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: patient recorded as having no known allergies to drugs attending: chief complaint: cc: major surgical or invasive procedure: ercp w/ removal of cbd stent and sphincterotomy intubation for hypoxia and icu admission history of present illness: 72 yo male with multiple sclerosis on chronic steroids admitted for elective cbd stent removal , developed mild bleeding post-sphincerotomy and now had episode of hypotension (sbp 70s) in the setting of a 7 point hct drop (although his hct may have been slightly hemoconcentrated on admission). initially presented with ascending cholangitis that required abx and cbd stent placement. he has been doing well since that admission. his hct in was in low 30s, however, today was 37.2 prior to procedure. during the ercp he had an episode of desaturation to 70s. his old stent was removed, he underwent a sphincterotomy and placement of a new stent. he received flumazenil and naloxone after he became hypoxic. his oxygen sats have been normal since then on 2liters nc. at 3:30am he developed acute onset sbp in 70s and st to 140s that responded to a few hundred cc of ivfs. he had an og lavage that showed cherry cola colored fluid that did not clear after 1200cc. after ogt removed, had 100cc emesis. concern was for upper gi bleed and airway protection so he was transferred to the icu for closer monitoring. past medical history: # multiple sclerosis: symptoms for one year (le weakness), diagnosed a few months ago, had bx of spinal cord as per pt, on prednisone and hypdrocortisone. # copd: has been on inhalers for a few years, never been intubated for or treated for copd flare. never had pfts. not on home o2. # "neurogenic bladder" by records but symptoms seem more consistent with bph- dribbling and difficulty initiating urination # cancer: s/o resection 10 years ago, no adjunctive treatment # osteomyelitis of left hip as child- left with difficulty walking for life but did not need cane . pshx: ccy resection resection of benign rul tumor appy right knee repair hernia repair x2 social history: shx: married. tobacco- 1pack per day for 60 years, quit 1.5 years ago no etoh. uses a walker to walk but rarely walks outside of home. family history: mother: ca physical exam: pe: nad. alert and oriented. perrl. neck supple. tachy s1/s2 cta, no wheezes abd soft, mildly distended, +bs, mildly distended no peripheral edema, lateral deviation of toes +dp pulses b/l pertinent results: 137/4.4/101/29/33/0.5/93, ag 7 alt-11, ast-15, ap-33, tuberculosis-0.6, -35, lip-43 7/37.2/216, 75%pmn hct 37.2-->30.4 after 11 hours . ekg: sinus tachycardia @100bpm, nl axis, nl intervals . cxr:enlargement of pulm knob, clear lung fields, left cp angle cut- off but clear on 1am x-ray 01:20pm blood wbc-7.0 rbc-4.12* hgb-12.5* hct-37.2* mcv-90 mch-30.3 mchc-33.6 rdw-15.5 plt ct-216 04:58pm blood wbc-14.1*# rbc-4.99 hgb-15.1 hct-43.5 mcv-87 mch-30.3 mchc-34.7 rdw-14.5 plt ct-77*# 08:36pm blood wbc-16.3* rbc-4.68 hgb-14.4 hct-40.6 mcv-87 mch-30.7 mchc-35.4* rdw-15.4 plt ct-80* 07:00am blood wbc-7.0 rbc-4.28* hgb-13.0* hct-38.1* mcv-89 mch-30.3 mchc-34.0 rdw-14.4 plt ct-192 01:20pm blood urean-18 creat-0.6 12:03am blood glucose-93 urean-33* creat-0.5 na-137 k-4.4 cl-101 hco3-29 angap-11 07:00am blood glucose-108* urean-9 creat-0.6 na-143 k-3.8 cl-102 hco3-33* angap-12 01:20pm blood alt-13 ast-39 alkphos-41 totbili-0.4 06:04am blood alt-16 ast-65* alkphos-40 amylase-24 totbili-2.6* 06:17am blood alt-20 ast-45* alkphos-35* amylase-31 totbili-1.7* 05:45am blood tsh-2.1 brief hospital course: 72 yo male with hx of ms, ascending cholangitis, s/p cholecystectomy, copd and rul resection for benign mass who presented for outpatient elective removal of cbd stent complicated by hypoxia and bleeding after sphincterotomy. hypotension/gi bleed - hypotension was secondary to significant gi bleed. pt received 10 units prbcs, 3 units ffp, and ivf for a total of 13l fluid resuscitation. gi performed egd which showed old blood but no active bleeding site. he had been started on stress dose steroids on floor given chronic steroid use and probable baseline adrenal insufficiency. this was continued initially but once stable, was quickly tapered to home dose. he then received iv lasix for diuresis given volume load during