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: patient recorded as having no known allergies to drugs attending: chief complaint: gib major surgical or invasive procedure: intubation (electively for egd only; otherwise dnr/dni) colonoscopy egd history of present illness: 86m with h/o recent nstemi , and recent admission to osh for gib of unclear source (plavix stopped x5d, then restarted), presenting to -n this morning for altered mental status, lethargy, and black stools. vs there 97.7 118 16 78/48 90%ra. exam notable for guaic positive stool and lethargy. labs revealed hct 22, k 6.0 (hemolyzed), cre 2.9. ng lavage revealed green gastric contents, no blood, no coffee grounds. he received 2 pivs, nexium gtt, ctx 1 gm, azithromycin, and 2u prbc, with bp improvement to 101/42 hr 89 at time of transfer to . of note, he was admitted to hospital in the setting of weakenss and large dark bowel movement, found to be anemic (hct 21.3 on admission, up to 34.1 at discharge after total 5u prbcs), and was admitted for evaluation of gib with egd, with course c/b respiratory failure requiring intubation (per family x3d) felt chf vs pna. egd at that time revealed esophagitis and duodenitis per discharge summary. in ed vs = 97.8 93 128/58 20 100%. labs upon arrival notable for k 5.8, cre 2.4 (baseline 1.3 at time of discharge ), hct 25.6 (after 2u prbc from osh), wbc 20.1, inr 1.2. sbp dropped to 77/42 with hr 103, so cvl was placed and he was started on levophed, and received an additional . sbp improved to 120s after 1l ns and an additional 1u prbc, which is still hanging. gi consult obtained, cardiology made aware. past medical history: - cad s/p 2 vessel cabg in , bioprosthetic avr, nstemi with des to rca (>90% stenosis), and pl, otherwise open sv grafts x 2 (lad, diag), native 90% lcx dx. - chf (ef= 30-44%), mod tr, lae on tte at osh. - pvd - known r sfa occlusion @ cath . - htn - dm2 - on oral meds. - hyperlipidemia - h/o cva in with slurred speech, found to have (atrophy, small vessel ischemic changes, subtle chronic left pontine infarct) on ct head at osh . social history: lives alone, 7 children. no tobacco, drinks glasses of wine a week, denies ivdu. family history: htn, cad, dm. physical exam: vitals: 97.4 95 150/55 27 99%2l general: lethargic, oriented x1, no acute distress heent: mm dry, oropharynx clear, poor dentition neck: supple, jvp not elevated, no lad lungs: clear to auscultation anteriorly, no wheezes, rales, ronchi cv: regular rate, normal s1 + s2, 2/6 sem @ rsb, no rubs, gallops abdomen: soft, non-tender, non-distended, hypoactive bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: 08:35pm wbc-18.7* rbc-2.82* hgb-8.5* hct-25.0* mcv-89 mch-30.2 mchc-34.1 rdw-18.7* 08:35pm plt count-214 08:28pm glucose-232* urea n-111* creat-2.0* sodium-142 potassium-5.5* chloride-112* total co2-20* anion gap-16 08:28pm ck(cpk)-152 08:28pm ck-mb-23* mb indx-15.1* ctropnt-0.63* 04:51pm type-art po2-475* pco2-40 ph-7.32* total co2-22 base xs--5 04:51pm lactate-0.8 03:37pm wbc-17.6* rbc-2.66* hgb-8.3* hct-23.5* mcv-88 mch-31.1 mchc-35.2* rdw-18.7* 03:37pm plt count-215 01:03pm urine blood-sm nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-tr 10:36am lactate-1.4 09:47am hgb-9.0* calchct-27 09:45am glucose-231* urea n-123* creat-2.4*# sodium-136 potassium-5.8* chloride-104 total co2-19* anion gap-19 09:45am alt(sgpt)-21 ast(sgot)-25 alk phos-43 tot bili-1.0 09:45am ld(ldh)-163 ck(cpk)-95 09:45am lipase-85* 09:45am ctropnt-0.42* 09:45am caltibc-291 haptoglob-163 ferritin-94 trf-224 09:45am wbc-20.1* rbc-2.83* hgb-8.6* hct-25.6* mcv-90# mch-30.4# mchc-33.7 rdw-17.9* 09:45am neuts-92.3* lymphs-5.7* monos-1.9* eos-0.1 basos-0.1 09:45am plt count-245 09:45am pt-14.1* ptt-24.6 inr(pt)-1.2* studies: ecg: lbbb (old), nl axis, no ste per sgarbossa criteria, std and twi in 1, avl, v4-6 c/w lvh. cxr: no obvious infiltrate, pulmonary edema. ?free air under right diaphragm. prior cabg and avr seen. : colonoscopy: there was a very tight bend at the sigmoid colon which could represent previous anastomosis if patient has had prior surgery. there were a few areas of a few red drops of blood seen in the ascending colon which were washed without underlying lesion seen. mucosa appeared very friable and occasional contact bleeding was seen. however, this was minimal and does not account for transfusion requirement. polyp in the sigmoid colon bile was seen in the terminal ileum and cecum without evidence of blood. ileum was normal up to 25 cm. otherwise normal colonoscopy to terminal ileum to 20 cm. : egd: impression: mild gastritis. otherwise normal egd to second part of the duodenum : ct abd/pelvis 1. no retroperitoneal bleed. right femoral venous catheter in expected position. 