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: percocet / morphine / tylenol attending: chief complaint: right colonic mass major surgical or invasive procedure: : right colectomy history of present illness: ms is a 70 year old female with history of renal transplant in and a transverse colectomy for colon polyps in , who presented for evaluation of a large right colonic polyp. ms. poylp was found in the distal ascending colon at the hepatic flexure on surveillance colonoscopy and was unresectable by scope. she denies fatigue, fever, chills, chest pain or shortness of breath. she denies constipation, bloody or black stool. she denies urinary incontinence. risks and benefits of watchful waiting versus surgical excision were discussed. to prevent of transformation to cancer, a partial colectomy was offered and consent was reviewed and signed. past medical history: - colon polyps - esrd from hypertension status post kidney transplant - osteoporosis - hyperlipidemia - immune suppression from transplant - thromboembolic disease of the left lower extremity, on coumadin past surgical history: - cadaveric renal transplant from a pediatric kidney on - partial colectomy for colonic polyps - thyroid resection for benign disease - ventral hernia repair - ichemic left leg s/p common femoral and profunda endarterectomy, sfa embolectomy, four compartment fasciotomies - peritoneal dialysis with catheter placement and removal. social history: ms. lives in with her husband. she has 2 daughters and 1 son. she is retired. she denies alcohol or tobacco use. family history: noncontributory physical exam: vital signs: t-97.9 hr-95 bp- 115/72 rr-12 o2-98%ra general: well appearing, nad : nonicteric sclera cv: irregular, nl s1, s2 resp: ctab, no distress abdomen: multiple scars, soft, mildly firm, +bs, no masses extremities: no edema, warm neuro: no gross abnormalities psych: a&ox3. appropriate pertinent results: laboratory: cbc: 01:33pm blood hct-37.1 06:10am blood wbc-12.0*# rbc-4.14* hgb-11.7* hct-36.5 mcv-88 mch-28.2 mchc-32.1 rdw-14.8 plt ct-267 08:40am blood wbc-10.4 rbc-4.23 hgb-11.9* hct-37.4 mcv-89 mch-28.2 mchc-31.9 rdw-15.2 plt ct-383 08:00am blood hct-34.3* 03:26pm blood wbc-8.5 rbc-3.59* hgb-10.2* hct-32.3* mcv-90 mch-28.4 mchc-31.5 rdw-15.1 plt ct-383 12:48am blood wbc-7.0 rbc-3.57* hgb-9.9* hct-31.1* mcv-87 mch-27.8 mchc-32.0 rdw-15.1 plt ct-359 07:25am blood wbc-5.3 rbc-3.56* hgb-9.9* hct-31.6* mcv-89 mch-27.8 mchc-31.3 rdw-15.1 plt ct-419 07:10am blood hct-28.7* coagulation panel: 12:30pm blood pt-16.4* ptt-33.1 inr(pt)-1.5* 09:20am blood pt-19.1* ptt-34.0 inr(pt)-1.7* 07:40am blood pt-31.1* inr(pt)-3.1* 08:40am blood pt-35.3* inr(pt)-3.6* 08:00am blood pt-38.0* inr(pt)-4.0* 03:26pm blood pt-43.4* ptt-39.9* inr(pt)-4.6* 12:48am blood pt-39.8* ptt-40.4* inr(pt)-4.2* 07:10am blood pt-38.1* inr(pt)-4.0* chemistry: 06:10am blood glucose-185* urean-14 creat-0.9 na-137 k-4.1 cl-103 hco3-22 angap-16 09:20am blood glucose-142* urean-6 creat-0.7 na-135 k-4.7 cl-103 hco3-26 angap-11 05:45pm blood glucose-121* urean-7 creat-0.9 na-137 k-3.9 cl-104 hco3-22 angap-15 07:40am blood glucose-117* urean-8 creat-0.8 na-139 k-3.9 cl-106 hco3-26 angap-11 08:40am blood glucose-126* urean-10 creat-0.8 na-138 k-5.0 cl-106 hco3-24 angap-13 08:00am blood glucose-127* urean-10 creat-0.7 na-139 k-4.6 cl-107 hco3-25 angap-12 02:53pm blood glucose-127* urean-10 creat-0.9 na-136 k-5.3* cl-103 hco3-22 angap-16 03:26pm blood glucose-775* urean-9 creat-0.8 na-114* k-3.8 cl-85* hco3-20* angap-13 12:48am blood glucose-135* urean-8 creat-0.8 na-138 k-3.9 cl-105 hco3-28 angap-9 07:25am blood glucose-131* urean-6 creat-0.7 na-137 k-3.8 cl-104 hco3-24 angap-13 07:10am blood glucose-113* urean-8 creat-0.7 na-138 k-4.5 cl-106 hco3-22 angap-15 imaging: cxr heart size is normal. aorta is mildly tortuous. lungs are clear except for small linear focus of atelectasis at the left lung base. mildly distended loops of bowel in upper abdomen are incompletely evaluated on the chest radiograph examination which could be more fully assessed with standard abdominal views if warranted clinically. brief hospital course: ms. an