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: ibuprofen / oxycodone hcl/acetaminophen / aspirin attending: chief complaint: brbpr major surgical or invasive procedure: colonoscopy history of present illness: mr. is a 87 yo m w/ h/o aortic disease, critical as, cad planned for cabg and avr the day after admission who presents with brbpr. of note, the pt had a cardiac cath which showed 80% lad and bifurcated diag with >70% stenosis in both poles. post op course was complicated by formation of a pseudoaneurysm. pt presented to the ed with complaints of increase in size of groin hematoma. at that time, us showed no flow into pseudoanaerysm which was thought to be thrombosed. pt was sent home by vasc surgery from the ed. . on sat , pt was constipated and took prune juice resulting in a bm. when he wiped, there was some blood on the toilet paper. in the evening , pt had bm, noted blood on the toilet paper and also around the mostly brown stool. in pt had a streaky brown marroon stool. initial vitals were t 98.5 p 82 bp 129/37 r 15 o2 sat 100 on ra. there, he was found to have hct 24.5 from 26.6 2 days prior. of note, pt had cauderization of cecal av malformation at an osh in . in the ed, the pt became hypotensive from bp 130/37 on arrival to a low of sbp 86. hr 80s rose from to 90s (pt is normally not on any beta blocker at home). at no time in his ed course was the pt symptomatic although he did admit to fleeting lightheadedness on the day prior to admission. gi was consulted from the ed and recommended ppi gtt which was started and transfusion of prbcs for goal hct>30. they stated they would talk to the icu team on arrival about possible egd on day of admission. 2 units of prbcs were ordered in the ed and the first hung just prior to transfer to the icu. pt was given about 2l ivf in the ed. 2 large bore ivs were placed in the ed. . in the ed, the pt refused ngt and when this was brought up, he began to c/o chest pain. ekg at that time showed st depressions in v2 and v4-6 which were worse from earlier in the day, new ste in avr and the pt was thought to be in an irregular rhythm ? multifocal atrial tachycardia. after the pt was told that an ngt would not be attempted since he had refused it, his cp resolved. cardiology was called from the ed who said, given the pt's bleeding, there was nothing more to do but that they would follow the pt in the icu. cardiac surgery was also made aware of his admission given his planned surgery on . . on the floor, pt is c/o left sided chest tightness with out lightheadedness, sob or palpitations. pt states he has had similar chest pain for several months. usually resolves with drinking cold water and rest. past medical history: 1. aortic stenosis (valve area 0.6cm2) 2. hypercholesterolemia (total 144, ldl 85, hdl 32 in ) 3. htn 4. l shoulder fx ~2wk ago 5. multiple large lymph nodes seen on ct social history: lives alone. two daughters. denies tobacco and etoh. family history: n/c physical exam: vitals: t: 97.3 bp: 109/37 p: 71 r: 18 o2: 96% ra general: nad, alert, oriented heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated lungs: clear to auscultation bilaterally, no wheezes or crackles cv: regular rhythm, normal rate, no s1 or s2 appreciated, ii/vi systolic murmur at base, no rubs or gallops appreciated abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, no clubbing, cyanosis or edema pulses: dp 1+ pulses pertinent results: 01:45am wbc-12.9* rbc-3.13* hgb-8.0* hct-24.5* mcv-80* mch-26.0* mchc-32.7 rdw-15.1 01:45am neuts-80.7* lymphs-11.6* monos-4.4 eos-2.9 basos-0.3 01:45am ctropnt-0.14* 01:45am ck(cpk)-42* 01:45am glucose-105* urea n-27* creat-1.3* sodium-132* potassium-4.5 chloride-100 total co2-23 anion gap-14 tte: the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the number of aortic valve leaflets cannot be determined. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. the tricuspid valve leaflets are mildly thickened. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the prior study (images reviewed) of , pulmonary artery pressures can be assessed on the current study and are mildly elevated. aortic stenosis remains crtical. brief hospital course: 87-year-old male with history of cad, critical as planned for cabg, avr presented with brbpr and demand ischemia. # bright red blood per rectum: the patient had a 3 point hct drop in 2 days and 1 maroon stool by report. the patient was transfused 3 units of packed rbcs to a hct over 30. stool guaiac was trace positive in the icu. gi was consulted and did a colonoscopy. they found evidence of hemorrhoids and diverticula and one rectal polyp without evidence of active bleeding. the patient was discharged with stable hematocrit. # chest pain: the patient developed chest pain. he had a planned cabg and avr. after blood transfusion the patient was asymptomatic. the patient was continued on his lipitor and anticoagulation was held. the patient had a slight cardiac enzyme elevation which is likely secondary to demand ischemia. the patient cardiac enzymes were trending down at the time of discharge. after the colonoscopy the patient was started on metoprolol succinate and diovan per outpatient regimen. # severe as: the patient also has significant cad. he was scheduled for a cabg/avr however developed the gi bleed. he remained chest pain free while he was an inpatient in the hospital. the patient was continued on the above cad medications. he was evaluated by csurg and scheduled for a cabg/avr in the near future. plavix and aspirin were held in anticipation of the surgery and the recent gi bleed. # hypertension: antihypertensives were held in setting of gi bleed. they were restarted at time of discharge. # dyslipidemia: continued statin. medications on admission: vitamin d 1,000 unit cap, 1 capsule(s) by mouth once a day saw 80 mg cap diovan 80 mg tab fish oil 1,000 mg cap, 1 capsule(s) by mouth once a day triamterene-hydrochlorothiazide 37.5 mg-25 mg cap, 1 capsule(s) by mouth daily omeprazole 40 mg cap, delayed release, 1 capsule(s) by mouth once a day centrum silver tab oral, 1 tablet(s) once daily lipitor 20 mg tab oral, 1.5 tablet(s) once daily discharge medications: 1. vitamin d 1,000 unit capsule sig: one (1) capsule po once a day. 2. saw 80 mg capsule sig: one (1) capsule po once a day. 3. diovan 80 mg tablet sig: one (1) tablet po once a day. 4. fish oil 1,000 mg capsule sig: one (1) capsule po once a day. 5. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 6. centrum silver tablet sig: one (1) tablet po once a day. 7. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 8. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*30 tablet sustained release 24 hr(s)* refills:*0* 9. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*0* discharge disposition: home with service facility: home health care discharge diagnosis: primary diagnosis: 1. lower gi bleed 2. nstemi 3. hemorrhoids secondary diagnosis: 1. cad 2. htn 3. critical as 4. hld 5. pulmonary hyptertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted with lower gi bleed. you also developed chest pain as well. you were transfused blood and your hematocrit (red blood cell count) remained stable. you had a slight increase in your cardiac enzymes suggesting a small heart attack. your chest pain has now resolved. you had a colonscopy to look for the bleed. they found hemorrhoids and no other obvious bleed. a polyp was found. you will need another colonoscopy to remove this polyp after your heart surgery. you were started on metoprolol tartrate, diovan and aspirin. you were discharged with a plan to return thrusday for cardiac surgery. the following changes were made to your medications: 1. start metoprolol succinate 25mg once daily 2. start aspirin 81mg once daily 3. increase your atorvastatin (liptor) to 80 mg daily followup instructions: you will have cardiac surgery on thursday. the surgery team will call you on wednesday to discuss when you should come in the following day. they will discuss the surgery further at this time. procedure: colonoscopy diagnoses: subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery unspecified essential hypertension other chronic pulmonary heart diseases other and unspecified hyperlipidemia benign neoplasm of colon diverticulosis of colon with hemorrhage rheumatic aortic stenosis internal hemorrhoids without mention of complication 

Answer: The patient is high likely exposed to