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: right upper quadrant pain with jaundice s/p ptca stent placement major surgical or invasive procedure: cholecystectomy, common bile duct excision, left hepatic lobectomy, roux-en-y hepaticojejunostomy, repair of right hepatic artery with inferior mesenteric vein interposition and graft exploratory laparotomy, evacuation of ascites, wound closure of dehisence exploratory laparotomy, evacuation of intraabdominal hematoma and blood, ligation of the right hepatic artery. open tracheostomy. history of present illness: this patient is a 48 year old male with a past medical history of hepatits c and herniated lumbar disc who was found to have biliary obstruction during work-up for right upper quadrant pain with jaundice. the patient underwent ptca on with dilation of a stricture ant the confluence o fthe right and left hepatic ducts. the stricture was biopsied and showed chronic infalmmation with fibrosis. the patient now presents for hepatic resection with roux-en-y hepaticojejunostomy. past medical history: hepc () herniated disk recurrent sinus infection social history: 35+ pk/yr hx of tobacco use denies etoh works for rehab company physical exam: t 98.4 hr 84 bp 147/80 spo2 97%ra rrr, normal s1 and s2 cta b/l abdomen soft, nt/nd with +bowel sounds. ptca tubes in place and draining. extremeties warm/well-perfused brief hospital course: the patient was admitted to the hospital and was taken to the operating room on for a cholecystectomy, common bile duct excision, left hepatic lobectomy, roux-en-y hepaticojejunostomy. the case was complicated by hepatic artery dissection and required repair of right hepatic artery with inferior mesenteric vein interposition and graft. the patient tolerated this procedure well but was transferred to the pacu intubated and in guarded condition. the patient was admitted to the sicu, where, after a prolonged hospital course, he expired on . the hospital course will be dictated by systems. neuro: patient remained sedated post-operatively. his pain was controlled with morphine. pod 7, po pain medications were given. following return to or for wound dehisence, post-op pain was controlled with morphine. pod patient noted to be anxious but responsive with well-controlled pain. pod 15/8 patient attempted to get out of bed to go to bathroom unassisted. got dizzy and fell. no neurological sequelae from fall. pod 16/9/1 morphine stopped, dilaudid started for improved pain control. pod 23/16/8 began propofol wean to off in attempt to extubate. when re-intubated that day, patient was again sedated. pod 41/34/27/2 propofol drip weaned, patient started on fentanyl drip and haldol prn. cardiovascular: patient was tachycardic immediately post-op, and was felt to be septic secondary to pancreatitis. he was placed on neosynephrine to maintain blood pressure. he was monitored carefully and agressively hydrated post-operatively. map was kept >65. on post-op day #2, the patient was taken off pressors. pod 6 beta blockade started for mild hypertension/tachycardia. pod sustained tachycardia w/o changes on ekg noted, likely secondary to anxiety and pain. pod tachycardia noted to be improving with stable bp's. pod 15/8 patient noted to be tachycardic after slipping and falling. moved to sicu and became tachycardic/hypotensive. taken to or on emergently for gi bleeding. right hepatic artery ligated in or. pod 16/9/1 patient noted to be tachycardic with stable bp. patient continued to remain tachycardic thereafter. on pod 38/31/23 patient became hypotensive. neosynephrine started to maintain blood pressure. pod 46/39/31/7 tte demonstrates no evidence of vegetations in heart. pod 48/41/33/9 blood pressure begins to decrease. beta-blockade held. pod 53/46/38/14 patient found to be hemodynamically unstable, unresponsive to fluid boluses, developing signs of shock. pressors started. pod 63/56/48/24 patient becomes hemodynamically unstable. he is made cmo by his family and expires on . respiratory: the patient was initially supported by ventilator immediately after surgery. this was weaned and patient extubated by pod#3. incentive spiromety encouraged. pod 7/0, extubated after return to or for wound dehisence. pod patient noted to have some respiratory distress though