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: sulfa(sulfonamide antibiotics) / heparin agents attending: chief complaint: painless jaundice. major surgical or invasive procedure: : -diagnostic laparoscopy. -peritoneal washings and cytology -exploratory laparotomy. -cholecystectomy. -harvest of pedicled omental flap for protection of anastomoses. -pancreaticoduodenectomy with standard gastrojejunostomy, antecolic. - right hepatic artery reconstruction using right gonadal vein interposition graft (performed by dr. ). history of present illness: 71f presented with painless jaundice, dark urine, bloating, and anorexia. she first noticed the onset of symptoms in or and then was alerted by a friend to her increasing jaundice, which prompted medical evaluation. at , her labs were as follows: total bilirubin 28, alk phos 338, alt 128 prior to arrival. she underwent an ultrasound and a ct with contrast and was found to have a 2.4 x 1.8 cm mass with a cystic structre in the head of the pancreas, distended and thickened gallbladder, intrahepatic (1.9 cm)and pancreatic duct (1.2 cm). at the time of consultation she was clinically well and denies nausea, vomiting, or changes in bowel habits. she underwent ercp which revealed a single irregular stricture of malignant appearance that was 2 cm long at the lower third of the common bile duct. there was severe post-obstructive dilation. a limited pancreatogram revealed a stricture of the main duct at the head. cannulation of the biliary duct was successful. contrast medium was injected resulting in complete opacification. a sphincterotomy was performed. a 7cm by 10fr biliary stent was placed. cytology samples were obtained for histology which returned positive for adenocarcinoma. the patient was offered a whipple operation, with the following explained: a 1-2% risk of death, a 30-40% risk of complication. from her osh scan report, she had no involvement of the mesenteric vessels and no evidence of metastatic disease, although there is periportal lymphadenopathy. she understood the risks/benefits of the surgery, and decided to proceed with the operation. past medical history: pmh: none psh: tonsillectomy/adenoidectomy, all teeth extracted social history: retired high school teacher, no children, lives with her female hcp. , drank glasses of wine per night until symptoms started in /, no drug use. family history: sister died from leukemia at age 65, mother died of cervical cancer. no history of benign or malignant pancreatic disease. physical exam: physical exam on admission: 97.3 91 173/94 20 100%ra gen: alert and oriented, pleasant skin: pronounced scleral and dermal jaundice cv: rrr resp: clear to auscultation abd: soft, non-tender, non-distended. negative sign, no palpable masses ext: 1+ edema, palp dp/pt pulses. pertinent results: 07:24am blood vanco-31.4* 06:05am blood vanco-12.4 07:54pm blood albumin-2.1* calcium-8.9 phos-5.7*# mg-1.9 01:56am blood calcium-10.9* phos-2.1* mg-2.7* 07:54pm blood ck-mb-2 ctropnt-<0.01 12:58pm blood ck-mb-2 ctropnt-0.03* 03:30am blood lipase-13 01:23am blood lipase-7 07:54pm blood alt-303* ast-827* ck(cpk)-57 alkphos-56 totbili-5.7* 01:45am blood alt-38 ast-80* alkphos-59 totbili-32.4* dirbili-23.7* indbili-8.7 01:18am blood alt-49* ast-82* alkphos-65 totbili-36.9* 01:56am blood alt-59* ast-94* ld(ldh)-202 alkphos-77 totbili-33.6* 07:54pm blood glucose-104* urean-11 creat-0.6 na-134 k-4.8 cl-100 hco3-15* angap-24* 01:56am blood glucose-143* urean-4* creat-0.5 na-142 k-4.7 cl-101 hco3-9* angap-37* 08:12am blood fibrino-515* 07:50pm blood fibrino-156*# 08:12am blood pt-12.3 ptt-27.8 inr(pt)-1.1 03:48am blood plt ct-139* 11:55pm blood plt smr-very low plt ct-62* 02:57am blood plt ct-56*# 08:15pm blood plt ct-<5 01:56am blood pt-49.9* ptt-122.1* inr(pt)-4.9* 11:55pm blood neuts-86* bands-3 lymphs-4* monos-3 eos-2 baso-0 atyps-0 metas-1* myelos-1* nrbc-1* 02:16am blood neuts-90* bands-1 