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: kefzol / solarcaine / polocaine attending: chief complaint: tx from osh for cardiac catheterization major surgical or invasive procedure: : cardiac cathetirization with stenting of the lad with cypher des central line placement : exploratory laparotomy, diagnostic angiography, placment of celiac stent history of present illness: this is a 78 yr old woman with esrd on dialysis, h/o aaa repair () who is referred by dr. for cardiac catheterization. pt presented to osh tues w/progressive sob after several days of uri sx. she notes that she had returned from vacationing in fl where she felt well, she had nasal congestion and nonproductive cough, no fever/chills. she awoke on day of presentation w/sob without improvement after sitting up and called 911. she denies cp/palpitations, no ha/dizzyness/n/v/visual changes/diaphoresis. she also denies le edema, orthopnea, pnd. she notes that she had had complete hd on monday, day pt presentation. . on presentation to the osh, she had bp in 90s/50s which quickly resolved. ekg showed lad, atrial flutter at 143 bpm and peaked t waves bnp was 2060. her k was 7.0 and she was found to have a tni 0.23 which increased to 1.31, ck 133 later that day. she was started on asa and metoprolol as well as diltiazem for rate control, had another hd session and was treated for a presumed copd flare w/steroids and levofloxacin. . on hd2, tni increased to 2.93 and ekg showed st depressions in ii, iii, avf although there is a question of lead placement after repeat ekg here. she continued to be cp free. echocardiogram revealed mid to low septal akinesis, apical hypokinesis new from prior echo in . today, her tni was 4.34 because of hypoxia, she was placed on cpap but weaned down to 5l nc prior to tx. she received 300mg plavix. there is no osh ekg from today. however, ekg here shows deep twi in precordial leads. . on review of symptoms, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, + dyspnea on exertion, no paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. + fatigue. past medical history: orif for l hip fx. - aaa repair (also by dr. - htn - dx. about 15 yrs. ago copd hyperlipidemia anemia hydradenitis of axillae - surgically treated esrd on hd mwf social history: social history is significant for +tobacco 1 ppd x 60 yrs. + etoh, 5 glasses of wine/week. there is no history of alcohol abuse. family history: + sister w/mi at 58y. sister - d. of pancreatic ca. in brother - d. from dm rest of family hx. not assessed physical exam: vs: t 99.2, bp 124/49, hr 97, rr 27, o2 98% on 3lnc, 0/10 pain gen: nad, resp or otherwise. oriented x3. mood, affect appropriate. pleasant. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa, dry mm. neck: supple with jvp of 6cm, + right carotid bruits cv: pmi located in 5th intercostal space, midclavicular line. irregularly irregular, 2/6 systolic murmur, normal s2. no s4, no s3; chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. decreased bs bl, no crackles, wheeze, rhonchi. abd: midline scar from aaa repair. obese, soft, + ruq tenderness, nd, no hsm or tenderness. + abdominial bruit. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp left: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp neuro: cn's intact a&o x 3; 5/5 strength upper and lower extremities symmetric bl pertinent results: ekg demonstrated a.flutter at 85bpm deep twi in v2-v6 new compared with prior dated . 2d-echocardiogram performed on at osh demonstrated: ef 50%, normal lv size and mild systolid dysfunction with mid to low septal akinesis, apical hypokinesis new from prior echo in . fibrosclerotic aortic valve change without significant stenosis trace mr, trace tr . 2d-echocardiogram performed on at osh demonstrated: ef 50%, normal lv size and mild systolid dysfunction with mid to low septal akinesis, apical hypokinesis new from prior echo in . fibrosclerotic aortic valve change without significant stenosis trace mr, trace tr . cxr : no acute process . cardiac cath : the initial angiography revealed an 80% calcified proximal lad lesion. bivalirudin was administered for anticoagulation. the strategy to attempt to predilate and stent the lesion with provisional rotablation if the balloon were to fail to expand. xblad 3.5 guide provided good support. prowater wire crossed the lesion easily. 2.5 x 12 mm quantum maverick balloon appeared to expand well although somewhat differentially at 12 atms. 3.0 x 13 mm cypher des was deployed at 16 atms with some mid-stent residual stenosis but good stent apposition at stent edges. 3.0 x 9 mm nc ranger balloon was used for mid stent post-dilated at 30 atms. there was a 20% residual stenosis with normal flow and no dissection. the patient left the cath lab in stable condition. . 1. one vessel coronary artery disease. 2. normal ventricular function. 3. successful stenting of the lad with cypher des. . ct abdomen : 1. bibasilar patchy airspace opacities, left greater than right, may represent infectious process, possible aspiration. other entities cannot be ruled out. follow up study after appropriate treatment is recommended to document resolution. 2. 4.6 x 4.4 cm right adnexal cyst. if clinicaly indicated, us and or mri could be performed for further characterization. 3. mild distal small bowel mucosal wall thickening may represent ischemia given the extensive vascular calcifications, infection or inflammatory process. 4. fluid-filled mildly distended descending colon and sigmoid. 5. infrarenal aaa status post repair. 