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: mr. is a 53 year old male with a diagnosis of muscle invasive grade ii to iii/iii bladder carcinoma. in addition, his prostatic urethral biopsies had been positive for carcinoma in situ. he is status post transurethral resection of bladder tumor and bcg therapy. his pathology sides have been reviewed here at the and have shown a micro-papillary variant which tends to be very aggressive. he had undergone mvac chemotherapy with dr. . at this time, he presents for discussion for his continent urinary diversion. his cystoprostatectomy will be performed by dr. . he had a ct scan and bone scan in , prior to his chemotherapy that showed no evidence of metastatic disease. he had a recent prostate biopsy because of a prostatic nodule which showed no malignancy. past medical history: 1. diet controlled type 2 diabetes mellitus. medications: he is on no medications except a multivitamin. past surgical history: 1. transurethral resection of bladder tumor. social history: he quit smoking eight years ago. he does have a 30 pack year smoking history previous to that. he is a district service manager for the steris company. he drinks two to three caffeinated drinks per day and one to two alcoholic beverages per day. family history: significant for his father with a history of lung cancer and a sister with diabetes mellitus. allergies: allergies are a questionable possible allergy to ampicillin. review of systems: review of systems on pre-surgical evaluation showed mild urinary urgency after bcg treatment and had decreased erectile function. physical examination: vital signs were 130/88; pulse 78 and regular; respiratory rate was 16 and unlabored. abdomen soft, nontender, no palpable masses. no costovertebral angle tenderness. no inguinal lymphadenopathy. genitourinary: normal phallus, meatus and testes. no inguinal hernia. rectal: normal tone; 40 gram prostate. nodularity in the left prostatic lobe. extremities and neurological: moves all four extremities without difficulty. normal gait. neurologically and mentally intact. laboratory: white blood cell count 6.7, hematocrit 35, platelet count 267, bun and creatinine are 20 and 1.0. urinalysis dipstick was three plus glucose; otherwise unremarkable. given this preoperatively assessment, he was given a nulytely bowel prep and erythromycin and neomycin based antibiotics preoperatively. he had a preoperative ct scan repeated that did not show any evidence of metastatic disease at that time. hospital course: on , he came to the and underwent a radical cystoprostatectomy with bilateral pelvic lymph node dissection and a continent cutaneous diversion. this was performed by dr. and also dr. , with assistant of dr. . this was done under general endotracheal anesthesia. approximately ten liters of fluids were utilized interoperatively and the patient had a 1500 cc. blood loss. urine output was not complete measured but was thought to be "very good" per the anesthesia record. he did receive two units of autologous blood interoperatively and received clindamycin and gentamicin for antibiotics during the case. specimens from the case included bladder, prostate, bilateral pelvic lymph nodes, ureteral cuff margins bilaterally. drains were the suprapubic tube, the diversion tube, bilateral stents, - times two, a subclavian line and an arterial line. findings overall were that of a normal anatomy. he was discharged, intubated, to the post anesthesia care unit and ultimately to the intensive care unit. he was extubated overnight. his pain was being controlled with an epidural and he was otherwise feeling okay. he was noted to have some mild hypotension immediately postoperatively in the 70s. he was resuscitated with aggressive normal saline boluses. his postoperative hematocrit was 32. sodium was 138, potassium was 4.8, bun and creatinine were 17 and 1.0. his epidural was titrated back to help enhance his blood pressure. his propofol was weaned off to extubation. the neobladder had flushes serially with normal saline and he was maintained on clindamycin and gentamycin for 48 hours postoperatively. x-rays showed no pneumothorax and he had a left subclavian line that was in appropriate position. over the next 48 hours, the patient had some low grade temperatures to 100.5 and 100.8 f., respectively. he was requiring significant fluid boluses to keep his mean arterial pressure in the 50s to 70s. central venous pressures were measured to be around 12. ultimately, his urine output through his suprapubic tube picked up. he was transferred to the floor on postoperative day number two. his hematocrit