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: abdominal pain major surgical or invasive procedure: sigmoidoscopy followed by exploratory laparotomy, washout and resection of perforated sigmoid, procedure. history of present illness: 49m placed 14 inch foreign body up to hilt into rectum. he felt immediate pain and took the foreign body out, which yielded to blood. one hour later, he felt significant abdominal pain in bilateral lower quadrants (l>r). he did have associated nausea, vomiting, and chills. the next morning the pt gave himself a water enema after which the water did not come out. he presents to the ed with worsening abdominal pain. past medical history: male xx with hypogonadism, on testerone iron deficiency anemia hemorrhoids social history: works as a cpa physical exam: on admission: 101, 145, 165/112, 18, 99ra gen: appears uncomfortable cv: rapid heart rate chest: clear to auscultation bilaterally abd: rigid, diffuse tenderness, diffuse peritoneal signs rectal: refused secondary to pain per ed, guiac negative pertinent results: 06:35am blood wbc-6.1 rbc-3.10* hgb-9.9* hct-30.0* mcv-97 mch-31.9 mchc-33.0 rdw-14.0 plt ct-232 08:45am blood wbc-6.2# rbc-3.31* hgb-10.4* hct-31.9* mcv-97 mch-31.5 mchc-32.6 rdw-13.9 plt ct-155 04:10am blood wbc-12.6* rbc-3.31* hgb-11.0* hct-32.8* mcv-99* mch-33.1* mchc-33.4 rdw-13.6 plt ct-131* 04:30am blood wbc-12.9* hct-32.1* plt ct-121* 04:06am blood wbc-9.2 rbc-3.53*# hgb-11.5*# hct-33.9* mcv-96 mch-32.6* mchc-33.9 rdw-13.5 plt ct-153 03:56pm blood hct-36.1*# 10:15am blood wbc-7.1# rbc-5.21 hgb-16.6 hct-49.5 mcv-95 mch-31.9 mchc-33.6 rdw-13.3 plt ct-290 04:06am blood neuts-61 bands-7* lymphs-12* monos-9 eos-0 baso-0 atyps-2* metas-4* myelos-5* 10:15am blood neuts-81* bands-8* lymphs-6* monos-3 eos-0 baso-0 atyps-1* metas-0 myelos-1* 04:06am blood hypochr-normal anisocy-normal poiklo-normal macrocy-occasional microcy-normal polychr-normal 10:15am blood hypochr-normal anisocy-normal poiklo-occasional macrocy-normal microcy-normal polychr-normal ovalocy-occasional 06:35am blood plt ct-232 08:45am blood plt ct-155 04:10am blood plt ct-131* 04:06am blood plt ct-153 10:15am blood plt smr-normal plt ct-290 10:15am blood pt-13.2 ptt-21.8* inr(pt)-1.2 09:55am blood glucose-109* urean-16 creat-0.8 na-140 k-3.8 cl-105 hco3-26 angap-13 04:30am blood glucose-78 urean-14 creat-0.9 na-137 k-4.3 cl-103 hco3-26 angap-12 12:52pm blood glucose-87 urean-16 creat-1.1 na-138 k-4.3 cl-106 hco3-24 angap-12 04:06am blood glucose-88 urean-17 creat-1.2 na-135 k-4.8 cl-105 hco3-22 angap-13 03:56pm blood glucose-128* urean-15 creat-1.0 na-137 k-5.1 cl-109* hco3-19* angap-14 10:15am blood glucose-183* urean-18 creat-1.6* na-142 k-5.0 cl-101 hco3-24 angap-22* 09:55am blood calcium-8.5 phos-2.7 mg-1.8 04:30am blood calcium-8.1* phos-2.5* mg-1.8 12:52pm blood calcium-8.2* phos-3.6 mg-2.1 07:45am blood mg-1.8 04:06am blood calcium-8.3* phos-4.5 mg-1.0* 03:56pm blood calcium-7.7* phos-3.0 07:53am blood type-art po2-84* pco2-42 ph-7.37 calhco3-25 base xs-0 04:08pm blood type-art po2-436* pco2-38 ph-7.34* calhco3-21 base xs--4 03:02pm blood type-art po2-214* pco2-34* ph-7.37 calhco3-20* base xs--4 intubat-intubated 07:53am blood lactate-1.5 04:08pm blood lactate-4.1* 03:02pm blood glucose-100 lactate-4.6* na-135 k-4.3 cl-108 03:02pm blood hgb-10.8* calchct-32 07:53am blood freeca-1.18 03:02pm blood freeca-1.06* axr: no foreign body found. no free air identified on this limited supine view of the abdomen which does not visualize the hemidiaphragms. cxr: 1. a sliver of free air is seen under both hemidiaphragms. 2. no pneumothorax ekg: sinus tachycardia. since the previous tracing of sinus tachycardia has appeared and the axis has shifted leftward. no other diagnostic changes. pathology: colon, segmental resections, two: 1. perforated sigmoid (a-h): a. endocrine cell tumor, slides b and c, subserosal, up to 1.7 mm; see note. b. perforation with associated fibrinopurulent exudates. c. resection margins free of tumor. note: the subserosal location and small size of the tumor suggest a metastasis. additional sections from the area and immunohistochemical studies are pending and will be reported in an addendum. dr. . reviewed slides b and c and concurred. 