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: new diagnosis colon cancer major surgical or invasive procedure: : ercp with sphincterotomy : laparoscopic right colectomy history of present illness: mr. is a 70 y.o. male with hx of crohn's disease, afib, dilated cmp, h/o pe who presents after recent discharge due to colon biopsies found positive for colon cancer. pt recent admission was for bloody stools and significantly elevated inr. during this admission he had colonoscopy with multiple biopsies. he was discharged in stable condition without any ibd meds and without anticoagulation. he was called by pcp and told to come back due to positive colon biopsy and need for further staging/workup. pt denies any grossly bloody stools at home, has not been taking any meds and has been tolerating po well with minimal rectal pain. past medical history: 1. crohn's dz, found in on colonoscopy for anal fissure, positive , been treated with remicade 2. rheumatoid arthritis 3. htn 4. hx of renal calculus 5. s/p appendectomy 6. s/p turp 7. s/p cholecystectomy 8. recent pulmonary embolism- on coumadin since 9. lvh, lv enlargement, apical lv aneurysm with lv thrombus, ef 25% 10. chronic left knee pain s/p meniscectomy, synovectomy, and debridement of left knee 11. recent gallstone pancreatitis 12. afib - rate controlled on atenolol social history: married for 46 years and lives with wife. 3 children who all live in area. no tobocco, h/o occasional etoh, stopped drinking in , denies h/o etoh abuse. no illicit drugs. family history: father died at 62 from mi mother died at 52 of cirrhosis no cancer or diabetes to patient's knowledge no history of clotting disorders physical exam: t-96.8 bp-140/70 p-96 rr-20 sats-95% on ra gen: nad, comfortable heent: ncat, eomi, mmm, oropharynx cv: irreg/irreg no m/r/g no jvd resp: ctab no w/r/crackles abd: soft/nt/nd/nabs extr: no c/c/edema, +pt pulses bilaterally pertinent results: admission labs: wbc-8.7 rbc-3.87* hgb-10.5* hct-31.9* mcv-82 mch-27.2 mchc-33.0 rdw-16.4* calcium-8.2* phosphate-2.8 magnesium-1.9 glucose-84 urea n-12 creat-0.9 sodium-139 potassium-4.2 chloride-106 total co2-26 anion gap-11 plt count-352 cea 1.5 : echo la is normal in size. no asd is seen by 2d or color doppler. there is mild symmetric lv hypertrophy. lv cavity is moderately dilated. there is a sessile mural thrombus at the lv apex; the clot is mural and not mobile. overall lv systolic function is moderately-to-severely depressed (lvef= 30 %) secondary to severe hypokinesis of the inferior, posterior, and lateral walls, and extensive apical akinesis. there is no vsd. rv chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. av leaflets (3) are mildly thickened but as is not present. mild (1+) ar is seen. mv leaflets are mildly thickened. there is no mvp. mild (1+) mr is seen. lv inflow pattern suggests impaired relaxation. the estimated pa systolic pressure is normal. there is no pericardial effusion. compared with the findings of the prior report (images unavailable for review) of , a lv apical thrombus is now present stress test: impression: no significant st-t wave changes in the setting of baseline st-t wave abnormalities. no anginal-type symptoms. nuclear report sent separately. pmibi: impression: 1. abnormal study. 2. severe, fixed perfusion defect involving the inferior wall and the a large region at the apex. 3. moderately dilated lv. 4. akinetic apex and inferior wall with lvef 28%. mri abdomen impression: 1. hypodense flat subcapsular lesion within segment iv-b on prior ct from , demonstrates a slight delayed enhancement; however gross stability since ct abdomen and pelvis suggest a benign lesion. this lesion is amenable to further evaluation by targeted ultrasound, possibly with biopsy, as clinically indicated. 2. vague 1.3 cm lesion in segment 7 on prior ct from is not clearly visualized. however, this examination is motion limited and a small lesion within this vicinity cannot entirely be excluded. 3. filling defect in the lower common bile duct suggests choledocholithiasis without evidence of acute obstruction. ct chest/abd/pelvis w/ w/o contrast 1) 3.7 cm irregular soft tissue mass at the lateral aspect of the ascending colon, associated with lymph nodes, corresponding to the colon cancer seen on colonoscopy. small amount of fluid along the right paracolic gutter, probably due to biopsy. 2) featureless appearance of the descending and sigmoid colon, with increased wall thickening and fat stranding in the descending colon, suggestive of active inflammation due to crohn's disease. 3) ill-defined 1.3 cm lesion in the segment 7 of the liver, for which metastasis is suspected given the colon cancer. further evaluation by multiphasic mri is recommended. 4) unchanged nodular appearance of the left adrenal gland. the finding can be evaluated at the time of mri as well. 6) new bilateral pleural effusion. 7) increased mucosal enhancement in the perianal region, with probable perianal fistula on the right, new since prior study. 8) multiple hypodense lesions in the kidney, unchanged since prior study. 