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: cipro cystitis attending: chief complaint: abdominal pain - acute cholecystitis with impacted stone in gallbladder neck major surgical or invasive procedure: laparoscopic cholecystectomy history of present illness: 88-year-old man with history of cad and mi s/p stenting and cabg presents with chest and abdominal pain. the patient reports pain across his chest beginning before dinner last night along with nausea but no vomiting. the patient ate dinner hoping that it would help but reported that it made no difference for the pain and made the nausea worse. he slept but was awoken off and on throughout the night by his pain which gradually got worse and migrated to his ruq throughout the night and the next day (during which he could not eat) until he presented to the ed. during this course, the patient denies fevers, chills. he reports no changes in his bowel/bladder habits and denies pain with either. he had his most recent bowel movement this morning which did not have blood and was otherwise normal. notably, the patient denied feeling lightheaded, diaphoretic, or palpitations during this course. at the ed, given the patient's cardiac history, nitro and aspirin were given due to concern for acute coronary syndrome. ekg was done which showed no acute changes. cta-abdomen was done which showed gallstone impacted in the neck with gb distention and pericholecystic fluid, and liver/gb us was done which corroborated these findings. past medical history: past medical history: - hypertension - cad and h/o mi and cabg in at - prostate ca (s/p xrt), urethral stricture - evaluation on revealed a negative bone scan as well as ct scan for metastatic disease. per urology hormonal therapy could be started in the next 2 years. past surgical history: - stenting x 3 at for cad and mi in - cabg in at - melanoma on his back resected in at - right inguinal hernia repair 2mo ago - left inguinal hernia repair social history: lives in with his wife. stopped smoking in . occasional etoh use. no recreational drugs. family history: father: "heart problems" lived to 91 mother: , lived to 70 physical exam: physical examination: upon admission temp:97.8 hr:70 bp:161/72 resp:14 o(2)sat:100 normal constitutional: comfortable heent: normocephalic, atraumatic chest: coarse cardiovascular: regular rate and rhythm, normal first and second heart sounds abdominal: soft, min ttp in epigastrium, nondistended gu/flank: no costovertebral angle tenderness extr/back: no cyanosis, clubbing or edema skin: no rash neuro: speech fluent psych: normal mood, normal mentation pertinent results: 04:09am blood wbc-12.3* rbc-3.22* hgb-9.5* hct-28.6* mcv-89 mch-29.5 mchc-33.3 rdw-15.5 plt ct-614* 05:43am blood wbc-11.7* rbc-3.11* hgb-9.9* hct-28.8* mcv-93 mch-32.0 mchc-34.6 rdw-22.2* plt ct-491* 01:46am blood wbc-14.6* rbc-3.35* hgb-10.5* hct-30.5* mcv-91 mch-31.3 mchc-34.3 rdw-18.4* plt ct-439 02:07am blood wbc-22.3* rbc-3.07* hgb-9.8* hct-28.5* mcv-93 mch-32.0 mchc-34.5 rdw-22.6* plt ct-335 01:46am blood wbc-13.0*# rbc-3.86* hgb-12.1* hct-34.6* mcv-90 mch-31.5 mchc-35.1* rdw-15.9* plt ct-187 12:41pm blood wbc-5.2 rbc-4.33* hgb-14.0 hct-39.7* mcv-92 mch-32.3* mchc-35.2* rdw-18.6* plt ct-221 05:10pm blood wbc-9.1 rbc-4.09* hgb-13.0* hct-36.7* mcv-90 mch-31.8 mchc-35.5* rdw-18.1* plt ct-192 05:10pm blood neuts-70.6* lymphs-19.6 monos-6.2 eos-3.3 baso-0.3 04:09am blood plt ct-614* 04:24am blood pt-33.1* ptt-34.5 inr(pt)-3.3* 05:50am blood pt-24.5* inr(pt)-2.3* 05:43am blood plt ct-491* 05:43am blood pt-20.1* inr(pt)-1.8* 06:06am blood pt-32.6* inr(pt)-3.2* 04:09am blood glucose-101* urean-15 creat-0.8 na-129* k-4.1 cl-94* hco3-26 angap-13 04:24am blood glucose-116* urean-14 creat-0.9 na-132* k-3.6 cl-98 hco3-28 angap-10 03:43pm blood glucose-110* urean-19 creat-1.0 na-133 k-3.8 cl-100 hco3-24 angap-13 12:41am blood ck(cpk)-39* 01:47pm blood ck(cpk)-114 05:10am blood ck-mb-2 ctropnt-0.02* 12:41am blood ck-mb-4 ctropnt-0.03* 01:47pm blood ck-mb-3 ctropnt-0.05* 04:09am blood calcium-8.2* phos-2.4* mg-1.9 04:24am blood calcium-8.4 phos-3.0 mg-2.1 05:30pm blood lactate-1.6 : chest x-ray: impression: 1. no acute cardiopulmonary process. 