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: shellfish / carboplatin attending: chief complaint: weight loss & unable to take pos. major surgical or invasive procedure: 1. exploratory laparotomy. 2. lysis of adhesions. 3. biopsy of peritoneal implant. 4. suture repair of enterotomy (small intestine). 5. repair of incisional hernia with mesh. 6. small bowel bypass with (anastomosis x1) 7. picc line right upper arm 8. picc line left upper arm 7. ct guided drainage of pelvic fluid collection 8. ct guided drainage of second pelvic fluid collection history of present illness: 73 y.o. female w/ stage iiic papillary serous ovarian cancer s/p paclitaxel, 6 cycles of carboplatin/gemcitabine, on cycle 6 of doxorubicin, h.o. sbo w/ necrotic ileum s/p ileostomy, multiple abdominal surgery who is being admitted directly from clinic due to concern about her rapid weight loss and inability to eat. she had a recent 9 day admission to the hospital starting on . her ct scan at that time showed sbo with a transition point within the left pelvis, extensive adhesions and decrease in mesentery deposits compatible with treatment response. she was treated conservatively with bowel rest. she was seen received her 6th cycle of doxil on . she has continued to have emesis despite restriction to a full liquid diet. she had a rapid 20 lb weight loss since her previous discharge and has only been able to tolerate water for the past few days. . she reports that she feels nauseated after eating any food or fluid and generally vomits a half an hour or so after eating. she denies having any abdominal pain. she reports passing gas through her ostomy and having some output. she has lost approximately 15-20 lbs in the past 2 weeks. she was able to tolerate solids only for 2-3 days after her previous discharge. she felt lightheaded earlier to day but that improved with ivf in the clinic. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies chest pain or tightness, palpitations. denies cough, shortness of breath, or wheezes. no recent change in bladder habits. no dysuria. denies arthralgias or myalgias. denies rashes. past medical history: pmh: htn, depression, basal cell carcinoma, recurrent ovarian cancer with peritoneal carcinomatosis, h/o tia, cataracts psh: l cea (); ex lap, tah-bso, lymphadenectomy, omentectomy, proctosigmoidectomy (); exploration of wound dehisence w/ debridement and closure of fascia ; laparoscopic incisional hernia repair w/ mesh (); ex lap, loa, excision of infected mesh, appendectomy, drainage of abscess, ileostomy/mucous fistula creation, closure with vicryl mesh (); delayed primary closure abdominal wound ( social history: 30 pack-year h/o smoking, quit 9 years ago; social etoh use; lives alone in , 2 children, both live out of state but very involved family history: family history: she denies any family history of cancer. physical exam: vs: 99.4 144/78 71 18 100% ra. gen: aox3, nad, pleasant. heent: perrla. mmm. no lad. jvp at 5cm. neck supple. cards: rrr s1/s2 normal. no murmurs/gallops/rubs. pulm: no dullness to percussion, ctab no crackles or wheezes abd: high pitched bowel sounds. soft, tender to deep palpation, ostomy in place, no rebound/guarding. neg hsm. neg sign. extremities: wwp, no edema. dps, pts 2+ bilat. skin: no rashes or bruising neuro/psych: cns ii-xii grossly intact, mae. pertinent results: 11:05am wbc-4.9 rbc-3.88* hgb-12.0 hct-35.7* mcv-92 mch-30.9 mchc-33.7 rdw-14.3 11:05am plt count-162 11:05am albumin-3.9 magnesium-1.7 11:05am alt(sgpt)-20 ast(sgot)-28 alk phos-79 tot bili-0.5 11:05am urea n-14 creat-1.0 sodium-136 potassium-4.3 chloride-100 ct abd/ pelvis : 1. dilated small bowel proximally with a probable transition point in the pelvis and relatively decompressed distal small bowel and colon, compatible with small bowel obstruction. no evidence of perforation. 2. new areas of hypodensity in the left hepatic lobe may represent focal fat deposition, although metastatic disease cannot be fully excluded. mri of the liver is recommended for further evaluation. otherwise, stable exam. abd ct : 1. dilated loops of small bowel with air-fluid levels and distal decompressed loops of small bowel with transition region noted within the midline pelvis in region of newly created small bowel anastomosis. this is concerning for small-bowel obstruction but appears similar to prior exams and should be correlated with clinical picture. 2. large thin-rim-enhancing fluid collection within the midline central pelvis extending into the lower abdomen near new anastomotic site. underlying abscess is not excluded. the more inferior pelvic component does appear amendable to image-guided percutaneous drainage as indicated. 3. interval increase in right pleural effusion with new left pleural effusion. compressive atelectasis of the lower lobes. small amount of new intra-abdominal ascites. 