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: sulfa (sulfonamide antibiotics) attending: chief complaint: nausea, fatigue, doing poorly at home major surgical or invasive procedure: none history of present illness: 59 year-old female with crohn's disease status post multiple bowel resections with ileostomy, on chronic tpn, as well as smoldering myeloma followed without treatment, with a history of metastatic squamous cell esophageal cancer, presents with worsening fatigue and draining enterocutaneous fistula. patient has not received any treatment for esophageal cancer given her poor performance status. she reports that the fistula has opened for about 3 weeks but cannot quantify the output. she reports that her ileostomy output might be less than usual. her energy level has been dramatically less than before, with her too weak to do anything at home but staying in bed. she continues to rely on tpn. recently she received metronidazole and experienced nausea, which resolved after the antibiotic was stopped. she continues to experience pain in her left shoulder and both legs. she also has intermittent abdominal pain. . review of systems: (+) per hpi (-) review of systems: gen: no fever, chills, night sweats, recent weight loss or gain. heent: no headache, sinus tenderness, rhinorrhea or congestion. cv: no chest pain or tightness, palpitations. pulm: no shortness of breath, or wheezing. gui: no dysuria or change in bladder habits. neuro: no numbness/tingling in extremities. past medical history: oncologic history: she initially noted new heartburn intermittently in fall . this became more severe in and on egd was performed by dr. , and this showed segmental continuous granularity, friability, and erythema of the mucosa in the distal esophagus from 25-30 cm. biopsy of distal esophagus revealed markedly atypical squamous epithelium highly suspicious for squamous cell carcinoma. on endoscopic ultrasound showed an ulcerated, infiltrative circumferential mass at 30 cm causing partial obstruction, close to 2 cm in maximum depth. by eus criteria this was t3n1 with evidence of invasion beyond the muscularis layer. two peri-tumoral nodes were noted which were not sampled as they could not be sampled without traversing the primary esophageal lesion first. biopsy revealed invasive squamous cell carcinoma. on pet/ct showed fdg-avid mass (suv 15.4) involving the distal of the esophagus through the level of the ge junction, with adjacent fdg avid soft tissue possibly representing a nodal mass. there was fdg avidity (suv 5.6) in ill-defined retrotracheal soft tissue, concerning for second site of esophageal involvement or nodal conglomerate. there was a posterolateral subpleural right upper lobe mass, 1.9 x 2.2 cm, concerning for pleural metastasis (suv 14.9). in the right femur, 4 cm below the femoral neck was markedly increased fdg avidity (suv 9.4) in marrow without correlative lesion on ct. on she had ct-guided biopsy of the right upper lobe mass revealing squamous cell carcinoma, felt to be metastatic from her esophageal primary. she is also followed by dr. who has recommended palliative radiation, possibly with concurrent chemotherapy, for her dysphagia. . other medical history: # crohn's disease with history of resections and short gut syndrome, ileostomy, on chronic tpn since # smoldering myeloma, followed by dr. since , with stable paraprotein. has not required therapy. # arthritis # osteoporosis and history of multiple thoracic compression fractures # history of mssa disseminated infection s/p admission to the in with septic pulmonary emboli, left iliopsoas abscess, t9 paraspinal abscess, and t7-9 vertebral osteomyelitis s/p percutaneous pigtail drain, parascapular abscess social history: she lives with her husband of 33 years as well as their 25 year-old son. she retired in and previously ran the production line at . she smoked about 3 cigarettes/day for 20-25 years. she denies alcohol, illicit drug use. family history: her grandmother had myeloma. her mother had thyroid cancer. there is no other family history of cancers. physical exam: vs: t 97.9, bp 118/70, hr 116, rr 16, 94%ra gen: cachetic woman looking much older than age, awake, alert, nad heent: perrla. mmm. no lad. no jvd. neck supple. no cervical, supraclavicular, or axillary lad cards: rr s1/s2 normal. no murmurs/gallops/rubs. pulm: no dullness to percussion, ctab no crackles or wheezes abd: soft, nontender, ileostomy bag in place with stool, midline fistula with surrounding erythema and no active drainage extremities: wwp, no edema. dps, pts 2+. pertinent results: admission: 12:57am blood wbc-39.6*# rbc-4.12* hgb-10.8* hct-34.3* mcv-83 mch-26.2* mchc-31.5 rdw-15.2 plt ct-174# 12:57am blood glucose-114* urean-28* creat-0.7 na-155* k-2.1* cl-109* hco3-35* angap-13 12:57am blood calcium-10.7* phos-2.7 mg-2.1 day of death: 03:18am blood wbc-54.9* rbc-3.49* hgb-9.4* hct-29.0* mcv-83 mch-27.0 mchc-32.5 rdw-19.1* plt ct-19* 03:18am blood pt-23.4* ptt-75.7* inr(pt)-2.2* 03:18am blood glucose-103* urean-48* creat-2.1*# na-145 k-4.1 cl-114* hco3-17* angap-18 03:18am blood alt-26 ast-61* ld(ldh)-816* alkphos-136* totbili-3.1* 03:18am blood calcium-10.0 phos-7.2*# mg-3.0* imaging: ct abd & pelvis with contrast study date of 3:58 pm impression: 1. multifocal large hypoenhancing areas in the kidneys and spleen, compatible with multifocal abscess from septic emboli. 