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: demerol attending: chief complaint: hypotension major surgical or invasive procedure: none history of present illness: 65 year-old male with a complicated history transferred from where he presented following a syncopal episode and left hand pain. per patient he went to the bathroom and on his way back to his room, he felt lightheaded and had a syncopal episode and fell on his left hand. he denies preceding chest pain, sob or palpitations. his wife heard some noise, found him on the floor, and helped him back to his room. he denies post-event confusion. he has a history of similar syncopal events with dizziness with standing. for this reason he uses a wheelchair. he is usually able to make the trip to the bathroom by walking unassisted. . this morning, he awoke with pain in his left hand, with swelling and redness. the swelling worsening significantly during the course of the day, and he presented to . there his was inr 4.7 and his hand x-ray negative. with concern for compartment syndrome, and he was transferred to for further evaluation. . initial ed eval notable for vs t 98.3, hr 90, bp 140/70, rr 18, sat 100% on 2l. he was seen by plastic surgery, who did not feel that he was having a compartment syndrome. he was also seen by the medicine consult service and cleared for or if needed. he was admitted to the medical service for serial exams and monitoring. . in the am of pt was noted to have sbp in the 60's, o2 sat 90's this am when being evaluated by short call team. pt was put on 4l nc with improvement of sat to mid 90's, and abg 7.32/50/71. he was bolused 2l ns with slight improvement of blood pressure to 80's systolic (from 140's at admission). he got 2 units of ffp and 5 sq vit k to correct his inr of 6. pt remaines aao x 3. ddx included hypotension related to narcotics (2 mg morphine + percocet, w/ h/o low bp to narcs per his wife/pcp), hypovolemia (but not fluid responsive), sepsis (given granulating abdominal wound), and blood loss given elevated inr. no pressors were given. 1 dose of narcan was given with improvement in sbp's to 100's. pt was subsequently transferred to the where he was observed for a day and found to have improved hypotension, an inr of 2.2, an abg was done and found to be 7.32/50/71. the patient mentated at baseline and had no increase in o2 requirement. he is subsequently being transferred back to the floor. past medical history: 1. left circumflex stent in 3/. 2. catheterization in with three vessel disease. 3. status post coronary artery bypass graft x 3. 4. s/p catheterization - with stent to native right coronary artery with an occluded saphenous vein graft. 5. insulin dependent diabetes mellitus. 6. cri with a baseline creatinine of 1.1 to 1.3. 7. hypothyroidism 8. copd 9. ? pe in 10. history of etoh. 11. pancreatitis. 12. s/p cabg complicated by osteomyelitis of the sternum. the patient had a left hemisternectomy in due to infection. sternal debridement rectus flap and bilateral pectoralis flaps. still open wound. 13. history of lens transplant in right eye secondary to cataract. last cath in : lmca normal. lad occluded . the lcx was widely patent and the stented sites were open. at the origin of the om3, there was 50% restenosis. the rca stents were widely patent. lima-lad patent. cath () the lad had a proximal 60% lesion, a mid 80% lesion, and distal competitive flow from the lima-lad. the lcx stents were widely patent with normal flow. the rca had a proximal 60% lesion at a crook, with diffuse mid disease up to a sub-total occlusion in the mid vessel. the distal vessel supplied a lower am/pda and a rpl branch. 