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 major surgical or invasive procedure: 1. exploratory laparotomy. 2. ileo-right colectomy. 3. ileostomy/hartmann procedure. 4. liver biopsy. history of present illness: 59m recently diagnosed with sclerosing cecal adenocarcinoma on routine colonoscopy at presented with acute onset abdominal pain/vomiting to . kub positive for free air. patient transferred to . past medical history: path at : mod differentiated sclerosing adenocarcinoma social history: pt is married with children and one grandchild. pt is an avid swimmer. he denies all tobacco, ethanol, and recreational drug use. family history: non-contributory physical exam: on discharge: 98.7 87 118/64 18 94%ra gen: nad cvs: rrr, nl s1s2 pulm: cta b/l abd: soft, nt, nd, +bs, wound healing well s erythema/drainage, ostomy pink & viable with brown stool & gas in bag ext: 2+ pitting edema b/l le, warm & well perfused pertinent results: on admission: 10:50pm blood wbc-1.5* rbc-5.10 hgb-14.3 hct-42.6 mcv-84 mch-28.1 mchc-33.6 rdw-16.6* plt ct-480* 10:50pm blood pt-16.1* ptt-29.1 inr(pt)-1.5* 10:50pm blood gran ct-1100* 10:50pm blood glucose-168* urean-19 creat-1.1 na-139 k-3.7 cl-102 hco3-25 angap-16 . on discharge: 04:08am blood caltibc-173* vitb12-174* ferritn-20* trf-133* 02:12am blood alt-20 ast-40 ld(ldh)-192 alkphos-33* amylase-42 totbili-0.8 02:12am blood lipase-10 04:03am blood glucose-59* urean-10 creat-0.8 na-137 k-3.6 cl-105 hco3-28 angap-8 04:03am blood calcium-7.7* phos-1.9* mg-1.8 06:30am blood cea-4.6* 04:53pm blood pt-16.3* ptt-29.4 inr(pt)-1.5* 04:53pm blood folate-7.6 06:40am blood wbc-10.2 rbc-3.14* hgb-8.8* hct-26.4* mcv-84 mch-28.1 mchc-33.4 rdw-16.9* plt ct-318 . pathology: 1. right colon and terminal ileum, hemi-colectomy (a-s): a. adenocarcinoma, see synoptic report. b. evidence of perforation with surgical repair; acute serositis and granulation tissue with pigmented and polarizable material. 2. liver biopsy (t): metastatic adenocarcinoma consistent with colonic primary. colon and rectum: resection synopsis macroscopic specimen type: colonic resection. location: right colon (hemicolectomy). specimen size greatest dimension: 31.5 cm. tumor site: cecum. tumor configuration: exophytic. tumor size greatest dimension: 5 cm. additional dimensions: 3 cm x 0.8 cm. microscopic histologic type: adenocarcinoma. histologic grade: low-grade (well or moderately differentiated). extent of invasion primary tumor: pt3: tumor invades through the muscularis propria into the subserosa or the nonperitonealized pericolic or perirectal soft tissues. regional lymph nodes: pn2: metastasis in 4 or more lymph nodes. lymph nodes number examined: 18. number involved: 7. distant metastasis: pm1: distant metastasis: liver. margins (see comment.) proximal margin: uninvolved by invasive carcinoma. distance of tumor from closest margin: 110 mm. distal margin: uninvolved by invasive carcinoma. distance of tumor from closest margin: 135 mm. circumferential (radial) margin: uninvolved by invasive carcinoma. distance of tumor from closest margin: 45 mm. lymphatic small vessel invasion: present. venous (large vessel) invasion: absent. additional pathologic findings: adenomas (0.7 cm, 0.6 cm, distant from margin). comments: tumor directly extends to peritoneal surface and is present associated with granulation tissue on the serosa. . ct abdomen: impression: 1. status post ileal/right colectomy and ileostomy/hartmann pouch. again seen is bowel wall thickening in particularly involving the ileum, which may be related to anasarca and large amount of intraabdominal fluid. 2. the small bowel is mildly dilated, likely representative of ileus. no evidence of bowel obstruction. 3. multiple low-density lesions within the liver, which is concerning for metastases. 4. moderate-sized bilateral pleural effusion and adjacent atelectasis. indeterminate nodular opacities in the lungs, which may represent atelctasis however cannot exclude metastatic lesion. recommend reevaluation with ct chest with better inspiratory effort after resolution of pleural effusions. 5. large amount of intraabdominal fluid , which limits evaluation for omental lesions. no intraabdominal abscess is identified. . lenis no evidence of dvt. . ct torso: 1. status post ileal/right colectomy and ileostomy/hartmann pouch. there is bowel wall thickening, in particular involving the ileum, which may be related to anasarca/large amount of intrabdominal fluid. 2. multiple incompletely characterized low-density lesions within the liver for which metastatic lesion cannot be excluded. geometric wedge-shaped defect is seen within the right posterior lobe of the liver consistent with biopsy. 3. moderate-sized bilateral pleural effusion and adjacent atelectasis. indeterminate nodular opacity in the right lower lobe, which may be related to atelectasis/inflammatory process. recommend reevaluation after resolution of atelectasis and effusion. 