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: this is a 64-year-old gentleman with a history of severe chronic obstructive pulmonary disease who was found to have esophageal cancer on endoscopy and biopsy. he underwent chemotherapy and radiation with evidence of shrinkage on ct scan. he now presents for preoperative preparation for his distal esophagectomy and total gastrectomy. past medical history: 1. esophageal cancer status post chemotherapy and radiation therapy. 2. esophagus. 3. chronic obstructive pulmonary disease requiring home o2 at three liters. 4. peptic ulcer disease. 5. coronary artery disease status post myocardial infarction eight years ago. 6. ventral hernia not repaired. medications: 1. atrovent 2 puffs q.i.d. 2. flovent 2 puffs b.i.d. 3. lasix 20 p.o. q.d. 4. diltiazem 240 mg p.o. q.d. 5. theophylline 300 mg p.o. b.i.d. 6. isosorbide dinitrate 20 mg p.o. b.i.d. 7. xanax 0.5 mg p.o. q.d. p.r.n. 8. protonix 40 mg p.o. b.i.d. social history: the patient is a significant smoker who requires home oxygen and does have a history of alcohol in the past but quit 20 years ago. physical examination: he was afebrile at 99.9, heart rate 110, blood pressure stable at 120/60, respiratory rate 24, and he was 92% on three liters of oxygen. he was in no apparent distress. he had moist mucous membranes. pupils were equally round and reactive to light. extraocular movements were intact. his lungs were clear with mild wheezes and crackles at the bases. his heart was tachycardic but with no murmurs. his abdomen was soft, nontender, nondistended. he was mildly obese and had a well-healed ventral hernia scar. his extremities were warm and well perfused. there was no clubbing noted. laboratory data: on admission his arterial blood gas showed a ph of 7.45, pco2 52, po2 60, bicarbonate 37 and a base excess of 9. his white count was 6.3, hematocrit 39.1, platelet count 165. his chemistries showed a sodium of 145, potassium 2.8, chloride 99, bicarbonate 35, bun 15, creatinine 1.0, blood sugar 157. his ast was 27, alt 23, alkaline phosphatase 148, total bilirubin 0.6, albumin 4.3. hospital course: he was admitted to the hospital and given a bowel preparation with neomycin and erythromycin and made n.p.o. for the planned operation. on the patient was taken to the operating room where a distal esophagectomy and total gastrectomy was performed as well as a jejunostomy tube placement. the patient was transferred to the surgical intensive care unit postoperatively. please see the operative report for details. the patient did well in the surgical intensive care unit. his pco2 was maintained below 60 with his po2 maintained above 60 as well. the patient was put on patient-controlled analgesia for pain control on postoperative day one after his epidural had fallen out. he had good pain control at that time. the patient was able to be extubated immediately postoperatively and did well. his laboratory values were all within normal limits. he had good urine output at that time. he was started on postoperative day one on tube feeds, impact with fiber at half-strength, 20 cc an hour. the patient was doing well on his tube feeds and the dilaudid pca on postoperative day number two. his tube feeds were slowly increased to 30 cc an hour. he was also started back on his diltiazem. his pco2 at that time was 60. physical therapy was consulted to evaluate for ambulation and the patient was found to be doing well from this standpoint. it was felt that after adequate pain control was obtained the patient would be able to be successfully able to ambulate throughout his hospital course and could ultimately go home when medically stable. nutrition was also consulted at that time on for evaluation of nutritional needs. it was felt that the patient would require 90 cc of full-strength impact with fiber in order to meet his nutritional needs. his tube feeds on postoperative day number three were increased again to 50 cc an hour. he continued to improve. his blood gas at that time also revealed that his pco2 was in the 50s and his po2 was in the 50s as well. the patient was maintained on nasal cannula oxygen throughout his hospital course after extubation. aggressive chest physical therapy and pulmonary toilet were instituted and the patient maintained a good o2 saturation on three liters of oxygen. the patient was transferred to the floor on . his tube feeds were slowly advanced to goal at half strength at 90 cc an hour and the patient was tolerating the tube feeds well. his blood gases continued to have pco2 in the 50s and po2 in the 50s. the patient was out of bed and ambulating and doing well at that time. it was decided that the patient could be increased to two-thirds strength tube feeds after arriving on the floor due to the fact that the patient was tolerating his tube feeds. physical therapy continued to evaluate him at that time as well and felt that he was doing well and progressing. the patient was started on sips on postoperative day six which he was able to tolerate after an upper gi/small bowel follow-through was performed. this showed an open anastomosis with no leak, therefore his nasogastric tube was removed using mineral oil to lubricate. on postoperative day number eight his tube feeds were switched to two-thirds strength and the patient tolerated the switch well. he was also started on a clear liquid diet which he was able to tolerate. on postoperative day eight in the evening he was stared on a soft solid diet and he continued to improve. on postoperative day number nine his tube feeds were cycled so that they would run from 7 pm to 7 am, giving him two-thirds strength impact with fiber at 90 cc an hour and he could be disconnected from his jejunostomy tube feeds during the day, allowing him to ambulate. the patient continued to do well and continued receiving chest physical therapy, and was out of bed and ambulating. jp teaching was performed and on postoperative day number 10 the patient was tolerating a soft solid diet, having six small meals a day. nutrition had seen him and had given him nutritional teaching about a soft solid diet and multiple small meals, and it was decided that the patient could be discharged home. the patient was discharged home in stable condition with services in place, for planned jejunostomy tube feeds at 90 cc an hour of two-thirds strength impact with fiber. the patient was also planned to have vna services for - drain monitoring and wound check. the patient was discharged home at that time in stable condition. discharge medications: 1. atrovent 2 puffs q.i.d. 2. flovent 2 puffs b.i.d. 3. lasix 20 p.o. q.d. 4. diltiazem 240 mg p.o. q.d. 5. theophylline 300 mg p.o. b.i.d. 6. isosorbide dinitrate 20 mg p.o. b.i.d. 7. xanax 0.5 mg p.o. q.d. p.r.n. 8. protonix 40 mg p.o. b.i.d. 9. tube feeds with the kangaroo pump, impact with fiber two-thirds strength at 90 cc an hour to be cycled from 7 pm to 7 am. 10. vicodin for pain control. discharge diagnoses: 1. esophageal cancer status post xrt and chemotherapy now status post distal esophagectomy and total gastrectomy with jejunostomy tube placement. 2. esophagus. 3. chronic obstructive pulmonary disease requiring home oxygen. 4. peptic ulcer disease. 5. coronary artery disease status post myocardial infarction. 6. ventral hernia repair. condition on discharge: stable. discharge instructions: he was instructed to follow up with dr. in one week's time for wound check, - drain removal as well as review of pathology. pathology reports were not back at the time of discharge. , m.d. dictated by: medquist36 procedure: other enterostomy enteral infusion of concentrated nutritional substances excision or destruction of peritoneal tissue open biopsy of liver total gastrectomy with intestinal interposition diagnoses: coronary atherosclerosis of native coronary artery iron deficiency anemia secondary to blood loss (chronic) chronic airway obstruction, not elsewhere classified old myocardial infarction personal history of irradiation, presenting hazards to health malignant neoplasm of other specified part of esophagus secondary malignant neoplasm of other digestive organs and spleen 

Answer: The patient is high likely exposed to