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: the patient is an 88 transfer from hospital who presented with fevers and jaundice. the patient is an 88-year-old gentleman with a history of hypertension, hypercholesterolemia, recent motor vehicle accident who is now transferred to from hospital with fevers, jaundice, and elevated liver function tests, status post an episode of ventricular tachycardia which has been cardioverted. the patient presented to hospital on with a 2-day history of nausea, and decreased oral intake, epigastric right-sided abdominal pain/discomfort, and yellowish skin. the patient was noted to have a temperature of 100, a total bilirubin of 12.2, a direct bilirubin of 4.3, an alkaline phosphatase of 521, and transaminases in the 90s. a computed tomography of the abdomen showed intrahepatic and extrahepatic ductal dilatation. common bile duct dilated to ampulla with a questionable stone near ampulla of vater. at hospital, the patient was admitted and kept nothing by mouth. the patient was given intravenous fluids plus zosyn with plans for endoscopic retrograde cholangiopancreatography. hospital course at hospital showed culture positive for gram-negative rods in bottles of blood cultures. on the morning of transfer an episode of ventricular tachycardia to 150. the patient was asymptomatic but with decreased blood pressures to 92/62. he was transferred to the coronary care unit, and cardioverted, and started on an amiodarone bolus plus drip, and since cardioverted to a normal sinus rhythm, and has been having stable blood pressures. he was then transferred to for further workup. here at , we have an 88-year-old gentleman with coronary artery disease, hypertension, paroxysmal atrial fibrillation, now with cholangitis, and gram-negative rod bacteremia, status post ventricular tachycardia, with cardioversion (on amiodarone) which is getting worked up. he was here to be evaluated by the electrophysiology service. physical examination on presentation: on admission to his vital signs revealed temperature was 94.7 degrees fahrenheit, his blood pressure was 103/45, his heart rate was 65, his respiratory rate was 15, and his oxygen saturation was 98% on room air. on general physical examination, the patient was a pleasant elderly male, well-nourished, and in no acute distress. head, eyes, ears, nose, and throat examination revealed he had positive jaundice. he had bilateral scleral icterus. the mucous membranes were dry. positive mucosal jaundice. on lung examination, he crackles at the right base; otherwise, clear to auscultation bilaterally. cardiovascular examination revealed occasional extra beats, irregular, and distant heart sounds. no murmurs, gallops, or rubs. the abdomen was soft and nontender. bowel sounds were present. the liver edge was at 2 cm below the costal margin. no splenomegaly. extremities were dry and cool. he had 1+ pulses bilaterally in the lower extremities. he had an amputated right arm. neurologic examination revealed the patient was alert and oriented times three. pertinent laboratory values on presentation: laboratories at hospital were as follows. his sodium was 135, his potassium was 3.2, his chloride was 103, his bicarbonate was 22, his blood urea nitrogen was 18, his creatinine was 1.4, and his blood glucose was 89. his calcium was 9.9. his inr was 1.4. his partial thromboplastin time was 26.4. white blood cell count was 13.5, hemoglobin was 12.1, hematocrit was 37.2, and platelets were 190. differential with 78% neutrophils, 2% lymphocytes, and 17% bands. albumin was 3. his total bilirubin was 11.2, his direct bilirubin was 4.3, his amylase was 180, his lipase was 184, his alkaline phosphatase was 521, his ast was 82, and his alt was 95. urinalysis was brown/clear, greater than 1.03 specific gravity, ph was 5.5. there were small leukocytes, 30 protein, trace ketones, plus bilirubin, plus nitrites, 3 to 5 white blood cells, occasional epithelial cells. blood cultures revealed gram-negative rods; identification and sensitivities were pending. pertinent radiology/imaging: a chest x-ray showed low lung volumes with increased patchy consolidation at the right base. on an echocardiogram at showed mild symmetrical left ventricular hypertrophy, moderately depressed left ventricular ejection fraction, and 1+ mitral regurgitation. electrocardiogram also showed sinus at 76 with occasional premature ventricular contractions. concise summary of hospital course: since admission, the patient received an endoscopic retrograde cholangiopancreatography on and sphincterotomy secondary to his cholangitis without any complications. in summary, the patient is an 88-year-old gentleman with coronary artery disease (status post 2-vessel stent in ) with paroxysmal atrial fibrillation and known ventricular tachycardia with a hospitalization on at an outside hospital for acute cholangitis who