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: abdominal pain and cough major surgical or invasive procedure: laparoscopic cholecystectomy history of present illness: pcp: : , a./ pa/ location: medical associates, pc address: 20 granite state court, , phone: fax: confirmed by paperwork sent with pt from doctor's visit on the day of presentation. last saw urgent care pa on . also confirmed pt's doctors with dtr. . cardiologist dr. pulmonologist: dr. the patient is a poor historian in terms of dates and timing so much of the history is obtained from his dtr. his dtr confirms that he does have short term memory deficits. . hpi: 77 year old male sent from hospital with known history of cholelithiasis with recurrent ruq pain x 1 month which began one month ago, other complicated medical history including cabg, implanted defibrillator, bladder ca s/p urostomy, orthostatic hypotension sent to for ct today showing 9 mm stone in cbd. of note he was admitted to hospital on for pna s/p l thoracentesis. he was also having abdominal pain then. an us was performed which demonstrated cholelithiasis but there was no cholecystitis so there was no intervention. he then went to rehab from to . he improved somewhat but still walking with a wheelchair. he then started home vna. two days later he developed nausea with non bloody, bilious emesis. he did not take the last doses of the levaquin because his family was concerned that this might be contributing to his nausea and vomiting. he continued to report ruq abdominal pain, burping, worse with palpation. two days ptp his blood pressure was lower than baseline 77/33. the home vna. his lasix and potassium was held. his bp continued to fluctuate. he remained ill with malaise and worsening abdominal pain. he then went to his pcp-> hospital -> hospital. he also reports ongoing cough of productive white sputum. per his daughter there is no change in his baseline. pain with deep inspiration. t = 100.9 the night prior to presentation. tbe patient is unable to identify any ameliorating or triggerin factors. pain not relived with iv morphine. he reports spasms of sharp pain which lasts seconds. he reports that he has had a cough for a while. he is on 2l of oxygen at home. per his dtr the pain is worse with eating and there has been no change in his baseline cough. there may have been some improvement since he is on mucinex. . in er: (triage vitals: 19:16 10 98.8 70 135/44 16 96 ) meds given: unasyn 3 g iv, morphine 2 mg iv, coreg 3.125 mg po, zocor 20 mg po, advair 250/50 2 puffs inh fluids given: none at but 500 cc at cch po intake in ed uop 300cc radiology studies:, consults called: surgery; admit to medicine for ercp. ercp aware vitals 98.7, 71, 125/52, 16, 95% on 2l . pain scale: location: ruq _______________________________________________________________ review of systems: as per hpi past medical history: coronary artery disease s/p cabg x - s/p defibrillator placed in because he developed v-tach s/p ablataion which was not effective - l ventricular anneurysm - h/o hyperlipidemia - h/o malignancy s/p bladder resection for bladder cancer - orthostatic hypotension choledolithiasis s/p ercp ? @ - did not undergo surgery at this time given history of heart disease. recurrent abd pain since that time. + alcoholic encephalopathy- recovering alcoholic + neuropathy - admitted to hospital with klebsiella pna on s/p l lung thoracentesis thrombophlebitis of l arm at site of iv during recent rehab stay social history: social history/ functional status: dnr per conversation with daughter - hcp who lives with him. family contact information: cell can also answer questions (daughter in law) cigarettes: 50 pack years, quit , recovering alcoholic 2 drinks/day: drugs: none occupation: unemployed marital status: divorced, lives with daughter . independent of adls but dtr helps him put on his socks he walks pushing a wheelchair and he sits down when he is tired. dtrs does accounting, dtr's partner cooks. does not drive. dentures/hearing aides/eye glasses no recent falls ppd negative family history: + for coronary artery disease and cva. mother died of colon ca physical exam: pain score: vs t = 97.2 p = 65 bp = 146/122-> 120/48 on re-check rr = 20 o2sat = 91% on 2l general: thin male laying in bed. nourishment: at risk grooming: ok mentation: alert, not delirious but a difficult historian since he cannot clearly tell me when his pain started, what makes it worse, etc. eyes:nc/at, perrl, eomi without nystagmus, no scleral icterus noted ears/nose/mouth/throat: mmm, no lesions noted in op neck: supple, no jvd or carotid bruits appreciated respiratory: decreased breath sounds at the bases b/l cardiovascular: rrr, nl. s1s2, no m/r/g noted but heart sounds are distant gastrointestinal: soft, tender in the ruq with deep palpation. genitourinary: periumbilical urostomy bag draining clear yellow urine. no prostate tenderness guiac negative brown stool skin: no rashes or lesions noted. no pressure ulcer extremities: no c/c/e bilaterally, 2+ radial, dp pulses b/l. l arm more swollen than right. lymphatics/heme/immun: no cervical, lymphadenopathy noted. neurologic: -mental status: alert, oriented x 3. able to do dowb -cranial nerves: ii-xii grossly intact -motor: normal bulk, strength and tone throughout. no abnormal movements noted. + urostomy catheter draining clear yellow urine. site c/d/i psychiatric: appropriate full affect access: piv cvl site ______ urostomy catheter foley: present none urostomy: :present none site c/d/i pertinent results: 10:28pm comments-green 10:28pm lactate-1.0 08:00pm glucose-97 urea n-11 creat-1.1 sodium-135 potassium-3.7 chloride-97 total co2-28 anion gap-14 08:00pm estgfr-using this 08:00pm alt(sgpt)-13 ast(sgot)-29 alk phos-80 tot bili-0.7 08:00pm lipase-14 08:00pm albumin-3.3* 08:00pm wbc-8.3 rbc-3.87* hgb-12.2* hct-37.1* mcv-96 mch-31.6 