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: no known allergies / adverse drug reactions attending: chief complaint: right leg laceration major surgical or invasive procedure: none placement of wound vac placement of picc line history of present illness: 85 year old wheelchair-bound woman with a history of transverse myelitis, theapeutic on coumadin for prior dvts, admitted for a laceration to the right anterior thigh after being hit by her wheelchair. on fall, patient did not have a head strike. she presented to the ed with profuse right calf bleeding. in the ed, patient had a syncopal event in the context of hypotension to sbp 50. hgb stable, trop x 1 negative. ekg without changes. she was given 3l of fluid. she underwent x-ray of the right femur and right knee. patient was seen by surgery. primary closure of her wound was attempted, but was unable to be approximated due to edema. the patient was found to have dopplerable pulses on the right. a wet to dry bandage was placed on the wound. she was given morphine 2mg iv x 1 for pain and was transferred to the floor. . on the floor, the patient triggered immediately on admission for 78/palp, and altered mental status in the setting of profuse blood loss. bleeding was controlled. access with 1 20-gauge iv was obtained. multiple attempts were made to establish a second iv site, without success. the patient was type and crossed, and transferred to the icu. . on admission to the icu, vs: 96 110/85 89 15 100% ra. the patient complained of pain in her leg and mild dizziness, but was otherwise stable. she was alert and oriented x 3. past medical history: - collagenous colitis - transverse myelitis, wheelchair bound - tia - bilateral dvts () on coumadin - osteoarthritis - glaucoma - mrsa discitis in - carpal tunnel syndrome s/p right decompression 2 years ago - maxillary cancer s/p resection & reconstruction - ? seizure - history of c. diff social history: - lives at home, has vna for chronic indwelling foley - previously employed as a lawyer (graduated from law) - tobacco: denies. quit 40 years ago. - etoh: occasional - recreational drugs: never family history: non-contributory physical exam: admission physical exam: vs: 96 110/85 89 15 100% ra heent: mm dry; no lymphadenopathy or thyromegaly; no jvd card: normal s1, s2, no murmurs, rubs or gallops lungs: cta bilaterally abdomen: soft, non-tender, non-distended ext: large, profusely bleeding contusion on leg with surrounding expanding hematoma. hematoma tender to palpation; right dp and pt with biphasic doppler signals neuro: a&ox3; cn ii- xii grossly intact; strength 5/5 bilaterally; sensation grossly intact skin: scattered ecchymosis on upper and lower extremities bilaterally discharge physical exam: o: vs t97.4 bp 122/62 p 72 96% ra heent: mmm, eomi card: normal s1, s2, no murmurs, rubs or gallops lungs: cta bilaterally, no wheezing or rhonchi abdomen: soft, non-tender, non-distended ext: irregular lac to r thigh, wound vac running. leg grossly swollen but improved and softer. left arm swollen and red. denies pain. neuro: a&ox3; cn ii- xii grossly intact; no sensation in lower extremities with limited stregnth. 4+/5 bilaterally in upper extremities. skin: scattered ecchymosis on upper and lower extremities bilaterally pertinent results: 10:25am blood wbc-10.4 rbc-4.13* hgb-12.2 hct-37.5 mcv-91 mch-29.5 mchc-32.5 rdw-15.0 plt ct-356# 09:40pm blood wbc-11.6* rbc-1.96*# hgb-5.8*# hct-17.3*# mcv-88 mch-29.5 mchc-33.4 rdw-14.9 plt ct-243 03:29am blood wbc-9.6 rbc-2.68*# hgb-8.2*# hct-23.9*# mcv-89 mch-30.8 mchc-34.5 rdw-14.5 plt ct-181 10:25am blood plt ct-356# 11:40am blood pt-36.1* ptt-30.0 inr(pt)-3.6* 09:40pm blood pt-42.6* ptt-32.5 inr(pt)-4.4* 08:54am blood pt-13.1 ptt-24.1 inr(pt)-1.1 10:25am blood glucose-95 urean-14 creat-0.4 na-140 k-3.3 cl-104 hco3-28 angap-11 09:40pm blood glucose-137* urean-12 creat-0.2* na-143 k-2.8* cl-117* hco3-21* angap-8 03:29am blood glucose-104* urean-11 creat-0.3* na-142 k-3.7 cl-113* hco3-24 angap-9 10:25am blood ctropnt-<0.01 03:29am blood ck-mb-5 ctropnt-0.10* 08:52am blood ck-mb-5 ctropnt-0.07* 09:40pm blood calcium-6.8* phos-2.9 mg-1.4* 03:29am blood calcium-8.3* phos-3.9 mg-3.8* 09:47pm blood lactate-0.6 . relevant labs: 03:29am blood ck-mb-5 ctropnt-0.10* 08:52am blood ck-mb-5 ctropnt-0.07* 03:25pm blood ck-mb-4 ctropnt-0.05* . discharge labs: 05:20am blood wbc-9.2 rbc-3.05* hgb-9.3* hct-27.1* mcv-89 mch-30.4 mchc-34.3 rdw-14.9 plt ct-180 05:20am blood glucose-100 urean-14 creat-0.3* na-143 k-3.9 cl-108 hco3-29 angap-10 . imaging: femur ap/lat: 1. increased callus formation about a right intertrochanteric hip fracture. no evidence of new fractures. 