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: no known allergies / adverse drug reactions attending: chief complaint: ercp for suspected cholangitis major surgical or invasive procedure: - endoscopic retrograde cholangiopancreatography history of present illness: the patient is an 80 yo m w hx of htn, hld, bph, 3 weeks of malaise and ruq pain, fevers, chills, nightweats. he went to see his pcp and was found to have elevated wbc and lfts then sent to ed at . ruq us was unremarkable. at the osh ed, his labs were significant for wbc 34, 22% bands, creat 3 (baseline 1.5), elevated lfts, received flagyl, zosyn, 2 l ns. . in the ed, initial vs were: 98.8 70 107/74 16 98% ra. he had a wbc of 24, a tbili of 8.9, a cr 2.9 and an inr of 1.7. he was given another 2l of ns. he was noted to have sbp's in the 90's and there was concern for sepsis therefore a icu was requested. in the icu, his exam was notable for jaundiced male, ruq tenderness to minimal palpation with min guarding, no rebound. no hypotention in micu. he underwent ruq which showed sludge. he was continued on zosyn for suspected cholangitis. he also received an additional 1 l ns and morphine. . stoic, oriented. no complaints currently. . in micu, continued zosyn for ? cholangitis, getting morphine, 1 l ns. past medical history: past medical history (per micu admit note): hypertension hyperlipidemia gout bph gerd low testosterone/low growth hormone glaucoma social history: - tobacco: 1 pack per day but states that he does not inhale - alcohol: denies - illicits: denies family history: he notes that his sister died at the age of 43 from esophageal cancer. physical exam: admission exam: . vitals: t: bp: p: r: 18 o2: general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema . pertinent results: admission labs: . 09:34pm blood wbc-24.0* rbc-3.42* hgb-11.6* hct-36.4* mcv-106* mch-33.8* mchc-31.8 rdw-14.6 plt ct-180 09:34pm blood neuts-97.4* lymphs-1.4* monos-0.9* eos-0.1 baso-0.2 09:34pm blood pt-17.6* ptt-29.6 inr(pt)-1.7* 09:34pm blood glucose-105* urean-55* creat-2.9* na-136 k-5.3* cl-109* hco3-16* angap-16 09:34pm blood alt-143* ast-74* alkphos-356* totbili-8.9* 05:28am blood calcium-7.5* phos-3.1 mg-1.5* 09:42pm blood lactate-1.8 . dsicharge labs: . microbiologic data: blood cultures (x 2) - pending mrsa screen - pending . imaging studies: . ercp - cannulation of the biliary duct was successful and deep with a sphincterotome using a free-hand technique. contrast medium was injected resulting in opacification. biliary tree: a moderate diffuse dilation was seen at the biliary tree with the cbd measuring 10 mm. three stones ranging in size from 6 mm to 10 mm that were causing partial obstruction were seen at the lower third of the common bile duct and middle third of the common bile duct. full cholangiogram was not obtained given cholangitis. procedures: a 5cm by 10fr double pig-tail biliary stent was placed successfully using a oasis system stent introducer kit. impression: stones in the common bile duct causing obstruction. diffuse biliary dilation was noted. a biliary stent was placed. blood cx ngtd brief hospital course: impressions: 80m with a history of cad, htn, hld who presented to his pcp's office with 5-weeks of feeling unwell and ruq abdominal pain noted to have a leukocytosis and hypotension concerning for sepsis. . # transaminitis - he is noted to have an elevated alt, t-bili and alk phos which is consistent with a cholestatic picture, however, he may have a component of hepatocellular injury. based on history and leukocytosis there was concern for cholangitis. ruq u/s showed sludge in the gallbladder but no cholecystitis or cbd dilation. zosyn iv was started for probable cholangitis. ercp was performed on and no sphincterotomy was performed given his coagulopathy but sphincterotome was placed through the ampulla. he was dosed morphine for pain control. acs surgery was following the patient given the need for possible future cholecystectomy. following ercp, the patient will continue antibiotics and need repeat ercp in 3-weeks. - repeat ercp in 3 weeks at - complete 10 day course augmentin (osh cultures negative) - surgery follow up following ercp to schedule cholecystectomy . # hypotension - he notably had an elevated wbc and abnormal lfts which was concerning for cholangitis. with hypotension, he