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: radio contrast attending: chief complaint: abdominal pain, hypotension major surgical or invasive procedure: ercp w/ stent placement in common bile duct history of present illness: mr. is a 67 yo man hx of cva, polysubstance abuse, pvd, cad, and afib on asa who is transferred from osh with presumed cholangitis. patient presented to hospital this morning with 2 day history of epigastric abdominal pain and dry heaves along with intermittent chest pain. cardiac workup including ekg and troponin was negative, although ruq us showed dilated cbd and with cholelithiasis. labs were notable for lipase 146, tbili 3.3, bil dir 2.6, ast/alt 645/714. patient was given dilaudid for pain control and ceftriaxone and flagyl. he was then transferred for ercp. in the ed, initial vs were: t 98.8, hr 79, bp 98/65, rr 18, satting 100% on ra. labs were noteable for lactate of 3.7, wbc of 20.4 with 10% bands, tbili 3.7, alt 553 and ast 469. ua notable for 18 wbc and 5 rbc. antibiotics were changed to levofloxacin and flagyl. because of sbp's in the 90's, patient received 2l ns, and blood pressure continued to be in the low 90's/50s and patient was admitted to the . vitals prior to transfer were pulse 64, rr 18, bp 101/64, o2 95 % on 2l. on arrival to the micu, patient's vs were 97.8, 73, 110/66, rr 25 o2 92% on 2l. he is moderately tremulous but without signficant complaint. he describes his abdominal pain as epigastric up to , but currently . he notes subjective fever and chills over the preceeding day along with decreased appetite and some mild dyspnea. he denies dizziness. the chest pain he had at osh is resolved, and he denies cough. he is requesting his primidone to help with his tremor. past medical history: -cva -polysubstance abuse -pvd -cad -afib on asa social history: currently living in ecf. former plumber. 40 pack year smoking history, quit in . history of alcohol abuse, sober since . remote mj and cocaine use. denies ever ivda. family history: no known liver disease. sister with kidney disease, mother uterine cancer. otherwise unremarkable. physical exam: admisson physical exam: general: disheveled appearing man, tremulous at rest in arms and head at rest, although nad heent: sclera anicteric, dry mm, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no mrg lungs: good air movment, clear to auscultation except somewhat decreased bs at left base abdomen: soft, non-distended, ttp over epigastrum, bowel sounds present, no rebound or guarding, no sign ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: alert, oriented, somewhat poor attention, symetric face, tongue midline, eomi, perll, 5/5 strength upper/lower extremities, gait deferred. discharge physical exam: vs: 99.2 117/79 p 58 r20 o2 93ra gen: male who appears stated age, in nad heent: nc/at, oropharynx clear, mucous membranes moist, no anterior cervical lymphadenopathy, edentulous cv: brady, regular rhythm, 2+midsystolic murmur at 4th intercostal space, left sternal border. resp: cta bl in anterior and posterior lung fields, no increased work of breathing or accessory muscle use. abdomen: multiple small echymoses over abdomen, soft, nt/nd, no organomegaly appreciated. ext: no clubbing, cyanosis, or edema of distal extremities, unable to palpate dp pulse however no pain, no pallor neuro: mild dysarthria, slow speech. pertinent results: admission labs 10:17pm lactate-2.6* 08:50pm pt-13.0* ptt-22.3* inr(pt)-1.2* 08:30pm urine hours-random 08:30pm urine gr hold-hold 08:30pm urine color-dkamb appear-hazy sp -1.026 08:30pm urine blood-mod nitrite-neg protein-100 glucose-neg ketone-tr bilirubin-mod urobilngn-2* ph-6.0 leuk-neg 08:30pm urine rbc-5* wbc-18* bacteria-few yeast-none epi-<1 08:30pm urine granular-3* hyaline-3* 08:30pm urine mucous-occ 08:11pm to ptt-unable to inr(pt)-unable to 07:52pm lactate-3.7* 07:20pm glucose-105* urea n-28* creat-1.0 