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: penicillins attending: chief complaint: jaundice major surgical or invasive procedure: ptc - biliary drain multiple cholangiographies ercp embolization of hepatic artery picc placement history of present illness: ms. is a 71 y/o f w/ dm2, pancreatic ca (dx'd ), who was admitted on after she had presented with biliary obstruction. ercp attempted but unable to cannulate cbd. on the patient underwent placement of a percutaneous biliary drain. she tolerated the procedure well and bili was trending down. on she began complaining of ruq pain and hct trended down from 33 -> 28 -> 26.9 from . on the morning of hct was seen to drop from 28.9 to 19.1 and pt became hypotensive with sbp's in the 80's and hr in the 110's. she was complaining of diffuse tenderness in her abdomen and had guaiac positive brown stool. transferred to icu. . brief course: a r subclavian line was attempted but not successful, and r ij was similarly unsuccessful. a cordis was placed in the r groin and she received a total of 5 units prbc's over the next few hours (17->29). she was taken to ir but pullback cholangiogram was normal. she was then taken for a prbc scan which revealed bleeding in the liver parenchyma. arteriogram performed w/ positive bleeding from pseudoaneurysm at a posterior branch of the right hepatic artery. successful embolization of the lesion w/ 2 straight coils. she was given another two units of packed red blood cells on morning of when hct dropped from 29 -> 22. her hct remained stable (31->32->27->29->29). her ct abdomen noon showed no retroperitoneal bleed but did show hemoperitoneum and two sources within the liver. past medical history: type 2 dm with retinopathy h/o gastric ulcer as per egd, h. pylori (-) htn pancreatic ca underwent eus at with bx which demonstrated mass in the head of the pancreas) hypercholesterolemia . social history: retired cook, lives with dtr. 40pk-year tob history. no etoh or iv drug use. family history: father with htn and cancer; many aunts with . physical exam: : laying in bed, nad heent: ncat, +jaundiced neck: supple, jvd flat, no carotid bruits chest: crackles at bases cvs: rrr, no m/r/g abd: soft, hypoactive bs's, ruq drain in place extrem: no c/c/e neuro: cn ii-xii intact msk: no joint effusions, normal rom pertinent results: 06:30am blood wbc-26.9* rbc-3.24* hgb-10.0* hct-29.2* mcv-90 mch-30.8 mchc-34.2 rdw-16.4* plt ct-397 07:18pm blood hct-29.8* 05:00am blood wbc-26.2* rbc-3.37* hgb-10.2* hct-30.3* mcv-90 mch-30.2 mchc-33.6 rdw-16.1* plt ct-532* 08:30am blood wbc-11.8* rbc-4.11* hgb-11.7* hct-34.5* mcv-84 mch-28.5 mchc-34.0 rdw-16.0* plt ct-435 04:39am blood wbc-17.3* rbc-2.26*# hgb-6.7*# hct-19.1*# mcv-84 mch-29.6 mchc-35.1* rdw-17.1* plt ct-394 06:22am blood pt-18.9* ptt-31.9 inr(pt)-1.8* 06:30am blood glucose-84 urean-33* creat-1.2* na-124* k-5.0 cl-86* hco3-25 angap-18 05:00am blood glucose-82 urean-16 creat-1.0 na-129* k-4.8 cl-91* hco3-26 angap-17 05:20pm blood glucose-79 urean-18 creat-0.8 na-131* k-3.8 cl-94* hco3-28 angap-13 06:30am blood alt-53* ast-127* alkphos-514* totbili-20.9* 05:52am blood alt-196* ast-94* alkphos-436* amylase-30 totbili-10.9* 08:14am blood alt-374* ast-875* alkphos-527* totbili-3.9* 05:20pm blood alt-374* ast-260* alkphos-1177* amylase-78 totbili-10.1* 05:00am blood calcium-8.4 phos-4.1 mg-2.2 06:06am blood osmolal-261* 07:30am blood cortsol-28.0* 07:30am blood tsh-0.72 03:33pm blood hbsag-negative hbsab-positive 03:37pm blood hiv ab-negative 05:54pm blood ca -9 -test 12:13pm urine color-yellow appear-clear sp -1.005 12:13pm urine blood-neg nitrite-neg protein-tr glucose-250 ketone-neg bilirub-mod urobiln-neg ph-7.0 leuks-neg 04:18pm urine hours-random creat-78 na-17 4:46 pm bile **final report ** gram stain (final ): no polymorphonuclear leukocytes seen. 1+ (<1 per 1000x field): budding yeast. fluid culture (final ): yeast, presumptively not c. albicans. moderate growth. 12:19 pm bile **final report ** gram stain (final ): reported by phone to 5pm . 