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: gi bleeding major surgical or invasive procedure: ir angio embolization of right and middle colic arteries open total abdominal colectomy history of present illness: 58 year old male h/o of ?crohns colitis and diverticulosis, hl, barretts with h.o hemodynamically significant gi bleed many years ago who presents with 2 episodes of black stool with flecks of blood that was "loose" in the bowl on thursday. today, pt had a very large bm with large amounts of black stool mixed with a large amount of bright red blood at 10:30am. pt called gi and was referred to the ed. while walking from cab to , pt experienced sensation of "heart fluttering". pt had an additional episode of small black stools with flecks of red blood ~4pm today. pt states presentation very similar to large gib episode years ago. pt otherwise denies abdominal pain, nausea, vomiting, gerd, constipation, fever, chills, travel, sick contacts, new foods, chest pain, shortness of breath. in addition, pt denies dysuria, hematuria, rash, joint pain, paresthesias, weight loss, headache, st, uri, blurred vision. . in the er, pt was initially a trigger found to be in svt rate ~180-190s and given 6mg iv adenosine x1 with rate resolving into sinus tachycardia initially rate 130's then 100's. rectal exam found maroon and brbpr, no melena/black stool per ed. . initial vitals: time pain temp hr bp rr pox +12:02 0 190 122/105 22 100% most recent vitals: 97.6 hr 101 (st) 122/87 18 99% ra past medical history: -colitis-per gi thought to be due to crohns vs. diverticular colitis -barretts -hyperlipidemia -fx ankle -anxiety -htn social history: pt works as a communications engineer. married. never smoker. reports drinking 4-6drinks 2x weekly. smokes occasional marijuana, last use last week. family history: adopted, does not know family history physical exam: gen: well appearing, sitting upright in bed, nad vitals: t 97.4, bp 154/96, hr 105, rr 20, sat 98% on ra heent:ncat eomi anicteric mmm no op lesions neck: no lad, no jvd, supple chest: b/l no w/c/r heart: s1s2 rr no m/r/g abd:+bs, soft, nt, nd, no guarding or rebound tenderness rectal: ed exam-maroon stool, ext: no c/c/e 2+pulses neuro: aaox3, cn2-12 intact, motor x4, no tremor psych: calm, cooperative pertinent results: micro: mrsa screen negative urine urine culture-pending inpatient stool clostridium difficile toxin a & b test-final inpatient stool clostridium difficile toxin a & b test-final inpatient urine urine culture-final inpatient blood culture blood culture, routine-pending inpatient stool fecal culture-final; campylobacter culture-final; clostridium difficile toxin a & b test-final inpatient urine urine culture-final inpatient mrsa screen mrsa screen-final inpatient mrsa screen mrsa screen-final path, colon + portion of omentum: : diagnosis: 1. total colectomy: a. diverticular disease with multifocal diverticulitis and peri diverticulitis, rupture, and recent hemorrhage. b. focal superficial ischemic type mucosal injury. c. focal mucosal crypt abscesses and distorted architecture, likely related to diverticular disease. d. appendix with focal mild mucosal acute inflammation and recent hemorrhage. e. adenoma, cecum. . omentum: within normal limits. imaging: adm ekg: supraventricular tachycardia with 2:1 block. atrial cycle length fast for flutter at 160 to 180 milliseconds. s1-s2-s3 pattern. rsr' pattern in lead v1. since the previous tracing of the rate is faster. rsr' pattern is more prominent. clinical correlation is suggested gi bleed study: no evidence of gi bleed. tte: symmetric lvh with normal global and regional biventricular systolic function and high cardiac output gi bleed study: no evidence of bleeding cxr: lateral aspect of the right lower chest is excluded from the examination. other imaged pleural surfaces are normal. left pic line ends in the upper right atrium close to the superior cavoatrial junction. heart size normal. lungs clear. cta: diverticulosis without diverticulitis. no acute pathology identified. no evidence of