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: abdominal pain associated with a syncopal episode. major surgical or invasive procedure: ercp laparoscopic cholecystectomy history of present illness: the patient is a 57-year-old male who was at church on , when he began having abdominal pain, mostly in the upper abdomen. he ate a small amount of lunch - salad, according to him, then felt very week and had a syncopal episode that waswitnessed. his son was called, and he brought his father to the forfurther evaluation. at , his main complaint was of severe back pain, in addition to pain in the upper abdomen. the patient has a traumatic brain injury and is able to give only a limited history. his son is able to fill in a few details. past medical history: pmh: traumatic brain injury ( in ), insomnia, hyperlipidemia, umbilical hernia, h. pylori, chronic polyps, diabetes mellitus type ii psh: umbilical herniorrhaphy social history: primarily portuguese-creole speaking from . has a son who is quite involved in his care. he does not smoke or drink alcohol. family history: non-contributory physical exam: on admission: vs: 98.4 70-90 114/76->160/75 18 96ra -> 96 2l nc gen: well-appearing male in moderate to severe distress, appears younger than stated age, no icterus, + expiratory wheeze, + dyspneic heent: nc/at, eomi, perrla bilat., dry mm, without cervical lad on my exam cor: rrr without m/g/r, no jvd, no bruits lungs: cta bilat., diminished breath sounds at bases : +bs, rigid upper abdomen, no masses, well-healed infra-umbilical scar, mildly tender at upper abdomen ext: warm feet, no edema pertinent results: 06:50pm urine blood-tr nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-sm urobilngn-1 ph-8.0 leuk-neg 06:50pm urine rbc-0-2 wbc-* bacteria-few yeast-none epi-0-2 06:50pm urine granular-<1 06:50pm urine mucous-few 06:12pm lactate-2.3* 04:00pm lactate-3.3* 03:30pm glucose-181* urea n-10 creat-1.1 sodium-140 potassium-4.0 chloride-103 total co2-24 anion gap-17 03:30pm alt(sgpt)-567* ast(sgot)-784* alk phos-175* tot bili-1.8* dir bili-1.2* indir bil-0.6 03:30pm lipase-* 03:30pm acetmnphn-neg 03:30pm wbc-7.8 rbc-5.13 hgb-15.6 hct-44.6 mcv-87 mch-30.5 mchc-35.1* rdw-13.5 03:30pm neuts-69 bands-26* lymphs-3* monos-0 eos-0 basos-0 atyps-0 metas-2* myelos-0 03:30pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 03:30pm plt count-173 . thoracic/abd/pelvic ct w&w/o contrast & recon: 1. no aortic dissection. 2. heterogeneous appearance of the liver. evaluation for focal lesion limited on this early arterial phase exam. if there is concern for portal vein thrombosis, recommend correlation with ultrasound. 3. small amount of pericholecystic and periportal fluid, of uncertain significance. no other definite evidence of pancreatitis or cholecystitis. 4. appearance of the abdominal mesentery, with multiple small nodes could be seen in the setting of mesenteric adenitis/panniculitis. 5. marked fecal impaction in the cecum, with small bowel fecalization seen as well, but no definite evidence of obstruction. . liver/gallbladder u/s: 1. heterogeneous hepatic echotexture may be related to fatty replacement though more advanced forms of liver disease cannot be excluded. 2. small amount of pericholecystic fluid, nonspecific, without additional findings to suggest cholecystitis. 3. patent portal vein with no evidence of central thrombosis. . echo: the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is a trivial/physiologic pericardial effusion. . radiology report unilat up ext veins us right: right cephalic vein thrombus, without evidence of dvt. . cxr: limited study demonstrating interval improvement in subsegmental atelectasis. possible small right effusion. brief hospital course: the patient was admitted to the general surgery service for evaluation and treatment of the aforementioned complaint on . he was made npo and started on iv fluid rescusitation. a foley was placed. he was given dilaudid iv prn for pain with good effect. in the ed, he was started on iv vancomycin and zosyn, which was changed to iv flagyl and cipro given the gallbladder findings once admitted. he was started on nebulizer treatments, chest pt, and aggressive respiratory toilet for tachypnea. labwork and diagnostic studies were performed. he was hemodynamically stable. on , the patient was sent for an ercp. at the time of the ercp, he underwent an uncomplicated intubation. he was doing well during the procedures until pressures fell from baseline 170s/90s, to 80s/50s briefly while insufflating stomach. o2 sats fell at that time to unclear levels. he was noted to be gurgling. his pressures came back up and he never required pressors. ercp with sphincterotomy and drainage of sludge was performed. at the end of case, his o2 saturation was 95% on 100% fio2 with co2 65. he remained intubated and was transferred to the for further care. course: #) hypoxia: patient remained intubated with a substantial a-a gradient of ~500. p/f ratio 151 initialy. differential includes ards secondary to pancreatitis, aspiration peri-proceudre, restriction from large abdomen, v/q mismatching secondary to atelectasis in the setting