uneventful right colectomy on .inraoperatively, she developed afib with rvr and was treated with iv lopressor. she remained hemodynamically stable throughout. the remainder of her post-operative course is detailed below by system: cardiopulmonary: ms remained in afib posteroperatively with several daily episodes of rapid ventricular response but was hemodynamically stable throughout. tachycardia was evaluated by ekg several times with no evidence of st/t changes and negative troponins. tte was performed on pod#2 with no wall motion abnormalities and an ef of 55%. tachycardia was managed with po lopressor with iv lopressor for refractory tachycardia. she was restarted on coumadin on pod#2, however this was held on pod# due to elevated inr. on pod#3, she developed an ileus and iv lopressor was used for rate control. on pod#4, she developed tachycardia resistant to iv lopressor and received iv diltiazem with good response. despite aggressive betablocker therapy, ms. rate was poorly controlled, tachy into 160s at times. after discussion with the patient and her cardiologist, cardioversion was recommended after tee. on pod#5, ms. tee with no evidence of intraatrial thrombus and an ef of 55%. she was electrically cardioverted into sinus rhythm in the 80s. on return to the floor, ms. was again in afib with hr of 160s, appeared cyanotic in face and hands, and desaturated to low 90s on 3l of o2. o2 sat continued to drop and patient was put on 100% o2 by nrb, with o2 sat down to high 70s. code blue was called. two ivs were placed, patient was ventilated by bag-mask with o2 return to 95%, iv diltiazem was given with good response, iv dilaudid was given for pain, 40 mg iv lasix were given for ?pulmonary edema from cardioversion, and foley was placed. patient responded well and was sat 95% on 100% o2 nrb. stat cxr showed no cardiopulmonary disease. she transferred to the icu where she was found to have methemoglobinemia, presumably from topical benzocaine use during tee. overnight, she was rate controlled on an amiodarone drip and given methylene blue with resolution of cyanosis. she was cardioverted again on pod#6 and started on po amiodarone and lopressor since ileus resolved. she was transferred to the floor on pod#6 and remained rate controlled for the remainder of her stay. her o2 sat steadily improved and she was sating 99% on ra on discharge. she will follow up with dr. , her cardiologist, for continued management of atrial fibrillation. gi: ms. felt well postoperatively with minimal pain, well controlled with iv dilaudid. she was switched to po dilaudid on pod#2 and tolerated clear liquid diet. however, she did not pass flatus. on pod#3, her abdomen felt distended and she vomited once. she was again made npo, and all medications were changed to iv route with transplant nephrology and cardiology consultation. on pod#6, she passed flatus and had a bowel movement. she was gradually advanced from clear liquids to a regular diet with continued bowel movements daily. her wound was checked daily with no hematoma or evidence of infection. pathology of right colonic mass consistent with adenoma and no evidence of carcinoma. she will follow up with dr. for removal of staples and postop follow up. renal/gu: ms. immunosuppresive therapy was continued postoperatively with the guidance of her transplant nephrologists. her cellcept was changed to iv when her ileus developed and sirolimus was given po with a sip of water. daily sirolimus levels were checked and dose maintained appropriately. cr remained stable at <1.0 throughout hospitalization. on pod#7, cellecept was changed back to po and cincalcet and ca were restarted. patient will follow up with dr. from transplant nephrology in one week after sirolimus level checked as outpatient. heme/id: ms. was maintained on bactrim prophylaxis postoperatively, although it was held during her ileus after consultation with transplant nephrology. postop inr was 1.4 and coumadin was restarted on pod#1. inr increased from 1.5 on pod#3 to 3.6 on pod#4, so coumadin was held. inr continued to rise and peaked at 4.2 before coming down again. bactrim was