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: erythromycin base attending: chief complaint: bleeding major surgical or invasive procedure: none history of present illness: ms. is a 78 yo female with extensive clot burden (pe, aortic throbus, splenic infarct) now on coumadin, svt s/p ablation, recent admission cardiac arrest (discharged ); now admit for large thigh hematoma leading to hct drop and hypotension. patient was recently discharged to rehab on after admission for s/p cardiac arrest and avnrt ablation. treated for c.diff that admission. discharged on coumadin and lovenox (until inr therapeutic, given through am of admission. . on am of awoke with l thigh pain and swelling. had been fine on prior day, went for a walk at rehab. had ct at rehab and found to have thigh hematoma there. reportedly did have instrumentation on l femoral region (? only venous or arterial) during last hospital course. . in the ed, t 99, bp 94/65, hr 120, r18, 100% ra. pressure dropped to 86/43. hct 22, inr 1.9. got 1 unit prbcs, awaiting second. given 1 l ns. not reversed given extensive clot burdern and overall stability. on cxr can't rule out pneumonia, written for ceftriaxone and levoflox but has not yet received. past medical history: htn svt s/p ablation on hyperlipidemia clot burden with pe, aortic thrombosis, and splenic infacrt seen on s/p cardiac arrest in c diff (finished po vanc on ) small subarachnoid hemorrhage in social history: married, lives in . retired, had her own business. denies tobacco, alcohol, or drug use. family history: grandmother with nephrolithiasis. no family history of early mi. physical exam: t 98.2, bp 122/58, hr 77, rr 20, o2sat 100% ra, wt 53.6kg general: elderly female sitting up in bed. nad. oriented to self but not to place or date or person. heent: ncat, aniceteric sclera, non-injected conjunctiva, eomi, mmm, strong aortic pulsation in neck. did not appreciate jvp. cv: rrr 3/6 sem lungs: ctab no w/r/r abdomen: +bs, soft, ntnd ext: left thigh enlarged and tense compared to right. dp and pt 2+ symmetric. no femoral bruit appreciated. neuro: cn iii-xii in tact including hearing to finger rub, strength seems full throughout but patient not fully cooperating with exam. sensation appears in tact. alert but not oriented other than to self. reflexes 2+ bicep, brachioradialis, patellar. toes mute. pertinent results: admission: wbc-13.8*# rbc-2.41*# hgb-7.3* hct-22.2* mcv-92 mch-30.1 mchc-32.7 rdw-17.0* plt ct-342 pt-20.7* ptt-30.1 inr(pt)-1.9* discharge: wbc-10.8 rbc-3.79* hgb-11.3* hct-34.6* mcv-91 mch-29.8 mchc-32.7 rdw-15.1 plt ct-691* pt-13.2 ptt-24.4 inr(pt)-1.1 glucose-85 urean-19 creat-0.6 na-138 k-4.3 cl-101 hco3-27 angap-14 alt-32 ast-30 ld(ldh)-292* alkphos-66 totbili-1.3 coagulopathy work up done off anticoagulation: 01:00pm blood at iii-pnd protcfn-pnd 01:00pm blood lupus-neg 07:15am blood thrombn-15.5*# 07:15am blood aca igg-4.4 aca igm-9.4 07:15am blood inh scr-neg at iii-59* 06:09am blood lmwh-0.54 micro: stool c diff positive stool fecal culture-negative; campylobacter culture-negative; clostridium difficile toxin a & b test-negative urine urine culture-negative mrsa screen mrsa screen-negative blood culture blood culture, routine-no growth blood culture blood culture, routine-no growth urine cytology pending ct torso and left le: impression: 1. no aortic thrombus. thrombosis of the celiac axis, as before. 2. large hypodense area within the spleen, likely sequelae from infarction. 3. very large left groin/medial thigh hematoma with high-attenuation focus located superiorly and centrally suspicious for arterial extravasation. ct abdomen/pelvis: impression: 1. no evidence of renal stones. 2. colonic wall thickening and pericolonic stranding is seen along the ascending colon and splenic flexure with mild sigmoid thickening in some areas, concerning for colitis. 3. cholelithiasis without evidence of cholecystitis. 4. mild improvement of the left pleural effusion and left lower lobe atelectasis since the prior study. persistent mild right atelectasis is seen. ct head without contrast: impression: 1. no acute intracranial abnormality. 