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: no known allergies / adverse drug reactions attending: chief complaint: enterocutaneous fistula abdominal cellulitis ventral hernia major surgical or invasive procedure: none history of present illness: mr. is a 57 year old male with history of obstructive sleep apnea, htn, paroxysmal afib, atrial flutter on coumadin, diastolic heart failure who has an long standing ventral hernia who presented to ed with a necrotic wound overlying his hernia. patient reported that he scratched his abdomen while scrawling through a window a week ago. the anterior abdominal skin became red the next day, however, pt didn't seek any medical attention until today when he noticed purulent drainage coming from a wound. he denied any fever, chills, nausea, vomiting, diarrhea, chest pain, shortness of breath. he continues to have regular bm and tolerates po until last night. of note, patient has been seen at for his ventral hernia. he reported that he was scheduled to undergo a repair a few years ago but the operation was aborted when he "couldn't tolerate anesthesia" in the or. he continues to follow a surgeon at but expressed that he wants to have this current issue taken care of at . he was admitted to the acs service at for treatment of his ventral hernia and enterocutaneous fistula and underwent a partial colectomy and ventral hernia repair with component separation. he had post-op pain, which was treated with dilaudid and tap blocksm, and his methadone was restarted. past medical history: 1 atrial fibrillation status post cardioversion in and at . 2. atrial flutter, status post cardioversion at on and status post atrial flutter ablation on & at . 3. hypertension. 4. hyperlipidemia. 5. aortic pseudoaneurysm after mva, status post repair in . 6. severe obstructive sleep apnea. 7. diastolic heart failure. 8. chronic back pain, on chronic narcotics. social history: repairs, insures, and rents out antique guitar amplifiers. smokes 1 ppd for 40+ years. drinks 3-4 beers per night. occasional marijuana use, but no other illicit drug use. family history: father died from an mi in his 40s. no other family history of premature mi, arrhythmias, or other cardiac history. physical exam: on admission: vitals: 99.6 100 127/72 18 96% 3l ns gen: a&ox3, nad, mild diaphoretic heent: no scleral icterus, mucus membranes moist cv: mild tachy, rr, no m/g/r pulm: clear to auscultation b/l, no w/r/r abd: soft, nondistended, mild tender at midline with large area of erythema and 3cm wound at center over previous scar with necrotic/purulent drainage on expression, no rebound or guarding, dre: deferred ext: no le edema, le warm and well perfused on discharge: vitals: gen: a&ox3, nad heent: no scleral icterus cv: rrr, no m/r/g pulm: ctab abd: +bs, soft, tender, midline incision clean, dry, intact except for open area at the upper margin of incision, which is dressed with a wet-to-dry dressing. bilateral jp drains in place draining serosanguinous fluid, insertion sites are non-erythematous, clean, and dry. ext: no le edema, le wwp, no calf-tenderness pertinent results: 05:40am blood wbc-11.6* rbc-5.05 hgb-15.9 hct-50.4 mcv-100* mch-31.5 mchc-31.6 rdw-14.5 plt ct-468* 06:50am blood wbc-9.9 rbc-5.06 hgb-16.3 hct-50.8 mcv-100* mch-32.3* mchc-32.2 rdw-14.4 plt ct-475* 06:10am blood wbc-12.2* rbc-4.93 hgb-15.5 hct-50.4 mcv-102* mch-31.5 mchc-30.8* rdw-14.1 plt ct-442* 06:58am blood wbc-15.0* rbc-4.89 hgb-15.7 hct-50.0 mcv-102* mch-32.1* mchc-31.4 rdw-14.1 plt ct-431 05:40am blood glucose-88 urean-12 creat-0.9 na-138 k-4.0 cl-105 hco3-24 angap-13 06:50am blood glucose-81 urean-11 creat-0.8 na-138 k-4.5 cl-105 hco3-24 angap-14 06:10am blood glucose-87 urean-11 creat-0.7 na-137 k-3.9 cl-103 hco3-24 angap-14 06:58am blood glucose-84 urean-16 creat-0.7 na-136 k-4.1 cl-102 hco3-23 angap-15 07:05am blood wbc-15.1* rbc-5.10 hgb-16.4 hct-52.0 mcv-102* mch-32.1* mchc-31.5 rdw-14.1 plt ct-462* 07:50am blood wbc-17.0* rbc-4.43* hgb-14.2 hct-44.3 mcv-100* mch-32.0 mchc-32.0 rdw-14.3 plt ct-381 07:05am blood wbc-13.9* rbc-4.60 hgb-14.4 hct-45.1 mcv-98 mch-31.4 mchc-31.9 rdw-14.5 plt ct-494* 07:05am blood plt ct-494* 05:40am blood glucose-88 urean-12 creat-0.9 na-138 k-4.0 cl-105 hco3-24 angap-13 02:35am blood glucose-94 urean-9 creat-0.8 na-141 k-4.1 cl-108 hco3-25 angap-12 07:05am blood glucose-115* urean-9 creat-0.8 na-136 k-4.0 cl-104 hco3-22 angap-14 05:40am blood albumin-3.3* calcium-8.9 phos-3.2 mg-1.7 02:35am blood calcium-7.6* phos-3.7 mg-1.9 07:05am blood albumin-3.0* calcium-8.6 phos-2.6* mg-1.9 brief hospital course: mr. was admitted to the acute care surgery service on for management of an enterocutaneous fistula with surrounding abdominal cellulitis. he was treated with bowel rest, iv antibiotics (unasyn), and local wound care (ostomy appliance over fistula site). he was taken to the operating room on for a ventral hernia repair with transverse colectomy and primary anastamosis. please refer to dr. operative summary for further details. patient tolerated the procedure well with an ebl of ~150ml. skin could not be well approximated upon closure, so a wound v.a.c. was placed at the superior portion of the incision. post-op, he was treated with dilaudid and tap blocks for pain. he was appropriately advanced to a regular diet and was encouraged