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: sulfa (sulfonamides) / heparin agents attending: chief complaint: gib major surgical or invasive procedure: colonoscopy central line placement by vir history of present illness: ms. is a yo female with severe ra who presented to osh with lgib on . -gastric lavage was negative. initally the patient was hypotensive with sbp in the 80s. the patient was given fluids and was transfused 2u of ffp and 2u of prbc. only poor peripheral access was obtained (20g in foot) and therefore a cvl was attempted. an attempt for a r femoral line was unsuccessful. a rij attempt was unsuccessful as the wire was traveling in the head. when trying to place a l subclavian line, the physician in the osh was unable to withdraw the wire. a cxr revealed the cvl wire coiled in the ivc filter. the patient is transfered for ir intervention to withdraw the wire. . on arrival to the , the patient denied any cp, sob, abdominal pain, back pain. she denied any brbpr prior to this episode. she states that the brbpr started last two days. the patient denies ever having had any colonoscopy before. she denies any lh or dizziness. the patient is s/p recent thr that was complicated by a dvt. the pt had an ivc filter placed and was on heparin sc tid for dvt prophylaxis. past medical history: pmh: rheumatoid arthritis - c/b chronic right pleural effusion, s/p recent thoracentesis, felt to be due to ra htn atrial fibrillation h/o of cva with residual l sided weakness frequent utis . psh: s/p b/l tkr in s/p r total hip replacement in complicated by a dvt for which an ivc filter was placed addendum/clarification based on discussion with the pcp ( ): she underwent r thr at in without complications, discharged on coumadin for dvt prophylaxis. readmitted in with thigh pain and a dvt was seen. on lovenox, plavix and aspirin, she developed a thigh hematoma complicated by hypotension, so anticoagulation was stopped and they placed an ivc filter. she was d/c'd to house. she was readmitted for chest pain and hypotension and found to have ra pericarditis, pericardial effusion, and pleuritis. placed on steroids. readmitted for the same and also developed a fib which spontaneously recovered. readmitted from rehab because she was placed on heparin sq despite the ivcf and developed brbpr and hypotension. social history: she has been living in a rehab since her thr in . prior to this, she lived alone with help from her son. she denies etoh and tobacco use. family history: non-contributory physical exam: gen: nad, aaox3 heent: perrla, mmm, no dentures in place neck: no lad, no jvd visible cor: s1s2, regular rhythm, non-radiating systolic murmur over precordium, distant heart sounds. pulm: cta b/l, no wheezing or rhonchi abd: + bowel sounds, soft, nd, nt skin: cool extremities, no rash, limited range of motion in ue joints, ecchymosis in r groin, wire taped to her left shoulder ext: 1+ dp, no edema/c/c, dermatosclerotic changes in feet b/l pertinent results: : ekg: rate 72, nsr, no st changes or twis, normal intervals . cxr: bilateral pleural effusions. subsegmental atelectasis right base. increased density in the retrocardiac area, which may represent atelectasis or consolidation. . ct abdomen/pelvis: 1. ct colonography unable to be performed due to lack of rectal tone. 2. extensive sigmoid diverticulosis. assessment of the nondistended colon is limited, but there is an area of asymmetric wall thickening with mucosal enhancement in a loop of redundant sigmoid colon low in the left lower quadrant. while this could be related to recent colonoscopy or represent inflammatory changes from diverticulosis, given the history of gi bleeding, a neoplastic process cannot be excluded. targeted colonoscopy of this area or single-contrast barium enema could be performed for further assessment. given lack rectal tone, single contrast enema may not be successful. 3. findings consistent with proctitis. 4. air in the bladder. correlate with recent history of foley catheter placement. given extensive diverticular disease, in the absence of prior foley catheterization, this would raise suspicion for enterovesicular fistula. no areas of asymmetric bladder wall thickening are identified adjacent to sigmoid colon to indicate an enterovesicular fistula. 5. moderate bilateral pleural effusions with associated bilateral lower lobe atelectasis. brief hospital course: a/p: f with pmh of ra, thr c/b dvt, s/p ivc filter placement, admitted to micu with lgib. . 