2. new large heterogeneously enhancing lesion in the left hepatic dome, adjacent to and contagious from the known esophageal cancer at the ge junction, likely represents interval aggressive tumor infiltrate. new large cystic lesion anterior to the new hepatic mass, could represent an abscess or a biloma. this cystic lesion is amenable to image-guided drainage/aspiration. 3. interval marked enlargement of bilateral adrenal lesions, compatible with aggressive metastatic growth. 4. oral contrast has reached the ileostomy, without small bowel obstruction. no free air. 5. interval marked enlargement of the right lower lobe squamous cell carcinoma site. 6. marked interval interstitial thickening in the posterior aspect of left lower lobe, likely represents lymphangitic carcinomatosis. however, if the patient had interval radiation therapy, this could also represent post-radiation changes. 7. ill-defined heterogeneous esophageal tumor at the ge junction, incompletely assessed. brief hospital course: 59 year-old female with crohn's disease status post multiple bowel resections with ileostomy, on chronic tpn, as well as smoldering myeloma followed without treatment, with a history of metastatic squamous cell esophageal cancer, presents with worsening fatigue and draining enterocutaneous fistula. brief hospital course: prior to transfer to the ms presented with failure to thrive at home. she was found to have profound hyperkalemia and on ct abdomen/pelvis there were multiple abscess as well as growing metastases noted. she had a ruptured enterocutaneous fistula that had been draining for the past few weeks. her wbc elevated to 45. she triggered for ams as she became more confused, tachypneic, to 30s, tachycardic to 130s and newly hypoxic to 86% on ra. called to evaluate as she was 97% on 2l. a/ox2 and appearing delirious. she had crackles on the left. she was tachycardic to 130s. her blood pressure was 110/70s. she was given 20mg iv lasix on the floor and then her bp dropped to 84/40 and she was given 500cc iv fluid and transferred to the . in the , she was covered for sepsis with broad spectrum antibiotics and id was consulted. her cardiac enzymes were positive, and cardiology was consulted. her wbc continued to climb. a discussion was held with her family, and her code status was changed to dnr/dni. overnight , her bp decreased. on evaluation she appeared to have a mixed picture of distributive and cardiogenic shock. she was started on a levophed drip to maintain blood pressures. her oxygen requirement began to increase, and at 4:30 in the morning, her heart rate went in to the 170s-190s in what appeared to be an svt. her husband was called and told that she was declining and that he ought to come in. on the phone he had agreed with the team to move toward comfort measures only. he arrived, and shortly after that she passed away peacefully with her husband at her side. medications on admission: clonidine - 0.1 mg tablet - 1 tablet(s) by mouth twice a day cyanocobalamin (vitamin b-12) - 1,000 mcg/ml solution - 1 cc injection qmo please give 10 cc vial fentanyl - 12 mcg/hour patch 72 hr - apply one patch every 72 hours omeprazole - 20 mg capsule, delayed release(e.c.) - 1 capsule(s) by mouth twice a day oxycodone - 5 mg tablet - 1 tablet(s) by mouth every 6 hours as needed for pain sucralfate - (not taking as prescribed: pt states she doesn't feel it really helps her) - 1 gram/10 ml suspension - 2 tsp by mouth four times a day tramadol-acetaminophen - 37.5 mg-325 mg tablet - 0.5-1 tablet(s) by mouth every 6 as needed for pain zoledronic acid-mannitol&water - (prescribed by other provider) - 5 mg/100 ml solution - once per year medications - otc calcium-vitamin d3-vitamin k - (prescribed by other provider) - 500 mg-100 unit- mcg tablet, chewable - 1 tablet(s) by mouth once a day loperamide - 2 mg tablet - 4 tablet(s) by mouth twice a day as needed psyllium - (prescribed by other provider; 2 wafers 2x/d) - dosage uncertain discharge medications: not applicable discharge disposition: expired discharge diagnosis: deceaseed discharge condition: expired discharge instructions: expired followup instructions: expired md, procedure: parenteral infusion of concentrated nutritional substances diagnoses: thrombocytopenia, unspecified subendocardial infarction, initial episode of care unspecified septicemia severe sepsis hypopotassemia regional enteritis of unspecified site pneumonitis due to inhalation of food or vomitus alkalosis septic shock multiple myeloma, without mention of having achieved remission do not resuscitate status secondary malignant neoplasm of lung other and unspecified postsurgical nonabsorption peritoneal abscess ileostomy status fistula of intestine, excluding rectum and anus malignant neoplasm of esophagus, unspecified site 

Answer: The patient is high likely exposed to