to ambulate. a wound vac was ordered for his home for use upon discharge. medications on admission: medications: - melatonin 1 mg po daily - lipitor 40 mg po daily - viagra 100 mg po daily prn - nuvigil 50mg qam - methadone 25 mg - aspirin 325 mg - lisinopril 20 mg po daily - testosterone 1.25 g/actuation (1%) transdermal gel pump - zolpidem 10 mg - rythmol 225 mg tid - warfarin 5 mg po daily - fluticasone 50 mcg/actuation nasal spray, susp 2 sprays intransal once daily - acetazolamide 125 mg po qhs discharge medications: 1. hospital bed dx: ventral hernia and enterocutaneous fistula surgery: partial transverse colectomy, ventral hernia repair with component separation 2. hydromorphone (dilaudid) 2-4 mg po q3h:prn pain rx *hydromorphone 2 mg tablet(s) by mouth every four (4) hours disp #*40 tablet refills:*0 3. warfarin 2.5 mg po once duration: 1 doses have your inr drawn by the home nurse and follow up with your pcp. *coumadin 2.5 mg 1 tablet(s) by mouth once disp #*5 tablet refills:*0 restart home meds. discharge disposition: home with service facility: homecare discharge diagnosis: enterocutaneous fistula ventral hernia wound cellulitis 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 because of a large ventral hernia and an enterocutaneous fistula with surrounding wound erythema (redness). you were treated with a partial transverse colectomy with ventral hernia repair by component separation, wound care via v.a.c appliance applied to the fistula site, bowel rest, and iv antibiotics. you responded well to this treatment. you are going home with a wet to dry dressing in the area of your open wound. you will have a v.a.c. sent to your home, and a nurse will come to your home to apply the v.a.c. in the event of v.a.c. failure, the wound can be dressed with a normal saline wet-to-dry dressing. inr please call your doctor or nurse practitioner if you experience the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down 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. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *your pain is not improving within 8-12 hours or is not gone within 24 hours. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. . general discharge instructions: please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. avoid driving or operating heavy machinery while taking pain medications. please follow-up with your surgeon and primary care provider (pcp) as advised. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. *if you have staples, they will be removed at your follow-up appointment. *if you have steri-strips, they will fall off on their own. please remove any remaining strips 7-10 days after surgery. jp drain care: *please look at the site every day for signs of infection (increased redness or pain, swelling, odor, yellow or bloody discharge, warm to touch, fever). *maintain suction of the bulb. *note color, consistency, and amount of fluid in the drain. call the doctor, nurse practitioner, or vna nurse if the amount increases significantly or changes in character. *be sure to empty the drain frequently. record the output and take these recorded values to your clinic appt. *you may shower; wash the area gently with warm, soapy water. *keep the insertion site clean and dry otherwise. *avoid swimming, baths, hot tubs; do not submerge yourself in water. *make sure to keep the drain attached securely to your body to prevent pulling or dislocation. . vna jp orders: jp drain care: to bulb suction. cleanse insertion site with mild soap and water or sterile saline, pat dry, and place a drain sponge daily and prn. monitor and record quality and quantity of output. empty bulb frequently. ensure that the jp is secured to the patient. monitor for s/s infection or dislocation. . general drain care: *please look at the site every day for signs of infection (increased redness or pain, swelling, odor, yellow or bloody discharge, warm to touch, fever). *if the drain is connected to a collection container, please note color, consistency, and amount of fluid in the drain. call the doctor, nurse practitioner, or vna nurse if the amount increases significantly or changes in character. be sure to empty the drain frequently. record the output, if instructed to do so. *wash the area gently with warm, soapy water or 1/2 strength hydrogen peroxide followed by saline rinse, pat dry, and place a drain sponge. change daily and as needed. *keep the insertion site clean and dry otherwise. *avoid swimming, baths, hot tubs; do not submerge yourself in water. *make sure to keep the drain attached securely to your body to prevent pulling or dislocation. the patient was admitted to the acs service for evaluation and treatment of his enterocutaneous fisutla and hernia. on , the patient underwent a partial transverse colectomy and ventral hernia repair with component separation, which went well without complication (reader referred to the operative note for details). after a brief, uneventful stay in the pacu, the patient arrived on the floor npo, on iv fluids and antibiotics, with a foley catheter, and dilaudid for pain control. the patient was hemodynamically stable. neuro: the patient received dilaudid with good effect and adequate pain control. when tolerating oral intake, the patient was transitioned to oral pain