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: vancomycin attending: chief complaint: pancreatic cancer major surgical or invasive procedure: - retroperitoneal lymph node biopsies, exploratory laparotomy, open cholecystectomy history of present illness: this 71-year-old man with severe chronic obstructive pulmonary disease presents with pancreatic cancer that is borderline resectable. he was prepared by a pulmonology consult deemed to be an acceptable but high risk for pancreatic resection and he opted to proceed. he was electively brought to the operating room for a planned whipple procedure, but intra-operatively it was noted that serosal implants existed beyond the nodal disease which rendered this stage iv pancreatic cancer and the operation was aborted. retroperitoneal lymph node biopsies, exploratory laparotomy and open cholecystectomy was performed. past medical history: pmh: copd, on home oxygen 2l continuously; anxiety; depression; osa; hx of arf; dmii, htn, cad s/p ptca yrs bu, ?seizures vs. syncope psh: open appendectomy, tonsillectomy, bilateral carotid stents social history: patient retired (used to work for oxygen device company) and lives with his mother in . has 5 children. previously smoked 3-4 packs/day x 45 years gradually decreasing for past 8 years, now 0.75 pack per day. patient states he quit alcohol 30 years ago. prior crack/cocaine x 2 yrs. quit a few yrs ago. family history: mother cabg , alive 95. father died at of pancreatic cancer at age 72. physical exam: vitals: afebrile, vitals signs stable. heent: normocephalic, atraumatic. eomi. perrl. nares clear. mucous membranes moist. neck supple without lymphadenopathy. cvs: regular rate and rhythm, without murmurs, rubs or gallops. s1 and s2. resp: clear to auscultation bilaterally without adventitious sounds. no wheezing, rhonchi or crackles. abd: soft, non-tender, non-distended, with normoactive bowel sounds. no masses or peritoneal signs. extr: no cyanosis, clubbing or edema, 2+ peripheral pulses incision: incision is clean, dry and intact, without evidence of erythema or drainage, staples have been removed. pertinent results: 05:21pm blood wbc-11.1* rbc-3.43* hgb-10.8* hct-32.7* mcv-95 mch-31.5 mchc-33.1 rdw-15.3 plt ct-169 05:21pm blood glucose-115* urean-17 creat-0.6 na-140 k-3.6 cl-111* hco3-25 angap-8 12:39pm blood ck-mb-3 ctropnt-<0.01 05:21pm blood calcium-8.7 phos-2.6*# mg-1.4* chest (pa & lat): right basal opacity most consistent with atelectasis. no evidence of pneumothorax is present. increased bilateral lung lucency most likely reflects emphysema ct abd & pelvis with contrast: status-post ccy, with a moderate amount of free intermediate density fluid in the perihepatic region and gallbladder fossa, extending to the inferior margin of the liver. no rim enhancement. small amount of pneumoperitoneum, relates to the recent surgery. biliary stent in place, with minimal pneumobilia, without biliary dilation. stable pancreatic ductal dilation, secondary to known pancreatic mass. mild narrowing of the smv, just proximal to the confluence. bilateral trace pleural effusions with basal atelectasis. small amount of simple pelvic free fluid. no retroperitoneal air to suggest duodenal perforation. brief hospital course: neuro/pain: the patient was maintained on iv pain medication in the immediate post-operative period and transitioned to po narcotic medication with adequate pain control on pod#3. the patient had some mental status changes in the post-operative period, which was attributed to his medications versus acute post-op delirium changes. he had serial neurologic exams. his medication list was optimized to avoid anticholingeric or delirium-inducing medications. it appeared that his home xanax was discontinued on admission and when resumed his mental status improved. the patient remained alert and oriented to person and place, but not always date/time. cardiovascular: the patient remained hemodynamically stable intra-op and in the immediate post-operative period. he did experience some episodic hypotension post-op requiring re-intubation and fluid resuscitation. their vitals signs were closely monitored with telemetry. the patient's home anti-hypertensive medications were resumed on pod# once his pressures responded to fluids. his home dose of plavix was restarted on pod#5, and his aspirin was continued immediately post-op. a right-sided central venous catheter was placed pre-op and removed on pod#5 when he was deemed hemodynamically stable. respiratory: the patient was extubated in the immediate post-op period successfully. his abg revealed evidence of hypercarbia and carbon dioxide retention post-op and he required re-intubation on pod#0. the patient had no episodes of desaturation or pulmonary concerns following being extubated