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: dyspnea and hypoxia following resection of left renal mass major surgical or invasive procedure: l nephrectomy bronchoscopy history of present illness: this is a 41 year old man with a pmh significant for factor v leiden mutation, who is now pod2 s/p resection of a left renal mass, who had episodes of oxygen desaturation on the floor and for whom a ct showed likely mucus plugging. he was transferred to the for planned bronchoscopy by the interventional pulmonology service. . he originally presented with back pain and in the process of workup for this got an mri which incidentally showed a 2 cm left renal mass. a ct scan confirmed the presence of the mass. he came to dr. for urological follow-up, who scheduled and, on , performed an open partial nephrectomy to resect the mass. this included chest tube placement in the left; the chest tube was pulled . at midnight , he had a trigger on the floor for hypoxia and fever, with temp 102.2 and o2 saturation of 87% on 3.5l nc. this increased to 92% with 5l nc and use of an incentive spirometer. at that time, the covering md noted that he was "asymptomatic" without sob, cp, dyspnea, n/v, chills, or calf pain. an abg at that time was 7.38/52/74 on 5l nc. . a pe protocol ct chest was ordered stat, and a provisional read showed "small left pneumothorax... obstructive atelecatsis of the left lower lobe and right middle and lower lobe due to fillings of the lower lobe bronchi, most likely mucous plug." . an ekg done around that time appears to show diffuse t-wave flattening compared to his earlier pre-op ekg but otherwise without diagnostic focal changes. . on the floor today, he continued to be febrile for much of the day, with tmax of 102.8 at 1415; he continued to require oxygen support of 5l nc with 40% facemask for much of the day, with oxygen saturations in the mid 90s to this. he was also tachycardic to the 110s-120s for most of the day. past medical history: lower extremity dvt in , diagnosed with heterozygous factor v leiden mutation; on coumadin, followed by right leg vein stripping for varicose veins, essential tremor social history: professor at . married. quit smoking in , was light smoker before then. 3 glasses of alcohol/month. denies recreational or iv drug use. family history: mother and sister with factor v leiden mutation; sister w past dvt physical exam: general appearance: well nourished, no acute distress eyes / conjunctiva: perrl head, ears, nose, throat: normocephalic lymphatic: cervical wnl, supraclavicular wnl cardiovascular: (s1: normal), (s2: normal) peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (expansion: symmetric), ( sounds: bronchial: , rhonchorous: diffusely) abdominal: soft, bowel sounds present extremities: right: absent, left: absent skin: not assessed neurologic: attentive, responds to: not assessed, oriented (to): x3, movement: not assessed, tone: not assessed pertinent results: 06:09pm glucose-131* urea n-10 creat-1.3* sodium-142 potassium-4.1 chloride-105 total co2-24 anion gap-17 06:09pm estgfr-using this 06:09pm magnesium-1.8 06:09pm wbc-14.3*# rbc-4.64 hgb-13.8* hct-39.9* mcv-86 mch-29.6 mchc-34.5 rdw-13.9 06:09pm plt count-157 06:09pm pt-16.6* ptt-22.0 inr(pt)-1.5* 11:45am pt-16.6* ptt-29.3 inr(pt)-1.5* 06:05am blood wbc-8.9 rbc-3.39* hgb-10.1* hct-29.8* mcv-88 mch-29.9 mchc-34.1 rdw-13.8 plt ct-191 04:30am blood wbc-11.6*# rbc-3.61* hgb-10.8* hct-31.9* mcv-88 mch-29.7 mchc-33.7 rdw-13.7 plt ct-157 06:05am blood neuts-82.0* lymphs-10.2* monos-5.3 eos-2.3 baso-0.1 06:05am blood pt-27.8* ptt-38.2* inr(pt)-2.8* 05:10pm blood pt-41.8* ptt-51.5* inr(pt)-4.6* 04:30am blood plt ct-157 04:30am blood pt-35.1* ptt-41.8* inr(pt)-3.7* 03:28am blood plt ct-154 06:05am blood glucose-103 urean-14 creat-1.3* na-141 k-3.1* cl-104 hco3-28 angap-12 05:10pm blood na-139 k-4.1 cl-103 04:30am blood glucose-103 urean-16 creat-1.4* na-134 k-3.9 cl-101 hco3-23 angap-14 03:28am blood glucose-95 urean-14 creat-1.3* na-141 k-3.9 cl-102 hco3-29 angap-14 04:32am blood alt-26 ast-40 alkphos-64 amylase-84 totbili-1.0 06:05am blood calcium-7.9* phos-2.4* mg-2.3 04:30am blood calcium-8.0* phos-2.1* mg-2.0 03:28am blood calcium-8.0* phos-2.0* mg-2.0 12:34pm blood type-art po2-67* pco2-53* ph-7.40 caltco2-34* base xs-5 05:54am blood type-art fio2-100 o2 flow-15 po2-52* pco2-50* ph-7.42 caltco2-34* base xs-6 aado2-630 req o2-100 intubat-not intuba cta: impression: 1. given a borderline suboptimal study, there is no pulmonary embolism to the segmental level. 2. obstruction of the bronchus intermedius and all segmental bronchi of the left lower lobe, likely due to mucus plugging, causing complete collapse of the middle lobe, right lower lobe, and almost all the left lower lobe. 3. new dependent opacities in the left upper lobe, lingula and less in the right upper lobe, could be due to aspiration. 4. left thyroid hypodensity, should be evaluated by ultrasound if not already known. 5. extensive post-operative changes of left partial nephrectomy. 