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: sulfonamides / penicillins / omeprazole / minocycline / nexium / bee sting kit attending: chief complaint: gi bleed major surgical or invasive procedure: : exploratory laparotomy, resection of sigmoid and descending colon with mobilization of splenic flexure, resection of small bowel x 2 and colostomy history of present illness: patient is a 43 woman with hx of cvid on recurrent igg infusions (last dose on ) and colitis concerning for crohn's on asacol and prednsione who was readmitted to with worsening diarrhea, found to have enterocolic fistula, complicated by lower gi bleed, and is transferred to for more subspecialty consultation in complicated undiagnosed patient. she was first admitted to from - for chronic abdominal pain with 45 lb weight loss since . ct showed thickening of descending colon, multiple loops of thickened small bowel. she had a normal upper scope. colonoscopy showed with 5 cm segment of ulcerated mucosa in descending colon. biopsies showed nonspecific colitis, inconclusive, v. c/w ibd. upper gi small bowel follow through showed improvement in small bowel loops compared to ct scan and some mild abnormalities with 1 thickened segment in the mid-abdomen. given her significant weight loss, she was started on tpn. she was started on asacol and did have some improvement. she was discharged home on a 5 day course of prednisone (not clearly for ibd). d/c weight was 101 lbs. she was home for 1.5 weeks, off tpn. a couple of days prior to her readmission, she began experience explosive diarrhea, multiple liquid episodes a day (up to 10), nonbloody. she did report black stools, on pepto-bismo. she also had worsening of her chronic, constant, stabbing llq abdominal pain, rating >. she was eating clear liquid supplement and small meals, which did not worsen her abdominal pain. no nausea, vomiting at that point. no fevers, chills, nightsweats. she was readmitted to sturdy on . c. diff toxin was negative. stool cultures are pending. repeat ct showed descending colon colitis with inflamed loops of small bowel adjacent to it and ?enterocolic fistula, concerning for crohns. patient was started on cipro, flagyl, and iv solumedrol; tpn continued. on , patient started to have a lower gi bleed with hemorrhagic shock. initial hct was 30, fell to 25. after 5 units of prbcs, her hct increased to 33. flex sig. to descending colon did not reveal active bleeding but verifed enterocolic fistula. no definitive diagnosis determined yet. vitals at time of transfer were: vitals: 98.4, 91, 106/64, 16, 99% on room air. her last episode of brbpr was on . since then her golytely prep, she had no further bowel movements. she is npo. she currently feels nauseated. she has only vomited once in the icu. her abdominal pain is >10. no ha, lightheadedness, chest pain, palpitations, sob, cough, wheezing, dysuria, urinary frequnecy, rashes, myalgias, vision problems. she has stable arthritis in her joints, chronic low back pain. she has anxiety and depression, declining social work. past medical history: -common variable immunodeficiency, diagnosed 2 years ago (initially presented with recurrent sinus infections and bronchitis, found to have hypogammaglobulinemia) -pancytopenia -type 2 dm since ; not currently on meds; no complications -presumed scleroderma with crest variant -pituitory microadenoma- recently diagnosed -depression, panic attacks and anxiety -chronic constipation- moves bowel 1 time a week -hypertriglyceridemia -mild asthma -s/p l5-s1 disc fusion -low back pain failed back surgery -gerd with barrett's esophagus -peptic ulcer disease -allergic rhinitis -colon polyp- gets a colonoscopy and endoscopy every 2 years -hypnagogis myoclonas -juvenile rheumatoid arthritis diagnosed at 12 years of age -migranes social history: lives at home with mother. 