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 a 78-year-old male who presented to the emergency department with bright red blood per rectum. he has a history of arteriovenous malformation, and colonic adenoma, as well as iron deficiency anemia. he reports developing bloody diarrhea on , at which time he presented to the emergency department. he stated he had one episode of watery diarrhea but denies hematemesis or coffee-grounds emesis. he also denied abdominal pain, fever, chills, or back pain. review of systems: review of systems was negative for chest pain for shortness of breath. he denies any recent travel, but he is currently on antibiotics for upper respiratory infection type symptoms and presumed bronchitis. the patient also reportedly has a sick contact who was treated for bloody diarrhea and presumed to have salmonella. on presentation to the emergency department, the patient had a blood pressure in the 90s to 80s systolic. the patient was responsive to fluids. his stool was noted to be bright red with clots. nasogastric lavage was negative. the patient was admitted to the intensive care unit for hypovolemic shock. past medical history: 1. cerebrovascular accident in with residual left lower extremity weakness. 2. the patient reportedly has 50% carotid stenosis bilaterally. 3. colonic adenoma, status post right colectomy in . 4. asthma with an fev1 of 1.14 and peak flow of 400. 5. history of lung lesion. 6. chronic renal insufficiency with a baseline creatinine of 1.8 to 2. 7. claudication. 8. hypertension. 9. type 2 diabetes. 10. history of klebsiella pneumonia. 11. question of colonic arteriovenous malformation. allergies: no known drug allergies. medications on admission: flovent 220 mcg 4 puffs b.i.d., serevent 2 puffs b.i.d., albuterol p.r.n., prednisone taper 10 mg p.o. q.d., zithromax, norvasc 5 mg p.o. q.d., aspirin 325 mg p.o. q.d. social history: the patient is from and does not speak english. he has a very supportive and large family who are with him at all times and interpret for him. he lives with his wife and family. she denies tobacco or alcohol use and has never used intravenous drugs. family history: family history is significant for a niece recently treated for salmonella. physical examination on presentation: vital signs on admission revealed a temperature of 96.8, heart rate of 88, blood pressure of 112/56, respiratory rate of 20, satting 100% on room air. the patient is pleasant, awake, alert and oriented times three, in no acute distress. pupils were notable for cataracts. there was no jugular venous distention. no lymphadenopathy. the oropharynx was clear, and mucous membranes were moist. heart had a regular rate and rhythm. normal first heart sound and second heart sound. a 2/6 systolic ejection murmur. chest revealed inspiratory and expiratory wheezes bilaterally. no rales. the abdomen was soft, nontender, and nondistended. bowel sounds were present. extremities had no edema, cool, 1+ distal pulses bilaterally. neurologic examination was grossly nonfocal with mild right lower extremity weakness and normal cranial nerve examination. pertinent laboratory data on presentation: laboratories on admission revealed a white blood cell count of 22.6, hematocrit of 22.4, platelets of 325. differential of 85 neutrophils, 1 band, 4 eosinophils. inr of 1.4. sodium of 132, potassium of 4.8, chloride of 105, bicarbonate of 15, blood urea nitrogen of 59, creatinine of 2.9, blood sugar of 192. radiology/imaging: electrocardiogram revealed sinus rhythm at 86 with no st-t wave changes. hospital course: 1. gastrointestinal: the patient was admitted to the intensive care unit for fluid resuscitation and close monitoring secondary to lower gastrointestinal bleed. it was felt that the bleed was likely secondary to infectious colitis, possibly provoking another source of bleed. his stool was sent for fecal cultures on , with the main concern being salmonella given a sick contact. the patient was empirically treated with ciprofloxacin to cover salmonella and flagyl to cover clostridium difficile given his recent course of azithromycin for bronchitis. the patient underwent tagged red blood cell scan on , which revealed a right colonic source of bleeding. a follow-up angiography was negative for bleeding. over the next several days the patient required 12 units of packed red blood cells transfusion to support hematocrit. a surgical consultation was obtained on , but no intervention was planned given the fact that angiography