2. discontinuity of the second sternal wire, again seen. : cat scan of abdomen: impression: 1. large laminated gallstone in the gallbladder neck with mild gallbladder distention and pericholecystic fluid, new compared to prior study of , concerning for acute cholecystitis. ultrasound of the liver and gallbladder might be considered for further evaluation. 2. loculated inferior pericardial fluid, present on prior exam, but appears slightly larger. 3. splenic calcifications most likely from prior granulomatous disease. 4. no evidence of mesenteric ischemi : gallbladder ultrasound: impression: 1. cholelithiasis with constellation of features concerning for acute cholecystitis as described above. 2. right upper pole renal cyst. : echo: conclusions the left atrium is mildly dilated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. impression: normal global and regional biventricular systolic function. elevated left ventricular filling pressures. mild mitral regurgitation. : chest x-ray: there is minimal improvement in the degree of moderate pulmonary edema. small bilateral pleural effusions and left retrocardiac opacity are again noted. the heart remains stably enlarged. there is no pneumothora : ekg: probable atrial fibrillation or possible flutter with a rapid ventricular response. low limb lead qrs voltage. consider left ventricular hypertrophy. delayed r wave progression may be due to left ventricular hypertrophy or possible prior septal myocardial infarction, although is non-diagnostic. st-t wave changes are non-specific. clinical correlation is suggested. since the previous tracing of the ventricular rate is faster and further st-t wave changes are present. : chest-xray: findings: as compared to the previous radiograph, there is unchanged moderate cardiomegaly and evidence of bilateral pleural effusions. moderate overhydration. no newly appeared focal parenchymal opacities. no pneumothorax. : chest- xray: findings: in comparison with the study of , there is continued enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions. some increased opacification at the right base could reflect worsening if effusion on this side in this patient who has undergone a previous cabg procedure with midline sternal wires, the second of which is not tightly tied. : echo: impression: mild spontaneous echo contrast in left atrium but no thrombus in left atrium, left atrial appendage, right atrium, or right atrial appendage. mild mitral regurgitation. brief hospital course: patient was admitted to the acs service from the er, and went promptly to the operating room for laparoscopic cholecystectomy. the operation was uneventful and the patient was taken to the pacu in stable condition. he developed hypotension post operatively and was maintained in the pacu for several hours. his bp did not rise appropriately, hovering instead around 80-90 systolic, and so it was decided he needed to be admitted to the surgical icu. there, he underwent careful resuscitation, as he had a cardiac history and we were concerned for chf. hi cardiologist was involved in his care while in the hospital. over the course of two days, his creatinine stabilized, his urine output improved and his blood pressure remained stable. he was therefore cleared for transfer to the surgical floor. on pod #5 he was transferred to the surgical floor. he was started on a heparin drip for anti-coagulation of his atrial fibrillation. he was started on a regular diet. he continued to have episodes of rapid heart rate and required addtional doses of lopressor. because he continued to have increases in his heart rate, he was evaluated by cardiology and his oral anti-arrthymics were increased. his foley catheter was discontinued and he is voiding via a condom catheter. he is tolerating a regular diet without difficulty. he has maintained his oxygen saturation at 93-94%on room air. he was evaluated by pt/ot to assess his mobility status and made recommendations for his rehabilitation because of his de-conditioning. despite changes in his oral anti-arrythimics, he continued to have episodes of rapid heart rate and hemodynamic instability. he returned to the intensive care unit on pod# 7. he was started on a diltiazem drip for additional rate control. because he was also febrile, he underwent a cat scan of his torso which