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: epigastric pain major surgical or invasive procedure: ercp history of present illness: pcp: , . address: , , phone: fax: 83 yo gentleman with little pmhx was admitted from ercp suite with history epigastric pain. he was initially admitted to (lgh) 10 days ago with acute on chronic epigastric pain and diagnosed with pancreatitis. additional review of systems is notable for the following: intermittent epigastric pain and anorexia over last 3-4 months. he denies fevers or jaundice. at lgh, labs were notable for leukocytosis with wbc >20,000, increasing serum and fluid amylase levels with serial fluid amylase readings of -3600s. imaging was notable for the following: abdominal ct with peripancreatic and ascitic fluid; mri which revealed an amorphous pancreatic head suggestive of hemorrhagic pancreatitis. a paracentesis was performed on , and fluid total protein was elevated, a saag was near zero, and fluid cell count revealed wbc 1700 with neutrophilic predominance. for treatment, he was started empirically on unasyn on and then changed to zosyn on . he also had a drain placed into one of his abdominal fluid collections. additional issues include the following: - malnutrition - he was started on tpn in the setting of being npo and with marked hypoalbuminemia with alb 1.5. - anemia - he received 1 unit prbcs. - atrial fibrillation - he developed rapid afib on . he was initially started on diltiazem with minimal improvement, and he was then transitioned to amiodarone. a pigtail drain was placed to drain ascitic fluid. he was transferred to assessment for ercp and possible transpapillary drainage with stenting. finger stick glucose was elevated to 225 this afternoon. ros: constitutional: no weight loss, fatigue, fevers, chills, night sweats, (+)anorexia for 3-4 months neuro: no headaches, confusion, numbness of extremities, dizziness or light-headedness, vertigo, weakness of extremities, tremor, parasthesias psychiatric: no depression, no suicidal ideation eyes: no blurry vision, diplopia, loss of vision, photophobia ent: no dry mouth, oral ulcers, bleeding nose or gums, tinnitus, sinus pain, sore throat cardiac: no chest pain, doe, syncope, pnd, orthopnea, palpitations, (+) chronic bilat lext peripheral edema pulmonary: no shortness of breath, cough, hemoptysis, pleuritic pain gi: (+) intermittent epigastric abd pain especially last 10 days, none now. no nausea, vomiting, diarrhea, constipation, hematemesis, melena, hematochezia, heme: no easy bleeding, bruising, lymphadenopathy gu: no dysuria, hematuria, (+) increased frequency, urgency chronically, but no incontinence endocrine: no changes in hair, skin, heat or cold intolerance, change in hat or glove size, weight changes, change in energy skin: (+) new rash mild today, no pruritis or lacerations, musculoskeletal: no myalgias, arthralgias, back pain allergy: no seasonal allergies; drug allergies as above past medical history: 1. cirrhosis - by recent mri (no known prior eval / pt not aware) 2. new onset rapid afib - recently at lgh in setting of fluid overload, started on amiodarone, now resolved 3. chronic diastolic congestive heart failure 4. benign hypertension 5. bph - prior prostate biopsy negative for cancer per pt, has urgency/frequency, no incontinence, no recent hydro social history: home: lives alone downstairs from brother in law and nieces. childless widower. was in the service. occupation: former shipping department worker for box company. tobacco: never smoked. etoh: occasional etoh in past drugs: denies family history: no cancers or genetic diseases physical exam: elderly gentleman, pleasant, slightly hard of hearing in no distress t 96.6, bp 118/50, hr 75 regular, rr 22 spo2 95%ra heent: anicteric, op mildly dry, no thrush, no lesions neck: jvp not elevated, no , neck is supple cor: rrr, nl s1/s2, no mrg, normal pmi lungs: scant crackles at bases, otherwise cta bilaterallly abd: distended with ascites, non-tender, no guarding, cannot evaluate for organomegaly given fluid ext: chronic venous stasis hemosiderosis, ++ bilat symmetric lext edema neuro: alert/oriented x 3, mild sensory hearing loss, no focal abnormalitis skin: mild blanching rash on chest/back arms. pertinent results: osh labs: na 133 / k 5.1 / cl 96 / co2 27 / bun 46 / cr .18 / bg 192 alb 2.6 ca 8.2 / tuberculosis 1.2 / alk phos 230 ast 31 / alt 38 / amylase 157 / lipase 1803 wbc 25.6 / hct 34 / plt 700 n 94 / l 4 / m 2 esr 75 wbc 28.4 / hct 31 / plt 589 ca -9 - 44 wbc 22 / hct 28.4 / plt 578 n 87 / bands 8 / l 0 / m 5 na 140 / k 4.3 / cl 107 / co2 24 / bun 47 / cr 1.4 / bg 198 alt 19 / ast 18 / alk phos 120 / amylase 185 / lipase 1456 bnp 159 wbc 18.2 / hct 28.2 / plt 489 n 77 / bands 4 / l 10 / m 7 / e 2 na 125 / k 3.8 / cl 93 / co2 26 / bun 38 / cr 1.9 alb 1.6 tuberculosis .5 / db .4 / alk phos 96 / alt 14 / ast 15 / amylase 124 / lipase 827 na 136 / k 3.8 / cl 102 / co2 30 / bun 19 / cr .9 ca 6.8 / phos 2.6 / mg 2.1 alb 1.5 alk phos 128 / tuberculosis .8 / ast 28 / alt 23 / amylase 149 / lipase 952 inr 1.2 wbc 16.1 / hct 27.6 / plt 386 peritoneal fluid wbc 1774 / rbc 10,000 / alb 1.9 / amylase 1640 / glucose 31 - no malignant cells. increased pmns with fibrinopurlent debris microbiology: blood cx x 2 pending --> negative ascites fluid cx pending --> negative afb smear - negative osh studies: peritoneal fluid - no malignant cells ct abd : 1. cirrhosis with moderate ascites 2. high density soft tissue pancreatic head abnormality c/w hemorrhagic fluid 3. no air within the focus to suggest perforation. fluid collection within central mesentary. 4. probable ileus 5. marked enlarged prostate 6. hiatal hernia kub : moderat ileus, no obstruction cxr : low lung volumes with atelectasis and small bilat effusions. mrcp : 1. pancreatic head mass secondary to acute hemorrhagic pancreatitis, need to r/o underlying mass. 2. secondary mild diation of main pd 6mm, unchanged from prior ct, no intra/extra hepatic biliary dilation. 3. mild gb distention w/o stones. 4. cirrhosis and moderate ascites. u/s : abdominal ascites with septations. heterogeneous liver, nl spleen, no hydronephrosis, small bilat effusions. echo : mild lvh, nl lv size, ef 65%, grade 1 diastolic dysfunction, nl rv, mod lae, minimal aortic stenosis w/ peak grad 15mmhg, tr tr, no pericardial effusion labs: admission labs wbc 17.7 / hct 32.1 / plt 401 na 138 / k 3.5 / cl 102 / co2 30 / bun 17 / cr .8 / bg 67 ca 7.1 / mg 1.9 / phos 2.9 alt 24 / ast 29 / amylase 212 / lipase 166 / alk phos 151 / ldh 227 / tuberculosis 1 / alb 2.1 igg 1527 hbsag negative / hbsab negative / hbcab negative hepatitis a antibody - negative negative hepatitis c antibody negative discharge labs: microbiology: c.diff toxin - positive urine cx negative blood cx - prelim gpc in clusters studies: ercp 1. edematous major papilla 2. the bile duct was not dilated. the distal bile duct filled poorly, most likely due to extrinsic compression from the pathology at the pancreatic head. no filling defects were noted. 3. contrast was injected into the pancreatic duct, which appeared to terminate abruptly in the pancreatic head, with no filling beyond that point. this is in keeping with the reported mrcp findings and is concerning for an obstructing pancreatic mass. endoscopic ultrasound 1. a 3.2 cm x 4.1 cm discrete anechoic lesion, consistent with a cyst was noted in the head of the pancreas. 2. the walls of the cyst were thick measuring 0.22cm. 3. layering debris was noted in the dependent part of the cyst. 4. a pseudoaneurysm was noted on the lateral wall of the cyst. 5. the cyst appeared to obstruct the main pancreatic duct, which was dilated distally. the cyst was also noted to compress the portal vein. 6. a single perigastric lymph node was noted, which measured 1.8 x 0.8cm. otherwise normal egd to third part of the duodenum cta abd/pelvis 1. multiple areas of fluid collection throughout the abdomen including the large bilobed pseudocyst above and below the pancreas, in the right paracolic gutter, transverse mesentery, and within anterior abdominal wall. 2. 6-mm pseudoaneurysm located within the pseudocyst at the level of the pancreas. there is also a 10-mm aneurysm at the origin of the common hepatic artery. 3. dilatation of the main pancreatic duct due to compressive effect of the pseudocyst. brief hospital course: 83yo male with history of bph was transferred from an osh for evaluation of pancreatitis. evaluation was notable for large pancreatic pseudocyst with multiple intra-abdominal fluid collections thought related to his pseudocyst. his course was complicated by unexplained pea arrest. the patient had an icu course s/p resuscitation wherein he did not regain mental faculties or responsiveness. his family chose comfort measures and mr. on . # pea arrest - unclear precipitant. patient never regained mental faculties. 