responsive to diuresis. pod 18/5 noted to be short of breath and diaphoretic shortly before emergent return to or for gi bleeding. patient remained intubated after procedure. attempted to wean starting pod 17/10/2. pod 22/15/7 cpap trials began but failed. pod 23/16/8 sedation weaned and on pod 24/17/9 patient self-extubated. later that day, due to increased work of breathing and fatigue, patient was re-intubated. daily chest xrays continued to demonstrate atelectasis with pulmonary edema. pod 28/21/13 ct guided thoracocentesis performed due to difficulty weaning from vent. pod 39/32/25 patient undergoes open tracheostomy after failing to wean from ventillatory support. pod 54/47/39/15 patient in septic shock with large right plerual effusion found on cxr. this is tapped via ultrasound guidance. patient remains ventilator dependent until death on . gastrointestinal: the patient was kept npo immediately after surgery with t-tubes to gravity. total bilirubin noted to be 3.4. on post-op day #2, ultrasound showed patent hepatic artery and vein. pod 4 ultrasound repeated and showed right anterior portal vein reverlsal of flow. lft's checked and found to be improving with exception of stable bilirubin at 5.2. patient taken to or on for wound dehisence. on examination, found to have intraluminal clot, dilated stomach and proximal small bowel, marked ascited and approx. 500cc old hematoma. total bilirubin noted to be 4.1. gi service consulted. pod , noted to be stable, sips started. pod , small amount of brbpr, passing flatus. pod , ultrasound noted to show patent hepatic flow. pod through pod 17/4, continued gi bleeding. pod 18/5 taken to or on for continued gi bleeding. right hepatic artery ligated in or. total bilirubin noted to rise from 3.2 to 6.5 on pod 19/6/1. on pod 21/14/6, ct scan obtained, showing moderate amount of intra-abdominal ascites, patchy areas of nonperfusion involving segments 5, 6 and 8 of the liver, and a patent right portal vein. ptca drain placed to decompress the right biliary duct system. total bilirubin noted to fall from 6.5 to 5.9. pod 25/18/10 ct abdomen failed to demonstrate evidence of intra-abdominal infection. stable amount of ascites. patent poral vein noted. total bilirubin noted to be 5.5. pod 34/27/19 trophic tube feeds started. total bilirubin noted to be 7.3. pod 37/30/22 ct scan obtained which showed unchanged appearance of the hepatic parenchyma with areas of infarction and unchanged size and appearance of three intraperitoneal fluid collections. total bilirubin noted to be 6.4. pod 38/31/23 dobhoff feeding tube placed. pod 42/36/28/3 ct scan performed, showing little change in the appearance of multiple fluid collections and drains. total bilirubin noted to be 9.1. pod 44/37/29/5 total bilirubin found to be 10.7. cholangiogram performed, which showed existing right biliary internal external drain in place with tip in the jejunum, no intrahepatic biliary ductal dilatation and contrast leak seen at the anastomotic site. pod 45/38/30/6 tube feeds advanced to goal. total bilirubin found to be 13.1. pod 47/40/32/8 tube feeds advanced to goal. total bilirubin 16.1. pod 51/44/11 repeat ct scan shows stable fluid collections, necrosis of liver. total bilirubin found to be 17.8. pod 53/46/38/13 bilirubin continues to rise, now to 18.9. transaminases noted to be rising as well. pod 54/47/39/15 patient in septic shock, bilirubin climbing to 20.2. pod 62/55/47/23 biliary catheter drainage is assessed due to rising bilirubin to 23.1. the catheter is exchanged and there is found to be large persistent leak at the anastamotic site. patient expires next day due to multi-system organ failure. hematalogic: serial hematocrits were obtained, as were coags. heparin was held initially. on post-op day #1, the patient was transfused 2 units of prbc's and 2 units of ffp for hematocrit of 27 and ptt on 107. aspirin and plavix started on pod 3. on pod 4, hematocrit found to be 23. transfused 4 units prbc's to hct 30. pod 7 hematocrit found to be 23.3. 