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: milk attending: chief complaint: gi bleed hepatic flexure hemorrhage major surgical or invasive procedure: extended right colectomy with primary anastomosis with incidental appendectomy right ijv nontunnelled 3-lumen cvc insertion history of present illness: this is a 73 year old female with dementia, tardive dyskinesia, schizophrenia, diabetes, hypertension, congestive heart failure and a history of a gi bleed that now presents with bright red blood per rectum (brbpr) x 24 hours. she was transfered here from a nursing home and admitted to the micu for hypotension. she had 3 episodes of brisk brbpr without hypotension or tachycardia. (hr 80-90, sbp 130's). a tagged rbc scan showed bleeding from the hepatic flexure. angio subsequently was performed demonstrating bleeding from of the middle colic artery feeding the hepatic flexure. this was not embolized due to the risk of gut ischemia. he was transfered back to the icu from angio. shortly thereafter, she dropped her pressure to sbp 50's and became unresponsive. she was volume resusciatated with 4 units prbcs and 3 liters of ns. her bp responded to the volume and was 127/47, hr 89. past medical history: adrenal insuff., hypothyroidism, schizophrenia, tardive dyskinesia, tia (on coumadin), dm, htn, chf, cataracts, venous thrombosis, recent hx of vaginal bleeding social history: 2 daughters, and physical exam: vs: 95.6, 88, 130/58, 17, 98% 3l gen: verbal, responds to commands, denies abdominal apin, confused. resp: cta cv: rrr abd: soft, distended, + bs, tympanic, nontender, no guarding rectum: gross blood per rectum ext: wnl pertinent results: reason: embolize source of gi bleeding. contrast: optiray medical condition: 73 year old woman with h/o dementia, schizophrenia, h/o gi bleed with profuse bleeding per rectum. 3 point hct drop and positive bleeding at hepatic flexure on tagged rbc scan. reason for this examination: embolize source of gi bleeding. final report. history: 73-year-old woman with gi bleed localize to hepatic flexure on tagged red blood cell scan. physicians: and with dr. , the attending radiologist, present and supervising during the procedure. procedure: following written informed consent, the patient was positioned supine on the angiography table. a preprocedure timeout was performed to confirm patient, procedure, and site. standard sterile prep and drape of the right inguinal region. local anesthesia with 10 cc of 1% lidocaine subcutaneously. using palpatory and fluoroscopic guidance, a 19-gauge single wall puncture of the right common femoral artery was performed. a 0.035-inch guidewire was advanced through the needle into the abdominal aorta using fluoroscopic guidance. needle was exchanged for a 5-french introducer sheath, which was attached to continuous heparinized saline flush. using a cobra catheter, the superior mesenteric artery was selected. superior mesenteric arteriography was performed to image the entire superior mesenteric artery territory. then, using a 3-french microcatheter, the right colic and middle colic arteries were selected and arteriograms were performed of the respective arteries. in the middle colic artery, the microcatheter was advanced into a branch of the middle colic artery supplying the hepatic flexure (third order branch from the aorta) and arteriography was performed. based on the findings of the diagnostic arteriograms, it was determined that the patient would not be a suitable candidate for embolization despite the fact that active extravasation of contrast was seen. all wires, catheters and the sheaths were removed and hemostasis was ensured with direct manual compression. the patient was transferred back to the icu and the case was discussed with the icu resident (dr. and surgery resident (dr. . there were no immediate complications. findings: superior mesenteric arteriography demonstrated patency of the superior mesenteric artery and its major branches. initially, no active bleeding or potential source of bleeding was identified. based on the findings of the nuclear medicine study, selective arteriography of potential arterial feeders to the hepatic flexure was performed. right colic arteriography did not demonstrate any active extravasation or potential source of bleeding. in the course of the procedure, the patient experienced hematochezia and superior mesenteric arteriography was repeated without the microcatheter. this demonstrated a source of active extravasation from the area of the hepatic flexure. as the right colic arteriography performed immediately previously had not demonstrated any source of bleeding, middle colic arteriography was