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: vancomycin attending: chief complaint: hematochezia, diarrhea major surgical or invasive procedure: colonoscopy history of present illness: 73 y/o m with h/o cad s/p cabg, afib, h/o vt, pvd, esrd p/w c. diff and hematochezia. he was initially admitted on for treatment of c diff colitis. he was started on flagyl 9 days ago by his nephrologist, dr. . due to hypotension, he was transfered to the . he was fluid resuscitated with improvement in blood pressure and was started on vancomycin 500mg po q 6 hours. he was tranferred out of the , but readmitted when he developed brbpr with hct drop from 32 to 28 over 24h. gi was consulted; colonscopy revealed a cecal clot which was not disturbed, and no intervention was done. a tagged rbc scan was negative for a source. asa and plavix were held. a total of 3u prbc (2u initial admission, then 1u when lgib the latter admission) were tranfsued this hospitalization. a repeat c-scope in the next 2-3 days for possible intervention is planned. he completed the course of vancomycin yesterday, . past medical history: 1. cad: s/p cabg x 3 (lima-lad, svg-om, svg-diag in at after presenting with loss of consciousness). followed by dr. . 2. s/p mv repair: (#28 physio ring) 3. s/p aicd implant: for vt 4. afib 5. esrd: iga nephropathy. on peritoneal dialysis since , s/p l av fistula . followed by dr. 6. htn 7. s/p left-sided cva 8. dyslipidemia 9. gout 10. elevated psa, sclerotic lesions on ct scan, but bone scan negative social history: he lives alone, has family in . he emigrated from in . he denies cigarette, alcohol or drug use. he does occasionally take chinese herbal medicines. family history: his parents are both deceased of unclear cause. he has two siblings, both deceased of unclear cause. he has three children ranging in age from 40-47. he is not able to specify what medical problems they have but says they do have medical problems. physical exam: vitals: t 98.8; bp 142/78; hr 70s: rr 18: 96% ra general: cantonese speaking man, awake, alert, nad. heent: eomi, sclera anicteric, mm dry, op without lesions neck: supple, no jvd chest: r sided hd tunneled line without erythema/ ttp pulm: cta cardiac: rrr nl s1/s2, 2/6 systolic murmur lsb abdomen: + bs, firm but not tense or rigid, nt. multiple healed pd catheter scars. ext: 2+ edema b/t. lue with fistula with palpable thrill, non-tender. r groin with cvl, minimal erythema, no exudate or ttp neurologic: aao x 3, appropriate, conversant in chinese. moving all 4 extremities equally pertinent results: 05:43am glucose-59* urea n-63* creat-6.7* sodium-138 potassium-5.0 chloride-99 total co2-26 anion gap-18 05:43am alt(sgpt)-12 ast(sgot)-19 alk phos-67 amylase-48 tot bili-0.8 05:43am lipase-9 05:43am calcium-7.9* phosphate-6.9*# magnesium-2.0 05:43am tsh-2.6 05:43am wbc-7.7 rbc-2.83* hgb-8.5* hct-27.5* mcv-97 mch-29.9 mchc-30.8* rdw-17.8* 05:43am plt count-221 05:43am pt-12.8 ptt-29.5 inr(pt)-1.1 10:00pm urine hours-random 10:00pm urine uhold-hold 10:00pm urine color-amber appear-hazy sp -1.023 10:00pm urine blood-tr nitrite-neg protein-100 glucose-neg ketone-tr bilirubin-sm urobilngn-neg ph-6.5 leuk-neg 10:00pm urine rbc-0-2 wbc-0-2 bacteria-few yeast-none epi-0 10:00pm urine amorph-many 07:13pm lactate-1.7 05:47pm glucose-75 urea n-55* creat-6.5*# sodium-143 potassium-4.9 chloride-96 total co2-28 anion gap-24* 05:47pm alt(sgpt)-12 ast(sgot)-24 alk phos-78 amylase-52 tot bili-0.8 05:47pm lipase-11 05:47pm albumin-2.2* 05:47pm wbc-10.8# rbc-2.96* hgb-9.2* hct-28.1* mcv-95 mch-31.2 mchc-32.9 rdw-17.7* 05:47pm neuts-93.9* bands-0 lymphs-3.6* monos-2.3 eos-0.2 basos-0.1 05:47pm hypochrom-2+ anisocyt-1+ poikilocy-occasional macrocyt-2+ microcyt-normal polychrom-normal ovalocyt-occasional 05:47pm plt smr-normal plt count-208 . abd xr : abdomen, two views: the inferior most median sternotomy wires, and the right ventricular pacemaker lead are identified. mobile gallstones are again seen overlying the right upper quadrant. there has been interval removal of a peritoneal dialysis catheter. multiple small radiopaque fragments overlie the right