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: influenza virus vaccine / amitriptyline / codeine / diclofenac attending: chief complaint: gallbladder adenocarcinoma major surgical or invasive procedure: ercp with metal stenting for malignant strictures history of present illness: this is a 70-year old female with pmh of htn, breast cancer s/p right breast mastectomy and radiation treatments in , s/p a difficult laparoscopic subtotal cholecystectomy and drain placement at osh for calculous cholecystitis on with pathology positive for gallbladder adenocarcinoma and a cirrhotic appearing liver intraoperatively transferred to for further management of gall bladder adenocarcinoma and an ercp for stent placement due to malignant stricturing and rising bilirubin. she was discharged home on pod 1 from osh, with a tbili level of 3.5. she returned to the osh a few days later with increased jaundice and back pain. she was found to have a markedly elevated bilirubin of 9.4 and an alk phos level of 492. alt/ast were moderately elevated at 348 and 291 respectively. amylase and lipase were 195 and 283. she had a normal wbc of 8 and remained afebrile and otherwise asymptomatic. there was concern that her jp output was slightly bilious however there was no other evidence of leak reported. ct abdomen demonstrated the drain in the appropriate position with mild peripancreatic stranding. her or pathology demonstrated infiltrating adenocarcinoma with positive margins, signet cells and extensive perineural and lymphovascular invasion. a cea level was 2.2. . she was transferred to for ercp and further work-up. past medical history: - htn: diagnosed 6 months ago - hyperlipidemia - breast cancer for the r breast s/p partial mastectomy and xrt () - renal cysts (per report) - gallbladder adenocarcinoma: newly diagnosed as of . past surgical history: -lap subtotal cholecystectomy () -r breast mastectomy (~) -d&c (remote) -tonsillectomy/adenoidectomy social history: rare etoh use, quit smoking in , no ivdu or illicit drug use. family history: mother with possible ovarian cancer, father with lung cancer. physical exam: admission vs: temp: 97.7, bp: 104/59, hr: 80s, rr: 26, o2sat: 99% ra gen: comfortable, but chronically ill appearing female in nad heent: perrl, eomi, icteric sclera, mmm resp: cta b/l with good air movement throughout cv: rrr, no m/r/g abd: obese, tense abdomen, diffusely tender to palpation, no rebound, bs+ ext: 1+ edema b/l skin: jaundiced neuro: aaox3. cn ii-xii intact. 5/5 strength throughout. no sensory deficits to light touch appreciated. discharge: expired. pertinent results: imaging: hida scan: serial images over the abdomen show uptake of tracer into the hepatic parenchyma. the gallbladder is surgically absent. at 9 minutes, tracer activity is noted in the small bowel. there is no evidence of biliary leak or biliary-gastric reflux. the parenchymal phase of the liver is prolonged. 1. no evidence of bile leak. 2. prolonged hepatic parenchymal phase can be seen in the setting of hepatitis. clinical correlation advised. . ercp: stricture of common bile duct and common hepatic duct with successful placement of metal stent across both strictures. blood counts 12:12am blood wbc-8.1 rbc-3.75* hgb-11.9* hct-35.8* mcv-96 mch-31.6 mchc-33.1 rdw-13.9 plt ct-210 05:05am blood wbc-29.5* rbc-2.71* hgb-8.4* hct-25.8* mcv-95 mch-31.0 mchc-32.7 rdw-18.1* plt ct-314 coags: 12:12am blood pt-16.7* ptt-26.7 inr(pt)-1.5* chemistry 12:12am blood glucose-107* urean-42* creat-2.6* na-132* k-4.7 cl-102 hco3-20* angap-15 05:05am blood glucose-112* urean-49* creat-6.3*# na-128* k-4.4 cl-91* hco3-25 angap-16 liver 12:12am blood alt-354* ast-290* ld(ldh)-214 alkphos-603* totbili-11.9* dirbili-11.2* indbili-0.7 05:49am blood alt-105* ast-157* ld(ldh)-243 alkphos-457* totbili-2.6* serology: 03:01am blood hbsag-negative hbsab-negative hbcab-negative 03:01am blood hcv ab-negative stool: cdiff tox pos brief hospital course: this is a 70-year old female found to have gallbladder adenoca and cirrhosis on laparoscopic subtotal cholecystectomy transferred to for further management of gallbladder adenocarcinoma and an