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 attending: chief complaint: sepsis major surgical or invasive procedure: none history of present illness: ms. is a 66 year old woman with a pmh of esrd secondary to dm, on hd who was in her usual state of health until she presented at hd with altered mental status and hypotension. she initiated hd about 2 weeks ago, dialyzing m,w,f. she was then sent to the osh ed for evaulation of her hypotension. at the she was found to have a wbc of 41.7 with 94 segmented neutrophils. her labs were also notable for a hct of 29.4. also of note, she had an alk phos of 1023. at the osh ed, she received 2 l ns, 3.375 mg zosyn, and 1 gm vancomycin after blood and urine cultures were sent. she was started on dopamine for a blood pressure of 53/45. arrangements were made for transfer to our ed. the patient notes that she has not taken her medications for two days because she ran out of some of them. she also states that she is in chronic stable back and abdominal pain. the pain starts in the right flank and radiates to the right uq and axilla. mrcp done to evaluate this was negative for stones but a biopsy of the liver showed mucinous adenocarcinoma on . . ros: + night sweats, fatigue, anorexia, nausea, emesis x 1. denies cp, hematemesis or hematochezia past medical history: niddm chf pna gallstones cri, secondary to dm and chronic nsaids, now on hd through rij, although patient noncompliant with regimen chf liver ca: primary cholangiocarcinoma or pancreatobiliary carcinoma hurthle cell adenoma chronic back pain on narcotics from lumbar disk disease diabetic retinopathy s/p laser treatments social history: lives with her son but there is a question of protective services per notes. smoker. denies etoh or illicits. former candystriper. her dog and cat need to be euthanized and this is stressing her out. her mom is also at home and sick. . family history: noncontributory physical exam: vitals - t bp 90/38 on dopa hr 104 rr gen- pleasant, cooperative, son and his friend sitting at her side dry mmm neck- supple, no lad cor-tachy, regular, iii/vi murmur best heard at lusb pulm- ctab but poor effort back- mild ttp at costophrenic angle abd- ttp localizing to ruq, no rebound, no guarding, soft ext- hands cold, legs with 2+ edema to thighs neuro- a+o x 3, cn ii-xii individually tested and intact, strength lower extremities but poor effort pertinent results: 08:35pm wbc-46.5* rbc-3.63* hgb-9.6* hct-32.7* mcv-90 mch-26.4* mchc-29.3* rdw-17.7* 08:35pm neuts-90* bands-6* lymphs-2* monos-1* eos-1 basos-0 atyps-0 metas-0 myelos-0 08:35pm plt count-153 08:35pm ck-mb-notdone ctropnt-0.13* 08:35pm lipase-15 08:35pm alt(sgpt)-52* ast(sgot)-139* ld(ldh)-872* ck(cpk)-81 alk phos-1054* tot bili-0.7 08:35pm glucose-147* urea n-54* creat-5.7* sodium-138 potassium-4.1 chloride-99 total co2-24 anion gap-19 08:42pm lactate-2.2* 09:10pm urine blood-tr nitrite-neg protein-30 glucose-neg ketone-tr bilirubin-sm urobilngn-neg ph-6.5 leuk-tr ............ ruq: 1. diffusely enlarged liver with multiple masses consistent with tumor. 2. decompressed gallbladder with wall thickening. 3. intrahepatic biliary dilatation. further evaluation with mrcp or ercp is recommended. ............... cxr impression: small right effusion with associated atelectasis. if there is a persistent concern for pneumonia and lateral view would be recommended to fully exclude right lower lobe pneumonia ........... echo conclusions: 1. the left atrium is moderately dilated. 2. there is severe symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. left ventricular systolic function is hyperdynamic (ef>75%). there is a mild resting left ventricular outflow tract obstruction. 3. the aortic valve leaflets are mildly thickened. 4. the mitral valve leaflets are mildly thickened. ............. ct chest/abd/pelvis impression: 1. large, diffuse infiltrating mass within the right lobe of the liver with possible peritoneal carcinomatosis. enlarged retroperitoneal lymph nodes, left adrenal mass and multiple lung nodules consistent with metastatic disease. 2. small, bilateral pleural effusions. 3. intrahepatic biliary dilatation, likely from the obstructing tumor. ............ ekg sinus tachycardia. right axis deviation. there is a late transition with anterior and anterolateral and lateral st-t wave changes consistent with possible right ventricular hypertrophy or ischemia. compared to the previous tracing of right axis deviation is new and the st-t wave changes are more prominent. .................. ct chest/abd/pelvis: 1. large, diffuse infiltrating mass within the right lobe of the liver with possible peritoneal carcinomatosis. enlarged retroperitoneal lymph nodes, left adrenal mass and multiple lung nodules consistent with metastatic disease. a contrast-enhanced study is recommended. if renal function precludes this, consider mri. 2. small, bilateral pleural effusions. 3. intrahepatic biliary dilatation, likely from the obstructing tumor. brief hospital course: a/p 66 y.o. with esrd on hd with markedly elevated wbc and hypotension of unclear etiology. . # hypotension: mrs. presented with persistent hypotension of unclear source. she was not previuosly dialyzed. sepsis was considered from hd line or intraabdominal process. pancytopenia in presence of leukocytosis concerning for hematologic malignancy. she had daily blood cultures, none of which grew anything by the time of this summary. cultures from the osh did not grow anything. her diltiazem was held. she required 2 pressors, and was still somewhat hypotensive. she was treated with vanco, levo, flagyl for a possible line infection. renal was consulted and it was decided not to pull her hd line in case she needed dialysis. ct of the abdomen showed a large mass in the right lobe of her liver, with possible peritoneal and lymph node involvement. over the course of her short stay her blood pressure remained low. he son was consulted and she was made dnr/dni. he flew up from to see her and to talk with his family about cmo. shortly after his arrival mrs. died of cardiac arrest. . # leukocytosis: mrs. had an elevated wbc count of unclear source. as discussed above all cultures were negative, and she received empiric antibiotic treatment with vanc, levo, flagyl. a tte evaluation for vegetations (she had a murmur) was negative. hematology/oncology was consulted, and felt that she had incurable disease with a grim prognosis. in her condition on admission there was no possible treatment option. this was discussed with her son , and contributed to his decision to make her dnr/dni. . # esrd: mrs. had been on hd for the last 2 weeks prior to admission. there was no indication for acute hd although she missed a few dialysis appointments. however, her hd line was left in place in case she did need hd during her stay. given her clinical deterioration though, she was not dialysed. . #coagulopathy - mr. had an elevated ptt and pt which was thought to possible be due to liver disease, or her large tumor burden. dic panel was negative. . # dm: mrs. sugars were controlled with a riss. . # hepatic mucinous adenocarcinoma: hematology/oncology was consulted, and felt that she had incurable disease with a grim prognosis. in her condition on admission there was no possible treatment option. lfts were followed and were elevated throughout, particularly ast and alk phos. her pain was controlled on her home regimen of oxycodone. . # prophylaxis: mrs. was on a ppi, sq heparin, and a bowel regimen . # full code on admission, then dnr/dni, then expired before family decided on cmo. . # access: mrs. had a lij, l a-line . # dispo: mrs. died monday at 9pm of cardiac arrest, thought to be secondary to her malignancy. an autopsy was declined by her family. medications on admission: epo 3 x week phoslo 2 tid prozac 20 mg qd diltiazem 120 qd albuterol flovent lipitor 20 mg zemplar 4 mcg 3 x week oxycontin 20 mg oxycodone 5 mg prn discharge medications: n/a discharge disposition: expired discharge diagnosis: expired discharge condition: expired discharge instructions: n/a followup instructions: n/a md procedure: hemodialysis infusion of vasopressor agent diagnoses: tobacco use disorder unspecified pleural effusion congestive heart failure, unspecified acquired coagulation factor deficiency unspecified septicemia severe sepsis hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease cardiac arrest secondary malignant neoplasm of lung other and unspecified disc disorder, lumbar region malignant neoplasm of liver, not specified as primary or secondary obstruction of bile duct diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled secondary malignant neoplasm of retroperitoneum and peritoneum 

Answer: The patient is high likely exposed to