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: abd pain, hypotension major surgical or invasive procedure: central line placement, r subclavian history of present illness: 75 y/o m w/ ild, avr who presented to the ed c/o abd pain. he was in his usoh until he was driving home from his cardiology appointment and developed blq abd pain. he reported eating raw clams earlier in the day. he became nauseous and vomited 3 times (non-bloody) and had one episode of diarrhea. also noted sob but denied any cough or chest pain. also had chills, no fevers. . in ed, he was initially tachycardic at 131, temp 99.5, bp 105/59, rr 20, 97% 2l. he spiked to 101.2 and was given levoflox 500 mg iv. his bp drifted down to 85/41, 78/palp-->66 at which point he was confused. lactate level was 2.8. cxr revealed a lll infiltrate. at this point a code sepsis was initiated and he was begun on levophed. he was given vancomycin 1g and 6l ns. r sc cvl was placed. initial cvp 8-10, mixed venous 71. he was admitted to the micu on the sepsis protocol. . micu course: patient was off pressors since arrival to the micu. he remained hemodynamically stable and afebrile on levofloxacin. he has been auto diuresing. . patient was transferred to medicine service on and was feeling well. he complained of abdominal pain with palpation. he is tolerating po diet and has not had episodes of emesis or diarrhea since admission. he is guiaic positive with hct 32 but stable. cardiac enzymes were noted for slightly elevated tropi 0.03 on , normal ck-mb. he was afebrile with normal wbc count. he had mild sob while laying flat. denied fevers, chills, chest pain, weakness, headache, dysuria, hematuria. past medical history: interstitial lung disase glaucoma gerd chf cataracts gi bleed fistula repair surgery social history: retired. lives with wife in , ma. quit smoking 30 years ago after a 35 pack year hsitory. drinks a glass of wine daily. denies any past or current recreational drug use. family history: noncontributory physical exam: t: tm 98.4 (oral) tc 98.4 (ax) p 93 bp 122.62 r 20 o2 98 on 2l gen: alert and oriented pleasant male in nad heent: anicteric, op clear neck: supple, no lad, no jvd lungs: dry crackles throughout, l>r at bases cv: rrr, ii/vi sem at lsb abd: soft, mildly distended, tender over blq, no rebound no guarding rectal - prior rectal fistula, guiac + per nf ext: no edema, warm/dry pertinent results: 12:50pm blood hct-35.0* 06:15am blood wbc-5.0 rbc-3.08* hgb-10.4* hct-30.9* mcv-101* mch-33.9* mchc-33.7 rdw-15.2 plt ct-144* 04:16am blood neuts-76.6* bands-0 lymphs-17.6* monos-4.0 eos-1.0 baso-0.7 05:30pm blood neuts-84* bands-1 lymphs-6* monos-9 eos-0 baso-0 atyps-0 metas-0 myelos-0 04:16am blood hypochr-normal anisocy-1+ poiklo-normal macrocy-2+ microcy-normal polychr-occasional 06:15am blood plt ct-144* 05:30pm blood pt-12.2 ptt-18.1* inr(pt)-1.0 06:15am blood glucose-94 urean-8 creat-0.7 na-142 k-3.9 cl-107 hco3-31 angap-8 03:34am blood glucose-121* urean-7 creat-0.8 na-142 k-3.3 cl-104 hco3-29 angap-12 06:15am blood ck-mb-notdone ctropnt-<0.01 10:12am blood ck-mb-3 ctropnt-0.03* 05:30pm blood ctropnt-<0.01 04:16am blood calcium-7.0* phos-3.0 mg-1.6 07:10pm blood comment-green top 01:00am blood lactate-1.3 11:32pm blood lactate-1.5 07:10pm blood lactate-2.8* 10:15pm urine color-yellow appear-clear sp -1.014 10:15pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg 10:15pm urine rbc-0 wbc-0 bacteri-rare yeast-none epi-0 chest port. line placement impression: properly positioned new right cv line. bilateral loculated pleural effusions that are stable. bilateral atelectasis and worsening pulmonary edema. chest (portable ap) 5:57 pm impression: 1) interval improvement in pulmonary edema compared to with persistent bilateral interstitial opacities. these are present on the preoperative study performed on , suggesting that they represent chronic changes. 2) there is loss of the definition of the left hemidiaphragm suggestive of a left lower lobe process. 3) density at the left lateral hemithorax with a sharp linear border is unchanged compared to the preoperative studies dated . possibly representing loculated pleural fluid or pleural thickening. ekg sinus tachycardia. compared to the previous tracing of the rate is now faster. ct abdomen w/contrast; ct pelvis w/contrast ct of the abdomen with iv contrast: there are diffuse interstitial opacities in both lower lobes with a peripheral predominance with areas of subpleural honeycombing. calcified pleural plaques are seen in the right lung base posteriorly. extensive pleural fat deposition is present. there are no pleural or pericardial effusions. there is a vague area of decreased density within the left medial lobe of the liver inferiorly (segment ivb), which is located anteriorly just to the right of the gallbladder which measures 15 x 18 mm, and is incompletely assessed. several tiny calcifications are seen in the periphery of the spleen. the gallbladder, adrenal glands, pancreas, stomach, and small bowel loops are unremarkable. there is no ascites or pathological mesenteric or retroperitoneal lymph node enlargement. both kidneys enhance symmetrically and homogeneously without evidence of focal mass or obstruction. no intra-abdominal collection is identified. ct of the pelvis with iv contrast: there is diffuse diverticulosis but no evidence of acute diverticulitis. distal ureters and bladder are unremarkable. there is no free fluid in the pelvis or pathological inguinal or pelvic lymph node enlargement. note is made of bilateral fat containing inguinal hernias, left greater than right. there is diffuse demineralization and degenerative changes in the spine. no suspicious lytic or sclerotic osseous lesions are identified. impression: 1. vague round low density lesion in segment ivb of liver, incompletely assessed. further evaluation with ultrasound is reccommended. 