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: penicillins attending: chief complaint: esophageal cancer. esophageal perforation. major surgical or invasive procedure: : exploratory laparotomy. transhiatal esophagectomy. laparoscopic jejunostomy. : videofluoroscopic swallowing evaluation : larynoscopy history of present illness: 76f with esophageal perforation s/p eus for evaluation of gej mass found on endoscopy. patient was noted to have dysphagia and on endoscopy she had an adenocarcinoma . ct revealed no evidence nor metastatic disease although a small 1.x2cm lesion was noted in the uncinate process. she presented to the the gi endoscopy unit for further evaluation with eus. during the procedure she was noted to have a quater sized perforation. post op patient was hemodynamically stable. after discussion with patient her family she was emergently booked for surgical exploration. colonoscopy : single polypectomy in the sigmoid colon. patient states she has pain without radiation in the epigastrium, no nausea, no vomiting. this pain is new since the eus. no fevers, chills. + wght loss due to pain with eating secondary to dysphagia. no cp or sob with walking. past medical history: diverticulosis barretts hemorrhoids hypertension social history: single lives alone. has a very supportive daughter family history: non-contributory physical exam: vs: t: 98.0 hr; 77 sr bp: 118/70 sats: 94% ra wt: 116.5 lbs general: 76 year-old female in no apparent distress heent: normocephalic, mucus membranes moist neck: supple card; rrr normal s1,s2 no murmur resp: clear breath sounds throughout. no crackles or wheezes gi: bowel sounds positive, abdomen soft non-tender. j-tube in site incision: abdominal & neck site clean dry intact. no erythema neuro: awake, alert oriented pertinent results: cxr: : bilateral lungs are hyperexpanded suggestive of emphysema. left minimal pleural effusion and -basal lung atelectasis are no different as compared to the prior radiograph. lower lung atelectasis is unchanged. there are no new lung opacities of concern. the heart size is normal. mediastinal and hilar contours are stable. : substantial opacification is seen at the left base, consistent with pleural effusion and compressive atelectasis. on the right, there is only mild blunting of the costophrenic angle with mild atelectatic changes. : surgical drain overlies the upper mediastinum is unchanged. skin staples over the base of the left neck and midline of the abdomen and surgical staples projecting over the left upper quadrant are noted. there has been interval removal of a drainage catheter at the left lung base with slight increase in small left pleural effusion. small right pleural effusion is unchanged. there is mild interstitial edema as before. there is no new focal consolidation. heart size and mediastinal silhouettes are unchanged. there is mild atherosclerotic calcification of the aortic arch. hilar contours are normal. upper extremity doppler: : non-occlusive deep venous thromboses of the right distal internal jugular and axillary veins and occlusive right basilic venous thrombosis. the right subclavian vein could be fully evaluated but color doppler analysis shows wall-to-wall flow suggesting patency. wbc-7.9 rbc-3.69* hgb-11.0* hct-32.3* mcv-88 mch-29.7 mchc-34.0 rdw-15.8* plt ct-456* wbc-5.9 rbc-4.66 hgb-14.1 hct-40.0 mcv-86 mch-30.2 mchc-35.2* rdw-14.2 plt ct-167 glucose-133* urean-29* creat-1.2* na-141 k-4.0 cl-106 hco3-26 glucose-109* urean-15 creat-1.0 na-138 k-6.6* cl-107 hco3-22 calcium-8.6 mg-2.1 inr(pt)-1.5 inr(pt)-1.6 inr(pt)-2.3 inr(pt)-1.6 inr(pt)-1.3 inr(pt)-1.2 brief hospital course: mrs. presented on for endobronchial ultrasound to evaluate her esophageal mass which was complicated by esophageal perforation. thoracic surgery was consulted and she was taken to the operating room for exploratory laparotomy. transhiatal esophagectomy with laparoscopic jejunostomy. she transfer to the icu intubated. with aggressive pulmonary toilet and nebs she was successfully extubated . on she developed atrial fibrillation 140's amiodarone iv was initiated, hypotensive requiring low-dose pressors.she converted to sr 60's within 24 hrs. hypoxic requiring re-intubation. successfully extubated . pleural effusion: right & left thoracentesis for 450 ml & left 1 liter with pigtail placment removed right , left . cxr showed left lower pleural effusion which was residual left lower lobe effusion. chylous leak: pigtail fluid appeared chylous. her tf were changed to vivonex, nonfat with medium change triglycerides. drainage improved but on small amount of chylous was noted. thoracentesis on for 300 ml, pigtail remained which slowly taper off. octreotide was started she was placed on low-fat diet. the pigtail was removed . cxr with no effusion. respiratory: following extubation with aggressive incentive spirometer, nebs, ambulation, good pain control and diuresis she titrated off oxygen with saturations of 93%. cardiac: remained in sinus rhythm 60-70's following amiodarone iv load, converted to po 400 mg on and decrease to 200 mg daily on discharge. she had no further atrial fibrillation while hospitalized and can be tapered off as an outpatient. lisinopril was started once her blood pressure increased 140-160's. on hypotensive 80's responded to fluid challenges with bp 112-124. lisinopril was held. restarted her benzapril/hctz as an outpatient. gi: ngt was removed . bowel regime & aggressive ppi continued nutrition: followed by nutrition. vivonex