4. status post repair of ventral hernia. unchanged ileostomy and parastomal hernia. abd ct : 1. overall decrease in size of multiple loculations of right lower quadrant abdominal fluid collection. marked decrease in size in the lowest collection which contains the drain. an anteriorly located collection is not contiguous with these loculations and is slightly increased in size. 2. persistent bilateral pleural effusions, moderate on the right, small on the left. 3. cholelithiasis without evidence of cholecystitis. 4. small hiatal hernia. 5. unchanged bilateral adrenal adenomas, as defined by mri from . abd ct : 1. interval decrease in thin rim-enhancing fluid collection within the midline central pelvis extending into the lower abdomen near the enteroenteric anastomotic site. interval removal of drain within the fluid collection immediately adjacent to the anastomotic site and superior to the bladder. interval placement of new drain within the superior pelvic component with decrease in size of fluid collection compared to . 2. anteriorly located fluid collection does not appear contiguous with these loculations and is stable in size and appearance compared to . 3. dilated loops of proximal small bowel with distal decompressed loops of small bowel with transition point noted within the midline pelvis within the region of the small bowel anastomosis. oral contrast is noted within the ileostomy. findings are concerning for partial small bowel obstruction, however, appears similar to prior examinations and may represent chronic dilated small bowel. recommend clinical correlation. 4. interval decrease in right-sided pleural effusion with resolution of left pleural effusion. adjacent compressive atelectasis within the right lung base. 5. unchanged ileostomy and parastomal hernia. 6. unchanged bilateral adrenal nodules, previously characterized as adenomas brief hospital course: ms. is a 73 year ole female with stage iiic papillary serous ovarian cancer s/p paclitaxel, 6 cycles of carboplatin/gemcitabine, on cycle 6 of doxorubicin; h/o sbo with necrotic ileum s/p ileostomy, multiple abdominal surgeries who was admitted for rapid weight loss and inability to eat in the setting of chronic sbo seen on ct scan one month prior to admission when the plan was conservative management with slow advancement of diet. she was admitted to the hospital on , put on iv fluids and made npo. she was then slowly advanced in diet but did not tolerate it well and on was remade as npo, had a picc line placed and was started on tpn for improvement of nutritional status prior to surgery. she was taken to the operating room on . an enterotomy was performed in the distal ileum with a small intestine bypass to relieve the obstruction. also, an incisional hernia was repaired with a veritas bioprosthetic mesh. the operation proceeded without complication and she was transferred to the floor after a short stay in the pacu. she was continued npo and with tpn post-surgery and observed for return of bowel function. on pod 4, bowel sounds became more prominent and she observed gas in the ostomy bag. she was advanced to a clear liquid diet on pod 5 which she tolerated well and to a full liquid diet on pod 6 and to a regular diet on pod 7. she tolerated all advances well. on pod 4, her right arm was noted to be edematous and there was increased resistance in flushing the picc. right upper extremity duplex was consistent with thrombotic occlusion of right brachial vein and right axillary vein. the picc was removed and replaced to the left arm. a heparin drip was started with serial ptts. coumadin bridging was started on pod 6 (inr 1.3) and reached therapeutic levels (inr 2.1) on pod 8. the heparin drip was then stopped. while ms. overall status appeared to be improving, she complained of new lower abdominal pain on pod 8. ct scan showed a pelvic fluid collection and on pod 9, a pigtail catheter was placed by ir to drain the fluid yielded 210 cc of brownish, cream-colored serosanguinous fluid. she was started on cipro/flagyl therapy, was briefly switched to zosyn for monotherapy, then switched back to ciprofloxacin after fluid cultures grew e. coli sensitive to ciprofloxacin. she was kept npo after the procedure and another advance of diet attempt was started on pod 12 with sips to clears then full liquids by pod 15. on pod 15 a repeat ct scan showed another fluid collection and a small collection near the midline mesh. a second pigtail catheter was placed, draining 15 cc of fluid and 25 cc of fluid was aspirated from the midline mesh area. following the procedure, she was advanced again to regular diet which she tolerated well. po intake continued to increase through pod 18, when tpn was cycled with 1/2 the usual volume over 12 hours and it was discontinued on . she was placed on calorie counts, given protein supplements and continued on a regular diet which she tolerated well in small amounts. she had a repeat ct scan on to assess the fluid collections which had markedly decreased. there was scant drainage from the tubes and they were removed on and respectively without difficulty. she will continue on her course of ciprofloxicin until . mrs. inr has been in the range of 2.3-2.8 on 2 mg daily. ( 2.8 on ) her picc line was removed on and she continues to try to take small frequent meals with carnation instant breakfast in between. her ostomy is active and she is comfortable in doing her ostomy care. she was discharged to rehab on with the hopes of increasing her strength and mobility so that she can return home. she will follow up with dr. in 2 weeks and dr., her oncologist, after discharge from rehab. medications on admission: 1. bupropion hcl 100 mg tablet sustained release sig: one (1) tablet sustained release po qam (once a day (in the morning)). 