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: levaquin attending: addendum: additional information from east gen surgery chief complaint: diverticulitis, colovesicular fistula major surgical or invasive procedure: colonoscopy open colovesical fistula takedown, sigmoid colectomy surgical rexploration retrograde urethrogram history of present illness: this patient is a 55 year-old, white male, with a known colovesical fistula. he has been treated appropriately with antibiotics and rest and now presents for excision of the diseased colon with primary anastomosis. in the patient experienced significant right lower quadrant pain with chills and fever. the next morning he felt better. in he experienced the onset of pneumaturia. in , he developed significant urinary tract infection and saw his physician, with antibiotics. in late he began to see significant amounts of stool coming out in his urine. at one point he stopped having regular bowel movements and was only passing stool through his urine. he presented to the ed and was found to have a colovesical fistula. he was started on augmentin and referred to dr. . he is actually well-controlled at present, has no significant symptom other than the pneumaturia. he has lost weight by dieting over the past several months. ct scan suggests the finding is related to his extensive diverticulosis. past medical history: pneumaturia, hyperlipidemia, hypertension, spinal effusion cervical spine, knee surgery past gastrointestinal procedures: none social history: social history: married, no children. smokes 3 to 5 cigars per day. social alcohol. two cups of coffee per day. he is a retired state police officer retired because of his neck injury family history: family history: diverticulosis physical exam: wt: 211 pounds ht: 5'" pulse: 68 temp: normal r: 12 constitutional: well-developed, well-nourished patient in no distress appearing appropriate age. skin: no rashes, ulcers, icterus or other lesions; no clubbing or telangiectasias. eyes: normal conjunctivae and lids. pupils: symmetrical. ent: external: normal external inspection of ears and nose. mouth: normal oral mucosa, lips and gums. normal tongue, hard and soft palate; posterior pharynx without erythema, exudate or lesions. neck: normal motion, central trachea, thyroid: normal size, consistency and position. respiratory: normal breath sounds; no rubs, wheezes, rales or rhonchi. cardiovascular: normal rhythm, s1 and s2; no rubs, murmurs or gallop. abdominal: abdominal aorta, no bruits. normal bowel sounds; no tenderness, rebound, guarding or masses. hernias: no hernias appreciated. liver: normal size and consistency. spleen: not palpable. rectal: hemoccult/guaiac: negative, no external lesions, hemorrhoids or tags. palpation: normal anal sphincter tone; no masses or tenderness. prostate not enlarged. gait: normal gait extremities: normal range of motion. no edema, varicosities or cyanosis. lymphatic: axillae: not palpable. groin: not palpable. neck: not palpable. neurologic: no evidence of depression, anxiety or agitation. orientation: oriented to time, space and person. pertinent results: ; urine: pseudomonas c.diff: neg wound: psuedomonas pansensitive wound: g+ r bacteroides beta lactamase positive, g- r sparse p cxr - lll infiltrate cxr : cardiomegaly and vascular engorgement but no frank pulmonary edema is present. there is no interval change in the left lower lobe consolidation as well as in the right middle lobe and lower lobe opacity that most likely represent atelectasis. echo - no endocard rus: no hydronephrosis . 05:15am blood glucose-91 urean-37* creat-3.6* na-142 k-5.0 cl-108 hco3-20* angap-19 . --ct cystogram (pel) w&w/o contr reason: retrograde urethrogram study due to colonic-vesicular fistula impression: leak noted at anterior aspect of bladder 06:20am blood wbc-10.7 rbc-2.88* hgb-8.0* hct-25.3* mcv-88 mch-27.7 mchc-31.5 rdw-14.2 plt ct-607* 06:20am blood glucose-110* urean-44* creat-3.1* na-141 k-4.7 cl-109* hco3-22 angap-15 06:20am blood calcium-7.7* phos-4.0 mg-2.6 brief hospital course: this is a 55 year old male with a known colovesical fistula. he had colonoscopy on which showed diverticulosis of the sigmoid colon and transverse colon with the colovesical fistula likely arising from diverticulum. . he went to the or on for: repair of colovesical fistula.he had a pca for pain control. toradol was also added. he was tolerating the pain. once back on a diet, he was started on po meds.gi/abd: he was npo with ivf. his abdomen was soft and nontender. he had a jp drain in the llq. he was started on clears on pod ... he diet was slowly advanced as he had return of bowel function... gu: during the operation, dr. noted a large phlegmon associated with the back wall of the bladder on its intraperitoneal surface and was concerned about the significance of the size of the mass and its potential to be bladder cancer, which would change the operation. upon inspection, the phlegmon, strongly suggested an inflammatory rather than malignant process. the patient was asymptomatic prior to surgery with regard to his urinary system. . on mr. had fevers up to 102 last 36h. started on pip/tazo afternoon for ecoli and pseudomonal uti. had a repeat ct abd which showed no evidence of anastomotic leak. . on pt was triggered for tachypnea and sbp 80s (down from 120s baseline). received 1l ivf which improved sbp to 100s. transferred to icu. upon arrival to icu, abg 7.45/29/75 w lactate 4.2. noted to have stool coming out of foley. he was taken back to or on and found to have stool in abd.subcutaneous skin left open. then transfered to , intubated. started on pressors. nephrology consulted for non oliguric renal failure with peak creatinine of 3.6 . pt resuscitated with ivf. and started on meropenem and vanc. pt defervesed. . by he was off pressors and extubated, cultures revealed pansensitive pseudomonas in urine . . transfered to 12reisman. progressed slowly. required reinforcement and encouragment to ambulate. c/o arthritis pain of knees and elbows. physical therapy consulted. pt declined pt services