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: poor po intake, weight-loss, loose bm's major surgical or invasive procedure: s/p total abdominal colectomy, end ileostomy history of present illness: 31 yo m seen by dr , his gastroenterologist, and currently being evaluated for ibd, presenting with worsening lethargy, nausea, and poor appetite. these symptoms have emerged in the setting of a prior 2 months hx of ongoing urgency, gas/bloating, and blood in stool. he initially saw his pcp who felt it might be irritable bowel. however, his symptoms persisted and 2 weeks pta patient reports having a ct abdomen at osh showing right lower colitis. pt also reports submitting 3 sets of stool samples at this time to his pcp for culture which were negative. he was started on prednisone 30mg, cipro, and flagyl for presumed uc. symptoms persisted and when seen by dr his prednisone was increased to 60mg daily. initially, the patient reports mild improvement in symptoms ( vs. 4 b/m's/d) but over the last few days he has had increased lethargy, diarrhea, and abdominal pain. he reports 15 lb weight loss over last 2 weeks. . patient reports hx of blood in his stools dating back at least until when he underwent flexible sigmoidoscopy which showed internal hemorrhoids. he has had intermittent rectal bleeding since then without other symptoms. additionally, he reports recent trip to approximately one mnth pta after which he endorses sx's began to get worse. denies any other sick contacts, fevers, any visual disturbances, arthralgias, rashes, mouth ulceration, dysuria or polyuria. . in the ed, initial vitals were 98.6 102 153/97 16 98%ra. received 5l ns,zofran 4mg iv x1 and morphine 4mg iv x 1. past medical history: none . allergies: nkda social history: he is married, no children. does not smoke he stopped 3yrs ago. drinks etoh several times per week. he works at admission office at . family history: no colitis. paternal gf died of colon cancer at age 73. mother with disease. physical exam: vitals: t 99.1, bp 144/68, hr 90, o2 sats 95%ra gen: pt lying comfortably in bed. nad. heent: eomi.clear conjuctiva. dry oral mucosa. no ulcers. no lad cv: rrr. nl s1s2. no m/g/r's. pulm: ctab. abd: soft, non-tender, non-distended. midline incision intact, except for a 6cm section adjacent to the umbilicus and stoma bag appliance, which is open and packed with gauze. no erythema. no rebound or guarding. stoma appears pink with brown liquid output. ext: wwp. +2 dp's. no edema. skin: no rashes. pertinent results: wbc 21.7 (n 80, band 5, l 9, m 6, e 0, b 0) on admission. hct drop 41.3-->33.5 since admission. . pathology examination procedure date sigmoid colon mucosal biopsy: 1. chronic active colitis. 2. no granulomas or dysplasia seen. clinical: hematochezia, colitis. . pathology examination procedure date previous biopsies: sigmoid. diagnosis: ileocolectomy: 1. ulcerative colitis, chronic active: a. diffuse involvement of cecum and colon to distal margin; and focal disease in the appendix. b. predominantly superficial disease with focal deep ulcers into the muscularis propria. c. no granulomas or dysplasia. 2. extensive organizing venous thrombi of the mesenteric veins, noted in mesocolon and colon wall. 3. ileal segment and omental fragment: within normal limits. clinical: ulcerative colitis/toxic megacolon. . radiology final report ct abd w&w/o c 11:13 am indication: 31-year-old with ulcerative colitis, status post colectomy with pathology showing total venous thrombosis. please assess patency of the mesenteric vasculature. impression: 1) findings suggestive of a small bowel obstruction. though the patient is recently postsurgical, this is less likely ileus given nondistended loops of small bowel distally. close follow up is recommended. 2) moderate abdominal free fluid, presumably post-operative. there are no additional findings to suggest small bowel ischemia. 3) patent mesenteric vasculature. 4) heterogeneous perfusion of the liver with perihepatic venous hypoattenuation and perferential peripheral enhancement, suggesting sluggish portal venous flow. 5) moderate-sized bilateral pleural effusions with associated atelectasis. . sigmoidoscopy date: thursday, findings: mucosa: severe diffuse erythema, friability and ulceration with contact bleeding were noted in the sigmoid colon. the inflammation went above the level of the scope. these findings are compatible with ulcerative colitis. cold forceps biopsies were performed for histology at the sigmoid colon. impression: erythema, friability and ulceration in the sigmoid colon compatible with ulcerative colitis (biopsy) otherwise normal sigmoidoscopy to sigmoid recommendations: follow-up biopsies continue iv steroids and tpn advance diet to clears . 