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: history of present illness: the patient is a 77 year old white female with a history of atrial fibrillation, st. aortic valve replacement, on coumadin, who presented with one to two weeks of progressive left lower quadrant pain. the pain was described as continuous, with intermittent periods of worsening. four days prior to admission, she noted a bloody bowel movement. on the day prior to admission, she had bright red blood per rectum times one. she reports one episode of emesis two days prior to admission, which was non-bilious and non-bloody. she also, per her daughter, has been more confused than normal. she has been on coumadin for her atrial fibrillation and aortic valve replacement. the dose was recently adjusted, although the patient is unclear about the dose. reportedly, her primary care physician has been following her inr via her visiting nurse. in the emergency room, the patient received one liter of normal saline with 20 meq of potassium. her hematocrit was noted to be 36.5 with a white blood cell count of 11.6 and her inr was 31. she received four units of fresh frozen plasma and a head ct scan was performed, which was read as negative for an acute intracranial hemorrhage. an abdominal ct scan was performed which revealed diverticula and a thickened proximal sigmoid and descending colon within significant stranding and calcified vascular structures. she received ceftriaxone and flagyl times one at the time of ct scan. on physical examination, the patient had moderate left lower quadrant tenderness without rebound or guarding. her rectal examination revealed maroon guaiac positive stool. she was afebrile and hemodynamically stable. she was admitted to the medicine service for further evaluation and management of her lower gastrointestinal bleed. past medical history: 1. history of diverticula in the sigmoid colon on a colonoscopy in . 2. chronic obstructive pulmonary disease. 3. st. aortic valve replacement in . 4. hypertension. 5. noninsulin dependent diabetes mellitus. 6. chronic atrial fibrillation. 7. coronary artery disease. 8. congestive heart failure, no echocardiogram available. 9. status post appendectomy. 10. status post left oophorectomy. 11. status post partial thyroidectomy. medications on admission: coumadin 2.5 mg p.o.q.d., lipitor 10 mg p.o.q.d., glyburide 10 mg p.o.b.i.d., glucophage 500 mg p.o.b.i.d., lopressor 37.5 mg p.o.b.i.d., serevent two puffs b.i.d., flovent two puffs b.i.d., combivent two puffs q.i.d., captopril 25 mg p.o.t.i.d., digoxin 0.125 mg p.o.q.d., lasix 40 mg p.o.b.i.d. allergies: penicillin (rash). social history: the patient is independent and lives alone, with a daughter in the area. she has a 20 pack year history of smoking, quit several years ago, and denies alcohol use. family history: noncontributory. review of systems: the patient denies chest pain, shortness of breath, fevers or chills. she complains of slight nausea, left lower quadrant and bright red blood per rectum, as above, no lightheadedness, headache, dysuria, recent emesis or recent antibiotic use. physical examination: on physical examination, the patient had a temperature of 98, heart rate 87 to 120, blood pressure 113/42, orthostatics negative, respiratory rate 22 and oxygen saturation 99% in room air. general: elderly white female in no acute distress, alert and oriented times three. head, eyes, ears, nose and throat: pupils equal, round, and reactive to light and accommodation, extraocular movements intact, oropharynx clear, dry mucous membranes, anicteric sclerae. neck: supple, no jugular venous pressure. lungs: clear to auscultation bilaterally. cardiovascular: irregularly irregular, mechanical s2, i/vi systolic murmur at left lower sternal border. abdomen: bowel sounds present, moderate tenderness to palpation in the left lower quadrant with no diffuse rebound or guarding, nondistended. rectal: maroon guaiac positive stool in emergency room, no masses. extremities: no cyanosis, clubbing or edema. laboratory data: white blood cell count was 11.6 with 82% neutrophils, 10% lymphocytes and 5.5% monocytes, hematocrit 36.5, platelet count 155,000, prothrombin time 69.1, partial thromboplastin time 87.1, inr 31.6, sodium 126, potassium 4.6, chloride 91, bicarbonate 27, bun 11 and creatinine 0.6. admission head ct negative was negative for intracranial or extracranial hemorrhage. admission ct of abdomen and pelvis revealed significant bowel wall thickening, stranding and pericolic fluid at the level of the left distal descending and proximal sigmoid colon, diverticula and vascular calcifications present; differential diagnosis diverticulitis versus ischemic bowel and/or hemorrhage into the bowel wall; there were also large gallstones present without evidence of cholecystitis. hospital course: 1. gastrointestinal: the patient was admitted to the medical team and was followed by the gastroenterology service