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: latex attending: chief complaint: known juxtarenal abdominal aortic aneurysm. major surgical or invasive procedure: open aaa repair, bilateral renal stents l hemicolectomy c hartmanns/colostomy history of present illness: mr. is a 78 y.o patient with a known abdominal aortic aneurysm had been following with dr. . risks and benefits of surgery were discussed with the patient, he has agreed to come in electively for repair. past medical history: aaa htn hypercholesterolemia dm afib (on coumadin) claudication vericose veins gerd anxiety social history: n/c family history: n/c physical exam: f pertinent results: 06:20am blood wbc-10.2 rbc-3.55* hgb-10.2* hct-31.4* mcv-89 mch-28.6 mchc-32.3 rdw-15.4 plt ct-564* 06:00am blood wbc-11.9* rbc-3.58* hgb-10.3* hct-31.7* mcv-89 mch-28.8 mchc-32.5 rdw-15.4 plt ct-620* 05:00am blood wbc-13.6* rbc-3.50* hgb-10.2* hct-30.6* mcv-88 mch-29.2 mchc-33.4 rdw-15.6* plt ct-630* 04:44am blood wbc-13.9* rbc-3.51* hgb-9.9* hct-30.5* mcv-87 mch-28.2 mchc-32.4 rdw-15.3 plt ct-643* 07:01am blood wbc-15.8* rbc-3.75* hgb-10.6* hct-32.7* mcv-87 mch-28.4 mchc-32.6 rdw-15.1 plt ct-713* 04:15am blood wbc-13.6* rbc-3.79* hgb-10.9* hct-32.8* mcv-87 mch-28.6 mchc-33.1 rdw-15.2 plt ct-631* 06:20am blood plt ct-564* 06:00am blood plt ct-620* 06:20am blood glucose-136* urean-20 creat-1.0 na-134 k-4.0 cl-98 hco3-33* angap-7* 06:00am blood glucose-118* urean-18 creat-0.8 na-136 k-4.2 cl-99 hco3-32 angap-9 05:00am blood glucose-132* urean-20 creat-0.8 na-136 k-4.0 cl-99 hco3-31 angap-10 04:44am blood glucose-115* urean-18 creat-0.8 na-137 k-4.4 cl-101 hco3-32 angap-8 06:00am blood alt-22 ast-23 alkphos-273* amylase-78 totbili-0.5 02:38am blood alt-86* ast-83* ld(ldh)-231 alkphos-696* amylase-78 totbili-0.6 02:06am blood alt-35 ast-42* ld(ldh)-248 alkphos-177* amylase-63 totbili-0.6 02:38am blood lipase-90* 02:06am blood lipase-77* 03:22am blood lipase-66* brief hospital course: mr. is a 78-year-old male a history of a. fib, diabetes, hypertension, hypercholesterolemia, chronic renal insufficiency (baseline creatinine of 1.8 likely due to bilateral high-grade renal artery stenoses), who was diagnosed with a rather large juxtarenal abdominal aortic aneurysm which is not a candidate for endovascular repair. the patient underwent a retroperitoneal open repair of abdominal aortic aneurysm and open delivery and deployment of bilateral renal artery stents on . at completion of the case there was evidence of likely embolism to the left forefoot with palpable dp pulse and viable appearing but pale toes. his postoperative course was complicated by the development of hypotension and diarrhea on . he developed heme-positive stools and abdominal distention with abdominal pressures almost approaching 30. vancomycin and zosyn were started empirically. flagyl was subsequently added. based upon clinical picture and concern for colonic ischemia, he was taken to the operating room for exploration. exploratory laparotomy identified a massively distended necrotic colon. left hemicolectomy and takedown of splenic flexure was performed. a colostomy was created in the ruq. postoperatively he developed cardiogenic shock failing multiple pressors and inotropes ultimately requiring and responding to iabp. he was gradually weaned off pressors by ,iabp was discontinued. he was extubated on . while on pressors he had ischemic appearing digits in all four extremities which all improved after weaning from pressors except the left forefoot which showed evidence of necrosis of the digits and questionable viability of the forefoot with a palpable dp pulse. the forefoot gradually improved over time with the likely preservation of a tma although the final point of demarcation has not yet been determined. the dp remains palpable. during the period of hypotension requiring pressors the patient did experience arf with high of creatinine of 2.6. pt hydrated / prbc's. on dc creatitnie is normalized to 1.0. pt is making urine. on , speech and swallow identified mild to moderate dysphagia and recommended a diet of nectar-thick liquids and soft solids which was begun. the pt was transferred