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: no known allergies / adverse drug reactions attending: chief complaint: concern for cholangitis and need for urgent ercp major surgical or invasive procedure: ercp x2 history of present illness: 64 y/o m with pmh of cabg, dmii, and recent ccy on at for biliary colic who was transferred to from with fever and concern for cholangitis. the patient was initially discharged home following the ccy in stable condition. on he was eating breakfast when he developed ruq abdominal pain similar in character to his prior biliary colic. associated with n/v, loose stools and diaphoresis. not relieved by tylenol. he presented to on where initial labs revealed a rising bili, elevated wbc and an elevated lipase. diagnosed with gallstone pancreatitis and started on unasyn. seen by gi team who recommended ercp. on the morning of , the patient spiked a fever to 101.0. decision was made to transfer the patient to for semi-urgent ercp given concern for developing cholangitis. . on arrival to the patient appeared stable with initial vitals 99.9 159/65 104 22 94%ra. he reports feeling generally well and denies any pain at present. past medical history: - s/p ccy - cad s/p cabg - dm - htn - hl - urinary retention s/p cyst removal social history: works part-time as a cpa. lives at home with his wife. former but quit 13 years ago. occasional etoh. no other drug use. family history: father and brother with cad. brother had lymphoma. father had lung ca physical exam: admission exam: vitals: 99.9 159/65 104 22 94%ra general: alert, oriented, no acute distress heent: perrla, eomi, icteric sclera, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, soft i/vi systolic murmur abdomen: soft, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly. mild ttp in ruq and also in luq. surgical wounds without surrouning erythema. skin: jaundiced ext: no gross deformity or edema neuro: awake, alert and oriented. cn ii-xii intact, strenght throughout. discharge exam: general: alert, oriented, no acute distress heent: perrla, eomi, icteric sclera, mmm lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, soft i/vi systolic murmur abdomen: soft, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly. skin: jaundiced ext: no gross deformity or edema pertinent results: admission labs: 04:31am blood wbc-17.7* rbc-3.72* hgb-11.9* hct-34.6* mcv-93 mch-32.1* mchc-34.4 rdw-13.6 plt ct-286 04:31am blood neuts-89.0* lymphs-6.2* monos-4.4 eos-0.1 baso-0.3 04:31am blood pt-14.9* ptt-29.0 inr(pt)-1.3* 04:31am blood glucose-187* urean-14 creat-0.9 na-136 k-4.3 cl-101 hco3-24 angap-15 04:31am blood alt-239* ast-107* alkphos-198* amylase-397* totbili-2.9* 04:31am blood lipase-642* 04:31am blood albumin-3.3* calcium-8.2* phos-1.8* mg-1.8 08:44am urine color-yellow appear-clear sp -1.015 08:44am urine blood-sm nitrite-neg protein-30 glucose-tr ketone-10 bilirub-neg urobiln-neg ph-5.5 leuks-mod 08:44am urine rbc-4* wbc-16* bacteri-none yeast-none epi-<1 transe-<1 . microbiology 8:44 am urine source: cvs. **final report ** urine culture (final ): no growth. . imaging: leni: impression: no evidence of dvt. . cxr: findings: no previous images. cardiac silhouette is at the upper limits of normal in size in the patient with intact midline sternal wires after cabg procedure. opacification at the right base medially most likely represents atelectasis and fibrous scarring. however, the lower right heart border is not sharply seen, and the possibility of supervening pneumonia would have to be considered in the appropriate clinical setting. remainder of the study is within normal limits with no evidence of vascular congestion. . ercp : impression: normal pancreatogram a 4cm by 5fr pancreatic stent was placed initially to facilitate cannulation. cannulation of the bile duct was then successful. the main bile duct appeared normal. the intrahepatic ducts appeared to have smaller than expected caliber sphincterotomy was extended in the 12 o'clock position using a sphincterotome over an existing guidewire. multiple stone fragments and sludge were extracted successfully using a balloon. no pus noted. the pancreatic stent was then removed by using a snare. . ercp : impression: esophagitis was noted in the lower third of the esophagus edema and distortion of the duodenal wall secondary to pancreatitis was noted an impacted stone was noted at distal cbd normal pancreatogram extremely stenotic papilla with impacted stone at distal cbd. therefore, a small precut sphincterotomy was performed. drainage of bile and small amount of sludge noted after sphincterotomy. no pus noted. deep cannulation of bile duct was not achieved due to the edema otherwise normal ercp to third part of the duodenum le doppler: no evidence of dvt. discharge labs: 03:21am blood wbc-7.4 rbc-3.39* hgb-10.8* hct-30.9* mcv-91 mch-31.8 mchc-34.9 rdw-13.4 plt ct-283 04:15am blood neuts-81.1* lymphs-10.6* monos-6.2 eos-1.6 baso-0.5 04:15am blood pt-12.7 ptt-26.6 inr(pt)-1.1 03:21am blood glucose-174* urean-11 creat-0.6 na-129* k-3.3 cl-95* hco3-25 angap-12 03:21am blood