pelvis, which were not present on the prior study, consistent with residual contrast from the recent ct scan. air fills the descending and transverse colons, and there are few colonic air-fluid levels. in addition, in the descending colon, there appears to be some thickening of the haustral concerning for infection, inflammation, or ischemia. a ct scan may be helpful. no free intraperitoneal air is identified. . cxr : chest, two views: the patient is status post median sternotomy, a left-sided pacemaker is in unchanged position. the patient has had a mitral valve replacement. there is a large-bore central venous catheter with its tip overlying the right atrium. a vascular stent is in unchanged position. the cardiac and mediastinal contours are stable with a tortuous aorta. the lungs demonstrate bibasilar atelectasis and blunting of the left costophrenic angle, a chronic finding. no free air is identified under the hemidiaphragms. impression: no change from the prior study. no free intraperitoneal air seen. . ct abd/pelvis : 1. features consistent with pancolitis, also with some involvement of the terminal ileum. 2. new abnormal small fluid collections in the left upper quadrant, which may communicate with each other. these do not appear to communicate with bowel. these are non-specific new fluid collections, but infection cannot be excluded. metastases are felt unlikely. 3. atrophic native kidneys. 4. cholelithiasis. . abdxr : non-specific, but no definite evidence for colonic distention . bleeding study : no scintigraphic evidence of gastrointestinal hemorrhage, though sensitivity is limited by extremely poor tracer labeling of rbc's, likely due to esrd. . abd xr : no overt features of toxic megacolon, no free air or pneumatosis. a partial or early small-bowel obstruction is possible and clinical correlation and followup film should be considered. . gi bleeding study : source of gi bleeding not identified. . rue u/s: large intraluminal thrombus within the right internal jugular vein, which is otherwise patent. imaging of the left internal jugular was not performed. . colonoscopy : a large organized blood clot was seen extending from proximal ascending colon to cecum. the clot could not be lavaged off so underlying mucosa or source of bleeding could not be seen. red blood was seen in the whole colon. normal mucosa was noted. there was no evidence of c diff colitis. multiple diverticula were seen in the sigmoid colon. diverticulosis appeared to be of mild severity. . blood in the proximal ascending colon and cecum blood in the whole colon diverticulosis of the sigmoid colon normal mucosa in the colon otherwise normal colonoscopy to cecum . colonoscopy (prelim): multiple diverticula seen but with no clear bleeding source identified, evidence of diffuse colitis, the diffrential includes infectious colitis and ischemic colitis brief hospital course: # gi bleeding. ddx avm, ischemic colitis, microscopic colitis, diverticular bleed, repeat colonoscopy done when pt's hematochezia resolved did not show clear bleeding source, showed multiple non-bleeding diverticula, and an area of colitis likely corresponding to healing c. diff. will need follow up colonoscopy in 3 months and f/u with dr. (gi) in 3 months for biopsy results and repeat colonoscopy. . # c. diff colitis. treated with a complete 14 day course of po vancomycin. will need follow up stool sent for c. diff, as well as follow up colonoscopy in 3 months. continued to have likely postinfectious diarrhea while in house but improved somewhat upon discharge. no abdominal pain while in house. . # luq lesions on admission ct. per discussion with radiology likely small abscesses from micro perforations. too small for drainage. should have follow up abd ct in months to document resolution. pt. had no abdominal pain, and normal wbc and afebrile on d/c. . # esrd, secondary to iga nephropathy. patient on hd m, w, friday. will continue hd in as usual. . # cv: s/p cabg, mv repair, aicd, h/o afib. aaa seen on ct scan. aspirin and plavix were held due to gi bleeding, which had been discussed with his cardiologist. pt. will