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: jaundice major surgical or invasive procedure: ercp history of present illness: this is an 85 yo male with h/o avr (mechanical valve), afib, aaa 5.9 cm not surgical candidate, admitted to for painless jaundice. he had an ercp with was unsuccessful at osh, therefore he was sent here for repeat ercp and evaluation. he had a stent removed, biopsies of a suspicious lesion, and new stent placed. during the procedure, he became intermittently hypotensive, with sbp in the 80s, requiring fluid boluses and 800 mcg of phenylephrine. he received versed 2 mg, propofol 100 mg, and fentanyl 75 mcg during the procedure. he received 800 ml of lr during the procedure. post ercp, he was in the holding area, noted to be hypotensive to low 90s, and with a concerning "wide complex rhythm". was called to evaluate and monitor the patient prior to transfer back to . at the time of evaluation, the patient only complained of some abdominal soreness, denied chest pain, sob, lightheadedness, or dizziness. sbp had already improved to 112/68. his rhythm was v-paced. cardiology was also at bedside to evaluate. . ros: the patient denies any fevers, chills, weight change, diarrhea, constipation, melena, hematochezia, chest pain, shortness of breath, cough, urinary frequency, urgency, dysuria, lightheadedness, gait unsteadiness, focal weakness, vision changes, headache, or rash. past medical history: 1) asthma 2) mechanical avr on coumadin- currently held and on lovenox 3) atrial fibrillation s/p ppm 4) aaa 5.9 cm not surgical candidate 5) anemia 6) hyperlipidemia 7) depression 8) ? seizure d/o social history: lives at home with a roommate. denies etoh or smoking. family history: nc physical exam: vitals: t: bp: hr: rr: o2sat: gen: well-appearing, well-nourished, no acute distress heent: eomi, perrl, sclera anicteric, no epistaxis or rhinorrhea, mmm, op clear neck: no jvd, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline cor: rrr, no m/g/r, normal s1 s2, radial pulses +2 pulm: lungs ctab, no w/r/r abd: soft, nt, nd, +bs, no hsm, no masses ext: no c/c/e, no palpable cords neuro: alert, oriented to person, place, and time. cn ii ?????? xii grossly intact. moves all 4 extremities. strength 5/5 in upper and lower extremities. patellar dtr +1. plantar reflex downgoing. no gait disturbance. no cerebellar dysfunction. skin: no jaundice, cyanosis, or gross dermatitis. no ecchymoses. pertinent results: 03:20pm glucose-126* urea n-14 creat-0.7 sodium-140 potassium-4.3 chloride-103 total co2-27 anion gap-14 03:20pm alt(sgpt)-102* ast(sgot)-175* ld(ldh)-212 ck(cpk)-17* alk phos-451* amylase-49 tot bili-13.6* 03:20pm lipase-28 03:20pm albumin-3.3* calcium-8.8 phosphate-3.0 magnesium-2.4 cholest-227* 03:20pm albumin-3.3* calcium-8.8 phosphate-3.0 magnesium-2.4 cholest-227* 03:20pm triglycer-156* hdl chol-13 chol/hdl-17.5 ldl(calc)-183* 03:20pm wbc-5.4 rbc-2.72* hgb-9.9* hct-29.3* mcv-108* mch-36.4* mchc-33.7 rdw-16.6* 03:20pm neuts-69 bands-1 lymphs-15* monos-9 eos-2 basos-2 atyps-0 metas-0 myelos-2* 03:20pm hypochrom-2+ anisocyt-1+ poikilocy-1+ macrocyt-1+ microcyt-normal polychrom-normal target-occasional ercp : impression: a plastic stent placed in the biliary duct was found in the major papilla. the stent was removed with a snare and sent for cytology. evidence of a previous sphincterotomy was noted in the major papilla. cannulation of the biliary duct was successful contrast medium was injected resulting in complete opacification. a single smooth stricture that was 35mm long was seen at the mid cbd extending to the hilum. there was moderate post-obstructive dilation. a 10fr by 250cm spyglass choledochoscope was introduced into the bile duct with success. the mucosa appeared irregular and friable, suspicious for a malignant process. three cold forceps biopsy were taken from the stricture through the spyglass choledochoscope for histology. a 10cm by 10frmm cotton biliary stent was placed successfully using a 10fr stent introducer kit. excellent bile drainage was achieved otherwise normal ercp to second part of the duodenum plan: return to outside hospital under dr. care follow for response/complications please call if develops jaundice, black stools, fever, or abdominal pain juices today when awake, alert, and at baseline follow-up cytology results follow-up biopsy results if malignancy confirmed will arrange ercp and metal stent insertion with dr ecg : multiple ecgs available for evaluation and telemtry strip. baseline underlying rhythm atrial fibrillation. some ecg are v-paced. difficult to determine whether there are any ischemic changes on v-paced beats, but no obvious st segment changes. rate in 90s-100. tele strip shows afib, then subsequent likely v-paced rhythm. brief hospital course: assessment: this is