4. large amount of intrabdominal fluid which limits evaluation for omental lesions. brief hospital course: pt transferred from osh with perforated viscus and taken to the or emergently. pt had colonoscopy on for unexplained weight loss/ this study demonstrated polps and adenocarcinoma of the cecum. on the day of admission, pt presented to with marked ruq abdominal pain and vomiting. he received a ct scan demonstrating free air. . neuro: in the immediate post-operative period, the patient was receiving propofol 50 for sedation. the patient's pupils were equal and reactive and his eomi. by the following day, the patient was extubated and was axox3 and was being given dilaudid iv for pain control. he was converted to po pain medication on pod 4 and has tolerated it well with eventually transitioning to po tylenol at the time of discharge. . cvs: during patient's stay in icu, he became intermittently hypotensive. this required intermittent levophed and vasopressin for support. in addition, pt received more than 20 liters of fluid resusciation in the first 24 hours after arrival. on pod# 1, levophed was weaned off and vasopressin was weaned to halve its previous dose. pt never required lasix for this robust fluid resuscitation. he has since had excellent urine output, and was hep locked on pod 3, taking a regular diet. . pulm: initially, pt was transferred to sicu on ac with fio2 of 60% rate of 18, peep of 5 without pressure support. pt was soon extubated and maintained on a face tent with high sats until being transferred to the floor. at the time of discharge the pt's breath sounds were clear with sats greater than 95 percent on room air only. sats have been stable during ambulation. . gi: surgery demonstrated gross fecal contamination and a 3 cm perforation in the cecum. pathology obtained from outside hospital was consistent with moderately differentiated sclerosing adenocarcinoma. during surgery, liver biopsy was sent. pt was also seen by our oncology service to discuss outpatient management of disease. pt also received stool softeners with his narcotics. . renal: pt with stable bun and creatinine throughout stay. pt with consistent and strong urinary output. . id: pt begun on cipro, flagyl, vanco at osh and continued during hospital admission. all antibiotics were stopped prior to discharge following a nine day course beginning with iv medication and concluding on po's. . heme: pt with stable crit throughout surgery and postop period. however, pt's inr at admission was noted to be 1.5 and increased to 2.5 directly post-op. the last inr for this patient was 1.5 on . . endo: pt maintained on iss with qid finger-sticks throughout his hospitalization. . fen: electrolytes were repleted as necessary. . medications on admission: aspirin saw discharge medications: 1. cyanocobalamin 1,000 mcg tablet sig: one (1) tablet po once a day for 1 months. disp:*30 tablet(s)* refills:*2* 2. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for 2 weeks. disp:*60 tablet(s)* refills:*0* 3. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. colace 100 mg capsule sig: one (1) capsule po twice a day for 1 months: to prevent constipation while taking narcotics for pain relief. disp:*60 capsule(s)* refills:*2* discharge disposition: home with service facility: , discharge diagnosis: perforated cecal adenocarcinoma discharge condition: afebrile, vital signs stable, tolerating regular diet, functioning ostomy, ambulating, pain well controlled on po medication. vna services arranged for wound care. discharge instructions: please call your doctor or return to the er for 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. * your skin, or the whites of your eyes become yellow. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * 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. * continue to ambulate several times per day. followup instructions: the following appointments have been made for you for follow-up care. . hematology oncology provider: . phone: date/time: 11:00 . gi hematology oncology: provider: , md phone: date/time: 11:00 . please call dr. , trauma surgery, at ( to schedule an appointment within 1-2 weeks. . please call dr. , hepatobiliary surgery, at ( to schedule an appointment within 1-2 weeks. procedure: venous catheterization, not elsewhere classified arterial catheterization suture of laceration of large intestine open and other right hemicolectomy other permanent ileostomy open biopsy of liver diagnoses: acidosis malignant neoplasm of liver, secondary unspecified septicemia perforation of intestine sepsis malignant neoplasm of cecum neutropenia, unspecified anemia in neoplastic disease 

Answer: The patient is high likely exposed to