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: generalized weakness major surgical or invasive procedure: bilateral nephrostomy tube placement history of present illness: pt is an 84 yo f w/ a hx of remote colon ca s/p resection and radiation, cad s/p mi, recently diagnosed w/ metastatic ca of unknown primary. she presents feeling lethargic w/ poor po intake for the past few days. she had been feeling unwell chronically, and had fallen last thursday, which worsened her overall state of health. she was initially taken to ed and transferred to after being found have a k of 6.3 and dilated small bowel on . at , she was given vanc/cipro and flatyl iv, as well as calcium gluconate iv, 1 amp of sodium bicarbonate, and 10 u iv regular insulin + d50. . on transfer to the ed, her vitals were initially t 96.7 hr 100, bp 126/33, 94% on 3l. she remained afebrile and hemodynamically stable. he k was 7.2 with no ekg changes. sh was given insulin and d50 x3. she was also given kayexalate 30 ml x1 initially, but had no bowel movements. she got a total 4.5 l iv ns. . on arrival to the floor, she was stable, afebrile, and not c/o pain. she was tired and not answering many questions. her daughter accompanied her and confirmed the brief above hx. immediately after arriving to the floor, she had a large, loose, green bowel movement. past medical history: past medical history: 1. colorectal cancer - status post treatment with resection and adjuvant radiation. 2. cad status post mi 3. squamous cell carcinoma of the bilateral lower extremities - the patient underwent excision of a squamous cell cancer on the right in 4/. she underwent excision of a squamous cell cancer with skin grafting on the left in 1/. 4. osteoarthritis 5. natural fusing of the neck resulting in chronic pain past surgical history: 1. status post resection of colorectal cancer - 2. status post bilateral total hip replacement - and 3. status post resection of squamous cell cancers 4. status post hysterectomy for fibroids - a small portion of one ovary was left. social history: social history: the patient is married and lives with her husband. they divide their time between a single family home in during the winter and an apartment in during the summer. although there are living space is on one floor, she has three stairs outside to reach her apartment. the patient has three children who live in and are involved in her care. she reports smoking cigarettes for three months in her early 30, but no tobacco use since that time. no alcohol. she has been utilizing a cane since her recent illness. she reports that she feels safe at home. family history: family history: the patient reports her father died of lung cancer. her mother had dementia. she is an only child. physical exam: vitals: t: 96.6 bp: 93/58 p: 90 rr 18 o2 sat: 97% on 2l . gen: pt moaning, looking uncomfortable heent: clear op, mmm, dry skin around mouth neck: supple, no lad, no jvd cv: rr, nl rate, nl s1/s2, no m/r/g pulm: crackles at bases, bsbl, no wheezes or rhonchi abd: distended, + fluid wave, mildly tender throughout, no rebound +bs ext: 2+ edema, 2+ dp bulses bl skin: stage ii pressure ulcer on buttock neuro: + reflexes, equal bl. gait assessment deferred. difficulty w/ concentration (not answering questions appropriately) pertinent results: cbc 03:30pm blood wbc-23.0*# rbc-3.65* hgb-10.1* hct-30.4* mcv-83 mch-27.7 mchc-33.3 rdw-15.1 plt ct-123*# 03:04am blood wbc-20.9* rbc-3.92* hgb-10.7* hct-33.3* mcv-85 mch-27.4 mchc-32.3 rdw-14.9 plt ct-114* 01:47am blood wbc-23.7* rbc-3.25* hgb-9.2* hct-26.6* mcv-82 mch-28.3 mchc-34.5 rdw-15.2 plt ct-124* 03:30pm blood neuts-85* bands-2 lymphs-5* monos-5 eos-0 baso-0 atyps-0 metas-0 myelos-3* . coags 03:30pm blood pt-14.1* ptt-27.4 inr(pt)-1.2* . chem-10: 03:30pm blood glucose-92 urean-166* creat-7.6*# na-131* k-6.3* cl-88* hco3-17* angap-32* 01:47am blood glucose-137* urean-152* creat-6.4* na-137 k-4.3 cl-89* hco3-26 angap-26* 03:30pm blood calcium-9.6 phos-7.4*# mg-3.0* 01:47am blood calcium-8.0* phos-7.1* mg-2.4 . lfts 10:10pm blood alt-19 ast-20 ld(ldh)-214 alkphos-137* totbili-0.8 . cardiac enzymes 03:30pm blood ctropnt-0.01 03:30pm blood ck(cpk)-29 . miscellaneous tests 09:38am blood hapto-379* 10:10pm blood tsh-0.76 03:49pm blood lactate-1.6 k-6.2* 09:54am blood lactate-2.3* . abgs 05:16am blood type-art po2-104 pco2-39 ph-7.35 caltco2-22 base xs--3 09:54am blood type- po2-84* pco2-47* ph-7.32* caltco2-25 base xs--2 . microbiology: . blood cx's:(final ): blood culture, routine klebsiella pneumoniae. . urine cx: 5:55 pm urine nephrostomy tube. escherichia coli. >100,000 organisms/ml.. . radiology