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: nausea vomitting major surgical or invasive procedure: none history of present illness: this is a 86 year old male w/ mmp, h/o ileocecectomy for stage i cr ca- subsequently developed high grade dysplasia and ~ 2weeks ago underwent a transverse colectomy (has an ileo-dscending colostomy). he was transfered here from a hospital after persistent nausea and vomitting and inability to take a regular diet. studies: ct showed some free air in the left hemidiaphram. gastograffin enema - no obstruction or leak ugi - delayed gastric emptying past medical history: pmh: afib, dm2, cad, pud, htn, bph, depression psh: b2 (antecolic j-j)~ 25 years ago, ileocecectomy ~ 20 years ago, cabg, pacer, open chole. social history: patient born and raised in . . wwii survivor. met wife in . patient and wife coauthored book about life in during wwii. patient has authored several other publications about the holocaust. immigrated to u.s. 35 . patient moved here to escape communism, physical exam: pe: 97.3 77 167/84 22 99ra gen: comfortable at rest heent: ncat, anicteric cv: rrr, pacemaker in place pulm: ctab abd: soft, nt, minimally distended, vertical midline incision healing well, no erythema, no induration ext: no le edema pertinent results: cardiology report ecg study date of 10:38:38 am atrial sensed ventricular paced no previous tracing available for comparison read by: , w. intervals axes rate pr qrs qt/qtc p qrs t 60 0 130 466/466 0 -44 126 chest (pa & lat) 9:38 am chest (pa & lat) reason: 86 year old man with ? of obstrxn / p/op leak medical condition: 86 year old man with ? of obstrxn / p/op leak reason for this examination: 86 year old man with ? of obstrxn / p/op leak chest radiograph indication: 86-year-old man with history of colorectal carcinoma and colectomy. no prior studies are available for comparison. findings: left-sided dual chamber pacemaker is identified. there is a free lead that probably corresponds to prior advise. bibasilar opacities are seen consistent with pleural effusions. the cardiac silhouette is obscured by these opacities and cannot be evaluated. the aorta appears tortuous. _____ vascular calcifications are identified. the upper lung zones appear clear. impression: bilateral pleural effusions. surgical clips are seen overlying the right upper quadrant and the mid abdomen cardiology report ecg study date of 3:27:52 pm ventricularly paced rhythm, rate 60. probable underlying atrial fibrillation. compared to the previous tracing of no diagnostic change. read by: , intervals axes rate pr qrs qt/qtc p qrs t 59 258 142 492/489.72 28 -38 51 ct abdomen w/contrast 1:30 pm ct abdomen w/contrast; ct pelvis w/contrast reason: please eval for collection, obstruction. please give gastro field of view: 36 medical condition: 86 year old man s/p transverse colectomy, now w/ vomiting, fever reason for this examination: please eval for collection, obstruction. please give gastrograffin (pt had ? of leak on outside hospital scan--we could not see evidence of such on studies). page w/ questions. contraindications for iv contrast: none. indication: 86-year-old man status post transverse colectomy, now with vomiting and fever. evaluate for collection or obstruction. please administer gastrografin. technique: mdct acquired axial images of the abdomen and pelvis were performed with iv contrast. ct abdomen with iv contrast: there is a large right pleural effusion with associated atelectasis and a small-to-moderate size left effusion. the liver, pancreas, spleen, adrenal glands, kidneys are unremarkable with the exception of a left large simple renal cyst. there are no pathologically enlarged lymph nodes within the retroperitoneum or mesentery. there is a small amount of free air within the abdomen and subcutaneous tissue adjacent to incision site. surrounding site of anastomosis in the region of the hepatic flexure, there is a moderate amount of fat stranding with no definite fluid collection identified. these findings could represent sequelae of the prior anastomosis from 10 days ago. ct pelvis with iv contrast: the urinary bladder, rectum, and sigmoid colon are unremarkable. the prostate is slightly enlarged. bone windows: no suspicious lytic or sclerotic bony lesions. impression: 1. large right and small-to-moderate left pleural effusions. 2. small amount of free air within the abdomen and subcutaneous tissues adjacent to incision site, likely postoperative sequelae. 3. small amount of fat stranding surrounding anastomotic site, consistent with postoperative sequelae. no focal fluid collection is identified. contrast is seen passing this site. 4. no evidence of bowel leak or obstruction. bilat lower ext veins 12:03 pm bilat lower ext veins reason: eval for dvt medical condition: 86 year old man with fevers, increasing wbc, with bilat pitting edema & signs reason for this examination: eval for dvt indication: an 86-year-old male with fevers and increasing white blood cell count and bilateral pitting edema. evaluate for dvt. bilateral lower extremity venous ultrasound: scale and doppler son of the right and left common femoral, superficial femoral, and popliteal veins were performed. normal compressibility, augmentation, flow, and waveforms are demonstrated. there is no evidence of intraluminal thrombus. impression: no evidence of dvt bilaterally. portable abdomen 