbc-3.66* hgb-10.7* hct-32.0* mcv-87 mch-29.1 mchc-33.4 rdw-14.3 plt ct-160 06:10am blood wbc-12.4* rbc-4.01* hgb-12.0* hct-34.6* mcv-86 mch-29.9 mchc-34.6 rdw-14.5 plt ct-164 06:00am blood wbc-9.0 rbc-4.04* hgb-11.5* hct-35.4* mcv-88 mch-28.5 mchc-32.6 rdw-14.5 plt ct-176 07:52pm blood hct-34.6* 04:57pm blood hct-33.4* 06:55am blood wbc-7.9 rbc-4.09* hgb-12.1* hct-35.6* mcv-87 mch-29.5 mchc-33.9 rdw-14.9 plt ct-181 01:05am blood hct-34.5* 06:45pm blood wbc-10.1 rbc-4.03* hgb-11.8* hct-35.0* mcv-87 mch-29.2 mchc-33.6 rdw-14.4 plt ct-175 12:58pm blood wbc-7.7 rbc-4.21* hgb-12.1* hct-36.1* mcv-86 mch-28.8 mchc-33.6 rdw-15.0 plt ct-169 07:35am blood alt-18 ast-20 alkphos-86 totbili-0.2 08:19am blood ck(cpk)-103 01:05am blood ck(cpk)-124 12:58pm blood ck(cpk)-189* 08:19am blood ck-mb-3 ctropnt-0.01 12:58pm blood ctropnt-0.01 08:14pm blood lactate-0.9 . 12:52 pm stool consistency: not applicable source: stool. **final report ** clostridium difficile toxin a & b test (final ): reported by phone to @ 3:55a . clostridium difficile. feces positive for c. difficile toxin by eia. . ct of the abdomen with iv contrast: within the visualized lung bases, there is atelectasis within the left lung base. there is no pleural effusion. visualized heart and pericardium reveal no pericardial effusion. the liver, spleen, pancreas, and adrenal glands are unremarkable. multiple rounded hypodensities in bilateral kidneys are stable, likely reflecting renal cysts. patient is status post cholecystectomy. the stomach and small bowel are unremarkable. there is diverticulosis of the colon, without evidence of diverticulitis. there is no evidence of acute inflammation, or secondary signs to suggest mesenteric ischemia. evaluation of the intra-abdominal vasculature reveals moderate diffuse atherosclerotic calcification involving the abdominal aorta, not significantly changed from prior study. there is mild atherosclerosis at the origin of the celiac axis. otherwise, celiac axis, superior mesenteric artery, and inferior mesenteric artery and their branches appear patent and unremarkable. there is no free air, free fluid, or pathologic adenopathy. ct of the pelvis with iv contrast: urinary bladder, rectum, and prostate are unremarkable. there is no pelvic lymphadenopathy or free fluid. osseous structures: patient status post total right hip replacement. no suspicious lytic or sclerotic lesions identified. impression: no acute intra-abdominal process identified. the celiac axis, sma, and appear patent without thrombosis or occlusion. no secondary signs to suggest mesenteric ischemia identified. . l-spine (ap & lat) findings: there is a levocurvature of the mid lumbar spine. multilevel anterior osteophytes are noted. the disc spaces appear largely preserved aside from the scoliosis. extensive vascular calcifications are noted. there is a right hip total arthroplasty, partially visualized. impression: multilevel degenerative changes as detailed. . gastric mucosal biopsies a. body: focal active gastritis; stain shows no definite helicobacter-like organisms with satisfactory control. b. antrum: no diagnostic abnormalities recognized. brief hospital course: #acute gastritis - the patient was admitted to the icu overnight for observation given reported hypotension prior to admission. blood pressure was readily fluid-responsive and the patient remained hemodynamically stable. melena resolved after admission and hematocrit remained stable, obviating the need for blood transfusion. he was treated with ppi gtt in the icu which was changed to ppi on the floor. the patient egd showing erosive gastritis and barrett's esophagus but no active bleeding. continued to hold coumadin. aspirin was restarted in the setting of ppi and carafate therapy which will be continued after discharge at the recommendation of the consulting gi team. he will follow up in clinic, in part to schedule surveillance endoscopy for the monitoring of barrett's. . #candidal esophagitis - egd also revealed candidal esophagitis which had been present on endoscopy 6 months prior and perhaps inadequately treated with a 10-day course of fluconazole. hiv ab test was negative at that time. a 3-week course of oral fluconazole was started with lft's to be rechecked 