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: morphine / latex attending: chief complaint: hematemesis x 2 episodes major surgical or invasive procedure: egd with gastric banding of esophageal varices. history of present illness: this is a 42 y.o lady w/ h/o cholangiocarcinoma (dx ) s/p wide resection in , now w/ known metastatic disease, presents after recent admit for hemoptysis/hematemesis w/ recurrence. pt was feeling well since discharge yesterday, until she felt nauseated this afternoon at 4 pm. she sat down and "knew i was going to have hematemesis." she had two episodes in succession, one 60 cc of bright red blood, the next of 80 cc bright red blood. she noted some clots as well. her appetite was "decent" today. unsure what preceded symptoms. feeling less jaundiced that previous days. biliary bag draining well, approx 80 cc/hr per her report. no change in drainage. denies abd pain, denies increasing ascites. on last admit, patient initially admitted to . she underwent egd w/ finding of grade iii esophageal varices and was started on octreotide/nadolol. pt also had low grade temp during admission w/ rising bili (max 17.8), w/ presumed cholangitis. she was started on zosyn, then switched to unasyn/flagyl/ceftriaxone for persistent fevers. she remained afebrile for several days and was then switched to levofloxacin. she had a 2nd egd during that admission w/ sclerosing of varices performed. banding could not be done secondary to latex allergy. she received a total 7 units of rpbc's, 8 units of platelets w/ hemodynamic stability during admission. she had a cholangiogram showing complete obstruction at hepatacojejunostomy anastamosis w/ percutaneous drain placed w/o complications. pt's bili came down nicely to 7.8, she was afebrile, and was discharged home in stable condition. in ed, vss, refused ng lavage. seen by gi. past medical history: 1. ca hx-klatskin tumor originally diagnosed after presenting with painless jaundice. pt underwent ex. lap with en bloc resection of l liver lobe, biliary tree, and portal vein. reconstructed portal vein followed by roux-en-y hepaticojejunostomy. per notes, pathology demonstrated biliary ductal adenocarcinoma (t3n0m0) stage . since presentation, patient had multiple episodes of cholangitis( in past 3 years with last on ), always short lived and treated with antimicrobial therapy. she has been on ciprofloxacin proph for about 1 year. followed with yearly abdominal ct without radiographic progression. cat scan was performed on at , which revealed that she had a recurrence of the tumor with occlusion of her portal vein occluding bile ducts, hepatic artery nearly completely occluded, and much ascites and was started on diuretics. she was was seen at heme/on clinic and had repeat ct scan which revealed metastatic cholangiocarcinoma with mets to the ovaries, with tremendous increase in metastatic disease. there was there was obstructive uropathy on the right side, as well as questionable gastric outlet obstruction and peritoneal carcinomatosis. 2. cholecystectomy at age 25 3. mva-multiple orthopedic procedures 4. strabismus social history: she is a nurse . she denies any alcohol, drugs or tobacco. she lives in with her mom. she is single, no children. family history: her maternal grandmother had breast cancer in her 80s and her dad's grandmother had stomach cancer and died in her 50s. on her mom's side is an extensive family cardiac history. physical exam: t 99.4 hr 80 bp 90/59 rr 16 sat 100%ra exam limited as pt in er hallway. gen: tired, jaundiced woman, no distress, visiting w/ family heent: scleral icterus, subungal jaundice, mm dry, perrl neck: supple, no lad cv: rrr no m/r/g chest: bcta abd: moderate ascites, soft, non tender even w/ deep palpation, biliary drain in place draining green fluid extrm: jaundiced, warm and well perfused, 2+ pulses dp and radial bilaterally neuro: good historian, a + ox 3, finger to nose intact, no asterixis, good strength throughout pertinent results: 07:30am pt-15.2* ptt-29.7 inr(pt)-1.5 07:30am wbc-2.2* rbc-3.09* hgb-9.6* hct-28.7* mcv-93 mch-31.2 mchc-33.6 rdw-17.0* 07:30am plt count-89* 07:30am glucose-117* urea n-11 creat-0.9 sodium-135 potassium-3.5 chloride-97 total co2-28 anion gap-14 07:30am alk phos-431* tot