2. chronic remodeling changes in the right femoral head and acetabulum consistent with congenital hip dysplasia. . ultrasound left arm final report indication: 85-year-old woman with worsening redness in the left upper arm. patient has a peripherally inserted line in the left brachial vein. comparison: none. findings: a small amount of thrombus coats the picc line as it courses through the left subclavian. the thrombus does not adhere to the vessel wall. it is nonocclusive with preserved flow. there is normal -scale appearance, compressibility and color flow of the left ij, axillary and brachial veins. there is normal flow and compressibility of the basilic and cephalic veins. impression: minimal amount of thrombus coating the picc line in the left subclavian vein. vein is patent with color flow. . brief hospital course: 85 year old wheelchair-bound woman with a history of transverse myelitis, theapeutic on coumadin for prior dvts, admitted to micu for hypotension in the setting of acute laceration with supra-therapuetic inr. #acute blood loss anemia / hemorrhage / hypovolemic hypotension - patient admitted with hypotension thought to be both hypovolemic due to acute blood loss and distributive secondary to administration of iv morphine. over the first hours of her admission, she developed a rapidly expanding hematoma surrounding her laceration associated with a hematocrit drop from 37.5 to 17.3 in the setting of a supratherapeutic inr to 4.4. she was transfused 3 units of prbcs, 3 units of ffp and 10 mg of vitamin k. her bleeding stabilized and her hypotension resolved. warfarin was held throughout admission. morphine was also held out of concern for hypotension. #coagulopathy - patient was admitted with a supratheraputic inr due to coumadin use and consumption of coagulation factors due to bleeding. warfarin was held throughout admission. patient was given 10 mg vitamin k and 3 units of ffp. warfarin held at discharge; defer to outpatient providers whether to restart in outpatient setting (takes for history of bilateral dvt in ). #laceration/hematoma - patient admitted with laceration from fall, assoiciated with rapidly enlarging hematoma. patient seen by surgery in ed, who attempted primary closure of the wound but wound was unable to be closed due to edema and felt that stiches would not be effective because of her very thin fragile skin. she was placed on wound vac running at 75 mmhg continuous with follow up with surgery. the patient's pulses remained stable throughout admission. she is discharged to rehab for wound care. #chest pain - patient had a short episode of chest pain on admission in the context of a hematocrit of 17 and hypotension. she had no associated ekg changes. troponin rose from 0.01 to 0.1, but swiftly decreased to baseline over the course of the following day. chest pain likely due to demand ischemia from hypotension and profound anemia. the patient did not have any further episodes of chest pain or ekg changes. consider outpatient cardiac workup if clinically indicated. #history dvts - on chronic coumadin. coumadin held throughout admission due to acute bleed. upon normalization of inr and stabilization of bleed, the patient was resumed on heparin 5000 units sc tid. at this time, it was felt that anticoagulation could be held until the laceration and hematoma improved and then resumed at the primary care physician's discretion. ultrasound in of this year revealed chronic dvts, which have not progressed