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: lipitor attending: chief complaint: brbpr major surgical or invasive procedure: egd x3 flex sig under anesthesia cortis cvl placement history of present illness: 65 y/o male with hx of colon cancer s/p subtotal colectomy with ileosigmoid anastomosis in , prostate cancer managed conservatively, cad s/p des about a year and half ago, presents with sudden onset of hematochezia. . this is the third episode of hematochezia in the last two weeks. he had a prostate biopsy on and 1 hour later he had severe lower gi bleed from the site of the biopsy which responded to packing in the ed. one week ago (last tuesday), he again developed second episode of hematochezia of the same intensity and was taken to osh where he was again packed. the next day, the packs were removed and this time he was bleeding. he had a quick flexsig when they noted a bleeding vessel at the site of the prostate biopsy that was clipped and the bleeding stopped. at ~9:00 pm, he strained for bowel movement and noticed brisk rectal bleeding. he was taken to an osh. at patient's request the ed physician did not put a packing but instead tried to stop bleeding by a foley baloon dilation but that failed to stop the bleed and he was transferred to for further management. . his initial vs in the ed was, 98, 71, 136/77, 14, 100% however in the ed his bp fell suddenly to sbp in 60s. he received a total of 5 units of prbcs in the ed, 2 units ffp and 1 unit platelets. a cordis was placed in right ij. the patient has been off asa and plavix for more than 5 days now after consultation with his cardiologist. he denies any abdominal pain. he was transferred urgently to thhe ir suite for possible embolization. on transfer to ir his vital signs were hr 91, bp 103/72, rr 17, spo2 100% on 2l nc. . radiology reported from ir that patient immediately started bleeding when packing was removed. bleeding appeared to be due to av fistula involving superior hemorrhoidal artery. six coils were placed with good result and no residual bleeding identified after rectal balloon deflated. serial hct in ir suite were 31.4, 26.9, 31.8. (in total he received 7 units prbc, 2 units ffp, 1 unit plt for blood products since arrival to .) he was then transferred to the icu. past medical history: colon cancer s/p subtotal colectomy with ileo sigmoid anastomosis in - coronary artery disease s/p des - high cholesterol - hypertension - low testosterone - obesity - prostate cancer on active surveillance social history: tobacco: denies etoh: beer 3-4 times per week illicits: denies, no ivda self employed and is rebuilding his business franchise family history: his father passed away from lung ca at age 62 and his mother died at 87 having had a prior cabg in her 80s. physical exam: vs: t 96.3, hr 92, bp 102/75, rr 13, o2sat 100% 2l nc gen: sedated, laying flat heent: perrl, eomi, no pallor, scleral edema neck: supple pulm: ctab anteriorly card: rrr, s1s2 normal, no m/r/g abd: s, nt, nd, nabs, verticle scar along left abdomen rectal: active bright red bleeding with clots pooling between legs ext: no edema, pulses 2+ pertinent results: imaging: cxr: findings: in comparison with the earlier study of this date, there has been placement of an orogastric tube that extends to the lower body of the stomach. the patient has taken a somewhat better inspiration. there is still atelectatic change at the left base, though this is less prominent than on the previous study. the right lung is clear. . ct abd: impression: 1. mild dilatation of the small bowel loops where oral contrast is located with a relatively collapsed loop at the distal jejunum/proximal ileum, but with more normal distal ileum. this could reflect normal small bowel distension due to oral contrast vs. a partial low-grade small-bowel obstruction. no free air. 2. small amount of free fluid surrounding the liver along with mostly pelvic retroperitoneal fluid. these findings are suggestive of fluid overload. 3. multiple subcentimeter hypodense lesions throughout the liver and are too small to characterize. the previously seen atypical fnh is also visualized. 4. small bilateral pleural effusions with associated compressive atelectasis. brief hospital course: 65 y/o male with hx of colon cancer s/p subtotal colectomy with anastomosis, prostate cancer, cad s/p des 1.5 years ago, who initially presented on with sudden onset of hematochezia, now s/p 13 units prbcs, 6 ffp, 3 units platelets and 2 units cryo, s/p hemrrhoidal artery coiling, transferred out of the micu to the floor with stable hcts and hemodynamics. . #. gib: upon arrival to the icu on , patient passed large bright red blood and clots x 2; he received 1 u prbcs, 1 u cryo on floor. surgery was consulted and took the patient to the or. under ga, they put a stitch in site of what looked like prior bleeding at the av fistula; and packed the rectum. patient