2+ (1-5 per 1000x field): polymorphonuclear leukocytes. 4+ (>10 per 1000x field): gram positive cocci. in pairs and chains. 2+ (1-5 per 1000x field): gram positive rod(s). smear reviewed; results confirmed. fluid culture (final ): due to mixed bacterial types ( >= 3 colony types) an abbreviated workup is performed appropriate to the isolates recovered from the site (including a screen for pseudomonas aeruginosa, staphylococcus aureus and beta streptococcus). enterococcus sp.. heavy growth. staphylococcus, coagulase negative. moderate growth. enterococcus sp.. moderate growth. 2nd strain. enterococcus sp.. isolated from broth media only, indicating very low numbers of organisms. 3rd strain. gram positive rods. growing in broth only. unable to grow for further identification. sensitivities: mic expressed in mcg/ml _________________________________________________________ enterococcus sp. | enterococcus sp. | | enterococcus sp. | | | ampicillin------------ =>32 r <=2 s =>32 r linezolid------------- 2 s 2 s penicillin------------ =>64 r 8 s =>64 r vancomycin------------ =>32 r <=1 s =>32 r 8:14 am bile **final report ** gram stain (final ): no polymorphonuclear leukocytes seen. 3+ (5-10 per 1000x field): gram positive cocci. in pairs and clusters. 2+ (1-5 per 1000x field): gram positive rod(s). fluid culture (final ): resembling micrococcus/stomatococcus species. moderate growth. lactobacillus species. sparse growth. cholangiogram - impression: 1. pullback cholangiogram demonstrates biliary leak at the posterior and inferior aspect of the right hepatic lobe with extravasation of contrast into the abdominal cavity. there is no communication with vascular structures. 2. successful placement of a 10 french biliary catheter with side holes draining the left biliary system and the common bile duct. the pigtail was coiled within the duodenum. an ultrasound of the abdomen is recommended in order to determine if there is any abdominal collections in the right upper quadrant. dr. dr. preliminaryapproved: 2:28 pm ct abdomen: impression: 1. contrast administered during recent cholangiogram collects at the base of the liver extending subhepatically and represents a biloma. previously described heterogeneous hepatic intraparenchymal lesions demonstrate hyperdense material within and it is difficult to tell whether this represents bleeding or recent contrast administration. previously noted evolving hemoperitoneum has decreased in size. 2. poor evaluation of pancreatic head mass extending into portahepatus and portal vein thrombosis without iv contrast. 3. increased size of small right pleural effusion. the study and the report were reviewed by the staff radiologist. dr. dr. approved: fri 5:28 pm cholangiogram: impression: 1. cholangiogram via existing catheter demonstrates decompressed intrahepatic ducts and good drainage of contrast through the catheter into the duodenum. 2. 10 cc of bile were sent for culture analysis. the study and the report were reviewed by the staff radiologist. dr. dr. approved: 11:25 am impression: active extravasation originating from the region around the right liver edge. the findings were discussed with dr. by dr. . brief hospital course: 72 f with metastatic pancreatic cancer - with a complicated hospital ourse - 1. blood loss anemia - due to hemoperitoneum as a complication of the procedur (ptc) - after transfusion, hepatic artery branches were embolised with stoppage of bleeding. the hematocrit remained stable thereafter. 2. obstructive jaundice, s/p biliary drain placed by ir. after initial decrease in bilirubin, the bili started rising and peaked >20. cholangigram showed a bile leak. the patient did not want further interventions as her goal was home with hospice. the cath was left in and hospice/vna arranged for cath checks/dressings. 3. bile infection with micrococcus, vre, yeast - to complete 2 weeks on linezolid, metronidazole and fluconazole as per our id service. blood culures remained negative at the time of discharge. 4. leucocytosis - likely due to 3. above. no other source of infection found. 