was started and changed to replete on . on her ct output appearred chylous again and was changed to vivonex goal of 70 ml/hr. speech: seen by speech and swallow for bedside evaluation intermittent s/sx of aspiration with both thin and nectar-thick liquids. pt was noted with significant anxiety related to po intake, and it is possible that some of thesymptoms of aspiration or discomfort noted at bedside were due to this anxiety, however, aspiration cannot be r/o. video-swallow was done moderate-severe oropharyngeal dysphagia remarkable for aspiration of nectar thick liquids during the swallow. she was safe from an oropharyngeal standpoint for po intake of pureed solids and honey thick liquids only. she remained npo. she was re-evaluated on by speech and found to be less anxious and improved strength. she was started on pureed solids with honey thick liquids only. medications crushed with apple sauce. she was given swallow-strengthing exercise instructions for home. she will follow-up with speech in 2 weeks for repeat video-swallow. ent: voice weak and mild hoarsness. seen by ent for flexible laryngoscopy: nasal cavity, nasopharynx, oropharynx normal. hypopharynx with pooling in left pyriform. left vocal fold absent abduction, adduction, median position. right vocal fold normal abduction, adduction. they recommended diet per speech and swallow. lemg at 1 month post-op to determine prognosis if voice or swallowing worsens, will suggest temporary vocal fold injection as outpatient. renal: gentle diuresis with iv lasix. renal function within normal range with good urine output. electrolytes were replete as needed. dvt: right upper extremity edema noted. right upper extremity doppler showed non-occlusive deep venous thromboses of the right distal internal jugular and axillary veins and occlusive right basilic venous thrombosis. heparin-coumadin bridge was started. heparin d/c when inr 2.0. warfarin , 5 mg (inr 1.2), 5 mg 1.6, , 3 mg 1.6, 3mg 2.3 1mg, 1.6, 3mg, 1.5 discharge coumadin dose is 3mg. her pcp . was notified and agree to manage her coumadin as out patient. inr goal 2.0-2.5 disposition: seen by physical therapy who deemed her safe for home with rolling walker and home pt. she continue to make steady progress and was discharged to home with vna 1-, pt and speech. she will follow-up with dr. , speech, oncology, ent and her pcp as an outpatient. medications on admission: benazepril-hctz 20-12.5 discharge medications: 1. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr every twelve (12) hours. disp:*60 tablet,rapid dissolve, dr(s)* refills:*2* 2. trazodone 50 mg tablet : 0.5 tablet po at bedtime. disp:*30 tablet(s)* refills:*2* 3. amiodarone 200 mg tablet : one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 4. oxycodone-acetaminophen 5-325 mg/5 ml solution : five (5) ml po every 4-6 hours as needed for pain. disp:*300 ml(s)* refills:*0* 5. warfarin 1 mg tablet : three (3) tablet po take as directed: ij dvt inr goal 2.0-2.5. disp:*100 tablet(s)* refills:*2* 6. isosource 1.5 goal 60 ml/x 18 hours flush with 150 ml of water 4 times a day refills: 5 tube feed and supplies discharge disposition: home with service facility: vna discharge diagnosis: esophageal cancer barretts esophagus diverticulosis hypertension hemorrhoids discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: call dr. office if you experience: -fevers greater than 101 or chills -increased shortness of breath, cough or chest pain -nausea, vomiting (take anti-nausea medication) -increased abdominal pain -incision develops drainage or increased redness -j-tube falls out or suture breaks pain -roxicet via j-tube as needed for pain -take stool softners with narcotics activity -shower daily. wash incision with mild soap & water, rinse, pat dry -no tub bathing, swimming or hot tub until incision healed -no driving while taking narcotics -no lifting greater than 10 pounds until seen warfarin for right internal jugular dvt: inr goal 2.0-2.5 for 1-2 months. fingerstick inr daily. please call dr. office for warfarin dosing. lovenox injections twice daily (12 hours apart). stop when inr is 2.0 followup instructions: follow-up with dr. np date/time: following your speech and swallow appt chest x-ray radiology same time as video-swallow follow-up with dr. (fax) once discharged from hospital for further warfarin instructions follow-up with speech & swallow at 9:45 for a video-swallow exam. report to the clinical center radiology. procedure: insertion of intercostal catheter for drainage insertion of intercostal catheter for drainage continuous invasive mechanical ventilation for less than 96 consecutive hours other total gastrectomy other enterostomy insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis laryngoscopy and other tracheoscopy closed [endoscopic] biopsy of bronchus diagnoses: unspecified pleural effusion unspecified essential hypertension hyposmolality and/or hyponatremia 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 other complications due to other vascular device, implant, and graft barrett's esophagus stricture and stenosis of esophagus secondary and unspecified malignant neoplasm of lymph nodes of head, face, and neck malignant neoplasm of cardia other noninfectious disorders of lymphatic channels acute venous embolism and thrombosis of internal jugular veins acute venous embolism and thrombosis of superficial veins of upper extremity acute venous embolism and thrombosis of axillary veins 

Answer: The patient is high likely exposed to