4:50 pm portable abdomen; follow-up,request by rad. reason: chk for gastric emptying post ugi indication: check for gastric emptying status post upper gi. note is made of the gi/small bowel follow through of , . supine abdominal radiograph: clips are seen in the right upper quadrant. contrast is seen within the stomach as well as within loops of small and large bowel. staples are seen over the mid abdomen. there is no evidence of obstruction. impression: 1. contrast remains within the stomach. no evidence of obstruction. bas/ugi air/sbft 2:21 pm bas/ugi air/sbft reason: eval gastric emptying... directed consult to dr . pls medical condition: 86m s/p distant b2 with gastric bezoar (but no strciture on egd) & n/v after transverse colectmoy reason for this examination: eval gastric emptying... directed consult to dr . pls call with questions indication: a distant history of gastric bezoar with nausea and vomiting after transverse colectomy. please evaluate gastric emptying. comparison: none. findings: a focussed fluoroscopic study of the stomach was performed. patient was orally administered a thin barium, which demonstrated free passage through the esophagus into the stomach. there is no evidence for hiatal hernia. there was significant reflux with a large column of contrast refluxing into the esophagus to the upper mediastinum. this was accompanied by dysfunctional tertiary peristaltic waves. esophageal lumen is featureless with a small diverticulum noted in the mid portion of the esophagus. the patient was kept in the fluoroscopic suite for 20 minutes without opacification of the stomach antrum. given a large column of reflux of contrast, a decision was made not to administer fizzies for stomach dilation. study will be continued on the floor with subsequent portable abdominal radiograph to assess gastric emptying. three-lead pacemaker is noted with leads coursing their anticipated paths. surgical clips are present in the right upper quadrant, midline, as well as skin staples present along the midline. contrast is present within the colon from a previous contrast study. abdominal supine portable radiograph performed one hour after thin barium administration demonstrates unchanged appearance of contrast in the stomach. contrast in the colon is from a prior study. abdominal supine portable radiographs performed two hours after thin barium administration demonstrates contrast opacification of non-distended stomach. contrast has progressed into the duodenum and proximal jejunum. impression: 1. marked esopphageal reflux with large column of barium persisting in esophagus to the upper mediastinum (exam performed in near upright position). patient is at risk for aspiration. small mid-esophageal diverticulum. 2. contrast passage through non-dilated normal-appearing stomach demonstrated two hours post contrast administration. chest (pa & lat) 1:29 pm chest (pa & lat) reason: eval for passage of contrast medical condition: 86 year old man with nausea, vomiting, fever. s/p transverse colectomy reason for this examination: eval for passage of contrast pelvic ultrasound. indication: nausea, vomiting, and fever, status post transverse colectomy. comparison: . since the prior examination, there has been interval removal of the enteric tube. stable appearance of the left-sided central venous catheter with its tip projecting over the svc. slight increased opacity in the right lung base may represent a possible consolidation. stable appearance of the left lower lobe opacification. left-sided dual chamber pacemaker is unchanged with the presence of an abandoned lead from prior device. the upper abdomen demonstrates gas fluid level and barium layering in a slight dilated stomach. some of the contrast exited the stomach, but cannot be assessed. impression: possible consolidation in both lung bases, particularly in the right. interval removal of the enteric tube. large amount of residual contrast layering in the stomach with at least some in the small bowel cardiology report ecg study date of 10:19:16 am ventricularly paced rhythm at 60 beats per minute with probable underlying atrial fibrillation. compared to the previous tracing of the ventricular pacing is new. read by: , intervals axes rate pr qrs qt/qtc p qrs t 59 0 128 440/437.72 0 -45 92 () radiology final report -intestinal tube placement (w/fluoro) 3:43 pm -intestinal tube placement reason: please change over a wire and replace nj tube.* medical condition: 86 year old man with -jejunal tube that is clogged. reason for this examination: please change over a wire and replace nj tube.* indications: 86-year-old man with clogged nasojejunal tube. technique: placement of feeding tube under fluoroscopy. findings: a 14 french - nasointestinal feeding tube was passed into the stomach without difficulty, and the existing tube removed. however, attempts to pass the tube beyond the stomach were not successful. a redundant segment was left in the stomach in order to potentially facilitate distal passage. persistent debris in the fundus of the stomach is noted. impression: 1. placement of feeding tube within the stomach. the tube could not be advanced into the jejunum (the patient is s/p billrothii) . it could be helpful to acquire an abdominal radiograph in the morning, and if the tube does not spontaneously pass into the jejunum by that time, the patient could be returned to the fluoroscopy suite for repositioning. 