performed. this confirmed that the bleeding arose from a branch of the middle colic artery supplying the hepatic flexure. the microcatheter was advanced distally in the middle colic artery territory and arteriography was repeated, confirming that this branch was supplying the source of bleeding. however, the main artery-feeding vessel that was bleeding was too small to accept the microcatheter. the position in the middle colic artery branch where the microcatheter was, also supplied several other small arterial feeders to other parts of the hepatic flexure without collateral arterial supply from elsewhere in the middle colic or right colic artery territories. as such, it was determined that the patient was not a suitable candidate for embolization, as a large segment of the hepatic flexure would have undergone ischemia had embolization been performed. moderate sedation was provided by administering divided doses of versed (total 2 mg intravenously) and fentanyl (total of 50 mcg intravenously) over a total interservice time of two hours during which the patient's hemodynamic parameters were continuously monitored by the radiology nursing service. the patient's heart rate was stable throughout the procedure at approximately 90 beats per minute. 290 cc of optiray radiographic contrast was utilized. impression: active bleeding from a branch of the middle colic artery. embolization could not be safely performed. gi bleeding study reason: h/o gi bleeding currently with large bloody bowel movements evaluate source of bleeding that can be embolized radiopharmeceutical data: 16.2 mci tc-m rbc; history: 73 year old female with a history of a gi bleed. now large bloody bm. interpretation: following intravenous injection of autologous red blood cells l labeled with tc-m, blood flow and dynamic images of the abdomen for 39 minutes were obtained. blood flow images do not show any focal abnormality. dynamic blood pool images show brisk bleeding from the hepatic flexure of the colon. impression: there is brisk bleeding from a site near the hepatic flexure of the colon. the team was notified of the results of the test at study completion. portable abdomen 11:58 am portable abdomen reason: eval ng tube placement medical condition: 73 year old woman with schizophrenia (tardive dyskinesia), h/o gi bleeds s/p ng tube placement. reason for this examination: evaluate for tube placement. 73-year-old schizophrenic woman with tardive dyskinesia now with gastrointestinal bleeding. referred for evaluation of nasogastric tube placement. abdomen single supine view: there is a nasogastric tube which crosses from the left upper abdomen over the spine to terminate in the right mid abdomen, probably within the second portion of the duodenum. there are no dilated loops of bowel or air fluid levels. there is a normal bowel gas pattern. no definite free intra-abdominal air is identified on this study, which does not include the hemidiaphragms. two ovoid shaped calcific densities projecting over the right upper quadrant measuring 4 x 3 cm and 1.7 x 1.6 cm are probably large gallstones. the patient is status post right hip arthroplasty. impression: 1) nasogastric tube terminates within the second portion of the duodenum. 2) gallstones sinus rhythm at lower limits of normal range with sudden p-r interval prolongation and subsequent block and then restoration of sinus rhythm. mild p-r interval prolongation. low voltage, especially in the limb leads. q waves in leads vi-v2. since the previous tracing of the episode of a-v block is new. the q wave in lead v2 is new. the q-t interval is shorter. clinical correlation is suggested. tracing #1 read by: , a. intervals axes rate pr qrs qt/qtc p qrs t 52 198 100 -7 36 chest (portable ap) 7:23 am chest (portable ap) reason: acute cardiopulm medical condition: post intubation, line placement reason for this examination: acute cardiopulm : history: line placement. impression: ap chest compared to : et tube now in standard placement. tip of the left subclavian line projects over the svc. nasogastric tube passes into the stomach and out of view. moderate bilateral pleural effusions and mediastinal vascular engorgement have increased. bibasilar lung opacification is probably atelectasis. vascular congestion and borderline interstitial edema are present in the upper lungs. no pneumothorax. ct abdomen w/contrast 10:27 am ct abdomen w/contrast; ct pelvis w/contrast reason: please assess for fluid collection/abscess, colitis, etc field of view: 48 contrast: optiray medical condition: 73 year old woman s/p r hemicolectomy w/ hypothermia, wbc 24, and abd pain reason for this examination: please assess for fluid