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: patient recorded as having no known allergies to drugs attending: chief complaint: brbpr; with clots major surgical or invasive procedure: colonoscopy ir mesenteric angiography history of present illness: patient is a 87 year old male with history of htn, a. fib on chronic anti-coagulation, and per report, diverticulosis who is transferred from osh with brbpr. patient notes bloody bowel movements for "weeks". he denies any other symptoms. no chest pain/pressure, no dyspnea, no pre-syncope/syncope. no n/v, no emesis/hematemesis. he presented to the osh on with brbpr. he received a total of 4 units of prbcs and one unit of ffp in addition to vitamin k. he was never hemodynamically unstable. a tagged red blood cell scan was obtained yesterday and showed active bleeding either in the distal transverse colon or splenic flexure area. he was transferred directly to the icu for ir embolization. . labs at time of transfer were hct 28.9, inr 1.2. . upon arrival to the icu, patient reported frequent urges to move his bowels. he denied chest pain/pressure, lightheadedness, dyspnea. remainder of ros as noted below. had bloody bowel movement soon after arrival, comprised of blood clots. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no dysuria. denied arthralgias or myalgias. past medical history: htn hl a. fib on warfarin type ii dm seronegative inflammatory arthritis h/o diastolic heart failure obesity bph h/o recurrent utis social history: lives in with his wife. denies tobacco use. endorses 1 bottle of beer per week. no other drug use. married for almost 68 years family history: non-contributory physical exam: on transfer to : . vs: 114/73 hr 110s 97% ra rr 16 ga: aox3, nad, marked pallor heent: perrla. mmm. no lad. no jvd. neck supple. cards: pmi palpable at 5/6th ic space. no rvh. rrr s1/s2 heard. no murmurs/gallops/rubs. pulm: ctab no crackles or wheezes abd: obese, soft, nt, +bs. no g/rt. neg hsm. neg sign. extremities: wwp, no edema. dps, pts 2+. skin: neuro/psych: cns ii-xii intact. 5/5 strength in u/l extremities. dtrs 2+ bl (biceps, achilles, patellar). sensation and strength grossly intact. cerebellar fxn intact (ftn, hts). gait deferred. pertinent results: labs at osh: wbc 6.2 hb 9.8 hct 28.9 (initially 24.8) plt 141 sodium 143 k 3.8 chloride 112 co2 27 bun 13 crea 1.1 trop 0.02 inr 1.2 labs on admission: 06:43pm fibrinoge-433* 06:43pm pt-14.7* ptt-24.0 inr(pt)-1.3* 06:43pm plt count-205 06:43pm neuts-73.4* lymphs-18.0 monos-4.1 eos-4.3* basos-0.2 06:43pm wbc-7.5 rbc-3.69* hgb-9.8* hct-31.3* mcv-85 mch-26.6* mchc-31.3 rdw-15.8* 06:43pm albumin-3.1* calcium-8.3* phosphate-2.0* magnesium-2.0 06:43pm alt(sgpt)-10 ast(sgot)-20 alk phos-118 tot bili-0.5 06:43pm estgfr-using this 06:43pm glucose-152* urea n-13 creat-1.2 sodium-144 potassium-4.1 chloride-110* total co2-28 anion gap-10 09:40pm fibrinoge-458* 09:40pm pt-15.0* ptt-24.0 inr(pt)-1.3* 09:40pm plt count-185 09:40pm wbc-7.4 rbc-3.50* hgb-9.9* hct-29.7* mcv-85 mch-28.2 mchc-33.2 rdw-15.6* 09:40pm calcium-7.8* magnesium-1.9 09:40pm sodium-142 potassium-4.1 chloride-111* ecg atrial fibrillation with a mean ventricular rate of 106. right bundle branch block. diffuse non-diagnostic repolarization abnormalities. no previous tracing available for comparison colonoscopy: polyps in the ascending colon polyp in the hepatic flexure polyps in the transverse colon polyps in the descending colon friability, erythema and congestion in the 40 cm from anal verge compatible with ischemic colitis diverticulosis of the cecum, ascending colon, transverse colon and descending colon polypectomy not performed in the setting of gib. otherwise normal colonoscopy to cecum labs on discharge: 06:24am blood wbc-9.1 rbc-3.13* hgb-8.7* hct-27.1* mcv-87 mch-27.8 mchc-32.1 rdw-16.5* plt ct-222 06:24am blood pt-15.5* inr(pt)-1.4* 06:24am blood glucose-168* urean-7 creat-1.1 na-139 k-4.0 cl-111* hco3-22 angap-10 06:24am blood calcium-7.9* phos-2.5* mg-2.1 urine culture (final ): no growth brief hospital course: 87 year old male with history of htn, hl, a. fib on chronic anti-coagulation with brbpr. . # brbpr- the patient has a history of diverticular bleeding in . he was initially admitted to hospital in with a hct of 24.8 and inr of 1.5 and reports of brbpr x wks. he was hemodynamically stable. he continued to pass clots per rectum and was transfused with 4u prbcs and his inr was reversed. a tagged red cell scan was performed, which showed active bleeding. surgery was consulted at the osh and determined the patient was not a surgical candidate so the patient was transferred to for ir embolization. at , the patient continued to pass brbpr (clots) and he was transfused an additional unit. ir took the patient for possible embolization but did not see any active bleeding so no intervention was performed. gi was consulted and performed a colonoscopy which did not show any active areas of hemorrhage, but did show multiple polyps, diverticulosis, and possible ischemic colitis. gi recommended an outpatient colonoscopy. the patient remained hemodynamically stable with a stable hematocrit during his entire admission. the patient was instructed to follow-up with his pcp for gi referral for colonoscopy. on the day of d/c, the patient's hct was 27.1 with inr 1.4. . # a. fib - the patient's home medication verapamil was stopped out of concern for gi bleeding and hypotension; metoprolol 50 mg tid was continued. on , the patient had an episode of atrial fibrillation with rvr and required 10 mg iv diltiazem pushed. he was started on 40 mg po verapamil tid. he was discharged on his home medication verapamil 180 mg sr qd. the patient was instructed and the rehab facility was notified that he should restart coumadin on . the patient's daughter, also his health care proxy, was made aware of the risks and benefits of restarting anticoagulation. she expressed interest in speaking with the patient's pcp about the issue. . # htn- anti-hypertensives were intially held but were restarted during the patient's admission. his