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: no known allergies / adverse drug reactions attending: chief complaint: pancreatic head mass major surgical or invasive procedure: - pylorus-sparing pacreaticoduodenectomy (whipple procedure) history of present illness: this is a 62-year old female who presented initially with obstructive jaundice. she underwent ercp at hospital on with sphincterotomy, brushings and stent placement across a mid-biliary duct stricture. fine-needle aspiration biopsy performed on revealed necrotic debris, with remaining concerns for malignancy given the findings of a pancreatic head mass on endoscopic ultrasound. she was admitted electively on following her pancreaticoduodenectomy (whipple procedure). past medical history: pmh: former smoker (20 pack-year), obesity, meniere disease, psh: tonsillectomy, appendectomy social history: attests to 0.5 packs-per-day for 40-years (20 pack-year), rare alcohol use ( drinks/year), denies recreational substance use family history: non-contributory physical exam: vitals: afebrile, vitals signs stable. heent: normocephalic, atraumatic. eomi. perrl. nares clear. mucous membranes moist. neck supple without lymphadenopathy. cvs: regular rate and rhythm, without murmurs, rubs or gallops. s1 and s2. resp: clear to auscultation bilaterally without adventitious sounds. no wheezing, rhonchi or crackles. abd: soft, obese-appearing, appropriately tender, non-distended, with normoactive bowel sounds. no masses or peritoneal signs. extr: no cyanosis, clubbing or edema, 2+ peripheral pulses incision: transverse incision is clean, dry and intact, without evidence of erythema or drainage. minimal serosanguinous drainage noted. staples open to air with steristrips between. pertinent results: 02:44am blood wbc-9.2 rbc-3.78* hgb-12.9 hct-37.6 mcv-99* mch-34.0* mchc-34.2 rdw-14.3 plt ct-239 06:10am blood creat-0.6 na-138 k-3.8 cl-94* 02:44am blood calcium-8.5 phos-3.0 mg-2.5 11:24 am bile fluid should not be sent in swab transport media. submit fluids in a capped syringe (no needle), red top tube, or sterile cup. gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. wound culture (final ): a swab is not the optimal specimen collection to evaluate body fluids. klebsiella oxytoca. rare growth. piperacillin/tazobactam sensitivity testing available on request. sensitivities: mic expressed in mcg/ml _________________________________________________________ klebsiella oxytoca | ampicillin/sulbactam-- 4 s cefazolin------------- 16 i cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s anaerobic culture (final ): no anaerobes isolated. fungal culture (preliminary): no fungus isolated. pathology examination name birthdate age sex pathology # , 62 female report to: dr. gross description by: dr. , dr. /dif specimen submitted: gallbladder, omentum, whipple specimen. procedure date tissue received report date diagnosed by dr. . /vf diagnosis: 1. omentum (a-d): unremarkable adipose tissue; no malignancy identified. 2. gallbladder (e-i): chronic cholecystitis and cholelithiasis. one unremarkable lymph node, no malignancy identified. 3. whipple specimen (j-ad): pancreatic ductal adenocarcinoma arising in association with an intraductal pancreatic mucinous neoplasm; see synoptic report. pancreas (exocrine): resection synopsis staging according to american joint committee on cancer staging manual -- 7th edition, macroscopicl: specimen type: pancreaticoduodenectomy, partial pancreatectomy. tumor site: pancreatic head. tumor size greatest dimension: 1.2 cm. additional dimensions: 1.2 cm x 1.0 cm. other organs/tissues received: gallbladder, omentum. microscopic: histologic type: ductal adenocarcinoma. histologic grade: g1: well differentiated. extent of invasion primary tumor: pt3: tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery. regional lymph nodes: pn0: no regional lymph node metastasis. lymph nodes number examined: 4. number involved: 0. distant metastasis: pmx: cannot be assessed. margins: margins uninvolved by invasive carcinoma: distance from closest margin: 4 mm. specified margin: posterior margin (black-inked). venous/lymphatic vessel invasion: absent. perineural invasion: absent. additional pathologic findings: chronic pancreatitis, intraductal papillary mucinous tumor with high-grade dysplasia involving main and side branch pancreatic ducts. clinical: pancreatic mass. ap chest: impression: ap chest compared to and at 4:37 a.m.: small region of heterogeneous opacification at the right lung base has been present for several days. whether this is pneumonia or atelectasis is indeterminate. pulmonary vasculature is minimally engorged, and there is no pulmonary edema. pleural effusion if any is minimal. cardiomediastinal silhouette is normal. there is no obvious explanation for new hypoxia. brief hospital course: neuro/pain: the patient was maintained on iv pain medication in the immediate post-operative period and had an epidural catheter in place in the immediate post-op period; and was transitioned to po narcotic medication with adequate pain control on pod#. the patient remained neurologically intact and without change from baseline during their stay. the patient remained alert and oriented to person, location and place. cardiovascular: the patient remained hemodynamically stable intra-op and in the immediate post-operative period. she did require a minor amount of neosynephrine gtt iv intra-operatively, but this was weaned without post-op requirement, and she remained hemodynamically stable. the patient was maintained on iv anti-hypertensive medication in the immediate post-op period, with transition to their oral home anti-hypertensives on pod#. their vitals signs were closely monitored. the patient's home anti-hypertensive medications were resumed on pod#. respiratory: he patient was extubated in the immediate post-op period successfully, but given some hypercarbia and carbon dioxide retention attributed to underlying smoking history and likely a copd component, the patient was 93% on non-rebreather in the pacu and required re-intubation before transfer to the surgical icu for futher monitoring. the patient was weaned to cpap and tolerated this well on