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 / methotrexate / aspirin attending: chief complaint: esophageal cancer major surgical or invasive procedure: minimally invasive esophagectomy with gastric pull-up history of present illness: mr. is a 71 yo m who had an egd done in for abdominal pain with weight loss. this demonstrated an esophageal mass. biopsy demonstrated poorly differentiated adenocarcinoma. t3 lesion on eus. he completed neoadjuvant chemoradiation therapy and now presents for definitive surgery with a minimally invasive esophagectomy with gastric pull-up in cooperation with dr. of thoracic surgery. past medical history: pmh: esophageal cancer, poorly differentiated adenocarcinoma, eus showing t3 lesion, s/p neoadjuvant chemoradiotherapy, hypertension, hyperlipidemia, rheumatoid arthritis, hemorrhoids, gerd psh: hemorrhoidectomy, laparoscopic cholecystectomy, rhinoplasty, and tooth extraction social history: he lives in and worked as a property manager but was just laid off. he has a significant other - - who has been helping to take care of him. he was formerly a heavy drinker, however, cut back in the last 10 years or so, now drinks two to three drinks a night, although less recently. he smoked three packs a day for 30 years but quit 35 years ago. no illicits. family history: family history: - mother: uterine cancer in her 70s - father: cad, colon cancer in his 50s - brother with multiple dystrophy - brother: prostate cancer. physical exam: at surgical consultation: on physical examination, he is a well-developed gentleman. head, eyes, ears, nose, and throat are normal. he has dentures. the neck is supple, without mass, nodes, or thyromegaly. chest is clear to percussion and auscultation. heart sounds are regular without murmurs or gallops. the abdomen is soft without tenderness, mass, or organomegaly. there are well-healed laparoscopic scars. extremities are without cyanosis, clubbing, or edema. he is neurologically intact. pertinent results: pet scan : 1. marked fdg-avidity at the gastroesophageal junction, compatible with known carcinoma. 2. no metastatic disease identified. barium esophagogram : 1. no leak at the site of anastomosis. 2. pneumoperitoneum, which is expected post-surgically, unchanged from . brief hospital course: mr. minimally invasive esophagectomy with gastric pull-up on and was admitted to the general surgery service. immediately after the surgery, he was taken, after being extubated, to the surgical icu for close monitoring. overall, he had a smooth hospital course and was discharged home on post-op day 9 in stable condition. his post-operative course is summarized below by system. neuro: while npo, the patient received iv narcotics with good effect. this was transitioned to liquid oxycodone and liquid acetaminophen after he began taken pos and he was discharged with pain well controlled on oral medications. he has baseline anxiety which was treated while in house with benzodiazapines with satisfactory effect. cv/fluids/electrolytes: the patient received adequate fluids postop and was bolused as needed to maintain sbp. pressors were avoided in order to protect the anastamosis. the patient responded well to these interventions and there were no major issues during his stay. he received metoprolol iv while npo and had some ectopy thought to be related to low mg, which was repleted. he was put back on his home dose of atenolol after he was able to tolerate them enterally. his ekg did not show any concerning changes. pulm: the chest tubes were kept until after the patient had his barium swallow on pod 6 and it was read as negative. the chest tubes as well as the neck jp were removed on pod 7. of note, he had been complaining of severe back pain thought to be related to irritation from the chest tubes. ekgs were performed to assure us that it was not cardiac in origin. this pain completely resolved with removal of the tubes. gi/nutrition: the patient had had previous placement of a jtube and had been receiving tube feeds at home. on pod 2, these tube feeds were restarted through the jtube for nutritional support. on pod6, the ngt was removed after a negative barium swallow and he was started on a clear liquid diet. on pod7, he was advanced to a soft solid diet, on which he was discharged. gu: after the patient became ambulatory and was thought able to handle urinating on his own, the foley catheter was removed and he was able to void without issue. id: the patient received routine antibiotic prophylaxis in the perioperative period. these were appropriately discontinued postop. heme: the patient had baseline anemia prior to the operation, requiring transfusions in the months prior to the operation. postop, the patient did well, but was noted to have a low hematocrit. in order to protect the anastamosis, he was transfused three units packed red blood cells to maintain a hematocrit of 30. after the initial postop period, he required no further transfusions. discharge medications: 1. docusate sodium 50 mg/5 ml liquid sig: ten (10) ml po bid (2 times a day). disp:*600 ml* refills:*2* 2. acetaminophen 650 mg/20.3 ml solution sig: six y (650) mg po q6h (every 6 hours) as needed for pain. disp:*600 ml* refills:*2* 3. oxycodone 5 mg/5 ml solution sig: ml po q3h (every 3 hours) as needed for pain. disp:*300 ml* refills:*0* 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 5. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain . disp:*50 tablet(s)* refills:*0* 6. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* 7. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 8. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation. 9. lorazepam 0.5 mg tablet sig: 1-2 tablets po q8h (every 8 hours) as needed for anxiety. disp:*30 tablet(s)* refills:*0* 10. atenolol 50 mg tablet sig: one (1) tablet po daily (daily). 11. ondansetron 4 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po every eight (8) hours as needed for nausea. disp:*50 tablet, rapid dissolve(s)* refills:*0* 12. peptamen 1.5 liquid sig: seventy five (75) cc po qhour: please run 75 cc/hr cycled over 12 hours at night. disp:*120 cans* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: esophageal cancer s/p esophagectomy with gastric pull-up atrial ectopy discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: please call your doctor or return to the er if you experience the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *your pain is not improving within 8-12 hours or is not gone within 24 hours. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. general discharge instructions: please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. avoid driving or operating heavy machinery while taking pain medications. please follow-up with your surgeon and primary care provider (pcp) as advised. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. *if you have staples, they will be removed at your follow-up appointment. *if you have steri-strips, they will fall off on their own. please remove any remaining strips 7-10 days after surgery. followup instructions: please follow up with dr. on at 3:45 in his office. call dr. office at ( for any problems before then. provider: , md phone: date/time: 2:00 provider: , md phone: date/time: 2:30 provider: , md phone: date/time: 2:30 your port was deaccessed and heparin locked today (). please remember to get your port flushed and heparin locked per nursing protocol every month. procedure: other total gastrectomy enteral infusion of concentrated nutritional substances laparoscopy diagnoses: obstructive sleep apnea (adult)(pediatric) anemia, unspecified esophageal reflux hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified other and unspecified hyperlipidemia rheumatoid arthritis malignant neoplasm of cardia unspecified hemorrhoids without mention of complication 

Answer: The patient is high likely exposed to