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: patient recorded as having no known allergies to drugs attending: chief complaint: abdominal pain major surgical or invasive procedure: mesenteric arteriogram with attempted stent placement history of present illness: 41-year-old woman, who has a very complex medical history. she is a known vasculopath with history of mesenteric ischemia now with just greater than 24 hour history of acute onset abdominal pain, which was severe, achy, and crampy in nature and was in the left greater than right lower quadrants. she also noted at least one or two episodes of bloody stool. of note, this feels exactly the same as her most recent bout of mesenteric ischemia for which she underwent an exploratory laparotomy and small bowel resection in . she has had no fevers or chills, nausea or vomiting. she has had no food fear or weight loss until recently after her small bowel resection at and it turns out she has lost approximately 20 pounds in the last several weeks. past medical history: hypertension, copd, diabetes mellitus, coronary artery disease, myocardial infarction, ischemic colon and small intestine, chronic diarrhea, congestive heart failure, gastroesophageal reflux, hiatal hernia, low back pain with degenerative joint disease, and ejection fraction of 50-60% with a dilated atrium. bilateral carotid endarterectomies 6 years ago, left carotid subclavian bypass, coronary artery bypass with mitral valve repair, commissurotomy 2 years ago, subtotal colectomy for ischemia in , exploratory laparotomy, small bowel resection, and 32 cm of resection on , incarcerated ventral hernia repair with mesh, l4-l5 fusion, a cholecystectomy and appendectomy. social history: she is a former smoker. she lives alone. she is retired. she does not drink excessively. family history: notable for heart disease, rheumatic heart disease, breast cancer, and colonic polyps. physical exam: vital signs: pulses in the 90s, blood pressure is 120. general: she is alert, oriented and in no acute distress. heent: normocephalic and atraumatic. sclerae anicteric. pupils were equal, round, reactive to light. extraocular movements were intact. neck: supple. no lymphadenopathy. there are no nodules or bruits. lungs: clear, except for occasional expiratory wheezes. heart: regular. abdomen: soft, with minimal bilateral lower quadrant tenderness, left greater than right. there is no rebound. there are no obvious hernias. guaiac positive with normal tone. extremities: warm. she has 2+ femoral pulses bilaterally. she has dopplerable bilateral dorsal pedal pulses. pertinent results: 02:36am blood wbc-9.1 rbc-3.50* hgb-10.6* hct-33.8* mcv-97 mch-30.4 mchc-31.5 rdw-16.2* plt ct-246 03:09am blood wbc-7.3 rbc-2.99* hgb-9.0* hct-28.2* mcv-94 mch-30.0 mchc-31.9 rdw-16.2* plt ct-250 02:36am blood pt-14.3* ptt-27.0 inr(pt)-1.4 09:30am blood pt-15.4* ptt-79.5* inr(pt)-1.6 03:09am blood pt-14.4* ptt-71.5* inr(pt)-1.4 02:36am blood glucose-124* urean-6 creat-0.7 na-145 k-3.5 cl-111* hco3-22 angap-16 03:09am blood glucose-98 urean-4* creat-0.5 na-142 k-4.1 cl-106 hco3-23 angap-17 02:50am blood alt-11 ast-17 ld(ldh)-202 ck(cpk)-56 alkphos-85 amylase-103* totbili-0.4 02:50am blood ck-mb-6 ctropnt-<0.01 07:27pm blood ck-mb-notdone ctropnt-<0.01 02:36am blood calcium-8.1* phos-2.3* mg-1.4* 03:09am blood calcium-7.7* phos-2.4* mg-1.9 08:52pm blood type-art po2-146* pco2-34* ph-7.41 calhco3-22 base xs--1 08:52pm blood lactate-1.1 radiology final report ct 150cc nonionic contrast 4:26 am ct abd w&w/o c; ct pelvis w&w/o c reason: ? closed loop field of view: 40 contrast: optiray medical condition: 66 year old woman with ? closed loop obstruction reason for this examination: ? closed loop contraindications for iv contrast: none. indication: 66-year-old female with history of prior ischemic bowel status post resection. ct in outside hospital demonstrated very dilated loops of small bowel. comparisons: comparison is made to ct performed at an outside hospital at , at 7 p.m. technique: 64-mdct axial images of the abdomen and pelvis were obtained without iv contrast after administration of iv contrast (40 seconds and 80 seconds). nonionic iv contrast was used due to rapid bolus of this study. 150 cc of optiray-350 were administered. ct of the abdomen without and with iv contrast: there are bilateral small pleural effusions. there are no focal consolidations. there is no pericardial effusion. there is calcification of the mitral annulus of the heart. the heart is otherwise of normal size. no focal lesions are seen in the liver, and there is no intrahepatic bile duct dilatation. however, the extrahepatic bile duct measures up to 12 mm and appears in the pancreas. correlation with lfts is recommended. there is an ng tube with the tip in the stomach. the stomach is otherwise unremarkable. the spleen and pancreas are unremarkable. there are several small hypodensities in the kidneys bilaterally that are too small to characterize (less than 5 mm). the aorta is heavily calcified. there is stenosis at the origin of the celiac, and there is likely complete occlusion or near complete occlusion of the sma at the origin in an 8-mm segment. although contrast filled the distal aspect of the sma, this could be due to retrograde filling. when compared to the prior study, the contrast now reaches the rectum, and there is no evidence of obstruction or closed loop obstruction. the small