pod#3, with successful extubation on pod#3. the patient denied cough or respiratory symptoms following this, but continued to require supplemental oxygen. pulse oximetry was monitored closely and the patient maintained adequate oxygenation on liters of nasal cannula supplementation, requiring home oxygen on discharge to rehab. intermittent lasix iv was given for diuresis. gastrointestinal: the patient was npo following their procedure and maintained on iv fluids for hydration while npo. serial abdominal exams were performed, and once flatus resumed, the patient was transitioned to a clear liquid diet and their iv fluids were hep-locked on pod#7. the patient experienced no nausea or vomiting. a nasogastric tube was maintained until the output was minimal, and was removed on pod#3. a regular diet was initiated on pod#9 and the patient tolerated this well. the patient was maintained on octreotide in the post-op period as well, which was discontinued on pod#9. -/ drain remained in place post-operatively, anf the output was greater than 30 cc in a 24-hour period, thus she was discharged with the drain in place. the - drain had an amylase level of 18 on pod#8, after the patient tolerated full liquids, and she was transitioned to diet without issue. genitourinary: the patient's urine output was closely monitored in the immediate post-operative period. a foley catheter was placed intra-operatively and removed on pod#4, at which time the patient was able to successfully void without issue. the patient's intake and output was closely monitored for urine output > 30 ml per hour output. the patient's creatinine was stable. a mild transaminitis was noted following her procedure, which was attributed to clamping of the bile duct during the procedure. her lfts were trended and improved appropriately. heme: the patient's post-op hematocrit was stable and trended closely. the patient remained hemodynamically stable and did not require transfusion. the patient's coagulation profile remained normal. the patient had no evidence of bleeding from their incision. id: the patient showed no signs of infection and remained afebrile in the post-op period. their white count was stable post-operatively and their incision was closely monitored for any evidence of infection or erythema. the patient received only standard peri-operative antibiotics, and did not require further antibiotics post-op. endocrine: the patient's blood glucose was closely monitored in the post-op period with q6 hour glucose checks. blood glucose levels greater than 120 mg/dl were addressed with an insulin sliding scale. prophylaxis: the patient was maintained on heparin 5000 units sq tid for dvt/pe prophylaxis and encouraged to ambulate immediately post-op once cleared by physical therapy. the patient also had sequential compression boot devices in place during immobilization to promote circulation. gi prophylaxis was sustained with protonix/famotidine when necessary. the patient was encouraged to utilize incentive spirometry, ambulate early and was discharged in stable condition to a pulmonary rehabilitation facility. medications on admission: tylenol 1000 mg po bid, calcium carbonate prn, naprosyn prn discharge medications: 1. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*45 tablet(s)* refills:*0* 2. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 3. ipratropium bromide 0.02 % solution sig: one (1) nebulizer inhalation q6h (every 6 hours) as needed for wheeze/sob. 4. metoclopramide 10 mg tablet sig: one (1) tablet po four times a day. 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 6. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation every six (6) hours as needed for shortness of breath or wheezing. 7. colace 100 mg capsule sig: one (1) capsule po twice a day. discharge disposition: extended care facility: life care center of discharge diagnosis: pancreatic head mass post-op respiratory failure discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to dr. surgical service for evaluation and management of your pancreatic head mass, following your whipple procedure. you are now being discharged in rehab. please follow these instructions to aid in your recovery: please call your doctor or go to the emergency department if: * you experience new chest pain, pressure, squeezing or tightness. * you develop new or worsening cough, shortness of breath, or wheezing. * you are vomiting and cannot keep down fluids, or your medications. * if 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 an unusual discharge. * your pain is not improving within 12 hours or is not under control within 24 hours. * your pain worsens or changes location. * you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. * you develop any other concerning symptoms. * please resume all regular home medications, unless specifically advised not to take a particular medication. * please take any new medications as prescribed. * please take the prescribed analgesic medications as needed. you may not drive or operate heavy machinery while taking narcotic analgesic medications. you may also take acetaminophen (tylenol) as directed, but do not exceed 4000 mg in one day. * please get plenty of rest, continue to walk several times per day, and drink adequate amounts of fluids. * avoid strenuous physical activity and refrain from heavy lifting greater than 10 lbs., until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. * please also follow-up with your primary care physician. incision care: * please call your surgeon or go to the emergency department if you have increased pain, swelling, redness, or drainage from the incision site. * avoid swimming and baths until cleared by your surgeon. * you may shower and wash 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: provider: , md phone: date/time: 9:30 3, please follow up with your primary care physician weeks following discharge. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours radical pancreaticoduodenectomy cholecystectomy diagnoses: acidosis unspecified essential hypertension malignant neoplasm of head of pancreas obesity, unspecified m?ni?re's disease, unspecified 

Answer: The patient is high likely exposed to