bili-7.8* 07:30am calcium-8.3* phosphate-3.5 magnesium-1.9 06:45pm wbc-3.9*# rbc-3.03* hgb-9.3* hct-27.9* mcv-92 mch-30.5 mchc-33.1 rdw-17.4* 06:45pm glucose-111* urea n-10 creat-1.0 sodium-136 potassium-3.8 chloride-99 total co2-29 anion gap-12 06:55am blood hct-24.5* 07:05am blood wbc-2.3* rbc-2.62* hgb-8.0* hct-24.6* mcv-94 mch-30.7 mchc-32.6 rdw-18.3* plt ct-138* 10:25pm blood hct-26.3* 02:35am blood wbc-2.9* rbc-3.13* hgb-9.8* hct-28.8* mcv-92 mch-31.4 mchc-34.0 rdw-17.4* plt ct-145* 08:27am blood hct-28.3* . egd: "varices at the middle third of the esophagus and lower third of the esophagus, likely the source of bleeding (ligation). diffuse congestion was seen, compatible with portal gastropathy. several large varices were seen in the fundus, with some cherry red spots. these could have been a source of bleeding, but overall did not appear as likely the source as the esophageal varices. small hiatal hernia. otherwise normal egd to second part of the duodenum." the esophageal varices were banded x3 with good hemostasis. brief hospital course: 42 y.o lady w/ metastatic cholangiocarcinoma complicated by history of multiple episodes of cholangitis who now presents with recurrent hemoptysis (pt previous admitted and discharged from s/p epinephrine injection of bleeding varices). . 1. ugi bleed: likely secondary to known grade iii varices. not banded on last admission, given allergy to latex and lack of availability of latex-free bands. pt banded with latex free bands but gastirc varices seen on endoscopy which can not be banded. pt's hct remained stable through out admission. will have repeat egd in 3 weeks. 2. biliary obstruction: drain in place which cont to drain green translucent bile. bili has cont to decrease. on levofloxacin course from last admit for presumed cholangitis versus obstruction. will cont 4 days after admission. restarted nadolol and octreotide drip. will d/c octreotide on discharge and cont nadolol. diuretics held while admitted. will restart home doses of lasix and aldactone on discharge. 3. cholangiocarcinoma: under care of drs. and . has metastatic disease. future chemo planned w/ cisplatinum and gemzar per onc clinic notes. symptoms management for nausea, pain prn. 4. fen: started npo but by discharge was tolerating a regular diet well. 5. code: dnr but will be intubated for procedure per onc fellow. medications on admission: 1. pantoprazole sodium 40 mg twice daily 2. furosemide 40 mg twice daily 3. spironolactone 25 mg tablet twice daily 4. levofloxacin 500 mg tablet once daily 5. ursodiol 300 mg capsule three times daily 6. prochlorperazine 10 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 7. nystatin 100,000 unit/ml suspension sig: five (5) ml po four times a day: swish and swallow. 8. nadolol 20 mg tablet sig: one (1) tablet po once a day. discharge medications: 1. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. 2. furosemide 40 mg tablet sig: one (1) tablet po twice a day. 3. spironolactone 25 mg tablet sig: one (1) tablet po twice a day. 4. ursodiol 300 mg capsule sig: one (1) capsule po three times a day. 5. nadolol 20 mg tablet sig: one (1) tablet po once a day. 6. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 4 days. disp:*4 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary: hematemasis from esophageal and gastric varices secondary: biliary ductal adenocarcinoma discharge condition: good. discharge instructions: please take all of your medications. please follow up with your doctors. if you have any further episodes of vomiting blood or any excessive bleeding please call your pcp or come to the ed. followup instructions: please follow up with your primary care doctor within two weeks of discharge. md procedure: other endoscopy of small intestine endoscopic excision or destruction of lesion or tissue of esophagus transfusion of packed cells transfusion of other serum diagnoses: malignant neoplasm of liver, secondary portal hypertension esophageal varices in diseases classified elsewhere, with bleeding cholangitis personal history of malignant neoplasm of other gastrointestinal tract secondary malignant neoplasm of retroperitoneum and peritoneum secondary malignant neoplasm of ovary 

Answer: The patient is high likely exposed to