1. pancreatititis, pancreatic pseudocysts, intra-abdominal fluid collections on ercp, patient was found to have bile duct filling defect, suggestive of external compression. he underwent follow-up eus which revealed a large pancreatic pseudocyst. cta pancreas was also performed, which confirmed the large pseudocysts but also noted multiple large abdominal fluid collections. he was evaluated by our general surgery team, who thought his abdominal process of pancreatic pseudocyst and associated inflammation was relatively immature, and that surgical intervention or drainage at this time was not indicated. he developed a bleeding gda aneurysm and was taken to ir for embolization before which he developed pea arrest. this gda was ultimately embolized. 2. clostridium difficile infection within 48 hours of admission, patient developed increased diarrhea and marked leukocytosis from 17 to 26. he was c. diff positive and started on flagyl on with improvement in his diarrhea. he was recommended to continue flagyl for 2 weeks from 4/7-20/10. 3. hepatic cirrhosis imaging from abdominal ct and mrcp revealed hepatic cirrhosis, although patient has no history of this in the past. 4. atrial fibrillation patient was diagnosed with atrial fibrillation at the osh and was started on diltiazem before being transitioned to amiodarone. upon transfer to , his picc line was noted to be advanced into the right atrium, and it was thought that this may have been triggering his atrial fibrillation. during his hospitalization at , he remained in sinus rhythm and with excellent rate control. his amiodarone was discontinued. 5. acute renal failure during his admission at the osh, his creatinine was as high as 1.9 and then remained stable between .. 6. malnutrition patient was started on tpn at the osh and was continued on this during his hospitalization. he was npo during this hospitalization and was npo on discharge. at rehab, we recommend that he remain npo for the first week. he could take sips for comfort after this time. 7. anemia unknown baseline. his hematocrit has remained stable during this admission from 27-30. 8. hyperglycemia he was started on insulin during his hospitalization at and was continued on insulin during his hospitalization at . 9. family contact patient's family contact is the patient's niece . her home number is (; work number is (; cell number is (. medications on admission: transfer medications: 1. amiodarone 400mg 2. nitroglycerin ointment ss qid (sbp >120 2 in, 110-119 1.5in, 100-109 1 in, <100 wipe off 3. octreotide 100mcg iv q8hr 4. pantoprazole 40mg po q 24 5. zosyn 3.375 iv q6hr (day 1 - ) 6. tamsulosin .4mg po daily 7. neutra-phos 2pack po bid 8. bacitracin ointment top daily prn 9. demerol 50mg im q4h prn pain 10. demerol 75mg im q 4hr 11. zoldipem 10mg qhs prn 12. tpn per nutrition home medications: 1. lasix 2. tamsulosin discharge medications: deceased discharge disposition: discharge diagnosis: deceased discharge condition: deceased discharge instructions: deceased followup instructions: deceased md procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other endoscopy of small intestine insertion of endotracheal tube arterial catheterization arteriography of other intra-abdominal arteries arteriography of other intra-abdominal arteries other endovascular procedures on other vessels cardiopulmonary resuscitation, not otherwise specified endoscopic retrograde cholangiopancreatography [ercp] diagnostic ultrasound of digestive system diagnoses: anemia, unspecified acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified septicemia severe sepsis cardiac complications, not elsewhere classified atrial fibrillation acute on chronic diastolic heart failure hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure cardiac arrest compression of vein intestinal infection due to clostridium difficile paralytic ileus dermatitis due to drugs and medicines taken internally other ascites hypovolemia other and unspecified infection due to central venous catheter obstruction of bile duct acute pancreatitis other specified diseases of pancreas cyst and pseudocyst of pancreas benign essential hypertension malnutrition of moderate degree aneurysm of other visceral artery unspecified antibiotic causing adverse effects in therapeutic use body mass index 36.0-36.9, adult 

Answer: The patient is high likely exposed to