1 week after discharge. he was counseled regarding the proper use of his corticosteroid inhalers including rinsing thoroughly after use. . #c. difficile colitis - the patient was started on a 2 week course of flagyl. he was placed on contact precautions. was counseled not to drink alcohol while taking metronidazole. . #abdominal/back pain - this pain reportedly had been present for several years but had subacutely worsened over the past months. paraspinal muscle tenderness on examination was suggestive of musculoskeletal pathology. cta abd/pelvis showed sigmoid diverticulosis but no evidence of mesenteric ischemia or aaa. lumbar plain film showed only chronic degenerative changes but no compression deformity or lytic lesion. stable hematocrit made a rp bleed unlikely. urinalysis, lft's, calcium, and spep/upep were normal. pain was well-controlled with tylenol. . #chronic systolic chf - the patient appeared euvolemic without signs or symptoms of acute chf. acei had been discontinued prior to admission due to hypotension. he will continue on beta-blocker, digoxin, and diuretic therapy after discharge. . #atrial fibrillation - coumadin was held due to recurrent ugib, as above. aspirin was continued. he was encouraged to follow up with his cardiologist as soon as possible. . #chronic kidney disease stage iii - creatinine remained at baseline. medications were dosed accordingly. . #hyperlipidemia - continued statin. . #hypothyroidism - continued levothyroxine. . #asthma - continued home regimen with counseling regarding proper use of steroid inhalers, as above. . #nutrition - heart-healthy diet. . #propylaxis - pneumoboots, ppi medications on admission: sotalol 80 mg po bid atorvastatin 20 mg po daily donepezil 5 mg po hs citalopram 40 mg 1.5 tab po daily quetiapine 25 mg tab po tid clonazepam 0.5 mg tablet 1 tablet po tid prn anxiety digoxin 62.5 mcg po daily k-dur 20 meq tab sust.rel. particle/crystal 1 tab po daily levothyroxine 112 mcg tablet 1 tablet po daily trazodone 50 mg tablet 1 po hs mexiletine 150 mg capsule 1 capsule po q8h albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation nitroquick 0.4 mg tablet, sublingual sig: one (1) sublingual as needed as needed for chest pain magnesium oxide 400 mg tablet 1 tablet po daily pantoprazole 40 mg tablet 1 tab q 12 aspirin 81 mg tablet po daily spironolactone 25 mg tablet sig: 0.5 tablet po daily fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation metoclopramide 10 mg tablet sig: 0.5 tablet po tid/prn nausea metoprolol succinate 50 mg tablet sustained release 24 hr po daily furosemide 80 mg tablet po daily discharge medications: 1. fluconazole 100 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 11 days: through wednesday, . disp:*11 tablet(s)* refills:*0* 2. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 11 days: through wednesday, . disp:*33 tablet(s)* refills:*0* 3. sotalol 80 mg tablet sig: one (1) tablet po bid (2 times a day). 4. levothyroxine 112 mcg tablet sig: one (1) tablet po daily (daily). 5. citalopram 40 mg tablet sig: 1.5 tablets po once a day. 6. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 7. quetiapine 25 mg tablet sig: two (2) tablet po qam (once a day (in the morning)). 8. quetiapine 25 mg tablet sig: one (1) tablet po noon (at noon). 9. quetiapine 25 mg tablet sig: three (3) tablet po hs (at bedtime). 10. sucralfate 1 gram tablet sig: one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*0* 11. mexiletine 150 mg capsule sig: one (1) capsule po q8h (every 8 hours). 12. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*0* 13. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 14. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) inh inhalation (2 times a day). 15. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation every 4-6 hours as needed for shortness of breath or wheezing. 16. metoclopramide 10 mg tablet sig: 0.5 tablet po q8h (every 8 hours) as needed for nausea. 17. klonopin 0.5 mg tablet sig: one (1) tablet po three times a day as needed for anxiety. 18. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 19. aspirin ec 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 20. donepezil 5 mg tablet sig: one (1) tablet po at bedtime. 