imaging: ct abd/pelvis (): indication: 84 year old with history of carcinomatosis, abdominal pain and renal failure. . comparison: ct dated from outside hospital, medical imaging. pet ct dated which demonstrated abnormal uptake in the anterior abdomen and pelvis concerning for peritoneal carcinomatosis and the proximity of the uptake in the pelvis to the prior colon resection site was concerning for recurrence of colon carcinoma. . technique: mdct acquired images were obtained through the abdomen and pelvis without administration of intravenous contrast. oral contrast was administered. . ct abdomen: heart size is within the upper limits of normal. the lung bases demonstrate mild bibasilar atelectasis and trace pleural effusions. . an enteric catheter is present with its tip coursing through the esophagus into the mid stomach. the liver is grossly unremarkable. abdominal ascites has decreased. the gallbladder is somewhat distended without evidence of pericholecystic fluid or gallstones to suggest acute cholecystitis. the pancreas and spleen are grossly unremarkable. the adrenals are unremarkable. both kidneys have increased in size since prior exam. there is marked right hydroureteronephrosis that is increased since the prior study. there is no evidence of stone or mass on the right. the left kidney has also increased in size without evidence of hydronephrosis, stone or mass. the increase in renal size is thought to be secondary to obstruction caused by the pelvic mass and or pelvic carcinomatosis. . there is a small amount of mesenteric fluid, decreased somewhat since prior exam. the small bowel is somewhat dilated but does contain contrast proximal to the pelvic resection site. small bowel does not fill with contrast distal to the resection site and the small bowel segments seem somewhat tethered at the resection site, which may be secondary to adhesions. these findings could represent an evolving small bowel obstruciton. . there is an ill-defined mass in the pelvis adjacent to multiple clips, which is markedly obscured by streak artifact from bilateral hip prostheses, and is concerning for tumor recurrence. colon does not appear dilated. cecum and ascending colon appears mildly thickened, and there appears to be soft tissue thickening in the right lower quadrant adjacent to the region of prior resection, concerning for carcinomatosis and or tumor recurrence. . ct pelvis: evaluation is markedly limited by bilateral hip prostheses. there is increased amorphous soft tissue density in the pelvis adjacent to surgical clips with adjacent small bowel wall thickening and colonic wall thickening suggestive of increased carcinomatosis. . bone windows: degenerative changes throughout the thoracolumbar spine without evidence of acute fracture or malalignment. grade 1 anterolisthesis of l4 on l5 is noted. . impression: 1. findings concerning for evolving small-bowel obstruction. 2. progressive peritoneal carcinomatosis; concerning soft tissue mass/thickening adjacent to surgical clips in pelvis, partially obscured by streak artifact from hip prostheses. 3. right hydroureteronephrosis and increased size of kidneys bilaterally. there may be developing obstruction of both kidneys related to pelvic mass/ carcinomatosis. . cxr: () impression: bibasal opacities/aspiration atelectasis. infectious process cannot be excluded. dilated upper mediastinum most likely related to volume overload and asymmetric position of the patient. evaluation with symmetric radiograph is recommended. brief hospital course: pt is an 84 you f w/ a history of remote colon ca and recent dx of metastatic cancer in the abdomen (unknown primary) who presents w/ a partial large bowel obstruction and hyperkalemia 2' to acute post obstructive renal failure. given her multiple medical co-morbidities and poor cancer prognosis, the family chose to change the patient's code status from full to dnr/dni/cmo and she expired on due to cardiopulmonary arrest. . hyperkalemia. the maximum k was 7.2. she was given calc gluconate at osh and insulin and d50 x4, and kayexelate 30 ml x1. she had an ekg on admission with peaked t waves. sh did have bowel movements on the floor. ekg and ks were checked frequently (q4-8h.). renal was consulted for dialysis, but they did not recommend any, given at the time of consult the family was interested in comfort measures only. she was given insulin, ivfs, and kayexelate as needed. all these meds were discontinued when the code status was changed to dnr/dni/cmo. . arf: her baseline cre was 1.0, was 7.2 on admission. the etiology was likely post-renal given the