5. siadh - na maintained in the mid-120's with 1 lit water restriction/day. 6. hypertension - po meds as below. 7. metastatic pancreatic cancer - deemed inoperable by surgery. med oncology did not think chemo would be indicated unless the current bleeding, infection clear up. the patient did not wish any further treatment for cancer and her goal was to go home with her family. she was disharged to her daghter, home with hospice. case management, sw, palliative care all involved in a safe and appropriate discahrge plan. pain control was fairly well achieved. there was a concern that one of the patient's son has psychiatric issues () and would occasionally verbally abuse patient. sw involved and elder svcs were contact who refused to take report as the patient was in hospital. the patient was not dicharged to her home (where lives) but to (daughter's) home. patient did not want to file a restraining order against this son. our palliative care sw, will relay this to the hospice palliative care sw. the above was communicated to dr (pcp) on the of discharge. medications on admission: metformin lisinopril avandia glipizide asa plavix (recently held) prilosec insulin (15-20u) qam discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 2. lactulose 10 g/15 ml syrup sig: fifteen (15) ml po every hours as needed for constipation. disp:*3 ml(s)* refills:*0* 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*0* 5. metoprolol tartrate 50 mg tablet sig: 1.5 tablets po bid (2 times a day). disp:*90 tablet(s)* refills:*0* 6. oxycodone 20 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po q12h (every 12 hours). disp:*60 tablet sustained release 12 hr(s)* refills:*0* 7. simethicone 80 mg tablet, chewable sig: 0.5 tablet, chewable po qid (4 times a day) as needed. disp:*60 tablet, chewable(s)* refills:*0* 8. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic q4h (every 4 hours) as needed. disp:*2 * refills:*0* 9. fluconazole 200 mg tablet sig: one (1) tablet po once a day for 14 days. disp:*14 tablet(s)* refills:*0* 10. oxycodone 5 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 11. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 6 days. disp:*18 tablet(s)* refills:*0* 12. linezolid 600 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 4 days. disp:*8 tablet(s)* refills:*0* 13. insulin glargine 100 unit/ml solution sig: eight (8) units subcutaneous before breakfast every morning. disp:*3 * refills:*0* 14. hospital bed, bedside commode, shower chair discharge disposition: home with service facility: healthcare of discharge diagnosis: metastatic pancreatic cancer blood loss anemia obstructive jaundice, s/p biliary drain bile infection with micrococcus, vre, yeast leucocytosis siadh acute renal failure hypertension discharge condition: fair discharge instructions: please contact the hospice services or your primary doctor if you have worsening pain or any other symptoms of concern to you. take medicines as prescribed. followup instructions: provider: , md phone: date/time: 12:30 provider: west,room three gi rooms date/time: 12:30 if you decide on further treatment for cancer - call dr and make a follow up appointment -- . dr - your primary doctor will care for your further medical needs. procedure: venous catheterization, not elsewhere classified other endovascular procedures on other vessels transfusion of packed cells transfusion of other serum other percutaneous procedures on biliary tract diagnoses: unspecified essential hypertension acute posthemorrhagic anemia acute kidney failure, unspecified paroxysmal ventricular tachycardia other and unspecified hyperlipidemia disorders of phosphorus metabolism malignant neoplasm of head of pancreas gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction other disorders of neurohypophysis cholangitis obstruction of bile duct hemoperitoneum (nontraumatic) diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy aneurysm of other visceral artery 

Answer: The patient is high likely exposed to