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: prozac attending: chief complaint: vomiting, abdominal discomfort major surgical or invasive procedure: upper endoscopy picc line history of present illness: mr. is an 80 year-old male with multiple sclerosis, peripheral vascular disease, bl le ulcers transferred from house with leukocytosis and vomiting for several days. he denied pain, chest pain, cough, dyspnea, abdominal pain, dysuria. he had been intermittently feeling nauseated with 2 episodes of vomiting in the two days prior to admission. unknown last bowel movement prior to admission. . ed course: he was initially afebrile on presentation, and then spiked to 102.6. his bp was also stable at first. he had a distended though benign abdominal exam. during his ed course, he developed more abdominal distension and a ct abd / pelvis was done which showed a partial sbo and likely bibasilar infiltrates. his bp was trending down. he received 4 liters of lactated ringers. he was started on vancomycin, levofloxacin and flagyl. he had a central line placed. a nasogastric tube was placed with large output after which time he felt better. past medical history: multiple sclerosis neurogenic bladder myelodysplastic syndrome dm - pvd - non-healing bilateral ulcers social history: married with three children. lives in . no etoh, drugs, tobacco. family history: noncontributory. physical exam: physical exam~ vs- 100.0 111/43 96 16 99 2l nc weight 67kg gen- elderly ill appearing male lying flat in bed, nad heent- mmdry, anicteric, poor dentition, eomi, perrl neck- supple, radiating cardiac murmur, no lad cor- regular, tachy, ii/vi sem at usb to carotids chest- clear anteriorlly abd- obese, distended, soft, nt, no palpable masses, decreased bs in lower quadrants, no surgical scars ext- no edema. open ulcers bilateral heels, no sign of infection. neuro- aao x 3, no movement of ble (old), some sensation to light touch. motor strength in bue. skin- ulcers on heels and one pressure ulcer on right lateral leg pertinent results: ecg: sinus tachy vs ectopic atrial rhythm at 116. lad. lafb. ni. prwp. 0.5mm std in lateral leads. . studies~ . ct abd: 1. patchy bilateral lower lobe pneumonia with probable small adjacent pleural effusions and small pericardial effusion. 2. dilated jejunum measuring 3-4 cm with air-fluid levels and non-abrupt tapering transition point within the left lower quadrant. these findings are most suggestive of an early mild partial small-bowel obstruction, although atypical appearing ileus is also within the differential. consider serial radiographs to assess for change and contrast progression. 3. large fusiform infrarenal aortic aneurysm with a large amount of intramural thrombus as described above. moderate atherosclerotic disease involving the intrathoracic aorta and its branches. 4. hypoattenuating hepatic lesion, too small to definitively characterize. left renal cyst. . cxr: no radiographic evidence of pneumonia. . repeat cxr: 1. appropriately-positioned left subclavian catheter without evidence of pneumothorax on the supine film. 2. bilateral lower lobe pneumonia is better appreciated on concomitantly performed abdominal ct examination. picc line placement indication: iv access needed for antibiotics. the procedure was explained to the patient. a timeout was performed. radiologists: dr. and dr. performed the procedure.dr. , the attending radiologist, was present for the entire procedure. technique: using sterile technique and local anesthesia, the right basilic vein was punctured under direct ultrasound guidance using a micropuncture set. hard copies of ultrasound images were obtained before and immediately after establishing intravenous access. a peel-away sheath was then placed over a guidewire and a right double-lumen picc line measuring 40 cm in length was then placed through the peel-away sheath with its tip positioned in the svc under fluoroscopic guidance. position of the catheter was confirmed by a fluoroscopic spot film of the chest. the peel-away sheath and guide wire were then removed. the catheter was secured to the skin, flushed, and a sterile dressing applied. the patient tolerated the procedure well. there were no immediate complications. impression: uncomplicated ultrasound and fluoroscopically guided 5 french double-lumen picc line placement via the right basilic venous approach. final internal length is 40 cm, with the tip positioned in svc. the line is ready to use. dr. dr. preliminaryapproved: tue 12:22 pm brief hospital course: 80 male with history of ms (paraplegia), dm, mds, chronic anemia admitted for sepsis and transferred to floor after stabilization and transient pressor needs, then found to have ugib, transfer out of micu after 8 units prbc, stable on floor. . hypotension and sepsis mr. was admitted with a high fever from his nursing home, and was found to be hypotensive in the ed. the sepsis protocol was initiated, and he was admitted to the micu. the differential diagnosis remained pneumonia or as related to his gastrointestintal tract, as he was found to have a partial small bowel obstruction. patient completed course of levofloxacin and flagyl on . the patient had a transient rise in wbc