developed ventricular tachycardia and bacteremia (specifically klebsiella). he was then cardioverted and transferred to the for endoscopic retrograde cholangiopancreatography and sphincterotomy. the patient is now transferred to the electrophysiology service for electrophysiology consultation. the patient was afebrile and hemodynamically stable. his most acute issues since he has been on the service was monomorphic ventricular tachycardia, ablated through electrophysiology, without any complications. although, on telemetry, occasional premature ventricular contractions persisted. he had nonsustained runs of ventricular tachycardia; specifically 4 to 5 premature ventricular contraction that were present. the patient was stable and without any complications. 1. coronary artery disease issues: since he has been on this service, for his coronary artery disease, he was ruled out for a myocardial infarction. he was continued on aspirin, statin, and metoprolol. he has been on a cardiac healthy diet and he was continued on his plavix since he was status post catheterization. 2. arrhythmia and atrial fibrillation issues: he was continued on his amiodarone. for his ventricular tachycardia he was continued on his amiodarone, metoprolol, and electrophysiology had ablated the ventricular tachycardia site successfully. 3. hematologic issues: the patient with slight anemia. recently, for the past two days, he developed a slight drop in his hematocrit and guaiac-positive stools, which since has been stabilized on his hematocrit level with no active bleeding or active issues. the patient is being followed closely by gastroenterology, and the source of guaiac-positive stool is unknown; although gastroenterology has noted that post sphincterotomy guaiac-positive stool is to be expected. also, he had 1+ hyperchromic, 1 target cell, 1 burr cell, and no microcytic anemia. the burr cell could be an artifact. the target cell could be secondary to increased cell membrane or decreased cell volume; so it could be obstructive liver disease or reduced hemoglobin as in iron deficiency thalassemia or liver disease; although less likely in this case. 4. pulmonary issues: his lungs were clear to auscultation bilaterally. his oxygen saturations were monitored closely, and he was saturating well. 5. right arm wound issues: wound care, status post surgery, following motor vehicle accident, was getting changed regularly. 6. cholangitis issues: the etiology of his cholangitis was unclear. this was most likely related to cholelithiasis and stasis in the biliary tract and obstructive liver disease; also correlate to the finding of burr cells also (which was mentioned above). he was continued on levofloxacin. his liver function tests were monitored. his albumin, prothrombin time, and partial thromboplastin time surveillance cultures were pending. monitored for his coagulopathy and treat with vitamin k and fresh frozen plasma as appropriate. 7. major interventions: endoscopic retrograde cholangiopancreatography which was successfully completed. 8. prophylaxis issues: currently, he is continuing with magnesium and phosphate repletion, and he is getting his ins-and-outs monitored regularly. he is on a prophylaxis bowel regimen, protonix, and zolpidem for sleep. condition at discharge: condition on discharge was stable. discharge status: the patient was to be discharged to a rehabilitation center when a bed is provided. discharge diagnoses: 1. cholangitis. 2. klebsiella bacteremia. 3. anemia. medications on discharge: 1. alendronate 5 mg by mouth every day. 2. levofloxacin 500 mg by mouth q.24h. (for five more days for a total of a 14-day course of antibiotics); his last dose should be on . 3. neutra-phos one packet by mouth twice per day. 4. clopidogrel 75 mg by mouth once per day. 5. amiodarone 400 mg by mouth once per day. 6. metoprolol 12.5 mg by mouth twice per day. 7. docusate 200 mg by mouth twice per day as needed. 8. senna one tablet by mouth twice per day as needed. 9. zolpidem 5 mg by mouth q.h.s. as needed. 10. pantoprazole 40 mg by mouth q.12h. 11. atorvastatin 10 mg by mouth q.h.s. 12. enteric-coated aspirin 81 mg by mouth every day. discharge instructions/followup: the patient was to have close followup with primary care physician (which is dr. for post care followup. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach endoscopic removal of stone(s) from biliary tract endoscopic sphincterotomy and papillotomy esophagogastroduodenoscopy [egd] with closed biopsy cardiac mapping application of other wound dressing diagnoses: unspecified pleural effusion congestive heart failure, unspecified atrial fibrillation pulmonary collapse paroxysmal ventricular tachycardia blood in stool other septicemia due to gram-negative organisms cholangitis calculus of bile duct without mention of cholecystitis, with obstruction 

Answer: The patient is high likely exposed to