was negative. the patient underwent an abdominal ct on which revealed no free air, no perforation, scattered diverticula, but no evidence of diverticulitis. after a stable hematocrit in the middle 30s for 24 hours, the patient was transferred to the floor on . once admitted to the floor, the patient received a golytely bowel preparation for colonoscopy to look for a source of bleeding. a colonoscopy was attempted on , but the preparation was inadequate. the patient's hematocrit remained stable, and stool was guaiac-negative by that point. on the evening of , the patient had a maroon bowel movement followed by bright red blood per rectum, and he was transferred back to the intensive care unit. a repeat tagged red blood cell scan showed bleeding source in the stomach, but a follow-up nasogastric tube was negative, leading the team to believe that the tagged scan was a false positive. the interventional radiology as well as surgical teams were called to evaluate the patient but neither wanted to intervene. the patient's hematocrit remained relatively stable in the low 30s with a blood transfusion of 1 unit. on , the patient underwent a colonoscopy after a repeat bowel preparation. colonoscopy revealed a diverticula in the transverse colon with fresh clot. aggressive washing did not remove the clot, and the area was not intervened on further. neither the surgical team or the interventional radiology felt that intervention was needed. on , the patient was again called out to the floor. his hematocrit was monitored for an additional 24 hours. it remained stable, and the patient had no further guaiac-positive stools. the patient was discharged on ; but, of note, after his discharge stool cultures from the were positive for giardiasis. the patient was called at home and started on flagyl to treat giardia. 2. hematology: the patient was transfused a total of 13 units of packed red blood cells during this hospitalization. after initial transfusion of 12 units, he developed a dic-type picture and required 2 units of fresh frozen plasma and 1 unit of platelets with resolution of coagulopathy. 3. rheumatology: of note, on the patient developed a hot, swollen, and painful left knee. the knee was tapped and was positive for gout crystals. due to contraindication to oral steroids given his recent significant gastrointestinal bleed, on the knee joint was injected with corticosteroids resulting in resolution of symptoms. 4. pulmonary: the patient has a history of asthma as well as an ill-defined lung nodule. a ct scan done on admission was concerning for some interstitial lung disease concerning for bronchiolitis obliterans-organizing pneumonia. the patient's respiratory status was stable throughout this hospitalization and further workup was deferred to the outpatient setting. 5. cardiovascular: the patient has a history of hypertension, but when admitted was in hypovolemic shock. after fluid resuscitation and stabilization, his blood pressure was systolic in the 190s/70s. his norvasc was restarted without much result and was changed to lopressor 12.5 mg b.i.d. with good affect. 6. infectious disease: as noted above, the patient was initially empirically treated for approximately four days with ciprofloxacin and flagyl upon admission for clostridium difficile and salmonella. this was stopped after a few days of negative stool cultures. on , the patient spiked a temperature that was thought to be secondary to his right internal jugular line that was placed on approximately . when the patient was transferred out to the floor on , the line was promptly removed. the patient had no further episodes of fever. after discharge, stool cultures were positive for giardia, and the patient was treated with flagyl. discharge diagnoses: 1. lower gastrointestinal bleed, likely secondary to diverticula. 2. giardia. 3. asthma. 4. chronic renal insufficiency. 5. anemia. 6. gout. medications on discharge: 1. protonix 40 mg p.o. b.i.d. 2. flovent. 3. serevent. 4. lopressor 12.5 mg p.o. b.i.d. discharge status: the patient was discharged to home. discharge followup: to follow up with his primary care physician. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine colonoscopy diagnoses: acidosis thrombocytopenia, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled gout, unspecified asthma, unspecified type, unspecified diverticulosis of colon with hemorrhage other specified alveolar and parietoalveolar pneumonopathies 

Answer: The patient is high likely exposed to