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: cholecystitis and arf. transferred for ercp major surgical or invasive procedure: ercp intubation, s/p extubation egd tunnelled hd catheter placement history of present illness: obtained from verbal communication with dr. from . this is a 81 year-old female with a history of recent cholceystitis who presents with ruq pain to on . was found to be in arf (baseline unknown), community aquired pna, leucocytosis and acute cholecystitis. was intubated at that time, had us guided cholecystostomy tube placed, with subsequent decompression and improvement of clinical status. arf did not resolve and pt was started on hd. she also was given vanc/unacyn and extubated on day 7. cultures from drain as well as blood remained negative. repeat ruq us wnl, but persistent elevated wbc. given concern for abscess pt had ct abdomen, showing leak with some new ascites. hidaa scan confirmed leak. per surgical recommendation pt now is being send to undergo ercp procedure for papilotomy. prior to transport, during dialysis, pt had some ruq pain and was tachycardic and hypertensive. she was given 5 mg iv lopressor, zofran and pain medication (iv fentanyl) and had relieve of symptoms but also significantly sedated. . ros: patient accompanied by sister, communication through translater. the patient reportedly had fevers, chills, weight change. but only nausea, vomiting, and ruq abdominal pain. no diarrhea, constipation, melena, hematochezia, chest pain, shortness of breath, orthopnea, pnd, lower extremity oedema, cough, urinary frequency, urgency, dysuria, lightheadedness, gait unsteadiness, focal weakness, vision changes, headache, rash or skin changes. past medical history: gerd dyslipidemia htn hc questionable hx of stroke 10 y ago social history: lives with daughter, does not speak english, code discussion with daughter who is accompaning the mother, per her her mother would not want chest compression but short term intubation ok. she has a hx of 20 ppd smoking. no alcohol. family history: non-contributory physical exam: t: 96.7 136/54 80 100%ra gen: well-appearing, well-nourished, no acute distress heent: mmm, op clear neck: tunnelled hd catheter r neck. cor: rrr, no m/g/r, normal s1 s2 pulm: lungs ctab, no w/r/r abd: soft, nt, nd, +bs, no hsm, no masses, healed scar from past perc cct tube ext: no c/c/e, no palpable cords pertinent results: admission labs: 08:22pm blood wbc-23.3* rbc-3.13* hgb-9.0* hct-27.6* mcv-88 mch-28.7 mchc-32.6 rdw-16.9* plt ct-89*# 08:22pm blood neuts-82* bands-0 lymphs-15* monos-2 eos-0 baso-0 atyps-0 metas-1* myelos-0 08:22pm blood hypochr-3+ anisocy-1+ poiklo-normal macrocy-normal microcy-normal polychr-normal stipple-occasional 08:22pm blood pt-13.1 ptt-45.0* inr(pt)-1.1 08:22pm blood plt smr-low plt ct-89*# 08:22pm blood glucose-82 urean-24* creat-3.2*# na-138 k-4.2 cl-100 hco3-31 angap-11 08:22pm blood alt-7 ast-19 ld(ldh)-233 alkphos-203* amylase-129* totbili-2.5* 08:22pm blood lipase-179* 08:22pm blood albumin-3.2* calcium-8.2* phos-4.4 mg-1.8 08:22pm blood vanco-29.5* 11:50pm blood type-art temp-35.9 rates-16/ tidal v-400 peep-5 fio2-100 po2-421* pco2-50* ph-7.39 caltco2-31* base xs-4 aado2-258 req o2-49 -assist/con intubat-intubated . ercp: impression: 1. dilatation of the extra-hepatic biliary ducts. per realtime findings, sludge was extracted from the biliary tree. 2. placement of plastic common bile duct stent. 3. normal pancreatic duct, at the level of the pancreas. - repeat ercp in 8 weeks for stent removal. . liver us impression: 1. status post recent ercp with gas in the common bile duct and the gallbladder. although no definite shadowing stone is visualized, presence of gas within the gallbladder and common bile ducts makes complete evaluation of these structures limited. 2. moderate dilatation of cbd. cbd stent is in place. . cxr: findings: in comparison with the study of , the endotracheal tube has been removed. the jugular catheters remain in place and the nasogastric tube has been removed. little change in the appearance of the heart and lungs, with some continued bibasilar atelectatic change and possible left pleural effusion. . egd: the biliary stent was identified, and bile was present in the duodenum. erythema and congestion in the duodenal bulb compatible with mild duodenitis. erythema and congestion in the antrum and pre-pyloric region compatible with mild gastritis. otherwise normal egd to third part of the duodenum. . labs at time of discharge: 06:30am blood wbc-6.3 rbc-2.84* hgb-8.6* hct-27.5* mcv-97 mch-30.1 mchc-31.2 rdw-20.9* plt ct-124* 06:30am blood glucose-86 urean-25* creat-4.6*# na-141 k-4.2 cl-104 hco3-31 angap-10 06:30am blood calcium-7.5* phos-3.4 mg-1.7 07:08am blood hbsag-negative hbsab-positive c-diff negative . *** pending at time of discharge: (please follow up) hbcab-pnd *** . . bedside swallow evaluation: this swallowing pattern correlates to a dysphagia outcome severity scale (doss) rating of level 5, mild dysphagia. recommendations: 1. po intake of nectar thick liquids and moist soft solids. patient may take sips of thin liquids as preferred/requested. 2. pills crushed with puree. 3. supervision to assist with feeding and monitor swallow safety. 4. recommend adding extra sauce, gravy, condiments to keep all solid foods moist to ease mastication and transition. 