21. toprol xl 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po at bedtime. 22. lasix 40 mg tablet sig: one (1) tablet po once a day. 23. spironolactone 25 mg tablet sig: 0.5 tablet po once a day. 24. k-dur 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. 25. magnesium oxide 400 mg tablet sig: one (1) tablet po once a day. 26. glycolax 17 gram (100 %) powder in packet sig: one (1) packet po once a day. 27. nitrostat 0.3 mg tablet, sublingual sig: one (1) tablet sublingual three times a day as needed for chest pain: take up to 3 tablets 5 minutes apart as needed for chest pain and seek immediate medical attention. 28. outpatient lab work please check chemistries and liver function tests on , and fax the results to the office of dr. at . discharge disposition: home with service facility: homecare discharge diagnosis: primary 1) acute blood loss anemia 2) acute gastritis 3) candidal esophagitis 4) clostridium difficile colitis secondary 1) coronary artery disease 2) chronic systolic heart failure 3) atrial fibrillation 4) chronic kidney disease stage iii 5) hypothyroidism discharge condition: asymptomatic with stable vital signs. discharge instructions: you were admitted to the hospital with dark stools, likely from erosions and inflammation in the lining of the stomach seen on upper endoscopy. your coumadin (warfarin) was discontinued due to recurrent bleeding. continue taking aspirin daily as prescribed. take protonix 2 times daily and a new medication carafate (sucralfate) 4 times daily to help heal and protect the stomach lining. upper endoscopy also showed a fungal infection in the esophagus which was partially treated with an antifungal medication. please continue taking fluconazole through tuesday, . please have blood drawn for chemistries and liver function tests on , and ensure that the results are faxed to dr. office at . you were diagnosed with a bacterial infection in the large intestine which was partially treated with an antibiotic medication. please continue flagyl (metronidazole) as prescribed through wednesday, . do not drink alcohol while taking this medication due to the risks of side effects from this combination. you no longer need to use the fluticasone inhaler if you are also using advair. please be sure to rinse out your mouth and throat after using this medication to help prevent infection. please continue taking your other medications as prescribed. please adhere to a diet with less than 2 grams of sodium daily. please weight yourself daily and call your physician if your weight increases by greater than 3 lbs. please call the office of dr. at to arrange a follow up appointment in 1 week. please call the office of dr. at to arrange a follow up appointment in weeks. please follow up with dr. on friday, at 1:00. the office phone number is . please call your physician or return to the emergency department if you experience fever, chills, sweats, dizziness, lightheadedness, difficulty or pain with swallowing, chest pain, palpitations, shortness of breath, cough, abdominal pain, vomiting, diarrhea, bloody or black stools, or leg swelling or pain. followup instructions: provider: , md phone: date/time: 1:00 provider: , md phone: date/time: 8:40 provider: clinic phone: date/time: 1:00 md procedure: esophagogastroduodenoscopy [egd] with closed biopsy esophagogastroduodenoscopy [egd] with closed biopsy diagnoses: esophageal reflux congestive heart failure, unspecified acute posthemorrhagic anemia unspecified acquired hypothyroidism atrial fibrillation aortocoronary bypass status asthma, unspecified type, unspecified aortic valve disorders other specified forms of chronic ischemic heart disease other and unspecified hyperlipidemia chronic kidney disease, stage iii (moderate) intestinal infection due to clostridium difficile chronic systolic heart failure long-term (current) use of anticoagulants automatic implantable cardiac defibrillator in situ alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance barrett's esophagus diverticulosis of colon (without mention of hemorrhage) unspecified analgesic and antipyretic causing adverse effects in therapeutic use candidal esophagitis other specified gastritis, with hemorrhage 

Answer: The patient is high likely exposed to