25 pack year smoking, quit in . no etoh or drug use. family history: fh of colon and breast cancer and diabetes. father had alcoholism. mother with cad. no siblings. physical exam: vs: 96.5, 90/58, 86, 20, 99ra gen: cachetic woman in mild distress from pain, anxious heent: per, eomi, mmm, sclera anicteric, not injected neck: no lad cardiovascular: rrr normal s1, s2, no murmurs or gallops respiratory: clear to auscultation bilaterally, no wheezes, rales or rhonchi abd: hyperactive bowel sounds, soft, tender in llq, no rebound, no guarding, nondistended, mass noted in llq, no heptosplenomegaly extremities: no edema, 2+ dp/pt pulses neurological: normal attention, decreased sensation in l le (chronic), ms 4+/5 in l le elsewhere , slightly hyperreflexic at l patellar compared to elsewhere, babinski difficult assess a pt highly ticklish integument: warm, moist, no rash or ulceration psychiatric: anxious pertinent results: osh labs: hct 31, wbc 4.2, "electrolytes are within normal limits" flex sig: the colonoscope was introduced into the rectum and passed through a normal left colon where there was blood and brown liquid stool to teh level of 60cm from the anal verge. the whole left colon appeared to be fixed. there was an ulcerated area and the scope went itno a lumen which appeared to be small bowel. biopsies of ?small bowel as taken. probably large mouth fistual connecting left colon and small bowel. . labs on transfer from : 04:46am blood wbc-1.0* rbc-3.64* hgb-10.5* hct-29.3* mcv-80* mch-28.9 mchc-36.0* rdw-15.5 plt ct-40* 04:46am blood neuts-80* bands-0 lymphs-18 monos-2 eos-0 baso-0 atyps-0 metas-0 myelos-0 04:46am blood pt-11.1 ptt-26.0 inr(pt)-0.9 04:46am blood plt smr-very low plt ct-40* 04:46am blood fibrino-546* 04:46am blood gran ct-784* 04:46am blood glucose-175* urean-16 creat-0.2* na-145 k-4.1 cl-112* hco3-29 angap-8 04:46am blood calcium-8.0* phos-3.4 mg-1.8 brief hospital course: 43yo f with hx of cvid on q3 month ivig infusions (last dose on given ) and colitis concerning for crohn's on asacol and prednsione who was readmitted to with worsening diarrhea, found to have enterocolic fistula, complicated by lower gi bleed, and is transferred to for more subspecialty consultation in complicated undiagnosed patient. colonic mass was found to be due to b-cell lymphoma. she was transferred to the hematology/oncology service and she recieved five days of . on she developed increased abdominal pain and was found to have a perforated bowel. she was taken emergently to the or for exploratory laparotomy with resection of sigmoid and descending colon and end colostomy. her course was complicated by pan-cytopenia secondary to her previous chemotherapy. heme/onc was following and she recieved daily neupogen and vanc//voriconazole until her total granulocyte count passed 1000 when the neupogen and vanc were discontinued. per heme/onc she will continue meor/voriconazole for 14 days after her total granulocyte count reached 1000. her post-op course was otherwise uncomplicated. her diet was very slowly advanced and she was transitioned from pca to liquid po pain meds and a fentanyl patch once she was taking clears. she continued to work with physical therapy. all of her blood cultures post-op remained negative. she recieved a ct on which demonstrated no abscesses. medications on admission: dilaudid 2 mg q2 prn lispro iss nph 20 units qpm lorazepam 1 mg q2 prn protonix gtt cipro 400 mg q12 flagyl methadone 5 mg po qid zofran prn phenergan 12.5 mg prn methylpred 40 mg iv q8 asacol tablets 1200 mg tid cymbalta 20 mg qpm flagyl 500 mg iv q8 patanol eye drops nasonex spray synthroid 50 mcg daily gemfibrozil 600 mg 60 mg trazodone 100 mg qhs lyrica 75 mg tid nortriptyline 10 mg qhs clonazepam 1 mg tid imodium simethicone tylenol discharge medications: 1. nafitdine sig: small amount twice a day: to affected areas. disp:*15 g* refills:*0* 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q6h (every 6 hours) as needed for wheezing . 4. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 5. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 6. clonazepam 1 mg tablet sig: one (1) tablet po qid (4 times a day). 7. lorazepam 1 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for panic attack, breathrough anxiety. 8. insulin regular human 100 unit/ml solution sig: sliding scale injection asdir (as directed). 9. sodium chloride 0.9% flush 3 ml iv q8h:prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. 10. methadone 10 mg tablet sig: one (1) tablet po tid (3 times a day). 