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: penicillins attending: chief complaint: cold right lower extremity major surgical or invasive procedure: 1. aorto uni-iliac stent graft repair of abdominal aortic aneurysm. 2. left-to-right femoral-femoral bypass grafting. upper gi endoscopy tunnelled line placement jejenostomy tube placement tunnelled line removal history of present illness: 88yom with acute onset of rle pain beginning in the bathroom at approximately 8 am this morning. he states that up until that point he was doing well. he has had intermittent pain in the left leg, but never in the right. he has a known 7 cm aaa that may or may not involve the thoracic aorta as well - the history is poor. he currently states his pain is worst in the lower thigh to knee. he states his foot feels cold. past medical history: htn cad s/p cabg x 2 hypothyroidism anxiety anemia hypercholestrolemia afib psh: cabg x 2 - last in ', appy social history: came from a nh facility, has an elderly wife. hcp is son . family history: n/c physical exam: vs: t 97.9 p 86 bp 160/83 rr 20 o2 sat 99 % ra gen: alert, confused x 3, deaf. card: irregular, no m/r/g lungs; scattered rhonchi throughout abd: flat, nt, nd, jejenostomy tube clamped ext: right groin w/ a small scab over incision line, well perfused, warm b/l, 3+ edema up to hips b/l pertinent results: 04:21am blood wbc-7.5 rbc-2.82* hgb-9.0* hct-25.9* mcv-92 mch-31.9 mchc-34.8 rdw-19.9* plt ct-68* 04:45am blood wbc-7.7 rbc-3.07* hgb-9.3* hct-27.6* mcv-90 mch-30.3 mchc-33.7 rdw-19.1* plt ct-89* 08:41am blood wbc-8.0 rbc-3.16* hgb-9.8* hct-28.6* mcv-90 mch-30.9 mchc-34.2 rdw-19.1* plt ct-87*# 04:21am blood pt-18.0* ptt-27.2 inr(pt)-1.6* 04:45am blood pt-16.3* ptt-25.6 inr(pt)-1.5* 04:21am blood plt ct-68* 04:45am blood plt ct-89* 04:06am blood glucose-70 urean-54* creat-3.2* na-143 k-3.6 cl-111* hco3-24 angap-12 04:21am blood glucose-119* urean-37* creat-2.7* na-144 k-3.1* cl-109* hco3-30 angap-8 04:45am blood glucose-114* urean-54* creat-3.4* na-145 k-3.6 cl-112* hco3-26 angap-11 10:01am blood caltibc-120* ferritn-1671* trf-92* 03:16pm blood vitb12-991* folate-6.6 05:13am blood triglyc-101 09:41am blood hbsag-negative hbsab-borderline hbcab-negative 12:42pm blood hbsag-negative hbsab-negative 09:41am blood hcv ab-negative 12:42pm blood hcv ab-negative ecg study date of 5:36:18 pm ecg study date of 10:43:38 pm technically difficult study sinus rhythm early r wave progression anterolateral t wave changes low limb lead voltage no previous tracing available for comparison cta aorta/bifem/iliac runoff w/w&wo c and recons study date of 5:58 pm impression: 1. very large fusiform infrarenal aortic aneurysm with irregular plaque, thrombus and heterogeneous filling. for further details, see description above and refer to the aaa reporting tool. 2. focal areas of suprarenal aorta dissections or ulcerative plaques. 3. severe atherosclerotic disease of bilateral lower extremity vessels as described above. 50% stenosis of the right proximal sfa. 4. occlusion of the right common iliac artery with distal reconstitution via the internal iliac artery. 5. wedge compression fracture of l2 and severe degenerative changes. 6. scarring in both kidneys and left kidney hypodensity, too small to characterize, likely a cyst. 7. gallstones. 8. splenic calcifications, likely old hematoma, old infarct, prior infection or prior granulomatous exposure. 9. bibasilar interstitial thickening and ground-glass opacity could be due to volume overload or interstitial lung disease. portable tte (complete) done at 1:50:59 pm final conclusions: the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with basal to mid infero-lateral hypokinesis. no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. 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. ecg study date of 10:52:04 am sinus rhythm. left axis deviation. left anterior fascicular block. diffuse non-diagnostic repolarization abnormalities. compared to the previous tracing of multiple abnormalities as previously noted persist without major change. chest (pre-op pa & lat) study date of 12:09 pm chest, two views: the heart size is moderately enlarged. the patient is status post sternotomy and cabg. there are relatively low inspiratory lung volumes with mild elevation of the right hemidiaphragm causing some vascular crowding. there is no overt congestive failure and no focal consolidation or pleural effusion. calcified abdominal aortic aneurysm is noted. the study and the report were reviewed by the staff radiologist. ct abdomen w/o contrast study date of 9:14 am impression: 1. development of large intramuscular hematoma within the right iliopsoas muscle status post infrarenal aortic aneurysm graft repair. evaluation of the graft itself, as well as the fem-fem bypass graft, is limited without contrast. 2. cholelithiasis. interval development of gallbladder distention likely reflects limited p.o. intake. 