2. equivocal left frontovertex focal subarachnoid hemorrhage is no longer seen. 3. generalized atrophy, likely accounting for the symmetric prominence of the bifrontal extra-axial csf spaces. echo: conclusions the left atrium is mildly dilated. left ventricular wall thicknesses and cavity size are normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). the estimated cardiac index is normal (>=2.5l/min/m2). right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is mild mitral valve prolapse. a late systolic jet of moderate (2+) mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. compared with the prior study (images reviewed) of , left and right ventricular systolic function has normalized. the severity of mitral regurgitation has decreased. brief hospital course: 78 yo f with htn, recent cardiac arrest and large clot burden with pe, aortic thrombus, svt s/p recent ablation who presented with acute blood loss anemia and hypotension and found to be bleeding into her left thigh. given her clot burden she has been discharged on her prior admission on coumadin and lovenox. she presented with a large left thigh/groin hematoma and hypotension from acute blood loss anemia. she initially required a stay in the micu and required blood pressor agents and a total of 5 units of prbcs. vascular surgery and interventional radiology were consulted initially, but her bleeding quickly slowed down and she responded to blood products, so no procedural intervention was needed. once she was stabilized she was transferred to the medical floor. her hematocrit remained stable throughout the rest of the admission. . # acute blood loss anemia: she was subtherapeutic on admission with inr of 1.9 but also on lovenox at the time of the bleed. she had had prior instrumentation through her left groin for svt ablation procedure and a femoral venous line. this was believed to contribute to the fagility of her vessels. hematology consult was obtained regarding risks and benefits to restarting anticoagulation (recent bleed and huge fall risk, but large clot burden). her husband thought she had some bright red blood per rectum at rehab prior to admission, and she had a history of some gross hematuria. to further evaulate this she underwent upper and lower endoscopy which were clean without source of bleeding or polyps and she underwent cystoscopy which was also clean. urology consult believed that a prior kidney stone had contributed to her prior hematuria. two urinalyses were negative for blood. she does have a urine cytology pending at discharge. while off of anticoagulation, she also had a work up for coagulopathy which was largely negative. some tests were still pending at discharge. she should follow up with her outpatient hematologist. given this work up, it was decided that she should be restarted on anticoagulation in consultation with the hematologist. she was discharged on lovenox and coumadin. vna services will check her inr and hct and fax them to her pcp . . . # diarrhea: she had recently completed a two week course of po vancomycin for c diff infection on . she began to have watery guiac negative diarrhea during the admission. initial stool culture and c diff toxin were negative, but then subsequent c diff was positive. she was sent home on a 2 week course of po vancomycin for presumed insufficiently treated c diff infection. . # clot burden: she was previously diagnosed with pe and aortic and celiac thrombus and splenic infarcs. it was unclear why she had both venous and arterial clots but had been started on anticoagulation on her prior admission. as above, the risk of further clots outweighted the risk of further anticoagulation once she was stablized from her bleed. she was restarted on anticoagulation as described above with close follow up. a coagulopathy work up was performed off of anticoagulation and she will follow up with her outpatient hematologist. . # s/p cardiac arrest and subsequent svt ablation: last month she had cardiac arrest for unclear reason. she was left with possible mild hypoxic brain injury. her last echo after the arrest showed a stunned myocardium with lvef of 20%. a repeat echo this admission showed residual moderate mitral regurg but normal biventricular function. . # svt s/p ablation: she was maintained in sinus rhythm throughout admission. her metoprolol was increased slightly given ectopy on telemetry. . # s/p falls: with her hypoxic brain injury, she often forgot to call the nurses before getting out of bed. she fell two times in the hospital. head imaging showed no bleeds after the falls. she did have a left upper lip laceration after the second fall which required 4 sutures by plastic surgery. these should be removed in 7 days on . bacitracin should be applied twice a day. she was evaluated by physical therapy and they felt she needed 24 hour care. her husband wanted to take her home rather than resume a stay at rehab. he worked with physical therapy and they felt she was safe to go home with 24 hour care that her husband said he could provide. it was stressed that she could not be left alone given her fall risk especially in the setting of resuming of her anticoagulation. medications on admission: 1. vancomycin 125 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 8 days: completed . 