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: penicillin g / codeine attending: chief complaint: left flank pain major surgical or invasive procedure: : bedside drainage and washout of the left psoas abscess : egd : ct-guided aspiration of right psoas collection. : egd : left lateral open drainage, left retroperitoneal abscess. : successful placement of a right 10.2 french internal/external percutaneous transhepatic biliary drain. : exchange of a right 10.2 french ptbd s/t obstruction. : ercp, two stents placed history of present illness: patient is a 55 year old male with past medical history significant for necrotizing pancreatitis secondary to abuse s/p necrosectomy on followed by takedown of end of the enterocutaneous fistula with small-bowel resection and primary anastomosis on . patient recently admitted on for ruq pain. mrcp at that time showed a filling defect in the pancreatic duct concerning for a stone. patient agreed to have ercp as an outpatient with dr. . patient returns today with worsening left flank pain. he denies fevers, chills, nausea, vomiting and notes regular bowel movements. past medical history: pmh: hypertension, ulcerative colitis s/p colectomy, j pouch, removal of nonmalignant brain tumor, abuse, chronic methadone maintenance for heroin abuse past surgical history: - colectomy - brain tumor excision percutaneous tracheostomy. (dr. percutaneous drainage of retroperitoneal collection abscess of the pancreas x2 for infected retroperitoneal fluid collection. (dr. 1. pancreatic necrosectomy (minimally-invasive.) 2. replacement of percutaneous drains times 2 for a peripancreatic retroperitoneal abscess. (dr. , dr. 1. retroperitoneal laparoscopy. 2. replacement of percutaneous drains into retroperitoneal abscess. (dr. 1. takedown of end of the enterocutaneous fistula with small-bowel resection and primary anastomosis. 2. extended adhesiolysis. 3. repair of enterotomy. 4. g tube placement. 5. j-tube placement. (dr. social history: currently smokes one pack of cigarettes a day. patient has a long term history of abuse and dependence. typically drinks 1 pint of per day though he stopped drinking 6 weeks prior to admission. family history: father was an alcoholic physical exam: vs: t 98.0 80 131/84 18 98% gen: nad, aao x 3 cv: rrr pulm: coarse bs bl abdomen: + bs, thin, tender in midepigastric region, incisional ventral hernia through the midline laparotomy incision, reducible bowel contents, no rebound, left flank with bulge, tender to palpation, old drain site healed extremities: no edema pertinent results: cbc: 12.3>10.4<619 138 95 22 ------------<117 4.0 36 1.0 alt: 56 ap: 813 tbili: 2.7 alb: 2.7 ast: 79 ldh: 100 dbili: tprot: : lip: 15 n:85.8 l:9.4 m:4.1 e:0.3 bas:0.4 ct scan : 1. interval worsening of psoas fluid collections demonstrating rim enhancement since the examination from . there is now a large left psoas fluid collection measuring 13 x 7 x 3 cm that demonstrates a direct connection to the cutaneous tissues of the left lateral abdominal wall. this is either a primary fistula or has progressed through tract of a drain placed in the interval, though history or imaging evidence of such is not available here. in addition, there has been interval enlargement of a right psoas fluid collection measuring 7 x 3 x 3 cm. 2. associated mild hydronephrosis and hydroureter of both kidneys demonstrated to the level of these psoas fluid collections. 3. interval redevelopment of extensive small peripancreatic fluid collections with air within them since the examination from though present on prior examinations such as . 4. gallbladder sludge. 5. calcific density within the proximal aspect of the common bile duct can be correlated to an intraluminal stone as noted on mrcp from . additional calcific densities within the pancreas compatible with chronic pancreatitis. 6. stable appearance of an atrophic pancreas, with continued homogeneous enhancement of the remainder of the parenchyma. stable intra- and extra-hepatic biliary dilatation. ct scan : 1. interval decrease in the size of bilateral psoas abscesses and peripancreatic pseudocyst. 2. 7-mm stone noted in the pancreatic duct associated with pancreatic ductal dilatation; additional probably parenchymal calcifications in pancreatic head. findings are consistent with changes of chronic pancreatitis. 3. diffuse intra- and extra-hepatic biliary dilatation is essentially unchanged compared to the prior examination. 2:50 pm abscess site: abdomen rt abd. drainage. smear reviewed; results confirmed. wound culture (final ): pseudomonas aeruginosa. rare growth. _________________________________________________ pseudomonas aeruginosa | amikacin-------------- 16 s cefepime-------------- 4 s ceftazidime----------- <=1 s ciprofloxacin--------- =>4 r gentamicin------------ =>16 r meropenem------------- 4 s piperacillin/tazo----- <=4 s tobramycin------------ =>16 r anaerobic culture (final ): no anaerobes isolated 2:18 am bile fluid culture (final ): pseudomonas aeruginosa. sparse growth. _________________________________________________________ pseudomonas aeruginosa | amikacin-------------- 16 s cefepime-------------- 4 s ceftazidime----------- <=1 s ciprofloxacin--------- =>4 r gentamicin------------ =>16 r meropenem------------- 4 s piperacillin/tazo----- <=4 s tobramycin------------ =>16 r brief hospital course: mr. , a 55 year old male s/p pancreatic necrosectomy in complicated by bilateral fluid collections who now presents with increasing left sided flank pain. labs on admission also revealed a total bilirubin of 2.7 and alkaline phosphatase of 813, consistent with biliary obstruction. ct scan was obtained and revealed a 12 mm cbd with a 5 mm intraluminal stone and gallbladder sludge. it also demonstrated interval worsening of the psoas fluid collections in comparison to the prior study on . psoas collection on the left measured 13 cm and communicated with the left abdominal wall. right psoas fluid collection measured 7 cm. pancreas appeared calcified and atrophic, consistent with chronic pancreatitis. he was admitted, made npo and started on broad spectrum antibiotics, which were eventually tailored to cefepime and flagyl. on the patient underwent bedside drainage of the left psoas abscess. 