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: erythromycin estolate / penicillins attending: chief complaint: transfer for ep study/vt ablation major surgical or invasive procedure: ep study s/p mapping/ablation history of present illness: 48 yo m with hx of cad, mi x2, cabg x4 , ef 15-20%, hx of vt s/p icd, multiple icd shocks and noted slow vt, admitted to center in nh on after having his icd fire 10 times followed by few seconds of syncope despite being on amiodarone and quinidine. he has been having recurrent vt which was treated with amiodarone dose, quinidine, and increased beta-blocker. he reports that he could feel the pvc's and slow vt's and could tell the threshold before having the syncopal episode. he was recently cathed on to rule out ischemic component of dysrrhythmia which showed patent grafts. since he was discharged, he has had several icd shocks and was treated with increasing dose of b-blocker. on the day of admission to center, he had 10 icd firings, one of which was associtated with loss of consciousness for few seconds. at , pt was started on amiodarone and lidocaine drips. icd interrogation revealed a slow vt which was terminated with pacing. he was also found to have another fast vt. now with av (atrial/biventricular) pacing after device reprogramming. pt was transferred to for vt ablation. in the ep lab here, aggressive attempts were made to induce the sustained vt but only short runs of short vt were induced. mapping and ablation of multiple foci of slow vt were done. fast monomorphic vt w/ lbbb/l axis occurred (not induced) which were not pace terminable requiring shock 360 j x3 and then converted to sinus rhythm. ep history: history of vt ' s/p icd placement, hx of multiple recurrent icd shock between -, hx of slow monophasic vt (580-590 msec) noted in 4/', which was pace terminated and icd reprogrammed, upgrade to biventricular icd , vt ablation . ep study on after having icd firing after rapid vt 320-360 msec which failed to terminate with pacing. study showed 4 episodes of sustained monomorphic vt (320-340 msec), series of atp algorithms tested but no successful termination + was ultimatley terminated with shock. past medical history: -cad-remote imi, anterior mi , s/p cabg : lima-lad, svg-ramus+pda, svg-om. -cath : 100% lad; 100% lcx; 100% rca; lima-lad patent; ao-om patent; ao-ramus-pda patent. -chf: echo w/ ef 15-20% regional wall motion abnl c/w ischemic dz, mod biatrial enlargement, mild mr, lvh. rvh w/ hypokinesis -htn -hypothyroidism -cri (baseline 1.6-1.8 in ) -obstructive sleep apnea -obesity -hypercholesterolemia -copd -paroxismal a-fib social history: pt lives in , nh with his wife, has 7 kids (2 step kids, 2 adopted kids, and 3 biological kids), 35 yr of smoking 1 pack/day and quit 1 yr ago, occasional etoh, no recreational drug family history: pt was adopted, and does not know about his biological paterents. physical exam: vs: t 99.6 bp 110/61 hr 60 rr 18 o2sat 93% ra gen: obese, cheerful male lying in bed post-cath in nad heent: nc/at, perrl, eomi, mmm, no visible jvp cor: rrr, distant s1, s2, no audible murmurs or rubs lungs: cta on anterior exam abd: +bs, obese, soft, ntnd ext: r groin with no hematoma or eccymosis, no femoral bruits, 2+dp bilaterally, no edema neuro: a+ox3, cn intact, nonfocal. pertinent results: wbc-11.9* rbc-3.58* hgb-9.9* hct-31.2* mcv-87 mch-27.7 mchc-31.8 rdw-17.3* plt ct-216 wbc-14.0* rbc-3.35* hgb-9.5* hct-29.1* mcv-87 mch-28.4 mchc-32.8 rdw-17.5* plt ct-205 wbc-11.9* rbc-3.32* hgb-9.6* hct-28.8* mcv-87 mch-28.8 mchc-33.2 rdw-17.4* plt ct-245 wbc-9.7 rbc-3.53* hgb-9.9* hct-31.5* mcv-89 mch-27.9 mchc-31.3 rdw-16.9* plt ct-250 wbc-13.2* rbc-3.84* hgb-10.6* hct-34.0* mcv-89 mch-27.5 mchc-31.1 rdw-16.6* plt ct-391 neuts-85* bands-9* lymphs-2* monos-4 eos-0 baso-0 atyps-0 metas-0 myelos-0 neuts-89.7* lymphs-4.9* monos-3.6 eos-1.7 baso-0.1 pt-18.6* ptt-54.7* inr(pt)-2.2 pt-16.5* ptt-36.7* inr(pt)-1.7 pt-22.9* ptt-73.4* inr(pt)-3.3 glucose-108* urean-32* creat-1.9* na-138 k-4.4 