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: ticlid / lipitor attending: chief complaint: weakness, hypotension major surgical or invasive procedure: cardioversion history of present illness: mr. is an 83m with hx parosysmal afib not on coumadin, cad s/p cabg in with lima to lad which is totally occluded after d1, svg-d1 (stent in graft), svg-om (chronically occluded), with most recent pci in with stenting lcx, s/p hip replacement, with hx chronic c.diff infection x 5 years. pt was in usoh until the night prior to admission when he noted that he was unable to get up out of bed secondary to weakness, which he noted was worse in his legs than in his arms. he struggled to get oob for a while, eventually becoming sob, with subsequent mid sternal sharp non radiating chest pain experienced, similar to his anginal episodes. the pain was not associated with diaphoresis or nausea, p.o intake, there was no positional or pleuritic component. he took slntg x1 and the cp resolved. he continued to experience this weakness on the day of admission, called life line, with ems sent to his home. on arrival he was noted to have ? nsvt on monitor. of note, he has experienced several days of diarrhea with 10 or more loose stools a day. increased from baseline. . in the er, initial vs were t97.1, hr 150, bp 73/54 -> 86/59, rr 36, o2 100% nrb. ekg showed wide complex tachycardia afib with aberancy. having cp. labs notable for wbc 26, cr 1.9 from baseline 1.3. underwent cardioversion for a. fib with hypotension and subsequently converted to sinus rhythm with resolution of his chest pain. cxr negative for pna. overall impression was for sepsis c. diff and patient given metronidazole for his diarrhea and 2l of ivf. prior to transfer had been making urine >800cc. . vitals prior to transfer hr72 113/70 17 100%2l. . ros is notable for chronic fatigue. he denies recent uris, cough, hemoptysis, fever, chills, rigors, diaphoresis, abdominal pain, sick contacts, travel, prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, black stools or red stools. he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. . on arrival to the ccu he was seen to be in slow a.fib on ekg, and hypotensive to the high 80s. ivf boluses were initiated with subsequent improvement in pressure. he was found to have gnr on blood culture and was started on iv vanc/flagyll. he was started on amniodorone drip . past medical history: -cad with stable angina, s/p cabg ', multiple stents (last cath report : two vessel cad. patent lima-lad. patent svg-d1. svg-om is known to be chronically occluded. the lcx had 70% in-stent stenosis in the proximal stent. there was a 70% lesion just distal to the stent. successful ptca of the lcx.) -moderate systolic chf - lvef of 35%-40% on echo in -moderate pulmonary artery systolic hypertension - tr gradient of 49 mmhg on echo in -a-fib (paroxysmal)previously on coumadin but not currently taking -hemoperitoneum around the liver and in the pelvis along with two splenic artery pseudoaneurysms s/p ir embolization of both in -nstemi in the setting of acute blood loss anemia during hospitalization in - h/o c diff - found in , on chronic po vanco at home; when taken off vanco, has frequent diarrhea and dehydration -htn -hyperlipidemia -anemia -prostate ca s/p xrt (over 10 years ago), s/p turp -s/p discectomy -left hip arthroplasty -severe osteoarthritis . cardiac risk factors: dyslipidemia, hypertension . cardiac history: cabg, in anatomy as follows: -lima to lad, svg-d1 (stent in graft), svg-om (chronically occluded) social history: denies tobacco and etoh use. family history: noncontributory physical exam: vs - t: hr: 80 bp: 93/55 (64) rr: 13 spo2: 99% gen: notable pallor. poor cap refill. poor skin turgor. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 7 cm. cv:mostly regular rymth. pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abd: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. ext: no c/c/e. no femoral bruits. cool lower extremities. muscle strength bue, ble. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: dp/pt: dopperable bilaterally. pertinent results: 10:56pm hct-30.0* 07:56pm lactate-2.6* 07:45pm glucose-250* urea n-37* creat-1.9* sodium-139 potassium-4.7 chloride-109* total co2-18* anion gap-17 07:45pm ck(cpk)-597* 07:45pm ctropnt-2.85* 07:45pm ck-mb-58* mb indx-9.7* 02:00pm glucose-281* urea n-37* creat-1.9* sodium-139 potassium-4.8 chloride-105 total co2-14* anion gap-25* 02:00pm ck(cpk)-39* 02:00pm ctropnt-0.05* 02:00pm calcium-9.1 phosphate-4.1 magnesium-2.0 02:00pm wbc-26.4*# rbc-3.40* hgb-10.2* hct-31.2* mcv-92# mch-30.0 mchc-32.7 rdw-15.8* 02:00pm neuts-93.8* lymphs-4.5* monos-1.3* eos-0.2 basos-0.2 02:00pm plt count-292# 02:00pm pt-13.8* ptt-22.9 inr(pt)-1.2* . cxr findings: overlying ekg leads slightly obscures film. there is moderate cardiomegaly, unchanged. there is a tortuous aorta. patient is status post cabg. sternotomy wires are intact. there is no focal consolidation, pleural effusion or pneumothorax. impression: no focal consolidation. 05:58am blood wbc-12.5* rbc-3.14* hgb-9.4* hct-28.9* mcv-92 mch-30.0 mchc-32.6 rdw-15.9* plt ct-169 05:04am blood wbc-10.5 rbc-3.20* hgb-9.3* hct-28.2* mcv-88 mch-29.0 mchc-32.8 rdw-16.4* plt ct-167 06:54am blood wbc-13.2* rbc-2.91* hgb-8.6* hct-25.8* mcv-89 mch-29.4 mchc-33.2 rdw-16.9* plt ct-155 04:54am blood pt-15.0* ptt-26.5 inr(pt)-1.3* 04:29am blood pt-15.0* ptt-28.3 inr(pt)-1.3* 03:44pm blood glucose-110* urean-42* creat-1.5* na-138 k-3.6 cl-111* hco3-17* angap-14 06:15am blood glucose-133* urean-43* creat-1.4* na-140 k-3.8 cl-112* hco3-15* angap-17 05:58am blood glucose-110* urean-39* creat-1.2 na-140 k-3.6 cl-112* hco3-17* angap-15 05:04am blood glucose-111* urean-36* creat-1.0 na-141 k-3.5 cl-114* hco3-18* angap-13 06:54am blood glucose-120* urean-31* creat-1.1 na-139 k-3.5 cl-112* hco3-16* angap-15 07:45pm blood ck(cpk)-597* 04:54am blood alt-194* ast-345* ld(ldh)-459* ck(cpk)-529* alkphos-128 amylase-224* totbili-0.4 04:29am blood alt-150* ast-167* ld(ldh)-388* alkphos-111 totbili-0.4 05:04am blood ck(cpk)-32* 02:39pm blood lipase-15 02:00pm blood ctropnt-0.05* 07:45pm blood ck-mb-58* mb indx-9.7* 07:45pm blood ctropnt-2.85* 04:54am blood ck-mb-50* mb indx-9.5* ctropnt-4.12* 05:04am blood ck-mb-notdone ctropnt-2.48* 02:00pm blood calcium-9.1 phos-4.1 mg-2.0 06:54am blood calcium-8.5 phos-2.5* mg-2.1 07:56pm blood lactate-2.6* 05:16am blood lactate-3.6* 03:11pm blood lactate-1.5 brief hospital course: patient is a 83 y/o m w paf, cad s/p cabg/pci and chronic c. diff infection who p/w hypotension, a. fib with rvr, and found to have gnr bacteremia. # urosepsis- patient was admitted to the icu with hypotension. he was volume resuscitated with adequately controlled blood pressures not requiring additional fluids. he was initially treated with iv flagyl, iv zosyn and po vancomycin given concern for c.diff (patient has chronic c.diff). blood cultures grew back gnr and urine cultures grew e.coli. patient diagnosed with urosepsis. he was switched to cefepime and flagyl. once stabilized in the unit, he was transferred to the floor. blood cultures remained negative since and wbc trended down. patient remained afebrile with no systemic complaints. he was continued on po vanc (125mg po bid) for his chronic c.diff. of note, c.diff was negative x 2 while here. cultures grew pansensitive e.coli so he was switched from cefepime to po cipro (and continued on po vancomycin). he is to continue antibiotics for 14 days (course started on ). # atrial fibrillation: patient has paroxysmal atrial fibrillation. he required cardioversion in ed. he went to slow vt and then to a.fibrillation. he was admitted to the ccu for further stabilization. while there, he was started on iv amiodarone and then transitioned to po on (400mg tid x 1 week and then 200mg daily x 3 weeks). he remained in sinus rhythm while on the floor. it was thought that the rvr was due to sepsis. he is not anticoagulated with coumadin due to fall risk and history of hemoperitoneum. home beta-blocker was held given slow hr (60-65 on day of discharge). patient continued on home dose of aspirin. #. coronary artery disease : cad s/p cabg in with lima to lad which is totally occluded after d1, svg-d1 (stent in