at this time was 23.9. he was given an additional two units of packed red cells. creatinine was 0.8. his inr was 1.5. his arterial line had been discontinued by this point. he had a right internal jugular at this time; it was a new site and stick that was placed. he had two ureteral stents, a foley catheter and a suprapubic tube. his epidural was still being utilized, but it had been titrated back and he was now on a total regimen of epidural and pca for pain control. he was hemodynamically stable. he had had a low-grade temperature to 100.3 f., the night before, but was ultimately deemed stable and appropriate for discharge, and sent to the floor. on postoperative day number three, he was off antibiotics, feeling well with no pain. his post transfusion hematocrit was 27.3. his tachycardia had subsided. his bun and creatinine were 12.0 and 0.7 respectively. his examination was otherwise benign. he was now walking and out of bed without assistance. he was learning to care for his drains. over the next three to four days postoperatively, the patient did well. he ultimately passed gas by postoperative day six. at this time, his diet was advanced. his epidural was discontinued. he was being controlled for pain with a pca. he was tolerating a clear liquid diet. at this point of his postoperative course, the stents had essentially all but fallen out on their own, so they were discontinued. the - outputs had dropped off on the left side, but the right - was noted to increase immediately after the stent removal. the fear for a possible urine leak status post stent removal was investigated and creatinine values on the - drains were drawn. they were showing to be 0.6 on the right side and 0.4 on the left. this all but practically refutes a possible urine leak. the patient did very well over the next couple of days and ultimately, by postoperative day number eight, he was afebrile with a temperature of 98.6 f., pulse 80, blood pressure 140/90; respiratory rate was 20 with 98% room air saturation. he was tolerating a regular diet. his fluids had been hep-locked. he was making over a liter and a half of urine through the suprapubic tube. his right - outputs were averaging 100 to 150 q. shift, and his left - out between 30 and 50 cc. q. shift. blood sugars were adequately controlled just on diet, ranging 106 to 112. his examination was otherwise unremarkable. his wound is well approximated with no drainage. steri-strips were in place at this point postoperatively. he did have bowel sounds and he was soft and flat otherwise. - sites were secure times two. suprapubic tube was additionally in place draining yellow urine. the remainder of his examination was unremarkable. at this point, he was deemed appropriate and stable for discharge. discharge medications: 1. percocet 5/325, one to two tablets p.o. q. four to six p.r.n. 2. colace 100 mg p.o. twice a day. 3. protonix 40 mg p.o. q. day. 4. multivitamin one tablet p.o. q. day. discharge instructions: 1. he will receive 30 to 40 cc. of normal saline flushes with pull-back gently through the suprapubic tube three times a day and p.r.n. 2. - care and output recordings. 3. he will receive a visiting nurse him with these tasks. 4. follow-up instructions will be to see dr. in approximately one to two weeks. 5. he will have a cystogram to test the patency of the neobladder in approximately two weeks from time of discharge. 6. he will not be accessing his foley catheter at that time in his continent cutaneous diversion. this will be only accessed in the presence of dr. in the office. 7. the patient is going to be required to have follow-up with dr. as well as dr. , that his plan of care can be coordinated. discharge diagnoses: 1. bladder carcinoma. pathology: final pathology was pending, and please refer to the interim pathology specimen report that is in the computer. discharge status: to home. condition at discharge: stable. , m.d. dictated by: medquist36 procedure: radical cystectomy formation of cutaneous uretero-ileostomy division or crushing of other cranial and peripheral nerves regional lymph node excision radical cystectomy formation of cutaneous uretero-ileostomy division or crushing of other cranial and peripheral nerves regional lymph node excision diagnoses: acidosis thrombocytopenia, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled pulmonary collapse other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation malignant neoplasm of other specified sites of bladder secondary and unspecified malignant neoplasm of lymph nodes of inguinal region and lower limb 

Answer: The patient is high likely exposed to