appeared septic. he was given a dose of zosyn and flagyl at the osh. he was also given a total of 4l of ns prior to arriving to the micu. we continued zosyn iv given his cholangitis concerns and his pressures improved with fluid resuscitation. he was ultimately transitioned to augmentin to complete a course. . # acute renal failure - on review of his va records his creatinine was 1.5 in . based on his presentation, we suspected a prerenal etiology. urine lytes were obtained and his creatinine trended. his creatinine improved with hydration. his cr was 1.8 on discharge. his home medications were resumed. . # coagulopathy - he was noted to have an inr of 1.7 on transfer. there is no previous inr's on review of his records. the differential for him includes nutritional deficit vs. synthetic dysfunction. he was noted to have an albumin of 3.4. he was given vitamin k to help correct his defficiency . # hypertension - he is hypertensive at baseline; however, with possible sepsis his anti-hypertensive medications were held. they were restarted on discharge. . # gout - appears to be well controlled on his current regimen. we continued allopurinol 300 mg po daily. . # bph - patient noted that he has been having significant symptoms from his bph. unclear what his regimen, however, noted to be on tamsulosin which was held given hypotension concerns. medications on admission: omeprazole 40mg daily imodium 2mg qid allopurinol 300mg daily aspirin 325mg daily clobetasol 0.05% cream glucosamine 1000mg daily hyzaar 50mg/12.5mg daily multivitiamin 1 tab daily somatropin 0.2mg poweder zymar 0.3% ophthalmic solution androgel pump ketoraloac tromethamine 0.5% ophthalmic solution saw 160mg capsules tamsulosin 0.8mg qhs discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 3. tamsulosin 0.4 mg capsule, ext release 24 hr sig: two (2) capsule, ext release 24 hr po hs (at bedtime). 4. hyzaar 50-12.5 mg tablet sig: one (1) tablet po once a day. 5. loperamide 2 mg capsule sig: one (1) capsule po qid (4 times a day) as needed for diarrhea. 6. somatropin 0.2 mg/0.25 ml syringe sig: one (1) injection subcutaneous every other day. 7. clobetasol 0.05 % cream sig: one (1) application topical twice a day. 8. ketorolac 0.5 % drops sig: one (1) drop ophthalmic once a day. 9. saw resume home dose 10. outpatient lab work chem 7, bun, creatinine, ast, alt, t. bili, alk phos. - next pcp follow up 11. amoxicillin-pot clavulanate 875-125 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 5 days. disp:*10 tablet(s)* refills:*0* 12. ambien 5 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. disp:*5 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: cholangitis choledocholithiasis obstructive jaundice acute renal failure chronic kidney disease iii gout discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were intially admitted to an outside hospital for malaise, an elevated wbc and ruq pain. you came to for an ercp for which gallstones were found in your biliary duct, and a stent was placed. you were also found to have kidney failure. you improved with iv fluids. you will need to have a repeat ercp for stone removal. following that, you should see a surgeon to consider gallbladder removal. please resume your home medications. you will be given an antibiotic to complete a full course followup instructions: name: , m. location: family medical associates address: , , phone: appointment: monday at 2:45pm department: endo suites when: thursday at 10:30 am department: digestive disease center when: thursday at 10:30 am with: , md building: building (/ complex) campus: east best parking: main garage please call our surgery dept for a follow up appointment in description: general surgery appointment scheduling phone: ( procedure: endoscopic insertion of stent (tube) into bile duct diagnoses: tobacco use disorder acute kidney failure, unspecified unspecified septicemia severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) other and unspecified hyperlipidemia chronic kidney disease, stage iii (moderate) septic shock cholangitis other and unspecified coagulation defects hypertensive chronic kidney disease, benign, with chronic kidney disease stage i through stage iv, or unspecified calculus of bile duct without mention of cholecystitis, with obstruction 

Answer: The patient is high likely exposed to