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: gerd and small hiatal hernia major surgical or invasive procedure: laparoscopic converted to open, redo nissen fundoplication, and repair of hiatal hernia. esophagogastroduodenoscopy. 1. reopening of abdomen and washout of intraperitoneal hematoma. 2. endoscopy ct guided pigtail placement left pleural space ct guided drain placed in perisplenic fluid collection history of present illness: 41-year-old black gentleman status post nissen fundoplication five years ago. he did great during this time with no reflux or difficulty swallowing at all. he had previously undergone endoscopic approaches to relieve his heartburn, which had failed. however, for the last two months, he has had difficulty with some reflux as well as swallowing water. endoscopy revealed a small hiatal hernia and gastritis. a barium swallow showed a small herniation of the ge junction possibly above the diaphragm. he complains of these problems with swallowing and also notes more frequent burping. past medical history: episcleritis bilaterally: followed by dr. . gerd s/p nissen fundoplication obesity hypercholesterolemia: borderline in the past. chronically elevated liver function tests: normal evaluation in the past. chronic low back pain hypertension. s/p distal biceps tear and repair on by dr. . social history: the patient states that he drinks beer occasionally on the weekends. he smokes occasional cigars, but is exposed to secondhand smoke at home. the patient smoked while he was in military but quit over 10 years ago. family history: mother has a history of migraine headaches. his mother has a history of diabetes. uncle has a history of lung cancer. he has four children who are all healthy. physical exam: vital signs temperature of 97.2, blood pressure 143/92, o2 sat 99%, pulse 84, resp 20, weight 236 pounds. breathing comfortably. abdomen is soft. incision is well healed. moving all extremities well. pertinent results: ugi : no evidence of leak. slow passage of contrast from the esophagus into the stomach, likely from edema, with residual barium within the distal esophagus. ct abd/pelvis/cta chest : 1. dense right lower lobe consolidation consistent with pneumonia. large left pleural effusion with pleural enhancement; infection cannot be excluded. small right effusion. patchy consolidation at lung apices suggests aspiration or infection. 2. fluid collection in the surgical bed, extending along the stomach and pancreatic tail, with marked stranding in left upper quadrant. extraluminal hyperdense material at the ge junction may represent surgical pledgets or extravasated contrast. cannot exclude anastomotic leak. notably, however, there is no intraperitoneal free air (endoscopy with insufflation was performed prior to this examination to assess for leak). 3. limited evaluation for pulmonary embolus due to timing of contrast, but no evidence of large pulmonary embolus. 4. peripancreatic fluid may be tracking from surgical bed, but recommend obtaining pancreatic enzymes for clinical correlation to exclude pancreatitis as a cause of left upper quadrant inflammatory change. 5. ett terminates 1.4 cm above the carina. consider repositioning. tte : mild symmetric left ventricular hypertrophy with normal systolic function. right ventricular dilation, hypertrophy, mild hypokinesis, and severe estimated pulmonary artery systolic hypertension. these findings are consistent with a primary chronic pulmonary process. esophagus : no evidence of leak at the gastric fundus to correlate with the findings on previous ct. while it remains possible that the density at the ge junction seen on the previous ct represents leaked barium, given the inability to demonstrate leak on the present examination, these densities are felt more likely to represent hyperdense pledgets which were reportedly used in the surgery. ct abd/pelvis : 1. stable size and configuration of peri-ge junction low-density fluid. no new intraabdominal collection. unchanged extraluminal hyperdense material, may represent extraluminal contrast versus surgical pledgets. 2. new small-bowel obstruction with transition point in the mid abdomen (2, 66), most likely due to adhesion. 3. improved bilateral pleural effusions status post left chest tube placement. improved but persistent bibasilar atelectasis. 4. trace pneumomediastinum, likely expected post-surgical change. ct abd/pelvis : 1. interval placement of multiple intra-abdominal drains, with persistent multiple low-density collections within the lesser sac and peripancreatic location, gastrohepatic space, and perisplenic regions. though one of the drains situated in the gastrohepatic space appears centered within a fluid collection, the remainder of the drains do not. 2. moderate left pleural effusion, larger in size, that is slightly hyperattenuating, may contain hemorrhagic or proteinacious components. 3. left subclavian line tip not central in location and should be adjusted. 4. trace free fluid in the pelvis, nonspecific, and may reflect sequela of recent surgery. ct abd/pelvis : 1. interval decrease in size of perisplenic fluid collection which contains a pigtail catheter; decreased although persistent smaller loculations including lesser sac, peripancreatic and gastrohepatic collection. 2. near-resolution of a left pleural effusion which contains a pigtail catheter. 3. stranding and low density within the abdominal wall musculature, developing collection not entirely excluded. correlation with physical examination and consideration of ultrasound is suggested if an infection is suspected in the area. the ct findings are non-specific and may be post-operative or due to serous or infected fluid. 