need to follow up with dr. in weeks after discharge to decide when to restart these medications. his bp medications were also decreased due to recurrent episodes of hypotension in house. his lopressor dose was decreased as well as his norvasc. continued on amiodarone and is not a coumadin candidate due to bleeding risk. . # anemia, chronic, secondary to esrd. fe studies from c/w acd. b12 and folate wnl. . # high psa. per patient he was seen by a urologist and was started on tamsulosin. recent bone scan did not confirm sclerotic bone lesions on ct. - outpatient follow up . # prophylaxis: ppi. pneumoboots. . # fen: treated with a brief course of tpn while in house due to profuse diarrhea, then transitioned to renal, cardiac diet. . # access: patient with right dialysis catheter, also had picc placed for tpn while in house, which was removed upon d/c. . # code status: full code . medications on admission: lisinopril 20 mg, acetaminophen 325-650 mg po q4-6h:prn, pantoprazole 40 qd, paroxetine hcl 10 mg po daily, amiodarone hcl 200 mg po daily, atorvastatin 40 mg po daily, calcitriol 0.25 mcg po daily, flagyl 500 mg tid, metoprolol 50 mg , norvasc 5 mg daily, tamsulosin 0.4 mg hs discharge medications: 1. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 2. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 3. paroxetine hcl 10 mg tablet sig: one (1) tablet po daily (daily). 4. calcitriol 0.25 mcg capsule sig: one (1) capsule po daily (daily). 5. lisinopril 20 mg tablet sig: one (1) tablet po once a day. 6. zinc oxide-cod liver oil 40 % ointment sig: one (1) appl topical prn (as needed). disp:*qs 2 weeks* refills:*2* 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 8. amlodipine 2.5 mg tablet sig: one (1) tablet po daily (daily). 9. sodium chloride 0.65 % aerosol, spray sig: sprays nasal qid (4 times a day) as needed. 10. fluticasone 50 mcg/actuation aerosol, spray sig: one (1) spray nasal (2 times a day). disp:*qs 1 month* refills:*0* 11. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 12. tamsulosin 0.4 mg capsule, sust. release 24hr sig: one (1) capsule, sust. release 24hr po at bedtime. discharge disposition: home with service facility: homecare discharge diagnosis: clostridium difficile colitis lower gi bleeding esrd discharge condition: stable discharge instructions: please continue your regular medications except please do not take your aspirin, plavix, or hydrochlorothiazide until you follow up with your pcp or cardiologist, and also your metoprolol dose and your norvasc dose was decreased. you will need a follow up colonoscopy in 3 months. you will also need to follow up with your gastroenterologist, dr. , in months. please follow up with your pcp, , and nephrologist in weeks. you can have your dialysis tomorrow in as usual. please call your doctor if you experience worsening diarrhea, abdominal pain, fever, or other concerning symptoms. followup instructions: 1. please follow up with dr. , your gastroenterologist in 3 months. please call to schedule an appointment. you will need to follow up on your biopsy results and have another colonoscopy at that time. 2. provider: , md phone: date/time: 11:20 3. provider: , m.d. phone: date/time: 9:40 provider: , md phone: date/time: 3:40 4. provider: , . call to schedule appointment procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances hemodialysis colonoscopy endoscopic polypectomy of large intestine transfusion of packed cells diagnoses: anemia in chronic kidney disease end stage renal disease acute posthemorrhagic anemia atrial fibrillation aortocoronary bypass status hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hypotension, unspecified blood in stool intestinal infection due to clostridium difficile automatic implantable cardiac defibrillator in situ hypovolemia benign neoplasm of colon disorder of bone and cartilage, unspecified diverticulitis of colon (without mention of hemorrhage) nephritis and nephropathy, not specified as acute or chronic, with unspecified pathological lesion in kidney elevated prostate specific antigen [psa] 

Answer: The patient is high likely exposed to