2. persistent debris within the fundus of the stomach. the study and the report were reviewed by the staff radiologist. dr. dr. approved: 5:06 pm radiology final report catheter, drainage 2:32 pm reason: please place gj tube tube with g port to vent stomach & j po contrast: optiray medical condition: 86m s/p bilroth 2, with delayed gastric emptying & need for feeding tube. reason for this examination: please place gj tube tube with g port to vent stomach & j port into efferent jejnual limb for tube feedings... history: gastric outlet obstruction in a patient with a billroth ii procedure. please place gj tube. technique/findings: after informed consent was obtained, the patient's anterior abdominal wall was prepped and draped in a sterile fashion. insufflation of the patient's current ng tube was performed in conjunction with review of a recent ct scan. this demonstrated the gastric remnant to be of decent size and directly below the anterior abdominal wall. hence, after insufflation, two t-fasteners were placed along the greater curvature of the stomach, after which the seldinger technique was used to place a 5 french sheath within the gastric remnant lumen. wire and kumpe catheter were used to manipulate into the patient's efferent loop. this loop was confirmed both with contrast and passage of a 150-cm wire. the catheter-wire combination were manipulated approximately 100 cm into the efferent limb, after which the wire was exchanged for an amplatz wire. -coons gastrojejunostomy tube was shortened (regularly 100 cm, shortened to approximately 80 cm) with additional sideholes placed and then advanced into the efferent limb after tract dilatation. the proximal port which is for gastric aspiration, was left within the gastric remnant, the distal port, 80 cm in the efferent limb for tube feeding. the tube was sutured in place with 0-prolene. as well, it contains a mushroom tip for internal anchoring. impression: placement of a double-lumen gastrojejunostomy tube via this patient's gastric remnant, proximal port within the remnant, distal port approximately 80 cm within the efferent limb in this patient who is status post a billroth ii procedure. no complications. dr. approved: tue 9:22 am radiology final report perc plcmt gastromy tube 2:32 pm reason: please place gj tube tube with g port to vent stomach & j po contrast: optiray medical condition: 86m s/p bilroth 2, with delayed gastric emptying & need for feeding tube. reason for this examination: please place gj tube tube with g port to vent stomach & j port into efferent jejnual limb for tube feedings... history: gastric outlet obstruction in a patient with a billroth ii procedure. please place gj tube. technique/findings: after informed consent was obtained, the patient's anterior abdominal wall was prepped and draped in a sterile fashion. insufflation of the patient's current ng tube was performed in conjunction with review of a recent ct scan. this demonstrated the gastric remnant to be of decent size and directly below the anterior abdominal wall. hence, after insufflation, two t-fasteners were placed along the greater curvature of the stomach, after which the seldinger technique was used to place a 5 french sheath within the gastric remnant lumen. wire and kumpe catheter were used to manipulate into the patient's efferent loop. this loop was confirmed both with contrast and passage of a 150-cm wire. the catheter-wire combination were manipulated approximately 100 cm into the efferent limb, after which the wire was exchanged for an amplatz wire. -coons gastrojejunostomy tube was shortened (regularly 100 cm, shortened to approximately 80 cm) with additional sideholes placed and then advanced into the efferent limb after tract dilatation. the proximal port which is for gastric aspiration, was left within the gastric remnant, the distal port, 80 cm in the efferent limb for tube feeding. the tube was sutured in place with 0-prolene. as well, it contains a mushroom tip for internal anchoring. impression: placement of a double-lumen gastrojejunostomy tube via this patient's gastric remnant, proximal port within the remnant, distal port approximately 80 cm within the efferent limb in this patient who is status post a billroth ii procedure. no complications. dr. approved: tue 9:22 am radiology final report chest (portable ap) 9:26 am chest (portable ap) reason: resp distress medical condition: 86 year old man with nausea, vomiting, fever. s/p transverse colectomy reason for this examination: resp distress ap chest 9:40 a.m. . history: nausea, vomiting and fever following transverse colectomy. respiratory distress. impression: ap chest compared to through : moderate pulmonary edema best demonstrated in the perihilar left lung has developed since . there is consolidation in both lower lungs, particularly the right, strongly suggestive of concurrent pneumonia. accompanying small-to-moderate right pleural effusion could be related to either development. heart is at least moderately enlarged partially obscured by right-sided consolidation. there is no pneumothorax. two transvenous right ventricular and one right atrial pacer lead are unchanged in their respective positions originating in the left axillary pacemaker. a right central line probably a picc can be traced as far as the junction of the brachiocephalic veins. findings were