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: penicillins / ultracet / codeine / flagyl attending: chief complaint: fever, chills major surgical or invasive procedure: endoscopic retrograde cholangiopancreatography history of present illness: the pt is an 84m with stage two metastastic pancreatic cancer with palliative cbd stent placement who presents with fevers and chills for 1 day. he does not endorse feeling particularly short of breath although he admits now that he feels better with oxygen. he measured his temperature at home to be ~100.6. he also notes continued abdominal bloating that he has had for months, although he feels it is actually slightly better now. he does not have any focal abdominal tenderness. he states he had dysuria about 1-2 weeks ago but this stopped a few days ago. . in the ed cxr showed a right-sided pna. his ua was floridly positive. after discussion with the id fellow, he was treated with levo and clinda due to allergies to pcn and flagyl. his sbp was mostly in the 120s initially. his lfts were found to be markedly abnormal, and he was sent for ruq us that showed air in the gallbladder, indicating patency of the cbd stent; sludge and stones in the gb; and thickening of the cbd wall that may represent infiltration of tumor. upon return from us, his sbp dropped to the high 70s but responded to the 90s-100s with an additional 1l of ivf. he received a total of ~2l ivf in the ed. he was admitted to the micu for further fluids and monitoring. past medical history: past onc hx: he was diagnosed with pancreatic ca in after an episode of cholangitis and sepsis. he had ercp w/ stenting and ptc placed. he is s/p biliary stent (). his disease was felt to be unresectable due to the confluence of the splenic vein and lack of fat planes for resection. he was treated w/ palliative, weekly gemcitabine x 3 from to . his postchemo course was c/b prolonged periods of neutropenia fevers and infections such as klebsiella bacteremia. he underwent cyberknife therapy in . pet was notable for a fdg-avid infiltrating mass originating in pancreatic head that extends to porta hepatitis and which abuts, but does not appear to extend beyond, the site of fiducial markers. no evidence of remote fdg-avid metastatic disease. ca19-9 on - 126 from 11 in . . other pmh: cri (1.6-2) gerd lumbar stenosis s/p repair copd peripheral disease prostatectomy for early stage prostate ca hernia repair hypertension cva- tia years ago, no residual deficits chronic constipation rheumatic fever as a child social history: lives in with wife of 12 . retired president of insurance company. the patient is a 100-pack year smoker but quit 25 ago. he used to drink alcohol socially, but currently not drinking at all. no children. he is an only child. wife is very supportive. family history: non-contirbutory physical exam: vs: 98.3, 108/52, 91, 96% 4l nc gen: nad, pleasant elderly man appearing younger than stated age heent: perrl, eomi, anicteric, mm dry, op clear neck: no lad, supple, no jvd lungs: ctab cv: rrr, nl s1s2, i/vi hsm lusb abd: +bs, soft, nontender, distended, tympanitic ext: no c/c/e, 2+ dp pulses b/l neuro: aaox3, cn ii-xii intact, sensory/motor grossly intact pertinent results: liver or gallbladder us: 1. air in the biliary system indicating patency of the common bile duct stent. 2. sludge and stones in the gallbladder, with focus of air in the gallbladder also suggesting patency with the biliary system. 3. unchanged appearance since ct scan of thickening of the common bile duct, which itself is normal caliber. . cxr: no evidence of acute cardiopulmonary process. . ecg: sinus rhythm. low limb lead voltage. delayed precordial r wave progression. compared to the previous tracing of the rate has slowed and there is variation in precordial lead placement. otherwise, no diagnostic interim change. . cxr: compared with 4/16, the chf/fluid overload has almost completely cleared. . cxr: no evidence of lung consolidation. . abdomen (supine & erect): non-specific bowel gas pattern which includes dilated loops of small bowel. however air and stool are seen in the colon. if there is persistent pain, followup radiographs or cross-sectional imaging is recommended. . cxr: small bilateral pleural effusions with no evidence of pulmonary edema. . abdomen (supine & erect): mildly distended gas-filled loops of large bowel with multiple air-fluid levels, which likely represents ileus. the appearance is improved when compared to the prior study. . ercp: a metal stent was found in the major papilla. cannulation of the biliary duct was successful and deep with a sphincterotome through the metal stent seen in good position at the ampulla. contrast medium was injected resulting in complete opacification. filling defects in the stent within the cbd were noted. the intrahepatic ducts were normal.biliary debris and purulent bile was extracted successfully using sweeps with a balloon catheter. the stent allowed passage of a fully inflated 12mm balloon. occlusion cholangiogram performed at the end of the procedure revealed no overgrowth or ingrowth of tumor into the stent. . 