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: penicillins / fish oil / iodine attending: addendum: no addendum necessary. chief complaint: ruq abdominal pain, fever major surgical or invasive procedure: ercp percuatenous transhepatic cholangiogram thoracentesis history of present illness: this is a 70 y/o female with a history of cad s/p cabg 1 year ago (no stents), htn, s/p ccy requiring placement of a drain, who presented to hospital with ruq pain, nausea, and vomiting of bilious material x 2 days. in addition she had a fever to 101 at home. at , labs were significant for wbc 5.9, bili 5 (indirect 0.6), ap 602, lipase 47. ct scan demonstrated cbd dilitation of 1.5 cm, intra- and extra-hepatic dilitation, and ?round densities in the cbd (?stone). she was given zofran, morphine, and meropenem; transferred to for surgical and ercp evaluation. in the ed: vs: 98.9 69 122/56 16 98% on ra. surgery and ercp were consulted. ruq u/s confirmed similar findings. currently, the patient reports intermittent ruq pain. no current f/c/s. no nausea or vomiting. bowels normal, no urinary difficulties. 10-point ros otherwise negative in detail. past medical history: 1. coronary artery disease s/p cabg () 2. copd 3. hypertension 4. hyperlipidemia 5. atrial fibrillation 6. osteoporosis 7. gerd 8. osteoarthritis 9. ccy , complicated by drain placement 10. s/p hysterectomy 11. gastroduodensotomy for pud 12. right ovarian cystectomy 13. hiatal hernia repair social history: she lives at home by herself with her daughter close by. she has a 50+ pack-year history of smoking, currently smoking 4 cigarettes/day. no alcohol or illicit drug use. she is active at baseline and uses a cane occasionally. family history: mother died from emphysema. history of cad and unknown malignancies in her mother's family. no history of gi malignancies. physical exam: on discharge: t 99.2, bp 117/66, hr 66, rr 20, 99% on 2 liters general - appears well, sitting on comode able to speak in complete sentences cv - irregular; no audible murmurs pulm - dull at the right base abd - soft; mildly tender in ruq near site of drain; no tenderness elsewhere; drain site itself has mild purulent discharge ext - warm; no edema neuro - awake, alert, conversent pertinent results: discharge labs: 138 102 15 ------------87 4.0 30 1.1 ca: 7.7 mg: 2.4 p: 3.7 wbc: 4.1 hct: 26.1 most recent lfts (): alt: 8 ast: 14 ap: 83 bili: 0.5 cxr () showed persistent right-sided pleural effusion brief hospital course: this is a 70 year old woman with coronary disease s/p cabg (no stents) on aspirin and coumadin who presented with cholangitis. a ct and ruq ultrasound on admission showed cbd dilitation and stones. she received ciprofloxacin and flagyl with improvement in her fever, liver function tests, and all of her symptoms. she underwent an unsuccessful ercp on (inability to visualize the papilla). she underwent an mrcp that same day, which demonstrated 2 large stones in the cbd with intra and extra-hepatic dilitation. she underwent an ptc placement on after 1 day of being pre-medicated due to a contrast allergy (hives). the ercp team attempted a rendezvous procedure on using the ptc, however, they were unable to access the ampulla. the patient had a complicated anatomy from gastric bypass in the . she underwent an ir guided procedure for stone extraction on which was successful but was complicated with hypoxia and respiratory distress. she was then admitted to micu (). she was initially placed on bipap but was weaned latter to 2 l nasal cannula. hypoxic respiratory distress was from decompensated chf and flash pulmonary edema as well as her copd/asthma exacerbation and improved with diuresis and bronchodilators. tte showed no systolic failure but she may had diastolic heart failure. she also received diltiazem for several episodes of atrial fibrillation and rapid ventricular rate and her beta blocker dose was increased. she remains on metoprolol, which should continue to be titrated. coumadin was held due to procedures but she was started on lovenox 70 mg sc bid since will need a repeat outpatient ir procedure on . despite significant gi improvement, she developed progressive right pleural effusion. she underwent thoracentesis for diagnostic purpuses to rule out parapneumonic effusion and effusion related to subdiaphragm process. she was treated for 5 days for a cellulitis at the drain site; at the time of discharge there continued to be mild discharge around the area. medications on admission: metoprolol 25 mg furosemide 40 mg daily simvastatin 40 mg daily coumadin 2 mg daily, 8 mg qmon singulair 10 mg daily advair 500/50 mcg prilosec 40 mg kcl 20 meq daily reglan 10 mg qidachs caltrate-d mvi ativan 0.5 mg , qhs spiriva neurontin 300 mg tid discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. fluticasone-salmeterol 500-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 3. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 4. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 5. gabapentin 300 mg capsule sig: one (1) capsule po q12h (every 12 hours). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 8. enoxaparin 80 mg/0.8 ml syringe sig: 70 mg subcutaneous q12h (every 12 hours): please continue until she is back on coumadin (once the biliary drain is out). please hold one dose prior to her outpatient radiology appointment as the drain may get removed. 9. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 10. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 11. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q4h (every 4 hours) as needed for sob/wheezing. 12. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 13. furosemide 40 mg tablet sig: 1.5 tablets po daily (daily). 14. nicotine 7 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily) as needed for nicotine cravings. 15. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day). discharge disposition: extended care facility: - - discharge diagnosis: atrial fibrillation with rapid ventricular rate acute diastolic heart failure acute renal failure cholangitis choledocholithiasis copd with acute exacerbation coronary artery disease, s/p cabg discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted with bile duct obstruction and infection. there were several unsuccessful attempts to remove the obstruction but finally on radiology removed the stones and inserted a biliary catheter for drainage. this was capped on , and restudied on . an ampullary stricture was seen, and a procedure to open this stricture is needed before the drain can be removed. it is essential that you follow-up with the interventional radiologists for drain removal. your appointment information is listed below. followup instructions: interventional radiology follow-up 9:00 building, phone department: radiology when: friday at 10:00 am building: cc clinical center campus: west best parking: garage md procedure: other endoscopy of small intestine thoracentesis other cholangiogram other percutaneous procedures on biliary tract other percutaneous procedures on biliary tract endoscopic retrograde cholangiopancreatography [ercp] diagnoses: esophageal reflux tobacco use disorder unspecified pleural effusion congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status atrial flutter other and unspecified hyperlipidemia osteoporosis, unspecified long-term (current) use of anticoagulants chronic obstructive asthma with (acute) exacerbation acute diastolic heart failure cholangitis other respiratory abnormalities bariatric surgery status calculus of bile duct without mention of cholecystitis, with obstruction 

Answer: The patient is high likely exposed to