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: portal vein thrombosis major surgical or invasive procedure: colonoscopy history of present illness: 72y/o f presented to ed after seeing pcp for weight loss, fevers, and malaise over 3-4 weeks. pt notes that she lost about 6# during this time. has had anorexia with decreased po intake. fevers daily up to 102 for about one week. no night sweats. has noted darker urine during this time; stool not acholic. no brbpr, no diarrhea, no hematemesis. denies frank abdominal pain. + nausea, occasional dry heaves. denies myalgias. pt's daughter commented on change in color of skin - "more pale" - but pt's vision blurry and cannot comment. fatigue has limited her level of activity - describes herself as a baseline active person, has been lying in bed for the most part for the last few weeks. + sob particularly with exertion. denies chest pressure or palpitations. . pt has no known liver disease, no h/o etoh. has not traveled recently, never lived outside of this area. no sick contacts. . no recent infectious symptoms - minimal headache, no back pain; +slight nonproductive cough, no dysuria, no diarrhea, no abdominal pain. . pt noted to have ruq tenderness found to have anemia and leukocytosis with shift. portal vein thrombosis found on ruq ultrasound. . in the , pt was given acetaminophen 1000mg, levofloxacin 500mg, metronidazole 500mg, vancomycin 1g, dolasetron 12.5mg, ibuprofen 600mg. pt's bp dropped into 70s, and a code sepsis was called. access was difficult to obtain - r groin line placed. levophed was started. 2 unit prbcs transfused. . past medical history: 1) dyslipidimia 2) hypertension 3) type 2 dm 4) echo: ef > 55%, mild pulmonary hypertension, 1+ mr 5) s/p l cornea implant 2 years ago social history: lives with 2 daughters, has 9 children total. had one miscarriage. denies tobacco except for 6 month use as teen; denies past or present etoh, denies ivdu. has not worked outside the home. family history: no known miscarriages, no known ca or liver disease physical exam: t 98.4 hr 82 bp 165/106 rr 26 98%ra gen: comfortable, lying flat on back, nad heent: perrl, anicteric, mmm, op clear neck: left ij; supple no r lad, no supraclavic lad, jvp nondistended cv: rrr, ii/vi sem resp: ctab abd: obese, soft, nt, nd, +bs, liver palp 3cm below costal margin, no splenomegaly ext: no edema, 2+ dp pulses neuro: a&ox3, maew, sensation intact grossly pertinent results: admission labs: 09:15pm blood wbc-15.8* rbc-2.79* hgb-7.9* hct-23.5* mcv-85 mch-28.3 mchc-33.5 rdw-16.0* plt ct-550* 08:47am blood hct-28.5* 03:06pm blood wbc-32.5*# rbc-3.55*# hgb-10.5*# hct-30.7* mcv-86 mch-29.5 mchc-34.1 rdw-16.5* plt ct-733* 09:15pm blood neuts-89.5* lymphs-7.5* monos-2.8 eos-0.2 baso-0.1 08:06pm blood neuts-94.9* lymphs-3.7* monos-1.2* eos-0 baso-0.1 09:15pm blood anisocy-1+ microcy-1+ 09:15pm blood plt ct-550* 05:32am blood pt-16.1* ptt-27.1 inr(pt)-1.5* 03:06pm blood pt-16.1* inr(pt)-1.5* 03:06pm blood plt ct-733* 04:00am blood ret aut-1.2 05:32am blood fibrino-772* d-dimer-4339* 12:21pm blood fdp-10-40 09:15pm blood glucose-117* urean-21* creat-0.9 na-136 k-4.3 cl-100 hco3-20* angap-20 08:47am blood glucose-151* na-137 k-4.2 cl-105 hco3-15* angap-21* 09:15pm blood alt-62* ast-106* ld(ldh)-175 alkphos-431* amylase-28 totbili-1.9* 08:47am blood ld(ldh)-215 totbili-2.9* dirbili-2.6* indbili-0.3 09:15pm blood lipase-23 08:47am blood ggt-257* 12:23pm blood ck-mb-1 ctropnt-<0.01 04:55pm blood ck-mb-1 ctropnt-<0.01 08:47am blood calcium-7.3* phos-3.4 mg-1.9 iron-48 08:47am blood caltibc-118* ferritn-1716* trf-91* 06:07am blood caltibc-124* ferritn-1048* trf-95* 04:00am blood homocys-7.6 04:00am blood tsh-1.3 04:00am blood free t4-1.4 09:15pm blood cortsol-25.3* 10:48am blood cortsol-42.0* 11:22am blood cortsol-45.1* 04:56pm blood hbsag-negative hbsab-negative hbcab-negative 04:56pm blood ama-negative smooth-positive 04:56pm blood -negative 04:56pm blood igg-777 09:15pm blood crp-greater th 10:12am blood vanco-41.2* 09:29pm blood lactate-1.6 04:00am