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: vancomycin attending: chief complaint: lower abdominal pain. "feels like gas". wife reports marked dyspnea after bowel movement with feet turning blue. major surgical or invasive procedure: ir placement of picc line ugi endoscope performed egd with multiple biopsies history of present illness: mr. is a yo male with a past medical history of hyptertension, cad with , dvt, pulmomary embolism, osteoarthritis, & chronic lower back pain who presented to ed accompanied by his wife with c/o lower abdominal pain for the past few days. his wife also reports that he became increasingly short of breath after having a bowel movment, and his lower extremeties turned blue. past medical history: - gerd/hiatal hernia - osteoarthritis - chronic lbp x 6 months - likely sciatica - varicose veins s/p stripping in rle - type iib heart block, asymptomatic bradycardia during sleep - h/o pe in with ivc filter social history: . married. lives with wife. etoh. quit smoking 30 years ago, no illicit drug use. pt is a retired jazz pianist. he likes to swim but has not done so for several months. . family history: non contributory physical exam: vitals: t-94.1, hr-79, bp-106/66, o2 sat 99% ra gen: nad cardiac: rrr resp: coarse vs. bilateral crackles, diminished @bases abd: soft, nondistended with epigastric discomfort rectal: guaiac negative pertinent results: 09:29am blood wbc-12.6* rbc-unable to hgb-9.5*# hct-31.0* mcv-unable to mch-unable to mchc-25.4*# rdw-unable to plt ct-342 09:09am blood wbc-12.4* rbc-4.41* hgb-12.7* hct-38.2* mcv-87 mch-28.9 mchc-33.3 rdw-14.2 plt ct-320 02:30pm blood wbc-14.0*# rbc-4.84 hgb-14.4 hct-42.8 mcv-88 mch-29.6 mchc-33.5 rdw-14.6 plt ct-188 07:10am blood ptt-73.4* 06:15am blood pt-12.7 ptt-39.2* inr(pt)-1.1 07:10am blood glucose-138* urean-27* creat-1.1 na-140 k-4.1 cl-109* hco3-23 angap-12 02:30pm blood glucose-133* urean-24* creat-1.5* na-140 k-3.1* cl-103 hco3-24 angap-16 07:00am blood amylase-127* totbili-0.7 02:30pm blood alt-74* ast-108* ld(ldh)-209 alkphos-83 amylase-2621* totbili-1.0 07:00am blood lipase-79* 02:30pm blood lipase-2382* 07:10am blood albumin-3.1* calcium-8.8 phos-3.7 mg-2.1 iron-39* 02:30pm blood albumin-4.3 calcium-10.1 phos-2.0* mg-1.9 07:10am blood caltibc-231* ferritn-277 trf-178* 07:10am blood triglyc-67 06:15am blood triglyc-112 . radiology final report ct abdomen w/contrast 3:51 pm reason: r/o obstruction-gastrograffin please abdomen and pelvis ct with contrast, at 18:36 hours history: on coumadin with abdominal pain, nausea, and distended abdomen. impression: 1. distended stomach. patient would likely benefit from nasogastric tube decompression. there is also dilated duodenum and proximal jejunum. no clear transition point is identified in part because of poor oral preparation. however, more distal small bowel loops are collapsed. there is extensive stool throughout the colon including the rectal vault. an early high-grade obstruction cannot be entirely excluded. 2. markedly distended edematous gallbladder as above. while pericholecystic inflammatory stranding is not present to a significant degree, the wall edema is quite impressive and acute cholecystitis cannot be excluded. to confirm or refute this diagnosis, consider hida scan for further evaluation. us will likely not provide further data. 3. enlarged prostate without definite focal mass lesion. findings most consistent with benign prostatic hypertrophy; however, ct is not sensitive to detect subtle prostate tumors. if indicated, consider ultrasound or mri for further evaluation. 4. infrarenal ivc filter . radiology final report portable abdomen 5:14 am indication: acute pancreatitis. gastric dilatation on ct. comparison: no previous plain film available for comparison. findings: an ivc filter is in situ. impression: some prominent loops of small bowel which may represent an ileus. . radiology final report us abd limit, single organ 11:16 am reason: please evaluate ruq and gallbladder changes indication: acute pancreatitis, possible gallbladder problem since right upper quadrant pain. impression: equivocal findings for acute cholecystitis with gallbladder wall edema and distended gallbladder although no pericholecystic fluid or stone is identified. a hida scan is recommended for further evaluation. . radiology final report abdomen (supine & erect) 12:44 pm reason: evaluate for obstruction impression: 1. no free intraperitoneal air identified. 2. marked gaseous distension of the stomach. is there concern for outlet obstruction. 3. non-dilated colonic and small bowel segments filled with air. . radiology final report small bowel only (barium) 1:15 pm reason: ugi series w/ sm bowel follow-through to evaluate for sbo history: -year-old male with gastric distention, sliding hiatal hernia, pancreatitis. evaluate for small bowel obstruction. comparison: abdomen supine and erect, . impression: there is no evidence for anatomical obstruction. there was retained contrast within the stomach after approximately three hours, which may represent an ileus. there was mild fold thickening of the third portion of the duodenum. . radiology final report unilat up ext veins us left 4:55 pm reason: rule/out lue dvt at picc site. left upper extremity venous ultrasound study. clinical history: -year-old man with pancreatitis and gastric dilatation. left-sided picc line. evaluate for left upper extremity dvt at picc line site. impression: extensive deep venous thrombosis extending from the distal left subclavian to the left axillary and the left basilic veins. . date: , endoscopist indications: abnormal ct with duodenal thickening upto