active extravasation, perfusional abnormality, or pseudoaneurysm identified. ir procedure: subselective mesenteric angiography demonstrating active extravasation at the hepatic flexure. embolization performed with one coil to the supplying branch of the right colic artery and two coils to a branch of the middle colic artery. cxr: left picc is in the upper svc. right ij catheter tip is in the mid svc. compared to prior study there is resolution of vascular congestion. the cardiac size has decreased in size. there is no pneumothorax or pleural effusion. ng tube tip is out of view below the diaphragm. aside from atelectasis in the left base the lungs are clear. there is a small pneumoperitoneum expected post-op. cta with iv contrast: left subclavian central venous catheter in place with tip in mid-svc. there is moderate multivessel coronary arterial calcifications as well as mitral annular and aortic valve calcifications. no evidence of pulmonary embolism. new small bilateral effusions, left greater than right, with associated atelectasis. new small perihepatic effusion. cholelithiasis. . -echo focused views to assess lv/rv function. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. the mitral valve appears structurally normal with trivial mitral regurgitation. there is borderline pulmonary artery systolic hypertension. . leni-impression: acute thrombosis involving the posterior tibial veins in both lower extremities. . impression: 1. diffuse severe dilatation of the esophagus, stomach, and small bowel loops extending to a few centimeters proximal to the level of the ileocolonic anastomosis. a transition at this level, raising concern for partial bowel obstruction versus ileus with compression of the small bowel loops. small-to-moderate amount of abdominopelvic ascites, with slightly highdensity material in the pelvis, which may be secondary to layering debris or small amount of hemoperitoneum. 2. no indirect evidence of anastomotic leak. limited assessment of the anastomosis due to the lack of intraluminal contrast at this level. however, no focal fluid collections or free air is seen to suggest disruption of the anastomosis. 3. bibasilar consolidation, likely atelectasis, however, superimposed aspiration cannot be excluded. 4. no evidence of pulmonary embolism or acute thoracic aortic pathology. . cxr - small bilateral pleural effusions and a small region of consolidation at one of the lung bases, probably the right, have increased. whether this is atelectasis or pneumonia is radiographically indeterminate. the upper lungs grossly clear and the heart is normal size. nasogastric tube ending ends in the mid stomach and a left pic line ends in the upper svc. no pneumothorax. . egd -impression: slightly irregular z-line. no definitive evidence of barretts. (biopsy)otherwise normal egd to third part of the duodenum recommendations: follow-up biopsy results. follow up with dr. in clinic. egd in years if no dysplasia. inr=1.0 on 03:55pm blood hct-27.5* 04:27am blood wbc-10.9 rbc-2.81* hgb-8.2* hct-24.1* mcv-86 mch-29.2 mchc-34.0 rdw-14.6 plt ct-547* 04:38am blood wbc-13.0* rbc-3.06* hgb-9.2* hct-26.9* mcv-88 mch-30.0 mchc-34.1 rdw-14.2 plt ct-734* 12:20pm blood wbc-10.0 rbc-4.48* hgb-14.1 hct-39.9* mcv-89 mch-31.4 mchc-35.2* rdw-13.0 plt ct-371 05:31am blood neuts-63 bands-2 lymphs-6* monos-14* eos-4 baso-0 atyps-0 metas-11* myelos-0 10:24am blood pt-15.2* ptt-74.1* inr(pt)-1.3* 12:20pm blood pt-11.7 ptt-27.1 inr(pt)-1.0 06:25pm blood fibrino-303# 04:27am blood glucose-122* urean-6 creat-0.4* na-137 k-3.2* cl-104 hco3-25 angap-11 09:05am blood glucose-115* urean-9 creat-0.7 na-132* k-3.8 cl-95* hco3-26 angap-15 12:20pm blood glucose-103* urean-17 creat-0.8 na-137 k-4.7 cl-103 hco3-22 angap-17 05:49am blood alt-33 ast-34 alkphos-55 totbili-0.1 05:07am blood ck-mb-3 ctropnt-<0.01 05:31am blood caltibc-254* ferritn-587* trf-195* 11:08pm blood triglyc-99 06:43pm blood tsh-4.4* 11:31am blood tsh-1.7 brief hospital course: 59 yo m with h/o crohn's colits, diverticulosis who presented with severe gi bleeding