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: abdominal pain, fever major surgical or invasive procedure: exploratory laparotomy, small bowel resection, end-ileostomy history of present illness: history of presenting illness this patient is a 49 year old male who complains of fever/abd pain. 49m with hx of t2dm and previous hx of unexplained neutropenia who now presents with 3-4 days of fever and chills with one day of right sided abdominal pain. + nausea, - vomiting. pt with previous neutropenia that was possibly attributed to his glipizide use, and subsequent bmbx was unrevealing. he was hospitalized in for neutropenia again, and this was possibly attributed to ongoing cocaine use -- "recently, numerous case reports have related neutropenia and anca positivity with cocaine mixed with an anti-helminthic known as levamisole (a cutting ). the patient was reluctant to divulge his recent use, but eventually admitted to ongoing cocaine use over the past year at least. a serum test for levamisole was pending at discharge." here w/ rigors, hypotensivge and abd pain- trigger timing: gradual quality: dull duration: hours past medical history: type 2 diabetes-on oral medications chronic back pain-evidence of djd status post tonsillectomy status post appendectomy recent admission in for chin abscess/neutropenia microscopic hematuria with neg w/u social history: the patient is married. patient lives with his wife and his 12 year old son. currently takes care of his sister who is ill. he works as an electrical engineer and travels to nh three times weekly which is adding stress. sister has a dog and a cat but no scratches or bites recently. drinks 0-1 drinks a week. no tobacco history. he denied illicit drug use on admission, but later admitted to recent and ongoing cocaine use during this past year, with unclear details as to the duration of use. family history: sister with als dad with dm cva mi mom with dm physical exam: physical examination hr:132 bp:86/44 resp:26 o(2)sat:98 normal constitutional: comfortable heent: normocephalic, atraumatic, pupils equal, round and reactive to light oropharynx within normal limits chest: clear to auscultation cardiovascular: regular rate and rhythm- tachy abdominal: soft, diffusely tender r>l no rebound. gu/flank: no costovertebral angle tenderness extr/back: no cyanosis, clubbing or edema skin: no rash neuro: speech fluent psych: normal mood heme//: no petechiae pertinent results: 05:38am blood wbc-11.2* rbc-4.35* hgb-11.4* hct-35.3* mcv-81* mch-26.2* mchc-32.3 rdw-15.6* plt ct-70* 04:59am blood wbc-9.6 rbc-4.49* hgb-11.9* hct-36.0* mcv-80* mch-26.4* mchc-33.0 rdw-15.9* plt ct-90* 05:20am blood wbc-12.5*# rbc-4.71# hgb-12.5* hct-38.0* mcv-81* mch-26.6* mchc-33.0 rdw-15.4 plt ct-116* 03:44pm blood wbc-0.7* rbc-3.98* hgb-10.7* hct-30.6* mcv-77* mch-27.0 mchc-35.1* rdw-15.0 plt ct-190 05:12am blood wbc-0.9* rbc-4.00* hgb-11.0* hct-31.3* mcv-78* mch-27.5 mchc-35.2* rdw-14.8 plt ct-247 08:17pm blood wbc-0.5*# rbc-3.86* hgb-10.4* hct-29.8* mcv-77* mch-27.0 mchc-35.1* rdw-14.4 plt ct-281 02:03am blood neuts-48* bands-6* lymphs-23 monos-17* eos-0 baso-0 atyps-0 metas-1* myelos-5* nrbc-1* 01:54am blood neuts-11* bands-20* lymphs-48* monos-10 eos-0 baso-0 atyps-9* metas-2* myelos-0 05:38am blood plt ct-70* 04:59am blood plt smr-low plt ct-90* 05:20am blood plt ct-116* 02:03am blood pt-16.3* ptt-37.3* inr(pt)-1.4* 01:54am blood plt smr-normal plt ct-198 06:15am blood glucose-98 urean-17 creat-0.9 na-135 k-3.8 cl-98 hco3-31 angap-10 05:38am blood glucose-204* urean-24* creat-0.9 na-141 k-3.9 cl-105 hco3-31 angap-9 04:59am blood glucose-213* urean-29* creat-1.0 na-140 k-3.7 cl-103 hco3-32 angap-9 08:17pm blood glucose-138* urean-32* creat-1.7* na-135 k-3.9 cl-95* hco3-26 angap-18 02:03am blood alt-69* ast-61* alkphos-40 totbili-3.9* dirbili-3.5* indbili-0.4 06:15am blood dirbili-3.5* 06:15am blood dirbili-3.5* 01:54am blood alt-73* ast-54* ld(ldh)-162 alkphos-31* totbili-4.4* dirbili-3.6* indbili-0.8 08:17pm blood alt-22 ast-23 alkphos-46 totbili-1.1 05:12am blood ck-mb-3 ctropnt-<0.01 06:15am blood calcium-7.8* phos-4.1 mg-1.7 05:38am blood calcium-7.5* phos-3.3 mg-1.9 04:59am blood calcium-7.6* phos-3.4 mg-2.1 02:12am blood lactate-2.2* 03:20am blood glucose-213* lactate-2.9* na-133* k-4.6 cl-103 03:24am blood freeca-1.17 09:05pm blood freeca-1.18 : x-ray of the abdomen: impression: nonspecific bowel gas pattern, with a few mildly dilated loops of small bowel and small scattered air-fluid levels, which could reflect gastroenteritis or ileus. early or partial obstruction cannot be excluded and could be further evaluated on ct as clinically warranted. : chest x-ray: impression: low lung volumes, but no focal consolidation. no evidence of free air beneath the diaphragm. : echo: clinical implications: the patient has moderate mitral regurgitation. based on acc/aha valvular heart disease guidelines, a follow-up echocardiogram is suggested in 1 year. the left ventricular ejection fraction is <40%, a threshold for which the patient may benefit from a beta blocker and an ace inhibitor or . based on aha endocarditis prophylaxis recommendations, the echo findings indicate prophylaxis is not recommended. clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. : cat scan of the abdomen: impression: findings concerning for distal ileal inflammation,perforation, and ischemia. potential etiologies include neutropenic enterocolitis, cocaine vasculopathy, and inflammatory bowel disease. : echo: conclusions no spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. normal interatrial septum by color doppler. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. no masses or vegetations are seen on the aortic valve. