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: haldol / penicillins attending: chief complaint: rectal cancer major surgical or invasive procedure: attempted transanal endoscopic microsurgery (tem), proctectomy, end-colostomy with mobilization of splenic flexure. history of present illness: the patient is a 65yo male with a rectal mass that had appearance of a sizeable rectal cancer. his biopsy showed just an adenoma. his previous biopsy was complicated by significant bleeding. we did check the cea, which was slightly elevated at 4.9. we did an mri of the pelvis which most of the time tend to be one of the best studies which we can get, however, in his case because of absence of any fat in his body, it was really not diagnostic. he underwent an ultrasound today which was also very difficult, but showed may be a t2 lesion at best but some areas cannot be really well evaluated. he is complaining of some phlegm and some coughing that has been persistent and he is going to get an x-ray at your office tomorrow. otherwise, he has been in the same health. he has occasional abdominal cramping and he is having some diarrhea. he occasionally passes some blood. he has been trying to eat, but unable to gain much weight. he presents for surgical staging with tem. past medical history: past medical history: htn, copd, pvd, 'abnormal heart beat' past surgical history: aortobifemal bypass with repair of left cfa aneurysm ()left fem-bk bypass with in situ vein () right fem-pt bypass w/ svg () right inguinal hernia repair social history: lives with daughter and her family. heavy smoker 1.5 pack/day for 50 years, etoh 4 beers/day, denies drugs family history: non-contributory physical exam: at time of discharge 97.7 62 136/67 16 95ra nad rrr breathing easily abd soft, nd, nt, no r/g ext no edema, r le in multipodus boot pertinent results: 05:00am blood wbc-8.0 rbc-2.93* hgb-9.1* hct-27.3* mcv-93 mch-31.2 mchc-33.5 rdw-14.7 plt ct-270 06:48pm blood wbc-15.2* rbc-3.52* hgb-10.8* hct-33.1* mcv-94 mch-30.7 mchc-32.6 rdw-15.3 plt ct-291 02:48pm blood glucose-158* urean-13 creat-0.5 na-133 k-4.2 cl-94* hco3-31 angap-12 02:48pm blood calcium-8.3* phos-3.8 mg-1.6 brief hospital course: the patient underwent attempted transanal microsurgical excision of his tumor which was unsuccessful. he was converted to proctectomy with end colostomy. due to his many medical comorbidities he was transferred to the icu post-operatively. he was closely monitored and did well overall. his urine output was low and required multiple fluid boluses to support. he was extubated and had good oxygen saturations on 2-3l nc and was slowly weaned off of oxygen. on pod#1 he was transferred from the icu to a regular floor bed. he was monitored closely on telemetry. his blood pressure was elevated in the 190s and his home atenolol and lisinopril were restarted and his bp decreased appropriately. his anticoagulation was held. the vascular surgery service saw the patient and evaluated his r femoral to peroneal bypass and felt it was stable and recommended outpatient follow-up with dr. . the patient has a history of alcohol withdrawal and was monitored on a ciwa scale. he did not require any ativan or valium for withdrawal. he was also given thiamine. on pod#2 he had gas in his ostomy bag and his diet was advanced to clears. his foley catheter was removed but he failed to void and it was replaced. he was started on flomax. on pod#3 peripheral iv access was obtained and his right ij central line was removed. his stoma continued to have gas but no output, and he was given a dulcolax suppository to his stoma without effect. he was also given milk of magnesia. on the remaining post-operative days his ostomy began putting out an appropriate amount of stool and gas. he was restarted on his home medications and the reglan was discontinued. he was tolerating a regular diet and voiding. he worked with pt who recommended home with home pt. his family came in and underwent teaching regarding his care at home. he was discharged home and will follow-up in colorectal surgery clinic. medications on admission: 1. atorvastatin 20 daily 2. aspirin 325 daily 3. docusate sodium 4. oxycodone 5 prn 5. daliresp 500 mcg daily 6. symbicort 80-4.5 mcg 7. proair hfa 90 mcg 1-2 per day 8. plavix 75 mg daily 9. atenolol 50 10. lisinopril 20 daily 11. omeprazole 40 daily 12. nicotine 14 mg/24 hr patch 24 hr daily 13. calcium carbonate 200 mg calcium tid prn 14. thiamine hcl 100 daily 15. acetaminophen prn discharge medications: 1. roflumilast 500 mcg tablet sig: one (1) tablet po daily (). 2. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 3. tamsulosin 0.4 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po hs (at bedtime). disp:*30 capsule, ext release 24 hr(s)* refills:*2* 4. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 5. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 6. budesonide-formoterol 80-4.5 mcg/actuation hfa aerosol inhaler sig: two (2) puffs inhalation (2 times a day). 7. