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: history of present illness: this is a 59 year old male with a recently diagnosed pancreatic cancer in , who is status post chemotherapy, who presented to the emergency department today with complaints of worsening dyspnea on exertion, new onset of orthopnea and generalized weakness in the setting of mild bright red blood per rectum. his dyspnea on exertion began on thursday and has been progressively worsening such that he is no longer able to climb a flight of stairs. no association with chest pain, nausea, vomiting, diaphoresis. he has also had new onset of orthopnea and is now sleeping in a recliner. he reports generalized weakness since saturday. he reports orthostatic symptoms, dizziness when getting up out of chair. he has no documented coronary artery disease but had an exercise treadmill test with nuclear imaging in with moderate reversible inferior perfusion defect. his last echocardiogram was also in with left atrial enlargement, normal ejection fraction, minimal aortic stenosis, one plus mitral regurgitation, one plus tricuspid regurgitation. per the patient he was started on by mouth lasix, unspecified doses, last week, for fluid in his lungs. he reports not feeling greatly shortness of breath at that time and that the lasix was started for radiographic findings rather than symptoms. his dose was increased over the weekend because of this progressive shortness of breath and he was told to go to the emergency room on monday if he did not improve. he has had intermittent bright red blood per rectum for six months, usually on toilet paper and sometimes in the stool. the bleeding is small in amount and chronic. he denies any melena. review of systems: he denies fevers, chills, headache, upper respiratory infection symptoms or cough. he does have a chronic intermittent right upper quadrant pain, especially after eating. he denies diarrhea, constipation, or straining; no dysuria. in the emergency room, he had a blood pressure of 75/46 and an oxygen saturation of 87% on room air on arrival. his rectal examination showed a small amount of red blood. a nasogastric lavage showed bilious fluid. initial hematocrit was 17 with a potassium of 1.7. he received three liters of normal saline, one unit of fresh frozen plasma, 40 meq of potassium by mouth and 40 meq of potassium intravenously. he was noted to be in atrial flutter with a controlled rate. he was transferred to the intensive care unit. past medical history: 1. pancreatic cancer first diagnosed in , after presenting with painless jaundice and acholic stools. his ct scan showed a pancreatic mass. a biopsy showed adenocarcinoma. he had metastatic lesions to the liver with near complete portal vein obstruction, mild ductal dilatation of the common bile duct and intrahepatic duct, ascites on a ct scan from . he is status post gemcitabine now undergoing gemcitabine and cisplatin for chemotherapy. 2. hodgkin's disease diagnosed 30 years ago, status post chest radiation therapy and splenectomy. 3. prostate cancer diagnosed six years ago status post radiation therapy. 4. chronic obstructive pulmonary disease. 5. hypertension. 6. hypothyroidism. 7. candidal esophagitis. 8. gastritis. 9. status post bilateral carotid endarterectomies. medications on admission: 1. accupril 5 mg p.o. q. day. 2. albuterol 2 puffs every four hours as needed. 3. amoxicillin two grams before dental visits. 4. enteric-coated aspirin 81 mg a day. 5. cardizem 300 mg once every day. 6. flovent two puffs twice a day. 7. isosorbide mononitrate 60 mg once a day. 8. levoxyl 88 micrograms p.o. q. day. 9. lipitor 10 mg p.o. q. day. 10. plavix 75 mg p.o. q. day. 11. serevent two puffs twice a day. 12. theophylline 200 mg three times a day. 13. reglan with meals. allergies: he has no known drug allergies. social history: he lives with his wife. used to work in manufacturing. he has three children in the area. he is a former smoker tho quit 13 years ago. minimal alcohol use. family history: sister with breast cancer. physical examination: temperature 98.6 f.; heart rate 84 laying down and 109 sitting up; blood pressure 102/49 laying down, 98/46 sitting up; respiratory rate 24; 97% on three liters. in general, alert, very pleasant, in no acute distress. no pallor. heent: pupils are equal, round and reactive to light. scleral icterus. oropharynx mild thrush. neck with jugular venous pressure of about 8 to 9 centimeters. no lymphadenopathy or thyromegaly. heart is regular rate and rhythm, i/vi high pitched systolic murmur at the left lower sternal border, no gallop. lungs are clear to auscultation bilaterally. abdomen is soft, nondistended, tender in the right upper quadrant. no percussion tenderness or rebound. normoactive bowel sounds. rectal in the emergency department showed red blood. extremities had no edema. laboratory: white blood cell count of 8.0, hematocrit of 17.2, platelets of 181. sodium of 143, potassium 1.7, chloride of 122, bicarbonate of 15, bun of 13, creatinine 0.3, glucose of 54. inr of 1.9, pt