11. oxycodone 5 mg tablet sig: 2-3 tablets po q6h (every 6 hours) as needed for breakthrough pain for 5 days. 12. meropenem 500 mg recon soln sig: one (1) recon soln intravenous q6h (every 6 hours) for 9 days: please continue for 9 more days. last dose should be . 13. heparin, porcine (pf) 10 unit/ml syringe sig: two (2) ml intravenous prn (as needed) as needed for line flush. 14. micafungin 100 mg recon soln sig: one (1) intravenous every twenty-four(24) hours for 9 days: please continue therapy until . nine additional days of therapy needed. . 15. insulin sliding scale insulin sc sliding scale breakfast dinner bedtime glucose insulin dose 0-70 mg/dl proceed with hypoglycemia protocol 71-119 mg/dl 0 units 0 units 0 units 0 units 120-159 mg/dl 2 units 2 units 2 units 2 units 160-199 mg/dl 6 units 6 units 6 units 6 units 200-239 mg/dl 10 units 10 units 10 units 10 units 240-279 mg/dl 14 units 14 units 14 units 14 units 280-319 mg/dl 18 units 18 units 18 units 18 units > 321 mg/dl notify m.d. discharge disposition: extended care facility: northeast - discharge diagnosis: colonic lymphoma and simdoid perforation discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulating without assistance. discharge instructions: you were admitted to in transfer from another hospital for concerns of a large descending colonic mass, weight loss, abdominal pain, gi bleeding and diarrhea. you were evaluated by surgery, gastroenterology, hematology, and you were seen by your immunologist. you underwent a colonoscopy for tissue biopsy, which revealed colonic lymphoma. you were transferred to the hemeatology/oncology service for chemotherapy. after undergoing 5 days of therapy you experienced a bowel perforation and were taken for emergency surgery. you underwent a sigmoid colectomy with end descending colostomy. your post-operative course was complicated by pan-cytopenia due to the previous chemotherapy. your blood cell counts were closely monitored and you remained on antibiotics. you remained afebrile and progressed from sips to clears to full liquids to regular diet without complication. your appetite has been poor and we have been supplementing your intake with tpn. you have been ambulating and working with physical therapy. incision care: -your incision line is closed with internal sutures and skin glue. you also have retention sutures which must stay in until your post-operative appoitment with dr. . -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. 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. * please resume all regular home medications and take any new meds as ordered. * continue to ambulate several times per day. followup instructions: 1. please return to see dr. in weeks. call to make an appointment. procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances biopsy of bone marrow colostomy, not otherwise specified closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of large intestine open and other sigmoidectomy injection or infusion of cancer chemotherapeutic substance multiple segmental resection of small intestine injection or infusion of immunoglobulin debridement of nail, nail bed, or nail fold diagnoses: other and unspecified noninfectious gastroenteritis and colitis esophageal reflux diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled perforation of intestine asthma, unspecified type, unspecified pure hyperglyceridemia constipation, unspecified other malignant lymphomas, unspecified site, extranodal and solid organ sites other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure infection and inflammatory reaction due to other vascular device, implant, and graft lumbago other and unspecified coagulation defects other and unspecified mycoses fistula of intestine, excluding rectum and anus arthrodesis status hemorrhage of rectum and anus nutritional marasmus polyarticular juvenile rheumatoid arthritis, chronic or unspecified adjustment disorder with mixed anxiety and depressed mood systemic sclerosis benign neoplasm of pituitary gland and craniopharyngeal duct dermatophytosis of nail common variable immunodeficiency 

Answer: The patient is high likely exposed to