2. no other evidence of intraabdominal infection. 3. multiple hepatic granulomas. 4. diffuse interstitial lung disease in both lung bases with calcified pleural plaques and extensive fat deposition in the subpleural space. differential diagnosis includes pulmonary fibrosis and asbestosis. 5. diverticulosis without evidence of acute diverticulitis. . chest (pa & lat) 5:20 pm pa and lateral chest x-ray: patient is status post median sternotomy with the prosthetic aortic valve in stable position. the cardiac silhouette, mediastinal, and hilar contours are stable. there is decreased pulmonary edema compared with prior exam. stable interstitial opacities are seen diffusely and bilaterally. there is circumferential pleural thickening bilaterally, with nodularity at the right lung apex. increased opacity in the left lower lung is likely related is to the surrounding pleural thickening. the surrounding soft tissue and osseous structures are stable. . there has been interval removal of a right subclavian central venous catheter. no pneumothorax is seen. . impression: interval decrease in pulmonary edema. brief hospital course: 75 y/o m w/interstitial lung disease on chronic steroids who presents with fever, hypotension, and tachycardia. . # sirs w/sepsis: patient's clinical status improved quickly with antibiotics and fluids. it is possible that the patient may have had a viral/bacterial gastroenteritis resulting in sepsis. this can happen in immunosuppressed patients. patient's wbc count was normal since he is on azothioprine preventing from mounting an immune response to infection. lung exam noted for bibasilar crackles to interstitial lung disease. cxr in icu was negative for pneumonia which may not have been intially detected given low volume status. however, a pneumonia could have also resulted in patient's sepsis. a repeat cxr on to eval pneumonia/infiltrate showed interval decrease in pulmonary edema. patient was on levofloxacin and flagyl for enteric and anaerobic bacterial coverage. he remained afebrile and hemodynamically stable after transfer from icu to floor. . #abdominal pain: differential includes infectious causes resulting in sepsis either bacterial or viral gastroenteritis; diverticulosis or diverticulitis also likely given guiaic + stool; low probability of ischemic bowel due to improved abdominal exam and lack of board-like rigidity. ct abdomen with/without contrast revealed diffuse diverticulosis, multiple granulomas in liver, and vague round low density lesion in segment ivb of liver, incompletely assessed. hematocrit had increased and initial drop was most likely dilutional effect from aggressive ivf resucitation. he was advised include fiber in his diet and stay well hydrated. . #. demand ischemia: patient is diabetic and presented sob. he had a mild increase in cardiac tropt due to strain on pump in setting of sudden hypotension and lack of oxygen being delivered to myocardium. however, his last set of enzymes were within normal and initial st depressions in v4-v6 had resolved on repeat ekg. . #. htn patient's bp was stable in icu and on medicine floor. his metoprolo was restarted prior to discharge, however patient may benefit from ace more given diabetes. . #. ild: on home o2 (2l nc), currently sats great on stable o2 requirement. he was resumed on prednisone, azathioprine; his oxygen requirement was at his home o2 of 2l. . #. type 2 dm: fs qid, insulin sliding scale. blood sugars remained stable while inpatient. . #. dispo: patient will be discharged with followup by outpatient cardiologist for caridiac stress test and echocardiogram for further evaluation. pcp . updated on inpatient status and progress. medications on admission: metoprolol 25 mg protonix 40 mg daily lasix 20 mg daily aspirin 81 mg daily prednisone 5 mg colace 1 drop timolol left eye daily azathioprine 50 mg daily discharge medications: 1. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. prednisone 5 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 4. azathioprine 50 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. timolol maleate 0.25 % drops sig: one (1) drop ophthalmic daily (daily). disp:*1 * refills:*2* 6. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). tablet(s) 7. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 6 days. disp:*6 tablet(s)* refills:*0* 8. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 6 days. disp:*18 tablet(s)* refills:*0* 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: sepsis viral gastroenteritis possible pneumonia secondary diagnoses: interstitial lung disease with moderate restrictive pfts porcine avr for severe as dm type ii htn gerd glaucoma discharge condition: stable discharge instructions: please take all medications. avoid eating raw clams. continue antibiotic course of levofloxacin and flagyl for 5 days. followup instructions: please see pcp at for further management. recommend cardiac stress test and echocardiogram outpatient given slightly elevated cardiac enzymes during hospital course. md procedure: venous catheterization, not elsewhere classified diagnoses: pneumonia, organism unspecified esophageal reflux congestive heart failure, unspecified long-term (current) use of steroids diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia sepsis postinflammatory pulmonary fibrosis heart valve replaced by transplant intestinal infection due to other organism, not elsewhere classified 

Answer: The patient is high likely exposed to