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: osh transfer- lower extremity weakness/cauda equina perforated bowel major surgical or invasive procedure: exploratory laparotomy, right colectomy, ileostomy placement tracheostomy and percutaneous endoscopic gastrostomy. history of present illness: 57 y/o male w/ probable metastatic lung ca, met to l5 spine, who presents from osh with leg weakness secondary to cauda equina syndrome. he was admitted to hospital on with a 20 lb weight loss and long standing history of progressive low back pain, followed by leg weakness. the low back pain has been an issue for the last 2-3 years, but over the last 2 months has become more severe and has radiated to his posterior thigh and calves. in addition he reports numbness of his feet, which began 2-3 years ago. within the last 2 weeks he has not been able to walk and has been wheelchair bound. he reports that he cannot stand due to pain rather than to weakness. he denies loss of bowel or bladder function. neuro evaluation there on showed normal pin sensation of les, although there was subjective numbness of the feet. no focal weakness of the extremity muscles was noted to manual testing and dtrs were noted to be 1+ and symmetric at knees, and absent at ankles. work-up showed a destructive lesion in l5 with a soft tissue component, likely representing metastatic disease. there was also evidence of pathologic compression of the body of l5 and severe foraminal narrowing at l5-s1 with cauda equina compression. he was also found to have a cavitary lesion in the right upper lobe of the lung measuring almost 1cm, suspicious for nonsmall cell lung cancer, likely squamous cell. biopsy of the l5 lesion was performed and results were pendning at time of transfer. the patient was started on reglan and external beam xrt. his pain improved after optimization of his pain regimen, however he became constipated. he also had a foley placed for ?urinary retention. he was seen daily by neurosurgery and there was a long debate on how to proceed. clinically the patient was not improving and still had significant leg weakness, and therefore it was recommended by the neurosurgeons to transfer him for consideration of cyberknife treatment. note dated comments that patient reported legs were weaker than the day prior. note dated reports patient can lift lower extremities bilaterally but cannot wiggle toes with slight foot drop on l. on arrival today, patient reports pain in low back. complains of weakness and numbness of his lower extremities, which he reports has become worse over the last 2 days. he reports constipation and abdominal distention, however he does admit to having a small bm yesterday. he also admits though that he does have numbness in his buttocks and does not feel that he has full control over his bowel movements. in regards to urinary retention, this is less clear, because he currently has a foley catheter. he reports this was placed after he was told his urine output was not as good as it should be. denies upper extremity weakness or numbness. no cough, hoarseness, chest pain, sob. ros: as per hpi. also denies cough, sob, sputum production or hemoptysis. no headache, n/v, vision changes. low back pain, + left hip pain, lower extremity weakness, and numbness in toes. past medical history: probable metastatic lung ca (9mm lesion rul) h/o low back pain hepatitis c h/o etoh social history: smokes pack cigarettes per day. drinks etoh heavily, beers per day and sometimes pint of vodka per day family history: mother with lung ca physical exam: vitals- 98.6, 129/88, hr 82, rr 20, 95% ra, wt 124 lb gen- cachectic appearing male, awake, alert, nad heent- eomi. mm moist. op clear. neck- supple, no lad pulm- cta b/l. no r/r/w cv- rrr. no m/r/g abd- soft, distended, tympanic to persussion, w/o tenderness to palpation, rebound or guarding. hypoactive bs. ext- + clubbing, no edema, rash. 2+ dp pulses neuro- cnii-xii intact. ue motor b/l, w/ nl sensation. le: no ability to plantar/dorsiflex b/l. not able to lift lle against resistance, and only minimally against gravity. rle able to lift leg strt against gravity, but easily breaks against resistance. passive rom full. no pain ellicitid w/ knee flexion/extention. pain ellicitid in right hip/low back w/ r hip flexion. no sciatica. sensation largely intact to pinprick and light touch with exception of decreased sensation in large toes b/l (l>r) and reported decreased sensation in buttocks area, however felt examiner easily on rectal exam. unable to elicit anal wink on rectal exam, with decreased rectal tone. babinski reflexes equivocal b/l. unable to ellicit l patella reflex, with r patella reflex 1 + . did not assess gait. on discharge: 102.8, 99.8, 101, 96/57, 27, 100 trach mask alert and oriented he is able to fully move ue - has no le motor function tracheostomy in proper position without surrounding erythema or exudate tachycardia but regular rhythm coarse breath sounds bilateral lungs with r>l abdomen is flat and nondistended. he has peg in good position that is 2cm at skin. he has a midline wound that is granulating in nicely. ostomy is pink and has good function. le as mentioned no motor function. no edema pertinent results: reports- mri - mild pathologic compression fx of l5. tumor has destroyed posterior cortex of the vertebral body and causes critical spinal stenosis at this level with critical compression of the cauda equina. extension of tumor into the posterior elements. severe bilateral foraminal narrowing at l5-s1 and moderate bilateral foraminal narrowing at l4-l5. ct guided bone bx - pending at time of transfer kub no intestinal obstruction or other acute intr-abdominal abnormality. lytic metastatic dx involving left side body l5. bone scan- probable mild to moderate generalized peripheral arthritic changes as described above. otherwise negative for significant focal skeletal lesion in the rest of the whole body. negative for significant focal skeletal lesion in the thoracolumbar vertebrae. - mri brain- no evidence of intracranial metastasis. normal contrast enhanced brain mri. trace chronic paranasal sinus disease. - ct chest- cavity lesion right upper lung, 9mm. right hilar adenopathy. calcied lymph node left hilum. small non-calcified nodule left upper lung posteriorly. - ct abd- liver, spleen, panc, gb unremarkable. no extra or intrahepatic ductal dilatation. right and left kidneys unremarkable axr - findings: there is a large amount of free intraperitoneal air. there is contrast in the large bowel. there is a right upper lobe lung mass, better characterized on recent chest radiograph, but appears to contain cavitation. cta chest findings: 1. no evidence of pulmonary embolism. 2. multifocal ground-glass opacity and consolidation superimposed upon diffuse centrilobular emphysema. the most likely cause for these findings includes ards or multifocal pneumonia. 3. small pneumoperitoneum. impression: 1. increase in size of the patient's right upper lobe cavitary lesion as noted. decreased prominence of bilateral patchy airspace opacities previously noted. persistent airspace opacities seen within the right lung with debris in the right mainstem bronchus as noted. soft tissue attenuation surrounding the airways of the right lung as noted, likely reflecting the patient's known lung carcinoma. 2. significant distention of numerous loops of small bowel. the diffuse nature of this distention suggests a functional ileus. no area of transition is seen to suggest a mechanical small-bowel obstruction. 3. free fluid seen within the peritoneal cavity. if clinically dictated, this may be accessed for aspiration via ultrasound guidance to exclude infection. 4. lytic l5 vertebral body lesion, previously seen on prior ct to better detail. cxr (most recent) reason for this examination: assess cardiopulmonary process history: ventilator-dependent failure with right cavitary lesion. findings: in comparison with the previous study, there is little overall change. again there is a large left upper lung cavity. the atelectatic change at the left base has essentially cleared. the left lung also is clear. impression little change. laboratory: cbc: hct 34, wbc 34, platelets 888 cbc: hct 20, wbc 7.7, platelets 435 coags: inr 1.4, ptt 31.4 chemistry: na 128, k 4.0, cl 108, hco3 21, bun 18, cr. .6, glc 100 lfts: ast 13, alt 20, alk phos 64, amylase 109*, t. bili 4.6* cea 2.1 psa 1.1 brief hospital course: a/p: 57 y/o male w/ probable metastatic lung ca, met to l5 spine, who presents from osh with leg weakness secondary to cauda equina syndrome - will resulting colonic perforation. neuro: he was admitted for workup and treatment of his symptomatic spine lesion. he was to be operated on but was found to have perforated bowel. he was never operated on and his symptoms of cauda equina persisted. after long discussion, it was decided to not pursue spine stabilization. cv: patient was in sinus tachycardia throughout the hospitalization. he was transfused one unit of blood for a hct of 20 on the day of discharge which brought his heart rate down to around 100. he was rate controlled on iv metoprolol. pulm: he was maintained on a ventilator throughout most of his hospitalization. he had a tracheostomy placed on (three days prior to d/c) and on the day of discharge was able to come off the vent and have good 02 sats on trach mask. he has a large right lung abscess that was assessed by the thoracics team. it was determined by them that in the current setting iv abx would be the best treatment. any intervention would not likely improve survival gi: abdominal distention/constipation- kub