thought to be interacting with coumadin levels and was changed from ds to ss. inr on discharge was ???? patient will follow up with dr. on for coumadin dosing after recheck of inr. neuro/psych, endocrine, derm: ms. had no issues during her hospitalization. at the time of discharge she was ambulating, tolerating diet, voiding. she continued to have loose stools and was discharged on loperamide. the stool cultures were sent and will be followed. patient understands and agrees with discharge planning. medications on admission: - sulfamethoxazole-trimethoprim 400-80 mg tablet sig: one (1) tablet po daily (daily). - sirolimus 1 mg tablet sig: one (1) tablet po 5x/week (,mo,we,th,sa). - mycophenolate mofetil 250 mg tablet sig: one (1) tablet po bid (2 times a day) - amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). - atorvastatin 40 mg tablet sig: one (1) tablet po hs (at bedtime). - cinacalcet 30 mg tablet sig: one (1) tablet po bid (2 times a day). - metoprolol succinate 100 mg tablet po hs - calcium carbonate 500 mg (1,250 mg) tablet sig: one (1) tablet po daily (daily). discharge medications: 1. sulfamethoxazole-trimethoprim 400-80 mg tablet sig: one (1) tablet po daily (daily). 2. amiodarone 200 mg tablet sig: one (1) tablet po qam (once a day (in the morning)) as needed for afib. disp:*30 tablet(s)* refills:*0* 3. sirolimus 1 mg tablet sig: one (1) tablet po 5x/week (,mo,we,th,sa). 4. mycophenolate mofetil 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 5. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 6. atorvastatin 40 mg tablet sig: one (1) tablet po hs (at bedtime). 7. cinacalcet 30 mg tablet sig: one (1) tablet po bid (2 times a day). 8. metoprolol succinate 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po hs (at bedtime) as needed for afib. 9. calcium carbonate 500 mg (1,250 mg) tablet sig: one (1) tablet po daily (daily). 10. dilaudid 2 mg tablet sig: one (1) tablet po every 4-6 hours as needed for pain. disp:*20 tablet(s)* refills:*0* 11. imodium a-d 2 mg tablet sig: one (1) tablet po four times a day. disp:*120 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: right colonic polyp methehemoglobinemia atrial fibrillation with rapid ventricular response discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted for removal of your right colon for a colonic polyp. please call your doctor or nurse practitioner or return to the emergency department for any of the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down 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. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *your pain in not improving within 8-12 hours or is not gone within 24 hours. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon. avoid driving or operating heavy machinery while taking pain medications. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. *if you have staples, they will be removed at your follow-up appointment. *if you have steri-strips, they will fall off on their own. please remove any remaining strips 7-10 days after surgery. followup instructions: please follow up with dr. on . please call his office for your appointment at (. please follow up with dr. after your rapamycin level in one week as per usual. you can contact his office at (. please follow up with dr. , your cardiologist, to review the medications for your atrial fibrillation. you may contact her office at(. please follow up with dr. about your coumadin dosing on , after your inr is checked at quest lab in . you may contact his office at . procedure: diagnostic ultrasound of heart other electric countershock of heart other electric countershock of heart excision or destruction of peritoneal tissue open and other right hemicolectomy other small-to-large intestinal anastomosis diagnoses: unspecified essential hypertension cardiac complications, not elsewhere classified atrial fibrillation atrial flutter long-term (current) use of anticoagulants paralytic ileus personal history of venous thrombosis and embolism benign neoplasm of colon methemoglobinemia kidney replaced by transplant 

Answer: The patient is high likely exposed to