remained intubated for egd, which showed some bright blood in oropharynx, probably ngt/intubation trauma and stomach full of food and coffee grounds, but no active bleeding. repeat egd on showed patient still had coffee grounds, and a suspected avm underlying the debris. ppi drip was subsequently started and patient was safely extubated. on , 3rd egd was done and showed showed laryngeal ulcer; ent was consulted and concluded ulcer was likely seondary to et tube trauma. he continued to have melena, and he recived an additional 2 units prbcs, hct increased from 26 to 31. in total, he has received 13 units prbcs, 6 ffp, 3 units platelets and 2 units cryo during this admission. thus, 2 sources currently suspected: upper gi bleed from avm, causing coffee grounds seen on ct scan and hemorrhoidal avm causing brbpr s/p prostate biopsy on . his hcts remained stable for the remainder of admission. . #. fevers: patient spiked a fever to 101.2 around the time of intubation; he was placed emperically on vanco/zosyn. ct abdomen/pelvis showed no source for fevers. antibiotics were subsquently stopped the next day as patient afebrile with no sourcelikely occured in the setting of induction for intubation absed on timing. no obvious source of infection, blood cultures ngtd, c diff negative. he remained afebrile remainder of admission. . #. cad/hyperlipidemia: asa, plavix initially held. aspirin 162 mg was restarted on . his plavix will be stopped on discharge. continued statin/ezetemibe . #. hypertension: metoprolol initially held, then restarted once hemodynamically stable. medications on admission: 1) acetaminophen 650 mg po q6h:prn pain 2) metoprolol tartrate 25 mg po daily 3) ezetimibe 10 mg po daily 4) rosuvastatin 40 mg po daily 5) aspirin 81 mg po daily 6) plavix 75 mg po daily (on hold for >5 days) discharge medications: 1. aspirin 81 mg tablet, chewable sig: two (2) tablet, chewable po daily (daily). 2. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 3. rosuvastatin 40 mg tablet sig: one (1) tablet po once a day. 4. metoprolol tartrate 25 mg tablet sig: one (1) tablet po daily (daily). 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 6. triamcinolone acetonide 0.05 % ointment sig: thin layer topical twice a day for 7 days: apply thin layer to affected area twice daily as needed for rash. disp:*qs * refills:*0* discharge disposition: home discharge diagnosis: upper and lower gastrointestinal bleeding contact dermatitis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were seen in the hospital because of an upper and lower gi bleed. you were transfused many units of red blood cells. you had an artery that was bleeding near your rectum, and this was coiled by interventional radiology. we also started you on a proton pump inhibitor called pantoprazole to help heal the bleed that was found in your upper gastrontenstinal tract. on discharge, you blood counts were all stable and there were no new signs of bleeding. you had developed a minor rash which was likely just an irritation from the sheets at the hospital. we are giving you some steroid ointment which you can use on this rash until it resolves. if your rash does not resolve within the next week please call your physician's office to have it further evaluated. because of this episode of bleeding, you should stop taking the plavix but continue to take aspirin. we made the following changes to your medications: stopped plavix started pantprazole twice a day started triamcinalone cream for your rash which you should use for the next 7 days it was a pleaure taking care of you during your hospital stay. followup instructions: please make an appointment to see your primary care doctor, dr. , within the next week at . you should also follow-up with the gi doctors. please call their office at ( to make an appointment within the next several weeks. procedure: other endoscopy of small intestine other endoscopy of small intestine other endoscopy of small intestine laryngoscopy and other tracheoscopy control of hemorrhage, not otherwise specified other endovascular procedures on other vessels rigid proctosigmoidoscopy diagnoses: pure hypercholesterolemia unspecified essential hypertension intestinal bypass or anastomosis status acute posthemorrhagic anemia percutaneous transluminal coronary angioplasty status diaphragmatic hernia without mention of obstruction or gangrene hemorrhage complicating a procedure other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure malignant neoplasm of prostate personal history of malignant neoplasm of large intestine obesity, unspecified leukocytosis, unspecified unspecified hemorrhoids with other complication edema dieulafoy lesion (hemorrhagic) of intestine acquired absence of intestine (large) (small) postprocedural fever contact dermatitis and other eczema due to other specified agents 

Answer: The patient is high likely exposed to