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: iodine; iodine containing / bee pollens attending: chief complaint: obstructive jaundice major surgical or invasive procedure: exploratory laparotomy, hepaticojejunostomy, bile duct biopsy. history of present illness: 70 year old male with h/o whipple in ' for duodenal adenocarcinoma and esophagectomy for esophageal squamous cell ca in who became jaundiced with fever in . mrcp on showed diffuse dilatation of intrahepatic biliary tree. cholangiogram demonstrated a high-grade stricture in the common hepatic duct, with dilation in both r and l hepatic duct. placement of an 8.5 french 25 cm ultra thin - biliary drain in the left hepatic duct. mrcp on showed a 1.9 x 2.8 x 2.8 cm mass concering for cholangiocarcinoma,located centrally in klatskin location, causing obstruction of r and left hepatic bile ducts. on , he had internalization of existing left-sided biliary catheter and a r internal-external biliary catheter was placed. he is now admitted for exploratory laparotomy, hepaticojejunostomy, bile duct biopsy. past medical history: duodenal adenocarcinoma (whipple surgery in ), esophageal squamous cell cancer with esophagectomy in , dental abscess with drainage in , left incisional hernia repair in , right incisional hernia repair . echo (pmg internal medicine and cardiology, ): normal lv and rv size and systolic function mild thickening of the aortic and mitral valves without vegetations or stenosis trace ar, mr, and tr. stress echo (dr. , ) social history: no alcohol or tobacco use. no history of recreational drug use. he is happily married in . family history: n/c physical exam: post op t-101, 84, 96/57, 18, 98%2l, 68.7 kg gen: drowsy but arousable, c/o pain with movement heent: temporal wasting noted, dry mucous membranes card: rrr, no m/r/g lungs: cta bilaterally abd: 3 ptc drains in place with bilious appearing fluid and 1 jp. abdomen soft, tender on palpation non-distended extr: no edema, 2+ dps neuro: no focal deficits skin: warm and dry gu: foley in place, 400 cc in bag pertinent results: on admission: wbc-9.1 rbc-3.73* hgb-11.0* hct-32.3* mcv-87 mch-29.5 mchc-34.1 rdw-20.6* plt ct-487* pt-15.8* ptt-34.4 inr(pt)-1.4* glucose-102 urean-11 creat-0.4* na-136 k-4.0 cl-101 hco3-26 angap-13 alt-119* ast-183* alkphos-226* totbili-3.5* on discharge wbc-5.7 rbc-3.52* hgb-10.6* hct-30.4* mcv-86 mch-30.1 mchc-34.8 rdw-18.5* plt ct-468* glucose-84 urean-11 creat-0.7 na-135 k-3.6 cl-102 hco3-26 angap-11 alt-30 ast-33 alkphos-600* totbili-2.2* brief hospital course: 70 y/o male admitted following exploratory laparotomy, hepaticojejunostomy, bile duct biopsy. he was taken to the or with dr . in summasry: the hilum was densely scarred with extensive sclerotic reaction. no tumors or malignancies demonstrated within the metastatic deposits within the abdominal cavity or on the liver itself. on the distal aspect of bile duct there appeared to be a large amount of sclerotic tissue and possibly intraluminal mass. a piece of this was sent for frozen section analysis which came back benign fibrosis tissue. a number of attempts were made to try to peel the common bile duct off the portal vein; but at each time, ultimately created a large venotomy in the portal vein. after several attempts at this and requiring suture closure of the manner of the venotomy in the portal vein, we did not believe that we could safely complete the resection. extending further up into the hilum, there was extensive sclerotic reaction, and at this time patient was deemed unresectable. the hepaticojejunostomy was reapproximated. please see the operative note for full details. in the post op period in the pacu the patient became hypotensive and was febrile to 101.9. he received a fluid bolus, was cultured and was transferred to the sicu for monitoring. blood and urine cultures reported as no growth. he was started on cipro which continued through the hospitalization. he was slowly transitioned to pos on he underwent tube cholangiogram which showed evidence of a small leak at the level of the hepaticojejunostomy anastomosis. contrast is demonstrated to slowly enter the surgically placed jp drain in the right upper abdominal quadrant. as well, he has redemonstration of hilar, right and left biliary strictures as before. ct of abdomen on shows: four drainage catheters are in place, including: the external-internal biliary drain, a right lateral drain coursing through the liver and terminating at the hepaticojejunostomy (2:23), a drain entering the skin at the right lower abdomen and coursing superiorly and terminating medial to the left lobe of liver near the diaphragm, and a drain entering the left mid abdomen, coursing medially, possibly through the left lobe of liver into the hepatic hilum. the second mentioned drain located in the right lateral abdomen posterior to the external-internal biliary drain is well positioned adjacent to the hepaticojejunostomy, at the site of demonstrated leak. no significant collection is seen surrounding this drainage tube. the internal/exernal biliary drain was capped during the course of the hospitalization, however, the jp drain exhibited an increase in the bilious appearance of the fluid, and the decision was made to uncap all drains and ptcs. patient to have cholangiogram during the following week and follow up with dr to determine plan of care. he remained afebrile and was discharged home on po cipro. he was tolerating diet and using supplements and was ambulating. medications on admission: viokase (4 tablets) tid, mvi 1 qd, colace 100mg , senna 1 prn , vicodin 1 tab prn (~ 3 tabs per day for last 2 weeks) discharge medications: 1. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 2. amylase-lipase-protease 30,000-8,000- 30,000 unit tablet sig: 3-4 tablets po tid (3 times a day): with meals. 3. hydrocodone-acetaminophen 5-500 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*20 tablet(s)* refills:*0* 4. docusate sodium 100 mg capsule sig: two (2) capsule po bid (2 times a day). 5. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours). disp:*60 tablet(s)* refills:*2* 6. multivitamin tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: intake discharge diagnosis: hepatic cholangiocarcinoma vs sclerotic tissue s/p radiation therapy biopsy not definitive discharge condition: good discharge instructions: please call for fever > 101, chills, nausea, vomiting, diarrhea, inability to take or keep down medications, increased fatigue, yellowing of skin or eyes or any other concerning symptoms. the drains will be left open to bag drainage for now. measure and record drainage twice daily or more often as necessary, bring copy with you to clinic visit. note the color of the drainage, especially in the jp drain. please call if this becomes a darker yellow or brownish/green color, has blood in the drain or develops a foul odor. you will be scheduled for a repeat cholangiogram for the middle of next week. dr office will be in touch regarding the scheduling of this test. monitor the incision for redness, drainage or bleeding. the staples will come out next week. no heavy lifting no driving if taking vicodin or any other narcotic pain medication followup instructions: cholangiogram week of dr , week of . office will be in contact for appointment procedure: other cholangiogram anastomosis of hepatic duct to gastrointestinal tract open biopsy of gallbladder or bile ducts diagnoses: cholangitis obstruction of bile duct personal history of malignant neoplasm of other gastrointestinal tract malignant neoplasm of intrahepatic bile ducts personal history of malignant neoplasm of esophagus 

Answer: The patient is high likely exposed to