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: 1. colon cancer 2. recurrent ventral hernia major surgical or invasive procedure: : 1. exploratory laparotomy. 2. removal of mesh. 3. left colectomy. 4. ventral hernia repair with component separation. history of present illness: 79m w multiple medical problems who on screening colonoscopy was found to have a descending colon adenocarcinoma. preoperatively, patient denies any symptoms that could be related to his diagnosed cancer, including bleeding, abdominal pain, nausea, vomiting, change in bowel movements, change in size of bowel movements, constipation or any other problems. does have a large lump on his belly, which looks like an incarcerated hernia and occasionally causes him some discomfort; however, he never had any obstruction symptoms from this. at this point, he is feeling well and does not have any concerns. past medical history: # colon adenocarcinoma # diabetes type 2 # cad status post stent # hypertension # svt (avnrt) status post ablation # hypercholesterolemia # rib fracture # dislocated right shoulder # reactive airway disease during the winter months, # epigastric hernia that was repaired in under general anesthesia # cataract surgery of his left eye. social history: - spanish speaking - lives alone in a senior housing apartment - has 3 sons in the area - tobacco: 20 pack year smoking history. quit 15 years ago. - alcohol: none. quit many years ago - illicits: none family history: mother died of unknown causes. father died of heart disease at the age of 86, had heart disease starting in his 50s. sister has diabetes. physical exam: physical exam on discharge tmax: 99.3 ??????f, tcurrent: 97.5??????f, hr: 75-108bpm, bp (126-150)/(57-84)mmhg, rr 22 insp/min, spo2 98% on ra general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: reduced bs on left, + wheeze cv: tachy, pmi not displaced, no murmors appreciated abdomen: soft, non-distended, non-tender; gu: + foley ext: palpable pulses, 1+ lower extremity edema, + stockings pertinent results: ================= labs ================= - cbc with differentials: wbc-7.2 rbc-3.62* hgb-10.0* hct-30.7* mcv-89 mch-27.7 mchc-31.1 rdw-16.3* plt ct-276 neuts-79* bands-0 lymphs-14* monos-4 eos-3 baso-0 atyps-0 metas-0 myelos-0 - chem 6: urean-27* creat-1.4* na-143 k-4.5 cl-110* hco3-21* - cardiac enzymes @ 1:52pm: ck(cpk)-453* ck-mb-4 ctropnt-0.04* - cardiac enzymes @ 10:22pm: ck(cpk)-699* ck-mb-4 ctropnt-0.05* - chem 7: glucose-139* urean-38* creat-2.2* na-142 k-5.0 cl-109* hco3-20* - cardiac enzymes @ 06:36am: ck(cpk)-1124* ck-mb-4 ctropnt-0.04* - ck (cpk) @ 02:22pm: 1268* - lactate: 2.7* - ua: coloer-yellow appear-hazy sp -1.016 blood-sm nitrite-neg protein-30 glucose-neg ketone-10 bilirub-neg urobiln-neg ph-5.0 leuks-sm rbc-16* wbc-7* bacteri-few yeast-none epi-<1 casthy-5* amorphx-rare mucous-rare eos-negative - urine lytes: urean-470 creat-162 na-15 k-90 cl-44 calcium-0.6 uric ac-18.3 osmolal-440 - lfts: alt-16 ast-31 alkphos-79 totbili-0.3 - ck (cpk) @ 5:35am: 1171* - cbc: wbc-9.1 rbc-2.25* hgb-6.5* hct-19.8* mcv-88 mch-28.7 mchc-32.6 rdw-17.0* plt ct-247 - cardiac enzymes @ 08:30pm: ck (cpk) 688* ck-mb-3 ctropnt-0.03* - lactate: 1.3 - cbc: wbc-6.1 rbc-3.08* hgb-9.0* hct-27.2* mcv-88 mch-29.1 mchc-33.0 rdw-16.6* plt ct-272 - chem 7: glucose-181* urean-47* creat-1.7* na-142 k-3.6 cl-102 hco3-28 =================== microbiology =================== - abdominal wound swab: 1+ polymorphonuclear leukocytes, wound culture negative, ngtd anaerobics - urine cx- negative - blood cx 1x- ngtd : c. diff: positive ================== imaging ================== - cxr: left lower lobar collapse with small pleural effusion. diaphragmatic injury from procedure is possible, but unlikely. - cxr: increased moderate biventricular congestive heart failure. - echo: the left atrium is mildly dilated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). the estimated cardiac index is normal (>=2.5l/min/m2). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. the mitral valve leaflets are mildly thickened. there is mild anterior leaflet mitral valve prolapse. an eccentric, inferolaterally directed jet of mild-moderate (+) mitral regurgitation is seen. due to the eccentric nature of the regurgitant jet, its severity may be significantly underestimated (coanda effect). there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mitral valve prolapse with at least mild-moderate mitral regurgitation. mild pulmonary artery systolic hypertension. normal biventricular cavity sizes with preserved global and regional biventricular systolic function. compared with the prior study (images reviewed) of , the estimated pulmonary artery systolic pressure is now higher. the other findings are similar. path : 1.7cm colonic adenocarcinoma t1n1amx; lymph nodes positive