3. anasarca and small right pleural effusion. brief hospital course: transferred from osh with ischemic/cold right lower extremity. cta was done that showed- very large fusiform infrarenal aortic aneurysm with irregular plaque, thrombus and heterogeneous filling. suprarenal aorta dissections or ulcerative plaques.severe atherosclerotic disease of bilateral lower extremity vessels. occlusion of the r cia. routine nursing care, pre-op for angiogram/evar. cardiac clearance, ecg, echo was done- dilated. normal lv w/ left systolic dysfunction, basal to mid infero-lateral hypokinesis. rv normal.(1+) ar. (1+) mr. s. taken to or and underwent aorto uni-iliac stent graft repair of abdominal aortic aneurysm. left-to-right femoral-femoral bypass grafting. routine invasive monitoring lines were placed. recovered in the pacu, then transferred to vicu/telemetry. pod1 overnight patient was confused-restrained. hct down 24.2 transfused w/ 2 units prbc. low urine output- recieved multiple fluid boluses. tachycardic started metoprolol iv prn to keep hr <100. hydromorphone iv for pain control. electrolytes repleted. pod2 remains confused and mechanically restrained, also strted on lorazepam for agitation. remained in the vicu. on lower extremity bypass pathway. bedrest. continued to drop hct. transfused w/ 2 uints prbc given lasix post transfusion. pod3 continues to drop hct and require blood transfusions. ct pelvis was done showed- right iliopsoas muscle with a large hematoma. remains confused w/ periods of agitation w/ wrist restraints and lorazepam prn agitation. became tachycardic 150's a-flutter- bolused w/ diltiazem and placed on a drip to keep hr under 100. creatinine bumped up w/ low urine output- given escalating lasix dose. pa line converted to tripple lumen cl- placement confirmed by x-ray. 02/24-25/09 pod4-5 remains in the vicu. remains confused w/ periods of agitation wrist restraints and lorazepam prn agitation. started haldol. started clear liquids. social work consult for family. low urine output, given more lasix. started bowel regimen. remained on diltiazem drip. started po meds. creatinine continue to rise nephrology consulted. pod6-7 remains in vicu, confused w/ periods of agitation wrist restraints and haldol prn agitation. noted to be coughing with eating- scpeech and swallow consulted- + aspiration- recs npo. po meds converted to iv, started iv maintenance fluids. remains on diltiazem drip. continues on hydromorphone iv for pain control. urine from admission growing gram negative rods- started on levaquin. started tube feeds and po meds through ngt, started having diarrhea, sent for c-diff and started on metronidazole, also started on vanco emperically. creatinine continue to rise w/ poor urine output, temporary hd catheter placed, placement confirmed and started hd. temp maxed 101.8, cl d/c'd- tip sent for culture and pan cultured. 02/28-29/09 pod8-9 remains in the vicu. continues to have periods of agitation wrist restraints and haldol prn agitation. diltiazem drip d/c'd after po dilt down ngt. tube feeds advanced, now at goal. pod10-11 remains in the vicu. speech and swallow re-evaluation. tube feeds at goal. continue to have periods of agitation wrist restraints and haldol prn agitation. hdialysed today, vanco hd protocol per renal service, continued w/ levo and flagyl. sputum came back positive for klebshiella pneumoniae. speech and swallow-re-evaluation- continue to aspirate-recs strict npo, re-evaluation in a few days. pod12 remains in vicu. cxr-multifocal lung opacities are overall stable. stool negtive for c-diff. blood cultures no growth.continue to have periods of agitation wrist restraints and haldol prn agitation. re-inserted dobhoff- confirmed by x-ray. physical therapy re-consult for dispo planning. hemodialysed for fluid removal. had episode of hematemesis and massive melena stool w/ drops in bp. transferred to cvicu. intubated and sedated., dobhoff d/c'd. gi consulted-performed endoscopy- found to have ulcers in fundus, and duedenum-recs potonix drip, check h-pylori and serial hct. hct down to 22.3 transfused with 4 units prbcs. geriatrics consult-will follow. riss for glycemic control. pod13 remains in cvicu, intubated and sedated. protonix drip and ntg drip. hct stable.continues to have marginal urine output. diltiazem iv for rate control, in a-fib.dialysed at bedside. pod14 remains in cvicu, intubated and sedated on propofol drip. remains on dilt and protonix drips. transfused w/ 2 units prbcs. patient made dnr/dni per patient hcp corroborated by attending physician . . creatinine continue to be elevated w/ minimal urine output, continues to have hd.general surgery consulted for j tube placement. pod15 remains in cvicu dnr/dni, intubated, sedate. diltiazem and protonix drip. continues to have serial hct. oliguric.antibiotics switched to vanco/aztreonam/flagyl. pod16-18 remains in cvicu dnr/dni, extubated, hdialysed. dobhoff placed, started tube feeds. added cipro to antibiotics. remains on protonix drip change to dosing, diltiazem weaned off, placed on metoprolol iv prn. cipro d/c'd. npo post mn for tunnelled hd line placement. pod19 transferred to 5/vicu dnr/dni. had some episodes of confusion/agitation- given haldol, applied wrist restraints. continued w/ tube feeds advanced to goal od 45 cc/h. tunnelled line placed in interventional radiology, hemodialysed. physical therapy re-consult. speech and swallow re-consult-continue to aspirate- strict npo inluding meds. c-diff cultures negative. 