refractory to ir embolization requiring total abdominal colectomy with ilea-distal sigmoid anastomosis. his hospital course was c/b difficult to control atrial fibrillation #gi bleeding/acute blood loss anemia/total colectomy/severe diverticulosis- patient presented with gi bleeding which on angiography was found to be associated with right and middle colic arteries (tagged rbc and cta were negative). he was admitted to the icu. he underwent ir guided angiographic embolization of branches of the r and middle colic arteries at the hepatic flexure but continued to bleed post procedure necesitating total abdominal colectomy with ilio-sigmoid anastomosis. his hematocrit remained stable in the mid 20s following surgery. in the setting of large quantities of ivf and likely prolonged npo status and acute illness, hct trended down and he was given 2 more units prbcs. there was no sign of active bleeding during this time. during hospitalization, pt received >20units of prbcs. . #significant ileus-pt was noted to have abdominal distention/bloating-ct of the abdomen was performed that showed ileus from anastamosis to esophagus. no evidence of leak. for this, pt was made npo and given an ngt. eventually, symptoms improved, ngt was removed and diet advanced. due to ileus and prolonged npo status, tpn was initiated and all meds were converted to iv, eventually he was able to tolerate po and tpn was discontinued. #diarrhea: prior to discharge patient was able to tolerate a diet. he had diarrhea which was negative for c. diffx3 and felt to be due to lack of colon. he was treated with immodium with reduction in stool volume. at the time of discharge, his 24 hour gi output was approximately 700cc. #atrial fibrillation/aflutter: post-operatively patient had difficult to control atrial fibrillation/flutter with rates in the 120s-200s. he remained hemodynamically stable with these heart rates. he continued to have tachycardia on almost maximal doses of metoprolol and diltiazem with further tachycardia with exercise. therefore, per cardiology recommendations, patient was started oral amiodarone with return to sinus rhythm and improvement in heart rate. workup for atrial fibrillation was notable for normal tsh and absence of infection (no pneumonia on cxr, negative urine culture, neg c. diff). tte showed lvef >55% with mild symmetric lvh and cta was negative for pe. rates improved wtih addition of amiodarone to betablocker and calcium channel blocker. this course became difficult as pt was found to be not absorbing po pills (found whole in the stool) and meds were continually uptitrated and pt had large gi losses/dehydration and was continually given ivf. in addition, pt developed a significant ileus and he was made strict npo and placed on standing iv metoprolol. he did well on this and when his ileus resolved, he was continued on oral metoprolol with good control of his heart rate. . #acute dvt-despite hep sc tid and pneumoboots, pt was found to have b/l dvts. he was started on iv heparin. this was discussed with surgery who was ok with this plan. pt did not show any signs of bleeding after initiation of anticoagulation. he was started on po coumadin and will require therapy for at least 3 months after discharge. his iv heparin was changed to low molecular weight heparin and this will be used to bridge him until the coumadin is therapeutic. #anemia-acute blood loss- patient had hematocrit stably in the mid 20s following colectomy. see above, he was given some additional prbcs for hct trending down in the absence of apparent bleeding. #thrombocytosis: patient developed thrombocytosis towards end of hospitalization. this was felt to be related to recovery of the bone marrow from suppression during acute illness as it was associated with a few bands and metamyelocytes but there was no evidence of infection or inflammation and patient was overall improving. additionally, there was low suspicion for development of acute clot as patient was on heparin ppx and had had a recent cta. #anxiety: pt has history of generalized anxiety