09:15am blood wbc-13.6* rbc-2.73* hgb-8.5* hct-25.0* mcv-92 mch-31.2 mchc-34.0 rdw-15.1 plt ct-292 10:00pm blood wbc-21.7*# rbc-4.67 hgb-14.6 hct-41.3 mcv-88 mch-31.2 mchc-35.3* rdw-12.8 plt ct-432 05:55am blood neuts-80* bands-2 lymphs-12* monos-5 eos-0 baso-0 atyps-0 metas-1* myelos-0 10:00pm blood neuts-80* bands-5 lymphs-9* monos-6 eos-0 baso-0 atyps-0 metas-0 myelos-0 04:21am blood pt-16.7* ptt-30.2 inr(pt)-1.5* 10:45am blood aca igg-12.2 aca igm-7.5 10:45am blood lupus-neg at iii-88 09:15am blood glucose-72 urean-10 creat-0.6 na-136 k-4.4 cl-98 hco3-28 angap-14 10:00pm blood glucose-126* urean-12 creat-0.9 na-131* k-6.5* cl-93* hco3-26 angap-19 09:45pm blood alt-128* ast-71* alkphos-107 totbili-0.4 09:15am blood calcium-7.6* phos-3.0 mg-2.0 10:00pm blood calcium-8.7 phos-3.8 mg-2.2 05:32am blood caltibc-111* hapto-234* ferritn-419* trf-85* 10:45am blood homocys-5.3 06:35am blood triglyc-80 06:20am blood triglyc-68 hdl-27 chol/hd-3.2 ldlcalc-45 06:20am blood crp-63.8* . 1:30 pm blood culture source: line-picc. **final report ** blood culture, routine (final ): staphylococcus, coagulase negative. of two colonial morphologies. isolated from one set only. sensitivities performed on request.. aerobic bottle gram stain (final ): gram positive cocci in clusters. anaerobic bottle gram stain (final ): gram positive cocci in clusters. . radiology final report ct abd w&w/o c 11:13 am medical condition: 31 year old man s/p tac for uc with hemorrhagic colits pathology showing massive mesenteric venous thrombosis impression: 1) findings suggestive of a small bowel obstruction. though the patient is recently postsurgical, this is less likely ileus given nondistended loops of small bowel distally. close follow up is recommended. 2) moderate abdominal free fluid, presumably post-operative. there are no additional findings to suggest small bowel ischemia. 3) patent mesenteric vasculature. 4) heterogeneous perfusion of the liver with perihepatic venous hypoattenuation and perferential peripheral enhancement, suggesting sluggish portal venous flow. 5) moderate-sized bilateral pleural effusions with associated atelectasis. brief hospital course: 31 yo m presented w/aggressive uc flare. he was admitted for evaluation and medical management of undiagnosed ibd. he presented w/2 month hx of worsening loose bloody bowel movements, failure of 2 week regimen of oral steroids w/cypro/flagyl regimen, and precipitous drop of 15 lbs over 2 weeks pta. sigmoidoscopy was performed on w/findings c/w uc, and iv steroids treatment was initiated w/continued cypro/flagyl. patient has continued having loose, bloody bm's, and has demonstrated a hct drop <25% requiring one uprbc transfusion. he also developed thrombocytopenia into 60k platelet count, and is being evaluated for possible dic and hit given ?bacteremia and heparin use on admission. of note, he was also started on vancomycin for possible mrsa bacteremia. given his marked wt loss and ongoing uc he was started on tpn. on -general surgery was consulted. . icu course: on , he was admitted to icu from ed due to copious (>1 liter) of bloody stools. he required closer monitoring, and stabilization. including multiple transfusions. he was stabilized, and consented for surgical resection of diseased bowel with dr. . . post-op: operative course was uncomplicated. monitored in pacu slightly longer due to previously mentioned hemodynamic instability. rectal tube inserted due to persistent melanous rectal leaking. hct's remained stable as well as hr & bp. transferred to for further management. . floor course: : progressed according to colectomy pathway. tolerating sips of fluids. ostomy with visble effluence & gas. appeared to be progressing well. on reported nausea, decreased appetite. abdomen distened. ct scan revealed dilated loops of bowel. ngt inserted, ivf started, and patient maintained npo for a few days. all medication transitioned to iv, including steroid taper. pod7/hd13: maintained npo with the ngt in place. ngt output decreased to 400cc, and the stoma bag began to contain small amounts of air with