2. two rim calcified infrarenal abdominal aortic aneurysms measuring up to 3 cm in diameter are chronic, without adjacent paraaortic abnormality. these may be the sequelae of prior penetrating ulcer or focal dissection. dense calcification at the origin of the renal arteries and sma; significant stenosis cannot be excluded. 3. cholelithiasis without evidence for cholecystitis on this limited non-contrast exam. echo the left atrium is elongated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is moderate regional left ventricular systolic dysfunction with inferior and infero-lateral akinesis with septal hypokinesis. no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. a bioprosthetic aortic valve prosthesis is present. the aortic valve prosthesis appears well seated, with normal leaflet/disc motion and transvalvular gradients. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is mild functional mitral stenosis (mean gradient 5 mmhg) due to mitral annular calcification. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. brief hospital course: # gib - patient having melanotic stools with hemodynamic instability requiring total of (6units, last transfusion on ) of prbcs at . gi was consulted. egd was negative for acute bleed. colonoscopy was negative for acute bleed. ct scan was negative for rp bleed. hemolysis labs were negative. hct remained stable since last transfusion on # hypotension - initially concerning for gib given guaic positive stool, decreased hct, and recent similar admission. ddx also included sepsis, so evaluated for possible sources with cxr, bcx, and ucx. cxr was negative. bcx and ucx were negative patient was given aggressive ivf and blood as above. after the colonoscopy he did require levophed briefly, but then was able to maintain bps without pressor-support. # confusion - per family, confusion was typical of pt's hospitalizations, and likely multifactorial with contribution from poor neurologic reserve (h/o cva, chronic vascular changes), hypotension, and possible septic picture. no evidence to suggest primary cns infection (no meningismus, headache, kernig, brudzinki negative), no focal neurologic deficits on exam. seroquel was held, then restarted at home dose. pt returned alert and oriented x 3 once transferred out of icu. # hyperkalemia - likely arf. no ecg changes c/w hyperkalemia. resolved. . # arf - likely volume depletion. lactate negative. resolved with ivf. . # cad - s/p nstemi. denies chest pain or dyspnea, and ekg without frank evidence of ischemia though has old lbbb, and worsening twi and std in v4-6 in setting of sinus tach and anemia (likely reflects both lvh and some demand ischemia). feels acs is unlikely, but given +troponin and recent nstemi, will proceed as follows: - held asa and plaivx initially, then restarted when egd revealed no active bleeding. - held metoprolol, lisinopril given initial hypotension, then restarted when pt actually became hypertensive on the floor - transfuse to maintain hct > 27. - echo done, result as above . # chf - ef 40% at osh in , on lasix at home. held lisinopril and lasix initially, then restarted prior to discharge. # dm2 - on orals at home; covered with iss during hospital stay. . # hyperlipidemia - held statin initially, then restarted prior to discharge. . # code: dnr/dni medications on admission: - metformin 500mg po bid - plavix 75mg po qdaily (stopped x5d during admission) - glipizide 10mg po bid - metorolol 50mg po bid - isosorbide mononitrate 30mg po qdaily - lisinopril 20mg po qdaily - digoxin 125mg po qdaily - hydralazine 25 mg po tid - lipitor 20mg po qdaily - senna - colace - aspirin 81mg po qdaily - mvi - seroquel 25mg po bid (started ) - lasix 40mg po qdaily - prilosec 40mg po bid discharge medications: 1. equipment 3-in-1 commode (diagnosis of cva) 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 4. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 5. lisinopril 20 mg tablet sig: one (1) tablet po once a day. 6. metoprolol tartrate 50 mg tablet sig: two (2) tablet po twice a day. 7. quetiapine 25 mg tablet sig: one (1) tablet po hs (at bedtime). 8. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 9. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 10. potassium chloride 10 meq tablet sustained release sig: one (1) tablet sustained release po once a day. disp:*30 tablet sustained release(s)* refills:*2* 11. metformin 500 mg tablet sig: one (1) tablet po twice a day. 12. imdur 30 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 13. lipitor 20 mg tablet sig: one (1) tablet po at bedtime. 14. glipizide 10 mg tablet sig: one (1) tablet po twice a day. 15. colace 100 mg capsule sig: one (1) capsule po twice a day as needed for constipation. 16. senna 8.6 mg tablet sig: one (1) tablet po twice a day as needed for constipation. 17. multivitamins tablet, chewable sig: one (1) tablet, chewable po once a day. 18. nystatin 100,000 unit/g cream sig: one (1) appl topical (2 times a day) as needed for yeast infection on buttocks. discharge disposition: home with service facility: discharge diagnosis: primary: gi bleed acute renal failure . secondary: coronary artery disease hypertension chronic systolic heart failure discharge condition: improved discharge instructions: you were admitted to the hospital for bleeding in the gastrointestinal tract. upper and lower endoscopy was done however we could not find the source of the bleeding because it had stopped bleeding by then. . a capsule study has been scheduled for you. you will receive instructions by mail, but you should also call at to confirm the appointment and learn more about the procedure. . some changes were made to your medications: - stopped hydralazine (blood pressure medication) - stopped prilosec and instead started ranitidine - changed seroquel from 25 mg twice a day to 25 mg once at bedtime - added nystatin cream as needed for fungal infection of the buttocks . ct scan of your abdomen and pelvis done during this hospitalization showed some changes that should be followed up with a repeat scan in 3 months (-). your primary care doctor this. . please weigh yourself every morning and call your doctor if weight > 3 lbs. please adhere to 2 gm sodium diet. . if you experience dizziness, palpitations, black tarry stools, red blood with stools, or any other symptoms concerning to you, please call your doctor or return to the emergency room. followup instructions: please go to the following appointments as scheduled: capsule study: 8:00 am with dr. phone: follow up appointment with gastroenterology: , md phone: date/time: 1:30 pm . please call dr. office at to follow up in weeks (sometime after your appointment with dr. . please mention that you were asked to get a repeat imaging of your abdomen for the findings seen on ct scan during your hospital stay. a summary of your hospitalization will be faxed to her office. procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine insertion of endotracheal tube other bronchoscopy arterial catheterization colonoscopy transfusion of packed cells diagnoses: hyperpotassemia anemia, unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified peripheral vascular disease, unspecified percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia heart valve replaced by other means long-term (current) use of insulin old myocardial infarction other left bundle branch block chronic systolic heart failure personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits duodenitis, without mention of hemorrhage hemorrhage of gastrointestinal tract, unspecified esophagitis, unspecified benign neoplasm of colon unspecified gastritis and gastroduodenitis, without mention of hemorrhage leukocytosis, unspecified volume depletion, unspecified unspecified psychosis 

Answer: The patient is high likely exposed to