2. successful stenting of the rca was performed with overlapping 2.5 x 28 mm and 3.0 x 13 mm cypher (drug-eluting) stents, post-dilated using 2.5 and 3.25 mm nc balloons respectively. there was <10% residual stenosis, no angiographically-apparent dissection, and normal flow (see ptca comments). social history: he lives with his wife. they have 4 children and 18 grandchildren. ex-smoker, quit 6 months ago. has 150 pack-year smoking history. prior etoh use. history of addiction to narcotics. family history: f: died at 63 of mi physical exam: vitals: t 97.2 , hr 96 , bp 134/80 , rr 22 , sat 94% on 2l gen: caucasian male, in nad. heent: anicteric. resp: ctab. cvs: rrr. normal s1, s2. no s3, s4. no murmur or rub. gi: obese abdomen. soft, non-tender, nd, bsna. skin: chronic wound on abdomen, about 10 cm long, with granulating base. ext: left hand swelling of left hand and forearm, wrapped in a dressing vasc: palpable radial and ulnar pulses (per plastics). pertinent results: 06:45pm glucose-344* urea n-23* creat-1.6* sodium-139 potassium-4.4 chloride-104 total co2-24 anion gap-15 06:45pm ck(cpk)-71 06:45pm ck-mb-notdone ctropnt-0.01 06:45pm calcium-9.5 phosphate-2.5* magnesium-1.9 06:45pm wbc-9.8 rbc-3.91* hgb-11.5* hct-33.5* mcv-86 mch-29.5 mchc-34.4 rdw-15.6* 06:45pm neuts-56.3 lymphs-34.5 monos-6.3 eos-2.0 basos-0.9 06:45pm microcyt-1+ 06:45pm plt count-417 06:45pm pt-27.3* ptt-41.8* inr(pt)-5.5 . 07:00am blood wbc-12.6* rbc-3.60* hgb-10.7* hct-32.5* mcv-90 mch-29.8 mchc-33.0 rdw-15.1 plt ct-401 07:00am blood plt ct-401 07:00am blood glucose-72 urean-22* creat-1.3* na-140 k-4.5 cl-109* hco3-23 angap-13 07:00am blood calcium-9.5 phos-2.3* mg-2.1 06:40am blood ck-mb-notdone ctropnt-0.06* 11:46am blood hbsag-negative hbsab-negative igm hbc-negative igm hav-negative 08:30am blood type-art po2-71* pco2-50* ph-7.32* calhco3-27 base xs-0 intubat-not intuba comment-nc 08:30am blood lactate-1.6 . l wrist x rays : impression: 1. no fracture or dislocation within the hand. 2. diffuse soft tissue swelling involving the dorsum of the hand. focal round lesion noted within the subcutaneous tissues of the dorsal aspect of the left hand, which may represent a hematoma or focal lesion such as a sebaceous cyst. . ct head impression: no evidence of acute intracranial hemorrhage. . cxr the left ventricle is enlarged. no overt chf or active infiltrates. no pneumothorax identified brief hospital course: assessment and plan: 65 yo male with transferred from osh following a syncopal event and ? compartment syndrome in left hand is setting of supratherapeutic inr, now with hypotension. . hypotension: intial ddx included hypotension related to narcotics (2 mg morphine + percocet), hypovolemia, sepsis, and blood loss given elevated inr. he did not have evidence of gib, is afebrile, and continued to make good urine output (although evidence of urinary retention w/ foley placement). given his clear history of low bp in setting of narcotics and improvement with narcan, this seemed like the most likely etiology. we held further antihypertensives and narcotics. his bp remained stable and he was discharged a day after transfer back to the floor without any new symptoms. he was discharged off home bp meds with planned follow up with pcp. . left hand hematoma: seen by plastics, and the patient appeared to have improvement in swelling and had no evidence of compartment syndrome. we continued dressing changes per plastics, and ot followed. we followed inr s/p vit k and ffp were given (see hpi), which remained wnl. he was discharged with a stable hematoma and no evidence of compartment syndrome. . syncope: by history pt had post-micturitional syncope, with history of prior similar episodes. suspect vasovagal syncope. not orthostatic at osh. ekg without acute changes, 2 sets of enzymes negative with >1 day prior. ct head negative. he had no syncopal events after transfer to the floor. . cad: s/p cabg/ptca, and s/p r/o romi as noted above. we continued cardiac meds once bp stabilized. . dm type 2: continued outpatient regiment with lantus 40 units and humalog ss. fs qid. . copd: no acute issues during admission. patient reportedly on home oxygen, and we continued this as well as home albuterol/atrovent inhalers prn. . supratherapeutic inr: on coumadin for unclear reasons. as per above, this was reversed and remained wnl after vit k and ffp. was discharged off coumadin for planned follow up with pcp. . acute on chronic renal failure: likely due to obstruction, as pt had 1400 cc urine out when foley placed on floor. also had to place coudet as regular foley did not pass prostate. he trended down to a creatinine of 1.3 by time of discharge with good urine