proximal jejunum. impression: medium hiatal hernia erythema and congestion in the antrum compatible with mild gastritis (biopsy) normal mucosa in the first part of the duodenum, second part of the duodenum, third part of the duodenum and fourth part of the duodenum (biopsy, biopsy) no luminal narrowing was noted upto proximal jejunum. otherwise normal egd to second part of the duodenum recommendations: 1. follow biopsy results 2. follow up clinically. brief hospital course: mr. was evaluated in the ed. his labwork indicated an acute pancreatitis, and possible cholecystitis. he underwent diagnostics which revealed a small bowel obstruction. he was admitted under the general surgery service for further management. . cardiac-his heart rate and blood pressure remained stable during this admission. . resp-his lungs sounds are decreased bilaterally with coarse crackles which have improved. his oxygen saturation remains >95% on ra. . nut-he was npo upon admission, and started on tpn for nutritional support. his ngt was removed, and his diet was advanced as his bowel function resumed. he was placed on aspiration precautions prophylactically due to his frail condition. he has shown no signs of aspiration. he is tolerating a regular diet with ensure supplements. . extrem-he developed a thrombus of the lue where the picc line was inserted. he was treated with iv heparin, and transitioned to lovenox. he has a strong history of coagulpathies. he will transitioned back to coumadin under the supervision of his pcp (dr. ) once he is discharged from rehab. this information was discussed with dr. rn at health center. he continues with bilateral with positive pedal pulses bilaterally. . gi/abd-there were multiple attempts to insert an ngt in the ed, but was unsuccessful. he was admitted to the icu on for observation and insertion of ngt under iv conscious sedation, intravenous resuscitation, and insertion of a foley catheter. the ngt was inserted successfully. he remained stable, and was transferred to . according to ruq u/s, his gallbladder appeared distended with no evidence of stones. his labwork indicating pancreatitis resolved gradually. the etiology remained unknown. he had multiple loose bm's. the cdiff culture was negative. gi was consulted. an egd was completed x2 with collection of multiple biopsies which are presently pending. first revealed a hiatal hernia, and the second a hiatal hernia, erythema. please refer to pertinent lab result section. he also underwent a small bowel follow through that indicated no evidence of anatomical obstruction. . id-he received iv levaquin & flagyl x 1 in the ed. he has remained afebrile, and has not required additional antimicrobial treatment. . neuro-he became confused after ivcs in the icu. he was managed medically, and had hand mitts applied to prevent removal of ngt and other devices. his mental status cleared, and he returned to his baseline which was confirmed by his wife who remained at his bedside. he is hard of hearing, but pleasant & cooperative. . mobility-he was evaluated per physical therapy due to his weakened condition. he ambulates with a walker and assist. he requires monitoring for safety. he will continue rehabilitation in rehab. medications on admission: coumadin 6 mg, hctz 25 mg, aspirin 81 mg, multivitamin, calcium discharge medications: 1. enoxaparin 100 mg/ml syringe sig: one (1) 90mg subcutaneous q12h (every 12 hours): please expel 10mg for 90mg dose. 2. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). discharge disposition: extended care facility: hospital discharge diagnosis: primary: acute pancreatitis treated with intravenous hydration small bowel obstruction treated with ngt & intravenous hydration hyperglycemia treated with regular insulin sliding scale left upper extremity thrombosis treated with intravenous heparin . secondary: 1. pe in , s/p ivc filter 2.htn 3.complete heart block s/p pacer in 4. gerd 5.hiatal hernia 6.osteoarthritis 7.lbp 8. parkinson disease diagnosed discharge condition: good tolerating a regular diet with supplements denies pain. discharge instructions: please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomitting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomitting, 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. * your skin, or the whites of your eyes become yellow. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered. * continue to amubulate several times per day. . lovenox to coumadin: -follow-up with your pcp after discharge from rehab to be transitioned from lovenox back to your coumadin. followup instructions: please call dr. office at for a follow-up appointment in 2 weeks. please follow-up with dr. after dissharge from rehab. provider: call phone: date/time: 11:30 provider: clinic phone: date/time: 1:00 provider: , m.d. phone: date/time: 2:40 procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances other gastroscopy insertion of other (naso-)gastric tube esophagogastroduodenoscopy [egd] with closed biopsy diagnoses: esophageal reflux unspecified essential hypertension personal history of tobacco use diaphragmatic hernia without mention of obstruction or gangrene paralysis agitans personal history of other diseases of circulatory system other complications due to other vascular device, implant, and graft long-term (current) use of anticoagulants osteoarthrosis, unspecified whether generalized or localized, site unspecified cardiac pacemaker in situ lumbago acute pancreatitis acute and chronic cholecystitis arterial embolism and thrombosis of upper extremity other specified disorders of intestine 

Answer: The patient is high likely exposed to