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: meperidine / percocet / codeine attending: chief complaint: lethargy major surgical or invasive procedure: history of present illness: 82 y/o woman with a history of lung cancer s/p lobectomy and adjuvant chemotherapy admitted to the icu from the emergency department where she presented with fever and altered mental status. the history was obtained from review of the notes as the patient was intubated and sedated at the time of admission to the icu. per reports, she had several days of diarrhea, abdominal pain, nausea, vomitting and increased lethergy. she had some improvement yesterday, but was barely arousable today and was brought in for evaluation. in the ed she was found to be febrile to 103, with hr 82, bp 146/77. she had elevated transaminases, a lactate that peaked at 4.7, and a ct torso showed dialted common bile duct. she had a central venous line placed, and was given 4l of ns and was intubated due to increased lethargy. she was not hypotensive in the emergency department. a blood gas obtained after intubation was 7.29/51/72. she was taken to the . on arrival to the her blood pressure was in the 60s systolic. she was given further fluid resussication (4 liters, for 8 liters total) and started on levophed. she was then taken emergenctly to the suite where a stent was placed in the common bile duct and frank pus was expressed. she returned to the on ac 500 x 14, 100%fi02 and 5peep. her fi02 was weaned. she was continued on levophed. ros was not able to be obtained as the patient was intubated and sedated. . past medical history: 1. adenocarcinoma of the lung, nonmetastatic, status post resection, grade t2n0m0. she is status post carboplatin and taxol on , status post right upper lobectomy on . 2. hypertension. 3. hypercholesterolemia. 4. diverticulosis. 5. hiatal hernia. 6. gastroesophageal reflux disease. 7. status post cholecystectomy, appendectomy, total abdominal hysterectomy with bilateral salpingo-oophorectomy. social history: social history: the patient lives in . she has a positive tobacco history. she smokes two packs per day for 52 years; she quit ten years ago. 2 very involved daughters, and . family history: father died of a brain tumor, but no other family history of cancer. physical exam: intuabed, sedated bp :68/40 hr 120 temp 101 no jvp rrr s1, s2, no m/g/r cta laterally no edema pertinent results: 12:26pm wbc-4.9 rbc-4.52 hgb-13.2 hct-40.6 mcv-90 mch-29.3 mchc-32.6 rdw-16.0* 12:26pm alt(sgpt)-312* ast(sgot)-173* alk phos-563* tot bili-6.3* 12:26pm glucose-123* urea n-24* creat-1.3* sodium-135 potassium-2.9* chloride-91* total co2-33* anion gap-14 01:40pm lactate-4.7* cta , d. f 82 radiology report cta chest w&w/o c&recons, non-coronary study date of 10:57 am , eu 10:57 am cta chest w&w/o c&recons, non-; ct abdomen w/contrast; ct pelvis w/contrast clip # reason: pe? pna? medical condition: 82 year old woman with hx of aneurysm w/ lobectomy and vp shunt w/ vomiting and altered ms. hypoxic on ra. reason for this examination: pe? pna? contraindications for iv contrast: none. wet read: 12:04 pm no pe or dissection. left basilar airspace disease represent aspiration vs pneumonia vs atelectasis. . ct abd/pelvis: mild to moderate biliary dilitation with probable soft tissue defect in cbd. chd measures 17 mm. rec mrcp for further eval. left adnexal cyst, larger than prior. rec us for further eval. wet read audit # 1 11:54 am no pe or dissection. left basilar airspace disease represent aspiration vs pneumonia vs atelectasis. final report ct torso, comparison: . history: 82-year-old female with history of aneurysm and lobectomy and vp shunt with vomiting and altered mental status. findings: contiguous helical acquisition through the chest, abdomen and pelvis was performed with intravenous contrast. ct chest: the heart is normal in size. there is atherosclerotic disease of the coronary arteries and aorta. the pulmonary artery and branch vessel opacifies normally with no evidence of intraluminal thrombus. the aorta opacifies normally with no evidence of aortic dissection. there is no mediastinal or hilar lymphadenopathy identified. there is left basilar air space disease identified. the right lung is clear. a surgical clip is noted at the right lung base. post-surgical changes within the lungs are noted status post right upper lobectomy. there are diffuse emphysematous changes identified. there are old right-sided rib fractures noted. the osseous structures are otherwise intact. there are degenerative changes of the bilateral shoulders and spine. ct abdomen: there is mild-to-moderate intra- and extra-hepatic biliary dilatation which is new compared to the prior study dated . also noted is a probable soft tissue-density filling defect within the mid/distal common bile duct. the common hepatic bile duct measures 17 mm in diameter. the patient is status post cholecystectomy. the pancreas is normal in appearance with no evidence of pancreatic ductal dilatation. the spleen, adrenal glands, and bowel are normal in appearance. there are multiple low-density lesions noted within the kidneys bilaterally which are too small to characterize but likely represent renal cysts. there is no free air or free fluid identified. there is atherosclerotic disease of the descending aorta. there is a ventriculostomy shunt catheter identified. ct pelvis: there is a left adnexal cyst which appears somewhat larger compared to the prior study and currently measures 2.8 cm. there is diverticulosis of the sigmoid and descending colon without evidence of diverticulitis. no pelvic masses or lymphadenopathy is identified. the osseous structures are intact with degenerative changes noted within the lumbar spine. impression: 1) no evidence of pulmonary embolism or aortic dissection. 