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: penicillins attending: chief complaint: abdominal pain and constipation major surgical or invasive procedure: : exploratory laparotomy, hemoperitoneum washout and open splenectomy and splenic flexure takedown. history of present illness: 77 year-old male with abdominal pain for 2 days, sudden onset, denies trauma. pain is dull, aching, left upper quandrant, nonradiating. had some nausea 2 days ago, resolved. no vomiting. last bowel movement was this morning, small. last normal bowel movement was 1 week ago, passing flatus. past medical history: pmh: htn hypercholesterolemia psh: 3 vessel cabg ( social history: lives on and in , ma with his wife owns advertising company enjoys boating physical exam: pe: t 97.6, hr 158, bp 92/59, rr 18, so2 98%ra gen- no acute distress, alert and oriented x 3 lungs- cta b/l heart- rrr, s1s2, no m/r/g abd- bs positive, soft, mildly distended, left upper quadrant mildly tender, no rebound or guarding rectal- guaic neg ext- no c/c/e pertinent results: admission labs -------------- 11:05pm glucose-105 urea n-23* creat-1.1 sodium-135 potassium-4.3 chloride-100 total co2-26 anion gap-13 11:05pm estgfr-using this 11:05pm calcium-8.1* phosphate-3.7 magnesium-2.3 11:05pm wbc-4.6 rbc-3.27*# hgb-10.0*# hct-29.1*# mcv-89 mch-30.7 mchc-34.4 rdw-14.1 11:05pm plt count-155 11:05pm pt-12.6 ptt-30.8 inr(pt)-1.1 operative report surgeon: , md 2915 assistant: dr. and dr. preoperative diagnosis: splenic rupture. postoperative diagnosis: splenic rupture. procedure: exploratory laparotomy, hemoperitoneum washout and open splenectomy and splenic flexure takedown. . procedure in detail: through the upper midline incision a #10 blade scalpel was used to incise the skin and the incision was extended to the right side of the umbilicus. dissection through the subcutaneous tissue performed with electrocautery. the fascia was divided in the midline with electrocautery dissection. the abdomen was entered and the incision was extended superiorly and inferiorly through the fascia with electrocautery dissection. the abdomen explored. there were no obvious masses, no peritoneal studding. the liver and gallbladder were normal. the small bowel was normal. the colon appeared normal. there was diverticulosis within the left colon. the left upper quadrant was explored. there was dark blood within the right left upper quadrant. this was suctioned out of the abdominal cavity. the retractor system was then assembled and the left upper quadrant was exposed. . the short gastrics were then taken with serial clampings and tied with 2-0 silk ties. the splenic flexure was taken down with electrocautery dissection. the colon and stomach were then retracted inferiorly and the hilum of the spleen was carefully dissected. a penrose drain was passed around the hilum. a 2 mm vascular endo load was then placed around the hilum. the penrose drain was removed and the hilum was taken with that load. the spleen was then mobilized of its retroperitoneal attachments bluntly and then removed and placed in a bucket. the left upper quadrant was then irrigated copiously with sterile saline. the effluent was suctioned out of the abdominal cavity. a #19 - drain was then tunneled through the left side of the abdomen and placed in a gutter. this was placed to bulb suction and secured with a 3-0 nylon suture. the hemoperitoneum was then irrigated out of the abdominal cavity and lower abdomen and suctioned with sterile saline. the bowel was then placed in its new anatomic position. the nasogastric tube was confirmed in the stomach and then the fascia was closed with running #1 loop pds suture, 1 began superiorly and 1 inferiorly and cut in the middle. . the pain pump was then tunneled through the skin laterally and placed overlying the fascia and underneath the fascial closure. this was secured with dermabond. the skin was then reapproximated with 4-0 monocryl subcuticular suture. the dermabond was placed over the wound and the pain pump was activated. sterile occlusive dressings were placed over the wound. the patient was then extubated in the operating room and transferred to the post anesthesia care in stable condition. specimens to pathology were spleen. . findings: fracture and capsular rupture of the spleen with hemoperitoneum. complications: none were apparent at the time of procedure. i, dr. , was present for the entire procedure per hcfa regulations. . radiology final report - 10:14 am cta abd w&w/o c & recons; cta pelvis w&w/o c & recons reason for this examination:assess vasculature of spleen and extent of bleed/hematoma conclusion: 1. enlarged spleen with enlarging subcapsular hematoma, peripheral wedge- shaped hypoperfusion, and parenchymal aneurysms/hemorrhage. increased free fluid in the abdomen and pelvis, suggests continuing bleeding. the appearance of the spleen is unusual and is not diagnostic for a single entity; the differential may include vasculitis (polyarteritis nodosum), peliosis, or amyloid. 2. a hiatus hernia and duodenal diverticulum is noted. 3. multiple bilateral low-attenuation foci within the kidneys likely representing cysts. 