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: penicillamine / ciprofloxacin / vancomycin / insulins / lithium attending: chief complaint: transfer from surgery for further management major surgical or invasive procedure: none history of present illness: 66-year-old male w/mmp as below and recent admission for aspiration pna and flu (dced on vanc/zosyn w/course planned to end ) admitted to the surgical icu w/hematemesis and bloody output from his gtube. at the time of admission, he was s/p 2u prbc @ rehab and had experienced 200cc of bloody emesis there. in the ed, he had dark red blood from gtube which did not clear s/p 400cc of lavage. his hr was 110, sbp150 at that time. he had diffuse abdominal pain which has since been learned to be unchanged over the past year. . ct abdomen and pelvis in the ed revealed partial vs early sbo but no perforation or free air. his sicu course has been notable for stable hematocrits, stable bp, no further evidence of bleeding, and continued abdominal pain requiring 25-50 of fentanyl q2h. he was given imipenim for ?pna. of note, on admission his wbc was 21.4 and crit 37.2 which have fallen c/w time course of ivf administration. . last bm was small, last pm. it was not guaiced. past medical history: wilson's disease bipolar disease, hx si bronchiectasis atrial fibrillation s/p mvr cad pancreatitis s/p billroth ii for peptic ulcer disease cri baseline cr 1.9-2.4 psh s/p exploratory laparotomy s/p bowel resection for obstruction s/p partial colectomy. he is also status post gastrostomytube placement. s/p r hip fracture and thr. cataracts. anemia. had flu shot this year,pneumovax . **mrsa/vre** social history: lives at rehab, no etoh use, no tobacco family history: non-contributory. physical exam: 98.3 st103 115/26 (98-115/26-51) 20 96%2l; cvp 8 gen: cachectic, shaking, not in distress hennt: mmm, anicteric, perrl, eomi neck: supple, no jvd cv: tachy lungs: diffusely ronchorous abd: soft, distended, mild luq tenderness, hypoactive bs ext: no le edema, strong dp/pt pulses bilaterally neuro: a&ox3, cnii-xii intact, ue/le muscle strength 5/5 b/l skin: no rash rectal: no palpable masses. guaic negative. prostate large and non-nodular. pertinent results: 04:15pm blood wbc-21.4*# rbc-4.41*# hgb-12.4*# hct-37.2*# mcv-84 mch-28.1 mchc-33.3 rdw-18.4* plt ct-525*# 08:37pm blood wbc-19.6* rbc-3.86* hgb-10.9* hct-32.7* mcv-85 mch-28.3 mchc-33.3 rdw-18.2* plt ct-400 01:45am blood hct-30.6* 05:18am blood wbc-12.2* rbc-3.55* hgb-10.1* hct-30.0* mcv-85 mch-28.3 mchc-33.5 rdw-18.5* plt ct-354 08:54am blood hct-27.7* 01:00pm blood hct-26.7* 03:02pm blood wbc-10.9 rbc-3.19* hgb-9.0* hct-27.2* mcv-85 mch-28.4 mchc-33.2 rdw-18.3* plt ct-340 04:58pm blood hct-26.7* 01:38am blood wbc-9.1 rbc-3.01* hgb-8.5* hct-25.8* mcv-86 mch-28.3 mchc-33.1 rdw-18.2* plt ct-307 06:45pm blood hct-26.4* 06:01am blood wbc-8.6 rbc-3.07* hgb-8.7* hct-26.2* mcv-85 mch-28.3 mchc-33.2 rdw-17.5* plt ct-308. . ct abd/pelvis : ct of the abdomen and pelvis without iv contrast: a large hiatal hernia is noted. compared to prior study, there has been interval resolution of the previously seen left-sided pneumothorax. there are linear and patchy opacities seen at the lung bases bilaterally, suggesting scar as well as possible focal areas of consolidation which could represent infection. no effusions seen at the visualized lung bases. the liver, spleen, pancreas, and adrenal glands appear unremarkable allowing for limitations of a non-contrast study. rounded hypodensities are seen within the kidneys, likely representing simple cysts, not fully characterized. patient is status post cholecystectomy. there are multiple dilated loops of small bowel with air-fluid levels. no colon is identified. there is a short area of bowel narrowing close to the low anastomoses. there does appear to be fluid and gas in the rectum distal to this area of narrowing. this appearance is not significantly changed from prior study. the loops of small bowel may be slightly more dilated when compared to previous study. there is no evidence of free air or free fluid within the abdomen or pelvis. bone windows: again noted is a right hip prosthesis. bones appear osteopenic. injection granulomas again noted. no suspicious lytic or blastic lesions are identified. multiplanar reformatted images confirm the axial findings. impression: 1. partial versus early small-bowel obstruction with area of narrowing seen at the distal bowel in the area of the distal anastomosis, not significantly changed from prior study. 