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: bright red blood per rectum major surgical or invasive procedure: colonoscopy. history of present illness: 80m with a h/o copd and htn, prostate ca, s/p xrt 10yrs ago, presents to the ed after 2 days of brpbpr. reportedly woke up on with sheets soaked with brb. got up, showered, denied n/v/dizzy/lightheadedness, denied cp, sob, went back to bed. woke up with less amount of brbpr, worried, called pcp. pt, pcp : last () clean c-scope, so nothing to worry about. pt went golfing, completed 2 holes, then noted pants soaked in blood. went to the ed. hct 37 reportedly on admission. in ed, reportedly, tablespoons every 10-20mins, incontinent of stool. still blood with no stool. no hematemesis or hematochezia. no chest pain, no sob. no syncope or pre-syncope. hct was as low as 29, and pt reportedly given 4units of prbcs. enzymes were checked, and he had a + mb fraction, but no ekg changes, trop 0.03 thought to be an nstemi due to demand--pt was asymptomatic. he was continued on his betablocker, aspirin was held due to ongoing bleeding. transferred to osh icu, underwent a c-scope: showed bleed in sigmoid colon and left colon with no definite source that could be identified. hct 30.2 on at osh. hct 37 on . at least 1 episode of hypot (bp 89/60) at osh, given fluids and 2u prbcs-->hypot quickly resolved to bp 120/80. notes mention possible need for angiography of the to localize the source of the bleeding; therefore pt was transferred to for further workup/management. . upon arrival to , pt denies cp, sob, dizziness, lh. he was tachycardic to 120s, other vital signs were stable. no frank rectal bleeding, but bright red blood in the rectal vault. past medical history: copd (fev 0.7, on home o2-2lnc) ef 55-60% htn hyperlipidemia prostate ca s/p xrt->10yrs ago. diverticulosis of sigmoid colon h/o gi bleed 6-7yrs ago ( radiation proctatitis) social history: h/o tobacco 3ppd for many yrs, quit 20yrs ago. no illicits, occ etoh. lives with his wife. retired, formerly was small business owner. enjoys golf. family history: noncontributory. physical exam: admission exam vs: temp: 97.6 bp: 123-151/73-91; hr: 113-119 rr: 19 o2sat: 96% gen: pleasant, comfortable, nad, very hard of hearing heent: perrl, eomi, anicteric, mmm, op without lesions neck: no supraclavicular or cervical lymphadenopathy, no jvd, no carotid bruits, no thyromegaly or thyroid nodules resp: barrel chested. diffuse wheezing. good air movement. no crackles cv: rr, s1 and s2 wnl, hyperdynamic, 2/6 sem at apex increases with inspiration. abd: soft, distended, + bs. non-tender. no clear organomegaly identified. ext: no c/c/e. cool. faint, but palpable pulses. skin: no rashes/no jaundice neuro: aaox3. cn ii-xii intact. 5/5 strength throughout. no sensory deficits to light touch appreciated. no pass-pointing on finger to nose. 2+dtr's-patellar and biceps rectal: bright red blood in rectal vault. pertinent results: 05:53pm glucose-118* urea n-17 creat-0.9 sodium-139 potassium-3.7 chloride-105 total co2-27 anion gap-11 05:53pm alt(sgpt)-16 ast(sgot)-22 ld(ldh)-152 ck(cpk)-116 alk phos-60 tot bili-0.5 05:53pm ck-mb-9 ctropnt-<0.01 05:53pm calcium-8.3* phosphate-2.3* magnesium-2.0 05:53pm wbc-12.9* rbc-3.40* hgb-10.3* hct-28.8* mcv-85 mch-30.1 mchc-35.6* rdw-14.9 05:53pm plt count-174 05:53pm pt-13.2* ptt-27.7 inr(pt)-1.2* brief hospital course: pcp: . outside hospital lab results: fe 81 tibc: 292 transferrin: 208.8 . creat: 1.4 at time of discharge ( baseline) . ck 194-->211 ckmb 6.4-->12.1 tnt: 0.03 . inr 1.0 . wbc: 11.7 hct 37.0 on discharge: 31.0 pre-transfusion(on admisson): down to 29.8 on the day of xfer s/p 4 units prbc's. plt: 268 . tsh 1.29 ekg: . nsr 100. nml axis. occ pvcs. no ischemic changes. at : sinus tach 110, normal axis. normal intervals 0. depressions v3, v4, v5 . imaging: cxr at osh showed l basilar density, unknown if new or old. r foot xray: no acute fracture or dislocation is seen. there is an apparent lucency noted in the first distal phalanx. this lucency extends to the articular surface of the interphalangeal joint and has well circumscribed but nonsclerotic margins. this is best evaluated on the frontal and oblique radiographs and is not well seen on the lateral radiograph. no additional lytic or sclerotic lesions are seen. there is enthesopathy at the insertion of the achilles tendon and a small plantar calcaneal spur. there is also trace vascular calcification. the soft tissues are unremarkable. impression: 1. apparent well circumscribed lucency in the first distal phalanx. further evaluation with cross-sectional imaging is advised. 