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: codeine / morphine / penicillins / darvon / macrobid attending: chief complaint: presyncopal episodes major surgical or invasive procedure: ep ablation history of present illness: 66yof w/ pmh cad s/p cabg ', aaa repair, dm, pvd s/p bilat aka, hypoithyroid, hyperlipidemia, chf, dizziness, chroinic wounds (healed pressure ulcer on back, red cuts under breasts, old healing abd wound), presents to osh w/ presyncopal episodes and hypotension that had been on and off for three days. she was managed on the floor but tx to ccu for per report sustained vt w/ bp 50/. she was intubated and shocked x5. she was started on procainamide gtt at 3mg/min, neo gtt and propofol gtt. per report, while pt intubated and sedated, her she had no vt. her last shock was .she was weaned from sedation and extubated and her vt re-occurred. since then, she has been in ns/sb 48-52 and has recurrent vt (5-10 beat runs) w/ bp 80-90/. she reported presyncopal attacks for 3 days prior to presentation to the osh. during these episodes, she felt dizzy and had reduction in her vision. no associated chest pain, or palpitations. no history of diarrhoea, vomiting or reduced intake. there had been no recent change in her home medications. in addition, she reprots that her caregiver noticed dark stool on day 2 of symptoms, unclear whether melanotic. denies any brbpr, no nausea/vomiting/abdominal pain. transferred to for possible ep ablation of the focus of her presumed vtach. on arrival at ccu, ecg in sinus revealed rbbb, lafb, left atrial abnormality. ecg from osh() showed nsvt negative in ii, iii, f, positive in 1, l, transition at v3/v4 in setting of svt possible at at 260. past medical history: - cad s/p mi , s/p cabgx3 - h/o aaa repair in at - htn - hyperlipidemia - hypothyroidism - chf (ef 30-35%) - pvd s/p b aka infection of total knee prostheses, with left side revision and known dvt (on coumadin). - ventral hernia (incisional) - s/p cholecystectomy () - depression - precautions (mrsa - , vre - leg , esbl - urine klebs ) social history: she lives at with a personal care attendant, is able to dress/feed herself, but needs a lift to move around. 1.5 ppd tobacco. denies etoh, ivdu. sister (hcp) lives in (. family history: father: hx htn, angina physical exam: on admission: tcurrent: 36.3 ??????c (97.3 ??????f) hr: 100 (72 - 100) bpm bp: 91/61(66) {87/43(55) - 96/69(73)} mmhg rr: 14 (14 - 24) insp/min spo2: 91% heart rhythm: sr (sinus rhythm) general: nad. oriented x3. mood, affect appropriate. heent: sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with no elevation of jvp cardiac: pmi located in 5th intercostal space, midclavicular line. irregularly irregular cardiac impulse, normal s1, s2. no murmurs or added heart sounds. no thrills, lifts. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no abdominial bruits. extremities: bilateral aka. no femoral bruits. mild edema on the lower limb stumps bilaterally. skin: healing scars on her back, active lesions beneath her breasts. pulses: right: carotid 2+ femoral 2+ left: carotid 2+ femoral 2+ pertinent results: cxr sinus rhythm with ventricular premature beats. right bundle-branch block. left anterior fascicular block. anterolateral lead st-t wave abnormalities are primary and are non-specific. since the previous tracing of ventricular ectopy is present. otherwise, there is no significant change. . - cxr at osh showed no evidence of pulmonary congestion. . - ecg: ecg in sinus revealed rbbb, lafb, left atrial abnormality. ecg from osh() showed nsvt negative in ii, iii, f, positive in 1, l, transition at v3/v4 in setting of svt possible at at 260. . - echo: at . full report in chart. of note, ef 10-15%. severe diffuse hypokinesis. akinesis and aneursymal deformity of apical walls. mild mitral regurgitation, trace tricuspid regurgitation, pasp estimated at 13mmhg + ra pressure. . ct abd/pelvis 1. diffuse thinning of anterior abdominal musculature with diffuse bulge of abdomen. fat containing umbilical hernia. multiple gas-filled loops of bowel including the transverse colon, finding which can be seen in bedbound patients. no bowel obstruction. 2. diffusely abnormal abdominal aorta with long-segment fusiform aneurysm (5 cm), as previously described. size is similar to that seen on , however now with increased mural thrombus, effectively resulting in decreased size of true lumen. also now occluded right common iliac artery, with reconstitution of flow seen at right common femoral artery. 3. cardiomegaly with left ventricular enlargement and left ventricular aneurysm. 4. possible 3-mm right lower lobe nodule, incompletely imaged. criteria, if the patient is at high risk for intrathoracic malignancy, follow-up ct would be recommended in 1 year. otherwise, no further imaging would be recommended. 5. multiple renal hypodensities, too small to characterize. . tte poor image quality. the left atrium is mildly dilated. the right atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity is mildly dilated. there is severe regional left ventricular systolic dysfunction with akinesis of the distal 2/3rds of the ventricle. a left ventricular mass/thrombus cannot be excluded (not seen but poor visualization of the apex cannot exclude). there is no ventricular septal defect. the diameters of aorta at the sinus, ascending and arch levels are normal. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is no pericardial effusion. ef 20-25%. compared with the prior study (images reviewed) of , no clear change (given lv dysfunciton persists, takotsubo cm is no longer on the differential). if indicated, a repeat study with echo contrast or a cardiac mri may better assess lv/rv function and exclude apical thrombus. brief hospital course: 66f with cad s/p cabg , hl, pad s/p b/l aka in & aaa endovascular repair , hypothyroid, 1 ppd , 30-35% per echo , obesity, decub ulcer, ventral hernia with ulceration p/w vt storm to now transferred to for possible vt ablation by dr. . . #arrhythmia: svt with rbbb with intervals of vtach (runs of between 3 and 18 each time). at least two ectobic sites, one in the atria causing the svt and one causing the vt. probable causes previous mi, hyper/hypotension, elytes. pt denies any cp/sob/orthopnea. tsh was normal at 1.8. ecg from showed nsvt negative in ii, iii, f, positive in 1, l, transition at v3/v4 in setting of svt possible at at 260. ecg on arrival to in sinus showed rbbb, lafb, left atrial abnormality pt was started on procainamide gtt at 3, vt initially reduced but then flared up and gtt was increased to 4, and then dcd prior to ablation. ccu attending ?????? 60 minutes critical care. pt continued to have runs of vt and was taken for ablation. ep lab transseptal approach to ablate focus in lv, however found several other foci of vt as well as at. given multiple foci not all of which successfully ablated, decision to treat with antiarrythmics. pt also had a competing atrial tachycardia. given procainamide 950mg iv bolus which converted to sinus (although sinus rhythm difficult to tell from vt - mainly by rate - vt rate was 130, sinus in 90s) and then transitioned to amiodarone with procainamide dcd. pt was monitored but continued having occasional runs of vt, and plan was to place permanent pacer. progressive second degree heart block throughout day after the procedure with hr transiently dropping to 30s although bp stable. resited rij to left cordis/ trauma line and placed temp transvenous pacer. however, she developed septic picture and permanent hardware was not able to be placed in that setting (see sepsis, below). patient had sedation weaned and did not regain consciousness. in the setting of increasing leukocytosis, worsening renal failure, anasarca, and acute wound dehiscence at her groin puncture sites extending deep into the groin tissue, patient was transitioned to comfort measures only per the wishes of her family on the morning of . at 1827 on , patient expired peacefully of cardiac arrest, with family at bedside. . # hypotension: patient's sbp during course of illness ranged from low of 50s to 90. in the unit the maps have been btw 55-70 with sbp of 77-94 and dbp of 48-60. probable causes are cardiogenic(previous mi with non-contractile myocardium, svt/vt, valvular dxs), hypovolemia, anemia, sepsis, hypothyroidism, non-compliance to medication). pt was started on levophed but in setting of vt/arrythmia with increased ectopy this was changed to neosynephrine. . # chf: ptn with previous hx of cad/mi and cabg.on ace inh and bb at home. probable causes for decompensation include arrythmias, hypovolemia, anemia. repeat echo shows decline in ef: /12 - 10-15%, from 30-35% in . diuresis was attempted with lasix but was minimally successful. diuretics then held in setting of hypotension. acei and bblocker also held in setting of hypotension. . # : creatinine 0.8 on , went up to 1.8 on . renal assisted in examination of urine sediment and no casts were seen. cytology consistent with pre-renal picture (shrunken rbcs) but no signs of atn. fena was 0.13%. . # sepsis - wbc to 23 on . pt still with phenylephrine pressor requirement, fevers, and intermittently tachycardic. ua was dirty and there was evidence of skin breakdown around the areas where pt had vascular access. pt also had history of mrsa colonization, and was started empirically on vanc/cefepime. - central line in rij was changed over a wire. new line was placed in lij and catheter tip of rij was sent for culture. urine culture showed no growth. blood cultures pending at time of expiration. . # anemia: normocytic normochromic anemia. probably 2/2 blood loss (dark stool reported), hemolysis or anemia of chronic illness. hct down at 31 from 38 five days earlier. . # supratherapeutic inr - pt had inr of 2.5 on presentation (on warfarin for h/o dvt) which peaked at 4.5 on even though coumadin was held after inr was supratherapeutic at 3.5. . # sacral, chest, abdominal, groin wounds: chronic wounds. groin wounds developed secondary to femoral catheterization. pain controlled with methadone. medications on admission: - levothyroxine 50mcg/d - plavix 75mg/d - lisinopril 5mg/d - imdur 30mg - pravachol 20mg/d - coumadin - methadone 20mg/d - ativan prn - hydroxyzine prn discharge medications: expired. discharge disposition: expired discharge diagnosis: expired discharge condition: expired discharge instructions: expired followup instructions: expired procedure: excision or destruction of other lesion or tissue of heart, endovascular approach insertion of temporary transvenous pacemaker system cardiac mapping central venous catheter placement with guidance diagnoses: abnormal coagulation profile tobacco use disorder congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified unspecified septicemia iron deficiency anemia secondary to blood loss (chronic) severe sepsis unspecified acquired hypothyroidism coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status depressive disorder, not elsewhere classified paroxysmal ventricular tachycardia other and unspecified hyperlipidemia other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure hypotension, unspecified morbid obesity chronic systolic heart failure long-term (current) use of anticoagulants personal history of venous thrombosis and embolism carrier or suspected carrier of methicillin resistant staphylococcus aureus encounter for palliative care do not resuscitate status anticoagulants causing adverse effects in therapeutic use atherosclerosis of native arteries of the extremities, unspecified above knee amputation status paroxysmal supraventricular tachycardia other second degree atrioventricular block right bundle branch block and left anterior fascicular block disruption of wound, unspecified open wound of abdominal wall, anterior, complicated open wound of chest (wall), complicated 

Answer: The patient is high likely exposed to