brief hospital course: 79 yo spanish speaking m w/ colon adenocarcinoma (dx in ), dm, cad s/p stent lad/first diag (), svt s/p ablation, htn, dlp, cri (cr 1.4) s/p left colectomy with component separation/ventral hernia repair, drainage of abcess related to old abdominal mesh. immediate postoperative course c/b hypertension, tachycardia, and hypoxia transferred to for further care. consults were obtained from the icu, cardiology and geriatrics for assistance with this patient's care. neuro: pre-operatively, an epidural was placed for pain control. post-operatively, the patient continued with epidural anesthesia with good effect and adequate pain control. epidural was removed on pod4 and pain control managed with intermittent morphine iv. when tolerating oral intake, the patient was transitioned to oral pain medications. per recommendations from geriatrics, narcotic pain medications were discontinued on pod9 secondary to increased risk delirium in geriatric population. pain control then managed with non-narcotic po medication. cv: the patient was initially hypertensive postoperatively but then became hypotensive likely secondary to chf. cardiac enzymes were drawn times three to rule out myocardial infarction and they were negative. a cardiology consult was sought on pod3, there assessment was that underlying mitral regurgitation, continued hypertension, and overall positive fluid balance since surgery were contributing to his chf picture. a tte was obtained on pod3 and results are above. patient was found to be intermittently in atrial fibrillation and recommendations per cardiology were followed-beta blocker, amlodipine were titrated to appropriate heart rate and blood pressure. patient's fluid balance was carefully monitored and he intermittently received lasix vs fluid to achieve euvolemia such that he was adequately supported from a cardiovascular standpoint without fluid overload compromising his pulmonary status. patient also was transfused packed rbcs when appropriate to maintain adequate volume status without fluid overload. patient's vital signs were routinely monitored. pulmonary: postoperatively, patient required non-rebreather in icu setting to maintain oxygenation. as patient was diuresed oxygen requirement diminished and patient was transferred to floor on pod6 on supplemental oxygen via nasal canula and intermittent nebulizer treatments for shortness of breath/wheezing. the patient's fluid balance was balanced as per above. patient with baseline copd and patient received intermittent cxr's in addition to monitoring of vital signs to achieve adequate oxygen saturation. gi/gu: post-operatively, the patient was given iv fluids until tolerating oral intake. he was found to have elevated creatinine postoperatively consistent with atn per his fena. he was hydrated judiciously and his renal function eventually returned to baseline. patient's ace inhibitor was held during admission secondary to increased creatinine. it may be restarted per his pmd after assessment of renal function one week postoperatively. his diet was advanced when appropriate, which was tolerated well. foley was maintained throughout admission and will be continued following discharge given sensitive fluid balance issues and need for urine output monitoring. intake and output were closely monitored. id: the patient was given appropriate preoperative antibiotics. these were continued postoperatively (cipro/flagyl) as empiric coverage for possible infection. on pod4, patient was found to be positive for c diff and started on po vancomycin and iv flagyl. patient's number of bowel movements decreased on antibiotic therapy and he will be discharged to complete a 10 day course. the patient's temperature was closely watched for signs of infection. endocrine: patient was maintained on an insulin sliding scale and diabetic appropriate diet secondary to his dm2. geriatrics assisted in management of his blood sugars which hem/onc: patient transfused as per above to maintain adequate cardiopulmonary function. pathology showed t1n1amx colonic adenocarcinoma. he will be followed by medical oncology and surgery for management of this issue. prophylaxis: the patient received subcutaneous heparin during this stay, and was encouraged to get up and ambulate as early as possible. at the time of discharge on pod#14, the patient was doing well, afebrile with stable vital signs, tolerating a regular diet, ambulating with assistance, with a foley in place, and pain was well controlled. medications on admission: home medications: amlodipine 5 mg daily atorvastatin 40 mg daily lisinopril-hydrochlorothiazide 20 mg-25 mg daily metoprolol tartrate 50 mg daily nitroglycerin 0.4 mg tablet, sublingual prn ranitidine hcl 150 mg tablet sitagliptin 50 mg daily aspirin 325 mg tablet daily medications upon