alt-73* ast-34 alkphos-160* totbili-1.3 03:21am blood calcium-7.9* phos-2.5* mg-1.9 brief hospital course: mr. is a 64 y/o m with pmh of cabg, dmii, and recent ccy c/b likely retained stone and gallstone pancreatitis who was transferred to due to concern for developing cholangitis and need for urgent ercp. #. abdominal pain - the patient most likely had a retained stone following ccy that lead to gallstone pancreatitis. there was initially some concern for developing cholangitis given fever to 101.0 and worsening lfts; however he remained relatively pain free, normotensive and without mental status changes making this condition less likely. pt had ercp with sphincterotomy but was unable to canulate bile duct due to edema. he had repeat ercp that showed only stone fragments and sludge. he was continued on unasyn and his lfts and wbc trended downward. he was discharged on a course of augmentin for total 8 day antibiotic course. #. cad - pt is on lisinopril, aspirin and statin at home. these were initially held at the outside hospital and resumed here following successful ercp. he was also started on metoprolol tartrate before transfer to icu and this was continued while in icu at 50mg po tid for rate control. unclear if he was on metoprolol at home but given his cad, he would likely benefit from long term beta blocker and has remained stable with the addition of this to his regimen. recommend follow up with pcp. # hypertension: resumed home meds. also started metoprolol tartrate 50mg po tid while in house to control heart rate and bp and patient remained stable with this addition to his regimen. recommend follow up with pcp to cont to optimize htn regimen. #. dysuria - patient describes dysuria on ros. had on arrival to osh which resolved with fluid resucitation. initial urine culture negative. pt was on antibiotics for cholecystitis so this would treat uti as well. # diarrhea: developed diarrhea on day of discharge. unable to get stool sample before discharge. thought to be secondary to cholecystitis but recommended follow up with pcp # hyponatremia: sodium low to 129 on day of discharge. thought to be secondary to recent resumption of po intake and subsequent water consumption. recommended recheck and follow up with pcp #. dm ii: held oral meds and managed with ssi while in house, restarted home meds on discharge transitional issues: 1. follow up repeat sodium labs to evaluate hyponatremia 2. follow up bp now that pt has been started on metoprolol 3. follow up diarrhea medications on admission: amlodipine 5mg glipizide 5mg niaspan 100mg daily lisinopril 10mg daily asa 81mg daily fish oil vitamin c vitamin d multivitamin simvastatin 80mg actos 45mg discharge medications: 1. metoprolol tartrate 50 mg tablet sig: one (1) tablet po twice a day. 2. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 3. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 4. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 5. amoxicillin-pot clavulanate 875-125 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 4 days. disp:*8 tablet(s)* refills:*0* 6. glipizide 5 mg tablet sig: one (1) tablet po twice a day. 7. metformin 1,000 mg tablet sig: one (1) tablet po twice a day. 8. actos 45 mg tablet sig: one (1) tablet po once a day. 9. fish oil 1,000 mg capsule sig: one (1) capsule po once a day. 10. simvastatin 80 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: primary: gallstone pancreatitis secondary: cad diabetes htn hypercholesterolemia 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 taking care of you at . you were admitted for pancreatitis, likely caused by a gallstone and an infection in your biliary tract. you had an ercp which showed an impacted stone at the common bile duct. we were unable to remove the stone initially, so you had a repeat ercp which showed that the stone had disolved. we were able to advance your diet and you tolerated food well. you've had some diarrhea which here, that we feel is likely due to your recent cholecystectomy but you should be seen by your pcp for . your sodium was slightly low on the day you were discharged. . please make the following changes to your medications: 1. start amoxicillin-clavulanic acid 875 mg by mouth every 12 hours for 4 days. take all other medications as prescribed. followup instructions: name: , p. location: medical associates address: , , phone: at 11:45 am *** please have your electrolytes and blood counts check at this appointment. also, please inform your pcp about your diarrhea *** md procedure: endoscopic removal of stone(s) from biliary tract endoscopic removal of stone(s) from biliary tract endoscopic sphincterotomy and papillotomy endoscopic sphincterotomy and papillotomy endoscopic insertion of stent (tube) into pancreatic duct diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status other and unspecified hyperlipidemia hypoxemia other postprocedural status diarrhea tachycardia, unspecified acute pancreatitis calculus of bile duct without mention of cholecystitis, with obstruction dysuria 

Answer: The patient is high likely exposed to