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: penicillins attending: chief complaint: status post chemo-embolization major surgical or invasive procedure: chemo-embolization history of present illness: 70 yo m with a recent diagnosis of unresectablehepatocellular carcinoma and a renal mass consistent with renal cell carcinoma, now admitted for chemo-embolization. the paitent underwent uneventful chemoembolization on and is now admitted for observation. due to renal insufficiency he was pre-treated with mucomyst prior to the procedure but did not receive ivf intra-procedure. he also received 1 g iv vancomycin x 1. . ros was otherwise essentially negative. the pt denied recent unintended weight loss, fevers, night sweats, chills, headaches, dizziness or vertigo, changes in hearing or vision, including amaurosis fugax, neck stiffness, lymphadenopathy, hematemesis, coffee-ground emesis, dysphagia, odynophagia, heartburn, nausea, vomiting, diarrhea, constipation, steatorrhea, melena, hematochezia, cough, hemoptysis, wheezing, shortness of breath, chest pain, palpitations, dyspnea on exertion, increasing lower extremity swelling, orthpnea, paroxysmal nocturnal dyspnea, leg pain while walking, joint pain. past medical history: oncologic history: during an outpatient work-up of fatigue and anemia, a ct and mri of the abdomen and pelvis demonstrated a moderately enlarged spleen, a solitary mass in the right lobe of the liver as well as an enhancing solid mass in the upper pole of the left kidney without vascular invasion. ultrasound-guided core biopsy was performed on the right lobe mass within the liver on . findings were consistent with hepatocellular carcinoma noted to be well differentiated with established cirrhosis. the slides were sent to for immunohistochemical staining, which was positive for hep par 1 and pcea. his afp has remained normal. the patient met dr. within the transplant center and the mass was felt to be unresectable. additionally, he was seen by dr. within the urology division to discuss his renal mass. he has undergone repeat imaging as of within our institution. the liver mass measures 7.5 cm with associated partial portal venous thrombosis at the bifurcation extending into the left portal vein. there are some periportal lymph nodes present as large as 1.8 cm. the left kidney mass measures 4.7 cm in greatest dimension. resection of the renal mass will be considered after local therapy is completed for the hcc. . past medical history: (per omr and confirmed by patient) 1. chronic kidney disease with baseline creatinine of approximately 1.3 based on faxed records to our hospital. 2. chronic thrombocytopenia diagnosed in followed by dr. at . antiplatelet antibody was negative. the patient has declined bone marrow biopsy several times. 3. history of normocytic anemia. 4. type 2 diabetes. 5. acid reflux disease. 6. gout. 7. diverticulosis. 8. osteoarthritis. 9. hypertension. 10. kidney stones status post lithotripsy. 11. status post appendectomy. 12. hepatocellular carcinoma as described above, likely related to chronic alcohol consumption in the patient's remote history. 13. left kidney mass incidentally found on ct imaging in as above. social history: the patient is married and accompanied by his wife from . he formerly worked at gte warehouse and thereafter was retired though continued to work part-time at the tree shop building furniture. he has not been working for the past several weeks. he and his wife have three children who are alive and well. he has a remote history of alcohol consumption, which he describes as heavy, though he quit in . additionally, he has a 60-pack-year history of tobacco, though he quit 35 years ago. family history: notable for burkitt's lymphoma in his sister, breast cancer and thryoid cancer in another sister, otherwise positive for type 2 diabetes and coronary artery disease. physical exam: vitals: t: 95.6 bp: 167/98 p: 72 r: 18 sao2: 94% 2l general: sleeping but arousable to verbal and tactile stimuli, a and o x3, noted to have gaps in respiration of 3 seconds while sleeping heent: ncat, perrl, eomi, no scleral icterus, mmm, no lesions noted in op neck: supple, no significant jvd or carotid bruits appreciated pulmonary: lungs cta bilaterally, no wheezes, ronchi or rales cardiac: rr, nl s1 s2, no murmurs, rubs or gallops appreciated abdomen: soft, nt, distended and tympanic throughout, no dullness to percussion, no fluid wave, normoactive bowel sounds, no masses or organomegaly noted extremities: right groin catheter side c/d/i but small eccymosis surrounding bandage, no bruit, no edema, 2+ radial, dp pulses b/l skin: no rashes or lesions noted. neurologic: alert, oriented x 3. no asterexis. able to relate history without difficulty. cranial nerves ii-xii intact. normal bulk, strength and tone throughout. no abnormal movements noted. no deficits to light touch throughout. pertinent results: ========= labs ========= all inpatient urine urine culture-pending inpatient blood culture blood culture, routine-pending inpatient . 