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: fatigue major surgical or invasive procedure: scv central line placement ct guided drainage of j tube sq abscess, hepatic abscess s/p us guided paracentesis history of present illness: this is a 55 yo female with metastatic pancreatic cancer who presents from clinic to omed floor for evaluation of extreme fatigue, transferred to micu for hypotension. . she reports weakness that developed 1 week ago. she denies dizziness, lightheadedness, loc, falls. she denies fatigue, but feels more a lack of strength. also reports feeling anxious x 1 week; her husband gave her oxycodone for this with good effect. her husband notes that she has been slightly confused since friday, but attributes it temporally to oxycodone. she states has been vomiting once per morning, bilious fluid but no blood. this has not notably improved on reglan. they also reports significant leakage from her j tube. the tube was replaced but without significant improvement in leakage. recently on taxotere with last dose received on . she was directly admitted to the omed service. . on arrival to the omed floor, her sbp was in the 90s and she was tachycardic to the 120s. she was given 1l ivf with sbp in 70s. blood cultures were drawn in clinic. stat cxr done. she was empirically started on vanc, ceftaz, and flagyl. neuro-oncology evaluated her and did not recommend repeat imaging; they advised lp if no other source suspected. . . ros: denies headache, photophobia, neck stiffness. no chest pain, palpitations, or sob. denies diarrhea, dysuria. no fevers, chills, sweats. past medical history: # metastatic pancreatic cancer with metastasis to ovary # type 2 diabetes # hypercholesterolemia # h/o dvt this summer. tx with lovenox # h/o palpitations thought to be pvc's treated with atenolol. has had holter monitoring in past # s/p tah rso # s/p appendectomy # s/p biliary and duodenal stent procedures . onc hx: ms. is a 55-year-old female with unresectable pancreatic cancer diagnosed in . ct scan and a diagnostic laparoscopy was negative for any metastatic sites in . in , a ct showed a new pelvic mass that was rapidly growing. this turned out to be a metastasis on excision (tah, rso) on . she is s/p biostent placement (for a total bilirubin of 15.9 and jaundice), cyberknife radiation x3 treatments, percutaneous cholecystostomy placement (for cholecystitis). she had a l popliteal vein dvt and is currently on lovenox. she was started on weekly iv gemcitabine and daily po xeloda in a 2 weeks on 2 weeks off cycle on but the pelvic met progressed through this regimen and she had to undergo a tah/rso on . she has since been on gemcitabine and oxalipatin with intract nausea and vomiting. she was last seen at and was started on emend along with decadron in tapering doses. she has continued to have persistent nausea and emesis. social history: married; 3 children. non-smoker, no etoh. worked part time as clerical worker family history: significant for a cousin with prostate cancer. physical exam: t 97.9 bp 89/63 hr 109 rr 13 spo2 98% ra pulsus 4 mm hg general: chronically ill appearing female, in nad, pleasant heent: perrl, eomi, anicteric sclera. op clear with dry mm. neck: supple. no cervical lad. jvp flat with positive hepatojugular reflux. lungs: decreased breath sounds to right base. crackles to left base. cardiac: regular rate and rhythm. nl s1/s2, no mrg chest: port in left chest, c/d/i abdomen: soft, nontender, bs+. distended with fluid. tah/rso scar well-healed. l-sided j-tube with ostomy bag surrounding it. ostomy bag with yellow-green serous discharge. site non-tender and without erythema. extremities: 2+ pitting edema b/l neuro: alert & oriented x 3. cn ii-xii intact; strength 3/5 in b/l ue/le (? if effort-dependent) pertinent results: labs on admission 12:00pm wbc-2.4*# rbc-3.05* hgb-9.4* hct-28.7* mcv-94 mch-30.7 mchc-32.6 rdw-16.2* 12:00pm neuts-59.2 bands-0 lymphs-28.8 monos-10.9 eos-0.7 basos-0.4 12:00pm plt smr-normal plt count-157# 12:00pm gran ct-1440* 12:00pm glucose-172* urea n-21* creat-0.4 sodium-135 potassium-3.6 chloride-100 total co2-27 anion gap-12 12:00pm alt(sgpt)-18 ast(sgot)-17 ld(ldh)-199 alk phos-128* tot bili-0.8 dir bili-0.3 indir bil-0.5 12:00pm albumin-2.1* calcium-7.9* phosphate-2.4* magnesium-1.9 03:04pm pt-17.1* ptt-150* inr(pt)-1.5* 04:37pm lactate-1.5 03:04pm urine color-yellow appear-cloudy sp -1.029 03:04pm urine rbc-4* wbc-0 bacteria-none yeast-none epi-20 03:04pm urine mucous-occ imaging cxr - in comparison to study of , the left base is sharply seen with only mild blunting of the costophrenic angle. on the right, however, there is again evidence of pleural effusion with associated atelectatic changes. the upper lung zones remain clear. central catheter remains in position. ct abd/pelvis - 1. numerous hypodense hepatic lesions, new since with appearance suspicious for hepatic abscesses. necrotic metastases are considered, although less likely. 2. peribiliary enhancement consistent with cholangitis. 3. new bilateral pleural effusions and adjacent atelectasis. 4. new large amount of ascites. 5. questionable thickening of the ascending colon could relate to a serosal metastasis. 6. subcutaneous abscess adjacent to a jejunal feeding tube entry site. 7. bilateral filling defects in the common femoral veins consistent with deep venous thrombosis. lenis - bilateral occlusive thrombus involving the bilateral common femoral and superficial femoral veins as well as the right popliteal vein. ct/us guided drainage of j tube abcess, hepatic abscess, paracentesis - 1. successful drainage of anterior abdominal wall abscess. 