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: latex / morphine attending: chief complaint: myasthenia major surgical or invasive procedure: sigmoid colectomy and hartmanns history of present illness: 78m with history of myasthenia on prednisone with incidental finding of intraperitoneal free air concerning for perforated diverticulitis vs perforated sigmoid adenocarcinoma. initially managed conservatively, gastrografin study performed this am showed extravasation of contrast from the sigmoid colon. past medical history: pmh: htn, asthma, myasthenia psh: radical prostatectomy for benign bph in , r tkr 10 years ago social history: lives with wife, has dog. retired manager of electric company. no tobacco. drinks 3 glasses wine/week. no illicits. family history: father died of stomach ca, mother pna, both in 80s physical exam: gen: appears well, no acute distress cv: regular rate and rhythym resp: ctab, no distress, mildly decreased bs at the bases abd: soft, distended in upper abdomen, tender in llq, no rebound or guarding, lower midline incision well healed ext: warm, no edema pertinent results: 12:40am blood wbc-16.5*# rbc-5.06 hgb-15.9 hct-48.5 mcv-96 mch-31.5 mchc-32.8 rdw-13.1 plt ct-348# 08:50am blood wbc-13.3* rbc-4.64 hgb-14.7 hct-43.7 mcv-94 mch-31.6 mchc-33.5 rdw-12.8 plt ct-285 06:30am blood wbc-11.7* rbc-4.45* hgb-14.4 hct-42.5 mcv-96 mch-32.4* mchc-33.9 rdw-13.0 plt ct-228 02:44am blood wbc-22.4* rbc-4.67 hgb-14.8 hct-45.1 mcv-97 mch-31.6 mchc-32.7 rdw-13.1 plt ct-260 02:32am blood wbc-13.0* rbc-3.96* hgb-12.9* hct-38.1* mcv-96 mch-32.6* mchc-33.8 rdw-13.3 plt ct-215 kub - there is free air under the left and right hemidiaphragms consistent with outside hospital ct scan. no evidence of obstruction. gastrograffin enema - perforation of the proximal sigmoid colon with extravasation of contrast medially in relation to the sigmoid colon. cta pe : 1. multiple acute pulmonary emboli scattered throughout the segmental pulmonary arterial tree and distal aspects of the right and left main pulmonary arteries, detailed above. pulmonary arterial clot burden is likely increased in comparison to outside abdomen and pelvis ct examination, which also demonstrated incidentally noted pulmonary emboli. 2. main pulmonary artery enlargement and mild straightening of the interventricular septum with small amount of reflux of contrast material into the ivc are suggestive of right heart strain radiographically. 3. wedge-shaped ground-glass opacity in the periphery of the right upper lobe posteriorly may represent a small area of pulmonary hemorrhage/infarction. 4. right lower lobe atelectatic changes. 5. interval resolution of previously seen free intraperitoneal air in the upper abdomen in comparison to abdomen and pelvis ct examination. 6. calcified coronary artery atherosclerotic disease. brief hospital course: the patient was initially admitted to neurology for flare of , he was found to have incidental finding of intraperitoneal free air concerning for perforated diverticulitis vs perforated sigmoid adenocarcinoma on ct scan and was initially managed conservatively. gastrografin study performed on showed extravasation of contrast from the sigmoid colon. he was taken to the or on and had a sigmoid colectomy and hartmann's procedure done. the patient tolerated the procedure well. neuro: post-operatively, the patient received dilaudid iv/pca with good effect and adequate pain control. when tolerating oral intake, the patient was transitioned to oral pain medications. neurology followed pt through hospitalization and helped manage steroid regimen. pt began steroid taper on pod 2 and tolerated wean well. he was sent home on 20mg of prednisone daily and this was schedule to decrease to a maintenance dose of 10mg prednisone po daily after 5 days. patient was also scheduled to see the neurology service as an outpatient to follow this up. cv: the patient was stable from a cardiovascular standpoint; vital signs were routinely monitored. pulmonary: on pod 2 patient was noted to have desaturation episodes on ambulation down to the mid 80's on room air. he had a cta looking for pe done wand was found to have bilateral pes. at this point he was started on a heparin drip and quickly became theraputic. on pod6 he was started on coumadin and at the time of discharge he was sent home on a lovenox to coumadin bridge. at time od discharge he was not having issues with sob on ambulation and stated he felt at his baseline. he had bilateral le ultrasuonds looking for a source of the pes, that were negative. gi/gu: post-operatively, the patient was