4. few subtle wedge-shaped hypodensities within the renal parenchyma. main differential considerations include infarction versus infection, other etiologies are considered less likely. correlation with urinalysis and other clinical factors is suggested. the areas of relative hypoperfusion are in the upper poles only, so possibly the appearance is secondary to nearby peripancreatic inflammation and might not be significant in itself. blood culture, routine (final ): staphylococcus, coagulase negative. isolated from one set only. sensitivities performed on request.. peritoneal fluid gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. wound culture (final ): a swab is not the optimal specimen collection to evaluate body fluids. staphylococcus, coagulase negative. rare growth. anaerobic culture (final ): no anaerobes isolated. brief hospital course: mr. presented to on for a laparoscopic redo nissen which was converted to open nissen redo and hiatal hernia repair. postoperatively, he was transferred from the pacu to the floor where over the next few days experienced an increase in oxygen requirements with saturations in the 90s% despite vigorous pulmonary toilet. his chest xray revealed a new large left pleural effusion and a small right pleural effusion. this prompted an upper gi which ruled out a leak. his pain was controlled with an epidural and pca and his stomach remained decompressed with a nasogastric tube. on he was transferred to the sicu as he had more respiratory distress and was electively intubated for airway control and subsequent imaging. he had a ct scan of the chest, abdomen and pelvis. this imaging study showed a large left pleural effusion and rll consolidation c/w pneumonia, peri-ge junction fluid. his wbc 25k at that time and vancomycin was started. the thoracic surgery service was consulted for left chest tube placement and subsequent endoscopy which revealed normal mucosa, an intact wrap and no leaks. his chest tube drained about 850 cc and his po2 gradually improved. his sputum culture was mssa positive, bal were both negative. he also developed rapid atrial fibrillation and was seen by the cardiology service. part of their work up included an echo which showed moderate-severe rv dysfunction demonstrated by pasp 62. his ef was 60%. his atrial fibrillation converted to nsr with amiodarone. on , he was trialed for extubation, but reintubated for increased work of breathing. on he had a follow up ct scan which showed fluid at ge junction. due to an increasing wbc and no significant improvement he had an exploratory lap and washout of intraperitoneal hematoma which showed no evidence of leak. he was started zosyn and continued on vancomycin empirically. his left chest tube was removed without difficulty. from , mr. continued to be intubated with a mucus plug removed by bronchoscopy on , and a failed trial of extubation on . he had a follow up ct torso on which a large l pleural effusion and subdiaphragmatic/perisplenic collection. both the left pleural effusion and perisplenic abscess were drained by ir on with pig tail catheters. these collections both drained dark fluid which were culture negative. mr. wbc count began trending down from 17 to 12 following drainage. additionally, after the ir guided drainage of the left pleural effusion and perisplenic fluid, mr. respiratory status improved and he was extubated on . after extubation, he improved rapidly and on his tube feeds, nasogastric tube, foley, and central venous line were all discontinued and his diet was advanced to full liquids. he was transferred to the floor on . on the floor, mr. continued to improve dramatically while his wbc decreased to 10.3. he was seen by physical therapy for deconditioning but after a few treatments he was up and walking independently. a followup ct scan on showed that the left pleural effusion had mostly resolved and the perisplenic collection had decreased to 13 mm. his drains were then sequentially discontinued. on the last drain was removed, his wbc was 6k and his antibiotics were discontinued. his abdominal wound drained some serosanguinous fluid from the lower 1/3rd and was partially opened on . there was no cellulitis and the base of the wound was clean. he underwent dressing changes with saline moist to dry gauze. he did have some minor skin tears which were treated with non adherent dressings. his appetite was slowly improving and he was also started on ensure for supplementation. after a long, protracted hospital course he was discharged to home on and will follow up with dr. in 2 weeks. medications on admission: 1. econazole - 1 % cream - apply to groin and bottom and sides of feet twice a day use for at least 3 months, then once a week thereafter. ibuprofen - 800 mg tablet - 1 tablet(s) by mouth three times a day. take with food. omeprazole - 20 mg capsule, delayed release(e.c.) - 1 capsule(s) by mouth twice a day discharge medications: 1. prilosec 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 2. percocet 5-325 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*40 tablet(s)* refills:*0* 3. colace 100 mg capsule sig: one (1) capsule po twice a day: take this if you are requiring percocet to prevent constipation. disp:*60 capsule(s)* refills:*2* 4. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation four times a day as needed for wheezes. 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: 1. gastroesophageal reflux. 2. recurrent hiatal hernia. 3. abdominal fluid collection 4. pneumonia 5. parapneumonic effusion 6. atrial fibrillation discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: please call your doctor or nurse practitioner or return to the emergency department for any of the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *your pain in not improving within 8-12 hours or is not gone within 24 hours. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon. avoid driving or operating heavy machinery while taking pain medications. incision care: * your abdominal wound needs to be packed twice daily with saline moistened gauze and covered with a dry dressing. the vna will helpou with that. *please call dr. if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. followup instructions: please have followup ct scan in 6 mo for evaluation of peripancreatic fluid which has the potential to develop into a pseudocyst. provider: , md phone: date/time: 8:30 provider: , md phone: date/time: 1:00 call dr. for a follow up appointment in weeks. procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other endoscopy of small intestine enteral infusion of concentrated nutritional substances percutaneous abdominal drainage closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus reopening of recent laparotomy site other procedures for creation of esophagogastric sphincteric competence diagnoses: esophageal reflux pure hypercholesterolemia other postoperative infection unspecified pleural effusion unspecified essential hypertension unspecified septicemia atrial fibrillation pulmonary collapse diaphragmatic hernia without mention of obstruction or gangrene alkalosis other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation methicillin susceptible pneumonia due to staphylococcus aureus obesity, unspecified peritoneal abscess scleritis, unspecified leukocytosis, unspecified laparoscopic surgical procedure converted to open procedure body mass index 36.0-36.9, adult 

Answer: The patient is high likely exposed to