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: clogged j-tube major surgical or invasive procedure: none history of present illness: mr. is an 87 year old male with a past medical history of metastatic gastric cancer s/p subtotal gastrectomy, transverse colectomy and feeding jejunostomy who presents as osh transfer from hospital for clogged j tube. after a stay on the surgery service through for this procedure, patient was discharged to ne and then later to nh, during which time he had intolerance to tube feeding. he was refusing medications and feeds, and was sent to for further evaluation on . . at , initial cbc showed a wbc of 17 with 40% bands and cxr showed bilateral lower lobes consistent with possible aspiration. he was initially started on levofloxacin and unasyn, which was later transitioned to ticarcillin/clavulanate. course was also complicated by a blocked j tube, which was evaluted by surgery, who felt that this should be corrected by surgery at since the tube was placed here. patient also had some episodes of vomitting, and ct scan was performed which was negative for obstruction. patient was also seen by oncology who felt his poor nutrition status precluded him from chemotherapy, and felt that radiaton therapy was likely not indicated. the option of hospice was broached with the patient's son and hcp, who asked that this not be discussed with his father. . at this time, patient feels well and reports no chest pain, cough, dyspnea, abdominal pain or nausea past medical history: pmh: # recently diagnosed metastatic gastric adenocarcinoma causing gastric outlet obstruction s/p partial gastrectomy/transverse colectomy, j-tube () # stage ii coccyx decub ulcer # bilateral cataract surgery # elevated lfts on last admission felt to be tpn social history: was living at nursing home, retired storekeeper. no etoh, no tobacco, no drug use. family history: ca, uncle-lung ca, cousin x2- rectal cancer physical exam: physical exam vitals: t: 96.8 bp: 100/69 p: 70 r: 18 sao2: 100% 2l general: awake, alerti, interactive, cachectic, ill appearing heent: ncat, perrl, eomi, no scleral icterus, dry mm, no lesions noted in op, no thrush neck: supple, no significant jvd or carotid bruits appreciated pulmonary: lungs cta bilaterally, no wheezes, ronchi or rales cardiac: rr, nl s1 s2, no murmurs, rubs or gallops appreciated abdomen: scaohoid, with j tube in place with 1 cm surrounding erythema but no drainage/pus, non tender, nondistended, but abdomen is firm extremities: 2+ le bilateral symmetric edema skin: no rashes or lesions noted. neurologic: cranial nerves ii-xii intact. normal bulk, strength and tone throughout. no abnormal movements noted. no deficits to light touch throughout. pertinent results: 12:25am blood wbc-9.7 rbc-3.27* hgb-9.4* hct-29.9* mcv-92 mch-28.7 mchc-31.4 rdw-16.2* plt ct-425 12:25am blood neuts-77.6* lymphs-19.3 monos-1.7* eos-1.2 baso-0.2 12:25am blood pt-12.8 ptt-32.8 inr(pt)-1.1 12:25am blood glucose-86 urean-22* creat-0.4* na-149* k-3.7 cl-113* hco3-31 angap-9 12:25am blood albumin-2.3* calcium-8.5 phos-3.2 mg-2.4 12:25 am blood culture blood culture, routine (pending): cxr impression: 1. bilateral opacities consistent with multifocal infection. 2. interval increase in size of the loculated left pleural effusion. abdomen x-ray the current study demonstrates percutaneous gastrostomy in place. there are several nonspecifically dilated small bowel loops up to 4 cm. there are no other abnormalities seen. if clinically warranted, correlation with cross-sectional imaging might be considered. ct abdomen/pelvia with iv and per-j tube contrast impression: 1. new soft tissue mass at the level of the hepatic flexure adjacent to suture material concerning for metastasis or peritoneal implant. no dilated loops of bowel are seen at this point to suggest obstruction. 2. increased intrahepatic biliary ductal dilatation, likely related to the hepatic flexure soft tissue mass, as detailed above. 3. massive new ascites. thickening of the peritoneum within the upper abdomen and deep pelvis are concerning for peritoneal implants. 4. interval resolution of previously seen pneumatosis. 5. new right femoral deep venous thrombosis. duplex ultrasound is recommended to evaluate the extent of this. delayed re-scan after 7 hours: impression: 1. progression of oral contrast passed the soft tissue mass near the colocolonic anastomosis within the right upper quadrant. this excludes a complete obstruction, although a component of partial obstruction may still be present. 2. no other changes on this examination from the contrast-enhanced exam done earlier on same date. bilateral le ultrasound impression: 1. deep venous thrombosis of the right common femoral and proximal superficial femoral veins. no thrombus seen more distally. 