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 8. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 10. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q6h (every 6 hours) as needed for wheeze/sob. 11. atenolol 25 mg tablet sig: two (2) tablet po bid (2 times a day). 12. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po three times a day. 13. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 14. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 15. acetaminophen 500 mg tablet sig: one (1) tablet po q6h (every 6 hours). 16. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: home with service facility: all care vna of greater discharge diagnosis: rectal cancer discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were admitted to the hospital after proctectomy and end colostomy for surgical management of your rectal cancer. samples from your colon were taken and this tissue has been sent to the pathology department for analysis. you will receive these pathology results at your follow-up appointment. if there is an urgent need for the surgeon to contact you these results they will contact you before this time. you have tolerated a regular diet, passing gas and your pain is controlled with pain medications by mouth. if you have any of the following symptoms please call the office for advice or go to the emergency room if severe: increasing abdominal distension, increasing abdominal pain, nausea, vomiting, inability to tolerate food or liquids. you have an incision that can be left open to air or covered with a dry sterile gauze dressing if the staples become irritated from clothing. the staples will stay in place until your first post-operative visit at which time they can be removed in the clinic, most likely by the office nurse. please monitor the incision for signs and symptoms of infection including: increasing redness at the incision, opening of the incision, increased pain at the incision line, draining of white/green/yellow/foul smelling drainage, or if you develop a fever. please call the office if you develop these symptoms or go to the emergency room if the symptoms are severe. you may shower, let the warm water run over the incision line and pat the area dry with a towel, do not rub. no heavy lifting for at least 6 weeks after surgery unless instructed otherwise by dr. or dr. . you will be prescribed a small amount of the pain medication. please take this medication exactly as prescribed. you may take tylenol as recommended for pain. please do not take more than 4000mg of tylenol daily. do not drink alcohol while taking narcotic pain medication or tylenol. please do not drive a car while taking narcotic pain medication. thank you for allowing us to participate in your care! our hope is that you will have a quick return to your life and usual activities. good luck! you have a new colostomy. it is important to monitor the output from this stoma. it is expected that the stool from this ostomy will be solid and formed like regular stool. you should have bowel movements daily. if you notice that you have not had from your stoma in days, please call the office. you may take an over the counter stool softener such as colace if you find that you are becoming constipated from narcotic pain medications. please watch the appearance of the stoma, it should be beefy red/pink, if you notice that the stoma is turning darker blue or purple, or dark red please call the office for advice. the stoma (intestine that protrudes outside of your abdomen) should be beefy red or pink, it may ooze small amounts of blood at times when touched and this should subside with time. the skin around the ostomy site should be kept clean and intact. monitor the skin around the stoma for buldging or signs of infection listed above. please care for the ostomy as you have been instructed by the wound/ostomy nurses. you will be able to make an appointment with the ostomy nurse in the clinic 1 week after surgery, you will have a visiting nurse at home for the next few weeks helping to monitor your ostomy until you are comfortable caring for it on your own. followup instructions: call the colorectal surgery office to make an appointment for follow-up two weeks after surgery with the colorectal surgery outpatient nurse , np. at that appointment you will be set up with an appointment for your second post-operative check. call to make this appointment. please also call the clinic to make an appointment with the wound ostomy nurses approximately 1 week after discharge please contact dr. office to schedule a follow-up vascular surgery appointment. procedure: colostomy, not otherwise specified other resection of rectum diagnoses: tobacco use disorder unspecified essential hypertension chronic airway obstruction, not elsewhere classified peripheral vascular disease, unspecified ulcer of other part of foot benign neoplasm of rectum and anal canal malnutrition of moderate degree body mass index less than 19, adult 

Answer: The patient is high likely exposed to