sodium-140 potassium-4.4 chloride-101 total co2-26 07:20pm alt(sgpt)-553* ast(sgot)-469* alk phos-122 tot bili-3.7* 07:20pm lipase-21 07:20pm albumin-3.7 calcium-9.3 phosphate-2.2* magnesium-2.1 07:20pm wbc-20.4* rbc-4.37* hgb-13.4* hct-40.3 mcv-92 mch-30.8 mchc-33.4 rdw-14.2 07:20pm neuts-84* bands-10* lymphs-1* monos-3 eos-0 basos-0 atyps-0 metas-2* myelos-0 07:20pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 07:20pm plt smr-normal plt count-215 microbiology blood culture, routine (final ): enterobacter cloacae. identification and sensitivities performed on culture # (). anaerobic bottle gram stain (final ): gram negative rod(s). aerobic bottle gram stain (final ): gram negative rod(s). 7:40 pm blood culture #2. blood culture, routine (preliminary): enterobacter cloacae complex. final sensitivities. piperacillin/tazobactam sensitivity testing performed by . this organism may develop resistance to third generation cephalosporins during prolonged therapy. therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. for serious infections, repeat culture and sensitivity testing may therefore be warranted if third generation cephalosporins were used. sensitivities: mic expressed in mcg/ml _________________________________________________________ enterobacter cloacae complex | cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s piperacillin/tazo----- s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s anaerobic bottle gram stain (final ): gram negative rod(s). reported to and read back by 09:30am. imaging cxr : unchanged low lung volumes. borderline size of the cardiac silhouette. newly appeared atelectasis at the left lung base. new blunting of the left costophrenic sinus, so that the presence of a small pleural effusion cannot be excluded. short-term reevaluation of the patient, if possible with a frontal and lateral chest radiograph, is suggested. discharge labs: 01:55pm blood wbc-8.6 rbc-4.31* hgb-13.2* hct-39.1* mcv-91 mch-30.6 mchc-33.7 rdw-14.8 plt ct-174 01:55pm blood glucose-100 urean-11 creat-0.8 na-139 k-3.6 cl-102 hco3-28 angap-13 01:55pm blood alt-125* ast-78* alkphos-114 totbili-0.6 01:55pm blood calcium-8.7 phos-3.0 mg-1.9 08:03am blood lactate-1.1 brief hospital course: course the patient was transfered from an osh for epigastric pain elevated bilirubin with suspected cholangitis. he was hypotensive likely sepsis. ruq ultrasound showed dilated cbd and cholelithiasis. the patient was given dilaudid for pain control and started on ciprofloxacin and flagyl prior to undergoing ercp. the ercp revaled a diagnosis of cholangitis with frank pus in the bile duct. drainage and stenting were performed. the patient should continue on cipro and flagyn for 7-10 days and return in 2 weeks for stent removal. blood cultures showed gram negative rods, pansensitive to abx. the patient had some urinary retention with lower abominal discomfort and straining after his bph meds were stopped for several days in the setting of hypotension. his bph meds were restarted and a foley was placed for comfort. floor course: active issues: # sepsis/cholangitis: s/p ercp with stenting. proper source control on with iv cipro/flagyl. transitioned to po antibioics on and to continue until . pt scheduled for f/u ercp in weeks. will be contact by ercp team for follow up ercp. -augmentin 875 q12h -flagyl 500 tid -f/u ercp in weeks #increased o2 req: patient had increased o2 requirement on floor. had o2 saturations of 93-98 on 1-3l o2 via nc. this was thought to be due to fluid overload given that patient was aggressively fluid resuscitated for his sepsis. he responded well to 10mg iv lasix, and had o2 sats>93 on ra. #sinus brady/cad/a-fib: no heart failure hx, followed by dr. in . on sotalol chronically which contributes to bradycardia. no episodes of a-fib while in house. - con't asa, atorvastatin -cont. sotalol 80mg inactive issues: # hx of cva: slow speech at