and the surgical service given her lower gastrointestinal bleeding in the setting of supratherapeutic inr. given the constellation of an elevated white blood cell count with a left shift, the appearance of the ct scan, and her left lower quadrant pain, the most likely diagnosis was diverticulitis with an intramural bleed. the patient was kept on nothing by mouth and treated with intravenous fluids. she was started on intravenous ciprofloxacin and flagyl as well as intravenous vancomycin for enterococcus coverage, given her penicillin allergy. she remained hemodynamically stable, however, for her safety, she was transferred for two days to the intensive care unit for more intensive monitoring. she received two units of packed red blood cells as well as two additional units of fresh frozen plasma for an elevated inr. she had already received four units of fresh frozen plasma in the emergency room. on the day of admission, she received vitamin k 3 mg subcutaneously times one. the following day, while in the intensive care unit, she received 5 mg of intravenous vitamin k times one. the patient was transferred back to the regular medicine floor on . her diet was advanced to clears and she was changed over to oral antibiotics of ciprofloxacin 500 mg twice a day and flagyl 500 mg three times a day to complete a total of five days of oral antibiotics for presumptive diverticulitis. her diet was slowly advanced and, by the time of discharge, she was tolerating a regular diet. she continued to have trace guaiac positive stools, however, she had no gross bloody bowel movements. her left lower quadrant pain resolved and she had no further emesis. her hematocrit remained stable and she required no additional blood transfusions. the patient needs to follow up with dr. in the gastroenterology clinic in two to four weeks after discharge, telephone number . 2. cardiovascular: the patient has a history of atrial fibrillation and st. aortic valve replacement, for which she was on coumadin with a goal inr of 2.5 to 3.5. on admission, her inr was 31.6. she received fresh frozen plasma, blood transfusions and vitamin k, as above. the cardiology service was consulted in regard to whether she should be continued on anticoagulation given the high risk of stroke and with her mechanical valve. their recommendation was to continue intravenous heparin with a goal partial thromboplastin time of 50 to 60. heparin was therefore restarted and her partial thromboplastin time was monitored closely. after her inr fell to 2, her coumadin was restarted without a loading dose at 2.5 mg orally at bedtime. she will be continued on heparin until her inr is therapeutic, which is 2.5 to 3.5. the patient also has a history of coronary artery disease, congestive heart failure and hypertension. on admission, her cardiac medications were held in the setting of her acute bleed. these were gradually restarted as she tolerated them. she did have several episodes of atrial fibrillation with rapid ventricular rate, however, she remained hemodynamically stable and asymptomatic. her lopressor was titrated up for better rate control and digoxin was restarted. 3. pulmonary: the patient has a history of chronic obstructive pulmonary disease. she was continued on her serevent, flovent and combivent. she received additional lasix while in the intensive care unit for some mild pulmonary edema after receiving multiple units of fresh frozen plasma and packed red blood cells. 4. endocrine: the patient's oral hypoglycemics were held on admission and she was maintained on a regular insulin sliding scale. on discharge, she will be started back on glyburide and glucophage. 5. physical therapy: the physical therapy service was consulted to evaluate whether the patient was a candidate for rehabilitation. they recommended in-hospital physical therapy to maximize her independent function and mobility prior to returning to home. at the time of dictation, the patient was hemodynamically stable and feeling well. her medications were being optimized and she continued on heparin and coumadin while awaiting her inr to be therapeutic for her mechanical aortic valve. an addendum to this dictation will be dictated upon the patient's discharge, which will address her discharge medications and status. the patient will need follow-up with her primary care physician as well as with the gastroenterology service, dr. , in two to four weeks after discharge, in the gastroenterology clinic, telephone number . , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified diagnoses: abnormal coagulation profile congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled iron deficiency anemia secondary to blood loss (chronic) atrial fibrillation obstructive chronic bronchitis with (acute) exacerbation heart valve replaced by other means long-term (current) use of anticoagulants diverticulitis of colon with hemorrhage 

Answer: The patient is high likely exposed to