08:10am blood wbc-9.4 rbc-3.27* hgb-9.9* hct-29.4* mcv-90 mch-30.1 mchc-33.5 rdw-16.1* plt ct-211 08:00pm blood wbc-4.4 rbc-3.43* hgb-9.9* hct-28.9* mcv-84 mch-28.8 mchc-34.3 rdw-15.8* plt ct-110* 08:10am blood plt ct-211 07:10am blood plt ct-65* 07:10am blood pt-15.5* ptt-29.2 inr(pt)-1.4* 05:11am blood plt ct-59* 12:44am blood plt ct-80* 08:10am blood glucose-110* urean-21* creat-1.3* na-131* k-4.4 cl-93* hco3-29 angap-13 08:00pm blood glucose-171* urean-24* creat-1.3* na-129* k-3.8 cl-94* hco3-21* angap-18 08:10am blood alt-48* ast-28 alkphos-357* totbili-1.3 07:08am blood alt-120* ast-54* alkphos-541* totbili-2.3* 07:50am blood alt-165* ast-62* alkphos-548* totbili-2.5* 08:00pm blood alt-779* ast-565* alkphos-515* amylase-27 totbili-2.3* 07:20am blood lipase-37 07:20am blood caltibc-182* ferritn-649* trf-140* 08:35pm blood lactate-6.1* hit ab: negative brief hospital course: #biliary sepsis/gnr bacteremia: underwent ercp which showed biliary debris and purulent bile which was extracted successfully. blood cultures grew e. coli, morganella, and c. perfringens. treated with 14 day course of (initially vanc/gent/-->ctx-->cefpodox/cipro on discharge). . #copd: started on advair and albuterol prn. . #thrombocytopenia: resolved, hit negative. likely sepsis. . #narcotic induced ileus: resolved with aggressive bowel regimine. . #anemia of chronic disease: hct stable, no indication for transfusion. . #mild hypoxia: developed mild hypoxia (high 80s/low 90s). abg without c02 retention, cta without pe. likely from volume overload from resuscitation. improved after diuresis. medications on admission: 1. nexium 40 mg qd 2. atorvastatin 5 mg qod (recently stopped) 3. toprol xl 25 mg qd 4. ecotrin 325 mg qd 5. docusate sodium 100 mg 6. senna 8.6 mg tablet 7. hexavitamin qd 8. simethicone 80 mg qid prn 9. amylase-lipase-protease 20,000-4,500- 25,000 unit capsule, three (3) cap po tid w/meals 10. claritin 10 mg prn 11. erythromycin 250 mg tid (recently stopped) discharge medications: 1. toprol xl 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 2. hexavitamin tablet sig: one (1) cap po daily (daily). 3. amylase-lipase-protease 20,000-4,500- 25,000 unit capsule, delayed release(e.c.) sig: three (3) cap po tid w/meals (3 times a day with meals). 4. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 6. docusate sodium 100 mg capsule sig: two (2) capsule po bid (2 times a day). 7. cefpodoxime 200 mg tablet sig: one (1) tablet po twice a day for 6 days. disp:*12 tablet(s)* refills:*0* 8. simethicone 80 mg tablet, chewable sig: 0.5 tablet, chewable po qid (4 times a day). 9. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 6 days. disp:*12 tablet(s)* refills:*0* 10. atorvastatin 10 mg tablet sig: .5 tablet po every other day. 11. ecotrin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 12. fluticasone-salmeterol 100-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). disp:*1 disk with device(s)* refills:*2* 13. albuterol 90 mcg/actuation aerosol sig: one (1) inhalation inhalation every 4-6 hours. disp:*1 inhaler* refills:*2* discharge disposition: home with service facility: caregroup discharge diagnosis: 1. biliary sepsis/gnr bacteremia 2. pancreatic ca 3. copd 4. hypertension 5. thrombocytopenia, resolved 6. narcotic induced ileus, resolved 7. anemia of chronic disease discharge condition: stable discharge instructions: please return to the emergency room should you develop any fevers, chills, sweats, nausea, vomiting, abdominal pain, shortness of breath or any other complaints. followup instructions: provider: scan phone: date/time: 10:00 provider: , md phone: date/time: 10:00 provider: , (nhb) date/time: 10:00 procedure: endoscopic retrograde cholangiopancreatography [ercp] diagnoses: esophageal reflux unspecified essential hypertension chronic airway obstruction, not elsewhere classified peripheral vascular disease, unspecified sepsis paralytic ileus cholangitis anemia in neoplastic disease septicemia due to gram-negative organism, unspecified malignant neoplasm of other specified sites of pancreas 

Answer: The patient is high likely exposed to