graft), svg-om (chronically occluded), with most recent pci in with stenting lcx, s/p hip replacement. ekg not consistent with acs, chest pain and elevated troponin presumed due to demand ischemia (ck peaked ). # anemia: chronic normocytic anemia (mcv 92).near or above baseline, has a history of chronic anemia of unknown origin requiring multiple transfusions, no active issues. he did not require any transfusions while here. #arf: patient admitted with cr. of 1.5 (baseline 1.2). cr trended down to 1.1 after getting iv fluids and remained stable. #metabolic acidosis- improved; occured in setting of elevated lactate from sepsis/bacteremia; patient received iv fluids (ns) while here. # diarrhea: patient has a history of c. diff infection x 5 years. pt did present with worsening diarrhea prior to admission; initially received treatment dose of flagyl/vanc and, after urine culture returned, he resumed suppressive doses of vancomycin which he will continue indefinitely. medications on admission: aspirin 81 mg daily nigtroglycerin sr 2.5 mg metoprolol 25mg q24 sertraline 100mg vanco 125 folic acid 400mg avicor 20mg multivitamin discharge medications: 1. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 12 days. 2. vancomycin 125 mg capsule sig: one (1) capsule po bid (2 times a day). 3. multivitamin tablet sig: one (1) tablet po daily (daily). 4. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 5. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed for indigestion. 6. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 7. sertraline 100 mg tablet sig: one (1) tablet po twice a day. 8. nitroglycerin 2.5 mg capsule, sustained release sig: one (1) capsule, sustained release po once a day as needed for chest pain. 9. amiodarone 200 mg tablet sig: two (2) tablet po tid (3 times a day): through . 10. amiodarone 200 mg tablet sig: one (1) tablet po once a day for 1 months: please start on and take until . 11. heparin (porcine) 5,000 unit/ml cartridge sig: one (1) injection injection three times a day. discharge disposition: extended care facility: on the discharge diagnosis: primary paroxysmal atrial fibrillation urosepsis secondary clostridium difficile infection discharge condition: stable, good, baseline ambulatory status, baseline mental status discharge instructions: you were admitted to the hospital because you were having weakness, diarrhea and chest pain. you were found to have atrial fibrillation and an infection in your blood. you were treated with antibiotics, and your heart rhythm was cardioverted. you were started on a new medication for your heart rhythm, amiodarone. you infection improved, and upon discharge, you were afebrile and hemodynamically stable. the following changes were made to your medications: 1. please start taking ciprofloxacin 500mg by mouth every 12 hours for 14 days (day 1- ) 2. please continue taking your vancomycin by mouth twice a day for your chronic c.diff infection 3. please stop taking your metoprolol until you follow-up with dr. 4. please continue taking amiodarone 400mg by mouth three times per day until . on , please take 200mg by mouth daily for one month (until ) followup instructions: please follow-up with dr. on at 1pm. you can contact him at . procedure: other electric countershock of heart diagnoses: acidosis anemia, unspecified coronary atherosclerosis of native coronary artery urinary tract infection, site not specified unspecified essential hypertension acute kidney failure, unspecified coronary atherosclerosis of autologous vein bypass graft atrial fibrillation personal history of malignant neoplasm of prostate other chronic pulmonary heart diseases percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia bacteremia intestinal infection due to clostridium difficile old myocardial infarction osteoarthrosis, unspecified whether generalized or localized, site unspecified hip joint replacement coronary atherosclerosis of artery bypass graft other specified bacterial infections in conditions classified elsewhere and of unspecified site, other gram-negative organisms 

Answer: The patient is high likely exposed to