2. citalopram 40 mg tablet sig: one (1) tablet po once a day. 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 4. multivitamin,tx-minerals tablet sig: one (1) tablet po daily (daily). 5. omega-3 fatty acids capsule sig: one (1) capsule po bid (2 times a day). 6. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 7. avapro 75mg po qod discharge medications: 1. bupropion hcl 100 mg tablet sustained release sig: one (1) tablet sustained release po daily (daily). 2. citalopram 20 mg tablet sig: two (2) tablet po daily (daily). 3. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 4. multivitamin tablet sig: one (1) tablet po daily (daily). 5. omega-3 fatty acids capsule sig: one (1) capsule po bid (2 times a day). 6. vitamin d-3 400 unit tablet sig: one (1) tablet po once a day. 7. irbesartan 150 mg tablet sig: 0.5 tablet po qod (). 8. irbesartan 150 mg tablet sig: 0.5 tablet po every other day (every other day). 9. pyridoxine 50 mg tablet sig: two (2) tablet po daily (daily). 10. warfarin 2 mg tablet sig: one (1) tablet po once daily at 4 pm. 11. dronabinol 2.5 mg capsule sig: one (1) capsule po bid (2 times a day). 12. megestrol 400 mg/10 ml (40 mg/ml) suspension sig: ten (10) ml po bid (2 times a day). 13. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain not controlled by acetaminophen. 14. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours). 15. cipro 500 mg tablet sig: one (1) tablet po twice a day: thru . 16. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day): hold sbp < 100 hr < 60 . 17. lorazepam 0.5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for anxiety, nausea. discharge disposition: extended care facility: - discharge diagnosis: 1. small bowel obstruction. 2. incisional hernia. 3. stage iiic papillary serous ovarian cancer 4. dvt right axillary vein 5. recurrent pelvic fluid collections discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you are being discharged on medications to treat the pain from your operation. these medications will make you drowsy and impair your ability to drive a motor vehicle or operate machinery safely. you must refrain from such activities while taking these medications. please call your doctor or return to the emergency room if you have any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in 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 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. activity: no heavy lifting of items pounds for 6 weeks. you may resume moderate exercise at your discretion, no abdominal exercises. wound care: you may shower, no tub baths or swimming. if there is clear drainage from your incisions, cover with clean, dry gauze. your steri-strips will fall off on their own. please remove any remaining strips 7-10 days after surgery. please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. followup instructions: provider: , md phone: date/time: 1:45 call dr. for a follow up appointment after you are discharged from rehab. procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances percutaneous abdominal drainage percutaneous abdominal drainage other lysis of peritoneal adhesions other open incisional hernia repair with graft or prosthesis small-to-small intestinal anastomosis other repair of intestine biopsy of peritoneum diagnoses: other postoperative infection unspecified essential hypertension depressive disorder, not elsewhere classified accidental puncture or laceration during a procedure, not elsewhere classified personal history of other malignant neoplasm of skin loss of weight peritoneal adhesions (postoperative) (postinfection) incisional hernia without mention of obstruction or gangrene other complications due to other vascular device, implant, and graft personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits peritoneal abscess ileostomy status adult failure to thrive intestinal or peritoneal adhesions with obstruction (postoperative) (postinfection) secondary malignant neoplasm of retroperitoneum and peritoneum accidental cut, puncture, perforation or hemorrhage during surgical operation personal history of malignant neoplasm of ovary acute venous embolism and thrombosis of deep veins of upper extremity acute venous embolism and thrombosis of axillary veins 

Answer: The patient is high likely exposed to