2. linear opacities and patchy opacities in the lung bases bilaterally, consistent with scarring and possibly infection. 3. otherwise, no significant change from prior study. . cxr : again noted is a right-sided central line with tip overlying the svc. cardiomediastinal and hilar contours appear unchanged. pulmonary vascularity appears unremarkable. there has been interval improvement in bilateral lower lobe consolidations. there is increased airspace opacity again seen in the right lung greater than left consistent with infection, possibly blood. poorly defined linear lucency is seen in the medial aspect of the left hemidiaphragm. impression: 1. increased airspace opacity in the right lung greater than left, possibly representing infectious process versus blood. 2. poorly seen linear lucency at the medial aspect of the left hemidiaphragm. further evaluation with dedicated pa and lateral chest radiographs centered on this area would be helpful. . cxr : chest is markedly rotated to the left. right jugular cv line is in distal svc. no pneumothorax. there has been no significant change in the ill-defined patchy opacities at the left base, similar less marked opacities at the right lung base with some possible increased interstitial densities in the right lung, difficult to evaluate on this rotated film. no pneumothorax. . time taken not noted log-in date/time: 5:56 pm urine site: catheter **final report ** urine culture (final ): <10,000 organisms/ml. . 9:00 pm stool consistency: soft source: stool. **final report ** clostridium difficile toxin assay (final ): feces negative for c. difficile toxin by eia. reference range: negative. . egd: findings: esophagus: lumen: a medium size hiatal hernia was seen, displacing the z-line to 35cm from the incisors, with hiatal narrowing at 40cm from the incisors. he had a wide open esophageal sphincter. contents: bile was found in the stomach and small bowel. stomach: mucosa: diffuse continuous erythema and congestion of the mucosa were noted in the stomach body. these findings are compatible with gastritis. there was a point of active oozing of blood within the hiatal hernia,w hich was treated sucessfully with bicap cauterization. there was no discernible ulcer. duodenum: normal duodenum. other findings: area of the gastro-jejunal anastomosis appeared normal. impression: gastritis with point of bleeding in stomach within hiatal hernia. this was likely source of bleed and was treated with bicap cautery. recommendations: protonix 40 mg twice daily elevate head of bed, aspiration precautions. . abdominal u/s : right upper quadrant ultrasound: the patient is status post cholecystectomy. the common bile duct is not dilated. there is no intrahepatic biliary dilatation. there are no focal liver lesions. the portal vein is patent. impression: 1. no evidence of intrahepatic biliary dilatation. brief hospital course: a/p: 66 yo male with complicated medical hx, recent aspiration pna re-admitted with gib and ileus. . gib- no patient did not require any blood transfusion here as pt received 2 units at the rehab. pt remained hemodynamically stable, hct stabilized, and hematemasis and bleeding from peg stopped. iv ppi was switched to po ppi when peg feeding was restarted. pt underwent egd on which showed gastritis with point of bleeding in stomach within hiatal hernia which was likely source of bleed and was treated with bicap cautery. the patient was restarted on tube feeding after egd and tolerated well. . ileus/psbo- ct of abdomen was concerning for psbo vs early sbo, but these findings were not new and not significantly changed from ct abd/pelvis in . the patient was placed on bowel