to the floor, on where he was noted to have draingage from his left flank incision, this was cultured at the bedside and grew coag neg staph. the wound was partially opened and debrided and a vac was placed and subsequently switched to ns wet to dry dressings. psych was c/s due to pt being discouraged with signs and sx of depression in the context of ongoing medical problems. psych determined that the pt was not actively suicidal, but is somewhat hopeless or apathetic. psych recommended r/o medical causes and recommended methylphenidate for sx. psych to f/u in rehab. pt had a temp of 101.5 on . pan cx'd. on , the pt developed rapid afib and was transferred back to the cvicu. due to the patient having increasing white count, fever and abdominal ct scan demonstrating the presence of a pancreatic and retroperitoneal fluid collections, the pt was taken to or on for abdominal exploration. the pt was found to have a retroperitoneal intra-abdominal abscess and pancreatic tail necrosis and underwent incision and drainage of retroperitoneal abscess, pancreatic necrosectomy and temporary abdominal closure. id was re-consulted on regarding the collections and they recommended to continue iv vanco/zosyn and po vanco course. the following day (), pt returned to the or for planned reexploration for peripancreatic necrosis for definitive abdominal closure and abscess debridement. pt was extubated on and npo with tube feedings. on , speech and swallow was c/s to determine safest diet. speech and swallow reported that the pt presents with signs of aspiration with all textures and consistencies and determined it was difficult to determine the safest diet at bedside and recommended a videoswallow study. the videoswallow study, done on , showed severe oropharyngeal dysphagia and recommended purees and honey thick liquids by spoon only, meds via iv or ngt, 1:1 assist with pos, to continue supplemental means of nutruition. pt was given tube feeds and pureed solids and honey thick liquids. repeat videoswallow study, done on to evaluate for diet upgrade. the study showed some improvement from the prior study with moderate oral phase and mild pharyngeal phase dysphagia and recommended ground solids, thin liquids, po meds crushed in puree with follow up sips of liq to clear or via ngt. patient was continued on tube feeds and encouraged po intake. calorie count study was repeated on to assess adequate nutrition. on dc tf are cycled at night at 90 mlh / with residual checks q 4 hrs. his incision was closed with steristrips and is healing well without drainage or erythema. he remains afebrile. repeat ct showed small shrinking fluid in llq which will be followed. there is fluid around aorta as is typical and will be followed. wbc is 10. id and dr agree with plan for 6weeks of meropenim followed by repeat ct. at that point decision to be made regarding a course of oral cipro. follow-up with dr , dr , and dr arranged. medications on admission: norvasc 5 mg qd atenolol 25 mg qd hctz 25 m qd lisinopril 40 mg qd asa 81 mg qd coumadin 5 mg qhs(a-fib) calcium discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 5. sodium chloride 0.65 % aerosol, spray sig: sprays nasal tid (3 times a day) as needed. 6. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 7. ferrous sulfate 300 mg/5 ml liquid sig: one (1) po daily (daily). 8. diltiazem hcl 90 mg tablet sig: one (1) tablet po qid (4 times a day). 9. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 10. therapeutic multivitamin liquid sig: five (5) ml po daily (daily). 11. pantoprazole 40 mg iv q24h 12. meropenem 500 mg recon soln sig: one (1) recon soln intravenous q6h (every 6 hours) for 4 weeks: to end . 13. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection (2 times a day): may d/c once patient is up and walking regularly. 