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: right upper quadrant pain status post laparoscopic cholecystectomy major surgical or invasive procedure: : exploratory laparotomy, abdominal hemorrhage washout and clot removal and suture ligation and argon beam coagulation of the gallbladder fossa bleeding with the cystic duct stump bleeding. history of present illness: 72 year old male had a laparoscopic cholecystectomy and intraoperative cholangiogram on at hospital. pathology was chronic cholecystitis. the patient was having low grade temperatures while he was on the surgical floor during his recovery and his blood cultures were positive for pan sensitive e.coli. he also developed new onset atrial fibrillation. he was on coumadin previously for stroke that lost his left upper vision but that had been held. after he had atrial fibrillation he was started on digoxin, verapamil and restarted on coumadin. he was discharged on on augmentin. he returned to the hospital with right upper quadrant ultrasound on and ct scan showed "ascites" so he was discharged home. he returns to the emergency department because his right upper quadrant pain increased significantly today. he denies nausea or vomiting. he has not had a bowel movement in 2 days. his bowel movements have all been small since surgery. he has not passed gas until arrival to the emergency department. he denies fever, chills or night sweats. past medical history: pmhx: type ii dm, htn, stroke 18 years ago with tia in , atrial fibrillation since surgery on , hyperlipidemia, h/o herpes infection, obesity. . pshx: laparoscopic cholecystectomy , right knee surgery, s/p t&a. social history: patient drinks rarely. quit smoking over 40 yrs ago. family history: non-contributory. physical exam: on admission: vital signs: t 95.1 hr 97 bp 121/78 rr 18 o2 sat 99% 2 l nc general: no acute distress lungs: clear to auscultation bilaterally cardiac: regular rate and rhythm, s1/s2 abdomen: soft, tender in the right upper quadrant, distended, no rebound, no guarding rectal: normal tone, no gross blood, guaiac negative . at discharge: avss/afebrile heent: sclerae anicteric. o-p clear. neck: supple. lungs: cta(b) cor: rrr abd: midline incision with ........ c/d/i. bsx4. appropriately tender to palpation along incision, otherwise soft/nt/nd. extrem: wwp; no c/c/e. neuro: a+ox3. non-focal/grossly intact. pertinent results: on admission: 09:24pm urine color-yellow appear-clear sp -1.016 09:24pm urine blood-mod nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 09:24pm urine rbc-62* wbc-4 bacteria-few yeast-none epi-0 09:24pm urine hyaline-3* 09:24pm urine mucous-rare 07:51pm type-art po2-129* pco2-49* ph-7.35 total co2-28 base xs-0 07:51pm glucose-199* lactate-2.1* 07:51pm freeca-1.21 07:37pm glucose-142* urea n-38* creat-2.7* sodium-142 potassium-4.9 chloride-108 total co2-26 anion gap-13 07:37pm calcium-8.4 phosphate-4.6* magnesium-1.8 07:37pm wbc-15.5* rbc-2.84* hgb-8.3* hct-23.6* mcv-83 mch-29.2 mchc-35.2* rdw-14.5 07:37pm plt count-249# 07:37pm pt-15.2* ptt-30.9 inr(pt)-1.3* 06:32pm glucose-181* lactate-3.7* na+-138 k+-4.8 cl--105 tco2-24 06:32pm hgb-7.8* calchct-23 06:32pm freeca-1.08* 11:00pm glucose-235* urea n-30* creat-2.3* sodium-141 potassium-4.9 chloride-102 total co2-24 anion gap-20 11:00pm alt(sgpt)-109* ast(sgot)-28 ck(cpk)-38* alk phos-200* tot bili-0.3 11:00pm lipase-29 11:00pm ctropnt-0.02* 11:00pm ck-mb-notdone 11:00pm wbc-31.0* rbc-3.68* hgb-10.5* hct-32.6* mcv-89 mch-28.6 mchc-32.2 rdw-13.8 11:00pm neuts-95.0* lymphs-3.0* monos-1.7* eos-0.2 basos-0.2 11:00pm plt count-776* 11:00pm pt-22.0* ptt-29.0 inr(pt)-2.1* . imaging: ap cxr: low lung volumes. no subdiaphragmatic free air. . abd x-ray: gaseous distention of the stomach. non-obstructive bowel gas pattern. please refer to ct abdomen/pelvis report for further details. . abd/pelvic ct w/contrast: 1. moderate amount of high density ascites which could reflect intraperitoneal blood. please correlate with hematocrit for signs of active bleeding. 2. incompletely characterized hepatic lesions that can be further characterized with mri. if concern for bile leak persists, the mri should be performed with eovist. 3. small pericardial effusion. 4. diverticulosis, no evidence of diverticulitis. 5. bilateral renal cysts. . echo: left ventricular wall thickness, cavity size and regional/global systolic function are normal but hyperdynamic (lvef >75%). the number of aortic valve leaflets cannot be determined. no aortic regurgitation is seen. no mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is a trivial/physiologic pericardial effusion. . gallbladder scan: no evidence of bile leak during the time of the study. . ct paracentesis: successful ct-guided aspiration of fluid in the right abdomen, which yielded frank blood, confirming hemoperitoneum. samples were sent for gram stain and culture, as well as hematocrit. . cxr: in comparison with the earlier study of this date, there is increasing retrocardiac opacification. this could represent lower lobe collapse with small effusion. in the appropriate clinical setting, however, the possibility of pneumonia would have to be considered. there has been interval placement of an endotracheal tube with its tip approximately 6.5 cm above the carina. right ij central catheter remains in place. nasogastric tube is in the upper stomach, with the tip now pointing towards the antrum. . unilat up ext veins us left port: no evidence of left upper extremity dvt. nonvisualization of the left cephalic vein. . microbiology: sputum gram stain-final; respiratory culture-final: gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 1+ (<1 per 1000x field): gram negative rod(s). respiratory culture (final ): this is a corrected report (). reported by phone to , , 3:04pm. commensal respiratory flora absent. bacillus species. 