of 17. calcium of 3.6, magnesium of 0.8, alt of 60, ast of 41, alkaline phosphatase 264. total bilirubin of 2.5. chest x-ray showed bibasilar atelectasis, no pneumonia. an ekg showed atrial flutter with a rate in the 100s. normal axis, but depressions in v4 through v6 with t wave inversions and no evidence of heart strain. he had a chest ct scan with angiography done which showed multiple bilateral pulmonary emboli and possible pulmonary metastatic disease. assessment: this is a 59 year old male with a recently diagnosed pancreatic cancer who presents with shortness of breath found to have pulmonary emboli on chest ct scan, also with concurrent bright red blood per rectum. hospital course by system: 1. pulmonary: the patient had multiple bilateral pulmonary emboli. at first it was not clear given his bright red blood per rectum whether or not he should be started on anti-coagulation, however, gi was called, who advised to get an esophagogastroduodenoscopy and colonoscopy within the next few hours after his admission and defer any anti-coagulation until after that. thus, the patient underwent a colonoscopy and nothing was seen and he was then started on heparin and coumadin until his inr became therapeutic. at the time of his discharge, the patient's inr was therapeutic on coumadin alone. the patient was also seen to have a question of a pneumonia based on a follow-up chest x-ray. he was started on levofloxacin and received a five day course. for his chronic obstructive pulmonary disease, the patient was continued on salmeterol inhalers, ipratropium inhalers and fluticasone inhalers. at the time of his discharge, his room air oxygen saturation was 95% sitting, although 87% ambulatory. thus, he was sent home with home oxygen. 2. gastrointestinal: as mentioned prior, the patient was admitted with some bright red blood per rectum. the patient underwent a colonoscopy by the gastrointestinal service, who did not find any lesions. thus, it was thought that he was likely having these bleeds secondary to radiation proctitis. he was transfused appropriately and his hematocrit stabilized. 3. cardiovascular: the patient had a history of presumed coronary artery disease as he had had a prior positive stress test in the past and has been placed on imdur to prevent any symptoms of chest pain. the patient demonstrated atrial flutter and he had been on diltiazem to help control his rate. no further changes were made. he was ruled out for a myocardial infarction. the patient has a history of hypercholesterolemia and was continued on atorvastatin. the patient's blood pressure was not elevated while he was hospitalized, thus, his usual home accupril was held. it was thought that he would follow-up with his primary care physician when he would have his blood pressure rechecked and it would be determined whether he would need his accupril or not. 4. endocrine: the patient has a history of hypothyroidism. he was continued on his levothyroxine. discharge diagnoses: 1. pancreatic cancer. 2. chronic obstructive pulmonary disease. 3. hypertension. 4. hypothyroidism. 5. pulmonary emboli. 6. pneumonia. 7. atrial flutter. 8. candidal esophagitis. 9. gastritis. discharge medications: 1. warfarin 5 mg p.o. q. h.s. 2. fluticasone 110 micrograms two puffs inhaled twice a day. 3. levothyroxine 88 micrograms p.o. q. day. 4. atorvastatin 10 mg p.o. q. day. 5. pantoprazole 40 mg p.o. q. day. 6. ipratropium two puffs inhaled four times a day. 7. diltiazem 50 mg p.o. four times a day. 8. phexofenadine 60 mg p.o. twice a day. 9. salmeterol two puffs twice a day. 10. imdur 60 mg p.o. q. day. discharge instructions: 1. the patient should follow-up with his primary care physician regarding his accupril as his blood pressure was not elevated in the hospital. of note, his long-acting cardizem was changed to a four times a day diltiazem as his blood pressure had been on the low side and we felt that the patient should not be taking a sustained release tablet if he was feeling lightheaded; this can be also followed up by his primary care physician. 2. the patient needs home oxygen with ambulation. 3. he needs his inr drawn by visiting nurses association services and fax the results to dr. office. 4. the patient should follow-up with dr. on thursday, . he should have his inr checked on tuesday, , and saturday . this is very important since patient had been on levofloxacin in the hospital which can effect the level of coumadin metabolism, thus altering the inr level. 5. the patient should call dr. office to verify and confirm his appointment. , m.d. dictated by: medquist36 procedure: venous catheterization, not elsewhere classified colonoscopy diagnoses: pneumonia, organism unspecified malignant neoplasm of liver, secondary chronic airway obstruction, not elsewhere classified atrial flutter candidiasis of mouth hemorrhage of gastrointestinal tract, unspecified diseases of tricuspid valve other pulmonary embolism and infarction malignant neoplasm of other specified sites of pancreas 

Answer: The patient is high likely exposed to