lymphs-2* monos-4 eos-1 baso-0 atyps-0 metas-1* myelos-0 promyel-1* 07:54pm blood wbc-14.6*# rbc-2.58* hgb-8.2* hct-24.1* mcv-93# mch-31.7# mchc-34.0 rdw-16.5* plt ct-88* 07:50pm blood wbc-26.4*# rbc-3.07* hgb-9.7* hct-28.4* mcv-93 mch-31.7 mchc-34.2 rdw-16.3* plt ct-102* 05:41am blood wbc-28.5* rbc-3.23* hgb-9.7* hct-29.7* mcv-92 mch-30.0 mchc-32.6 rdw-16.0* plt ct-93* 12:49pm blood wbc-16.4* rbc-3.05* hgb-9.5* hct-28.8* mcv-95 mch-31.3 mchc-33.0 rdw-18.0* plt ct-43* 08:15pm blood wbc-41.4* rbc-2.19* hgb-7.5* hct-23.7* mcv-108* mch-34.3* mchc-31.7 rdw-22.5* plt ct-<5 10:15pm blood wbc-48.1* rbc-2.26* hgb-7.7* hct-24.9* mcv-110* mch-34.1* mchc-31.0 rdw-22.8* plt ct-88* 01:56am blood wbc-47.3* rbc-2.21* hgb-7.7* hct-24.5* mcv-115* mch-34.7* mchc-30.2* rdw-23.0* plt ct-72* . 11:46 am sputum source: endotracheal. gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 3+ (5-10 per 1000x field): gram negative rod(s). respiratory culture (final ): commensal respiratory flora absent. hafnia alvei. sparse growth. piperacillin/tazobactam sensitivity testing available on request. sensitivities: mic expressed in mcg/ml _________________________________________________________ hafnia alvei | ampicillin------------ 16 r ampicillin/sulbactam-- =>32 r cefazolin------------- =>64 r cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s . 5:55 am peritoneal fluid das acu verified by @0950. gram stain (final ): 4+ (>10 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. this is a concentrated smear made by cytospin method, please refer to hematology for a quantitative white blood cell count.. fluid culture (final ): reported to and read back by 2:45pm 4-3130. this culture contains mixed bacterial types (>=3) so an abbreviated workup is performed. any growth of p.aeruginosa, s.aureus and beta hemolytic streptococci will be reported. if these bacteria are not reported below, they are not present in this culture.. work-up of organism(s) listed below discontinued (excepted screened organisms) due to the presence of mixed bacterial flora detected after further incubation. enterococcus sp.. rare growth. sensitivities: mic expressed in mcg/ml _________________________________________________________ enterococcus sp. | ampicillin------------ =>32 r penicillin g---------- =>64 r vancomycin------------ <=0.5 s anaerobic culture (final ): no anaerobes isolated. fungal culture (preliminary): no fungus isolated. acid fast smear (final ): no acid fast bacilli seen on direct smear. acid fast culture (preliminary): no mycobacteria isolated. . : 10:54 am urine source: catheter. **final report ** urine culture (final ): yeast. >100,000 organisms/ml.. . : impression: non-occlusive deep vein thrombosis seen within one of the two left brachial veins . : impression: 1. status post whipple with serpiginous hypodensity seen in the left lobe most consistent with retraction injury. no drainable collection. 2. no radiologically evident cause of leukocytosis is observed. 3. extensive anasarca, likely secondary to volume overload. . final pathology report: macroscopic specimen type: pancreaticoduodenectomy, partial pancreatectomy. tumor site: pancreatic head, uncinate process. tumor size: greatest dimension: 2.9 cm. additional dimensions: 2.5 cm x 2.5 cm. other organs/tissues received: gallbladder, stomach. microscopic histologic type: ductal adenocarcinoma. histologic grade: g2: moderately differentiated. extent of invasion primary tumor: pt3: tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery. regional lymph nodes: pn1: regional lymph node metastasis. lymph nodes number examined: 11. number involved: 1. distant metastasis: pmx: cannot be assessed. margins: margins uninvolved by invasive carcinoma: distance from closest margin: 1 mm from peri-uncinate-process adipose tissue margin. venous/lymphatic vessel invasion: absent. perineural invasion: present. additional pathologic findings: pancreatic