on multiple occasions.unable to treat with nsaids due to elevated creatinine. discussed alternate options with rheumatology. started on topical capsaicin with adequate response. able to ambulate more comfortably. pt continued to be followed ostomy rn, teaching provided. . vancomycin discontinued. cr trended down. pt started on sips. diet advanced as bowel function resumed. urine output adequate. continued with supplemental oxygen via nasal cannula. instructed on importance of ambulation, is use, and coughing exercises. . pt given clears and transitioned to po pain meds. tolerated well. ambulating with minimal assist. ostomy functioning, stoma beefy red & viable. abdominal incision packed with amd kerlix and retentions sutures intact. . : tolerating regular food, and oral pain medications with pain <. pt went for retrograde urethrogram which revealed small leak at anterior aspect of bladder. foley remained in place. patient was education on foley to leg bag care for discharge. follow-up appointment was arranged with dr. on with ct scan prior to visit. visiting nursing services arranged for ostomy care, foley care, and glucose montoring. he was instructed to hold following medications due to elevated creatinine: lisinopril, gyburide/metformin, and indomethacin. creatinine will be followed per pcp and urology. . spoke to pt's pcp, . . confirmed pt's diagnosis of type ii dm. instructed to maintain on metformin 500 mg . will follow up with pcp 1 week. medications on admission: 60 prn, indomethacin 50qhs, glyburide/metformin 5/500', lisinopril 20', atenolol 50', simvatain 40', augmentin 875'' (finished course for uti) discharge medications: 1. 60 mg tablet sig: one (1) tablet po once a day as needed. 2. glyburide micronized-metformin 5-500 mg tablet sig: one (1) tablet po once a day: hold. 3. lisinopril 20 mg tablet sig: one (1) tablet po once a day: hold. 4. atenolol 50 mg tablet sig: one (1) tablet po once a day. 5. simvastatin 40 mg tablet sig: one (1) tablet po once a day. 6. simethicone 60 mg tablet sig: one (1) tablet po once a day as needed. 7. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain: do not exceed 8 tablets in one day. do not take tylenol while taking this medication. disp:*30 tablet(s)* refills:*0* 8. colace 100 mg capsule sig: one (1) capsule po twice a day as needed for constipation. disp:*50 capsule(s)* refills:*0* 9. capsaicin 0.025 % cream sig: one (1) appl topical tid (3 times a day) as needed for arthritic pain: please apply to affected joints . 10. medications to be held please do not continue taking your metformin/glyburide, lisinopril, and indomethacin until your kidney function has returned to . this will be managed per urology and your primary doctor. 11. indomethacin 50 mg capsule sig: one (1) capsule po at bedtime: hold. 12. metformin 500 mg tablet sig: one (1) tablet po twice a day: please make appointment with dr. in 1 week for follow up with diabetes dosing. disp:*60 tablet(s)* refills:*0* 13. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 14 days. disp:*14 tablet(s)* refills:*0* 14. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for infection for 2 weeks. disp:*42 tablet(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: primary: colovesical fistula diverticulitis anastamotic leak sepsis . secondary: hyperlipidemia, hypertension, spinal effusion cervical spine, knee surgery, diverticulosis/itis discharge condition: good vss ambulating, tolerating regular diet and pain well controlled with po pain meds. discharge instructions: please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomiting, diarrhea or other reasons. signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. *avoid lifting objects > 5lbs until your follow-up appointment with the surgeon. *avoid driving or operating heavy machinery while taking pain medications. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * continue to ambulate several times per day. * monitor your incision for signs of infection. * it is ok to shower and wash. no tub baths or swimming. keep incision clean and dry. . monitoring ostomy output/prevention of dehydration: -keep well hydrated. -replace fluid from ostomy daily. -avoid only drinking plain water. include gatorade and/or other vitamin drinks to replace fluid. -try to maintain ostomy output between 1000ml to 1500ml per day. -if ostomy output >1 liter, take 4mg of imodium, repeat 2mg with each episode of loose stool. do not exceed 16mg/24 hours. . incision care: -you may shower, and wash surgical incisions. -avoid swimming and baths until your follow-up appointment. -please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. . kidney function/medications to be held: please do not continue taking your metformin, glyburide, lisinopril, and indomethacin until your kidney function has returned to . this will be managed per urology and your primary doctor. followup instructions: 1. please follow-up with dr. ( in weeks. 2. follow-up with your pcp . in 1 week and as needed. 3. please follow-up with urology-dr. ( on date/time: 11:00 for management & removal of foley catheter, and follow-up of your kidney function. ***please have cat scan first-scheduled for date/time: 10:00,phone:. neither dictated nor read by me md procedure: temporary colostomy colonoscopy repair of fistula involving bladder and intestine open and other resection of transverse colon revision of anastomosis of large intestine diagnoses: anemia, unspecified tobacco use disorder acute kidney failure with lesion of tubular necrosis other postoperative infection unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled severe sepsis other and unspecified hyperlipidemia surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation septic shock dehydration diverticulitis of colon (without mention of hemorrhage) laparoscopic surgical procedure converted to open procedure other suppurative peritonitis septicemia due to pseudomonas other specified types of cystitis tachypnea intestinovesical fistula body mass index 33.0-33.9, adult 

Answer: The patient is high likely exposed to