2. no acute fracture or dislocation. . colonoscopy at osh: bleeding from sigmoid and l colon area. no bleeding in terminal ileum, r colon, xverse colon. multiple diverticuli in sigmoid colon. couldn't locate the source of bleeed. . echo at osh: ef 70% lv hyperdynamic lvot flow acceleration at rest, increased with valsalva rv normal trace mr . no focal wmas ******************** 80m with 2d of brbpr likely due to diverticular bleed, s/p c-scope unable to localize source of bleeding, transferred to for further workup and managment of the bleeding. the bleeding had slowed dramatically by transfer. colonoscopy at revealed extensive diverticular disease of the sigmoid colon without active bleeding. the patient's hct stabilized at ~25 for 24 hours, and on the patient left against medical advice. he and his wife stated that they understood that the medical team wanted to continue to monitor his hct, to obtain a pt consult as the patient had been bedbound for 5 days. the patient and his wife also stated their understanding that the patient was at risk to rebleed acutely, which could have devastating results. . #gi: brbpr- unlikely upper gi source per colonoscopy, original bleeding form the sigmoid, left colon per osh. at admission the pt had bright red blood in the rectal vault. he was admitted to the micu for close observation initially. he remained remained hemodynamically stable; hct remained ~25 x 24 hours; therefore he was transferred to the floor on . a repeat colonoscopy on revealed sigmoid diverticular disease but no active bleeding. 1 unit prbc's transfused to maintain hct >25. per gi, the patient should see surgery in outpatient follow up for consideration of a partial colectomy given his extensive sigmoid diverticular disease and high risk of re bleeding. #cv: ischemia: ckmb elevation at outside hospital; diagnosed with nstemi. this is likely due to demand ischemia in the setting of acute blood loss/anemia. there was no troponin elevation, no ekg changes, and the patient was asymptomatic throughout. the patient was started on a statin and continued on a betablocker. aspirin was held given gi bleed. a repeat ekg at was unchanged from osh. we continued the betablocker and statin. the patient will follow up with his pcp for discussion of initiation of asa therapy. pump: htn, tte ot osh revealed: ef of 70%, hyperdynamic, with no wall motion abnormalities. betablocker was continued; ace-i was restarted on (after stabilization of blood pressure). rhythm: the patient had intermittant sinus tachycardia to the 120s, thought to be due to hypovolemia and + increased catechols. this resolved overnight with ivf hydration. risk factors: htn, hyperlipidemia: on beta-blocker, ace-i, statin. . #pulmonary: pt has a history of copd, on home o2. he was chronically wheezy on exam and was found to have a ?left lower lobe infiltrate on cxr at osh. he was maintained on albuterol/atrovent nebs, his advair was continued. he maintained o2 sats of 92-96% on 2lnc. . #renal: the patient's creatinine was 1.4 on admission (baseline unknown). this was likely due to hypovolemia from his gib, and resolved with ivf hydration (0.8 on ). . #heme: anemia: gib, but also has a h/o iron deficiency anemia, on iron supplementation at home. the patient reportedly required 4 units prbc at the osh and did require one unit prbc transfusion at to maintain hct >25. iron supplements were continued. . #r foot pain: the patient reported acute onset foot pain over r 5th mtp joint. he denied h/o trauma; has no preceding h/o gout. he was found to be tender on exam w/ overlying edema, no erythema. foot xray revealed no acute process, but did reveal a well circumscribed lucency in the first distal phalanx. we recommend an outpatient mri as follow up. the patient's foot pain markedly improved spontaneously by . #prophylaxis: the patient was put on pneumoboots as pe prophylaxis. full code #comm: wife: : . medications on admission: lopressor (? dose) lisinopril hctz feso4 advair 250/50 nexium 40 lipitor 40 qd discharge medications: 1. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 2. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). tablet(s) 4. lisinopril 2.5 mg tablet sig: one (1) tablet po daily (daily). 5. ferrous sulfate 325 (65) mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 6. outpatient lab work please check complete blood count discharge disposition: home discharge diagnosis: diverticulosis. gi bleed. nstemi. discharge condition: stable. discharge instructions: **patient is leaving against medical advice** during this admission you have been treated for a gi bleed due to diverticulosis. you also had a small heart attack (which is called a nstemi) while at hospital. please continue to take all medications as prescribed. if you notice any recurrent bleeding from your rectum, or if you feel lightheaded, dizzy, experience chest pain or shortness of breath, or any other symptom that is concerning to you, please seek immediate medical care. in addition, the x-ray of your right foot showed a small abnormality in your 1st toe (a lucency of the distal phalanx); we recommend obtaining an mri to further evaluate this finding. followup instructions: have your hematocrit checked tomorrow and follow up with your pcp . you should have your bun and cr (kidney finction) checked in weeks. follow up with a surgeon in the next weeks. obtain an elective mri of r foot. procedure: colonoscopy transfusion of packed cells diagnoses: subendocardial infarction, initial episode of care unspecified essential hypertension acute posthemorrhagic anemia chronic airway obstruction, not elsewhere classified personal history of malignant neoplasm of prostate hypovolemia diverticulosis of colon with hemorrhage 

Answer: The patient is high likely exposed to