and patient was given up to 6mg po ativan as he takes 4mg po ativan/day at home. per patient he has not responded to ssris or other mood stabilizers previousy. #crohn's disease: previously known crohn's variant. no need to continue mesalamine per gi. . #fen-due to excessive gi losses-ngt and diarrhea, i/o's were closely monitored and pt was given aggressive ivf-lr. medications on admission: lipitor 80 mg tab-1 tablet(s) by mouth daily viagra 100 mg tab-tablet(s) by mouth as needed citracal + d 315 mg-200 unit tab-2 tablet(s) by mouth four times a day fish oil 1,000 mg cap-capsule(s) by mouth four times a day vitamin d 2,000 unit cap-capsule(s) by mouth once a day lorazepam 1 mg tab-one tablet(s) by mouth four times daily omeprazole 20 mg cap, delayed release-1 capsule(s) by mouth once a day asacol 400 mg tab-3 tablet(s) by mouth twice a day multivitamin cap discharge medications: 1. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 2. mesalamine 400 mg tablet, delayed release (e.c.) sig: three (3) tablet, delayed release (e.c.) po bid (2 times a day). 3. lorazepam 0.5-1 mg tablet po/ng qid prn anxiety, hold for oversedation 4. pantoprazole 40 mg iv q12 hours 5. metoclopramide 10 mg iv q6 hours 6. hydromorphone pca 0.12 mg iv, lockout interval 6 minutes, no basal rate, 1-hour max 1.2 mg 7. heparin 5000 units sc tid 8. metoprolol tartrate 75 mg po/ng tid 9. diltiazam 30mg po/ng qid 9. ondansetron 8 mg iv q8 hours, prn n/v discharge disposition: home discharge diagnosis: anemia crohn's disease atrial fibrillation dvt diverticular disease s/p total colectomy discharge condition: stable mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted with gastrointestinal bleeding. for this, you had your blood counts monitored and were evaluated by the gastroenterologists and surgeons. you underwent a red blood cell scan and a ct scan to help identify the site of your bleeding. interventional radiology blocked two arteries in your large bowel, and surgery removed part of your large bowel. you required several blood transfusions during your course in the icu. medication changes: addition of metoprolol 25 mg by mouth three times per day. please take all of your medications as prescribed and follow up with the appointments below. followup instructions: name: , address: ,ste 5a, , phone: appointment: friday 10:00am **at this visit please discuss about being setup in the coumadin clinic. department: surgical specialties when: tuesday at 9:45 am with: , md building: sc clinical ctr campus: east best parking: garage department: psychiatry hmfp when: tuesday at 5:40 pm with: , md building: ra (/ complex) campus: east best parking: main garage department: dermatology and laser when: thursday at 8:15 am with: , md building: (, ma) campus: off campus best parking: free parking on site department: div. of gastroenterology when: wednesday at 8:00 am with: building: ra (/ complex) campus: east best parking: main garage procedure: parenteral infusion of concentrated nutritional substances arteriography of other intra-abdominal arteries other small-to-large intestinal anastomosis other endovascular procedures on other vessels application or administration of an adhesion barrier substance repair and plastic operations on spleen open total intra-abdominal colectomy diagnoses: acidosis acute posthemorrhagic anemia hyposmolality and/or hyponatremia atrial fibrillation atrial flutter accidental puncture or laceration during a procedure, not elsewhere classified other and unspecified hyperlipidemia anxiety state, unspecified regional enteritis of unspecified site other specified cardiac dysrhythmias surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation paralytic ileus diarrhea hypovolemia diverticulosis of colon with hemorrhage other and unspecified postsurgical nonabsorption barrett's esophagus acute venous embolism and thrombosis of deep vessels of distal lower extremity accidental cut, puncture, perforation or hemorrhage during surgical operation essential thrombocythemia 

Answer: The patient is high likely exposed to