4. markedly enlarged prostate gland as described above. discharge labs -------------- brief hospital course: mr. is a 77-year-old gentleman with a history of acute onset of epigastric left upper quadrant pain who presented to an outside hospital with tachycardia and hypotension. non-contrast ct due to elevated creatinine (1.7) was performed that showed a splenic hematoma. he was stabilized with intravenous fluids and transferred to the surgical icu at for hemodynamic monitoring. patient was kept npo, received ivf, and was febrile to 101po. after 36 hours, his creatinine normalized (0.6) but his placed hematocrit drifted into the mid 20s. repeat ct scan with intravenous contrast suggested an increase in hemoperitoneum and splenic hematoma was well as question of pseudoaneurysms within the parenchyma of the spleen. there was no active extravasation seen on ct scan. due to the unclear nature or etiology of this splenic rupture and no history, he was offered splenectomy. patient had an exploratory laparotomy and splenectomy performed by dr. on . in the or, patient received 3.3l of crystalloids and 2 units of rbc. . hd3/pod0 - post-operatively, patient remained intubated because he was lethargic and slow to respond secondary to narcotics. patient also had bloody sputum and secretions from endotracheal tube when suctioned. he also had decreased urine output and received 1liter ivf bolus. tmax was 103.6, he had blood cultures and sputum cultures obtained. . hd4/pod1 - patient was brought to the surgical icu intubated secondary to sedation and extubated a few hours after arrival. he was placed on a 50% open face mask and o2sat was 100% and was gradually weaned to 4lnc. his incisional pain was managed with a pca of dilaudud with good effect. patient remained afebrile, hemocrit was stable at 31, had good urine output >1.2 liters, wbc was 13, abdomen with positive bowel sounds and passing flatus. the abdominal incision was well approximated with durabond with a small amount of serous drainage, - drainage ~135cc. patient was transfered a floor bed on cc6. . hd5/pod2 - tmax was 101.0 po, patient was encouraged to ambulate, and continue with deep breathing exercises and incentive spirometry. . hd6/pod3 - patient was tolerating a clear liquid diet and was advanced to a regular diet without adverse effect. a urinalysis and culture was obtained secondary to cloudy urine output. the urinalysis was positive and the culture revealed e. coli. he received ciprofloxacin 500mg q12hours for +uti. home medications were started along with percocets for pain and colace. . hd6/pod3 - jp drainage continually improving, jp fluid amylase level was 26. the pca was d/c and motrin 600mg by mouth three times a day was started. received haemophilus b, meningococcal and pneumococcal vaccinations. . hd7/pod4 - jp drain was d/c'ed without incident. hd8/pod5 - patient met all criteria for discharge and felt safe to go home. tolerating regular diet without difficulty, ambulating independently without difficulty, voiding independently without difficulty, tolerating an oral pain regimen with good effect and given follow up with dr. . medications on admission: ecotrin 81mg; 2 tablets by mouth twice a day cilostazol 100mg; 2 tablets by mouth twice a day metoprolol 25mg; 2 tablets by mouth twice a day lipitor 10mg; 1 tablet po daily at night flomax 0.4mg; 1 tablet po daily at night vit c 500mg; 1 tablet by mouth twice a day vitamin b6 100mg; 1 tablet by mouth in the morning vitamin b12 100mg; 1 tablet by mouth in the morning folic acid 400mg; 1 tablet by mouth twice a day *medication list was provided by the patient at the time of admission. discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. hydromorphone 2 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily) as needed for prophylaxis. disp:*30 tablet, chewable(s)* refills:*2* 4. acetaminophen 500 mg tablet sig: two (2) tablet po q8h (every 8 hours) as needed for pain. 5. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime) as needed for bph. 6. multivitamin,tx-minerals tablet sig: one (1) tablet po daily (daily). 7. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily) as needed for hyperlipidemia. 8. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 9. cyanocobalamin 100 mcg tablet sig: 0.5 tablet po daily (daily). 10. pyridoxine 50 mg tablet sig: one (1) tablet po daily (daily). 11. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 12. ibuprofen 600 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for pain. disp:*40 tablet(s)* refills:*0* 13. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for htn. disp:*30 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: ruptured spleen splenic lympoma discharge condition: good discharge instructions: please seek medical attention if you experience fever > 101.5, severe nausea, vomitting, or pain, excessive drainage from wound no driving until follow up no bathing or swimming until follow up followup instructions: please see dr on thursday at 3:35pm please follow up with your pcp within next 2-3 weeks procedure: total splenectomy transfusion of packed cells diagnoses: pure hypercholesterolemia urinary tract infection, site not specified unspecified essential hypertension aortocoronary bypass status hemoperitoneum (nontraumatic) other diseases of spleen other malignant lymphomas, spleen 

Answer: The patient is high likely exposed to