2 units prbc's given. patient returned to or for wound dehisence, 4 units prbc's 1 unit ffp given intraop. asa/plavix held post-op. pod serial hct noted to be stable. pod 1 unit prbc's given for hct 27.2. pod , 2 units prbc's given for hct 27.8. pod continued gi bleeding, transfused 4 units prbc's, 1 unit platelets, 1 unit cryo, 2 units ffp. pod 5 units prbc's transfused. pod 13/6 required 6 units prbc's, 7 units platelets, 3 units ffp, 2 units cryo for continued bleeding. pod 15/8, patient slipped and fell. after falling, serial hct showed drop from 32 to 26. 4 units prbc's and 2 units platelet transfused. patient taken to or where he received 10 units prbc's, 7 units ffp, 4 units platelets, 3 units cryo. pod 18/11/3, hct 28, transfused 1 unit prbc's to hct 30.5. pod 20/13/5 transfused 2 units prbc's to keep hct>30. pod 21/14/6 transfused 1 unit prbc's. pod 29/18/10 hct 28.1, transfused 1 unit prbc's. pod 32/25/17 ct scan demonstrated left inferior epigastric artery pseudoaneurysm, which was injected with thrombin. pod 33/26/18 hct dropped to 24. patient transfused 2 units prbc's, 2 units ffp. ct scan obtained to r/o hemorhage and failed to show evidence of bleed. pod 40/34/26/1 transfused 1 unit prbc's for persistent ooze around tracheostomy collar. pod 42/36/28/3 neosynephrine weaned. tte obtained, demonstrating mild lvh. beta-blockade restarted. pod 57/50/42/18 in the setting of multi-system organ failure, diffuse bleeding noted. 2 units prbc's transfused, 1 unit platelets transfused. pod 60/53/45/21 levophed weaned off. patient expires soon after. fluids/electrolytes/nutrition: patient was kept npo after surgery with aggressive iv hydration. albumin infusion was started immediately post-operatively to maintain level greater than 2.5. tpn started on pod#3. pod 4 clear liquid diet started. pod 6 diet advanced to regular diet. pod patient kept npo, tpn continued. pod 19/6/1 patient kept npo, tpn continued. pod 23/16/8 albumin infusions stopped. pod 34/27/19 trophic tube feeds started. tpn continued. pod 38/31/23 dobhoff feeding tube placed. pod 42/36/28/3 tube feeds started. pod 47/40/32/8 tube feeds advanced to goal. tpn discontinued. endocrine: patient was maintained on riss. genitourinary: urine output was initially good. electrolytes were checked daily and repleted prn. a foley catheter was placed and kept to gravity. patient began to autodiurese on pod3. on pod4, lasix 10mg started to help diuresis. pod 6 foley catheter was removed. pod lasix continued for diuresis. pod 16/9/1 lasix continued for diuresis after or. pod 24/17/9 diamox started. pod 27/20/12 lasix drip started. pod 30/23/15 lasix drip discontinued due to falling bp. pod 34/27/19 urology service consulted for hematuria. this was found to be self-limited. pod 52/45/37/13 creatinine bumped to 1.6, lasix drip held. pod 54/47/39/15 patient in septic shock, renal consulted to start cvvh. this is continued until expiration on . tubes/lines/drains: on post-op day #1, the pa line was changed because of infiltration of propofol into the pa catheter sheath. on pod#4, the swan line was changed to triple-lumen catheter, ng tube removed. pod 7/0, ngt, foley catheter replaced intraop. pod 14/7 ultrasound showing biliary tube had been pulled back into peritoneum. pod 18/5 blood noted in jp drain prior to emergent return to or . jp drain placed above liver, jp drain placed near biliary anastamosis. pod 17/10/2 left cordis changed to triple lumen catheter. pod 23/16/8 cvl changed over wire. pod 24/17/9 ngt removed with self-extubation but replaced when patient re-intubated. pod 28/21/13 central lines changed and re-sited. pod 42/36/28/3 rij cvl changed over wire. pod 53/46/38/14 a cordis/swan-ganz catheter is placed for monitoring. infectious diseases: patient was initially placed on zosyn for prophylaxis. on post-op day #2, the patient spiked a temperature and was pan-cultured. blood culture showed positive for gram positive cocci. vancomycin was started. on pod 4, zosyn discontinued and meropenem started. pod 5, levofloxacin and fluconazole started for coag negative staph and growing from peritoneal fluid. pod fluconazole stopped. pod 15/8, patient spiked temp to 103. unclear if related to transfusion of blood products. caspofungin started, vancomycin and meropenem continued. patient started spiking fevers daily after . pod 20/13/5 gram positive rods found in sputum cx. pod 21/14/6 peritoneal fluid from growing lactobacillus. pod 22/15/7 flagyl added for coverage. pod 27/16/8 ptc drainage growing psudomonas and enterobacter. pod 