liquid stool. he was maintained on iv steroids. : pod8/hd14: the ngt was discontinued. sips with meds were begun and the pt was started on a po prednisone taper, receiving 20mg on this day. the pt ambulated well and the stoma bag contained air as well as liquid stool. : pod9/hd15: diet was advanced to clears after sips were tolerated without nausea or vomiting. prednisone was tapered to 15mg qd. : pod10/hd16: pt tolerated a regular breakfast and lunch, and was discharged to home with vna for stoma bag teaching and care. prior to discharge, the wound staples were removed. a small area adjacent to the unbilicus developed a small serous leak. upon further evaluation, 6cm of the midline incision were opened and packed. no further tracts could be identified, and the pt was discharged with vna for assistance with dressing changes in this area of the incision. the remained of the incision was clean, dry and intact, without any surrounding erythema. at the time of discharge, final hematological workup was not complete. pending tests included factor v leiden and prothrombin mutation analyses. the surgical team will follow up on these tests and contact the pt if they are abnormal. the pt was discharged with 4 additional days of prednisone taper: 2 days of 10mg qd, then 2 days of 5 mg qd. medications on admission: home medications: prednisone 30 mg per day ciprofloxin 500 mg twice daily metronidazole 500 mg twice daily discharge medications: 1. mesalamine 1,000 mg suppository sig: one (1) suppository rectal qhs (once a day (at bedtime)). disp:*20 suppository(s)* refills:*0* 2. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia for 5 doses. disp:*5 tablet(s)* refills:*0* 3. prednisone 5 mg tablet sig: one (1) tablet po once a day for 4 days: 10mg x 2 days 5mg x 2 days stop. disp:*6 tablet(s)* refills:*0* 4. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po q4-6h () as needed for pain for 2 weeks. disp:*30 tablet(s)* refills:*0* 5. mesalamine 1,000 mg suppository sig: one (1) suppository rectal 3x/week (mo,th,sa). disp:*30 suppository(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: primary: blood loss anemia hypovolemia ulcerative colitis flare-up malnutriton post-op ileus vs sbo . secondary: ulcerative colitis discharge condition: stable tolerating a regular diet adequate pain control with oral medication discharge instructions: please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomiting, diarrhea or other reasons. signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. *avoid driving or operating heavy machinery while taking pain medications. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered. * continue to ambulate several times per day. . incision care: -your staples will be removed at your follow-up appointment. -you may shower, and wash surgical incisions. -avoid swimming and baths until your follow-up appointment. -please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. . monitoring ostomy output/prevention of dehydration: -keep well hydrated. -replace fluid loss from ostomy daily. -avoid only drinking plain water. include gatorade and/or other vitamin drinks to replace fluid. -try to maintain ostomy output between 500ml to 1000ml per day. -if ostomy output >1 liter, take 4mg of imodium, repeat 2mg with each episode of loose stool. do not exceed 16mg/24 hours. . steroid taper: *continue prednisone 10mg by mouth once a day x 2 days, decrease to 5mg by mouth once a day x 2 days, then discontinue. followup instructions: 1. please make a follow-up appointment with dr. in weeks. 2. make a follow-up appointment with dr. (pcp) in 1 week or as needed. 3.please follow-up with dr. (gi)( in weeks. 4. please wait 1 week to make a follow-up appointment with dr. (heme/onco) ( to review pending lab tests. **dr. surgery team will contact you in 1 week only if any heme/onco labwork results are abnormal. if you need to follow-up, you may call , and have resident paged at . procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances temporary ileostomy closed [endoscopic] biopsy of large intestine application or administration of an adhesion barrier substance diagnoses: thrombocytopenia, unspecified iron deficiency anemia secondary to blood loss (chronic) unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia paralytic ileus dehydration hypovolemia universal ulcerative (chronic) colitis 

Answer: The patient is high likely exposed to