2. sigmoid (i-l): segment of large bowel with vascular congestion; otherwise, no diagnostic abnormalities recognized. cxr: new patchy infiltrates. cxr: small bilateral effusions. urine cx: no growth blood cx (x2): no growth brief hospital course: this is a 49-year-old male who presents with a history of having participated in anal eroticism, at which point he had sudden onset of lower abdominal pain. this occurred at approximately 11:30 p.m. on . he did not come to the emergency room until the following morning at approximately o'clock in the morning. he was consulted to surgery around 11 a.m. after a ct scan revealed free air and he was brought urgently to the o.r. despite that, he had diffuse feculent spillage and fecal peritonitis. he had severe hypovolemia and a pre-septic shock picture. he had been pretreated with levaquin and flagyl. at surgery he was found to have a sigmoid colon loop which had been fixed to the lateral sidewall through inflammatory processes, some nature remotely allowing the flexure of the sigmoid colon to be somewhat tethered. the projectile had went out through the area of the mesenteric border of the sigmoid colon at approximately 20 cm from the anal verge, well above the peritoneal reflection. prior to starting the laparotomy the patient had sigmoidoscopy to rule out intrapelvic colon injury. a washout and resection of perforated sigmoid, as well as a procedure was performed. pt tolerated the procedure well and was transferred to the sicu while intubated for resuscitation. on pod1, pt was weaned off the ventilator and extubated without complications. he was transferred to the floor that evening in stable condition. he was continued on ng and npo diet. on pod3, pt had a recorded temperature of 101.4f. blood and urine cultures were sent. iv antibiotics were continued. social work was consulted re: family situation (pt did not want family to know the etiology of his injury). his stoma was also digitalized, which did not yield any stool return. during his hospitalization, the pt worked with the enterostomal nurses and received education on the care of his stoma. pt continued to be emotional regarding his health throughout his stay. a psychiatric consult was requested. the pt initially refused, and was later evaluated by psychiatry, who deemed him safe. by pod7, the ostomy began to have gas in the bag. pt's diet was advanced as tolerated. on pod9, it was noted that the pathology of his sigmoid colon had evidence of a subserosal endocrine tumor consistent with carcinoind. this was relayed to the pt, who took the news well. an octreotide scan and bowel resection at the time of colostomy takedown was discussed with the pt. by this time, the pt was tolerating a regular diet. he ostomy however, still had not expressed any stool. he was discharged home in stable condition on . medications on admission: ambien, lomotil, celexa, testerone, protonix. discharge medications: 1. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 4 days. disp:*4 tablet(s)* refills:*0* 2. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 4 days. disp:*12 tablet(s)* refills:*0* 3. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: sigmoid colon perforation discharge condition: stable discharge instructions: please restart your home medications (except the lomotil). you are prescribed two antibiotics. please fill the prescriptions and take as instructed. you may shower, but keep your incision clean and covered if there remains drainage. do not soak in a tub or go swimming until your incision is fully healed. do not drive while taking your pain medication. please call your physician or go to the emergency room if you experience fever >101.4f, intractable nausea or vomiting, pain unrelieved by medication, or foul-smelling drainage coming from your wound. followup instructions: please call dr. office at ( to schedule a follow-up appointment in 2 weeks. procedure: temporary colostomy open and other sigmoidectomy rigid proctosigmoidoscopy diagnoses: iron deficiency anemia, unspecified foreign body accidentally entering other orifice other testicular hypofunction injury to sigmoid colon, without mention of open wound into cavity 

Answer: The patient is high likely exposed to