without clinical signs of infection which resolved after the central line was removed. . small bowel obstruction, partial the patient received ngt placement, as well as decompression via rectal tube. surgery was consulted and followed the patient in house. he was started on tpn, and then diet slowly advanced. rectal tube was pulled prior to discharge. tpn was discontinued prior to discharge. the patient should be encouraged to take po. . upper gastrointestinal bleed after sepsis was stabilized in the micu, the patient was transferred to the floor, where he was found to have an increasing heart rate. suction on the ng tube revealed bloody return, and the patient was found to have a falling hematocrit. he was transferred to the micu for follow-up, and received 8 units of prbcs while there. after conversation with hcp, a decision to pursue endoscopy to attempt to identify and stop bleeding was made. egd showed marked friability of the stomach mucosa with contact bleeding, multiple non-bleeding ulcers were found in the stomach and a single bleeding ulcer was found in the cardia near the ge junction s/p electrocautery for hemostasis. subsequently, he has been hemodynamically stable with hr in 90s. hematocrit remained stable for >96 hours prior to discharge. he was discharged on pantoprazole 40mg twice daily. . hypoxia patient still on oxygen, currently 96% on 2 liters nasal cannula. combination of recovery from pneumonia and volume overload from fluids given in icu during gib. continue with gentle diuresis and monitor electrolytes. . nutrition due to concern of aspiration patient was evaluated by speech and swallow on , his diet was advanced to thin liquids and ground consistency solids. he needs assistance with meals and should have his pills whole with purees. tpn dicscontinued as above and picc line placed prior to discharge. . abdominal aortic aneurysm noted on ct scan was a 4.7 infrarenal aaa in the setting of profound atherosclerotic disease. maintain good bp control, will need serial imaging as an outpatient. . diabetes placed on regular insulin sliding scale. . code status dnr/dni, confirmed with patient communication: (hcp) - nephew medications on admission: medications: - lasix 20 daily - mvi - verapamil 120 sa daily - vitamin c 500 daily - simvastatin 80 daily - buproprion sr 150 - colace - lorazepam 0.25mg qid (9a, 1p, 5p, 9p) - tylenol 325 qid - risperdal 0.5 q 8p - senna - dulcolax - mom - prn - compazine prn discharge medications: 1. furosemide 20 mg tablet sig: one (1) tablet po once a day. 2. verapamil 120 mg cap,24 hr sust release pellets sig: one (1) cap,24 hr sust release pellets po once a day. 3. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. 5. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 6. ascorbic acid 500 mg tablet sig: one (1) tablet po daily (daily). 7. bupropion 75 mg tablet sig: two (2) tablet po bid (2 times a day). 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed. 9. risperidone 1 mg tablet sig: one (1) tablet po hs (at bedtime). 10. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed): as indicated. 11. lorazepam 0.5 mg tablet sig: one (1) tablet po four times a day: as needed for anxiety. 12. 0.5-2.5 mg/3 ml solution for nebulization sig: one (1) inhalation every six (6) hours as needed for shortness of breath or wheezing. 13. compazine 5 mg tablet sig: one (1) tablet po every six (6) hours as needed for nausea. 14. milk of magnesia 800 mg/5 ml suspension sig: one (1) po three times a day as needed for constipation. 15. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. discharge disposition: extended care facility: - discharge diagnosis: sepsis due to pneumonia partial small bowel obstruction upper gastrointestinal bleed abdominal aortic aneurysm diabetes mellitus type ii bilateral heel ulcers volume overload with anasarca discharge condition: stable discharge instructions: you were admitted with an infection of your lungs and partial small bowel obstruction. you also had a bleed in your stomach which you underwent an upper endoscopy to cauterize the lesion. you required several units of blood in the intensive care unit. you were stable afterwards, your diet was advanced after your evaluation with speech and swallow. return to the er or call you primary care physician if you experience any chest pain, shortness of breath, bloody or tarry stools, or any worrisome symptoms. take all of your medications as prescribed. followup instructions: follow up with your primary care doctor ( ) procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances insertion of other (naso-)gastric tube endoscopic control of gastric or duodenal bleeding transfusion of packed cells transfusion of other serum diagnoses: anemia, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis myelodysplastic syndrome, unspecified dysthymic disorder other and unspecified hyperlipidemia pneumonitis due to inhalation of food or vomitus septic shock pressure ulcer, other site chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction hypoxemia multiple sclerosis unspecified intestinal obstruction ulcer of heel and midfoot edema neurogenic bladder nos paralysis, unspecified 

Answer: The patient is high likely exposed to