14. outpatient occupational therapy needs weekly lfts, cr/bun and cbc/diff faxed to id rn . discharge disposition: extended care facility: & rehab center - discharge diagnosis: aaa (pre-op) ischemic bowel hypertension hypercholestol dm afib (on coumadin) claudication vericose veins gerd anxiety discharge condition: stable discharge instructions: division of vascular and endovascular surgery abdominal aortic aneurysm (aaa) surgery discharge instructions what to expect when you go home: 1. it is normal to feel weak and tired, this will last for weeks ?????? you should get up out of bed every day and gradually increase your activity each day ?????? you may walk and you may go up and down stairs ?????? increase your activities as you can tolerate- do not do too much right away! 2. it is normal to have incisional and leg swelling: ?????? wear loose fitting pants/clothing (this will be less irritating to incision) ?????? elevate your legs above the level of your heart (use pillows or a recliner) every 2-3 hours throughout the day and at night ?????? avoid prolonged periods of standing or sitting without your legs elevated 3. it is normal to have a decreased appetite, your appetite will return with time ?????? you will probably lose your taste for food and lose some weight ?????? eat small frequent meals ?????? it is important to eat nutritious food options (high fiber, lean meats, vegetables/fruits, low fat, low cholesterol) to maintain your strength and assist in wound healing ?????? to avoid constipation: eat a high fiber diet and use stool softener while taking pain medication what activities you can and cannot do: ?????? no driving until post-op visit and you are no longer taking pain medications ?????? you should get up every day, get dressed and walk, gradually increasing your activity ?????? you may up and down stairs, go outside and/or ride in a car ?????? increase your activities as you can tolerate- do not do too much right away! ?????? no heavy lifting, pushing or pulling (greater than 5 pounds) until your post op visit ?????? you may shower (let the soapy water run over incision, rinse and pat dry) ?????? your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing over the area that is draining, as needed ?????? take all the medications you were taking before surgery, unless otherwise directed ?????? take one full strength (325mg) enteric coated aspirin daily, unless otherwise directed ?????? call and schedule an appointment to be seen in 2 weeks for staple/suture removal what to report to office: ?????? redness that extends away from your incision ?????? a sudden increase in pain that is not controlled with pain medication ?????? a sudden change in the ability to move or use your leg or the ability to feel your leg ?????? temperature greater than 101.5f for 24 hours ?????? bleeding from incision ?????? new or increased drainage from incision or white, yellow or green drainage from incisions followup instructions: provider: , md phone: date/time: 3:00 provider: scan phone: date/time: 1:45 provider: , md phone: date/time: 2:30 provider: . phone: date/time: 9:30 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more other enterostomy diagnostic ultrasound of heart open and other left hemicolectomy enteral infusion of concentrated nutritional substances other electric countershock of heart angioplasty of other non-coronary vessel(s) percutaneous abdominal drainage implant of pulsation balloon insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) resection of vessel with replacement, aorta, abdominal nonoperative removal of heart assist system other excision or destruction of lesion or tissue of pancreas or pancreatic duct other excision or destruction of lesion or tissue of pancreas or pancreatic duct transposition of cranial and peripheral nerves insertion of two vascular stents procedure on two vessels diagnoses: acidosis other postoperative infection cellulitis and abscess of trunk unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver acute kidney failure, unspecified atrial fibrillation chronic kidney disease, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure atherosclerosis of renal artery cardiogenic shock intestinal infection due to clostridium difficile abdominal aneurysm without mention of rupture acute vascular insufficiency of intestine acute pancreatitis disruption of external operation (surgical) wound other retroperitoneal abscess nontraumatic compartment syndrome of abdomen 

Answer: The patient is high likely exposed to