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: aleve / ace inhibitors / florinef attending: chief complaint: nausea/vomitting major surgical or invasive procedure: ercp with stent placement history of present illness: yo m pmhx lymphoma p/w n/v x several hours. patient reports that shortly after eating dinner on day of admission, he developed acute onset nausea and vomitting. he had 3 episodes of nb/nb emesis. patient denied . found by ems rigoring. no cp, sob, abd pain, flank pain. fever to 100.2 at home. of note, patient reports eating a hamburger for dinner and is concerned that it may have been undercooked; no one else eating the dinner got sick; patient denies any other sick contacts, recent travel. . in the ed, initial vital signs were 100.4 (oral) 104.0 (rectal) 123 137/80 18 95%ra. labs were significant for wbc 3.1, hct 28, platelet 54, cr 1.6, alt/ast 168/226, ap456, tbili 1.2, lactate 2.7 (repeat lactate 3.2). cxr was unremarkable. patient was given iv vanco/cefepime. vital signs prior to transfer were 113/49 102 23 97. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: - recurrent malignant melanoma (including local recurrences), last that was pt1b - 3+3 prostate adenocarcinoma (diagnosed ) followed by surveillance with dr. - benign prostatic hypertrophy - cholecystectomy - chronic intestinal pneumatosis - type 2 dm - htn - asthma - hyperlipidemia - gerd - subarachnoid hemorrhage - orthostatic hypotension - anemia attributed to mds - thrombocytopenia - acute renal failure social history: retired 11 years ago after working as a travel for 50+ years; also worked conducting a band. lives at home with his 78yo wife. smoked 6-7 years as a young adult, none since. denies etoh, illicits family history: nc physical exam: admission vitals: t: 99.8 rectal bp: 97/42 p: 88 r: 18 o2: 97% general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: markedly distended and tympanic to percussion; non-tender, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: admission labs: 10:30pm wbc-3.1* rbc-3.02* hgb-9.6* hct-28.0* mcv-93 plt ct-54* glucose-145* urean-66* creat-1.7* na-140 k-6.0* cl-107 hco3-25 angap-14 alt-172* ast-271* alkphos-540* totbili-1.4 lactate-2.7* tte: the left atrium is mildly dilated. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). the aortic valve is not well seen. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. there is a small pericardial effusion. there are no echocardiographic signs of tamponade. impression: poor technical quality due to patient's body habitus. left ventricular function is probably normal, a focal wall motion abnormality cannot be fully excluded. the right ventricle is not well seen. no pathologic valvular abnormality seen. pulmonary artery systolic pressure could not be determined. compared with the prior study dated (images reviewed), image quality is worse. ct abd/pelvis: 1. opacities at the lung bases, right greater than left, concerning for aspiration pneumonia as seen on the recent chest x-ray. 2. no evidence of bowel obstruction. persistent mild gaseous distention of the colon which tapers to normal caliber at the sigmoid colon. 3. mild central intrahepatic biliary dilation and inflammatory changes surrounding the common bile duct, unchanged since . again, this is likely related to sequela of chronic cholangitis with no evidence of an active process. ruq u/s : this is a very limited study due to overlying gas, showing mild central common hepatic duct dilatation. the etiology for this is not apparent and most of the common duct cannot be imaged successfully. this could be further evaluated with mrcp or ercp if clinically appropriate. ercp : impression: a plastic stent placed in the biliary duct was found in the major papilla. the stent appeared occluded without noticeable drainage - this was successfully removed. upon removal, extensive sludge and debris extruded from the biliary orifice. three stones and debris ranging in size from 5 mm to 10 mm that were causing partial obstruction were seen at the common bile duct. the cbd was dilated to 12 mm. given recent mi and low platelets, decision was made not to proceed with sphincterotomy. a 7cm by 10fr biliary stent was placed successfully. good drainage of bile was noted from the stent after placement. microbiology: cultures no growth to date at the time of . labs: 05:26am wbc-2.2* rbc-2.71* hgb-8.4* hct-25.6* mcv-95 plt ct-36* glucose-121* urean-43* creat-1.5* na-140 k-4.3 cl-110* hco3-22 angap-12 alt-52* ast-27 ld(ldh)-238 alkphos-305* amylase-21 totbili-1.6* brief hospital course: hospital course yo m pmhx cll, recent sah, a/w fever, vomitting, elevated lfts, thought to have infection of biliary source, course complicated by nstemi. active diagnoses: # fever: patient was admitted with fever, rigors, labs significant for transaminitis and elevated alk phos suggesting billiary source; u/s abd demonstrated mild cbd dilatation, ct abd demonstrated intrahepatic biliary dilation and inflammatory changes surrounding the common bile duct, without significant change from prior imaging performed at time of recent cbd stenting. review of records demonstrated prior ercp performed at which time biliary stent was placed w recommendation for removal in 2 months, however this was never done. ercp was performed which showed sludge and debris from biliary orifice upon removal of an occluded stent. stones were found