2. enoxaparin 80 mg/0.8 ml syringe sig: one (1) subcutaneous subcutaneous q12h (every 12 hours): please discontinue after inr is therapeutic (between ) for 24 hours. given through am. then given enoxaparin 60 mg x 2 doses, last am 3. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 4. warfarin 2 mg tablet sig: one (1) tablet po once daily at 4 pm: please adjust dose for inr . 5. aspirin 81 mg tablet sig: one (1) tablet po once a day. bactrim 80-400 () for uti discharge medications: 1. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 2. multivitamin tablet sig: one (1) tablet po daily (daily). 3. outpatient lab work please check inr and hct on friday and fax to dr. at . please repeat inr on monday and then every three days until instructed otherwise by dr. . 4. warfarin 2.5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 5. enoxaparin 40 mg/0.4 ml syringe sig: one (1) subcutaneous q12h (every 12 hours) for 7 days. disp:*14 syringes* refills:*2* 6. vancomycin 250 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 14 days. disp:*56 capsule(s)* refills:*0* discharge disposition: home with service facility: greater vna discharge diagnosis: acute blood loss anemia from thigh hematoma s/p fall and lip laceration c diff recurrent secondary diagnosis: clot burden- pe, aortic thrombus and splenic infarct. svt s/p ablation htn hyperlipidemia discharge condition: stable hct. discharge instructions: you were admitted with bleeding into your thigh (called a hematoma). you were given several units of blood back and the bleeding stopped. you had endoscopy to evaluate for any bleeding from your stomach or colon and they were both normal with no bleeding. you had cystoscopy to evaluate if there was bleeding from your bladder and this was also normal. you likely had some bleeding before from a kidney stone which you passed. you were restarted on coumadin and lovenox until your inr (lab test to show your blood is thin. goal inr is between ). please have the vna check your inr on friday and send to dr. office to make adjustments as needed. fax to dr. . please check every three days until dr. instructs you to change this. you must continue lovenox injections until dr. says to stop. you have a c diff infection causing diarrhea. please take vancomycin by mouth for 2 weeks. do not take immodium while you have this infection as it can make things worse. you had sutures to your lip. you will need these removed on by the visiting nurse. you need to have 24 hour supervision at home because of your falling. this means someone must be with you 24 hours a day. if your husband needs to go out, someone else must come in to help take care you. please return to the ed or call your physician if you have fevers over 102, chills, signs of bleeding, chest pain or trouble breathing or any other symptoms which are concerning to you. followup instructions: primary care physician: . . please call to schedule an appointment in weeks at . hematology/oncology: , md , md phone: please call to reschedule as you were in the hospital and missed your appointment. cardiology: , md phone: date/time: 10:20 md procedure: other endoscopy of small intestine colonoscopy other cystoscopy suture of laceration of lip transfusion of packed cells diagnoses: congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia hematoma complicating a procedure other and unspecified hyperlipidemia anoxic brain damage other shock without mention of trauma intestinal infection due to clostridium difficile chronic systolic heart failure personal history of venous thrombosis and embolism primary hypercoagulable state nontraumatic hematoma of soft tissue personal history of urinary calculi embolism and thrombosis of other specified artery accidental fall from bed chronic vascular insufficiency of intestine open wound of lip, without mention of complication leukocytosis, unspecified history of fall 

Answer: The patient is high likely exposed to