blood factor v leiden- t . discharge labs: 06:45am blood wbc-8.2 rbc-3.66* hgb-11.0* hct-32.3* mcv-88 mch-30.1 mchc-34.1 rdw-17.1* plt ct-257 04:26am blood neuts-83.7* lymphs-11.3* monos-3.1 eos-1.6 baso-0.3 04:26am blood anisocy-1+ microcy-1+ 06:45am blood plt ct-257 06:45am blood glucose-87 urean-5* creat-0.4 na-138 k-3.1* cl-105 hco3-25 angap-11 06:45am blood alt-15 ast-18 alkphos-412* totbili-0.7 04:56am blood alt-10 ast-19 alkphos-448* totbili-0.6 06:07am blood lipase-28 06:45am blood calcium-7.9* phos-2.4* mg-1.9 . imaging: ruq u/s findings: a small amount of sludge is observed in the nondistended gallbladder. no stones are identified. the common duct is not dilated. the liver shows no focal or textural abnormalities. however, there is occlusion of the right portal vein with visualized thrombus. thrombus is also identified in the left portal vein, however a small amount of flow is observed around the thrombus. the pancreas is unremarkable. impression: portal vein thrombus with occlusion of the right portal and nonocclusive thrombus in the left portal vein. . the lungs are mildly hyperinflated. there is probable mild cardiomegaly. the aortic knob is calcified and ectatic. no chf or effusion is identified. there is hazy opacity at the lung base posteriorly on the lateral view. in the appropriate setting this could represent an early pneumonic infiltrate. however, the patient has demonstrated an opacity in this location on prior chest x-ray examinations from and . impression: focal ill-defined opacity at the base posteriorly, seen only on the lateral view. ct scan should be considered for further characterization. lungs are otherwise grossly clear, without other evidence for infiltrate. . ct chest: 1. portal vein occlusion with partial recanalization of the left portal vein. 2. 2.5 x 2 cm left adrenal lesion, which is not fully characterized on this exam and could represent an adenoma vs. malignancy. further characterization can be obtained with mri. 3. no pe. 4. mild pulmonary edema. 5. multiple small hazy nodular opacities, which are nonspecific in appearance. the largest nodule is located in the right upper lobe and measures 5 mm. given the presence of calcified lymph nodes, the nodules could represent prior granulomatous disease however neoplasm cannot be completely excluded. follow-up exam in six months is recommended. . mrcp: 1. persistent complete right portal vein and partial left portal vein thrombosis with small collateral formation. large area of edema within the left greater than right hepatic lobes with heterogeneous perfusion is likely related to portal vein thrombosis. no definite hepatic masses on this limited evaluation. 2. no biliary source for infection. normal caliber bile ducts. gallbladder wall edema likely relates to patient's anasarca. 3. 2.5 cm left adrenal lesion does not meet definitive criteria for an adenoma. this could still represent an adenoma, but metastasis or other primary adrenal lesion should be considered. 4. asymmetric adnexa with right adnexa containing soft tissue that may represent asymmetric ovarian tissue, however an ovarian lesion cannot be excluded as this is only seen on one image set. if clinically indicated, transvaginal ultrasound could be performed to characterize further. . ercp: ercp: 9 ercp images were obtained by dr. , and demonstrated normal biliary ducts without filling defect or dilatation. pancreatic duct was normal. . tv u/s: transabdominal imaging shows a uterus measuring 8.0 x 3.3 x 3.8 cm. transvaginal imaging was performed to better evaluate the uterus and the adnexa. there are multiple echogenic areas seen in the periphery of the myometrium consistent with calcified vessels. there is trace fluid seen within the endometrial cavity. the endometrium itself is thin measuring 1-2 mm. both ovaries are normal. there is trace fluid in the pelvis. neither kidney demonstrates evidence of hydronephrosis. impression: normal uterus and ovaries in a postmenopausal patient. . colonoscopy: see report. brief hospital course: a/p: 72y/o f with sepsis, constitutional symptoms and weight loss, and portal vein thrombosis. . 