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: iodine attending: chief complaint: abdominal pain major surgical or invasive procedure: expired history of present illness: 56 year old female with history of cholangiocarcinoma status post trisegmentectomy with roux-en-y hepaticojejunostomy and cholecystectomy and recent admission for c. dif (treated) now tranferred to from due to severe abdominal pain. she stated that she had decreased appetite after she came home from chemotherapy last thursday (), and the pain began approx 2 days ago. she has difficulty characterizing the pain but states that it is very bad. she reports associated diarrhea, however at reported constipation with only small bm/flatus today. denies fever or chills, no shortness of breath or chest pain. she had no nausea until arrival to the at which point she developed emesis. upon arrival there her vitals were as follows: t 97.9, hr 115, bp 112/69, o2 sat 96% on ra. ng tube was placed. ct scan was attempted, however, po contrast had not progressed sufficiently for accurate scan. upon arrival the the floor, the patient was very sleepy, answering questions only sporadically about her symptoms. past medical history: past oncologic history: she initially presented in the summer of , and she was found to have what appeared to be an unresectable locally advanced cholangiocarcinoma. she had two cycles of treatment on protocol with irinotecan plus gemcitabine. she seemed to tolerate this relatively well, and had a small improvement. she then underwent staging laparotomy in , and at that time, it appeared that she would be resectable. on , she underwent a trisegmentectomy with a roux-en-y hepaticojejunostomy and cholecystectomy by dr. . she had a complete recovery from this resection and remained well until when she had a local recurrence. she underwent rfa and had a hepatic artery thrombosis which resulted in a long course of chronic hepatic ischemia. she developed progressive disease and has consulted a number of physicians around the country. she saw dr. in who advised a chemotherapy program known as "g flip + avastin". she was extensively treated and recently her chemotherapy has been modified and decreased because of hematologic toxicity. per patient she's currently dtic, methotrexate and oxaliplatin. social history: she works as a software developer but is presently on disability. does not smoke or drink. lives in area here whole life. family history: it is significant for an aunt with cancer, father with prostate cancer and heart disease. physical exam: t 96.4, bp 102/69, p 132, rr 18, 96% ra gen - ill-appearing, cachectic, sleepy, breathing comfortably, jaundiced heent - mmm, no oral lesions. perrl, ?scleral icterus cv - tachcardic, reg. rhythm, nl s1, s2, no s3/s4, no murmurs lungs - poor insp. effort, decreased bs at l lung base, no crackles or wheezes appreciated. abd - soft, tender to palp ruq, llq, no guarding, no rebound tenderness. liver non-palpable, no fluid wave. +bs ext - no c/c/e, dp pulse 2+ b/l. neuro - a&o x 3, sensation grossly intact to light touch, moves all extremities equally. pertinent results: hypochrom-2+ anisocyt-2+ poikilocy-normal macrocyt-3+ microcyt-occasional polychrom-occasional neuts-90* bands-0 lymphs-2* monos-8 eos-0 basos-0 atyps-0 metas-0 myelos-0 wbc-1.7* rbc-3.05* hgb-10.1* hct-31.7* mcv-104* mch-33.1* mchc-31.9 rdw-21.7* alt(sgpt)-116* ast(sgot)-114* ld(ldh)-164 alk phos-369* amylase-27 tot bili-5.9* lipase-18 . ct scan abd/pelvis (): abdomen findngs: there is interval development of left basilar airspace opacity which is incompletely imaged. lack of intravenous contrast limits the evaluation of solid organs. again seen are the post-surgical changes with right hepatic lobe resection and post-whipple changes. the remainder of the liver and pancreas, spleen, adrenal glands and kidneys are grossly unremarkable. there is no hydronephrosis or hydroureter. no extra-luminal air is identified. multiple small and borderline enlarged retroperitoneal and mesenteric lymph nodes are seen, with the largest measuring approximately 9 mm in the portocaval region. evaluation of bowel loops is significantly limited due to inadequate contrast in the bowel and background mesenteric edema, which has increased compared to prior study. the oral contrast is noted predominantly in the stomach and proximal small bowel. there is diffuse mid to distal small bowel wall thickening to the level of terminal ileum, which could be related to liver dysfunction/hypoalbuminemia. the is distended with fluid, admixed with fecal material. the colonic wall does not appear thickened. no definitive bowel obstruction or transition point is noted. pelvis findings: the urinary bladder is grossly unremarkable. the uterus is grossly within normal limits. there is a stable left adnexal hyperdense lesion, which could represent a hemorrhagic cyst or dermoid. a moderate amount of pelvic ascites is noted. body wall edema is seen, slightly increased from prior study. bony structures are intact. impression: 1. significantly limited non-contrast ct examination of the abdomen and pelvis demonstrates stable post-surgical changes related to prior whipple and right hepatectomy. 