rest initially. as abdominal pain improved, restarted tube feeding per surgery recs and held for egd then was restarted tube feeding. tried to avoid narcotics, have the patient out of bed, and bowel regimens were given. . normal wbc with bandemia: the patient finished 14day course of vanc and imipenem on for aspiration pneumonia. pt initially had bandemia, and it resolved. blood and urine have not had growth. sputum sample was obtained but was a poor sample. the patient did not spike any fever or leukocytosis. however, the patient will need aggressive pulmonary toilet including good oral suctioning care and chest pt as pt is at risk for aspiration. . elevated lfts/amylase and lipase: pt is s/p cholecystectomy, and pt had an mrcp in for elevated amylase and lipase without any remarkable abnormalities. abdominal u/s during this admission did not reveal any intrahepatic dilitations or biliary obstructions either. as the patient had no clinical symptoms and h/o wilson's, recommended following clinically and lfts. . cad: continued bb, held asa for ugib. . bipolar do/psych- continued lamotragine, bupropion, klonipin, and olanzapine . wilson's dz- placed on zinc sulfate as does not carry trientine. . cri: was stable. renally dosed all meds. . fen: was npo while concerned for obstruction and on tpn for a day, then restarted tfs as tolerated. repleted 'lytes/prn. . # iv access: pt had a cvl (rij) from previous admissioni for iv antibiotics. the line was removed at the time of discharge. . #prophylaxis: ppi . pneumoboots. keep hob elevated. aspiration precaution. medications on admission: tylenol, ibuprofin, esomeprazole, fludrocortisone 0.1mg daily, guiafenesin/codine, lamotrigine 25mg , levoflox 500mg daily started 4/4/6, metoprolol 50mg tid, midodrine 5mg tid, olanzapine 10mg daily, oseltamvir 75mg daily started 4/6/6, sucralfate, trientine 250mg , coombivent, trimethobenzamide prn, hydrocortisone rectally prn. discharge medications: 1. lamotrigine 25 mg tablet sig: one (1) tablet po bid (2 times a day). 2. bupropion 100 mg tablet sig: one (1) tablet po bid (2 times a day). 3. sucralfate 1 g tablet sig: one (1) tablet po qid (4 times a day). 4. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q4-6h (every 4 to 6 hours) as needed. 5. ipratropium bromide 17 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 6. olanzapine 2.5 mg tablet sig: two (2) tablet po daily (daily). 7. clonazepam 0.5 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). 8. midodrine 5 mg tablet sig: one (1) tablet po tid (3 times a day). 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 10. lansoprazole 30 mg susp,delayed release for recon sig: one (1) po bid (2 times a day). 11. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 12. ipratropium bromide 0.02 % solution sig: one (1) inhalation qid (4 times a day). 13. albuterol sulfate 0.083 % solution sig: one (1) inhalation q2h (every 2 hours) as needed. 14. zinc sulfate 220 mg capsule sig: one (1) capsule po once a day. discharge disposition: extended care facility: for the aged - acute rehab discharge diagnosis: blood loss anemia gastritis discharge condition: stable hct at 28.9, no more hematemasis or bleeding from peg discharge instructions: please return to the emergency department if you have fevers, increased shortness of breath, bloody stools, black tarry stools, vomiting blood, chest pain, or any other worrisome symptoms. . keep your follow-up appointments. take your medications as instructed. followup instructions: follow-up with dr. in a week. . provider: breathing tests phone: date/time: 3:20 provider: exam room is (no charge) date/time: 3:40 provider: , intepretation billing date/time: 3:40 procedure: endoscopic control of gastric or duodenal bleeding diagnoses: iron deficiency anemia secondary to blood loss (chronic) atrial fibrillation diaphragmatic hernia without mention of obstruction or gangrene unspecified gastritis and gastroduodenitis, with hemorrhage paralytic ileus dehydration bipolar disorder, unspecified disorders of copper metabolism 

Answer: The patient is high likely exposed to