1. sepsis - unclear etiology of infection. wbc improved in on abx. ctx negative. abdominal exam benign and pt without abd pain; biliary source of infection likely. pt with decent uop, mentating well, oxygenating well, lactate now normal, all pointing away from poor end-organ perfusion. a cortisol stimulation test indicated normal adrenal function and she was not started on steroids. empiric coverage with amp/gent/flagyl changed to imipenem, vanc, flagyl, azithro as pt lactate was worsening on . the lactate improved to 1.6. mvo2 76 prior to d/c from . tsh and ft4 are wnl. cdiff positive on flagyl. the azithromycin was discontinued as there were no clear signs of pneumonia. she was continued on the imipenem and vancomycin for empiric coverage. she was weaned off of levofed and her pressures remained stable. a spep/upep were all normal. continued on imipenem, vanc, flagyl all started . switched to levaquin on txf to floor and discharged to finish 3 more days. . 2. portal vein thrombosis - unclear etiology - appears to be somewhat chronic given recanalization, though has had a decompensation of some sort with new bilirubinuria, jaundice. hepatitis serologies were all negative, and autoimmune panels were also negative. she had an essentially unremarkable mrcp and was scheduled for an ercp which was unremarkable as well. thought possibly malignancy but colonoscopy not suggestive, tv u/s not suggestive. factor v leiden pending. homocysteine normal. . 4. anemia - guaiac negative - iron studies - in setting of blood transfusion, distorted view, however pt appears to have a likely anemia of inflammation - dic labs- negative - given colonoscopy report, may have anemia hemorrhage from portal vein thrombosis. . 5. mfat: pt has been noted to have a wandering pcm intermittent with mfat over the past day. highest hr 120s. improved on floor off pressors. . 6. metabolic acidosis - likely due to lactic acidosis. it improved with hydration and was monitored. resolved on floor. . 7. diabetes mellitus - held metformin in setting of npo and lactic acidosis initially but then restarted metformin and pt. had good fsg control . 8. : cr at 0.8, at baseline; stayed at baseline. medications on admission: lisinopril 20mg daily lipitor glucophage 500mg predforte eye gtt afigan eye gtt discharge medications: 1. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 2. atorvastatin 10 mg tablet sig: one (1) tablet po once a day. 3. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). 4. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 3 days. disp:*9 tablet(s)* refills:*0* 5. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 3 days. disp:*3 tablet(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: primary 1. portal vein thrombosis 2. sepsis 3. anemia secondary 1. hypertension 2. type ii dm discharge condition: good discharge instructions: you should follow up with dr in 1 week. if you notice any worsening cp, sob, n/v, abd pain, headache, bleeding in your stools, or pain on eating or having a bowel movement, please return to the er and/or contact your pcp. should take all your medications as directed. you should keep all your appointments with health care providers followup instructions: you should call dr. at to schedule an appointment procedure: venous catheterization, not elsewhere classified endoscopic sphincterotomy and papillotomy endoscopic polypectomy of large intestine closed [endoscopic] biopsy of large intestine transfusion of packed cells diagnoses: mitral valve disorders unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified septicemia other and unspecified hyperlipidemia septic shock intestinal infection due to clostridium difficile dehydration benign neoplasm of colon systemic inflammatory response syndrome due to noninfectious process with acute organ dysfunction portal vein thrombosis cornea replaced by transplant 

Answer: The patient is high likely exposed to