from previous ultrasound imaging in mid . # lue edema: the patient developed mild lue edema around her picc site. ultrasound showed a small amount of thrombus coating the picc line only. picc was removed. #gerd - chronic. home pantoprazole ec 20 mg daily continued on admission. #hyperlipidemia - chronic. simvastatin 10 mg qd continued on admission. #collagenous colitis - budesonide continued on admission. #glaucoma - brimonide 0.2% ot to right eye continued on admission. dorzolamide-timolol 2-0.5 % ot held as non-formulary. #constipation - chronic. docusate 100 mg continued. #code- dnr/ok to intubate transitional issues: no outstanding tests or incidental findings. there is the issue of anticoagulation which will need close follow up. as the patient became hypotensive and had severe bleed requiring multiple units of prbc to correct, it was thought that restarting her anticoagulation for chronic dvts was be too risky at this time. we will leave the decision of whether to restart anticoagulation following improvement of wound to outpatient doctors. medications on admission: - acetaminophen 325 mg tid - pantoprazole ec 20 mg qbreakfast - simvastatin 10 mg qd - budesonide er 9 mg qd - dorzolamide-timolol 2-0.5 % ot - lidocaine 5 %(700 mg/patch) top daily - oxycodone 5 mg po q4h prn - docusate 100 mg - senna with narcotics - warfarin 3-4 mg qd - brimonide 0.2% ot to right eye discharge medications: 1. pantoprazole 20 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po qam. 2. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. budesonide 3 mg capsule, delayed & ext.release sig: three (3) capsule, delayed & ext.release po daily (daily). 4. dorzolamide-timolol 2-0.5 % drops sig: one (1) drop ophthalmic (2 times a day). 5. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) topical once a day: 12 hours on and 12 hours off. 6. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 9. brimonidine 0.15 % drops sig: one (1) drop ophthalmic (2 times a day). 10. acetaminophen 500 mg tablet sig: two (2) tablet po three times a day. discharge disposition: extended care facility: - discharge diagnosis: primary: right thigh laceration, chronic deep vein thrombosis, transverse myelitis secondary: gerd, hyperlipidemia, collagenous colitis, glaucoma 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 ms. , it was a pleasure taking care of you at . you were found to have a severe laceration of your right thigh after transferring yourself from your toilet to wheelchair. you had a large bleed which was corrected by reversing your anticoagulation from warfarin and you were given red blood cells. surgery felt that in order for your wound to heal properly, you would need to go home with a wound vac to help the blood drain. they felt that suturing your wound would not be possible, because your skin is very sensitive from your steroid medication. please discuss anticoagulation with your primary care physician. the degree of your bleeding from your leg, the surgeons have recommended at least one week without anticoagulation from the time of your injury. please discuss whether or not you need to resume anticoagulation as an outpatient. the following changes were made to your medication regimen: increase acetaminophen three times daily for pain stop warfarin followup instructions: please attend the following appointments: department: general surgery/ when: tuesday at 1 pm with: acute care clinic building: lm bldg () campus: west best parking: garage procedure: venous catheterization, not elsewhere classified diagnoses: other and unspecified noninfectious gastroenteritis and colitis abnormal coagulation profile acute posthemorrhagic anemia other and unspecified hyperlipidemia long-term (current) use of anticoagulants personal history of venous thrombosis and embolism other accident caused by striking against or being struck accidentally by objects or persons wheelchair dependence other causes of myelitis multiple and unspecified open wound of lower limb, without mention of complication 

Answer: The patient is high likely exposed to