ercp, found to have metastatic disease and made comfort measures only, passing away 1. adenocarcinoma: on arrival to on w fever, rising bili, she was treated empirically for ascending cholangitis with a 7 day course of unasyn on the surgical service. she also underwent an ercp with successful metal stenting for malignant strictures of her common bile duct and common hepatic duct. on she had a hida which demonstrated no bile leak. or pathology returned demonstrating infiltrating adenocarcinoma with positive margins, signet cells and extensive perineural and lymphovascular invasion. ct demonstrated peritoneal metastases. general surgery felt that given her ongoing medical issues, she was not a candidate for aggressive surgical options. oncology was consulted, who felt that, if there were no plans for resection of metastasis, palliative chemotherapy was the only option. however, given her ongoing active renal failure, she was not a candidate for chemotherapeutics. 2. goals of care: a family meeting was held , where the prognosis and options were discussed with the patient. patient opted to make herself cmo, stop hd, but continue antibiotics for her cdiff infection. hospice care signed on. on , patient had episode of billious vomiting after which she became tachypnic. it was believed this represented an aspiration event. she was treated symptomatically, but had increasing respiratory distress. a morphine drip was started for comfort. later that day, in the pressence of her family, she expired. 3. renal failure: the patient was admitted to the surgical service after ercp. she was noted to be oliguric with a rise in her creatinine from 2.9 to 8.6. hd/ultrafiltration was started on for atn which is being attributed to hypotension in the or. she remained on uf until opting for cmo care. 4. leukocytosis/hypotension: patient was noted to have a leukocytosis up to 22 from 10, in the setting of c diff positivie diarrhea, po vancomycin and iv flagyl started. diarrhea improved but patient remained with leukocytosis. she was started on iv vancomycin in case of an hd line infection. given her cmo status, the line was then pulled, the vancomycin stopped, and no further labs were drawn. 5. anemia. the patient's baseline hct was in the mid 30s until when it dropped to a low of 22.8 in the setting of a dark stool. this was thought to be to a gi bleed related to a metastasis. she was transfused 1 unit of prbcs at hd with appopriate hct response up to 26.4. a ppi was started. hematocrit was subsequently stable. 6. afib with rvr. the patient was found to have new onset atrial fibrillation to a hr in the 150s associated with hypotension to a systolic in the 70s. she was loaded with amiodarone, and beta blocker was stopped. after this her rate remained sinus in the 80s with a stable sbp in the 80s and 90s. patient remained dnr/dni during the course of this admission and was transferred to comfort measures only before expiring. medications on admission: -asa 81 mg daily -lisinopril 10 mg daily -vitamin d -topical steroids discharge medications: none discharge disposition: expired discharge diagnosis: . discharge condition: . discharge instructions: . followup instructions: . procedure: hemodialysis endoscopic insertion of stent (tube) into bile duct diagnoses: acute kidney failure with lesion of tubular necrosis unspecified essential hypertension cirrhosis of liver without mention of alcohol acute posthemorrhagic anemia other pulmonary insufficiency, not elsewhere classified hyposmolality and/or hyponatremia atrial fibrillation personal history of malignant neoplasm of breast intestinal infection due to clostridium difficile encounter for palliative care hemorrhage of gastrointestinal tract, unspecified personal history of malignant neoplasm of other gastrointestinal tract personal history of irradiation, presenting hazards to health other specified hypotension leukocytosis, unspecified secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes secondary malignant neoplasm of other digestive organs and spleen secondary malignant neoplasm of retroperitoneum and peritoneum 

Answer: The patient is high likely exposed to