2) emphysema and left lower lobe air space disease which may represent aspiration versus pneumonia versus atelectasis. clinical correlation is recommended. 3) new intra- and extra-hepatic biliary dilatation with a probable filling defect noted within the common bile duct, which could represent stones, sludge, or neoplastic process. an mrcp is recommended for further evaluation. 4) 2.8-cm left adnexal cyst which appears larger compared to the prior study. a pelvic ultrasound is recommended for further characterization given the patient's post-menopausal status. : twelve spot fluoroscopic radiographs were obtained during are provided for review. scout images demonstrate surgical clips in the patient's right upper quadrant, likely related to prior cholecystectomy. a nasogastric tube appears positioned near the duodenum. multiple additional tubing catheters overlie the patient. injection of contrast into the biliary system demonstrates a dilated common bile duct with luminal filling defect. there is mild dilatation of the intrahepatic biliary ducts. per the patient's report, a single 10-mm stone was present. a plastic stent catheter was positioned in the common bile duct. for full details, please refer to the patient's note from the same day. brief hospital course: 82 yo wf w pmhx of lung adeno ca sp lobectomy, htn, gerd, hx of cerberal aneurysm presents w septic shock cholangitis, needing icu stay, fluids, pressors, brief intubation 1. septic shock - cholangitis from choledocholithiasis w + bacteremia w strep and ecoli. now resolved. sp on w removal of sludge/pus and stent placement. repeat blood cx ngtd. initially placed on vanc/zosyn, abx narrowed to rocephin based on sensi. picc placed for a total of 14 day course. repeat in 4 weeks 2. mild hypoxia - to fluid overload from aggressive fluid resuscitation. repeat cxr shows improvement in fluid overload, continue to monitor. incentive spirometer to avoid pna. 2liters oxygen prn to keep sats >90% 3. incidental finding of l adnexal cyst - pt and daughter informed that pcp will need to do an outpt fu w pelvic ultrasound 4. recent episode of svt vs afib - no such episodes on floor, tele discontinued 5. anemia - mild anemia w stable hct. pcp to follow up at discharge 5. gerd - continued on ppi 6. hx of depression - continued on effexor 7. htn - switched to outpatient meds which included atenolol, triamterene/hctz . fen - regular diet . code status - full . vte prophylaxis - sq heparin . disposition - discharged to epic of nursing home medications on admission: 1. atenolol 25mg qd 2. triamterene/hctz 37.5/25mg qd 3. effexor xr 150mg qd 4. zocor 40mg qd 5. nexium 40mg qd 6. provigil 200mg qd 7. kcl 10meq qd discharge medications: 1. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed). 2. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed. 3. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 4. trazodone 50 mg tablet sig: 0.5 tablet po hs (at bedtime) as needed. 5. venlafaxine 75 mg capsule, sust. release 24 hr sig: two (2) capsule, sust. release 24 hr po daily (daily). 6. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). 7. triamterene-hydrochlorothiazid 37.5-25 mg capsule sig: one (1) cap po daily (daily). 8. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 9. ceftriaxone 1 gram piggyback sig: one (1) intravenous every twenty-four(24) hours for 6 days. 10. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 11. provigil 200 mg tablet sig: one (1) tablet po once a day as needed for excessive daytime sleepiness. 12. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed. 13. potassium chloride 10 meq tablet sustained release sig: one (1) tablet sustained release po once a day. discharge disposition: extended care facility: of discharge diagnosis: cholangitis discharge condition: good discharge instructions: you were admitted the hospital with severe infection in your bile duct, which had spread to your blood. you were treated with antibiotics and a procedure called where they took out the gallstone. you will finish iv antibiotics at the rehab and will have to come back for repeat please return to ed for fevers, chills, shortness of breath, abdominal pain, nausea, vomiting, bleeding followup instructions: 1. pcp, . , ph; , please call and make appt (you are currently on waitlist, the clinic should call rehab w appt date) provider: , md phone: date/time: 11:00 provider: 2 (st-4) gi rooms date/time: 10:00 provider: , md phone: date/time: 10:00 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube arterial catheterization endoscopic insertion of stent (tube) into bile duct diagnoses: thrombocytopenia, unspecified anemia, unspecified esophageal reflux pure hypercholesterolemia unspecified essential hypertension severe sepsis atrial fibrillation personal history of malignant neoplasm of bronchus and lung personal history of malignant neoplasm of breast depressive disorder, not elsewhere classified atrial flutter diaphragmatic hernia without mention of obstruction or gangrene acute respiratory failure other specified cardiac dysrhythmias personal history of other diseases of circulatory system right bundle branch block septic shock other postprocedural status septicemia due to escherichia coli [e. coli] streptococcal septicemia cholangitis other malaise and fatigue diverticulosis of colon (without mention of hemorrhage) other alteration of consciousness acquired absence of both cervix and uterus mixed acid-base balance disorder calculus of bile duct without mention of cholecystitis, with obstruction other noninflammatory disorders of ovary, fallopian tube, and broad ligament unspecified menopausal and postmenopausal disorder 

Answer: The patient is high likely exposed to