07:10am blood wbc-10.4 rbc-4.34* hgb-12.6* hct-38.3* mcv-88 mch-28.9 mchc-32.8 rdw-14.3 plt ct-63* 07:30am blood wbc-10.0 rbc-3.99* hgb-11.8* hct-35.3* mcv-89 mch-29.6 mchc-33.4 rdw-14.5 plt ct-70* 06:30pm blood hct-35.5* 06:35am blood wbc-11.3* rbc-4.47* hgb-13.1* hct-39.8* mcv-89 mch-29.3 mchc-32.9 rdw-14.5 plt ct-100* 08:30pm blood wbc-11.1*# rbc-4.41* hgb-13.0* hct-38.6* mcv-88 mch-29.5 mchc-33.7 rdw-14.6 plt ct-102* 06:35am blood neuts-89.1* lymphs-5.7* monos-4.9 eos-0.1 baso-0.2 07:10am blood plt ct-63* 07:30am blood plt smr-low plt ct-70* 06:35am blood plt ct-100* 06:35am blood pt-13.7* ptt-22.0 inr(pt)-1.2* 08:30pm blood plt ct-102* 07:10am blood alt-778* ast-248* alkphos-116 totbili-2.0* 07:30am blood alt-1075* ast-752* alkphos-111 totbili-1.4 06:35am blood alt-505* ast-476* ld(ldh)-619* alkphos-86 totbili-0.8 08:30pm blood alt-61* ast-59* alkphos-80 totbili-0.8 . ======== radiology ======== ct abdomen/pelvis - 1. heterogeneous distribution of chemoembolization material in the distribution of the right hepatic artery. there is increased uptake of this material within the mass occupying the right lobe of the liver. 2. hyperdense mass in the superior left pole of the kidney again concerning for malignancy. 3. 1.2-cm cystic structure adjacent to the body of the pancreas as seen previously. 4. unchanged appearance of portacaval and parapancreatic lymph nodes. . cxr - as compared to the previous examination, there is a newly occurred parenchymal opacity that projects over the left hilus and is accompanied by a small pleural effusion. this abnormality could correspond to a recent pneumonia. no other abnormalities in the lung parenchyma. no right-sided pleural effusion. in projection on the dome of the liver, branched radiopaque material is seen. this could correspond to sequela of a chemoembolization. brief hospital course: 70 y/o man with hcc s/p chemoembolization with known renal lesions suspicous for rcc and ? enlarged prostate on dre per urology note. noncontrast ct liver performed friday: heterogeneous distribution of chemoembolization material in the distribution of the right hepatic artery. noted to be febrile yesterday and cxr significant for l hilar opacity. started on lovenox for portal venous clot. . ## hcc s/p chemoembolization: patient's chemoembolization uneventful. continues to have ruq pain consistent with procedure. did spike a temperature over the weekend, so antibiotics (levofloxacin) initiated to cover for biliary pathogens. lfts trending down, but bili elevated. started on lovenox for known portal thrombosis and educated to continue as outpatient. . ## l hilar opacity: l hilar opacity noted on cxr when patient was febrile on hd#3. initiated antibiotics to cover cap respiratory flora, as well as bilary pathogens given recent procedure. continued levofloxacin - . ## type 2 dm: used sliding scale insulin while inpatient. resumed oral hypoglycemics at discharge. . ## chronic renal insufficiency (baseline cr 1.3): cr elevated today to l.5 likely in setting of catheterization and dye load. received mucomyst and ivf. trended down to________ . ## thrombocytopenia: antiplatelet antibody was negative. . ## chronic anemia: monitor edhct and transfuse for hct < 25 . ## hypertension: held lisinopril and hctz. continue atenolol . ## gerd: continued protonix . ## gout: continued allopurinol (renally dosed) . ## dyslipidemia: held statin while in house given ? liver fx post procedure . ## fen/lytes: regular diet, replete lytes prn . ## prophylaxis: heparin sc 5000 tid, bowel regimen, ambulation when tolerated . ## access: peripheral iv x 2 . ## communication: (wife) . ## code status: full code confirmed with pt on admission the patient was found to have free air and pneumatosis on ct scan after his procedure, he was taken to the or on for exploratory laparotomy, at that time, no compromised bowel was seen, the cecum was found to be grossly dilated, and a cecostomy tube was placed. post procedure the patient was on tpn, iv antiobiotics and kept npo. he had his first bowel movement postop on , but continued to have high ngt output. his lft's continued to be improved, but he required aggressive insulin therapy due to persistent hyperglycemia on tpn. his ngt was discontinued on . the hospital course was also complicated by hypernatremia, which responded to repletion of a free water deficit. the patient was then started on a regular diet which he tolearated without complications, following which tpn was discontinued. the patient is now stable for discharge home, and his blood glucose is stable. medications on admission: allopurinol 300 mg daily, atenolol 50 mgdaily, fluvastatin 20 mg daily, glyburide 5 mg daily, hydrochlorothiazide 20 mg daily, lisinopril 40 mg daily, pravastatin 10 mg daily, omeprazole 20 mg po daily, valsartan 320 mg po daily discharge medications: 1. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 2. atenolol 50 mg tablet sig: one (1) tablet po daily (daily). 3. lisinopril 40 mg tablet sig: one (1) tablet po once a day. 4. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po once a day. 5. glyburide 5 mg tablet sig: one (1) tablet po once a day. tablet(s) 6. valsartan 320 mg tablet sig: one (1) tablet po once a day. 7. fluvastatin 20 mg capsule sig: one (1) capsule po once a day. 8. allopurinol 300 mg tablet sig: one (1) tablet po once a day. tablet(s) 9. enoxaparin 100 mg/ml syringe sig: one (1) ml subcutaneous twice a day for 6 days. disp:*12 ml* refills:*0* 10. enoxaparin 100 mg/ml syringe sig: one (1) ml subcutaneous twice a day for 1 months. disp:*60 ml* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: primary diagnosis: hepatocellular carcinoma secondary diagnoses: 1. chronic kidney disease with baseline creatinine of approximately 1.3 based on faxed records to our hospital. 2. chronic thrombocytopenia diagnosed in followed by dr. at . antiplatelet antibody was negative. the patient has declined bone marrow biopsy several times. 3. history of normocytic anemia. 4. type 2 diabetes. 5. acid reflux disease. 6. gout. 7. diverticulosis. 8. osteoarthritis. 9. hypertension. 10. kidney stones status post lithotripsy. 11. status post appendectomy. 12. hepatocellular carcinoma as described above, likely related to chronic alcohol consumption in the patient's remote history. 13. left kidney mass incidentally found on ct imaging in as above. discharge condition: stable, afebrile discharge instructions: you presented to for scheduled chemo-embolization for hepatocellular carcinoma. you tolerated this procedure well. you were monitored post procedure. you were given antibiotics peri-procedure. you developed a pneumonia and were started on antibiotics for 5 days. you were also found to have a clot in your liver and were started on lovenox for blood thinning. please continue lovenox per dr. . you underwent exploratory laparotomy and placement of a cecostomy tube for free air in your abdomen and bowel wall. avoid heavy lifting for 4-6 weeks, keep your incision clean and dry, you may shower but not take baths, and when you shower, pat the incision dry afterwards. you may cover it with dressings if needed. please seek immediate medical attention if you develop gi bleeding, confusion, loss of conciousness, chest pain, shortness of breath, worsening abdominal pain, or any other change in your baseline health status. followup instructions: provider: scan phone: date/time: 1:00 provider: , md phone: date/time: 2:30 provider: , md phone: date/time: 2:30 see dr. in his office in weeks his number is (. md, procedure: parenteral infusion of concentrated nutritional substances temporary colostomy insertion of other (naso-)gastric tube excision or destruction of peritoneal tissue injection or infusion of cancer chemotherapeutic substance other injection of therapeutic substance into liver diagnoses: thrombocytopenia, unspecified esophageal reflux acute kidney failure with lesion of tubular necrosis diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled alcoholic cirrhosis of liver other and unspecified alcohol dependence, in remission hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified malignant neoplasm of kidney, except pelvis chronic kidney disease, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use paralytic ileus malignant neoplasm of liver, primary accidents occurring in residential institution urinary complications, not elsewhere classified diverticulosis of colon (without mention of hemorrhage) umbilical hernia without mention of obstruction or gangrene anemia in neoplastic disease other specified disorders of peritoneum portal vein thrombosis other specified disorders of intestine fever presenting with conditions classified elsewhere celiac artery compression syndrome encounter for antineoplastic chemotherapy 

Answer: The patient is high likely exposed to