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: history of present illness: the patient is an 85-year-old male with a history of coronary artery disease status post coronary artery bypass graft in , insulin-dependent diabetes mellitus who had a recent colonoscopy in with three polypectomies who had been doing well post procedure and presented to the emergency department on with black stools times 10 to 12 days and increasing fatigue. the patient also admits to periods of episodic confusion but no bright red blood per rectum. past medical history: 1. coronary artery disease status post coronary artery bypass graft in , status post percutaneous transluminal coronary angioplasty in . 2. hypertension. 3. high cholesterol. 4. gout. 5. history of polio, question of bulbar polio. 6. colonic polyps status post polypectomy times three in mid . 7. dementia. 8. non-insulin-dependent diabetes mellitus. 9. osteoarthritis. 10. history of urinary incontinence. medications on admission: 1. lasix 20. 2. imdur 60. 3. zebeta 10. 4. folgard 1. 5. allopurinol 300 daily. 6. k-dur 20. 7. lipitor 10. 8. plavix 75. 9. aricept 5. allergies: iodine dye, bextra. physical examination: temperature 99.5, heart rate 88, blood pressure 113/43, respiratory rate 22, oxygen saturation 95% on two liters. general: well-appearing, slightly confused but oriented in no acute distress. heent: pupils equal, round and reactive to light. sclerae anicteric. oropharynx clear. moist mucosal membranes. neck: jugular venous pressure approximately 9 cm. no lymphadenopathy. no bruits. chest: lungs clear to auscultation bilaterally. cardiovascular examination: regular rate and rhythm. no murmurs, rubs or gallops. abdomen slightly distended, non-tender, bowel sounds slightly decreased. no costovertebral angle tenderness. rectal examination showed occult blood positive in the emergency department. extremities: no edema, good dorsalis pedis pulses bilaterally. skin: no rashes. neurologic examination: alert and oriented times three with some reinforcement. patient had slurred speech. patient was found to have positive asterixis. strength was upper and lower extremities bilaterally. laboratory examination: white count 10.5 with 63% polys, 29% lymphs. hematocrit was 25.8, platelet count 258,000. sodium 133, potassium 5.3, chloride 96, bicarb 23, bun 67, creatinine 5.6, glucose 96. urinalysis was negative for infection. radiology: renal ultrasound performed showed a distended bladder, some simple kidney cysts. chest x-ray on admission showed no acute infiltrates and slight cardiomegaly. electrocardiogram: showed normal sinus rhythm at a rate of 86 with flat t-waves. no new ekg changes. hospital course: the patient was admitted to the surgical intensive care unit . gastrointestinal bleed: the patient had 10-12 days of melena with a history of recent colonoscopy and polypectomies. an nasogastric lavage in the emergency department was negative for blood. the patient was transfused to keep his hematocrit above 30. he was placed on intravenous proton pump inhibitor and aspirin and plavix were held. an esophagogastroduodenoscopy was performed. the findings were normal esophagus. the stomach had a submucosal nodule of 5 mm of benign appearance in the antrum. no lesion was seen that could have been responsible for patient's melena. the patient continued to require transfusions off and on throughout his hospital course. he bled intermittently with melanotic to maroon liquid stools with clots requiring up to five units of blood within one 24 hour period. a repeat colonoscopy was performed on to assess for signs of bleeding. the patient was found to have a small rectal polyp and a 5 cm ulcerated bleeding mass at the ileocecal valve. this mass subsequently was found on pathology to be a plasmacytoma. the patient continued to bleed after the colonoscopy and the patient continued to receive multiple units of blood in order to keep his hematocrit above 30. 2. multiple myeloma: the patient was thought to be in acute renal failure in the emergency department. this was a new development as his baseline creatinine had been 0.8 to 1.0. he was found to have a significant amount of protein in the urine based on the ssa study. serum protein electrophoresis showed 1% monoclonal light chain, however, urine protein electrophoresis showed greater than 80% light chain disease. the patient was started on therapy for his multiple myeloma. he received two four day bursts of high dose decadron at 40 mg a day with a rest of four days in between the two bursts. he also received five treatments of plasmapheresis in order to decrease the load of light chains in the serum. the hematology/oncology team considered adding another to the patient's chemotherapeutic regimen, however, due to the patient's hemodynamic instability and continuous gastrointestinal bleeding, no other was added. the patient underwent a bone marrow biopsy which showed 50% plasma cell infiltration in the bone marrow. 3. acute renal failure: the patient was found to be in acute renal failure upon presentation to the emergency department. this was found to be secondary to myeloma kidney and overwhelming light chain protein load on the patient's kidneys. he was started on hemodialysis and was seen by the renal consult team. the patient's renal failure continued throughout his admission. he required hemodialysis on mondays, wednesdays and fridays and his kidneys did not respond to therapy for the myeloma nor did they respond to the hemodialysis because patient continued to have virtually no urine output throughout his hospital stay. 4. coagulopathy: over the course of the hospital stay, he developed a coagulopathy. he has had a rising ptt, pt and slightly elevated inr. this was found to be secondary to the plasmapheresis and the patient was treated with subcu and oral vitamin k. he was given fresh frozen plasma and the last two sessions of plasmapheresis were followed by fresh frozen plasma transfusions. in addition, the patient was found to have a thrombocytopenia which was also felt to be related to his increased bleeding. he was taken off all heparin products including heparin flushes and heparin with dialysis. heparin antibody was ordered. he was transfused with platelets twice while bleeding. the decreased platelets were felt to be secondary to nutrition, uremic platelets and bone marrow infiltration. inhibitor studies were ordered. 5. tachycardia: on the patient was found to be tachycardic while at hemodialysis. his rate was 160 to 210. an ekg showed narrow complex tachycardia consistent with new onset atrial fibrillation. the patient was otherwise hemodynamically stable with a blood pressure of 90-105 systolic, however, he was found to have 250 cc of maroon blood per rectum. he was seen by the medical intensive care unit team and was transferred to the medical intensive care unit. , m.d. dictated by: medquist36 procedure: spinal tap incision of lung parenteral infusion of concentrated nutritional substances other endoscopy of small intestine enteral infusion of concentrated nutritional substances hemodialysis venous catheterization for renal dialysis biopsy of bone marrow insertion of other (naso-)gastric tube gastric lavage arteriography of other intra-abdominal arteries closed [endoscopic] biopsy of large intestine therapeutic plasmapheresis diagnoses: thrombocytopenia, unspecified acute kidney failure with lesion of tubular necrosis acute posthemorrhagic anemia atrial fibrillation bacteremia blood in stool infection and inflammatory reaction due to other vascular device, implant, and graft other immunoproliferative neoplasms, without mention of having achieved remission 

Answer: The patient is high likely exposed to