after this pulmonary episode. the patient denied cough or respiratory symptoms following this, and was maintained on nebulizers and pulmonary treatments. pulmonology was consulted pre-op for clearance, and they continued following post-op, and they recommended continuing his mdis. pulse oximetry was monitored closely and the patient maintained adequate oxygenation. he had a cxr on pod#5 which showed some right lower lobe atelectasis, but otherwise was reassuring. gastrointestinal: the patient was npo following their procedure and maintained on iv fluids for hydration while npo. serial abdominal exams were performed, and once flatus resumed, the patient was transitioned to a clear liquid diet and their iv fluids were hep-locked on pod#. the patient experienced no nausea or vomiting. a regular diet was initiated on pod# and the patient tolerated this well. there was some concern on pod#4 that the patient was clinical worsening. his wbc was elevated to 21, he spiked low grade temperatures and had new-onset tachycardiac (with stable ekg findings) which raised the concern for anastomotic leak or intra-abdominal bleeding. on pod#4, an upright abdominal x-ray revealed no free air and a ct of the abdomen and pelvis showed only a simple peri-hepatic fluid collection with post-operative changes and no extravasation of contrast or perforation. he was empirically placed on iv vancomycin and zosyn with improvement. he was closely monitored with serial abdominal exams, which were reassuring. genitourinary: the patient's urine output was closely monitored in the immediate post-operative period. a foley catheter was placed intra-operatively and removed on pod#2, at which time the patient was able to successfully void without issue. on pod#4 a foley catheter was replaced for some low urine output and the need for monitoring given the previous concerns for anastomotic leak or bleeding. the patient's intake and output was closely monitored for urine output > 30 ml per hour output. the foley was successfully removed again on pod#8. the patient's creatinine was stable. heme: the patient's post-op hematocrit was stable and trended closely. the patient remained hemodynamically stable and did not require transfusion. the patient's coagulation profile remained normal. the patient had no evidence of bleeding from their incision. id: their white count was 21 post-operatively (pod#4) and their incision was closely monitored for any evidence of infection or erythema. the patient initially only received standard peri-operative antibiotics, but was started on empiric iv vancomycin and zosyn on the evening of pod#4 given concerns for anastomotic leak or infection. blood and urine cultures were obtained for low grade temperatures. he clinically improved with iv antibiotics and his fevers resolved. blood cultures revealed bottle positive for gram negative rods which speciated e.coli that was pan-sensitive. he was continued on iv zosyn and transitioned to po-cipro for a 2-week course, which he will complete on discharge. endocrine: the patient's blood glucose was closely monitored in the post-op period with q6 hour glucose checks. blood glucose levels greater than 120 mg/dl were addressed with an insulin sliding scale. his home anti-hyperglycemic medications were resumed when diet was restored. prophylaxis: the patient was maintained on heparin 5000 units sq for dvt/pe prophylaxis and encouraged to ambulate immediately post-op once cleared by physical therapy. the patient also had sequential compression boot devices in place during immobilization to promote circulation. gi prophylaxis was sustained with protonix/famotidine when necessary. the patient was encouraged to utilize incentive spirometry, ambulate early and was discharged in stable condition. he was discharged home with his family, as rehabilitation was recommended, but the family declined. medications on admission: albuterol 5 mg/ml, alprazolam 1 mg'''', plavix 75 mg', effexor 75 mg' qod, finasteride 5 mg', fluticasone-salmeterol 250/50 mcg', glipizide 2.5 mg'', ipatroprium-albuterol 18/103 mcg'', lisinopril 10 mg', metoprolol 100 mg', percocet 5/325 mg qid, promethazine 6.25 mg/5 ml', aspirin 325 mg', docusate 100 mg', flaxseed oil, magnesium oxide 400 mg'', omega-3 fas 1000 mg'' discharge medications: 1. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: disk with devices inhalation (2 times a day). 2. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q4h (every 4 hours) as needed for sob/wheeze. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold if diarrhea. disp:*60 capsule(s)* refills:*2* 4. ipratropium bromide 17 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation qid (4 times a day). 5. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 6. glipizide 5 mg tablet sig: one (1) tablet po daily (daily). 7. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 8. venlafaxine 75 mg tablet sig: one (1) tablet po every other day (every other day). 9. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 10. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 11. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 12. 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* 13. metoprolol succinate 100 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po daily (daily). 14. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 15. multivitamin tablet sig: one (1) tablet po daily (daily). 16. acetaminophen 500 mg tablet sig: two (2) tablet po q 8h (every 8 hours). 17. lorazepam 0.5 mg tablet sig: 1-2 tablets po bid (2 times a day). 18. lorazepam 0.5 mg tablet sig: one (1) tablet po q12h (every 12 hours) as needed for anxiety. 19. alprazolam 1 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for agitation. 20. ciprofloxacin 750 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 10 days. disp:*20 tablet(s)* refills:*0* 21. glipizide 5 mg tablet sig: 0.5 tablet po bid (2 times a day). 22. tamsulosin 0.4 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po hs (at bedtime). disp:*30 capsule, ext release 24 hr(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: 1. unresectable metastatic pancreatic cancer 2. gram negative bacteremia 3. delirium discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to dr. surgical service for evaluation and management of your pancreatic malignancy. you are now being discharged home. please follow these instructions to aid in your recovery: please call your doctor or go to the emergency department if: * you experience new chest pain, pressure, squeezing or tightness. * you develop new or worsening cough, shortness of breath, or wheezing. * you are vomiting and cannot keep down fluids, or your medications. * if 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 an unusual discharge. * your pain is not improving within 12 hours or is not under control within 24 hours. * your pain worsens or changes location. * you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. * you develop any other concerning symptoms. general discharge instructions: * please resume all regular home medications, unless specifically advised not to take a particular medication. * please take any new medications as prescribed. * please take the prescribed analgesic medications as needed. you may not drive or operate heavy machinery while taking narcotic analgesic medications. you may also take acetaminophen (tylenol) as directed, but do not exceed 4000 mg in one day. * please get plenty of rest, continue to walk several times per day, and drink adequate amounts of fluids. * avoid strenuous physical activity and refrain from heavy lifting greater than 10 lbs., until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. * please also follow-up with your primary care physician. incision care: * please call your surgeon or go to the emergency department if you have increased pain, swelling, redness, or drainage from the incision site. * avoid swimming and baths until cleared by your surgeon. * you may shower and wash incisions with a mild soap and warm water. gently pat the area dry. * if you have staples, they will be removed at your follow-up appointment. * if you have steri-strips, they will fall off on their own. please remove any remaining strips 7-10 days after surgery. followup instructions: provider: , md phone: date/time: 8:45 3, . provider: function lab phone: date/time: 11:40 provider: ,interpret w/lab no check-in intepretation billing date/time: 12:00 provider: , m.d. phone: date/time: 12:00 . please follow up with your pcp weeks after discharge procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube cholecystectomy biopsy of lymphatic structure insertion of catheter into spinal canal for infusion of therapeutic or palliative substances systemic to pulmonary artery shunt biopsy of peritoneum diagnoses: acidosis obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery tobacco use disorder other postoperative infection unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified percutaneous transluminal coronary angioplasty status pulmonary collapse dysthymic disorder acute respiratory failure bacteremia malignant neoplasm of head of pancreas calculus of gallbladder with other cholecystitis, without mention of obstruction personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation tachycardia, unspecified other alteration of consciousness secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes secondary malignant neoplasm of retroperitoneum and peritoneum other dependence on machines, supplemental oxygen 

Answer: The patient is high likely exposed to