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 with nausea major surgical or invasive procedure: laparoscopy converted to laparotomy, small-bowel resection, and jejunostomy. history of present illness: ms. is 4 months after an esophago- gastrectomy for an esophageal cancer, which was treated with neoadjuvant treatment. she has had a jejunostomy tube in place. she has had some progressive nausea and now vomiting with dilatation of the bowel proximal to the jejunostomy site. there is no clear-cut evidence of cancer on a ct scan. the patient has not responded to conservative treatment, and therefore operation was advised and accepted by the patient. originally, we thought that a laparoscopic revision of the jejunostomy would be feasible. past medical history: diabetes mellitus hypertension hyperlipidemia copd esophageal cancer s/p minimally invasive esophagectomy breast cancer s/p right mastectomy social history: she has been a nonsmoker for the past year, having started at the age of 14 and smoked up to one pack per day. she drinks an occasional alcoholic beverage, but they are so rare she cannot remember when her last one was. family history: her family history is negative for breast or ovarian cancer. she had a maternal uncle with cancer and a maternal grandmother with some type of cancer that spread; she is unsure whether this could have been ovarian. there has been no prostate or pancreatic cancers. physical exam: pe: 98.1 76 110/54 16 96/ra nad, a&ox3, interactive and pleasant rrr, no m/r/g ctab, no w/c/r abd mildly distended, soft, diffusely tender to deep palpation, local rebound, no guarding, normal bowel sounds pertinent results: upon admission: 11:33am glucose-199* lactate-1.2 na+-135 k+-4.4 cl--91* tco2-31* 11:33am hgb-10.9* calchct-33 10:00am glucose-207* urea n-23* creat-0.8 sodium-133 potassium-4.4 chloride-95* total co2-30 anion gap-12 10:00am ck(cpk)-18* 10:00am ctropnt-<0.01 10:00am calcium-9.3 phosphate-3.4 magnesium-2.0 10:00am wbc-14.4* rbc-3.43* hgb-10.2* hct-31.1* mcv-91 mch-29.8 mchc-33.0 rdw-14.6 10:00am plt count-355 10:00am pt-13.8* ptt-27.8 inr(pt)-1.2* 11:20am alt(sgpt)-35 ast(sgot)-27 alk phos-141* 09:55am urine rbc-2 wbc-7* bacteria-few yeast-none epi-3 ct of the abdomen without intravenous contrast: post-surgical changes related to esophagectomy is present with large amount of debris and fluid within the distal neoesophagus. note is made of air layering in dependent portion of the esophagus, which is probably intraluminal, however close followup is recommended as pneumatosis may have a similar appearance. the lung bases show bibasilar atelectasis, right greater than left. small right pleural effusion is unchanged. within the limitations of a non-contrast exam no focal hepatic lesion is identified. the gallbladder is distended and there is mild intrahepatic biliary dilatation which may be related to fasting. there is no gallbladder wall thickening or pericholecystic fluid. the spleen, adrenal glands, and kidneys are unremarkable. the pancreas is atrophic. the duodenum is fluid filled and dilated measuring up to 4.8 cm with abrupt caliber change at the anterior abdominal wall (series 2a, image 47), worrisome for an obstruction. given that the oral contrast was administered via the jejunostomy, it is difficult to determine the degree of obstruction. the bowel loops distal to this and the jejunostomy remain relatively collapsed. there is no free air or free fluid. the abdominal aorta shows atherosclerotic calcification however maintains a normal caliber. ct of the pelvis without intravenous contrast: the rectum, sigmoid and bladder are within normal limits. the vagina contains soft tissue material which is of uncertain etiology. direct visualization is recommended as a fistulous connection to the adjacent bowel is not entirely excluded. small amount of free fluid is present within the pelvis. there is no lymphadenopathy. bone windows: no suspicious lytic or sclerotic lesion is identified. degenerative changes are seen involving the lower lumbar spine and bilateral hips. impression: 1. the distal neoesophagus and duodenum are fluid filled and dilated with abrupt caliber change at the anterior abdominal wall proximal to the jejunostomy, worrisome for obstruction. note is made of gas layering in the dependent portions of the distal esophagus, which is likely intraluminal, however close follow up is recommended as pneumatosis may have a similar appearance. 