showed a thickening of his colon, at this time he was also reported to have a klebsella uti. he was started on unasyn. as his hemodynamic status improved, his diltiazem drip was discontinued on pod # 8 and he received it orally. his coumain had been resumed, but by became supra-therapeutic on it with inr 7.1 for which he required ffp and vitamin k with correction of his inr to 1.7. he was transferred back to the surgical floor on pod #10. a picc line was placed for intravenous access and completion of the antibiotic for uti. his atrial fibrillation resumed and he was cardioverted on pod #13. an echocardiogram done prior to cardioversion showed no thrombus. he is preparing for discharge to a extended care facility. his picc line was discontinued. he will follow up with the acute care service in 2 weeks and with his cardiologist, dr. in 4 weeks. his coumadin will be resumed this evening with careful monitoring of his inr. medications on admission: medications: -atorvastatin 10 mg daily -ranitidine 150 mg daily -clopidogrel 75 mg daily -atenolol 25 mg daily -aspirin 325 mg daily -acetaminophen 500 mg q6-8h -valsartan 160 mg daily -oxycodone 5mg prn pain discharge medications: 1. tramadol 50 mg tablet sig: 0.5 tablet po q6h (every 6 hours) as needed for pain. 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for diarrhea. 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 4. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 5. acetaminophen 650 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for fever. 6. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inh inhalation q6h (every 6 hours) as needed for wheeze. 7. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed for itching. 8. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 9. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). 10. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 11. valsartan 160 mg tablet sig: one (1) tablet po daily (daily): hold for blood pressure <120 ( as per cards. recommendation). 12. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 13. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 14. coumadin 1 mg tablet sig: 1 mg tablet po for 1 doses: please follow-up on inr/pt ...maintain inr 2.0-3.0. discharge disposition: extended care facility: for the aged - ltc discharge diagnosis: cholecystitis atrial fibrillation 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 were admitted to the hospital with right upper quadrant pain. you went found to have gallstones. you were taken to the operating room where you had your gallbladder removed. post-operatively, you developed a urinary tract infection which you on antibiotics. you alos developed a rapid heart rate and this was controlled with medication and cardioversion. you are now preparing for discharge to an extended care facility with the following instructions: please call your doctor or nurse practitioner or return to the emergency department for any of the following: *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 followup instructions: follow up with dr. in weeks; call for an appointment. please follow up with dr. in 4 weeks. the telephone number is # md, procedure: venous catheterization, not elsewhere classified diagnostic ultrasound of heart other electric countershock of heart laparoscopic cholecystectomy diagnoses: other iatrogenic hypotension abnormal coagulation profile other postoperative infection urinary tract infection, site not specified congestive heart failure, unspecified unspecified essential hypertension unspecified septicemia atrial fibrillation personal history of malignant neoplasm of prostate coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status percutaneous transluminal coronary angioplasty status sepsis other specified cardiac dysrhythmias other and unspecified angina pectoris old myocardial infarction dehydration removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation diastolic heart failure, unspecified personal history of malignant melanoma of skin personal history of irradiation, presenting hazards to health other specified retention of urine calculus of gallbladder with acute cholecystitis, with obstruction hydrops of gallbladder 

Answer: The patient is high likely exposed to