bowel also is less dilated than it was in the prior study and now no definite thickening of the small bowel can be appreciated. however, in the prior study performed approximately 8 hours earlier, there was definite thickening of the small bowel. now, there is thickening of a short segment of colon, which can be seen for example in series 3b, image 152. there is also mild stranding of the mesentery. there are postoperative changes in the anterior abdominal wall. there is no evidence of air in the portal vein or pneumatosis. there is no free fluid in the abdomen. ct of the pelvis with oral without and with iv contrast: there is a foley catheter within the urinary bladder. the rectum appears to be unremarkable. the uterus and adnexa are within normal limits. bone windows: there is a small amount of air in the spinal canal at the level of l3/l4 likely related to degenerative changes of no significance. there are severe degenerative changes of the lumbar spine. there is a cage at the level of l4/l5. no suspicious lytic or blastic lesions are seen. another air bubble is seen in the left si joint, likely due to degenerative changes. ct reformations were important to evaluate the bowel. impression: 1. interval improvement in the degree of dilatation of the colon, and small bowel. small bowel thickening cannot be appreciated anymore but was definitely present in the prior study performed at the outside hospital. there is no evidence of small bowel obstruction since the contrast reaches the colon and the caliber of the small and large bowel are markedly decreased in size. 2. there is mild stranding of the mesenteric fat. 3. thickening of a short segment of the colon in the right lower quadrant could be ischemic. 4. complete or near complete occlusion of the origin of the sma and celiac artery stenosis at the origin. the is patent. given the patient's history and considering these findigns, the thickening of the colon in this study could be secondary to acute ischemia superimposed on chronic ischemic process. clinical correlation is recommended. 5. bilateral pleural effusions. 6. dilatation of the common bile duct without intrahepatic bile duct dilatation in this patient status post cholecystectomy. correlation with lfts is recommended. if there is increase in lfts, mrcp should be performed. brief hospital course: patient was transferred from osh directly to the sicu where she continued to be npo with and ngt, foley, and ivf as well as levo/flagyl antibiotics. hd 1 patient had a-gram with attempted unsuccessful celiac stent placement via femoral approach - celiac a 50% thrombosed, sma 100%, has no . hep drip was then restarted. patient remained npo with ngt because of initial thought to reattempt stenting on hd3. however, vascular surgery felt that given the aptient's improvement and resolution of symptoms, emergent a-gram could wait. on hd 3 patient had ngt & foley removed, and a right subclavian central line placed because no peripheral access could be obtained. of note, patient had acute, intense, 2 minute shoulder pain in the middle of the night - ecg, cxr, and enzymes x 3 were done and patient was ruled out for an mi. patient was started on clears and then advanced to regular diet. hd 4 a-line was dc'd. heparin to coumadin bridge as well as home meds were restarted. patient was discahrged on hd 5 in good condition with instructions for follow-up with dr. , 5 days of lovenox, and a new lasix dose of 40 . medications on admission: protonix, subcutaneous heparin t.i.d., albuterol, atrovent, sliding scale insulin, levoflox, and flagyl. discharge medications: 1. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 2. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 3. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q4h (every 4 hours) as needed. 4. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed. 5. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 6. nitroglycerin 0.8 mg/hr patch 24hr sig: one (1) transdermal q24h (every 24 hours): remove at bedtime. 7. spironolactone 25 mg tablet sig: one (1) tablet po bid (2 times a day). 8. atenolol 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 9. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day) as needed. 10. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 11. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po tid (3 times a day). 12. gabapentin 300 mg capsule sig: one (1) capsule po qid (4 times a day). 13. lovenox 80 mg/0.8 ml syringe sig: one (1) syringe (70mg) subcutaneous every twelve (12) hours for 5 days. disp:*10 syringes* refills:*0* 14. warfarin 1 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: home discharge diagnosis: mesenteric ischemia discharge condition: good discharge instructions: please seek medical attention if you experience fever > 101.5, severe nausea, vomitting, pain please resume home meds and take new ones as directed followup instructions: please follow up with dr - call procedure: venous catheterization, not elsewhere classified arterial catheterization arteriography of other intra-abdominal arteries diagnoses: coronary atherosclerosis of native coronary artery esophageal reflux unspecified pleural effusion unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified atrial fibrillation diarrhea other extrapyramidal diseases and abnormal movement disorders acute vascular insufficiency of intestine 

Answer: The patient is high likely exposed to