2. soft tissue material within the vaginal canal, which is of uncertain significance. recommend direct visualization as fistulous connection to bowel is not entirely excluded. 3. small amount of pelvic free fluid. 4. bibasilar atelectasis and small right pleural effusion. findings: there are dilated loops of small bowel measuring approximately 7 cm at its greatest diameter. there are associated air-fluid levels noted in the small bowel. there is no intraperitoneal free air noted. there are post-surgical clips noted in place. there is a nasogastric tube with its tip overlying the gastric shadow. these findings are consistent with small-bowel obstruction. there is slight increase distention from supine portable radiograph from . the visualized osseous and soft tissue structures are unremarkable. impression: dilated loops of small bowel, slightly worse from concerning for possible small-bowel obstruction. brief hospital course: pt admitted to surgical floor on under dr. . she was status post esophagogastrectomy with j tube placement for adenocarcinoma and was admitted with question of bowel obstruction after experiencing nausea, vomiting and abdominal pain. she was made npo and given morphine for pain control as well as anti-emetics for nausea/vomiting. an ng tube was placed for gastrointestinal decompression, which was later removed. a urinalysis specimen came back positive for uti and she was treated with a three day course of ciprofloxacin. she had also reported some vaginal bleeding when initially seen in the emergency department. gynecology was consulted after pelvic matter was seen in the vaginal on ct. she declined an exam in the hospital and it was felt that outpatient follow up with her regular gynecologist would be appropriate to further evaluate the bleeding and pelvic matter on imaging. for nutrition, tube feed were provided through her j tube, however, she continued to experience intermittent nausea and vomiting throughout the early days of her hospital stay. iv fluids were provided for hydration. potassium and magnesium were provided for correction of hypokalemia and hypomagnesemia respectively. after her nausea and vomiting failed to improve, the decision was made to return to the operating room on for small bowel resection and j tube revision. intraoperatively, she was found to have widespread cancer throughout her abdomen. her j tube was involved by tumor; the affected portion of the jejunum was resected and a new j tube insertion site was created. atrial fibrillation: hod 8 () prior to going to the or the patient developed a-fib with rvr her afternoon dose of lopressor was held. the pt was converted to nsr with lopressor 10mg ivp. the pt went to or for laparoscopy converted to laparotomy, small-bowelresection, and jejunostomy. pt tolerated the operation well, but developed a-fib with rapid ventricular response. loressor was used with success for a few hours, but the patient continued to convert to a-fib and dropped her sbp to 90s (map 50s). an amiodarone drip was started and the patient was transferred to the icu where she did well for the next few days. she was transferred out of the icu with no further episodes of a-fib. she continued to have further episodes of nausea and vomiting after transfer back to the floor and the ng tube was replaced again. reglan was tried to promote gastric motility and pantoprazole was provided for stomach acid reduction without any symptomatic improvement. nystatin was provided for oral candidiasis. because of the operative findings of carcinomatosis, there were no further surgical options which were likely to be of substantial curative benefit to the patient. tube feeds were restarted to the new j tube. a palliative care consult was obtained, which resulted in a family meeting being held. at the family meeting, the patient's diagnosis and prognosis were discussed. after considering all the information, the family chose to proceed with a planned discharge to home with hospice services. ng clamp trials were attempted in an effort to remove the ng, but she always had substantial residual volumes and felt more comfortable with the ng tube in place for decompression since she quickly became nauseated without it. on after home hospice had been arranged, she was discharged to home with a plan for further palliative and comfort care per hospice. medications on admission: albuterol, fentanyl 100 mcg/72h patch, advair, lasix 20', lansoprazole 30', ativan, reglan, lopressor 25'', zofran, oxycodone elixir, roxicet, colace discharge medications: 1. albuterol 90 mcg/actuation aerosol : two (2) puff inhalation q6h (every 6 hours) as needed for shortness of breath. disp:*1 * refills:*2* 2. fluticasone-salmeterol 250-50 mcg/dose disk with device : one (1) disk with device inhalation (2 times a day). disp:*60 disk with device(s)* refills:*2* 3. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily): via j-tube. disp:*30 tablet,rapid dissolve, dr(s)* refills:*2* 4. docusate sodium 50 mg/5 ml liquid : ten (10) ml's po bid (2 times a day). disp:*600 ml's* refills:*2* 5. bisacodyl 10 mg suppository : one (1) suppository rectal daily (daily) as needed for constipation. disp:*30 suppository(s)* refills:*0* 6. nystatin 100,000 unit/ml suspension : five (5) ml po qid (4 times a day) as needed for oral thrush. disp:*400 ml(s)* refills:*0* 7. fentanyl 100 mcg/hr patch 72 hr : one (1) patch 72 hr transdermal q72h (every 72 hours) as needed for pain. disp:*10 patch 72 hr(s)* refills:*0* 8. lidocaine 5 %(700 mg/patch) adhesive patch, medicated : one (1) adhesive patch, medicated topical daily (daily): apply to affected area as directed. disp:*30 adhesive patch, medicated(s)* refills:*2* 9. metoprolol tartrate 25 mg tablet : one (1) tablet po bid (2 times a day): via j-tube. disp:*60 tablet(s)* refills:*2* 10. scopolamine base 1.5 mg patch 72 hr : one (1) patch 72 hr transdermal q72h prn () as needed for secretions. disp:*10 patch 72 hr(s)* refills:*0* 11. oxycodone 20 mg/ml (1 ml) concentrate : 1/4-1 ml's po q3h:prn as needed for pain. disp:*60 * refills:*0* 12. acetaminophen 160 mg/5 ml solution : ten (10) ml's po q6h (every 6 hours) as needed for fever. disp:*500 ml's* refills:*0* 13. prochlorperazine maleate 10 mg tablet : one (1) tablet po every six (6) hours as needed for nausea. disp:*60 tablet(s)* refills:*1* 14. hyoscyamine sulfate 0.125 mg tablet, sublingual : one (1) tablet, sublingual sublingual q4-6h () as needed for secretions. disp:*30 tablet, sublingual(s)* refills:*1* 15. prochlorperazine 25 mg suppository : one (1) rectal every 6-8 hours as needed for nausea: use if unable to give via j-tube. disp:*30 * refills:*1* 16. dexamethasone 4 mg tablet : one (1) tablet po q12h (every 12 hours). disp:*60 tablet(s)* refills:*2* 17. ativan 1 mg tablet : 1-2 tablets po every 4-6 hours as needed for anxiety: use as alternate ativan liquid 5mg/ml; 1-2 mg every 4-6 hours prn. disp:*60 tablet(s)* refills:*1* 18. heparin, porcine (pf) 10 unit/ml syringe : five (5) ml intravenous prn (as needed) as needed for line flush: flush with 10 ml normal saline followed by heparin as above daily and prn per lumen. . disp:*60 ml(s)* refills:*1* 19. morphine concentrate 20 mg/ml solution : 0.25 ml's po every four (4) hours as needed for pain: give sublingually as needed for moderate to severe pain. disp:*15 ml's* refills:*0* 20. zofran 4 mg/5 ml solution : ml's po every 6-8 hours as needed for nausea. disp:*300 ml's* refills:*0* 21. intravenous fluids normal saline continuous at 100 ml/hour discharge disposition: home with service facility: discharge diagnosis: esophageal cancer w/ recurrnece small bowel obstruction carcinomatosis discharge condition: hemodynamically stable, pain adequately controlled discharge instructions: contact 24 hours a day/7 days a week if there are any concerns pertaining your health status and you will be directed accordingly. followup instructions: follow up in 2 weeks with dr. , call to make that appoinment. you will need to call for an appointment with dr. . you have an appoinment with provider: , md phone: date/time: 11:00 procedure: other enterostomy other partial resection of small intestine enteral infusion of concentrated nutritional substances small-to-small intestinal anastomosis biopsy of peritoneum diagnoses: urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified atrial fibrillation other specified intestinal obstruction hypopotassemia other and unspecified hyperlipidemia pressure ulcer, buttock encounter for palliative care disorders of magnesium metabolism secondary malignant neoplasm of retroperitoneum and peritoneum laparoscopic surgical procedure converted to open procedure personal history of malignant neoplasm of esophagus secondary malignant neoplasm of small intestine including duodenum 

Answer: The patient is high likely exposed to