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: history of present illness: the patient is a 54-year-old gravida 2 para 2 with a history of stage iiib cervical cancer who presented for a total pelvic exenteration secondary to cancer recurrence on bladder biopsy which was performed on . the patient had initially presented in with heavy irregular vaginal bleeding. a cervical biopsy in showed invasive squamous cell carcinoma. at this time she was stage iiib. the patient began cisplatin and radiation therapy in . at that time she was also noted to have left-sided hydronephrosis secondary to cancer obstruction and a double-j ureteral stent was placed on the left side. in the patient had completed five cycles of cisplatin and concomitant radiation therapy. in , the patient had brachytherapy (50 hours), on , a ct scan showed no metastases. on , the patient had a cystoscopy to replace a double-j stent in her left ureter. at that time a bladder mass was found which was biopsied. pathology showed that it was recurrent cervical carcinoma in the bladder. on , a ct scan showed no metastases; therefore, it appeared that the patient had an isolated central pelvic recurrence. at that point, the treatment options were discussed with the patient and that total pelvic exenteration would be the curative option at this point. once the procedure was discussed with the patient, including the risks and benefits of the procedure, and all questions were answered, she was consented for a total pelvic exenteration. only complaint on admission was urinary frequency and occasional hematuria. past gynecological history: please see history of present illness for details of stage iiib cervical cancer. no history of abnormal pap smears; although, her last pap smear was nine years prior to diagnosis of cancer. the patient denies a history of sexually transmitted diseases or endometriosis. past obstetrical history: status post spontaneous vaginal delivery times one and cesarean section times one. no complications with either procedure. past medical history: in the patient was diagnosed with melanoma of her right posterior calf, stage level 4. a surgical excision was performed without complications. there was no evidence of recurrence. past surgical history: cesarean section times one. medications on admission: valium 5 mg p.o. t.i.d. p.r.n. allergies: iv contrast and bactrim. social history: the patient is a cardiac nurse. she is widowed. she denies tobacco or alcohol use. family history: father died of bladder cancer in with liver and bone metastases. her mother died at the age of 72 of a abdominal aortic aneurysm. her mother also had hypertension. review of systems: review of systems revealed urinary frequency, hematuria. denied any bowel dysfunction. physical examination on admission: physical examination on admission was significant for a nontender and nondistended abdomen with positive bowel sounds. there was a vertical cesarean section scar. there was a question whether the uterus was palpable just below the umbilicus. on pelvic examination, the vulva and vagina had extensive radiation affect. the vaginal canal was foreshortened. the cervix was not identifiable. there was no obvious tumor on bimanual, and rectovaginal examination revealed smooth vaginal walls and smooth rectal mucosa. there was no nodularity, but there was extensive radiation affect. laboratory on admission: crossed and typed for 4 units. complete blood count and chem-10 were sent. the patient's preoperative hematocrit was 31.5. her creatinine was 1.2; however, her baseline creatinine was 1.1 to 1.4. the rest of the preoperative laboratories were within normal limits. hospital course: in summary, the patient is a 54-year-old gravida 2 para 2 with stage iiib cervical cancer, status post chemotherapy radiation and brachy therapy, who presented with localized recurrence in the bladder. she was admitted on the day prior to her total pelvic exenteration for preoperative bowel preparation with fleets soda. the patient underwent a total pelvic exenteration, pouch, and colostomy on . please see the operative note for details of the procedure. intraoperative the patient received 15 liters of intravenous fluids, 12 units of packed red blood cells, 7 units fresh frozen plasma, 6 packs of platelets, 100 cc albumin, 1000 cc of hespan. estimated blood loss was 5.5 liters. intraoperatively, the patient's hematocrit decreased to a low of 14.1. her platelets decreased to a low of 61, and her inr at maximum was 5. postoperatively, the patient was admitted to the surgical intensive care unit. she was transferred to the floor on postoperative day three. 1. cardiovascular: the patient was in normal sinus rhythm throughout her hospital course. in the surgical intensive care unit, her blood pressure was kept greater than 100 systolic and greater than 60 diastolic. she was repleted with crystalloid as well as with blood products to keep her hematocrit greater than 25. she did not require pressors. there were no active cardiac issues both in the medical intensive care unit and on the floor. 