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: complex recurrent incisional hernias of the abdomen. recurrent colon cancer major surgical or invasive procedure: 1. incisional hernia repair with surgisis. 2. completion colectomy by dr. . 3. aspiration right renal cyst. 4. picc line placement open total colectomy, ventral hernia repair with mesh history of present illness: mr. is a 60-year-old white male status post colorectal cancer both in for which he underwent a left colon cancer resection for stage iii colon cancer. he recieved chemotherapy 5-fu and leucovorin. in , he also underwent additional resection, a low anterior resection, for rectal cancer per the patient's report. he was in his usual state of health until and he underwent his routine interval colonoscopy which was noted to have a right colon mass in the cecum as well as a polyp at the rectosigmoid junction. pathology noted from outside hospital, the right cecal mass to be consistent with adenocarcinoma and the polypectomy specimen to be consistent with dysplasia. recent cea notes range anywhere from 4.2-4.9. the patient was referred from his primary care provider to dr. and dr. for evaluation of possible laparoscopic intervention of his right-sided colon cancer. past medical history: colon cancer, stage iii. treated with chemo and surgery in , low anterior resection for rectal cancer. history of urinary retention, as a result of nerve injury secondary to his low anterior resection. niddm impotence. a left hemicolectomy in , ventral hernia repair with mesh in , low anterior resection in . borderline hypertension. social history: a heavy smoker, 2-3 packs per day for 20 years, quit in of 06. denies heavy alcohol use. he reports approximately two drinks per week. denied illicit drugs or any other drug abuse. he is employed as an insurance . he is divorced. he has a one biological daughter. family history: nc physical exam: vss: t: 96.7 p: 84, rr 16, spo2 100% on ra, bp 112/62 5 feet 10 inches, his weight is 194 pounds general appearance: no apparent distress. a well-appearing 60-year-old man. psychiatric history: is ao x3. eyes: pupils equal, round, reactive to light. extraocular muscles intact. his sclerae anicteric. ent exam with normal. neck: no mass. lymph system: negative. respiratory system: clear to auscultation bilaterally. cardiac exam: regular rate and rhythm. no murmurs, rubs, or gallops. he had no bruits per his carotid exam, normal pulsations in his upper and lower extremities. gi system: soft, nontender, no masses palpable. on valsalva, he has a large ventral hernia in the midline, multiple well-healed scars. again, no masses palpated. rectal exam has poor tone, heme negative. no mass. neuro: cranial nerves ii through xii grossly intact. musculoskeletal: good strength and range of motion in all four extremities. skin: within normal limits. pertinent results: 04:22am blood pt-12.8 inr(pt)-1.1 echo results: impression: normal global and regional lv systolic function. mild mitral regurgitation. . clinical implications: the patient has mild mitral regurgitation. based on aha endocarditis prophylaxis recommendations, the echo findings indicate a moderate risk (prophylaxis recommended). clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. . cytology report rt renal cyst procedure date of . specimen description: received 25ml clear yellow fluid. prepared 1 thinprep slide. clinical data: colon cancer. report to: dr. . . diagnosis: fna, right renal cyst, aspiration: . negative for malignant cells. . hypocellular specimen. . few scattered macrophages (see note). . note: the findings are compatible with cyst contents; however, epithelial elements are not represented. clinical correlation is recommended . medical condition: 60 year old man s/p total colectomy, pod 8 now with nausea and vomiting. reason for this examination: evaluate for obstruction indication: status post total colectomy, postop day 8, now with nausea and vomiting. evaluate for obstruction. . abdomen, supine and erect: there are multiple loops of dilated small bowel with air-fluid levels. an ng tube is in place in the stomach. surgical clips are visualized in the lower midline. . there are areas of calcification overlying the region of the pubic symphysis which may represent calcification in the prostate gland or stones in the bladder. . impression: multiple dilated small bowel loops which may represent ileus or small bowel obstruction. . 9:05 am urine site: catheter **final report ** urine culture (final ): pseudomonas aeruginosa. >100,000 organisms/ml.. of two colonial morphologies. sensitivities: mic expressed in mcg/ml _________________________________________________________ pseudomonas aeruginosa | cefepime-------------- <=1 s ceftazidime----------- <=1 s ciprofloxacin--------- 2 i gentamicin------------ 8 i imipenem-------------- 8 i meropenem------------- 2 s piperacillin---------- <=4 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s brief hospital course: mr. was admitted on for scheduled open total colectomy and ventral hernia repair with mesh, see op note for details. he was transferred to pacu post-op and was extubated. he recovered well and was transferred to 9. . abdomen: pod #1 abdominal binder was in place with clean dry dressings intact. an intact jp #1 drained adequate output from the rlq and jp #2 drained serosainguinous fluid from the llq. the incision remained well approximated with staples and no drainage. ngt was in place post-op, and removed on pod#1. flatus was noted on pod #4. bowel movement occurred on pod#5. jp #1 was removed on pod #6. pod#8, first small loose bowel movement. frequent loose stools developed over the next 24 hours, he was treated with immodium prn with fair results. on pod #8, ngt was reinserted due to development of ileus, when 1000 cc of green drainage was rapidly evacuated. c. diff was negative x3. he was held npo, and kub obtained, see pertinent results. on pod #13, ngt was removed, patient tolerated well. bowel function resumed on pod#13 with staples were removed on pod#12, incision remained c/d/i, abdomen soft and