50cc's of fluid were expressed and a penrose drain was left in the sinus tract. cultures grew mixed bacterial flora. the patient later underwent ct-guided aspiration of right psoas collection, 30cc fluid aspirated which grew out pseudomonas. on the patient was brought to the or for washout of the left psoas abscess. he was bradycardic in pre-op holding, diagnosed as a self-limited vagal episode by cardiology. no further intervention recommended. post-operatively mr. failed to extubate and was transferred to the sicu where he remained stable overnight. he was transfused a total of 3 units of blood for low hematocrits and later transferred to the floor in stable condition. after several days of increasing nausea and abdominal distension mr. went to ir for ptc drain evaluation which demonstrated occlusion at the level of the cbd. a new 10 fr internal/external drain was placed. the drain was capped post-procedure which he tolerated well. on he underwent ercp which showed a 1.5 cm distal cbd stricture with proximal dilation. two 7 cm 10 fr cotton- stents were placed in the duct. brushings taken during the procedure revealed reactive epithelial cells without evidence of malignancy. ct scan was obtained on and showed interval decrease in bilateral fluid collection size. pancreatic duct stone was still present as were intrahepatic and extrahepatic ductal dilation. mr. was started on tpn four days prior to discharge. at this point he weighed 140 lbs and was approximately 35 lbs below his usual weight. toward the end of his hospitalization he was meeting his kcal/day nutritional requirement and taking nearly 100 grams of protein/day. he will be discharged with home tpn to meet half of his daily caloric needs. he will also continue cefepime and flagyl until his follow-up appointment with dr. in approximately two weeks. at the time of discharge, mr. was doing well, afebrile with stable vital signs. he was tolerating a regular diet, ambulating, voiding without assistance, and his pain was well controlled. the patient received discharge teaching and follow-up instructions with verbalized understanding and agreement with the discharge plan. medications on admission: asa, celexa 20', methadone 45', klonopin 1 qhs, ibuprofen discharge medications: 1. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 2. sucralfate 1 gram tablet sig: one (1) tablet po qid (4 times a day). 3. methadone 40 mg tablet, soluble sig: one (1) tablet, soluble po daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 6. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed for heartburn. 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 8. metronidazole 500 mg tablet sig: one (1) tablet po q8h (every 8 hours). disp:*66 tablet(s)* refills:*0* 9. cefepime 2 gram recon soln sig: one (1) intravenous every twelve (12) hours. disp:*42 bags* refills:*0* discharge disposition: home with service facility: home therapies discharge diagnosis: 1. necrotizing pancreatitis 2. bilateral retroperitoneal psoas abscesses 3. sinus bradycardia 4. hypercapnia s/p intubation 5. chronic anemia 6. biliary obstruction with lfts elevation and leukocytosis 7. malnutrition discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. avoid driving or operating heavy machinery while taking pain medications. please follow-up with your surgeon and primary care provider (pcp) as advised. penrose drains care: *please look at the site every day for signs of infection (increased redness or pain, swelling, odor, yellow or bloody discharge, warm to touch, fever). *if the drain is connected to a collection container (ostomy bag), please note color, consistency, and amount of fluid in the drain. call the doctor, nurse practitioner, or nurse if the amount increases significantly or changes in character. be sure to empty the drain frequently. record the output, if instructed to do so. *wash the area gently with warm, soapy water or 1/2 strength hydrogen peroxide followed by saline rinse, pat dry, and place a drain sponge. change daily and as needed. *keep the insertion site clean and dry otherwise. *avoid swimming, baths, hot tubs; do not submerge yourself in water. *make sure to keep the drain attached securely to your body to prevent pulling or dislocation. picc line: *please monitor the site regularly, and your md, nurse practitioner, or nurse if you notice redness, swelling, tenderness or pain, drainage or bleeding at the insertion site. * your md to the emergency room immediately if the picc line tubing becomes damaged or punctured, or if the line is pulled out partially or completely. do not use the picc line in these circumstances.please keep the dressing clean and dry. contact your nurse if the dressing comes undone or is significantly soiled for further instructions. ptbd drain care: keep capped. please look at the site every day for signs of infection (increased redness or pain, swelling, odor, yellow or bloody discharge, warm to touch, fever). *wash the area gently with warm, soapy water or 1/2 strength hydrogen peroxide followed by saline rinse, pat dry, and place a drain sponge. change daily and as needed. *keep the insertion site clean and dry otherwise. *avoid swimming, baths, hot tubs; do not submerge yourself in water. *make sure to keep the drain attached securely to your body to prevent pulling or dislocation followup instructions: provider: , md phone: date/time: 3:00 . please call dr. office to schedule a follow up appointment to see him. he would like to see you in 2 weeks. procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances percutaneous abdominal drainage percutaneous abdominal drainage incision of abdominal wall endoscopic insertion of stent (tube) into bile duct other percutaneous procedures on biliary tract other percutaneous procedures on biliary tract endoscopic retrograde cholangiopancreatography [ercp] endoscopic retrograde cholangiopancreatography [ercp] diagnoses: anemia, unspecified tobacco use disorder unspecified essential hypertension unspecified protein-calorie malnutrition opioid type dependence, unspecified other specified disorders of biliary tract hydronephrosis chronic pancreatitis other and unspecified alcohol dependence, unspecified acute pancreatitis cyst and pseudocyst of pancreas pseudomonas infection in conditions classified elsewhere and of unspecified site calculus of bile duct without mention of cholecystitis, with obstruction psoas muscle abscess 

Answer: The patient is high likely exposed to