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: diuril / sulfa (sulfonamides) / lasix attending: chief complaint: s/p self inflicted stab wounds to anterior neck major surgical or invasive procedure: none history of present illness: 89 yo male s/p multiple self inflicted stab wounds to his anrterior neck with a pair of scissors. he was transported from the scene; patient's facility; and transported to for further trauma care. past medical history: atrial fibrillation chf pancytopenia htn cad s/p pacemaker hypothyroid s/p colectomy/end colostomy for ca ' h/o tics social history: widower, wife died in has a son who is involved in his care retired postal worker; formerly chief operating officer of post office family history: pertinent results: 04:00pm hct-28.7* 08:32am glucose-190* lactate-1.6 na+-140 k+-4.2 cl--104 tco2-25 08:30am urea n-42* creat-1.5* 08:30am amylase-24 08:30am digoxin-1.2 08:30am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 08:30am wbc-17.0* rbc-3.35* hgb-10.6* hct-29.8* mcv-89 mch-31.7 mchc-35.6* rdw-13.9 08:30am plt count-184 08:30am pt-11.9 ptt-23.5 inr(pt)-1.0 08:30am fibrinoge-320 chest (portable ap) 5:14 am chest (portable ap) reason: ? evolution infiltrates medical condition: 89 year old man with ptx s/p chest tube placement l chest new infiltrates @ bases reason for this examination: ? evolution infiltrates reason for examination: follow up of a patient with left chest tube inserted. comparison: . the heart size is normal. the basilar opacifications are again noted, left worse than right with new small amount of left pleural effusion. there is no failure. there is no sizable amount of pneumothorax identified. the mid level left pleural tube is unchanged in position, tip impinging on the mediastinum. the transvenous right ventricular pacer lead is in standard placement. baseline artifact ventricular paced rhythm atrial mechanism uncertain - may be atrial fibrillation since previous tracing of , no significant change intervals axes rate pr qrs qt/qtc p qrs t 77 122 136 384/415.57 -122 -65 108 psychiatry consult id/cc: mr is an 89 year old man who attempted suicide two nights ago by stabbing himself in the neck with a pair of scissors 20 times. he is now pod2 s/p closure of neck lacerations and placement of a chest tube. psychiatry was consulted to evaluate him for depression and suicidal ideation and to assist with management. hpi: mr is an 89 year old gentleman who has led a productive, socially engaged life, but whose medical complaints and sense of despair have mounted over the past year. on the evening that he attempted suicide he felt "disgusted" with the way his life was going. he was "overwhelmed, with work piling up." referring to his bills, personal medical care tasks and mail. he says that "his heart wasn't in it" any more. he didn't want to "live like this anymore." he realized that "every day was costing a lot of money" referring to his care at an facility. he had always wanted to "end it before things really got out of hand." referring to his ideal "picture" of how he would die, and to his dnr/dmi order. at 1:30 on the morning of , unable to sleep and ruminating upon his medical impairments he saw a pair of scissors on his bedside table and thought "what the ." he stabbed himself 20 times with the intent to kill himself. he had not planned the suicide attempt, had not written any notes or made any preparations and contemplating suicide ever before. a nurse at his housing facility found him in a pool of blood at 7am and called ems. he says that his suicide attempt was "a silly thing to do." he says that he has more hope now. that he knows he "will be better." he regrets bringing any shame upon his son. when asked if he might do such a thing again he answers, "i believe that i wouldn't." mr says that his spirits began to decline one year ago after changing pcps. at that time his thyroid medication was reduced or changed. he began falling more frequently. he started disengaging from social activities at his housing complex like parties, dinners, chorus, eating out, working out. he began having difficulty sleeping, going to bed at 8 pm and waking at 2:30 am to watch nesn. his medical self care tasks, mail and bills began to feel overwhelming. his appetite, usually robust, started to decline. past psychiatric history: none. mr. every feeling depressed, every seeing a counselor or psychiatrist. past medical history: 1. chf 2. hypothyroid 3. a fib s/p pacemaker 4. diverticulitis s/p colectomy 5. pancytopenia 6. hypertension allergies: diaziden, lasix, sulfa, diuril meds on admission: asa, flomax, levoxyl, mvi, digoxin, lisinopril, xalatan, alphagen, demadex current medications: citalopram hydrobromide 10 mg po daily latanoprost 0.005% opth colu 1 drop ou pantoprazole insulin dorzolamide torsemide 20 mg po daily digoxin 0.125 mg po dialy levothyroxine 137 mcg po daily lisinopril 5 mg po daily tamsulosin hcl 0.4 mg po hs heparin 5000 sc bid oxycodone-acetaminophen 1.2 tab po q4-6 prn pain labs are notable for a cr:27, glu;195, ca8.2, hct 25.2 psychosocial hx: mr grew up in , one of seven siblings in a well known family in square. he was very active in his church communities, being the head of all four church congregations of which he was a member. he recalls his friendship with , a well known local figure. he played baseball for the navy in -44. he married and settled in , ma. he worked fro the postal service and became chief operating officer. he spent one year in advising the establishment of a postal service there. he had two sons. one son died 6 months ago from complications of diabetes. he retired to , ma, where he recalls spending the happiest years of his life. he swam and ate out at restaurants with friends daily. was known as the "mayor of ." his wife died in . he moved to the facility four years ago. he was still engaged in daily gym workouts, weekly social activities, church and chorus. substance use: tobacco, alcohol or other elicit substances. has a beer "once in a while." every few months. mental status exam appearance: elderly gentleman sitting in bed with bandage over several small sutured incisions. makes good eye contact. initially appeared bothered by interruption becoming more engaged. behavior: resting tremor of right hand. good eye contact attitude: cooperative, weary : "lousy" affect: sad, tired, limited range. teary. sarcastic. thought form: linear