26/19/12 paracentesis performed, fluid growing lactobacillus. sputum culture from same day grew pseudomonas. id service consulted. pod 30/23/15 paracentesis performed, cultures grow psudomonas, enterococcus, lactobacillus. pod 32/25/17 patient underwent ct guided drainage of a left subdiaphragmatic and left lower quadrant collection. cultures grow lactobacillus. pod 33/26/18 antibiotics changed to vancomycin, piperacillin, flagyl and caspofungin. pod 36/29/21 wound swab growing psudomonas. pod 37/30/22 subdiaphragmatic fluid collection aspirated via ct guidance. flagyl was discontinued and patient started on clindamycin for lactobacillus coverage. pod 41/34/27/2 ambisome started for disseminated fungal disease. pod 41/35/27/2 sputum growing pseudomonas. pod 42/36/28/3 ct scan performed, showing little change in the appearance of multiple fluid collections and drains. pod 45/38/30/8 blood culture growing pseudomonas. pod 47/40/32/8 clindamycin discontinued in favor of zosyn. pod 48/41/33/9 vancomycin discontinued, amikacin started. pod 49/42/34/10, colistin started. pod 53/46/38/14 patient begins to develop multi-system organ failure in setting of resistant pseudomonas. pod 61/51/46/22 patient started on cefipime. wound: immediately after surgery, the wound was noted to be clean and intact. pod 4 wound noted to be cellulitic. pod6 wound opened, no purulence. wet-to-dry dressings applied. pod 7 patient reported bloody drainage from wound after fit of coughing. wound probed and found to have dehisced. patient taken to or on for washout of wound and closure. pod 29/21/14 abdominal wound found to be infected again. pod 37/30/18 wound vac placed. medications on admission: protonix 40mg po qdaily. discharge disposition: expired discharge diagnosis: multisystem organ failure secondary to pseudomonas infection hepatic necrosis and failure secondary to ligated hepatic artery discharge condition: expired md, procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances diagnostic ultrasound of heart insertion of endotracheal tube hemodialysis venous catheterization for renal dialysis thoracentesis percutaneous abdominal drainage arterial catheterization cholecystectomy temporary tracheostomy pulmonary artery wedge monitoring reopening of recent laparotomy site other surgical occlusion of vessels, abdominal arteries transfusion of packed cells control of hemorrhage following vascular surgery closed biopsy of skin and subcutaneous tissue repair of blood vessel with tissue patch graft other cholangiogram anastomosis of hepatic duct to gastrointestinal tract excision of other bile duct reclosure of postoperative disruption of abdominal wall lobectomy of liver replacement of stent (tube) in biliary or pancreatic duct injection or infusion of oxazolidinone class of antibiotics diagnoses: acidosis other iatrogenic hypotension unspecified pleural effusion cirrhosis of liver without mention of alcohol acute kidney failure, unspecified acquired coagulation factor deficiency severe sepsis unspecified viral hepatitis c without hepatic coma pulmonary collapse paroxysmal ventricular tachycardia acute respiratory failure pneumonia due to pseudomonas alkalosis peripheral vascular complications, not elsewhere classified surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation blood in stool septic shock other complications due to other vascular device, implant, and graft other specified disorders of biliary tract mechanical complication due to other implant and internal device, not elsewhere classified removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation obstruction of bile duct other malignant neoplasm without specification of site other candidiasis of other specified sites other psoriasis acute pancreatitis pseudomonas infection in conditions classified elsewhere and of unspecified site malignant neoplasm of extrahepatic bile ducts disruption of external operation (surgical) wound other specified bacterial infections in conditions classified elsewhere and of unspecified site, other anaerobes other specified disorders of gallbladder septicemia due to pseudomonas other tracheostomy complications other staphylococcal septicemia dissection of other artery shock, unspecified parapsoriasis 

Answer: The patient is high likely exposed to