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: bactrim / tetracyclines / erythromycin base / optiray 350 attending: chief complaint: cc: abdominal pain & diarrhea major surgical or invasive procedure: tpa for acute stroke history of present illness: ms. is a 66yo female with pmh significant for cad, atrial fibrillation, htn, and ? sjogren's, who presents with abdominal pain and diarrhea. per patient, her symptoms first began back in early . at that time she felt tired and bloated. her pcp thought she had a bacterial infection in her abdomen and started her on augmentin x 2 weeks. her pain improved but as a result of the antibiotics she developed a yeast infection and was given diflucan. 2 weeks later, she was also started on protonix, which she states was very helpful. since her insurance required pre-approval for the protonix, she was switched to prilosec which was not as helpful. in addition her protonix, celebrex was changed to ibuprofen which further worsened her symptoms. she is not taking celebrex again. she also admits to nausea, which she has had for years. . starting about 1 week prior to admission, she notes an episode of increased pain and bloating. she experienced some urgency and noted a dark bowel movement with increased . this bowel movement also had some blood and mucus mixed with the stool. these loose bms resolved over the day and she returned to regular bms until the day prior to presentation. she again noted urgency and abdominal pain followed by a loose stool mixed with blood. this diarrhea continued for two more bms while in the emergency room. she denies any fevers, chest pain, sob, dizziness, or recent travel. she states that her son-in-law had a stomach virus last week. she has not had a colonoscopy or endoscopy. . ros: positive for whats noted above. denies fevers / chestpain / shortness of breath / vomiting / dysuria. positive for chronic fatigue, noted since the start of these symptoms as well as a chronic stable fatigue / decreased exercise tolerance that has occured for years. she also notes that she has experienced mechanical falls for her lifetime that has been worked up by multiple physicians. she also noted dry mouth and decreased tear production that is currently being workup by her pcp for sjogrens syndrome. past medical history: 1)?sjogrens syndrome-being worked up by pcp 2)spinal stenosis 3)hypothyroidism 4)type 2 dm 5)cad 6)atrial fibrillation 7)hypertension 8)mitral valve regurgitation 9)neuropathy 10)s/p r tkr 11)s/p r cataract and retinal surgery )arthritis 13)asthma 14)acne social history: denies tobaco, alcohol, or ivda. family history: no history of gastrointestinal diseases in her family. physical exam: vitals t98.7 bp132/76 hr 80 rr 20 o2 sat 97% on ra gen: pleasant female, lying in bed, nad heent: nc at, perrla, eomi, mouth dry, clear op neck: no lad, no thyromegaly heart: rrr, no m,r,g lungs: ctab, no crackles abdomen: nabs, soft, obese, diffusely tender to palpation, no guarding or rebound. no masses were able to be palpated. extremities: no c/c/e, 2+ dp pulses rectal: guiac positive (per ed) pertinent results: 05:00am glucose-139* urea n-15 creat-1.0 sodium-142 potassium-3.5 chloride-106 total co2-26 anion gap-14 05:00am ck(cpk)-373* 05:00am ck-mb-7 ctropnt-<0.01 05:00am wbc-8.0 rbc-4.17* hgb-13.0 hct-37.1 mcv-89 mch-31.2 mchc-35.1* rdw-13.2 05:00am neuts-72.3* lymphs-20.5 monos-5.7 eos-0.7 basos-0.8 05:00am plt count-171 05:19am lactate-2.0 . studies: chest xray: upright and lateral chest: allowing for differences in inspiration, the cardiomediastinal silhouette is not significantly changed. pulmonary vascularity is normal. lungs are clear and there is no pleural effusion or pneumothorax. thoracic spondylosis is observed. impression: no acute cardiopulmonary process. . ct abd/pelvis impression: 1. fluid filled colon with mild prominence of the bowel wall. findings may correlate with resolving colitis. 2. sigmoid diverticulosis without acute diverticulitis. 3. 3 mm pulmonary nodule requires one-year followup if there are significant risk factors (i.e., history of smoking or history of known malignancy). if there are no such risk factors, no followup is required. . abd u/s from abdominal ultrasound: the liver parenchyma is unremarkable without evidence of focal mass. no intrahepatic ductal dilatation is identified and the common bile duct is normal measuring approximately 7 mm. portal vein is patent with normal hepatopetal flow. patient is noted to be status post cholecystectomy. limited examination of the pancreatic head and body appears unremarkable. a small 2 x 0.5 x 1.8 cm peripancreatic lymph node is identified. the aorta is of normal caliber throughout and the spleen is noted to be slightly prominent but within normal limits measuring approximately 13.5 cm. the right kidney measures approximately 10.6 cm and the left kidney measures approximately 10.9 cm. there is no evidence of hydronephrosis or renal calculi bilaterally. no free fluid is noted within the abdominal quadrant. impression: unremarkable abdominal ultrasound. no cause for pain identified. brief hospital course: 66 year old women who presents with chronic abd pain / bloating and possible acute process causing recent diarrhea . #stroke: on the night of admission, the patient noted the acute onset of headache and left sided weakness. a code stroke was called and the patient was evaluted by the neurology team. ct scan of the head did not show any acute event