1 colony on 1 plate. previously reported as rare growth gram negative rod . . urine culture-final: no growth. abscess gram stain-final; wound culture-final; anaerobic culture-final: gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. wound culture (final ): no growth. anaerobic culture (final ): no growth. . blood culture-final: no growth. mrsa screen-final: negative. blood culture - final: no growth. brief hospital course: the patient was transferred and admitted to the general surgical service on for evaluation of right upper quadrant pain status post laparoscopic cholecystectomy on , which was performed at . admission abdominal/pelvic ct revealed a moderate amount of high density ascites which could reflect intraperitoneal blood. the study incompletely characterized hepatic lesions. the patient was admitted to the , made npo, started on iv fluid rescusitation, and started on iv vancomycin and meropenem for e. coli sepsis (blood cultures from osh grew e. coli). a gallbladder study performed on did not reveal a bile leak. a subsequent ct-guided aspiration of fluid from the right abdomen yielded frank blood, confirming hemoperitoneum. coumadin had been discontinued, and the inr reversed with a dose of vitamin k iv as well as 3 units of ffp. he also received 3 units of prbcs for a falling hematocrit down to 18.5 pre-operatively. . later on , the patient underwent exploratory laparotomy, abdominal hemorrhage washout and clot removal and suture ligation and argon beam coagulation of the gallbladder fossa bleeding with the cystic duct stump bleeding, which went well without complication (reader referred to the operative note for details). the patient received an additional 2 units of prbcs and ffps intra-operatively. after a brief, uneventful stay in the pacu, the patient was sent to the sicu intubated, npo with an ng tube, on iv fluids and continued on antibiotics, with a foley catheter and jp drain in place, briefly on iv neoepinephrine for pressure control, a propofol drip, and dilaudid iv prn for pain control. the patient was hemodynamically stable. . on pod#2, the patient was sucessfully extubated. the ng tube was discontinued, and the patient started on sips. empiric iv meropenem was discontinued. on pod#3, the patient was transferred to the floor. . post-operative pain was initially well controlled with the dilaudid iv prn, which was converted to oral pain medication when tolerating clear liquids. the patient was advanced to clears on pod#3. diet was progressively advanced as tolerated to a diabetic regular diet by pod#5. the foley catheter was discontinued at midnight of pod#5. the patient subsequently voided without problem. jp was discontinued on pod#6. lovenox and coumadin were started on pod#6 given the patient's history of atrial fibrillation and tia. once the patient's inr is therapeutic, the lovenox will be discontinued. at discharge, his inr was 1.5. inr goal 2.5; therapeutic range 2-3. his primary care provider (pcp) has kindly agreed to manage this transition. . during this hospitalization, the patient ambulated early and frequently, was adherent with respiratory toilet and incentive spirrometry, and actively participated in the plan of care. the patient received subcutaneous heparin and venodyne boots were used during this stay. the patient's blood sugar was monitored regularly throughout the stay; sliding scale insulin was administered when indicated. labwork was routinely followed; electrolytes were repleted when indicated. . at the time of discharge, the patient was doing well, afebrile with stable vital signs. the patient was tolerating a diabetic regular diet, ambulating, voiding without assistance, and pain was well controlled. he will continue on the lovenox-coumadin bridge. he was discharged home with vna services. the patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. medications on admission: 1. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 2. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 3. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever or pain. 4. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 5. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 6. verapamil sr 240mg 1 tab po daily. 7. vitamin d oral 8. vitamin c oral 9. multivitamin tablet sig: one (1) tablet po once a day. 10. acyclovir 400 mg tablet sig: one (1) tablet po twice a day. 11. aspirin 325 mg tablet sig: one (1) tablet po once a day. discharge medications: 1. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 2. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 3. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever or pain. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation: over-the-counter. 6. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 7. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 9. vitamin d oral 10. vitamin c oral 11. multivitamin tablet sig: one (1) tablet po once a day. 12. acyclovir 400 mg tablet sig: one (1) tablet po twice a day. 13. aspirin 325 mg tablet sig: one (1) tablet po once a day. 14. hydromorphone 2 mg tablet sig: 1-2 tablets po every hours as needed for pain. disp:*40 tablet(s)* refills:*0* 15. metformin 500 mg tablet sig: 0.5 tablet po once a day. 16. warfarin 2.5 mg tablet sig: one (1) tablet po daily in the evening. disp:*30 tablet(s)* refills:*0* 17. enoxaparin 80 mg/0.8 ml syringe sig: one (1) 0.8ml (80mg) subcutaneous every twelve (12) hours. disp:*14 pre-filled syringe* refills:*1* discharge disposition: home with service facility: visiting nurse of greater discharge diagnosis: primary: 1. intra-abdominal hemorrhage. 2. e.coli sepsis 3. acute renal failure . secondary: 1. new onset atrial fibrillation 2. h/o cva and tia 3. type ii dm 4. htn discharge condition: mental status: clear and coherent level of consciousness: alert and interactive activity status: ambulatory - independent discharge instructions: please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. avoid driving or operating heavy machinery while taking pain medications. please follow-up with your surgeon and primary care provider (pcp) as advised. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical 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. . coumadin (warfarin): what is this medicine used for? this medicine is used to thin the blood so that clots will not form. how does it work? warfarin changes the body's clotting system. it thins the blood to prevent clots from forming. what you should contact your healthcare provider : signs of a life-threatening reaction. these include wheezing; chest tightness; fever; itching; bad cough; blue skin color; fits; or swelling of face, lips, tongue, or throat, severe dizziness or passing out, falls or accidents, especially if you hit your head. talk with healthcare provider even if you feel fine, significant change in thinking clearly and logically, severe headache, severe back pain, severe belly pain, black, tarry, or bloody stools, blood in the urine, nosebleeds, coughing up blood, vomiting blood, unusual bruising or bleeding, severe menstrual bleedin, or rash. call your doctor if you are unable to eat for several days, for whatever reason. also call if you have stomach problems, vomiting, or diarrhea that lasts more than 1 day. these problems could affect your coumadin??????/warfarin dosage. coumadin (warfarin) and diet: certain foods and beverages can impair the effect of warfarin. for this reason, it's important to pay attention to what you eat while taking this medication. until recently, doctors advised taking warfarin to avoid foods high in vitamin k. this is because large amounts of vitamin k can counteract the benefits of warfarin. however, recent research shows that rather than eliminating vitamin k from your diet, it is more important to be consistent in your dietary vitamin k intake. these foods contain vitamin k: fruits and vegetables, such as: kiwi, blueberries, broccoli, cabbage, sprouts, green onions, asparagus, cauliflower, peas, lettuce, spinach, turnip, collard, and mustard greens, parsley, kale, endive. meats, such as: beef liver, pork liver. other: mayonnaise, margarine, canola oil, soybean oil, vitamins, soybeans and cashews. limit alcohol. alcohol can affect your coumadin??????/warfarin dosage but it does not mean you must avoid all alcohol. serious problems can occur with alcohol and coumadin??????/warfarin when you drink more than 2 drinks a day or when you change your usual pattern. binge drinking is not good for you. be careful on special occasions or holidays, and drink only what you usually would on any regular day of the week. monitoring: the doctor decides how much coumadin??????/warfarin you need by testing your blood. the test measures how fast your blood is clotting and lets the doctor know if your dosage should change. if your blood test is too high, you might be at risk for bleeding problems. if it is too low, you might be at risk for forming clots. your doctor has decided on a range on the blood test that is right for you. the blood test used for monitoring is called an inr. use of other medications: when coumadin??????/warfarin is taken with other medicines it can change the way other medicines work. other medicines can also change the way coumadin??????/warfarin works. it is very important to talk with your doctor about all of the other medicines that you are taking, including over-the-counter medicines, antibiotics, vitamins, or herbal products. followup instructions: please call ( to arrange a follow-up appointment with dr. (pcp) in weeks. . , np (surgery service) will contact you in the next few days to arrange a time to return for staple removal. you may call ( to speak to mr. with questions. . please call ( to schedule a follow-up appointment with dr. (surgery) in 2 weeks. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified percutaneous abdominal drainage other laparotomy diagnoses: unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified atrial fibrillation personal history of tobacco use sepsis other and unspecified hyperlipidemia hemorrhage complicating a procedure other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation long-term (current) use of anticoagulants other ascites personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits obesity, unspecified hypovolemia septicemia due to escherichia coli [e. coli] leukocytosis, unspecified 

Answer: The patient is high likely exposed to