medications. cv: the patient remained stable from a cardiovascular standpoint; vital signs were routinely monitored. pulmonary: the patient remained stable from a pulmonary standpoint; vital signs were routinely monitored. good pulmonary toilet, early ambulation and incentive spirrometry were encouraged throughout hospitalization. gi/gu/fen: post-operatively, the patient was made npo with iv fluids. diet was advanced when appropriate, which was well tolerated. patient's intake and output were closely monitored, and iv fluid was adjusted when necessary. electrolytes were routinely followed, and repleted when necessary. id: the patient's white blood count and fever curves were closely watched for signs of infection. vac was placed on open wound site. endocrine: the patient's blood sugar was monitored throughout his stay; insulin dosing was adjusted accordingly. hematology: the patient's complete blood count was examined routinely; no transfusions were required. prophylaxis: the patient received subcutaneous heparin and venodyne boots were used during this stay; was encouraged to get up and ambulate as early as possible. at the time of discharge, the patient was doing well, afebrile with stable vital signs. the patient was tolerating a regular diet, ambulating, voiding without assistance, and pain was well controlled. the patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. coumadin (warfarin): what is this medicine used for? this medicine is used to thin the blood so that clots will not form. how does it work? warfarin changes the body's clotting system. it thins the blood to prevent clots from forming. what you should contact your healthcare provider : signs of a life-threatening reaction. these include wheezing; chest tightness; fever; itching; bad cough; blue skin color; fits; or swelling of face, lips, tongue, or throat, severe dizziness or passing out, falls or accidents, especially if you hit your head. talk with healthcare provider even if you feel fine, significant change in thinking clearly and logically, severe headache, severe back pain, severe belly pain, black, tarry, or bloody stools, blood in the urine, nosebleeds, coughing up blood, vomiting blood, unusual bruising or bleeding, severe menstrual bleedin, or rash. call your doctor if you are unable to eat for several days, for whatever reason. also call if you have stomach problems, vomiting, or diarrhea that lasts more than 1 day. these problems could affect your coumadin??????/warfarin dosage. coumadin (warfarin) and diet: certain foods and beverages can impair the effect of warfarin. for this reason, it's important to pay attention to what you eat while taking this medication. until recently, doctors advised taking warfarin to avoid foods high in vitamin k. this is because large amounts of vitamin k can counteract the benefits of warfarin. however, recent research shows that rather than eliminating vitamin k from your diet, it is more important to be consistent in your dietary vitamin k intake. these foods contain vitamin k: fruits and vegetables, such as: kiwi, blueberries, broccoli, cabbage, sprouts, green onions, asparagus, cauliflower, peas, lettuce, spinach, turnip, collard, and mustard greens, parsley, kale, endive. meats, such as: beef liver, pork liver. other: mayonnaise, margarine, canola oil, soybean oil, vitamins, soybeans and cashews. limit alcohol. alcohol can affect your coumadin??????/warfarin dosage but it does not mean you must avoid all alcohol. serious problems can occur with alcohol and coumadin??????/warfarin when you drink more than 2 drinks a day or when you change your usual pattern. binge drinking is not good for you. be careful on special occasions or holidays, and drink only what you usually would on any regular day of the week. monitoring: the doctor decides how much coumadin??????/warfarin you need by testing your blood. the test measures how fast your blood is clotting and lets the doctor know if your dosage should change. if your blood test is too high, you might be at risk for bleeding problems. if it is too low, you might be at risk for forming clots. your doctor has decided on a range on the blood test that is right for you. the blood test used for monitoring is called an inr. use of other medications: when coumadin??????/warfarin is taken with other medicines it can change the way other medicines work. other medicines can also change the way coumadin??????/warfarin works. it is very important to talk with your doctor about all of the other medicines that you are taking, including over-the-counter medicines, antibiotics, vitamins, or herbal products. followup instructions: please follow up with clinic and pcp. please call clinic at to make an appointment to be seen within 14 days. procedure: large-to-large intestinal anastomosis open and other resection of transverse colon incisional hernia repair closure of fistula of large intestine diagnoses: obstructive sleep apnea (adult)(pediatric) cellulitis and abscess of trunk congestive heart failure, unspecified unspecified essential hypertension atrial fibrillation other and unspecified hyperlipidemia incisional hernia without mention of obstruction or gangrene long-term (current) use of anticoagulants fistula of intestine, excluding rectum and anus 

Answer: The patient is high likely exposed to