03/11-13/09 pod20-22 remains vicu. no acute events.continued w/ abx, (vanco/levo/flagyl)and peg placed, tube restarted and advanced to goal. had some hypotension in hd. controlled hr w/beta blocker and diltiazem.continue to have episodes of confusion/agitation- given haldol, applied wrist restraints. hepatitis panel negative. continue to have diarrhea- flexi seal fecal management placed. 03/14-17/09 pod22-27 remains vicu. vss. continues to have episodes of confusion/agitation- requiring haldol and wrist restraints. trial off hemodialysis. reapeat bedside swallowing evaluation-continue to have dyspahgia scale 1- continue strict npo. continued on tube feeds. pod28 no acute events. hemodialysed for fluid overload and elevated creatinine. pod29 no acute events. peg accidentally pulled by patient advanced in ir. pod30 patient continued to show no improvement of renal status. multidsiciplinary meeting with family. discussed dispo/treatment options. family aggreed make patient cmo, to stop hd, remove all invasive lines and stop meds that do not contribute to patient's comfort only. family will decide over the w/e where the patient will be discharged to home versus facility. 03/21-23/09 pod31-32 patient stable, on cmo dnr/dni. tunnelled line removed in ir. tlc d/c'd. family decided to discharge to extended care facility, screening done. bed offer at , nh. family aware. to discharge in am. pod33 discharged to extended care facility in fair condition, comfort measures only, dnr/dni. no need for fu w/ dr. . medications on admission: atenolol 25mg mg po qd lipitor 20mg po qd synthroid 50 mcg po qd zoloft 50 mg po qd felodipine 2.5 mg po qd discharge medications: 1. acetaminophen 160 mg/5 ml solution sig: po q6h (every 6 hours) as needed for pain. 2. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours). 3. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 4. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q2h (every 2 hours) as needed. 5. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day) as needed. 6. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical daily (daily) as needed. 7. nystatin 100,000 unit/ml suspension sig: five (5) ml po tid (3 times a day). disp:*450 ml(s)* refills:*2* 8. haloperidol 1 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* discharge disposition: extended care facility: discharge diagnosis: known aaa uti- treated dysphagia post-op pneuomonia- trated w/ abx post-op acute anemia requiring multiple blood transfusions post-op upper gi bleed 2nd to gastric and duedenal ulcers- resolved post-op gastric ulcer- treated medically & currently stable post-op duedenal ulcer- treated medically & currently stable acute renal failure- requiring hemodialysis- still in failure post-op delirium-requiring sedation and restraints history of: htn pvd hypothyroid anxiety cad s/p cabg x 2 - last in ', psh: s/p appy discharge condition: fair dnr/dni comfort measures only discharge instructions: patient is being discharged dnr/dni cmo followup instructions: fu w/ dr. on a prn basis only procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis other (peripheral) vascular shunt or bypass percutaneous [endoscopic] gastrostomy [peg] aortography endoscopic control of gastric or duodenal bleeding endovascular implantation of other graft in abdominal aorta diagnoses: pure hypercholesterolemia acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified unspecified essential hypertension acute posthemorrhagic anemia unspecified protein-calorie malnutrition unspecified acquired hypothyroidism atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status hematoma complicating a procedure unspecified transient mental disorder in conditions classified elsewhere atrial flutter pneumonitis due to inhalation of food or vomitus primary pulmonary hypertension other respiratory complications chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction abdominal aneurysm without mention of rupture hyperosmolality and/or hypernatremia urinary complications, not elsewhere classified atherosclerosis of native arteries of the extremities with rest pain pneumonia due to klebsiella pneumoniae other drugs and medicinal substances causing adverse effects in therapeutic use pneumonia due to other streptococcus 

Answer: The patient is high likely exposed to