6. small left pneumothorax. echo the left atrium is elongated. there is mild symmetric left ventricular hypertrophy with normal cavity size. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef>55%). tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are structurally normal. no mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is a small pericardial effusion. impression: suboptimal image quality. normal global and regional leftventricular systolic function. mild left ventricular hypertrophy. right ventricle could not be adequately assessed. brief hospital course: 41 yo m w pmhx of factor v leiden mutation and dvt, l renal mass sp partial l nephrectomy w post-op complications of fever, hypoxia . #. hypoxia - to multiple etiologies. initially thought to be due to mucus plugging but the due to aspiration vs hospital-acquired pneumonia with ?component of fluid overload. pt needed to be on bipap w high oxygen requirement which was been weaned down to ra. pt continues to do well on ra. is sp 7 day course of iv vanc/zosyn for hap. . #. cdiff colitis - continue oral vancomycin. will tx for 2 weeks p last abx dose. low grade temps likely to resolving cdiff colitis. pt reports that diarrhea is getting better. . #. hx of l renal mass sp partial nephrectomy - urology following. wound site looks good. path report from nephrectomy shows angiomyolipoma, no cancer. outpt fu w dr. at dc next thursday . #. hx of factor v leiden mutation and dvt - seen by heme preop and coumadin w goal inr of .5 4-6 weeks post op. his inr was supratherapeutic in icu, so coumadin was held and vitamin k given, coumadin restarted at low dose. inr on day of dc was 1.9. discussed w primary hematologist and dc on coumadin alone at 2mg mwf and 1mg t,t, sat, dose and inr check on monday . #. anemia - likely from post-op blood loss.remained stable throughout hospital stay around 30-31. . #. r flank discomfort - at one point pt complained of r flank pain, likely msk but was resolved at dc. ua only showed 13 rbc, not concerning for renal stone. pain resolved on its own . # ?ckd- baseline cr ~1.2, given young age, nl for pt his age. cr flucutated but remained around 1.3 at dc. . . medications on admission: home medications: warfarin 5 mg daily advil 600 mg prn ("occasionally") propranolol 20mg, prn ("very occasional" per pre-op med list) for palpitations before presentations fish oil mvi . transfer medications: cefazolin 2 g iv q8h acetaminophen 650 pr q4h: prn fever maalox 15-30 po qid:prn heartburn dilaudid pca 0.25 mg lockout 6 mins, basal 0, 1 hr max 2.5 mg ondansetron 4 mg iv q4h: prn nausea docusate sodium 100 mg po bid diphenhydramine 25-50 mg q6h: prn pruritus or insomnia discharge medications: 1. vancomycin 125 mg capsule sig: one (1) capsule po q6h (every 6 hours) for 14 days. disp:*56 capsule(s)* refills:*0* 2. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*20 tablet(s)* refills:*0* 3. warfarin 2 mg tablet sig: use as directed below tablet po once a day: take 2mg (1tab) on m, w, f and 1mg on tues, thurs, sat, sun ( tab). disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: -sp l partial nephrectomy for renal mass - confirmed to be angiomyolipoma -healthcare assoicated pneumonia -c diff colitis discharge condition: good discharge instructions: -you were admitted to the hospital for partial removal of left kidney due to a mass, which turned out not be cancer. after surgery you developed complications of mucus plugging and pneumonia. you also developed an infection of your bowel called c diff colitis. you finished the course of iv antibiotics for the pneumonia. you will need to take 2 additional weeks of oral vancomycin for the cdiff colitis. if at the end of the oral antibiotic course you are still having diarrehea, abdominal pain or fevers, you need to let your doctor know as you may need additional antibiotics. you have hx of factor v leiden mutation which makes you vulnerable to form blood clots especially around surgery, so per your hematologist, you have been placed on coumadin which will be continued for about 4-6 weeks after your surgery. please follow up with them regarding inr checks and coumadin adjustment please call your doctor right away or return to ed for fevers, chills, abdominal pain, chest pain, shortness of , concerning signs of infection at the incision site, worsening diarrhea followup instructions: 1. urology, provider: , m.d. phone: date/time: 3:30 2. pcp, . , ph: , appt is on tuesday, , 9:00 am 3. hematology, rn , ph: . come to 9, have blood drawn for inr check and will call you with results procedure: other bronchoscopy partial nephrectomy diagnoses: pneumonia, organism unspecified acute posthemorrhagic anemia chronic kidney disease, unspecified iatrogenic pneumothorax intestinal infection due to clostridium difficile other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other respiratory complications primary hypercoagulable state foreign body accidentally entering other orifice foreign body in main bronchus benign neoplasm of kidney, except pelvis long-term (current) use of antibiotics 

Answer: The patient is high likely exposed to