2. successful therapeutic and diagnostic paracentesis. 3. successful ultrasound-guided aspiration of liver abscess. brief hospital course: 55 yo f with metastatic pancreatic cancer who presents from clinic to omed floor for evaluation of extreme fatigue, altered mental status and transferred to micu for hypotension. # metastatic pancreatic cancer patient was made dnr/dni after discussion between patient, family, and attendings. palliative care was involved as well. patient was taken off pressors in the icu and transferred to medical floor, antibiotics were started orally in hopes this will prolong patient's time with family members while at home. patient was stable off pressors and decision was made for patient to go home with hospice services. patient is comfort measures only. # hypotension: differential diagnosis included sepsis vs. pe vs. cardiac tamponade, vs. cardiac ischemia with all but sepsis being less likely. the patient was palced on levophed after minor bp response to 3 l ivf boluses. other possible consideration for pt's hypotension included ivc compression secondary to mass effect from pancreatic ca. sources of sepsis included intrabadominal abscess, j-tube site infections, sbp. less likely causes include pna (not seen on cxr), uti (ua poor sample with 20 epis), or meningitis. a central line was placed and ivfs were bolused to maintain the pt's cvp between . she was started on vanc/ceftaz/flayl for broad coverage. a ct abd/pelvis was obtained on the night of admission to the given concern for abdominal tenderness and new onset ascites which revealed a large subcutaneous abscess around the site of the patient's j tube, multiple hepatic lesions suspicious for either abscess vs. necrotic metastases, possible cholangitis, and new large ascites. radiology was contact and the pt underwent a ct guided aspiration of the sq abscess, liver lesions and a 4 l us guided paracentesis which ruled out sbp, however gnr were growing on culture. unfortunately, there was no clinical improvement in terms of the pt's blood pressures after the procedure and vasopressin was added to augment levophed. after further discussions with the icu team, her oncologists, and her family, it was decided to make the patient cmo on hospital day 3. she was transferred to the floor. # confusion: most likely hypotension in the setting of infection with some improvement in her mental status after starting pressors. other possible causes were medication-related vs meningitis (low clinical suspicion). neuro-onc was also contact who felt the utility of a lp was low and that brain mets were unlikely to be contributing as the patient had had a negative head mri recently. # ftt / weakness: weakness and failure to thrive in setting of cancer and poor nutritional status. albumin of 2.2. # j tube leakage: patient with persistent leakage in spite of multiple ir j tube exchanges in the past. had culture on growing sparse e. coli and s. aureus. ir was contact who felt the tube was in good location and that there was no role in replacing the tube. # le edema: no hx of cardiac disease. likely secondary to hypoalbuminemic state, bilateral dvts, and obstructive pelvic mass. satting well on room air, started on heparin gtt for dvts. # anemia: baseline hct 25-28. # peripheral neuropathy: held lyrica per neuro-onc. . . # code status: patient was made dnr/dni after discussion between patient, family, and attendings. palliative care was involved as well. patient was taken off pressors in the icu and transferred to medical floor. patient was stable off pressors and decision was made for patient to go home with hospice services. patient is comfort measures only. medications on admission: taxotere - last on emla cream metoclopramide 10mg tab po tid before meals omeprazole e.c. 20 mg po daily lyrica 75mg po qday oxycodone 5 mg po qday mvi discharge medications: 1. lorazepam 0.5 mg tablet sig: one (1) tablet po q2h (every 2 hours) as needed for anxiety, insomnia, nausea. 2. acetaminophen 325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed. 3. scopolamine base 1.5 mg patch 72 hr sig: one (1) patch 72 hr transdermal once (once) as needed for secretions. 4. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours). 5. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po bid (2 times a day). discharge disposition: home with service facility: hospice discharge diagnosis: pancreatic carcinoma with metastasis discharge condition: comfort measures only discharge instructions: you are being discharged home with hospice services. followup instructions: provider: , md phone: date/time: 11:30 provider: . phone: date/time: 11:30 provider: /ostomy nurse phone: date/time: 1:00 procedure: venous catheterization, not elsewhere classified percutaneous abdominal drainage aspiration of skin and subcutaneous tissue percutaneous aspiration of liver diagnoses: pure hypercholesterolemia cellulitis and abscess of trunk diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis septic shock abscess of liver personal history of venous thrombosis and embolism dehydration unspecified hereditary and idiopathic peripheral neuropathy secondary malignant neoplasm of retroperitoneum and peritoneum malignant neoplasm of other specified sites of pancreas infection of colostomy or enterostomy secondary malignant neoplasm of ovary malignant ascites 

Answer: The patient is high likely exposed to