and neurosurgery thought a bleed was very unlikely. she refused an mri at the time. she was give iv tpa by the neurologists and transfered to the nicu. she did well in the icu and most of her deficits resolved. she has some minimal residual weakness on the left side and a small left facial droop. it is believed that the event represents a thromboembolic event, likely from her atrial fibrillation. after discussing with the patient and her pcp she was started on coumidin with iv heparin during the transition. she tolerated the coumidin well. she will follow up with the neurology stroke clinic. . #abd pain / diarrhea: no clear source of the abdmoninal pain was discovered. the patient may have been recovering from an acute infectious etiology at the time of admission as seen on the ct scan. gi saw the patient while she was in the hospital and deferred further evaluation until she was an outpatient because of her acute neurological event. she was started on a lactose free diet in the hospital and given senna and colace. she will follow up with gi as an outpatient. . #afib: patient was continued digoxin. metoprolol for rate control. due to the thromboembolic event, she was started on coumidin in house. she will be followed by her pcps to monitor her inr. they would like a more concervative goal of 2.0-2.5. . #htn: continued metoprolol. decreased dose to 25 . can be titrated as needed as an outpatient. . #type 2 dm: held orals in house. will keep on home regimin as outpatient. . #hypothyroidism: continue levothyroxine medications on admission: glipizide 5mg po qam digitek 0.25mg po daily lasix 40mg po daily celebrex 200mg po daily metoprolol 50mg po daily asa 81mg po qhs levoxyl 25 micrograms po daily vitamin d prilosec 40mg po daily discharge medications: 1. prilosec 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 2. digoxin 250 mcg tablet sig: one (1) tablet po daily (daily). 3. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 4. levothyroxine 25 mcg tablet sig: one (1) tablet po daily (daily). 5. diphenhydramine hcl 25 mg capsule sig: two (2) capsule po hs (at bedtime) as needed. 6. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) inhalation inhalation (2 times a day). 7. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed for bloating. 8. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 10. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 11. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 12. celebrex 100 mg capsule sig: one (1) capsule po twice a day. 13. aspirin 81 mg tablet sig: one (1) tablet po at bedtime. 14. vitamin d 400 unit tablet sig: one (1) tablet po once a day. 15. glipizide 5 mg tablet sig: one (1) tablet po once a day. 16. coumadin 4 mg tablet sig: one (1) tablet po once a day: please take in evening. disp:*30 tablet(s)* refills:*0* 17. outpatient lab work please check pt, ptt, inr on and fax results to dr. at discharge disposition: home with service facility: homecare discharge diagnosis: stroke atrial fibrillation diabetes abdominal pain asthma discharge condition: stable, abdominal pain improved, neurologically stable without additional events. discharge instructions: you were seen in the hospital for abdominal pain. we started you on new medications and your abdominal pain improved. you will see the gi physicians as an outpatient to follow up. . while you were in the hospital you had an acute thromboembolic stroke. you were seen by the neurologists and given a medication called tpa for your stroke. while in the hospital you were also started on a new medication called coumadin to help prevent future . your primary care physician will need to check blood levels to follow this medication. please discuss with your primary care physician if they would like you to continue taking aspirin and coumidin together. . a few changes were made to you medications. please discuss all of these medications with your primary care physician: was decreased to 20mg daily -metoprolol was decreased to 25mg twice daily -coumadin 4mg daily was added to your medications. -to help with your stomach you can take simethicone as needed for gas, colace can be taken twice daily to soften stools, and senna can be taken once or twice daily as needed for constiptation. these medications can be purchased at the drug store without a rx . please either call your primary care physician or return to the emergency room if you develop any new weakness, new sensory loss, difficulty speaking, a change in vision, new headache, bleeding, chest pain, shortness of breath, increased abdominal pain or other symptoms of concern to you. followup instructions: please call dr. at to make a follow up appointment in weeks. please call her and discuss when you will need to have your blood checked to follow your coumadin. . please call ( to make an appointment with dr. in the neurology clinic. they will need to see you in 4 weeks. . please follow up with the gi physicians. provider: west,room three gi rooms date/time: 9:00 provider: procedures fellow phone: date/time: 9:00 . provider: , md phone: date/time: 1:00 md procedure: injection or infusion of thrombolytic agent diagnoses: mitral valve disorders unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism atrial fibrillation asthma, unspecified type, unspecified cerebral embolism with cerebral infarction knee joint replacement infectious colitis, enteritis, and gastroenteritis sicca syndrome 

Answer: The patient is high likely exposed to