2. diffuse thickening of the mid to distal small bowel wall to the level of terminal ileum, which may be secondary to hypoalbuminemia. however, other potential etiologies including infectious and metastatic disease should be considered. given the limited passage of oral contrast, a delayed scan may be useful to further evaluate though no transition point is seen on this study. 3. increased ascites, mesenteric edema which may be related to volume status and/or liver dysfunction. 4. left lung base opacity, incompletely imaged. correlation with dedicated chest ct is recommended. ruq ultrasound: findings: this is a limited study for the evaluation of intrahepatic biliary dilatation. the patient is status post right hepatectomy. the left hepatic lobe is heterogeneous in echotexture with numerous focal areas of low echogenicity. no intrahepatic biliary dilatation is seen. within the left lobe a biliary duct is visualized measuring 4 mm which may represent the left main hepatic duct. the portal vein could not be definitively identified. impression: 1. limited study of the liver. heterogeneous echotexture and focal areas of decreased echogenicity. infiltrative process cannot be excluded and as previously suggested this would best be assessed by mri. 2. no intrahepatic biliary dilatation. 4 mm biliary duct in the left hepatic lobe may represent the main left hepatic duct. upright portable chest radiograph comparison is made to and radiographs. since the most recent radiograph, nasogastric tube has been removed, and size of bilateral pleural effusions has worsened as has perihilar edema. there are persistently low lung volumes, limiting assessment for pneumonia. retrocardiac density likely representing atelectasis and/or consolidation is not significantly changed. there is no evidence of pneumothorax with stable appearance to right-sided central venous catheter. gaseous distention to loops interposed bowel is again noted. impression: 1. low lung volumes with interval worsening and bilateral pleural effusions with probable adjacent atelectasis, underlying pneumonia cannot be excluded. 2. slight interval worsening to perihilar haziness, likely representing continued fluid overload concordant with clinical history provided. brief hospital course: 56 yo f with progressive cholangiocarcinoma s/p recent admission for c diff colitis, admitted for severe abdominal pain and vomiting #)abdominal pain / c.dif colitis - the patient developed severe c.diff colitis requiring micu stay for hypotension and septic picture. she was aggressively treated and eventually was discharged back to the floor. she slowly improved at first, but then her lfts continued to rise. initially, the rise was from her shock liver, but as that resolved, it eventually worsened. at this time, the patient was very deconditioned, had anasarca, and her abdominal pain and distension continued to get worse. family meetings were held, and it was decided to make the patient dnr/dni. although she never became cmo status, the family decided to stop medical interventions except for antiobiotics. the patient was started on a morphine and ativan drip to help with the pain and to provide the patient comfort, and she expired on at the hospital. #)hyperbilirubinemia - pt has a history of hyperbilirubinemia, likely a result of progressive disease state. the patient's hyperbilirubinemia worsened after her shock liver due to her sepsis, but then started to improve slowly. although, near the time of death, the hyperbilirubinemia began to worsen again likely due to progressive disease. #)recurrent cholangiocarcinoma: the patient was undergoing chemotherapy in ny with oncologist, regimen dtic, methotrexate and oxaliplatin, last dose received . the family pursued dnr/dni status, and the patient expired from worsening disease. #) social services and palliative care assisted in this patient's care. the family had a very difficult time dealing with the patient's decline in health, but we all provided support to help them cope. the patient was made comfortable at the time of death. the family was present, and a report was filled out. the attending was aware at the time of death. medications on admission: furosemide 20mg po daily actigall 300mg po bid tagamet 400mg po bid prilosec 20mg po bid lovenox 30mg inj daily torsemide 20mg po daily spironolactone 50mg po daily neulast/aranesp with chemo iron 325 tablet daily morphine sustained release 30mg msir 15mg q6h for pain recently finished course cipro/flagyl discharge medications: expired discharge disposition: expired discharge diagnosis: cholangiocarcinoma- expired discharge condition: expired discharge instructions: expired followup instructions: expired procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances diagnoses: anemia, unspecified unspecified protein-calorie malnutrition severe sepsis septic shock pressure ulcer, other site intestinal infection due to clostridium difficile other septicemia due to gram-negative organisms dehydration other and unspecified coagulation defects malignant neoplasm of intrahepatic bile ducts 

Answer: The patient is high likely exposed to