cl-101 hco3-25 urean-45* creat-2.9* na-135 k-4.8 cl-99 glucose-89 urean-52* creat-3.9* na-137 k-4.9 cl-99 hco3-26 glucose-101 urean-49* creat-2.2* na-140 k-4.7 cl-104 hco3-25 glucose-84 urean-29* creat-1.7* na-140 k-4.3 cl-104 hco3-27 glucose-104 urean-15 creat-1.3* na-138 k-4.4 cl-103 hco3-22 alt-25 ast-24 alkphos-64 amylase-28 totbili-0.9 ck(cpk)-218* ck-mb-16* mb indx-7.3* ctropnt-2.06* calcium-8.9 phos-4.8*# mg-2.2 calcium-9.3 phos-3.9 mg-2.0 calcium-8.2* phos-3.0 mg-1.9 vitb12-203* folate-7.3 iron-26* caltibc-281 hapto-447* ferritn-459* trf-216 aerobic bottle (final ): no growth. anaerobic bottle (final ): no growth. urine culture (final ): <10,000 organisms/ml. fecal culture (final ): no salmonella or shigella found. campylobacter culture (final ): no campylobacter found. clostridium difficile toxin assay (final ): feces negative for c. difficile toxin by eia. reference range: negative. cxr : there is moderate cardiomegaly in a patient with dual lead pacemaker insertion. the pacemaker chips overlie the right atrium and ventricle. patient has undergone prior cabg. there is bilateral moderate pulmonary vascular redistribution and perihilar haziness. the osseous structures are unremarkable. cxr : stable moderate-to-severe cardiomegaly in a patient status post cabg. the dual-lead pacemaker tips overlie the right atrium and ventricle. there is a slightly improved pulmonary vascular redistribution and interstitial edema. the osseous structures are unremarkable. impression: slight interval improvement in chf. : ct of the abdomen without contrast: patchy opacity is present within the right lung base which could represent atelectasis. the liver, spleen, pancreas, gallbladder, adrenal glands, kidneys, and small bowel are normal in appearance. no pathologically enlarged retroperitoneal or mesenteric lymph nodes are seen. ct of the pelvis with contrast: there is focal fat stranding within the pelvic fat surrounding the sigmoid colon. there are multiple diverticula. there is extraluminal gas adjacent to this area of fat stranding. there is no drainable fluid collection. oral contrast reaches the transverse colon indicating no evidence of obstruction. bone windows show no suspicious lytic or sclerotic lesions. reformatted imaging: images reformatted in the coronal and sagittal plane were essential in evaluating the patient's abdomen and pelvis and show fat stranding within the deep pelvis adjacent to the sigmoid colon, indicating diverticulitis. impression: sigmoid diverticulitis with a suggestion of microperforation. no drainable fluid collection present. axr : left upper chest pacemaker device, sternal wires and mediastinal clips are noted. the heart appears enlarged. there is no free air. images of the abdomen are of poor technical quality. a nonspecific bowel gas pattern is noted. axr : gaseous distention of stomach and moderate gaseous distention of multiple loops of small bowel with retained contrast in the rectosigmoid colon. findings could be related to ileus in the presence of intra-abdominal inflammatory process but correlate clinically. the gaseous distention of the stomach could be re- evaluated after passage of ng tube if clinically indicated. brief hospital course: 1)rhythm: as stated in hpi, pt underwent ep study with multiple ablation of slow vt foci, but unable to map and ablate the focus of fast vt. mapping and ablation of multiple foci of slow vt were done. fast monomorphic vt w/ lbbb/l axis occurred (not induced) which were not pace terminable requiring shock 360 j x3 and then converted to sinus rhythm. vt occurred during the study which was not induced, not terminable with pacing, and had to be shocked with 360 j x3. pt was transferred to the ccu and to the floor with no significant event. pt remained av paced at a rate of 60 bpm, increased to 80 bpm subsequently. pt was initially scheduled to return to nips and dft. however, pt developed fever and abdominal pain, and therefore nips and dft were canceled. the ep team felt that nips were not urgent, and they have spoken with his cardiologist dr. who will follow up with him in 4 weeks to do the nips. he was continued on amiodarone 400 mg po qd but quinidine was discontinued. due to hypotention, coreg was reduced to 12.5 mg from 50 mg . pt was continued on coumadin for his paroxysmal a-fib - he will need frequent inr checks while on antibiotics for diverticulitis (see below). 