1) lgib: patient presented to outside hospital with lower gi bleed and hypotension. she received 2 units of ffp and 2 units of prbc's at outside hospital and was subsequently transferred to for further management. she was admitted to the micu at and golytely was administered in preparation for a colonoscopy. on admission to this institution, she had a large drop in her hct from 33.8 to 26.6 and was transfused an additional 2 units of prbc's and started on iv ppi. she was subsequently hemodynamically stable for the duration of her hospital course. egd/colonoscopy revealed ischemic-appearing mucosa in the sigmoid colon and severe sigmoid narrowing, which they were unable to pass with the colonoscope. she underwent a diagnostic colonography under fluroscopy for further evaluation of stricture vs. obstructing mass. this study revealed severe sigmoid diverticulosis and findings consistent with proctitis. if indeed these findings are consistent ischemic colitis, it may be related to hypotensive event (reported per pcp) which occurred at outside hospital. at time of discharge, she was hemodynamically stable, and no further intervention was advised. this was discussed with both patient's son and her pcp who stated their agreement with plan for conservative management. . 2) access: at the outside hospital, ms. had several unsuccessful attempts at line placement and was transferred with a guidewire which was felt to be hooked into her ivc filter. ir found that in fact this was not the case, and they were able to remove the wire without difficulty. a left svc triple lumen catheter was placed by ir for access in the setting of active gi bleeding, as patient had a tenuous situation with peripheral iv's. . 3) rheumatoid arthritis - patient has a long history of ra for 30 years and is on a slow prednisone taper for recent ra pericarditis & pleuritis. current dose of 20 mg was continued to prevent adrenal insufficiency. her pcp will continue to manage the slow taper after discharge. . 4) leukocytosis: most likely due to chronic prednisone. no clinical, radiographic, or other laboratory evidence of infection. . 5) afib: sotalol was briefly held secondary to concern over brisk bleeding. once gi bleeding had subsided, it was restarted. heart rate was well-controlled. she is not currently a candidate for anticoagulation given gi bleed. . 6) fen: received gentle ivfs initially following admission. following colonoscopy, diet was slowly advanced from clear liquids to regular cardiac diet, which patient tolerated well. electrolytes were repleted as needed to maintain k>4, mg>2. . 7) prophylaxis: pneumoboots for dvt prophylaxis. patient has ivc filter in place given h/o dvt. ppi for gi prophylaxis. . 8) access: l scv line placed by ir; removed prior to discharge. . 9) code status: dnr/dni medications on admission: medications on admission to outside hospital: lipitor 10mg qd enteric coated aspirin 81 mg nexium 40mg qd sotalol 40mg qd prednisone 20mg qd . home meds: included sq heparin . medications on transfer to outside hospital: pantoprazole 40 mg po q12h prednisone 20 mg po daily acetaminophen 325-650 mg po q4-6h:prn sotalol hcl 40 mg po daily atorvastatin 10 mg po daily discharge medications: 1. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 2. acetaminophen 325 mg tablet sig: two (2) tablet po every hours as needed for pain. 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 4. prednisone 20 mg tablet sig: one (1) tablet po daily (daily). 5. sotalol 80 mg tablet sig: 0.5 tablet po daily (daily). discharge disposition: extended care facility: - discharge diagnosis: primary: gi bleed diverticulosis ischemic colitis gastritis cvl wire coiled in ivc filter . secondary: atrial fibrillation hypertension rheumatoid arthritis pericarditis pleuritis discharge condition: stable discharge instructions: you were admitted from hospital with a catheter coiled in the filter in your inferior vena cava. you were evaluated by interventional radiology, and the catheter was disentangled. . you have also been evaluated for the source of your gi bleeding. initially you received a blood transfusion to stabilize your hematocrit. your colonoscopy showed evidence of diverticulosis and of ischemia in your sigmoid colon (which means that your bowel may not be getting adequate blood supply to it). ischemic colitis is likely the source of your lower gi bleed. there is no further intervention necessary for these conditions. your bleeding has subsided, and you have been hemodynamically stable for several days. . you should return to the hospital if you experience gross blood in your stool, shortness of breath, or chest pain. followup instructions: you will follow-up with your primary care physician, . . procedure: venous catheterization, not elsewhere classified colonoscopy gastric lavage esophagogastroduodenoscopy [egd] with closed biopsy transfusion of packed cells removal of other device from thorax diagnoses: hypocalcemia unspecified essential hypertension adrenal cortical steroids causing adverse effects in therapeutic use acute posthemorrhagic anemia atrial fibrillation hypotension, unspecified blood in stool other late effects of cerebrovascular disease mechanical complication due to other implant and internal device, not elsewhere classified rheumatoid arthritis unspecified gastritis and gastroduodenitis, without mention of hemorrhage diverticulosis of colon (without mention of hemorrhage) leukocytosis, unspecified hip joint replacement unspecified vascular insufficiency of intestine other musculoskeletal symptoms referable to limbs 

Answer: The patient is high likely exposed to