collection/abscess, colitis, etc contraindications for iv contrast: none. clinical history: patient with recent right hemicolectomy with hypothermia, leukocytosis, abdominal pain. study: ct abdomen and pelvis with contrast. technique: axial multidetector ct was obtained of the abdomen and pelvis after the administration of intravenous and oral contrast. no comparisons are available. abdomen ct with contrast: there are bilateral pleural effusions and compressive atelectasis. heart size is within normal limits. ng tube is in expected position. there is moderate amount of ascites, mostly within the upper abdomen. _____ two large gallstones are calcified within the gallbladder, though no gallbladder wall, separate from the stones is seen and the possibility of porcelain gallbladder exists. there is fluid within the gallbladder fossa. no intrahepatic or extrahepatic biliary ductal dilatation. pancreas is normal in appearance. bilateral adrenal glands, and kidneys are normal in appearance. the bowel within the abdomen is within normal limits with the ileocolonic anastomosis having a normal appearance. no small bowel dilatation. no lymphadenopathy. ct pelvis with contrast: there is free fluid within the pelvis. no loculated collections to suggest abscess. bowel within the pelvis is normal in appearance, though there is a fair amount of fluid within the colon, which would be consistent with diarrhea. below the patient's midline skin incision, is a small mildly heterogeneous fluid collection without abnormal enhancement likely representing a seroma. there is sigmoid diverticula without evidence of diverticulitis. much of the pelvis is obscured by streak artifact from the right hip prosthesis. foley catheter is within the urinary bladder. bone windows: the l5 vertebral body is mildly collapsed but markedly sclerotic, raising the question of a sclerotic metastasis. superior aspect of the l4 vertebral body is sclerotic, but this may relate to disc generation. the l1 vertebral body is markedly collapsed and sclerotic. impression: 1. no evidence for abscess and the patient is status post right hemicolectomy with normal-appearing anastomosis and no bowel obstruction. there is free ascites. 2. likely large gallstones, though separate wall of the gallbladder cannot be seen and porcelain gallbladder is a consideration. the ascites limit the specificity for the pericholecystic fluid. if there is clinical concern for acute cholecystitis, ultrasound could be performed. 3. l1 and l5 vertebral compression fractures with more sclerosis within l5 than expected for the compression. bone scan could be performed as clinically indicated. object: gastrointestinal bleed. rule out seizure. referring doctor: dr. findings: abnormality #1: throughout the recording the background rhythm was slow and disorganized, typically remaining in the maximum of hz in most regions. abnormality #2: there were additional bursts of delta slowing seen primarily in the left parsagittal and parietal area or left fronto-temporal region and an additional area of focal slowing in the right fronto-central region. by video, the patient had frequent head movements, likely to lead artifact. hyperventilation: could not be performed. intermittent photic stimulation: could not be performed. sleep: no normal waking or sleeping morphologies were seen. cardiac monitor: showed a generally regular rhythm. impression: abnormal portable eeg due to the slow and disorganized background throughout and due to the additional focal slowing primarily in the left parasagittal and parietal area. the background abnormalities indicate a widespread encephalopathy. medications are a common cause. the focal slowing raises concern for an additional subcortical dysfunction especially in the left hemisphere, but the tracing cannot specify the nature of that disturbance. some of the slowing could have represented head movement artifact, but at least some of the slowing appeared to indicate a true focal abnormality. nevertheless, there were no epileptiform features throughout the recording. brief hospital course: this is a 73 year old female admitted on with brbpr and taken to the or on for a right colectomy. she remained intubated post-operatively for acidosis. on , she was made comfort care measures only. this happened to due the wishes of the family after a long discusion on . we then consulted dr. on pallative care. #respiratory she self-extubated on pod 2. she was stable initially after surgery. she passed a speech and swallow test and was allowed to start on sips. on , she developed respiratory distress. she was hypotensive, oliguric and somnolent and required intubation, sedation, swanned, a-lined