discussed by telephone with dr. at the time of dictation. dr. approved: tue 9:27 pm brief hospital course: he was admitted to on for nausea and vomitting since recent surgery. he has been unable to take a regular diet since that time. he continued to be nausea. a picc line was put in and tpn started. he subsequently developed a fever and increased wbc. the picc was then removed. blood cultures from grew staph form one bottle only. he was started on vancomycin, but then this was d/c'd on when other cultures did not reveal any growth. gi: a ngt was placed on . very foul smelling output from ng (only 75-100 cc). it was thought that the efferent limb of billroth is twisted due to recent surgery. ct showed oral contrast going down ok. an egd, down 20-30 cm in efferent limb, showed no stricture or obstruction. a sbft showed marked esophageal reflux with large column of barium persisting in esophagus to the upper mediastinum (exam performed in near upright position). regland was started. an egd on was performed with dilation, injection, nj feeding tube placement. he was then started on tube feedings. the tube became clogged and it was then decided to place a gj tube for nutritional support. his tubefeedings were slowly advanced to goal over the next few days. geriatrics: was consulted to help manage the care of this 86 year old gentleman. he was depressed and discouraged. he was started back on his home med of zoloft. other recommmendations were to d/c ibuprofen and give tylenol. psych: psych was consulted for his obvious depression and for thought of harming himself. he was switched from zoloft to celexa. his mood improved after be able to provide nutrition. endo: was consulted for elevated blood sugars. he needed 15 units humalog for a blood sugar on 430 on . his sliding scale was adjusted and his sugars were in better control. renal: he was ordered for lasix 40 mg iv bid for le edema and pleural effusion. cardiology: he was noted to have a fib on routine ecg. his pacer was interrogation and shows a fib since early this month. he was on his beta blocker. all cardiac enzymes tested were negative. musculoskeletal: he complained of joint pain and aches. he was ordered for tylenol and put back on his allopurinol and colchicine. resp: on , the patient was found by the nurses to be conscious, but not responding. his o2 sats were in the 70's, he was tachypenic, his lungs sounds were wet. it was thought that due to development of pneumonia, his respiratory status was compromised and he most likely aspirated. secretions were suctioned from his oralpharynx and a ngt was placed to relieve any gastric content. he vommited a small amount of foul smelling brownish gastric contents. he was transfered to the sicu and placed on bipap support. he was dnr/dni and so was not intubated. his family was notified and he was made cmo. he expired on . radiology: abd xray - no evidence of obstruction. chest xray - bilateral pleural effusions abd ct - large right and small-to-moderate left pleural effusions, small amount of free air within the abdomen and subcutaneous tissues adjacent to incision site, likely postoperative sequelae, small amount of fat stranding surrounding anastomotic site, consistent with postoperative sequelae. no focal fluid collection is identified. contrast is seen passing this site, no evidence of bowel leak or obstruction. us lower ext - no evidence of dvt bilaterally. abd x-ray - contrast remains within the stomach. no evidence of obstruction chest xray - possible consolidation in both lung bases, particularly in the right. interval removal of the enteric tube. large amount of residual contrast layering in the stomach with at least some in the small bowel cxr - bilateral loculated effusions, right much larger than left. medications on admission: glipizide 5", zoloft 100', atenolol 25', asa 81mg', lasix 40', colchicine 0.6', doxazosin 4', glucosamine/chondroitin', 400', allopurinol 100' discharge disposition: extended care discharge diagnosis: delayed gastric emptying discharge condition: expired md, procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances other endoscopy of small intestine other endoscopy of small intestine non-invasive mechanical ventilation insertion of other (naso-)gastric tube insertion of other (naso-)gastric tube arthrocentesis percutaneous [endoscopic] gastrojejunostomy transfusion of packed cells artificial pacemaker rate check diagnoses: anemia of other chronic disease coronary atherosclerosis of native coronary artery esophageal reflux unspecified pleural effusion congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified atrial fibrillation diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) percutaneous transluminal coronary angioplasty status chronic kidney disease, unspecified nausea with vomiting other and unspecified hyperlipidemia pneumonitis due to inhalation of food or vomitus major depressive affective disorder, single episode, unspecified osteoarthrosis, unspecified whether generalized or localized, site unspecified personal history of malignant neoplasm of large intestine cardiac pacemaker in situ other postprocedural status encounter for palliative care gastroparesis personal history of colonic polyps dyspepsia and other specified disorders of function of stomach acquired hypertrophic pyloric stenosis hiccough 

Answer: The patient is high likely exposed to