to be obstructing the cbd and there was biliary dilation. no spincterotomy was performed in the setting of recent nstemi and low platelets. patient remained afebrile on unasyn, and was transitioned to augmentin on . he is being discharged with a prescription for ten additional days of antibiotics. # nstemi: pt reported a brief episode of chest pain on admission accompanied by non-specific st depressions that resolved w/o intervention, followed by troponins peaking at 1.17 before trending downward. he was seen in consultation by cardiology who felt this was an nstemi. aspirin was started, along with a beta-blocker. he remained chest pain free on the general medicine service and in the icu. he will need to be seen in follow-up for a pressure check and consideration of further risk stratification. #myelodysplasia: oncology (dr. and dr. ) following. neulasta and epo held while patient hospitalized. he was transfused 2u prbc's and 1u platelets on in anticipation of his ercp. he developed a dry cough and 1-2l oxygen requirement following his second unit of prbc's, and was given one dose of lasix 5mg iv overnight and 20mg iv the morning of with resolution of his respiratory symptoms. he will resume his outpatient neulasta and epo schedule, with his next nursing visit scheduled for . #dm: patient had intermittent episodes of hypoglycemia while in the icu. his home insulin was held and the patient was placed on d51/2ns while npo. as his diet was advanced his sugars improved, and his home nph 70/30 was re-started at 7u rather than his prior dose of 15u. he was instructed to check his finger sticks at home and follow-up with his pcp to have his insulin increased as needed. #gerd: continued omeprazole #glaucoma: continued timolol and bimatoprost #bph: continued finasteride transitional issues - patient needs repeat ercp in 2 months for stent removal and stone extraction. the will call him to schedule that appointment. - follow-up final results of cultures - check pressure on toprol 50mg (new medication for patient) - uptitrate nph as needed medications on admission: 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 2. timolol maleate 0.25 % drops sig: one (1) drop ophthalmic (2 times a day). 3. bimatoprost 0.03 % drops sig: one (1) ophthalmic daily (). 4. magnesium oxide 140mg sig: two (2) twice a day. 5. finasteride 5 mg tablet sig: one (1) tablet po once a day. 6. insulin nph 70/30 sig: 15 units qam. disposition: home with service facility: homecare diagnosis: cholangitis nstemi (damage to your heart) pancytopenia (low counts) condition: mental status: clear and coherent. level of consciousness: alert and interactive. instructions: you were admitted to the hospital with fevers that were thought to be due to an infection of your biliary system. you were given iv antibiotics and underwent an ercp during which your previous stent was removed and a new stent was placed. you will need to follow-up with the ercp team in eight weeks to have that stent removed; their office will call you to schedule that appointment. in the setting of your fever and infection you had evidence of damage to your heart. for this reason you were started on a new medication called toprol. you will need to follow-up closely with your primary care doctor to have your pressure checked while on this medication. while in the hospital you received transfusions of and platelets; you were not given neulasta or epo. you should resume your usual schedule when you are discharged, and will receive your next doses on . you will follow-up with dr. again on . while in the hospital you were not able to eat for several days. in this setting, your sugars dropped down very low, and your home insulin was stopped. when you started eating again your sugars began to improve and your insulin was re-started at a lower dose (7 units instead of the 15 units you normally take at home). you should check your sugars at home and follow-up with your pcp so that they can help you increase your insulin dose back up to an appropriate level as your appetite improves. followup instructions: please call to schedule an appointment with your primary care doctor within 3 to 5 days of , and keep the following previously scheduled appointments: department: neurosurgery when: thursday at 10:30 am with: , md building: lm campus: west best parking: garage department: hematology/oncology when: thursday at 11:30 am with: , lpn building: campus: east best parking: garage department: hematology/oncology when: thursday at 2:30 pm with: dr. building: sc clinical ctr campus: east best parking: garage procedure: endoscopic retrograde cholangiopancreatography [ercp] replacement of stent (tube) in biliary or pancreatic duct diagnoses: subendocardial infarction, initial episode of care esophageal reflux unspecified septicemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified asthma, unspecified type, unspecified hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) sepsis chronic kidney disease, unspecified other and unspecified hyperlipidemia malignant neoplasm of prostate diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled do not resuscitate status cholangitis personal history of malignant melanoma of skin calculus of bile duct without mention of cholecystitis, with obstruction lymphosarcoma, unspecified site, extranodal and solid organ sites 

Answer: The patient is high likely exposed to