transfer to : heparin 5000 unit sc bid 1000 ml lr continuous at 85 ml/hr hydromorphone 10 mcg/ml + bupivacaine 0.1% 1 mg/ml ed insulin sc (per insulin flowsheet) acetaminophen 1000 mg po tid ipratropium bromide neb 1 neb ih q6h ciprofloxacin 200 mg iv q12h metoclopramide 10 mg iv q6h metronidazole (flagyl) 500 mg iv q8h order date: @ 1243 diphenhydramine 12.5-25 mg po/iv q6h:prn itching metoprolol tartrate 10 mg iv q6h droperidol 0.625 mg iv q6h:prn nausea nitroglycerin sl 0.4 mg sl prn chest pain enalaprilat 0.625 mg iv q6h ondansetron 4 mg iv q6h:prn nausea famotidine 20 mg iv q24h discharge medications: 1. acetaminophen 650 mg/20.3 ml solution sig: 20.3 ml po q6h (every 6 hours) as needed for pain. 2. vancomycin 125 mg capsule sig: one (1) capsule po q6h (every 6 hours) as needed for c diff for 4 days. disp:*40 capsule(s)* refills:*0* 3. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical (2 times a day) as needed for pruritis. 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain. 7. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) treatment inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 8. ipratropium bromide 0.02 % solution sig: one (1) treatment inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 9. metronidazole 500 mg tablet sig: one (1) tablet po three times a day for 4 days. disp:*30 tablet(s)* refills:*0* 10. cholestyramine-sucrose 4 gram packet sig: one (1) packet po bid (2 times a day) for 10 days: please give no sooner than three hours prior to vancomycin dosing. thank you. . 11. aspirin 325 mg tablet sig: one (1) tablet po once a day. 12. toprol xl 200 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 13. januvia 50 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: - discharge diagnosis: colon cancer discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the colorectal surgery service for open left colectomy and ventral hernia repair. please call your doctor or go to the emergency department if: *you experience new chest pain, pressure, squeezing or tightness. *you develop new or worsening cough, shortness of breath, or wheeze. *you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience an unusual discharge. *your pain is not improving within 12 hours or is not under control within 24 hours. *your pain worsens or changes location. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *you develop any concerning symptoms. general discharge instructions: please resume all regular home medications, unless specifically advised not to take a particular medication. please take any new medications as prescribed. please take the prescribed analgesic medications as needed. you may not drive or heavy machinery while taking narcotic analgesic medications. you may also take acetaminophen (tylenol) as directed, but do not exceed 4000 mg in one day. please get plenty of rest, continue to walk several times per day, and drink adequate amounts of fluids. avoid strenuous physical activity and refrain from heavy lifting greater than 10 lbs., until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. please also follow-up with your primary care physician. incision care: *please call your surgeon or go to the emergency department if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until cleared by your surgeon. *you may shower and wash incisions with a mild soap and warm water. gently pat the area dry. *if you have staples, they will be removed at your follow-up appointment. *if you have steri-strips, they will fall off on their own. please remove any remaining strips 7-10 days after surgery. followup instructions: please follow up with dr. in three weeks. call ( for an appointment. thank you. procedure: open and other left hemicolectomy incisional hernia repair central venous catheter placement with guidance diagnoses: acidosis anemia, unspecified esophageal reflux pure hypercholesterolemia mitral valve disorders acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled cardiac complications, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation acute on chronic diastolic heart failure personal history of tobacco use percutaneous transluminal coronary angioplasty status chronic kidney disease, unspecified pulmonary collapse intestinal infection due to clostridium difficile other respiratory complications dermatitis due to drugs and medicines taken internally hypoxemia chronic obstructive asthma, unspecified peritoneal abscess leukocytosis, unspecified infection and inflammatory reaction due to other internal prosthetic device, implant, and graft incisional ventral hernia with obstruction other drugs and medicinal substances causing adverse effects in therapeutic use other specified diseases of hair and hair follicles malignant neoplasm of descending colon 

Answer: The patient is high likely exposed to