of pain, immobility, and volume overload. he has received a significant amount of volume and been net in several liters daily for 2 days. also, cxr notable for low lung volumes and atelectasis. he was diuresed with good effect. peep was increased and fio2 weaned quickly over the first 12 horus. he tolerated psv and was subsequently extubated. . #) pancreatitis: presentation consistent with improving gallstone pancreatitis. iv hydration was stopped out of concern for volume overload, as above. he was maintained npo until extubation, after which cipro/flagyl were continued per surgery recommendations. . #) thrombocytopenia: platelets have fallen from 173 on admit to 63 .the time course would be too fast for hit because he had no known exposure to heparin within the past 30 days. there no evidence of thrombosis (portal vein thrombosis on admission ct but this was prior to heparin), but the magnitude is approximately right for that. ppi was stopped out of concern that it may be contributing. . #) hypertension: on lisinopril as an outpatient. this was stopped on admission (possibly due to mild acute renal failure) and bps per nursing records mostly 150s-160s. he had been hpotensive briefly during procedure, possibly a vagal reaction to stomach insufflation and/or sedation. sbp on arrival to icu 190, but quickly fell to 150s. no antihypertensives were required. . #) dm2: diagnosed in , diet controlled, hga1c 5.8% in . sliding scale insulin was continued. . on , the patient was transferred back to the floor. his diet had been advanced to clears, foley discontinued, off iv fluids, taking dialudid po prn for pain with good effect. iv cipro and flagyl were continued as well as albuterol and atrovent nebulizer treatments. he was prescribed artificial tears for eye irriation. . on , the patient was noted to have sigificant (r) arm swelling secondary to iv fluid infiltration. the piv was relocated to the other arm. a venous ultra-sound of the (r) upper extremity was was performed, which revealed a (r) cephalic vein thrombus wihtout dvt. elevation and warm compress was prescibed with improvement. the patient was started on erythromycin eye ointment for red eye. he was weaned off oxygen. . : low grade temperature noted; blood, urine, and sputum cultures sent. cxr performed. patient continued on cipro/flagyl. tolerated a regular diet. improved activity tolerance. . : gi consulted. ursodiol started for sludge on ercp. hepatitis serologies sent. ambulated frequently without assist. cleared by physical therapy. . : continued to tolerate a regular diet and activity. liver/gallbladder u/s ordered. : ct abd/pelvis with no drainable collections. : tolerating a regular diet on po antibiotics. d/c home in stable condition medications on admission: lisinopril - 5 mg tablet - 1 tablet(s) by mouth daily omeprazole - 20 mg capsule, delayed release(e.c.) - 2 capsule(s) by mouth twice a day simvastatin - 40 mg tablet - 1 tablet(s) by mouth daily medications - otc aspirin - 81 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth daily discharge medications: 1. lisinopril 5 mg tablet sig: one (1) tablet po once a day. 2. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 3. aspirin 81 mg tablet sig: one (1) tablet po once a day. 4. simvastatin 40 mg tablet sig: one (1) tablet po at bedtime. 5. colace 100 mg capsule sig: one (1) capsule po twice a day. disp:*60 capsule(s)* refills:*0* 6. hydromorphone 2 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. disp:*20 tablet(s)* refills:*0* 7. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puffs inhalation four times a day as needed for shortness of breath or wheezing. disp:*1 hfa* refills:*2* 8. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed) as needed for dryness. 9. bisacodyl 5 mg tablet sig: one (1) tablet po once a day as needed for constipation for 2 weeks. 10. cipro 500 mg tablet sig: one (1) tablet po twice a day for 14 days. disp:*28 tablet(s)* refills:*0* 11. flagyl 500 mg tablet sig: one (1) tablet po three times a day for 14 days. disp:*42 tablet(s)* refills:*0* discharge disposition: home with service facility: multicultural vna discharge diagnosis: acute pancreatitis discharge condition: good discharge instructions: please call your doctor or nurse practitioner or return to the emergency department for any of the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *your pain in not improving within 8-12 hours or is not gone within 24 hours. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon. avoid driving or operating heavy machinery while taking pain medications. followup instructions: please call ( to schedule a follow-up appointment with dr. (surgery) in 4 weeks. provider: , md phone: date/time: 9:30 procedure: endoscopic sphincterotomy and papillotomy laparoscopic cholecystectomy endoscopic retrograde cholangiopancreatography [ercp] diagnoses: thrombocytopenia, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled pulmonary collapse other and unspecified hyperlipidemia acute respiratory failure acute pancreatitis long-term (current) use of aspirin chronic cholecystitis 

Answer: The patient is high likely exposed to