2)pump: recent echo 15-20%. as above, pt will be discharged with reduced dose of coreg, and will be continued on his home meds of lisinopril, torsemide, and spironolactone. pt appeared euvolemic/hypovolemic clinically with hypotension to sbp 80's but the cxr showed moderate chf with increased interstitial markings and vascular redistribution. pt got one dose of lasix which increased the creatinine from 1.9 to 2.9. pt later received ivf which lowered the creatinine. additionally, his torsemide was held during the hospitalization, as well as spironolactone and lisinopril secondary to hypotension, and rising creatinine. he was started on digoxin 3 days before discharge and had improvement in his blood pressure enough to tolerate the lisinopril and spironolactone. additionally, his creatinine had normalized, also allowing reintroduction of these meds. his creatinine had been stable at 1.3 for two days prior to discharge, with sbp around 120. 3)cad: hx of prior inferior and anterior mi. patient was continued on asa, zocor, coreg, and lisinopril. 4)diverticulitis: on the second day of admission, pt developed fever of 102, abdominal pain, loose stools, and leukocytosis. patient had tender lower quadrant abdominal pain to palpation but with no peritoneal signs. pt underwent ct abdomen which showed sigmoid diverticulitis with possible microperforation. an axr did not demonstrate any free air. he was made npo, and started on levaquin and flagyl. his abdominal pain improved significantly, and had completely resolved, with only residual mild tenderness to palpation on discharge. reglan was started when an axr revealed gaseous distention of his stomach and intestine. his diet was slowly able to be advanced to low residue, which he was tolerating prior to discharge. his wbc count rose on the day of discharge, however the patient remained afebrile and was clinically improved; additionally, the hct and platelets also rose, making it most likely secondary to dehydration after restarting his diuretics. the patient was instructed to increase his fluid intake slightly over the next couple of days while he isn't taking in a full diet. he should remain on a low residue, heart healthy diet until he sees a gastroenterologist, at which time they may want to place him on a high fiber diet. 5)htn: pt was continued on coreg, lisinopril, torsemide + spironolactone. 6)hypercholesterolemia: pt was continued on zocor. 7)copd: initially, albuterol was held since it could potentially trigger vt. pt was continued on flovent and atrovent, but continued to have diffuse wheezing. pt was discharged with his home meds of comvient and flovent. 8)sleep apnea: pt was continued on bipap 15 cm. overnight, pt showed episodes of apnea and desaturation to the 70's and 80's. 7)hypothyroid: patient was continued on synthroid. 8)cri: baseline cr 1.6-1.8. creatinine on admission was 1.9 but creatinine increased to 2.9 after patient was npo for planned nips. pt also appeared intravscularly dry especially after getting a dose of iv lasix. pt got ivf bolus but creatinine continued to be elevated. his lisinopril and aldactone were held, and as his diverticulitis resolved his creatinine returned to baseline. his renal insult may have been a combination from his vt with hypoperfusion, as well as dehydration. his creatinine was 1.3 for two days prior to discharge. medications on admission: meds on transfer: amiodarone 400 mg po qd spironolactone 25 mg po bid synthroid 100 mcg po qd flovent 110 mcg 2 puffs combivent 3 puffs prn zocor 40 mg po qhs asa 325 mg po qd coreg 12.5 mg po bid toresmide 50 mg po qd amiodarone drip 0.5 mg/hr lidocaine drip 1 mg/min home meds: amiodarone 400 mg po qd quinoglute 324 mg po bid coreg 50 mg po bid lisinopril 10 mg po qd torsemide 50 mg po bid spironolactone 25 mg po bid lexapro 10 mg po qd combivent 14.7g 3 puffs prn flovent 110 mcg 2 puffs asa 325 mg po qd warfarin 2.5 mh po qd zocor 40 mg po qd synthroid 100 mcg po qd discharge medications: 1. amiodarone hcl 200 mg tablet sig: two (2) tablet po daily (daily). 