09:55am glucose-120* urea n-14 creat-0.9 sodium-140 potassium-3.6 chloride-110* total co2-26 anion gap-8 09:55am calcium-7.7* 09:55am wbc-7.8 rbc-3.69* hgb-9.8* hct-30.4* mcv-83 mch-26.7* mchc-32.3 rdw-16.5* 09:55am plt count-333 07:00am glucose-84 urea n-12 creat-0.9 sodium-139 potassium-4.2 chloride-106 total co2-26 anion gap-11 07:00am calcium-8.2* phosphate-2.8 magnesium-1.9 07:00am wbc-8.7 rbc-3.87* hgb-10.5* hct-31.9* mcv-82 mch-27.2 mchc-33.0 rdw-16.4* 07:00am plt count-352 brief hospital course: 70 y.o. male with hx of crohn's disease, afib, dilated cmp, h/o pe who presents after recent discharge for lgib in setting of supratherapeutic inr on the same day when colon biopsies were found positive for colon cancer. patient was admitted for metastatic work-up and cardiology clearance prior to colonic mass resection. . ## colon cancer: ct abdomen with 3-4 cm mass in ascending colon with enlarged lns, biopsies positive for ca. pt had ct of torso for staging, showing possible metastatic dz of a single nodule in the liver. mri w/ liver protocol performed, without lesion suspicious for mets. cardiology recommended addition of statin, asa, heparin gtt prior to surgery. pt at mod-high risk for moderate risk surgery. . ## dilated cmp/systolic dysfuction: monitoring strict i/os, remained euvolemic. continue meds of lisinopril and atenolol. stress w/ no significant st-t wave changes or anginal-type pain in setting of stress on . pmibi with evidence of fixed profusion deficit, severe apical , 28%. cardiology consulted. echo on showed mural thrombus and apical aneurysm. restarted asa and started simvastatin and heparin gtt. pt to require long-term anticoagulation on discharge. . # choledochololithiasis: seen on mri of the abdomen. patient s/p ercp w/ sphinctorotmy on without complication. . ## recent gi bleed/anemia: hematocrit is stable at 26-30. pt denies any grossly bloody stools. given mural thrombus, on iv heparin until colon resection. will send stools for guiac and monitor hct daily. . ## crohn's disease - stable, primarily rectal involvement. patient on lidocaine jelly and prn tylenol #3 for rectal pain. currently on no treatment for crohn's given colon ca diagnosis. . ## paroxysmal atrial fibrillation: pt was discharged without anticoagulation on last admission after being admitted with an inr > 7. benefits of anticoagution are outweighed by the risks at this time. to resume coumadin post-op. . ## benign essential htn: controlled on atenolol and lisinopril . ## h/o pe: anticoagulation with heparin gtt . ## fen: heart healthy diet, will replete lytes prn. . ## ppx: scds, bowel regimen . ## full code medications on admission: pt denies taking any meds at home at the time of this admission. pt has been on in the recent past: atenolol 50 daily lisinopril 10mg daily discharge medications: 1. atenolol 50 mg tablet sig: one (1) tablet po daily (daily). 2. lorazepam 0.5 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for anxiety. tablet(s) 3. lidocaine hcl 5 % ointment sig: one (1) appl topical tid (3 times a day) as needed. 4. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 5. cyanocobalamin 500 mcg tablet sig: two (2) tablet po daily (daily). 6. warfarin 1 mg tablet sig: one (1) tablet po once (once) for 1 doses. 7. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 8. hexavitamin tablet sig: one (1) cap po daily (daily). 9. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 10. hydroxychloroquine 200 mg tablet sig: one (1) tablet po bid (2 times a day). 11. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 12. metoclopramide 10 mg tablet sig: one (1) tablet po qid (4 times a day). 13. acetaminophen 500 mg tablet sig: two (2) tablet po tid (3 times a day). 14. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po q6h (every 6 hours) as needed for pruritis/insomnia. 15. colace 100 mg capsule sig: one (1) capsule po twice a day. 16. mesalamine 1,000 mg suppository sig: one (1) rectal once a day. 17. coumadin 1 mg tablet sig: one (1) tablet po at bedtime. 18. lidocaine hcl 5 % ointment sig: one (1) topical twice a day as needed for pain: appl topical twice a day as needed for pain for 2 weeks. . discharge disposition: extended care facility: for extended care - discharge diagnosis: primary diagnosis: colon ca secondary diagnosis: atrial fibrillation dilated cardiomyopathy - ef 28%, akinetic apex, lv mural thrombus, lv aneurysm h/o pe recent lower gi bleed gallstone pancreatitis h/o renal calculi crohn's disease discharge condition: stable tolerating a regular diet, poor appetite. needs encouragement adequate pain control with oral medication discharge instructions: please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomitting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomitting, diarrhea or other reasons. signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * your skin, or the whites of your eyes become yellow. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered. * continue to amubulate several times per day. * please check your weight once a day in the morning. followup instructions: follow up with dr. in 2 weeks. call to schedule this appointment. provider: , md phone: date/time: 11:10 provider: , md phone: date/time: 9:00 provider: , md phone: date/time: 1:00 procedure: closed [endoscopic] biopsy of large intestine transfusion of packed cells transfusion of other serum closed [endoscopic] biopsy of rectum diagnoses: other primary cardiomyopathies abnormal coagulation profile unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation blood in stool rheumatoid arthritis personal history of venous thrombosis and embolism hypovolemia malignant neoplasm of ascending colon regional enteritis of large intestine 

Answer: The patient is high likely exposed to