nontender. jp #2 was removed on pod#15. . pain: epidural pca was used with fair effect from hd#1 until pod #4. he was then transitioned to percocet po for pain control, with iv morphine injections for breakthrough pain until pod#7. patient reported minimal post-op pain, and required no po narcotics after pod#8. . cardiovascular: pt was stable in nsr until pod #5 when he developed atrial fibrillation. a cardiology consult was obtained. he was transferred to sicu for amiodarone drip. he converted to normal sinus rhythm, was transferred to cc6 and started on oral amiodarone. a tte was performed, see pertinent results. he was monitored on telemetry, with intervals of afib, converting back to nsr over the next few pod days. he recieved lopressor iv until pod# 12, which he initially refused when he was immediately post-op. coumadin was initiated and recommended by cardiology for 1 month. amiodarone was continued po, and recommended for 3 months. he remained in nsr at the time of discharge. . genitourinary: foley catheter was in place until pod#7, when it was initially dc'd. the patient triggered on pod#7, related to low urine output of 45 cc over 4 hours. foley was replaced, and output improved with fluid boluses. on pod#13, urine culture revealed pseudomonas, and cefipime iv was initiated, and continued at home after dc x 7 days total. foley was left in place to leg bag for discharge home. . respiratory: patient was on 2l nasal cannula o2 immediately post-op and weaned by pod#7. upon development of ileus, o2 sats dropped and he was replaced on o2 4l to keep sats> 92%. on pod#10, patient was weaned to ra. . activity: pt was up to the chair on pod#1 and ambulating halls pod#2. he remained active throughout his admission. . nutrition: tpn was started due to prolonged npo status as a result of ileus. he recieved tpn from pod#10 until pod#12. his diet was advanced and he tolerated a regular diet on pod#13. . he was discharged to home on pod#14 with appropriate follow up appointments and vna service for iv antibiotics. medications on admission: flomax 0.4 mg po bid aspirin 81 mg po qd avandia 8 mg po qd metformin 1000 mg po qam, 15oo mg po qpm lipitor 5 mg po qhs lisinopril 5 mg po qd androgel applied daily discharge medications: 1. atorvastatin 10 mg tablet sig: 0.5 tablet po daily (daily). 2. tamsulosin 0.4 mg capsule, sust. release 24hr sig: one (1) capsule, sust. release 24hr po hs (at bedtime). 3. hexavitamin tablet sig: one (1) cap po daily (daily). 4. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 5. zinc sulfate 220 mg capsule sig: one (1) capsule po daily (daily). 6. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 7. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 8. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day): until (then take 200mg once daily). disp:*20 tablet(s)* refills:*0* 9. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily): take until directed to stop by primary care physician (~3 month course). disp:*90 tablet(s)* refills:*0* 10. cefepime 1 g recon soln sig: one (1) gram intravenous q12h (every 12 hours) for 5 days. disp:*10 gram* refills:*0* 11. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*qs x 5 days ml* refills:*0* discharge disposition: home with service facility: critical care systems discharge diagnosis: right colon cancer s/p open total colectomy, ventral hernia repair with mesh atrial fibrillation urinary tract infection ileus discharge condition: good discharge instructions: please call your doctor or return to the emergency room if you develop a fever greater than 101.5, shortness of breath, rapid heart rate, chest pain, foul smelling drainage from your incision, pain unrelieved by your pain medications, any problems with the foley catheter, more than 3 loose stools per day, persistent nausea/vomiting or inability to pass gas/stool, or any other symptoms concerning to you. . no driving while on pain medications. . no tub baths or swimming, you may shower, keep incision open to air, clean and dry, keep picc line clean and dry. keep picc line covered with plastic wrap while showering. cover your abodminal incision with a dressing if you notice clear drainage. . resume your prior home medications, as directed by your primary care physician. your physician's office this week to have your blood drawn for inr level and coumadin dosed accordingly. you may require immodium if you have more than 4 loose, watery stools per day. if so, please call dr. office (number below) for instructions on dosing. followup instructions: see your primary care physician's office this week to have your blood drawn (inr level) and coumadin dose adjusted. provider: , md phone: date/time: 3:00, at surgical specialties. dr. (colorectal surgery) will see you when you have your appointment with dr. . her telephone # is . you have an appointment with dr. in winsockett on thursday at 10:00 am. the office is located at . procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances insertion of other (naso-)gastric tube other lysis of peritoneal adhesions other small-to-large intestinal anastomosis other open incisional hernia repair with graft or prosthesis flexible sigmoidoscopy transfusion of packed cells insertion of catheter into spinal canal for infusion of therapeutic or palliative substances systemic to pulmonary artery shunt application or administration of an adhesion barrier substance percutaneous aspiration of kidney (pelvis) diagnoses: anemia, unspecified esophageal reflux urinary tract infection, site not specified unspecified essential hypertension personal history of malignant neoplasm of gastrointestinal tract, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation personal history of tobacco use peritoneal adhesions (postoperative) (postinfection) incisional hernia without mention of obstruction or gangrene paralytic ileus retention of urine, unspecified malignant neoplasm of cecum pseudomonas infection in conditions classified elsewhere and of unspecified site infection and inflammatory reaction due to indwelling urinary catheter 

Answer: The patient is high likely exposed to