a 85 year-old male with a history of mechanical avr, atrial fibrillation, aaa, who is transferred to the s/p ercp c/b hypotension and concern for "wide complex" rhythm. # hypotension: patient's hypotension was thought to be secondary to sedation and possibly volume depletion. he underwent a rule-out for myocardial infarction that was negative. he was given a 500cc normal saline bolus and his blood pressure remained stable during his hospital stay. he did not require vasopressors. # hypoxia: patient had an oxygen requirement of 4l that was thought to be secondary to pulmonary edema. he will likely need gentle diuresis upon arrival at to help reduce his oxygen requirement. subjectively, he was not complaining of shortness of breath. # ventricular-paced rhythm/afib: patient has a history of afib with v-paced rhythm. he did not complain of chest pain and also ruled out for myocardial infarction. he was restarted on lovenox after his ercp on at . # painless jaundice: patient underwent a repeat ercp on the evening of at . a plastic stent placed in the biliary duct was found in the major papilla. the stent was removed with a snare and sent for cytology. evidence of a previous sphincterotomy was noted in the major papilla. cannulation of the biliary duct was successful. a single smooth stricture that was 35mm long was seen at the mid cbd extending to the hilum. there was moderate post-obstructive dilation. a 10fr by 250cm spyglass choledochoscope was introduced into the bile duct with success. the mucosa appeared irregular and friable, suspicious for a malignant process. three cold forceps biopsy were taken from the stricture through the spyglass choledochoscope for histology. a 10cm by 10frmm cotton biliary stent was placed successfully using a 10fr stent introducer kit. excellent bile drainage was achieved. otherwise normal ercp to second part of the duodenum. he should return to under dr. care and his cytology results should be followed-up. # mechanical avr: patient was restarted on lovenox after discussion with the ercp fellow. # c. diff: patient had diarrhea and his stool was positive for c. diff. he was started on po flagyl. medications on admission: albuterol 90 mcg 2 puffs ih q4h prn enoxaparin 80 mcg finasteride 5 mg daily folic acid 1 mg daily pantoprazole 40 mg daily phenytoin 200 mg qam and 300 mg qhs simvastatin 80 mg qhs terazosin 5 mg daily discharge medications: 1. influen tr-split vac (pf) 45 mcg/0.5 ml syringe sig: one (1) ml intramuscular asdir (as directed). 2. pneumococcal 23-valps vaccine 25 mcg/0.5 ml injectable sig: asdir ml injection asdir (as directed). 3. enoxaparin 80 mg/0.8 ml syringe sig: seventy (70) mg subcutaneous q12h (every 12 hours). 4. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed. 5. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 6. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. phenytoin 50 mg tablet, chewable sig: four (4) tablet, chewable po qam (once a day (in the morning)). 9. phenytoin 50 mg tablet, chewable sig: six (6) tablet, chewable po qhs (once a day (at bedtime)). 10. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 11. terazosin 5 mg capsule sig: one (1) capsule po hs (at bedtime). 12. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 13. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 14. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day). discharge disposition: extended care discharge diagnosis: primary: c. diff colitis hypotension . secondary: abdominal aortic aneurysm aortic valve repair atrial fibrillation discharge condition: stable discharge instructions: you were admitted because of low blood pressure. your blood pressure has remained stable while you were an inpatient here. we also performed an ercp and we replaced the stent that was placed in your bile duct at . we also took a biopsy of some of the tissue. while you were here, we also diagnosed you with c. diff, an infection of the bowel. to treat you for this, we gave you antibiotics. followup instructions: per primary team at hospital procedure: endoscopic retrograde cholangiopancreatography [ercp] other closed [endoscopic] biopsy of biliary duct or sphincter of oddi replacement of stent (tube) in biliary or pancreatic duct diagnoses: other iatrogenic hypotension anemia, unspecified atrial fibrillation asthma, unspecified type, unspecified depressive disorder, not elsewhere classified heart valve replaced by other means intestinal infection due to clostridium difficile long-term (current) use of anticoagulants cardiac pacemaker in situ epilepsy, unspecified, without mention of intractable epilepsy abdominal aneurysm without mention of rupture dehydration malignant neoplasm of other specified sites of gallbladder and extrahepatic bile ducts 

Answer: The patient is high likely exposed to