resucitation. his hct remained stable, and he did not require any further transfusions - the source of his gi bleed remained unclear. tachycardia/afib - pt with episode of atrial fibrillation on telemetry on . initially unclear if it was tachycardia causing hypotension or vice versa. however, he had 5l uop for the day, looked dry on exam, and so he was given ivf first with immediate improvement of bp to 110s/70s, hr slowed initially to 110s-130s, then converted to sinus rhythm after an addition 500cc bolus. this was most likely caused by hypovolemia. he was hydrated and lytes were repleted, and he remained in sinus rhythm. continued treatment for underlying infection as below. ventilatory support - pt was intubated given hypotension and respiratory distress. he received fluid resuscitation as described above and once stable, was extubated after sbt and rsbi of 30. unclear cause of hypoxia although hypervolemia due to fluid resuscitation was on the differential. pt was breathing comfortably on ra at time of discharge. pna - pt with likely pneumonia given rul opacity on exam. sputum grew pseudomonas; pt clinically stable. he was given empiric treatment with vanco and zosyn for 7 days, with subsequent decrease in sputum production and resolution of leukocytosis. biliary stent - lft's stabilized. not thought to have biliary source for sepsis. will need repeat ercp at some point as outpatient for removal of stent. tolerating po at time of discharge. copd - on inhalers while intubated and changed over to nebs after extubation. held albuterol given tachycardia. he was also given steroids for ms adrenal insufficiency. thrombocytopenia - dic labs wnl, concern for hit so avoided all heparin products. hit ab was sent which was found to be negative. ms - pt is bedbound given acute illness. he was given a steroid taper and arranged for outpatient services. ppx - he was given ppi, bowel regimen, and pneumoboots for prophylaxis. code status - full medications on admission: meds on admission: prednisone 15mg po daily fludrocrtisone 0.1mg ativan metoprolol 25mg ---??? asa 325mg daily prevacid 30mg daily advair 250/50- one puff spiriva- two puffs daily caclium and vitamin d daily citalopram 20 mg daily kcl 40meq daily discharge medications: 1. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 3. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 4. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 5. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 6. fludrocortisone 0.1 mg tablet sig: one (1) tablet po daily (daily). 7. albuterol 90 mcg/actuation aerosol sig: 2-4 puffs inhalation q4h (every 4 hours). disp:*1 bottle* refills:*2* 8. lorazepam 0.5 mg tablet sig: one (1) tablet po twice a day. 9. citalopram 20 mg tablet sig: one (1) tablet po once a day. 10. prednisone 10 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: vna discharge diagnosis: s/p ercp w/ post-sphincterotomy bleed hypoxia s/p intubation thrombocytopenia pneumonia multiple sclerosis copd discharge condition: stable, breathing comfortably on room air w/ stable hct discharge instructions: please go to the ed or call your physician if you have nausea, vomiting, increased abdominal pain, change in your skin color, diarrhea or constipation, shortness of breath, chest pain, dizziness, fever, chills or any other symptoms that are concerning to you. . take your medications as directed. please do not take aspirin at this time. followup instructions: please call dr. office to schedule a repeat ercp in the next month. . make sure to follow up with your primary care physician in the next few weeks. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours other endoscopy of small intestine insertion of endotracheal tube endoscopic sphincterotomy and papillotomy endoscopic insertion of stent (tube) into bile duct removal of t-tube, other bile duct tube, or liver tube transfusion of packed cells transfusion of other serum diagnoses: acidosis long-term (current) use of steroids acute posthemorrhagic anemia atrial fibrillation hemorrhage complicating a procedure acute respiratory failure pneumonia due to pseudomonas other shock without mention of trauma other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other emphysema multiple sclerosis 

Answer: The patient is high likely exposed to