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: history of present illness: the patient is an 85-year-old male with a history of a diverticular bleed while on coumadin for a stroke who had initially presented in of to find the source of the bleed, but failed intervention. the patient then underwent a partial colectomy and ileocolic anastomosis at medical center on . his hospital course there was complicated by intubation and tracheostomy for failure to wean, as well as peg placement for feeding. the patient, at that time, was discharged to for a period of three months where he was weaned from the tracheostomyt , and subsequently went to the , where he was weaned from the peg. he was discharged home. the patient was doing well, but recently seen at an outside hospital for aspiration pneumonia and methicillin resistant staphylococcus aureus sputum, requiring intubation, improved and discharged on bactrim back to the . however, on , the patient was noted to have abdominal pain, was found to have melena and clots from his ileostomy. the patient was then admitted to the micu at the and found to have a hematocrit of 30.0. the patient underwent angiography by interventional radiology which failed to detect bleed in his mesenteric arteries. the patient was subsequently scoped with an esophagogastroduodenoscopy on which showed two large and one small duodenal ulcers. the patient was placed on prilosec therapy for these duodenal ulcers. of note, helicobacter pylori studies also came back positive and the patient was to be started on triple antibiotic therapy. for the gastrointestinal bleed, the patient was transfused 5 units of packed red blood cells. during the patient's micu course, he was also noted to have elevated potassium and had a random cortisol to assess the question of renal insufficiency, but the result was not consistent with the diagnosis. the patient was also noted to have increased white blood cell count to 31.6 and was found to have gram positive cocci on his blood cultures on admission from his triple lumen catheter, now identified as staphylococcus epidermitis. the patient did well in the micu with a stable hematocrit and had denied lightheadedness, abdominal pain and bright red blood per ostomy and on , was transferred to the medicine service for further work up. past medical history: 1. diverticular bleed while on coumadin for cerebrovascular accident, status post subtotal colectomy with side to side ileocolic anastomosis at medical center on . 2. history of prostate cancer, status post xrt and orchiectomy. 3. renal cell carcinoma, status post left nephrectomy. 4. cerebrovascular accident with recent aphasia in for which she was on coumadin which was discontinued on 10/. 5. history of methicillin resistant staphylococcus aureus pneumonia. 6. depression 7. hypothyroidism 8. history of aspiration pneumonia 9. status post trach and peg placement, both of which are now removed. 10. left diaphragm paralysis. 11. question history of heart block and . 12. bilateral inguinal hernias repaired in . allergies: no known drug allergies, but the patient is sensitive to adhesive tape. social history: the patient is dnr/dni and is a patient at the . the patient is married with children admission medications: 1. synthroid 0.5 mg po q day 2. megace 800 mg 3. bactrim 4. aspirin 81 mg po q day 5. ritalin 5 mg po q day 6. albuterol metered dose inhaler 7. atrovent metered dose inhaler 8. prilosec 20 mg po q day transfer medications from micu on : 1. synthroid 0.75 mg po q day 2. vancomycin 1 mg po q 12 hours 3. prilosec 40 mg po bid 4. albuterol and atrovent metered dose inhalers laboratories: the patient's admitting hematocrit on was 30.0. after 5 units of blood, the patient's hematocrit remained stable at 31 to 32. on transfer to the medical floor, the patient's hematocrit was 31.6. chemistries were within normal limits. bun and creatinine were 35 and 1.0 respectively. tsh was 4.0. cortisol was 9.9. helicobacter pylori was positive. imaging: a chest x-ray from showed right retrocardiac density and a left hemidiaphragm elevation which was known to be old. a mesenteric angiogram on showed no evidence of bleed. a kub from showed no evidence of free air. physical exam on transfer: vital signs: temperature 98.5??????, pulse 88, blood pressure 141/50, respiratory rate 20, o2 saturation 94% on room air. general: the patient was a pleasant elderly gentleman in no apparent distress. head, ears, eyes, nose and throat: pupils equal, round and reactive to light, left surgical pupil. the patient's oropharynx was clear. mucous membranes moist. neck: right ij catheter. lungs: rancorous throughout the right lung at expiration. heart: regular rate and rhythm, normal s1, normal s2. abdomen: soft, nontender, nondistended with positive bowel sounds. there was an ostomy on the patient's right lower quadrant that showed dark stool, but not tarry. extremities: no edema. there was venostasis changes in his lower extremities bilaterally. neurologic: the patient was alert and oriented to the in . the patient's speech was slightly dysarthric, known to be old. the patient moved all four extremities. his deep tendon reflexes were 2+ throughout. cranial nerves ii through xii were intact. hospital course: in summary, an 85-year-old gentleman with subtotal colectomy and ileocolic anastomosis presents with an upper gastrointestinal bleed secondary to duodenal ulcers which was found to be helicobacter pylori positive. upon his transfer from the micu, the patient's hematocrit remained stable and while he had guaiac positive stools, he had no bright red blood per ostomy. the patient was started on a clear liquid diet and started on amoxicillin, biaxin and prilosec for triple therapy of his helicobacter pylori. the patient also remained on high dose prilosec for treatment of his duodenal ulcers. on the patient developed lower abdominal pain, as well as bilious vomiting. a kub showed elevated loops of bowel consistent with small bowel obstruction. the patient was evaluated by surgery, in which the patient was made npo and a nasogastric tube was placed. the patient also received a tube in his ileostomy for decompression through his ileostomy site to decompress his small bowel. the patient underwent a ct of the abdomen on which showed distended small bowel loops with distention all the way to the level of the ileostomy site. there was some question of whether there was focal narrowing at the ileostomy site versus generalized ileus. in addition, the patient had a low density lesion present in the right lobe of the liver which, on further review, was known to be old. the remainder of the hospital course and plan will be detailed by system: 1. partial small bowel obstruction: at this point, the patient continues to remain npo on tpn with a nasogastric tube. there was some discussion with surgery whether the patient may require a surgical procedure to assess whether adhesions are the source of the patient's obstruction. the patient underwent a barium enema per surgery to assess the patency of the ileosigmoid anastomosis and the ilium distal to the stoma. this was performed on which showed that the patient's bowel was patent from the ostomy site to the rectum. further discussion will be made with the surgical team concerning potential intervention. 2. duodenal ulcers: since the patient had a partial small bowel obstruction and was made npo. the patient's regimen for helicobacter pylori eradication was switched to intravenous protonix, intravenous azithromycin and intravenous flagyl. once the patient is able to take po's again, this regimen can be switched to a po antibiotic regimen. the patient's hematocrit remained stable at around 29 to 30 at the time of this discharge summary. 3. infectious disease: infectious disease consult was asked to asses the duration of patient's treatment with staphylococcus epidermitis bacteremia as the cultures that grew the staphylococcus epidermitis were drawn from the patient's right ij catheter. the patient had been receiving vancomycin therapy since the beginning of his hospitalization. currently, there are plans to consider removal of the triple lumen catheter once decision for surgery had been finalized and a picc line for additional access had been placed. at that point, decision for continuation of vancomycin therapy will be made pending. 4. zoster: the patient was noted to have fascicular lesions across the right upper back underneath the shoulder blade. he was ambulating with a direct fluorescent antibody test and found to be positive for varicella zoster. the patient was then started on intravenous acyclovir at 10 mg per kg per day for a total of a 7 day course. 5. hepatic: per the attending, the patient's previous primary care physician remarked that he had a previous ct in which showed a small low density in the right lower lobe that was unchanged since . 6. psychiatric: the patient was noted to be somewhat depressed during his admission and was restarted on his ritalin therapy. the patient was also involved with social work and that chaplaincy. discharge diagnoses: 1. duodenal ulcers 2. helicobacter pylori infection 3. partial small bowel obstruction 4. zoster 5. depression the remainder of the hospital course and discharge medications will be enumerated in a discharge summary addendum. , m.d. dictated by: medquist36 procedure: parenteral infusion of concentrated nutritional substances other partial resection of small intestine closure of stoma of small intestine other endoscopy of small intestine diagnoses: acidosis unspecified septicemia iron deficiency anemia secondary to blood loss (chronic) unspecified acquired hypothyroidism personal history of malignant neoplasm of prostate infection and inflammatory reaction due to other vascular device, implant, and graft chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction unspecified intestinal obstruction other colostomy and enterostomy complication 

Answer: The patient is high likely exposed to