w/o evidence of obstruction. suspect multifactorial from narcotics and cord compression. on the operating table for spine surgery he was found to have abdominal distension and a portable xray was done which showed air under the diaphragm. a stat general surgery consult was called and patient was taken emergently to the or for an exlap, r hemicolectomy, and placement of ileostomy. his fascia was closed but the skin was left open for wet to dry dressing changes. he was npo and eventually had a peg tube placed without problem. was tolerating tube feeds with good ostomy function at discharge. gu: he had has a foley in. his urine output has been adequate endo: he was on a riss id: he was covered broadly for his lung abscess and post operative prophylaxis. he was discharged on vanc, cipro, zosyn, and flagyl. fluconazole was started for yeast in urine and sputum. should be d/c'ed on . fen: has had hyponatremia - we have had him kvo and are trying to fluid restrict him. prophylaxis: sqh full code medications on admission: duragesic 25mcg q72 hours senokot-s 2mg po bid flexiril 10mg po bid decadron 4mg po qid reglan 10mg po bid prn nausea lactulose 30ml po bid prn zofran 8mg po tid prn dilaudid 4-8mg po q4prn discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 2. chlorhexidine gluconate 0.12 % mouthwash sig: one (1) ml mucous membrane (2 times a day). 3. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for fever. 4. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed: given through g tube. 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day): through j tube. 6. fluconazole 200 mg tablet sig: one (1) tablet po q24h (every 24 hours). 7. piperacillin-tazobactam na 4.5 g iv q8h 8. ciprofloxacin 400 mg iv q12h 9. metronidazole (flagyl) 500 mg iv q8h 10. vancomycin 1500 mg iv q 12h 11. sodium chloride 0.9% flush 10 ml iv prn line flush temporary central access-icu: flush with 10ml normal saline daily and prn. 12. metoprolol tartrate 5 mg iv q6h:prn hr > 100 13. lorazepam 1 mg tablet sig: one (1) tablet po q4h (every 4 hours). 14. potassium phosphate dibasic 3 mmole/ml parenteral solution sig: one (1) intravenous prn (as needed). 15. magnesium sulfate 4 % solution sig: one (1) injection prn (as needed): sliding scale. 16. potassium chloride 20 meq/50 ml piggyback sig: one (1) intravenous prn (as needed): sliding scale. 17. calcium gluconate 100 mg/ml (10%) solution sig: one (1) intravenous asdir (as directed): sliding scale. 18. insulin insulin sliding scale - please see printed sliding scale included in discharge material 19. pantoprazole 40 po qday discharge disposition: extended care facility: northeast - discharge diagnosis: metastatic lung ca perforated bowel r lung loculated abscess l5 metastatic lesion with cord compression acute blood loss anemia nutrional depletion discharge condition: fair discharge instructions: patient should call for additional questions regarding managment of ostomy, tracheostomy, peg or any other surgical concerns. he should continue to receive dressing changes and suction of his tracheostomy. a passy muir valve may be used for patient to communicate. his tube feeds should be continued and q4 flushing should be done. ostomy care should be undertaken. abdominal wound should continue to have wet to dry dressing changes . followup instructions: he should follow up with his pcp as needed. dr. is available on a as needed basis procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances non-invasive mechanical ventilation percutaneous [endoscopic] gastrostomy [peg] arterial catheterization insertion of other (naso-)gastric tube temporary tracheostomy open and other right hemicolectomy ileostomy, not otherwise specified diagnoses: pneumonia, organism unspecified other iatrogenic hypotension chronic hepatitis c without mention of hepatic coma acute posthemorrhagic anemia unspecified septicemia hyposmolality and/or hyponatremia candidiasis of other urogenital sites perforation of intestine constipation, unspecified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure other specified cardiac dysrhythmias malignant neoplasm of upper lobe, bronchus or lung other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation abscess of lung encounter for palliative care other and unspecified alcohol dependence, unspecified other candidiasis of other specified sites secondary malignant neoplasm of bone and bone marrow urinary incontinence, unspecified pseudomonas infection in conditions classified elsewhere and of unspecified site dependence on respirator, status pathologic fracture of vertebrae other specified analgesics and antipyretics causing adverse effects in therapeutic use chronic ulcer of other specified sites cauda equina syndrome without mention of neurogenic bladder 

Answer: The patient is high likely exposed to