2. fluticasone propionate 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 3. spironolactone 25 mg tablet sig: one (1) tablet po bid (2 times a day). 4. levothyroxine sodium 100 mcg tablet sig: one (1) tablet po daily (daily). 5. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 7. carvedilol 12.5 mg tablet sig: one (1) tablet po bid (2 times a day). 8. escitalopram oxalate 10 mg tablet sig: one (1) tablet po daily (daily). 9. combivent 103-18 mcg/actuation aerosol sig: three (3) inhalation q4h:prn. 10. torsemide 20 mg tablet sig: 2.5 tablets po bid (2 times a day). 11. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 12. digoxin 250 mcg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 13. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 9 days. disp:*9 tablet(s)* refills:*0* 14. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 9 days. disp:*27 tablet(s)* refills:*0* 15. warfarin sodium 1 mg tablet sig: 1-2 tablets po daily (daily): 2.5 mg, except for tues, thurs, sat. 1.5 mg, and as dictated by your inr checks. tablet(s) 16. cyanocobalamin 1,000 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: vt s/p ep study diverticulitis cad congestive heart failure copd hypertension hypothyroidism discharge condition: hemodynamcially stable, improved, having bowel movements, urinating on his own. discharge instructions: take all of your medications as directed - we have resumed all of your previous medications - except for the quinidine. we have decreased your dose of carvedilol to 12.5 mg twice a day (instead of 50). we have started two new medications: 1) digoxin - this is for your heart. 2) cyanocobalamin (vitamin b12) - this is for your anemia. you will also be on two antibiotics called levaquin and flagyl for the next 9 days. seek medical attention (pcp, ) if you develop worsening abdominal pain, nausea/vomiting, fever, chills, chest pain, palpitation, icd firing, sob, or any other concerning symptoms. you will need to follow up with your cardiologist dr. in 4 weeks. if she has any questions, she can reach dr. at . you will also need to see dr. (surgery), or another gastroenterologist in a couple of weeks to follow how your diverticulitis is doing. they will schedule you for a colonoscopy in the next 2-3 months. dr. number is . you will need to have your inr checked on friday, and every 3 days while you are on the antibiotics. you will need to stay on a low residue diet until you see dr. or another surgeon, at which time they should place you on a high fiber diet which you should stay on to help avoid future episodes of diverticulitis. followup instructions: provider: , . please make an appointment with her in the next 2 weeks. please have your pcp make an appointment for you with a gastroenterologist in your area. if they have any questions, or you would like to see a doctor here for your diverticulitis, call dr. at . you will need a colonoscopy in months, which they can set you up with. please see your primary care doctor in the next week or two - he should check your blood pressure, among other things, and consider going back to your usual carvedilol dosage. procedure: catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach cardiac mapping diagnoses: pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified atrial fibrillation aortocoronary bypass status paroxysmal ventricular tachycardia unspecified sleep apnea old myocardial infarction automatic implantable cardiac defibrillator in situ diverticulitis of colon (without mention of hemorrhage) 

Answer: The patient is high likely exposed to