pressures remained stable during the admission. . # hl- the patient was continued on his home statin. . # recurrent utis - the patient has a history of recurrent utis associated with his chronic in-dwelling foley catheter, which he has had for 5-7 years. his foley was changed in the hospital and he reports it is changed at home each month. the patient was intially started on antibiotics at the osh for his uti but these were stopped because the patient was asymptomatic and there is concern for propagating resistant infections. . #iddm: the patient was kept on sliding scale insulin during this admission. his insulin requirements were much lower than his listed home doses of lantus 16u qam, and 19u qpm. he was discharged on 10 u qpm but may require up-titration depending on his blood sugars. . the patient was maintained on heparin sc bid for dvt prophylaxis. his code status was dnr/dni. communication was with the patient and his wife, daughter - his health care proxy, and son-in-law. physical therapy worked with the patient and felt it was in his best interest to go to rehab to regain strength prior to going home. medications on admission: asa 81 mg daily furosemide 80 mg daily hydroxychloroquine 200 mg daily novolog metoprolol tartrate zocor 80 mg daily verapamil sr 180 mg daily lorazepam 0.5 mg tid lantus 16 units qam, 19 units qpm medications at time of transfer: ceftriaxone 1 gram iv q24 nexium 40 mg iv q24 metoprolol tartrate 5 mg iv q4 micatin powder . discharge medications: 1. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 2. ativan 0.5 mg tablet sig: 0.5 tablet po at bedtime as needed for insomnia. 3. aspirin 81 mg tablet sig: one (1) tablet po once a day. 4. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 5. lantus 100 unit/ml cartridge sig: ten (10) units subcutaneous at bedtime. 6. verapamil 180 mg tablet extended rel 24 hr sig: one (1) tablet extended rel 24 hr po once a day. 7. humalog 100 unit/ml cartridge sig: 1-12 units subcutaneous qachs: sliding scale insulin. 8. lasix 40 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: at discharge diagnosis: primary: lower gi bleed diverticulosis, colon polyps, possible ischemic colitis atrial fibrillation w/ rapid ventricular response secondary: htn hl afib type ii dm seronegative inflammatory arthritis h/o diastolic heart failure obesity bph h/o recurrent utis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear mr. , it was a pleasure taking care of you at the . you were diagnosed with a lower gastrointestinal bleed, for which you were intially treated at hospital in before transfer to . your blood pressure was never dangerously low, but you were transfused with 5 units of blood and your blood-thinning medication (coumadin) was stopped and its effects were reversed. you had a tagged red cell scan at , which indicated active bleeding and since it was felt that surgery was not in your best interest, you were transferred to for further management. here, our radiologists did a study and did not see evidence of active bleeding. because you did continue to have lower gi bleeding w/ clots, our gastroenterology team was consulted; they performed a colonoscopy, which showed evidence of diverticulosis, multiple small colon polyps, and possible evidence of ischemic colitis. they recommended a repeat colonoscopy as an outpatient. your red blood cell count remained stable during your entire admission at . on , you had a very fast heart rate due to your atrial fibrillation. you were placed back on your home medication verapamil and also received iv medication to help slow your heart rate. we made the following changes to your medications: we stopped coumadin due to your gi bleeding; further guidance regarding this medication is discussed below we stopped plaquenil as it was not clear whether you had an indication for this treatment and did not think you were taking this at home we changed your lasix from 80 mg once per day to 40 mg once per day; you should weigh yourself daily and if your weight increases more than 3 lbs over 2 days, you may need to increase this dose back to 80 mg once per day we changed your lantus dose from 16 u in the morning and 19u in the evening to 10 u in the evening- in addition to sliding scale insulin; depending on your blood sugar checks, your lantus dose may need to be increased we continued your aspirin 81 mg each day, ativan 0.5 mg each night as needed for sleep, verapamil 180 mg sr each morning, simvastatin 80 mg each day and metoprolol 50 mg three times per day we stopped your novolog . *you should restart your coumadin on at 5 mg per day. you should have your inr routinely checked in addition to your cbc. because being on coumadin does increase your risk for gi bleeds, any concerns regarding re-starting this medication should be discussed with your primary care doctor and your daughter. we spoke with your daughter and she was made aware of the risks and benefits of restarting coumadin. it may also be beneficial for your goal inr to be from 1.5 to 2.5 instead of 2 to 3.* you will see a doctor at the rehab facility. when you are discharged from rehab, you should make an appointment with your pcp, . and you should have him help refer you to a gi doctor for a colonoscopy. followup instructions: name: , m. location: healthcare - address: one pearl st, , , phone: *dr. office is closed until , . please call the office after discharge from rehab to schedule your follow up. please discuss with your pcp about follow up appointment with a gastroenterologist. thanks. procedure: colonoscopy arteriography of other intra-abdominal arteries diagnoses: tobacco use disorder 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 atrial fibrillation acute on chronic diastolic heart failure hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) long-term (current) use of anticoagulants hemorrhage of gastrointestinal tract, unspecified benign neoplasm of colon diverticulosis of colon (without mention of hemorrhage) unspecified vascular insufficiency of intestine 

Answer: The patient is high likely exposed to