in unit. it was presumed urospesis from a uti. she was started on broad spectrum antibiotics (vanco/levo/flagyl). on , she became comfort measures only so she was extubated and all her antibiotics were discontinued. she remained stable for a few days then went into respiratory failure which led to cardiovascular arrest. #nutrition she was started on tpn for nutritional support while intubated. pod 10 () a dobhoff was placed for enteral feeds. tube feedings were changed to promote c fiber at a goal 80cc/hr. on , she became comfort measures therefore her tube feeds were discontinued. #cardiovascular on , she was still having apneic episodes and bradycardic to 30s with mobitz type i morphology. cardiology was consulted. the patient continued to have a prolonged intubation and poor mental status. av nodal agents were avoided, pressure was stable and the mobitz i was seen as a benign rhythm and not further cardiology management was needed. pertinent micro: mrsa/vre p; ucx: yeast; sputcx-providenci stuartii (cefipime), ua-no bact, wbc, mod yeast (fluc), sputcx gnr (gs gpc/gnr); ucx gnr pertinent rads: head xray: metallic density along medial wall of llat orbit head ct-unchanged appearance of brain w/dolichocephaly, chronic small vessel ischemia/atrophy; b moderate effs,pulm edema; #gi bleed her hct was trending down over 10 days from (40's-> 30's-> 20's) and on was 21.2 with guaiac positive maroon stool. she was tranfused 2 units and her hct responded to 30.7. a ngt lavage was done wiht clear return and tube feedings were held. a scope on showed egd -gastritis, duodenitis, no source of bleeding. a colonoscopy was held since stable hct and a clean prep. #neurology neuro exam reveals eye deviation in and downward. motor exam with upper extremity flaccidity right more than left and moving left side more. only able to elicit reflexes in right upper extremity. findings might be more suggestive of lmn lesion (i.e previous neuropathy or icu polyneuropathy), but given somewhat preserved reflexes and along with apneic episodes, we need to consider basilar insufficiency. also need to rule out thalamic infarct given eye deviation. updates: : head ct with odd head shape and skull base irregularities, with diffuse perventricular white matter disease. needs mri to assess posterior fossa. : can't get mri because she has metal artifact signal in left orbit. : weaning to extubate. having episodes of bilateral shoulder shaking so checking eeg.. : eeg with left>right slowing. no epileptiform features. shoulder and chest wall movements not epileptic. unfortunately not much more for us to add so signing off. #psychiatry consult tardive dyskinesia is irreversible, so haldol 1mg q4 hours for agitation. she had a very difficult, complicated post-op course. it has been complicated by urosepsis, hypotension, somnolence and required reintubation. in total she has received 10 units of prbcs. she had down treading hct which became stable in the last week. she became comfort care only on the so we discontinued all her medications and iv fluids and extubated her. she was only on morphine tritated to comfort. she then developed respiratory failure which lead to cardiovascular arrest. medications on admission: nursing home meds: coumadin actos 30 mg qd paroxetine 10 mg qd levothyroxine 25 mcg qd metformin 500 mg hydrocortisone 20 mg mom prn kaopectate tylenol prn guiafenisis prn discharge medications: expired discharge disposition: expired discharge diagnosis: cardiovascular arrest discharge condition: expired procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other endoscopy of small intestine enteral infusion of concentrated nutritional substances arterial catheterization insertion of other (naso-)gastric tube insertion of other (naso-)gastric tube arteriography of other intra-abdominal arteries pulmonary artery wedge monitoring open and other right hemicolectomy other small-to-large intestinal anastomosis other incidental appendectomy transfusion of packed cells transfusion of other serum diagnoses: other postoperative infection urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia severe sepsis unspecified acquired hypothyroidism unspecified schizophrenia, unspecified acute respiratory failure long-term (current) use of anticoagulants personal history of venous thrombosis and embolism hemorrhage of gastrointestinal tract, unspecified cerebral artery occlusion, unspecified with cerebral infarction critical illness polyneuropathy mobitz (type) ii atrioventricular block apnea orofacial dyskinesia nonspecific (abnormal) findings on radiological and other examination of skull and head 

Answer: The patient is high likely exposed to