output. . hypothyoidism: continued outpatient levoxyl. . communication: with pcp . gets majority of care at . wife - . disp: to home. . medications on admission: - cardura 4 mg po qhs - flagyl 500 mg po tid (had c dif in ), - neurontin 600 mg po tid - celexa 40 mg po tid - lisinopril 20 mg po qd - toprol xl 100 mg po qd - remeron 30 mg po qhs - protonix 40 mg po qd - asa 81 mg po qd - coumadin 5 mg po qhs - synthroid 0.175 mg po qd - lasix 40 mg po qd - humalog ss tid with meals - lantus 40 units - lipitor 10 mg po qd discharge medications: 1. aquacel ag dressings sig: one (1) dressing once a day. disp:*qs * refills:*2* 2. adaptic bandage sig: one (1) bandage topical once a day. disp:*qs bandage* refills:*2* 3. normal saline sig: ten (10) ml topical (hair, nails and skin) once a day: to dressing. disp:*1 bottle* refills:*2* 4. gabapentin 300 mg capsule sig: two (2) capsule po tid (3 times a day). 5. mirtazapine 30 mg tablet sig: one (1) tablet po hs (at bedtime). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 8. levothyroxine 175 mcg tablet sig: one (1) tablet po daily (daily). 9. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 10. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 11. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 12. citalopram 20 mg tablet sig: two (2) tablet po bid (2 times a day). 13. tramadol 50 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 14. bacitracin zinc 500 unit/g ointment sig: one (1) appl topical daily (daily). 15. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*33 tablet(s)* refills:*0* 16. keflex 500 mg tablet sig: one (1) tablet po three times a day for 4 days. disp:*12 tablet(s)* refills:*0* 17. toprol xl 100 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po once a day. disp:*30 tablet sustained release 24hr(s)* refills:*2* 18. lantus 100 unit/ml cartridge sig: forty (40) units subcutaneous twice a day. 19. humalog 100 unit/ml cartridge sig: one (1) subcutaneous four times a day: per sliding scale. discharge disposition: home with service facility: home care discharge diagnosis: hand hamatoma s/p fall hypotension cad dm 2 discharge condition: stable discharge instructions: pls take all meds as prescribed. complete the full course of antibiotics. call your doctor if hand swelling worsens, if you experience any pain, fevers, nausea, vomiting, diarrhea, etc. follow up with your pcp and with cardiology as outlined below. you should discuss your ongoing syncope (fainting) and falls with your pcp and see cardiologist as soon as possible. also, wound nurse has recommended follow up with plastics. we are discharging you off your home blood pressure medications. please do not take these until you discuss with your pcp. are also discharging you off coumadin given recent falls and elevations in inr. please discuss with your pcp as well. to the abdominal wound, use silver ion dressing (aquacel ag or equivalent) change every 2 days (keep dry so remove for bathing). clean open hand wounds on left hand, with ns and apply adaptic and use dry dressing/clean wrap and change once a day. followup instructions: with your pcp , on monday, @ 1:15pm call your cardiologist, dr. in as soon as possible for a follow up appointment. call dr. ( (plastics) for follow up appointment for your abdominal wound md procedure: transfusion of other serum diagnoses: other iatrogenic hypotension abnormal coagulation profile congestive heart failure, unspecified acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified aortocoronary bypass status unspecified fall diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled percutaneous transluminal coronary angioplasty status chronic kidney disease, unspecified hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (luts) long-term (current) use of insulin intestinal infection due to clostridium difficile dehydration unspecified sedatives and hypnotics causing adverse effects in therapeutic use syncope and collapse orthostatic hypotension history of fall other degenerative diseases of the basal ganglia contusion of hand(s) blister of hand(s) except finger(s) alone, without mention of infection 

Answer: The patient is high likely exposed to