2. no left-sided deep veinous thrombosis seen, possible sequelae of previous left dvt. brief hospital course: mr. is an 87 year old korean-speaking gentleman with metastatic gastric cancer s/p subtotal gastrectomy/transverse colectomy/feeding jejunostomy 3 months ago, who had been treated at an outside hospital for aspiration pneumonia and was transferred to for clogged j-tube. upon arrival to the ed, his tube was no longer clogged, but he did have nausea/vomiting after tube feeds. he was not continued on antibiotics, as he had received a sufficient course and had no fever/leukocytosis/cough. during this admission, he had issues with feeding, poor nutritional status, and hypernatremia. the extent of his disease was further investigated, and it was determined that there were no further treatment options with regards to his underlying disease; efforts then were turned towards comfort-centered care. there were many cultural barriers to care in this patient's case: he insisted that his son be the one to make all medical decisions for him. unfortunately, his son lives in . a family meeting was held with the patient's wife, the son via , palliative care, oncology, and social work: information was shared regarding the patient's prognosis (days to weeks, per onc). the family agreed that the patient's care should be centered upon his comfort rather than combatting his underlying disease. we discussed the patient's values: that he would like to be able to eat by mouth. mr. son elected to keep the patient full code, however, at least until he was able to come to from dc. the primary team made sure that he knew that resuscitation attempts would likely be unsuccessful, but the healthcare proxy still insisted on full code status. ethics consult was called, and the team contact the patient's pcp who agreed to speak to the son regarding realistic goals of care. upon arrival, the patient had not received tube feeds for a few days and his nutritional status was extremely poor. since he had been recently treated for aspiration pneumonia, he underwent speech+swallow evaluation: he had normal swallowing function but he did tend to vomit after eating, and due to weakness was often unable to fully clear food from his airway. he was initially kept npo. tube feeds also resulted in extreme nausea/vomiting; ct scan showed that there was no obstruction distal to the j-tube, but he did have extensive abdominal ascites and peritoneal implants. he was started on ppn, and after the family meeting he was allowed to eat thin liquids and pureed solids by mouth. the patient tolerated this well, and per palliative care recs he was given iv decadron to stimulate appetite, which helped him. on the evening of , the patient's wife was feeding him chicken and plums (she knew he was only cleared to eat pureed solids) and the patient had an aspiration event. he triggered for o2 sat of 66%. respiratory therapy suctioned him; secretions were removed but o2 saturation rose to the 90's only once he was on 100% face tent. by the morning, he appeared to have very labored breathing, despite repeat suctioning. the patient's son was called, and wife was by the bedside - the decision was made to transfer to the icu. the patient agreed with this plan, and was aware that his respiratory status would likely require further intervention. while his son was on his way up to from dc, mr. was transferred to the micu with plans for bipap. he was stable on 100% face tent and was transferred back to the medical floor after a few days. --- mr. overall status continued to decline; he became extremely air-hungry, and this was treated with morphine prn. his family debated about intubation, but finally decided to change his code status to dni in addition to dnr. his respiratory rate slowed markedly, his blood pressures dropped, and he became minimally responsive. he was made cmo, and he died on in his family's presence. medications on admission: on tranfer: # ticarcillin/clavulanate 2.1 g q6h # amylase/lipase/protease 1 cap po daily # escitalopram 10 mg daily # senna # ursodiol 600 mg daily # tylenol 650 mg q4h prn # percocet 1 ta po q4h prn # albuterol prn # zofran 4 mg iv q6h prn discharge medications: patient expired discharge disposition: expired discharge diagnosis: metastatic gastric carcinoma discharge condition: patient expired. discharge instructions: patient expired. followup instructions: patient expired md procedure: parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances diagnoses: pneumonitis due to inhalation of food or vomitus long-term (current) use of other medications pressure ulcer, lower back other ascites encounter for palliative care acute venous embolism and thrombosis of deep vessels of proximal lower extremity hyperosmolality and/or hypernatremia pressure ulcer, stage ii nutritional marasmus secondary malignant neoplasm of retroperitoneum and peritoneum family history of malignant neoplasm of gastrointestinal tract family history of malignant neoplasm of trachea, bronchus, and lung status of other artificial opening of gastrointestinal tract acquired absence of organ, stomach acquired absence of intestine (large) (small) malignant neoplasm of stomach, unspecified site early satiety long-term (current) use of antibiotics personal history of pneumonia (recurrent) 

Answer: The patient is high likely exposed to