2. hematology: in the operating room, the patient appeared to have a mild coagulopathy. her blood products including fresh frozen plasma and platelets were repleted as needed. coagulation panel was checked in the medical intensive care unit. the patient did not have any further coagulopathy postoperatively. the patient was transfused as needed to keep her hematocrit greater than 25. she received a total of 14 units of packed red blood cells between the operating room and the surgical intensive care unit. she did not require further packed red blood cells on the floor. the patient was rh negative. given that, she received rh positive platelets. she was given rhogam times one. 3. pulmonary: the patient was intubated in the operating room and was taken to the surgical intensive care unit intubated. chest x-ray revealed proper placement of the endotracheal tube, and there was no evidence of infiltrate. the patient was sedated on propofol. attempts were made to wean the patient off of the respirator, and eventually, on postoperative day two, the patient was extubated. once the patient was extubated, throughout the hospital course there were no further respiratory issues. she was given incentive spirometry for the prevention of atelectasis. 4. infectious disease: given that the patient underwent a major intra-abdominal surgery, she was started on kefzol and flagyl postoperatively. she was afebrile on kefzol and flagyl. on postoperative day three, she had a temperature to 100.6 which was likely secondary to atelectasis. on postoperative day three, there was some erythema noted at the wound side. therefore, her antibiotics were changed to ampicillin, ceftriaxone, and flagyl. she completed a 7-day course of the triple antibiotics and was then started on a oxacillin for skin coverage. on postoperative day 14 (day five of the oxacillin) the patient was changed to dicloxacillin. she was sent home with a 7-day course total of the dicloxacillin (including the day she had spent on the oxacillin). 5. genitourinary: the patient had a pouch created. postoperatively, there were issues with low urine output. her - output was high in the surgical intensive care unit. her urine output did improve after receiving blood. by postoperative day two, the patient was draining urine from the pouch. on postoperative day two, the pouch started to be irrigated every three hours with 60 cc of normal saline. throughout the rest of her hospital course, the patient maintained adequate urine output. her creatinine throughout her hospital course was within her baseline range of 1.1 to 1.4. on the day prior to discharge there was some drainage of urine surrounding the foley catheter that was in the pouch. this was thought to be secondary to mucous plugging the urostomy. this resolved with irrigation and flushing of the pouch with normal saline. throughout her hospital course, the urostomy was violaceous and appeared to have no breakdown. 6. gastrointestinal: the patient had a colostomy at the time of the operation. the patient was made n.p.o. she was started on intravenous fluid hydration in the surgical intensive care unit, and her electrolytes were followed and repleted as needed. she was placed on protonix for gastrointestinal prophylaxis. the patient was started on total parenteral nutrition on postoperative day three. the patient had a right internal jugular to receive the total parenteral nutrition. this was changed to a left picc line on postoperative day four. the patient also had an nasogastric tube that was placed intraoperatively. this was maintained on low wall suction and was discontinued on postoperative day five. on postoperative day six, the patient's diet was advanced to clears, and her diet was advanced as tolerated. the total parenteral nutrition was weaned, and on postoperative day 13 the patient's total parenteral nutrition was discontinued. she was started on a multivitamin and was receiving boost supplements. nutrition laboratories were checked while the patient was on total parenteral nutrition, and there were no abnormalities. 7. neurology: while in the surgical intensive care unit, the patient was on propofol while intubated and was also receiving intravenous morphine and versed as needed for pain control. when the patient was transferred to the floor, she was receiving morphine as needed for pain control as well until she was tolerating adequate p.o. at that time she was changed to percocet which provided good pain relief. 8. prophylaxis: the patient was placed on pneumo boots until she was ambulating and received protonix as gastrointestinal prophylaxis. 9. postoperative care: the patient had staples to close her skin incision. these should remain for approximately one month postoperatively. 10. code status: throughout her hospital course, the patient remained full code. condition at discharge: condition at the time of discharge was stable. discharge diagnoses: 1. stage iiib cervical cancer with local recurrence to the bladder. 2. status post total pelvic exenteration, pouch, and colostomy. 3. history of melanoma. medications on discharge: 1. dicloxacillin 500 mg p.o. q.d. times six days for a total 10-day course of dicloxacillin and oxacillin. 2. multivitamin 1 tablet p.o. q.d. 3. tums 1 tablet p.o. b.i.d. 4. zofran 4 mg p.o. q.8.h. p.r.n. 5. percocet one to two tablets p.o. q.4-6h. p.r.n. 6. motrin 600 mg p.o. q.6h. p.r.n. 7. prilosec 20 mg p.o. b.i.d. 8. pouch flush 60 cc of 0.25% acetic acid and normal saline via the foley catheter q.3h. to irrigate and flush. 9. change ostomy bag as instructed. discharge followup: the patient was to follow up with dr. nine days after discharge. , m.d. dictated by: medquist36 procedure: parenteral infusion of concentrated nutritional substances urinary diversion to intestine pelvic evisceration other repair of omentum permanent colostomy diagnoses: hypopotassemia pulmonary collapse nausea alone other and unspecified coagulation defects personal history of malignant neoplasm of cervix uteri secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes other premature beats secondary malignant neoplasm of other urinary organs 

Answer: The patient is high likely exposed to