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 48 year-old man who is generally healthy who presented as an outpatient with approximately a two month history of epigastric pain. he was started on a proton pump inhibitor and hospitalized. at this time he was ruled out for an myocardial infarction and upper endoscopy actually revealed a tumor in the cardia of the stomach, which extended into the distal esophagus. a biopsy of the tumor revealed a well differentiated adenocarcinoma. he was referred to dr. for an esophagogastrectomy. the patient has not described any dysphagia. he is able to eat soft foods and liquids without any trouble, but does report a small amount of solid dysphagia. he does report that he ahs had approximately a 20 pound weight loss unintentionally over the past several months. he denies fevers, nausea, vomiting or any recent respiratory illnesses. past medical history: 1. hypertension. 2. history of cerebrovascular accident with mild residual left hemiparesis. 3. asthma. 4. history of basal cell carcinoma. allergies: no known drug allergies. medications: 1. hydrochlorothiazide 12.5 q.d. 2. paxil 40 mg po q.d. 3. protonix 40 mg po q.d. 4. norvasc 10 mg po q.d. 5. diovan 320 mg po q.d. 6. coumadin 1 mg po q.d. for his cerebrovascular accident. 7. oxycodone as needed for pain. family history: notable for multiple family members with carcinoma. his mother died of breast cancer. his father died of lung carcinoma. maternal grandfather died of esophageal cancer and his maternal uncle died of breast cancer. physical examination: this is a well developed man with obvious recent weight loss. his head and neck examination is all within normal limits. his neck is supple without any nodes or masses. his lungs are clear to auscultation bilaterally. heart sounds are regular rate and rhythm. abdomen is soft without any distention, tenderness, masses or organomegaly. his extremities are without any clubbing, cyanosis or edema. neurologically he is basically intact, although there is a slight right facial droop. hospital course: after reviewing the endoscopic photos and discussing his options with dr. the patient opted for an elective ivor- esophagogastrectomy. he presents on for that procedure. please refer to the previously dictated operative note by dr. from for the specifics of this surgery. in brief, an ivor- esophagogastrectomy was performed with resection of the tumor at the junction of the stomach and distal esophagus. the specimen was sent for pathology. eventually the pathology returned to show a well differentiated adenocarcinoma, t1 with no involvement in 13 adjacent lymph nodes. there is no lymphatic or venous invasion. margins were all clear. in addition, during this procedure a feeding jejunostomy was placed as well as bilateral chest tubes. the patient tolerated the procedure well and was transferred to the floor on subcutaneous heparin twice a day and an epidural for his pain control. the patient was doing well postoperatively until postoperative day two. the patient was noted to have respiratory distress with markedly decreasing oxygen saturation, tachypnea, tachycardia and significant confusion. in fact he pulled out his nasogastric tube at this point. he was transferred to the intensive care unit. a arterial blood gas at this time showed a ph of 7.52, pco2 of 32, po2 of 60, bicarb of 27 and a base deficit of 3. because of his significant aa gradient the patient was intubated at this time. workup for the respiratory distress included a cta of the chest, which revealed bilateral pulmonary emboli in the right upper lobe and left lower lobe. the patient was started on a heparin drip and was soon having therapeutic anticoagulation. on postoperative day three the patient's nasogastric tube was replaced under fluoroscopy. his deep veins in his lower and upper extremities were examined for thrombotic sources of pulmonary emboli, however, none were noted on these studies. his respiratory status improved and he was extubated. on the morning of postoperative day four the patient had again another bout of significant hypoxia with a large aa gradient. it was determined that he had a recurrent pulmonary emboli despite being on therapeutic heparin. at this point it was decided that he should have an inferior vena cava filter placement. this was placed by the vascular service on postoperative day five and the patient tolerated the procedure without any complications. the patient remained well for the next few days and on postoperative day nine was reextubated. at this time he was noted to be at his goal tube feedings. on a swallow study revealed no leak at the patient's esophagogastric anastomosis. the patient's nasogastric tube was discontinued and he was transferred to the floor from the intensive care unit. the next day the patient was started on clears. in addition he had his chest tubes removed without complications. the other remaining issues while the patient was on the floor revolved around preparing the patient for home. basically his nutritional status was buffed. by the time he was being discharged the patient was on a regular post esophagogastrectomy diet with six small meals a day. in addition for nutritional supplementation he received cycle tube feeds at night. he was also put on oral anticoagulation with coumadin and once his inr was greater then 2 it was determined that he was able to go home on oral coumadin. his primary care physician . was consulted and agreed to follow his inr as an outpatient. while on the unit he had been placed on antibiotics for several positive sputum cultures. these antibiotics were discontinued prior to discharge and finally a physical therapy evaluation determined that he was ready to go home and that he did not need outpatient rehab treatment. therefore on , which was postoperative day 19 the patient was tolerating a regular diet. he was afebrile for the last several days and he was properly anticoagulated for his pneumothorax. he was discharged home in good condition. discharge medications: 1. protonix 40 mg once a day. 2. paxil 40 mg once a day. 3. hydrochlorothiazide 12.5 mg once a day. 4. norvasc 10 mg once a day. 5. diovan 325 mg once a day. 6. coumadin 10 mg once a day. 7. atrovent and albuterol inhalers as needed. 8. ambien 10 mg po q.h.s. prn as needed for sleep. 9. roxicet one to two teaspoons as needed for pain every four to six hours. 10. replete with fiber tube feeds at 80 cc an hour for 12 hours at night. he is recommended to have twice weekly laboratory work to assess his inr with the results forwarded to dr. . discharge diagnoses: 1. esophageal carcinoma status post ivor- esophagogastrectomy. 2. status post feeding jejunostomy tube placement. 3. hypertension. 4. asthma. 5. history of cerebrovascular accident. 6. pulmonary emboli status post inferior vena cava filter placement. 7. pneumonia. , m.d. dictated by: medquist36 d: 12:03 t: 09:13 job#: procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more other total gastrectomy other enterostomy insertion of endotracheal tube interruption of the vena cava enteral infusion of concentrated nutritional substances arterial catheterization other incision of pleura diagnoses: pneumonia due to other gram-negative bacteria iatrogenic pulmonary embolism and infarction malignant neoplasm of cardia 

Answer: The patient is high likely exposed to