baseline, no acute changes. - con't asa and atorvastatin. - con't keppra seizure ppx - con't primidone # tremor: chronic condition, stable - con't primidone # psych: hx of polysubstance abuse and possibly depression. last drink - con't celexa - consider ciwa if tremor persists or if develops autonomic instability # bph: patient had complaints of urinary frequency and urgency, improved with curent medications. - cont tamsulosin and finasteride transitional issues -the patient should complete his full course of antibiotics until . -the patient will need to follow up with ercp in 2 weeks to take out the stent and preform a proper eval of the bile duct with potential stone removal. medications on admission: preadmission medications listed are correct and complete. information was obtained from rehab facility. 1. albuterol 0.083% neb soln 1 neb ih q6h:prn wheezing 2. atorvastatin 10 mg po daily 3. calcium carbonate 500 mg po bid 4. vitamin d 400 unit po daily 5. finasteride 5 mg po qhs 6. levetiracetam 500 mg po qid 7. primidone 250 mg po bid 8. ranitidine 150 mg po bid 9. sotalol 80 mg po bid 10. tamsulosin 0.4 mg po hs 11. citalopram 40 mg po daily 12. bisacodyl 10 mg po daily:prn constipation 13. docusate sodium 100 mg po bid 14. fleet enema 1 enema pr daily:prn constipation 15. milk of magnesia 30 ml po q6h:prn nausea 16. polyethylene glycol 17 g po daily 17. senna 1 tab po bid:prn constipation 18. acetaminophen 325 mg po q4h:prn pain 19. aspirin 81 mg po daily 20. ibuprofen 600 mg po q8h:prn pain discharge medications: 1. acetaminophen 325 mg po q4h:prn pain 2. aspirin 81 mg po daily 3. albuterol 0.083% neb soln 1 neb ih q6h:prn wheezing 4. atorvastatin 10 mg po daily 5. citalopram 40 mg po daily 6. docusate sodium 100 mg po bid 7. finasteride 5 mg po qhs 8. levetiracetam 500 mg po qid 9. polyethylene glycol 17 g po daily 10. primidone 250 mg po bid 11. ranitidine 150 mg po bid 12. senna 1 tab po bid:prn constipation 13. sotalol 80 mg po bid 14. tamsulosin 0.4 mg po hs 15. amoxicillin-clavulanic acid 875 mg po q12h duration: 9 days 16. metronidazole (flagyl) 500 mg po tid duration: 9 days 17. bisacodyl 10 mg po daily:prn constipation 18. calcium carbonate 500 mg po bid 19. fleet enema 1 enema pr daily:prn constipation 20. ibuprofen 600 mg po q8h:prn pain 21. milk of magnesia 30 ml po q6h:prn nausea 22. vitamin d 400 unit po daily discharge disposition: extended care facility: - care and rehab center discharge diagnosis: cholangitis s/p ercp with stent placement discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear mr. , it was a pleasure to treat you at . you were treated for a gastrointestinal infection. a tube was placed in one of your ducts to drain the infection. you are taking antibiotics for the infection and should continue to take them until . followup instructions: please follow up with gastroenterology at in weeks. they will contact you for your appointment. if you have not heard from them by , you can call them at: gi procedure scheduling procedure: endoscopic insertion of stent (tube) into bile duct diagnoses: urinary tract infection, site not specified atrial fibrillation depressive disorder, not elsewhere classified sepsis hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (luts) other specified cardiac dysrhythmias urinary frequency retention of urine, unspecified late effects of cerebrovascular disease, other speech and language deficits other septicemia due to gram-negative organisms accidents occurring in residential institution cholangitis late effects of cerebrovascular disease, cognitive deficits long-term (current) use of aspirin calculus of bile duct without mention of cholecystitis, with obstruction cardiac rhythm regulators causing adverse effects in therapeutic use other fluid overload fistula of bile duct essential and other specified forms of tremor urgency of urination 

Answer: The patient is high likely exposed to