given iv fluids until tolerating oral intake. his diet was advanced to sips on pod 2. on pod 3 he had return of bowel function and his diet was advanced as tolerated to regular. foley was removed on pod 2. intake and output were closely monitored. id: post-operatively, the patient was started on zosyn, which was continued through pod 2. the patient's temperature was closely watched for signs of infection, which there were none. as soon as he was taking pos again his prophylactic bactrim double strength was restarted. prophylaxis: the patient received subcutaneous heparin during this stay, and was encouraged to get up and ambulate as early as possible. subcutaneous heparin was transitioned into heparin drip after the pes were discovered. at the time of discharge on pod 8, the patient was doing well, afebrile with stable vital signs, tolerating a regular diet, ambulating, voiding without assistance, and pain was well controlled. medications on admission: atenolol 25 mg daily, pantoprazole 40 mg daily, prednisone 40 mg daily, mestanon 30 mg qid, bactrim 800/160 mg m/w/f, ca + vitd 600mg daily discharge medications: 1. nystatin 100,000 unit/ml suspension sig: five (5) ml po tid (3 times a day). :*450 ml(s)* refills:*2* 2. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). :*30 tablet(s)* refills:*2* 3. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. :*40 tablet(s)* refills:*0* 4. pyridostigmine bromide 60 mg tablet sig: 0.5 tablet po q6h (every 6 hours). :*60 tablet(s)* refills:*2* 5. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). :*60 tablet(s)* refills:*2* 6. sulfamethoxazole-trimethoprim 800-160 mg tablet sig: one (1) tablet po m,w,f (). :*12 tablet(s)* refills:*2* 7. enoxaparin 120 mg/0.8 ml syringe sig: one hundred-ten (110) mg subcutaneous q12h (every 12 hours): discontinue once inr range 2-3 reached. :*60 syringes* refills:*1* 8. prednisone 20 mg tablet sig: one (1) tablet po daily (daily): continue through then start tablet daily beginning . :*30 tablet(s)* refills:*2* 9. coumadin 2.5 mg tablet sig: two (2) tablet po every evening as directed: take 2 tablets on . subsequent dose will be determined by inr through your pcp. :*60 tablet(s)* refills:*1* 10. outpatient work pt/inr 2-3x/week dx: pulmonary emblous goal inr contact w/ results: dr., location: medical associates address: , , phone: fax: 11. colace 100 mg capsule sig: one (1) capsule po twice a day as needed for constipation. 12. ostomy supplies coloplast pouch, dist # man # change pouch 2x/week : #2 boxes refills: 6 13. osotmy supplies no-sting barrier wipe, dist # man # 3344 : 2 boxes refills: 6 14. ostomy supplies seal, dist # man # : #2 boxes refills: 6 discharge disposition: home with service facility: allcare vna discharge diagnosis: perforated diveticulitis pulmonary embolus discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital with diverticulitis and were observed for several days before proceeding to the operating room as your condition did not show any improvement. during your operation a colostomy was performed. your post operative course was complicated by a pulmonary embolus (blood clot) and you are now being treated with a blood thinner called coumadin. after you are discharged from the hospital you will need to have your blood levels called inr followed closely to regulate inr levels between . until your inr levels reach this range you will be discharged on an injection called lovenox that needs to be taken twice daily. once your levels are within the desied range the injections can stop. you may resume your home medications with the exception of the prednisone - this dose is being tapered so that you will be taking 10 mg daily starting . so for now you will continue with prednisone 20 mg twice daily until . followup instructions: follow up in acute care surgery clinic in weeks. upon discharge call for an appointment. follow up with your priamry care doctor (dr. this week for a general physical and for monitoring of your inr and adjustment of your coumadin. his office number is procedure: open and other left hemicolectomy temporary colostomy diagnoses: acidosis unspecified essential hypertension long-term (current) use of steroids asthma, unspecified type, unspecified surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation long-term (current) use of anticoagulants iatrogenic pulmonary embolism and infarction knee joint replacement diverticulitis of colon (without mention of hemorrhage) other specified disorders of peritoneum myasthenia gravis without (acute) exacerbation 

Answer: The patient is high likely exposed to