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: history of present illness: mr. is a pleasant 73-year-old gentleman with a past medical history significant for multiple myeloma, peptic ulcer disease, cholangitis, iron deficiency anemia, b12 deficiency anemia, status post cholecystectomy and appendectomy, who was transferred to the from for an ercp. the patient had an ercp that was done on , and had a stent placed with no significant findings except for mild dilatation, but no stones or strictures. the patient had developed gram-negative (klebsiella grown and e. coli) rod sepsis and jaundice prior to the first ercp. the patient did well for a few days, and then on , presented with a one day history of right upper quadrant pain, no nausea, vomiting, fever, or rigors. a mri that was done after showed abnormal tissue in the region of porta hepatis and some lymphadenopathy. so patient was transferred here for a repeat ercp. during the ercp procedure, the initial contrast revealed an amorphous intraductal mass. with further manipulation and extraction of the mass, there was an old blood clot and once the blood clot was removed, bright red blood began to drain from the biliary system. the gi fellow estimated about 1 unit of blood loss. the patient was stable and alert during and after the procedure, and was transferred to the intensive care unit for further management and eventually to interventional radiology for an a-gram. an a-gram was done that showed no active bleeding, however, the stent that was placed in the common bile duct was no longer there. the patient was then transferred to the floor after the hematocrit had been stable for greater than 24 hours and there was no evidence of any new acute bleed. past medical history: 1. multiple myeloma diagnosed in . 2. peptic ulcer disease. 3. cholangitis. 4. iron deficiency anemia. 5. b12 deficiency anemia. 6. status post cholecystectomy in . 7. status post appendectomy. medications on admission: 1. iron 325 mg po q day. 2. colace 100 mg po bid. 3. levaquin 500 mg po q day. 4. ambien 5 mg po q day. allergies: no known drug allergies. social history: the patient lives with his brother, , and the patient denies any alcohol, smoking, or iv drug abuse at this time. physical exam on admission to the unit: temperature of 97.0, blood pressure 130/55, heart rate of 105, respiratory rate 20, and o2 saturation 100% on room air. general: comfortable, in no acute distress. heent: moist mucosal membranes. extraocular movements are intact. pupils are equal, round, and reactive to light and accommodation. cardiovascular: s1, s2 slightly tachycardic, no murmurs, rubs, or gallops heard. lungs are clear to auscultation bilaterally. abdomen is soft, nondistended, mild tenderness in the epigastric area to deep palpation, decreased bowel sounds. extremities: no clubbing, cyanosis, or edema. skin: no evidence of any rash. neurologic: cranial nerves ii through xii tested grossly intact. laboratories on admission: white count 5.3, hematocrit 21.2, platelets of 301, sodium 133, potassium 3.1, chloride 106, bicarb 20, bun 13, creatinine 0.4, glucose 117, alt 303, ast 167, alkaline phosphatase 704, total bilirubin 1.2. hospital course: 1. gi: patient was admitted to the intensive care unit after an ercp because of a bleed. the patient's hematocrit at that time was 21.2 and the patient received 2 units and hematocrit was checked q6h for 24-48 hours. his hematocrit continued to remain stable between 25-27, however, one additional unit of blood was given when the patient was transferred to the floor and his hematocrit continued to remain stable in the range of 29-31. the patient also had a repeat ct angiogram for pancreatic protocol that was done on , and it was found that there was no evidence of any mass and patient had a dilated common bile duct with wall thickening and enhancement which is consistent with either hemobilia or cholangitis. however, patient's findings were most likely secondary to his hemobilia since he did have a bleed after his ercp. in addition, the ct angiogram did show extensive bony involvement of his multiple myeloma. also during the hospital course, the patient was started on broad antibiotic coverage consisting of ampicillin, flagyl, and levaquin for prophylaxis against developing cholangitis. during the hospital course, the patient did not seem to have any right upper quadrant tenderness or epigastric tenderness that would be concerned with cholangitis, and on the date of discharge, he was sent with levaquin 500 mg po q day for seven additional days. the patient's diet was also slowly advanced. he was made npo after his procedure for about two days and was started on a liquid diet and then eventually into a soft diet all of which the patient tolerated well. 2. oncology: the patient has a history of multiple myeloma, and as per the ct angiogram, it appears that there is extensive metastases to the bones. a brief discussion was brought up with the patient regarding further management, and if he wanted to see an oncologist at that time, he said that his care is provided by dr. in the area, and patient would want to talk to him before pursuing any further intervention. however, the patient would prefer to let it be as it is, and did not appear to be interested in any chemotherapy, or radiation therapy, or even talking to an oncologist during this hospital course. discharge diagnoses: 1. status post ercp bleed. 2. multiple myeloma. discharge condition: the patient is stable at time of discharge. discharge medications: 1. protonix 40 mg po q day. 2. levofloxacin 500 mg po q day x7 days. 3. the patient is to continue taking all of his outpatient medications. followup: the patient was asked to setup an appointment with his primary care physician, . in the next 3-4 days. the patient states that he would call and setup an appointment, according to his own time. , m.d. dictated by: medquist36 procedure: endoscopic sphincterotomy and papillotomy arteriography of other intra-abdominal arteries replacement of stent (tube) in biliary or pancreatic duct removal of foreign body, not otherwise specified diagnoses: acute posthemorrhagic anemia hemorrhage complicating a procedure other specified disorders of biliary tract multiple myeloma, without mention of having achieved remission mechanical complication due to other implant and internal device, not elsewhere classified iron deficiency anemia, unspecified other vitamin b12 deficiency anemia hemangioma of other sites 

Answer: The patient is high likely exposed to