mchc-33.0 rdw-15.0 08:00pm neuts-84.4* lymphs-9.1* monos-5.3 eos-1.0 basos-0.2 08:00pm plt count-160 . ecg: sr at 69 bpm, q in iii and avf, rbbb. no acute changes. labs: osh lipase/amylase wnl d bili = 0.4 t bili = 1.1 wbc = 9.5 with 84 % pmns. ua +ve . cxr: cch chronic atelectasis of the r lower lung field. increasing l pleural effusion and lll atelectasis. . ct scan: cch moderate amt of sludge filling of the gb with a 9 mm stone at the neck. no pericholecystic fluid or gb wall thickening is seen. with addition of contrast there is chronic enhancement similar to previous exam. no son sign. cbd = 9 mm. impression: possible obstructing cbd stone. acute cholecystitis cannot be ruled out. . ercp normal major papilla cannulation of the biliary duct was performed with a sphincterotome using a free-hand technique. cholangiogram showed a mild dilation of cbd and chd. the cystic duct was filled with contrast. a sphincterotomy was performed in the 12 o'clock position using a sphincterotome over an existing guidewire to prevent future biliary obstruction. balloon sweep was performed which did not show stone because of earlier passage of stone. recommendations: return to outside hospital under referring physician 's care npo overnight , then advance diet as tolerated in am. consider cholecystectomy no asa or nsaids for 10 days. follow-up with dr. additional notes: the procedure was performed by dr. and the gi fellow. the patient's reconciled home medication list is appended to this report. . brief hospital course: assessment: the patient is a 77 year old male with multiple medical problems including cad s/p cabg x 2, l ventricular anneurysm, s/p defibrillator placement, copd on home o2 2l, short term memory deficits, who presented with recurrent abdominal pain and was found to have cholangitis/choledolithiasis. . cholangitis/choledolithiasis: patient was started on iv unasyn. he underwent an ercp on with removal of a 12mm nonobstructing common bile duct stone. there was also noted to be a stone at the cystic duct. he tolerated the procedure well and returned to the floor postop. he continued to have intermittent ruq pain. the patient also underwent a thorocentesis on for his recurrent bloody pleural effusion. discussions were held with the patient, his family, the medical (primary) service, and the surgical service and the decision was made for laparoscopic cholecystectomy given continued pain and evidence of cholecystitis on imaging combined with his presentation of choledocholithiasis. his medical team felt that no further cardiac testing was required and that he would tolerate surgery. discussions were held regarding his increased risk of needing to remain intubated postoperatively given his chronic pulmonary issues and the patient agreed to this and a perioperative suspension of his dnr/dni order. he underwent a lap ccy on after evaluation by anesthesia for tolerance to general anesthesia. this was uncomplicated and he tolerated the procedure well. he was extubated postoperatively and his respiratory status was stable, however after iv fluids and pain medications, on pod1 he became sob and hypoxic w/ o2 sats at 86% on 6l face mask. he was also found to be transiently hypotensive so he was transferred to the icu for further management. in the icu his cxray showed worsening moderate interstitial pulmonary edema and moderate bilateral pleural effusions so he was started on lasix gtt. he was also kept on unasyn for possible pneumonia. there he was maintained on nonrebreather, but eventually developed hypercarbia. bipap was tried, but the patient could not tolerate it. he also developed worsening renal failure thought to be due to the hypotension as well as a pan sensative enterococus uti. after a family meeting, it was decided to transition the patient to comfort measures and he expired soon after. medications on admission: confirmed with dtr on admission protonix 40 mg po qd after breakfast amiodarone 200 mg after breakfast zocor 20 mg po qd after dinner coreg 3.125 mg t after dinner on m/w/f magox = 400 mg niferex 150 mg qhs spiriva t qd florinef 0.1 mg qd after breakfast aspirin 81 mg po qd mucinex 600 mg ibuprofen 600 mg tid prn lasix 20 mg po every other day after breakfast. his last dose was friday b12 q month advair 250/50 proair hfa 2 puff q4 prn o2 2l potassium 10 meq qod with lasix vitamin c 500 mg mvt discharge medications: na discharge disposition: expired discharge diagnosis: choledocholithiasis cholecystitis respiratory failure discharge condition: expired discharge instructions: n/a followup instructions: n.a procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube thoracentesis endoscopic removal of stone(s) from biliary tract laparoscopic cholecystectomy diagnoses: pneumonia, organism unspecified thrombocytopenia, unspecified mitral valve disorders other postoperative infection unspecified pleural effusion congestive heart failure, unspecified acute and subacute necrosis of liver acute kidney failure, unspecified unspecified septicemia severe sepsis chronic airway obstruction, not elsewhere classified aortocoronary bypass status other chronic pulmonary heart diseases personal history of tobacco use septic shock other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation old myocardial infarction personal history of malignant neoplasm of bladder automatic implantable cardiac defibrillator in situ alcoholic polyneuropathy hypovolemia urinary complications, not elsewhere classified acute on chronic systolic heart failure leukocytosis, unspecified personal history of alcoholism mixed acid-base balance disorder calculus of gallbladder and bile duct with acute cholecystitis, without mention of obstruction other artificial opening of urinary tract status benign essential hypertension alcohol-induced persisting dementia 

Answer: The patient is high likely exposed to