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. no mass or vegetation is seen on the mitral valve. no mitral regurgitation is seen. tricuspid valve is normal. no tricuspid regurgitation. no vegetation/mass is seen on the pulmonic valve. there is no pericardial effusion. impression: no valvular vegetations demonstrated. preserved biventricular systolic function. normal cardiac valves. : x-ray of the abdomen: stacked dilated loops of small bowel with distal air seen in the colon and rectum may be postoperative ileus but concerning for partial or evolving small-bowel obstruction is also considered. followup radiographs should be considered as clinically indicated. : chest x-ray: impression: bilateral subsegmental atelectasis. small left effusion. minimal right pleural effusion. increased density at the left lung base consistent with worsening atelectasis or consolidation. brief hospital course: 49 year old gentleman admitted to the acute care service with abdominal pain and fever. upon admission, he was found to be hypotensive, tachycardic and neutropenic. he was admitted to the intensive care unit where he required pressor support to maintain his blood pressure. he was made npo, given intravenous fluids antibiotics, and had imaging studies of his abdomen which were concerning for a perforation of his ileum. infectious disease was consulted and made recommendations regarding his managment. he was emergently taken to the operating room where he was found to have a perforated terminal ileum. he underwent an exploratory laparotomy, lysis of adhesions, distal ileum resection, ileostomy, and pouch. he also had placment of a right sided abdominal drain. his operative course was stable with a 500cc blood loss. he required blood products ,crystalloid, and pressors for maintainence of his blood pressure. he was transported to the intensive care unit after his surgery for monitoring where he was hypotensive and tachycardic. he underwent a bedside echo which showed hypokinesis. he also had blood cultures drawn which showed gpr's and recommendations were made for vancomycin, meropenum, and micafungin. his vital signs stablized, pressors weaned off, and he was successfully extubated on pod #1. his post-operative pain was managed with dilaudid pca. his micafungin was discontinued on pod #1 and his vancomycin discontinued on pod #2, meropenum on pod #6. he was transferred to the surgical floor on pod # 2. he did continue to have episodes of tachycardia and underwent a tee which showed no valvular vegatation and an lvef >55%. infectious disease continued to monitor his progress. the abdominal drain was discontinued on pod# 3. the ostomy nurse was consulted and provided care and supervison in the management of his ostomy. because of his deconditioning, physical and occupational therapy were consulted and evaluated his physical status for discharge. he was started on clear liquids with advancement to a regular diet. his vital signs are stable and he is afebrile. his white blood cell count is 10. he has been ambulating in the with assistance. he is tolerating a regular diet and is voiding without difficulty. his ostomy was draining a large amount of watery stool, but now slightly formed stool. he has not resumed his daily home dose of insulin because of his tenuous gi status but his blood sugars have been closely monitored. he is preparing for discharge home with vna services. he will follow-up in the acute care clinic in 2 weeks. medications on admission: : glargine 25 units qhs, lispro, vicodin prn, asa 81, ferrous sulfate 325' discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for fever. 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*25 tablet(s)* refills:*0* 4. insulin glargine 100 unit/ml cartridge sig: twenty (20) units subcutaneous daily: please monitor blood sugars and increase dose to pre-hospital as per blood sugars. 5. insulin lispro 100 unit/ml cartridge sig: 2-30 units subcutaneous prior to meals: as per sliding scale. discharge disposition: home with service facility: homecare discharge diagnosis: bowel ischemia neutropenia sepsis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were cared for in our hospital for neutropenia and enterocolitis requiring surgery. your illness may have been attributed to a unhealthy lifestyle. you have been advised to alter your lifestyle to prevent a recurrence. our general surgery team performed surgery on you first with an exploratory laporatomy. part of your small bowel was removed and an end-ileostomy was performed. you were monitored in the intensive care unit after the procedure, requiring antibiotics. your clinical status has improved and you are now preparing for discharge home with vna assistance. please follow these instructions: you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, 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. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon. avoid driving or operating heavy machinery while taking pain medications. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. *if you have staples, they will be removed at your follow-up appointment. please notify us if you have an increase in your ostomy drainage, any change in your ostomy. followup instructions: please follow-up with the acute care service in 2 weeks. you can schedule this appointment by calling # . md procedure: other partial resection of small intestine diagnostic ultrasound of heart other lysis of peritoneal adhesions ileostomy, not otherwise specified diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis perforation of intestine peritoneal adhesions (postoperative) (postinfection) septic shock paralytic ileus other ascites accidents occurring in residential institution acute vascular insufficiency of intestine drug induced neutropenia cocaine abuse, continuous poisoning by other specified drugs and medicinal substances spondylosis of unspecified site, without mention of myelopathy surgical operation with formation of external stoma causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation accidental poisoning by other specified drugs 

Answer: The patient is high likely exposed to