obstructing pelvic masses and the fact that her u/o was less than 200 ccs on the first few hours of admission. urology was consulted, and their recommendation was not to place a stent, which would most likely fail. ir placed bilateral nephrostomy tubes which resulted in less than desired u/o, but allowed resolution of hyperkalemia to ~4.3. paracentesis was considered to aid in decompressing ureter, but was not performed because the nephrostomy tubes were placed w/ good effect. . partial large bowel obstruction. she was suspected to have a partial lbo 2' to her hx of bowel surgery for colon ca and her new pelvic masses. pt was reported to have a bo on osh kub, and had not have bowel movements x2-3 days at home. no vomiting. ct on admission was c/f evolving sbo (areas of adhesion near the resection site), and also noted the new pelvic mass and some abdominal thickening in the rlq adjacent to the resection site c/f new cancer formation/carcinomatosis. she began having bowel movements on the floor. she was kept npo w/ ivfs. surgery was consulted and did not recommend any invasive surgical procedures beyond the ir nephrostomy tube placement. she was given an aggressive bowel regimen of standing colace and senna w/ kayexelate, lactulose, and enemas prn. all these meds were discontinued when the code status was changed to dnr/dni/cmo. . leukocytosis. pt had uti (final read e. coli) and urosepsis (klebsiella). wbc never resolved during hospital admission despite broad spectrum abx (flagyl, vancomycin, levoquin => cipro after speciation of uti pathogen). all these meds were discontinued when the code status was changed to dnr/dni/cmo. . metastatic carcinoma of unknonw primary: s/p first round of carboplatin/paclitaxel on . had planned to have chemotherapy every 3 weeks. given her multiple medical morbidities, oncology assessment was that prognosis was poor and no chemotherapy was administered while inpatient. . anemia: hct of 26.6 dropped from 33.3 on admission. no transfusion given as dnr/dni/cmo. . back pain: chronic back pain, worsening. given percocet elixer as needed. once dnr/dni/cmo, pt was given iv morphine 2-10 mg q2h:prn for comfort. . fen: npo, electrolytes repleted, ifvs. all labs and ivfs were stopped w/ dnr/dni/cmo change in code status. . ppx: heparin sc, pneumoboots. all stopped w/ change in code status. . access: pivs. kept in place for administration of morphine. . code: initially full, changed to dnr/dni/cmo on . pt expired on at 10:03 am 2' to cardiopulmonary arrest. . medications on admission: acetaminophen-codeine - 300 mg-30 mg tablet - tablet(s) by mouth every four (4) hours as needed for pain dexamethasone - 4 mg tablet - 5 tablet(s) by mouth take the night before and the morning of chemotherapy lorazepam - 0.5 mg tablet - 1 tablet(s) by mouth every six (6) hours as needed for nausea ondansetron hcl - 8 mg tablet - 1 tablet(s) by mouth every eight (8) hours as needed for nausea polyethylene glycol 3350 - 100 % powder - 1 powder(s) by mouth daily as needed for constipation prochlorperazine edisylate - 10 mg tablet - 1 tablet(s) by mouth every six (6) hours as needed for nausea medications - otc acetaminophen - (otc) - dosage uncertain docusate sodium - 100 mg capsule - 1 capsule(s) by mouth twice a day prn polycarbophil calcium - 625 mg tablet - 2 tablet(s) by mouth morning propoxyphene n-acetaminophen - (prescribed by other provider; otc) - dosage uncertain senna - 8.6 mg tablet - 1 tablet(s) by mouth prn discharge medications: none discharge disposition: expired discharge diagnosis: partial bowel obstruction acute renal failure urinary tract infection . secondary diagnosis colon ca s/p resection metastatic abdominal/pelvic ca (unknown origin) chronic back pain discharge condition: expired discharge instructions: none followup instructions: none md, procedure: percutaneous nephrostomy without fragmentation insertion of other (naso-)gastric tube diagnoses: hyperpotassemia other chronic pain coronary atherosclerosis of native coronary artery acute kidney failure, unspecified unspecified septicemia severe sepsis atrial fibrillation other specified intestinal obstruction personal history of tobacco use personal history of other malignant neoplasm of skin old myocardial infarction osteoarthrosis, unspecified whether generalized or localized, site unspecified personal history of malignant neoplasm of large intestine other ascites hydronephrosis other malignant neoplasm without specification of site hip joint replacement secondary malignant neoplasm of retroperitoneum and peritoneum cervicalgia 

Answer: The patient is high likely exposed to