6. l3 compression fracture with retropulsion of the fracture fragments narrowing the thecal sac at this level. , , : c.diff negative x3, stool cx neg. . blood cxs x2: ntd brief hospital course: 78 yr old woman with hx esrd on dialysis, dyslipidemia, htn, s/p aaa repair, no previously known h/o cad who was transferred for cardiac catheterization after she was found to be in new onset atrial flutter, elevated troponin i, and new wall motion abnormalities seen on echo at osh. . # nstemi - the patient was diagnosed with nstemi based on elevated cardiac enzymes, new wall motion abnormalities. she had cardiac cathetirization on showing an 80% calcified proximal lad lesion. she had a cypher des placed. she was maintained on asa, plavix (initially loaded at osh). she was not treated with integrillin because of renal failure. . # ischemic colitis - the day after cardiac cathetirization the patient developed diarrhea and the onset of brbpr, approximately 600cc of bloody stool. she remained hemodynamically stable. the patient had an ng lavage which was negative. a blood transfusion was started but pt developed fever from 97 to 100 degrees f, so transfusion was stopped. transfusion reaction labs were sent. a subsequent hct was noted to rise from 31 to 34 and remained stable. potential etiologies for her lgib were felt to be diverticular bleed/avm or mesenteric ischemia/colonic ischemia. of note, pt had transient hypotension earlier that day at dialysis from 140's to 90's, she had a recent cath with known aortic calcifications and had new onset af. gi was consulted and plans were made for colonscopy while hemodynamically supporting her and monitoring her abdominal exam. pt was started on golytely prep which she had difficulty tolerating and bowel movements did not clear, although pt only able to drink about 2.5 l of golytely. pt refused an ngt to help with the prep. pt remained afebrile and abdominal exam was benign during this time, hemodynamically stable. her wbc was noted to rise to 24 and she was empirically started on flagyl, c.diff toxin was negative x3 as was a stool cx. she had diarrhea attributed to golytely during this time. on pt became progressively tachypneic, an abg initially was 7.52/30/69 with lactate 3.4, but gradually increased to lactate of 11. a non-contrast abd ct was performed which showed mild distal small bowel mucosal wall thickening. the patient had progressive dyspnea requiring intubation and progressive hypotension, started on levophed and fluid resuscitation. she was given about 8l total of ivf, including 2units prbcs, 2 units of ffp however continued to be hypotensive to 80s and lactate continued to rise. gi performed sigmoidoscopy on , consistent with ischemic colitis and decision was made to take pt to surgery. on exploration pt was found to have compromised bowel. the stomach, liver, small bowel and large bowel appeared ischemic. only the cecum appeared to have transmural necrosis. there was no palpable or dopplerable celiac or sma pulses. an intraop vascular surgery consult was obtained. it was determined she may benefit from a vascular intervention. her abdomen was closed. she was taken to the angiography suite. an angiogram showed no branches off the aorta. it was possible to place a celiac stent, but the sma could not be crossed. she was taken to the sicu for rescusitation. over night, she became more acidemic and had an increased pressor requirement. she continued to decline and the patient's family came to the hospital. a discussion was had and a decision to make her cmo was made by the hcp, sister, . she expired shortly after removing support. . # a. fib/flutter: new onset in setting of ischemia noted on admission - the patient was started on metoprolol for rate control, not candidate for current anticoagulation given gi bleeding. . # s/p aaa repair - no evidence of acute process, focused on bp control and lipid control. . # htn: pt continued bb, plans for adding ace-i when tolerated. . # dyslipidemia: continue antihyperlipidemic . # copd: treated for flare at osh w/abx and steroids. continued ipratropium/albuterol nebs, supplemental oxygen as needed. . # fen: cardiac diet, renal diet . # code: full . # communication: sister, (hcp) medications on admission: medications at home: asa 81mg once daily renagel 1600 mg tid w/meals labeolol 200mg once daily zocor 40mg once daily . allergies: kefzol / solarcaine / polocaine discharge medications: deceased discharge disposition: expired discharge diagnosis: deceased discharge condition: deceased discharge instructions: deceased followup instructions: deceased procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours left heart cardiac catheterization coronary arteriography using a single catheter insertion of endotracheal tube hemodialysis angioplasty of other non-coronary vessel(s) arteriography of femoral and other lower extremity arteries exploratory laparotomy angiocardiography of right heart structures pulmonary artery wedge monitoring flexible sigmoidoscopy insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) insertion of drug-eluting coronary artery stent(s) cranial or peripheral nerve graft insertion of one vascular stent cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel procedure on single vessel diagnoses: anemia in chronic kidney disease end stage renal disease subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery acute kidney failure, unspecified unspecified septicemia severe sepsis atrial fibrillation obstructive chronic bronchitis with (acute) exacerbation atrial flutter hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia acute respiratory failure defibrination syndrome septic shock acute vascular insufficiency of intestine 

Answer: The patient is high likely exposed to