intraepithelial neoplasia -- highest grade: panin: iii; chronic pancreatitis. . brief hospital course: the patient was brought to the operating room on for whipple procedure, necessitating right hepatic artery reconstruction with gonadal vein for which the vascular surgery service was consulted intraoperatively. reader referred to both operative notes for full details. she received 6 u prbc, 2 ffp, and 500 of albumin in the or, and was left intubated on pressors, and taken to the surgical icu post operatively. her course thereafter in the icu was complicated. in brief: she required frequent blood transfusions of prbcs, ffp, and albumin, with a persistent pressor requirement; she developed acute renal failure requiring cvvh, had persistent elevations of lfts, had a persistent leukocytosis and in total the cardiology, infectious disease, renal, and hepatology services were consulted. significant events by post-operative day included: on pod2 the renal service was consulted given persistent renal failure postoperatively, and she was begun on cvvh. given down-trending platelets, hit panel was sent and returned positive on pod5, and the patient was begun on a bivalirudin drip per hematology recommendations. on pod6 tf were initiated via ngt, her foley was removed, and sputum cultures revealed gnr for which she was begun on vancomycin/ciprofloxacin/flagyl. antibiotics were thereafter tailored appropriately in consultation with the infectious disease service. on pod8 a left brachial vein clot was found on non-invasives and she was initiated on fondaparinux, subsequently discontinued. on pod11 the patient was noted to have qtc prolongation, for which the cardiology service was consulted, and recommendations were followed regarding medication adjustments. on the patient was extubated, and briefly off pressors. she was found to have sbp, and begun on meropenem in consultation with the hepatology and id services. lactulose was initiated given poor mental status (aox1 initially), on which she seemed to initially improve. on pod20 the patient failed a speech and swallow evaluation, and continued on tube feedings. her pressor requirement remained persistent, and her wbc continued to trend upwards. on , in discussion with the patient's hcp, she was made dnr/dni. on the evening of she was noted to be hypothermic to 89, was in dic per labarotory values and she passed away on , post-operative day 34. discharge disposition: expired discharge diagnosis: -pancreatic cancer -spontaneous bacterial peritonitis -heparin induced thrombocytopenia -renal failure discharge condition: expired. discharge instructions: n/a. followup instructions: n/a. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances hemodialysis radical pancreaticoduodenectomy cholecystectomy other repair of vessel diagnoses: acidosis end stage renal disease acute kidney failure with lesion of tubular necrosis unspecified essential hypertension acute posthemorrhagic anemia acute and subacute necrosis of liver atrial fibrillation accidental puncture or laceration during a procedure, not elsewhere classified other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure defibrination syndrome malignant neoplasm of head of pancreas surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other complications due to other vascular device, implant, and graft other ascites hepatic encephalopathy ventilator associated pneumonia removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation obstruction of bile duct disruption of external operation (surgical) wound heparin-induced thrombocytopenia (hit) spontaneous bacterial peritonitis other specified disorders of liver acute respiratory failure following trauma and surgery chronic passive congestion of liver acute venous embolism and thrombosis of deep veins of upper extremity postoperative shock, other obstruction of gallbladder 

Answer: The patient is high likely exposed to