5. nutrition may be helpful in continuing to provide high-calorie supplements if patient's appetite continues to be poor. 6. patient would benefit from further evaluation in a few days at rehab to ensure she is tolerating this diet and assess further toleration of thin liquids. brief hospital course: this is a 81 year-old female with a no significant past medical hx who presented from an osh s/p complicated hospital course due to cholecystitis and arf. she was transferred here for ercp and papilotomy. . # cholecystitis - pt underwent successful ercp with biliary stent placement right on admission . leukocytosis has since resolved and pt was afebrile in the icu. liver and gallbladder us on revealed moderate dilation of the cbd with stent in place. she completed a 10-day vanco/zosyn course per ercp recommendations. #. hct drop: during hospitalization she developed progressive drop in hct/hgb with continued urethral bleed and black guaiac positive stool. in addition, she had ecchymosis with sc soft tissue small hematomas. she had multiple lines placed as well with blood loss. hemolysis was ruled out. she received a total of 2 units rbcs. gi was consulted for slowly declining hematocrit and reports of melena and she underwent egd that only showed gastritis and duodenitis. her stool was observed to be dark brown and guaiac positive but not true melena. she may have a small bleeding source in the lower gi tract, but as her hct remained stable in the 27-30 range, colonoscopy was deferred to the outpatient setting. her urethral bleeding was thought to be from repeated straight cathing, which was stopped, and this bleeding subsided. she started getting epogen at hd. patient's hct was noted to fluctuate with hemodialysis, and current fluctuations likely represent cycles of heme-dilution/concentration. # arf: pt was followed by renal with hd. hd catheter placed at osh was not working well and she went for tunnelled hd line placement in ir on . she continued to be anuric and will need hd as an outpatient. she was continued on phosphate binders. during hospitalization, pt was noted to have dialysis reaction with agitation, tachycardia, and sob. this was classified as a "type b" reaction. hd was stopped at that time, and bath solution was changed to more biocompatible solution and hd was resumed within hours without subsequent reaction. # s/p respiratory failure: pt intubated during procedure for airway protection given somnolence. successfully weaned and extubated . she is currently doing well on nc. #. acute post ercp pancreatitis: patient with pacnreatitis by labs, likely post-ercp. patient without significant epigastric pain and after lipase started trending down, she was restarted on po intake, tolerating soft regular diet. # somnolence: pt was initially somnolent on transfer to icu. there is significant language barrier as she is cantonese speaking only. she does communicate with her family and interpreter. she is hard of hearing. she does respond to non-verbal cues and stimuli. her altered mental status was thought to be secondary to toxic/metabolic encephalopathy from infection, bleed, and azotemia. her mental status improved to baseline over time. by time of discharge, she returned to her baseline mental status per family. # dysphagia: the patient developed difficulty swallowing solids and a speech and swallow consult was placed which suggested that patient is safe to drink thin liquids, but pt appeared to have less difficulty with nectar-thick liquids. please see results section for full recommendations. medications on admission: home medications: atacand 16/2.5 mg daily omeprazole 20 mg daily naproxen 500mg po bid vitamin d 400units daily tylenol 500mg q4prn zocor 20mg daily metoprolol er 50 daily medications on transfer from osh: omeprazole vanco cefepime s.c heparine discharge medications: 1. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr po bid (2 times a day). 2. calcium acetate 667 mg capsule : two (2) capsule po tid w/meals (3 times a day with meals). 3. acetaminophen 500 mg tablet : two (2) tablet po q6h (every 6 hours) as needed. discharge disposition: extended care facility: radius hospital discharge diagnosis: cholecysitis acute renal failure type b hemodialysis reaction acute blood loss anemia respiratory failure pancreatitis discharge condition: good, stable, baseline mental status, no pain discharge instructions: you were evaluated for further management of cholecystitis and acute renal failure. you will need to continue to get hemodialysis as an outpatient. if you have abdominal pain, fevers, chills, difficulty breathing, inability to keep down food or liquid, or any other concerning symptoms, call your doctor followup instructions: you will be followed by the doctors at your rehab. follow up with your primary care physician 1-2 weeks after dishcarge. you will need to have follow up ercp approx 8 weeks following your previous procedure (), which is approx early to mid-. you will be contact with your follow up appointment. you will need to continue with hemodialysis as an outpatient; nephrology has made appropriate arrangements. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours other endoscopy of small intestine insertion of endotracheal tube hemodialysis venous catheterization for renal dialysis endoscopic sphincterotomy and papillotomy endoscopic insertion of stent (tube) into bile duct transfusion of packed cells diagnoses: pneumonia, organism unspecified acute kidney failure with lesion of tubular necrosis toxic encephalopathy acute posthemorrhagic anemia unspecified septicemia severe sepsis accidental puncture or laceration during a procedure, not elsewhere classified acute respiratory failure other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation kidney dialysis as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute cholecystitis cholangitis acute pancreatitis other specified disorders of urethra 

Answer: The patient is high likely exposed to