thought content: current , hi, auditory and visual illusions or hallucinations. no overt delusions. insight and judgement: fair/fair cognitive assessment: alert and oriented to person, place, situation attention: dowb memory: registration and recall fund of knowledge: named 5 presidents, named 6 objects correctly. named 20 words that begin with b in 60 seconds. apple and are fruit. assessment and plan: mr. is an 89 year old gentleman who describes a one year period of depressed , anhedonia, decreased energy and motivation, recently decreased appetite with weight loss, insomnia with early awakening and a recent suicide attempt. mr. suicide attempt is remarkable in its intensity, impulsivity and violence bringing into question the existence of an acute process of psychosis, or delirium, in addition to insidious depression. medical causes of delirium and depression such as drug overdose, hypothyroidism, neoplasm, cognitive dysfuntion process should be ruled out. chf, arrythmias and renal failure can also present with depression. given that this is a new diagnosis, and the impulsive nature of the suicide attempt, mr. would benefit from an inpatient geriatric psychiatric hospitalization both for safety and to initiate pharmacological and psychotherapy treatment. 1. continue 1:1 obs 2. follow up on thyroid function test and mri 3. when medically stable will facilitate transfer to inpatient geriatric psychiatry facility. psychiatry pt seen for followup. he continues to appear depressed, discouraged. "i don't see any progress, i really don't think i can get any better"..."i'd be very surprised if i could walk". no significant confusion noted over past... vague regarding si: "i don't think so". labs: hct 23.8. tranfusion is planned. on exam he is lying still in chair, limited eye contact, slowed . speech soft, clear. affect flat/depressed, is discouraged, negative. no active si but quite hopeless. when asked if he might again attempt suicide he answers, "i don't think so, i don't know". no thought disorder or overt delusions, si. no halluc. cogn: fully oriented to day/date and place. imp: depression, s/p suicide attempt. pt is weak, deconditioned, anemia may also contribute to his low energy. depressed, hopeless, he remains at risk for self harm. r/o underlying mild cognitive impairment. rec: -continue citalopram 10 mg -cont 1:1 obs -when medically stable we will facilitate transfer, ?inpt geripsych vs rehab with close psych f/u; need to consider pt's functional capacity and rehab needs, reassess post-transfusion. date: signed by , rn on affiliation: patient see for routine pouch change. the pouch could of easily lasted until monday but he was worried that there would not bed anyone to change it over the weekend. the hyperplasia around the stoma is slightly decreased since the last pouch change when the pouch was placed to protect the hyperplasia from contact with the stool. pouched with convatec surfit natura wafer and pouch with 1 inch flange and seal. there are more supplies in his room. will re-check him on monday. brief hospital course: he was admitted to the trauma service; he underwent ct imaging to rule out any vessel injury; no vascular process were identified. a left anterior pneumothorax was noted and a subsequent chest tube was placed. he was transferred to the trauma icu for close monitoring and remained stable. the chest tube was pulled on hospital day 5, a repeat chest xray was performed and revealed resolved pneumothorax. psychiatry was consulted early on and have been following him closely throughout his hospital stay. he has required 1:1 sitter during his hospitalization. he has been cooperative; no psychotic behaviors have been noted. it is being recommended that he go to an inpatient psychiatric facility once stable. he did have a low hematocrit, as low as 22, and it was decided to transfuse him with packed red blood cells. post transfusion hematocrit was initially 24.4 and then increased to 25.6 on . physical and occupational therapy have also been consulted and have recommended that patient may require inpatient rehabilitation stay. his neck sutures were removed on ; he may follow up in the trauma clinic as need by calling . medications on admission: levoxyl 137' flomax 0.4' digoxin .125' asa 81' lisinopril 5' torsemide 20' eye gtts medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q4-6h (every 4 to 6 hours) as needed for pain. 2. tamsulosin 0.4 mg capsule, sust. release 24hr sig: one (1) capsule, sust. release 24hr po hs (at bedtime). 3. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily): hold for sbp <110. 4. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 5. dorzolamide-timolol 2-0.5 % drops sig: one (1) drop ophthalmic (2 times a day): apply ou. 6. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime): apply ou. 7. brimonidine 0.15 % drops sig: one (1) drop ophthalmic (2 times a day): apply ou. 8. citalopram 20 mg tablet sig: 0.5 tablet po daily (daily). 9. torsemide 20 mg tablet sig: one (1) tablet po once a day. 10. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 11. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disposition: extended care facility: hospital diagnosis: s/p multiple self inflicted stab wounds to anterior neck region condition: stable instructions: return to the emergency room if you develop any fevers, chills, increased redness/drainage from neck wound sites (multiple); increased chest pain/shortness of breath and/or any other symptoms that are concerning to you. followup instructions: follow up as needed in the trauma clinic, call if you need to schedule an appointment, . follow up with your primary care doctor from psychiatric facility. you will need to call for an appointment. procedure: insertion of intercostal catheter for drainage closure of skin and subcutaneous tissue of other sites diagnoses: congestive heart failure, unspecified unspecified acquired hypothyroidism suicide and self-inflicted injury by cutting and piercing instrument atrial fibrillation paroxysmal ventricular tachycardia pneumonitis due to inhalation of food or vomitus cardiac pacemaker in situ accidents occurring in other specified places insomnia, unspecified traumatic pneumothorax with open wound into thorax open wound of other and unspecified parts of neck, without mention of complication unspecified episodic mood disorder 

Answer: The patient is high likely exposed to