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: fatigue major surgical or invasive procedure: icu stay, intubation, mechanical ventilation ct guided biopsy of liver. history of present illness: 65 yo m with h/o duodenal ulcer and gerd p/w brbpr who was recently diagnosed with a splenic flexure mass, most likely originating from the kidney who presents with fatigue, chills, shortness of breath and decreased appetite. the pt reports that for about one week now he has had decreased appetite and has only been able to soft foods and liquids. last friday he started to notice worsening sob but only with ambulation associated with a mild, dry cough. today in the afternoon he started to note chills and rigors and decided to come into the hospital. . in the ed, vs were 101.9, hr 124, bp 139/61, rr30, o2sat 93ra. a cxr showed b/l ll infiltrates r>l. the patient was given levofloxacin and ceftriaxone for pna. lactate was found to be elevated at 7.8. he was given 4l of ns. lactate decreased to 2.7. a ct abdomen was done whihc confirmed the large luq mass but did not show signs of other pathology, specifically an ischemic bowel. the patient continued to be tachycardic but was never hypotensive in the ed (lowest bp 92/66). his o2 requirements remained at 3l with o2 sats 96-99. . ros: positive for about 15lb weight loss in last 2 weeks. the patient also reports intermittent abdominal pain, present for weeks, but worsening since discharge from the hospital. he reports that the pain is worse when lying on the r side and about 15-20min after eating especially cold foods. pt denies ha, vision changes, cp, n, v, d, changes in the color of his stool or urine and specifically melena or brbpr. he also denies myalgias or arthralgias. . past medical history: gerd duodenal ulcer, yrs ago borderline diabetes . social history: drinks 1-7 beers/week (last drink was 6 days ago during superbowl), 45 pky smoking hx, no illicit drugs. at one point was a heavy drinker, quit liquor 27 years ago but denies abuse now. retired, lives in senior citizen apartment complex because of permanent disability. family history: no family history of heart disease, cancers (including colon cancer) or bleeding disorders. physical exam: vs: temp:97.9 bp: 103/53 hr: 98 rr: 20 o2sat 93 2lnc gen: pleasant, comfortable, nad, speaking in full sentences heent: perrl, anicteric, mmm, op without lesions neck: no supraclavicular or cervical lymphadenopathy, no jvd resp: moderate air movement throughout, decreased breath sounds at the bases, mild crackles in r base cv: rr, s1 and s2 wnl, no m/r/g, pmi non-displaced abd: nd, +b/s, soft, nt, no masses or hepatosplenomegaly, positive for blood in ed, brown stool ext: no c/c/e, warm, good pulses skin: no rashes/no jaundice neuro: aaox3. moving all extremities pertinent results: 04:30pm blood wbc-16.3*# rbc-3.21* hgb-9.7* hct-29.1* mcv-91 mch-30.2 mchc-33.3 rdw-13.8 plt ct-266 09:30pm blood wbc-15.2* rbc-2.58* hgb-7.6* hct-23.4* mcv-91 mch-29.5 mchc-32.5 rdw-13.7 plt ct-206 03:24am blood wbc-48.9* rbc-2.47* hgb-7.3* hct-23.1* mcv-93 mch-29.4 mchc-31.5 rdw-15.4 plt ct-106* 03:06am blood wbc-62.3* rbc-2.54* hgb-7.6* hct-23.7* mcv-93 mch-29.8 mchc-32.0 rdw-15.7* plt ct-107* 03:06am blood neuts-72* bands-9* lymphs-10* monos-2 eos-4 baso-0 atyps-0 metas-2* myelos-1* nrbc-5* 04:30pm blood glucose-177* urean-27* creat-1.2 na-138 k-4.2 cl-101 hco3-18* angap-23* 02:44pm blood glucose-158* urean-82* creat-2.1* na-148* k-5.1 cl-111* hco3-26 angap-16 04:30pm blood alt-39 ast-29 ld(ldh)-323* alkphos-169* amylase-26 totbili-0.6 05:32am blood alt-35 ast-42* ld(ldh)-445* alkphos-128* totbili-0.3 02:56am blood alt-57* ast-35 ld(ldh)-441* alkphos-189* totbili-0.9 03:16am blood alt-112* ast-194* ld(ldh)-* alkphos-201* totbili-0.8 04:30pm blood calcium-8.9 phos-3.2 mg-2.3 07:20am blood caltibc-169* ferritn-616* trf-130* 11:54am blood hapto-338* blood cultures: 4:30 pm blood culture blood culture, routine (final ): anaerobic gram positive rod(s). not clostridium perfringens or clostridium septicum. sputum culture: gram stain (final ): >25 pmns and <10 epithelial cells/100x field. 2+ (1-5 per 1000x field): budding yeast with pseudohyphae. ct abdomen 1. marked short-interval progression of extremely large and aggressive left upper quadrant mass that appears to arise from the tail of the pancreas with new compression of the stomach and near-complete encasement of the splenic flexure of the colon. frank infiltration of the stomach and colon cannot be excluded. 2. previously reported splenic vein thrombus now extends to the portal venous confluence and there are now new enlarged collateral vessels present within the anterior abdomen. the presence of splenic thrombosis at time of presentation also favors a pancreatic origin of this mass. 3. innumerable new liver metastasis with interval growth of two dominant metastases compared to ct of only two weeks ago. multiple lung metastases and left hilar nodal masses, as described. 4. no ct evidence of mesenteric ischemia. cta chest 1. no pulmonary embolus. 2. multiple nodules/masses scattered throughout the lungs consistent with metastases. mediastinal and hilar lymphadenopathy. 3. small bilateral pleural effusions and adjacent atelectasis. scattered ground-glass opacities seen throughout both lungs with more focal consolidative process within the right lower lobe which may represent infection. 4. diffuse hepatic metastatic lesions and splenic flexure mass, better evaluated on ct abdomen and pelvis of . 5. asymmetric enlargement of the left lobe of the thyroid. biopsy: cytology positive for malignant cells consistent with poorly-differentiated malignant neoplasm, see note. brief hospital course: pneumonia / gram positive rod bacteremia: the patient was admitted to the micu from the ed for an elevated lactate and concern for early/evolving sepsis, with new rll pneumonia. he was fluid resussitated and empirically started on vanco, cipro, and cefepime for antimicrobial coverage. his lactate level dropped over the course of several hours. imaging showed interval progression of his flank mass, including more hepatic lesions and extension of his splenic vein thrombosis, previously seen but not anticoagulated given his admission for gib. blood cultures grew out gram positive rods, and he was continued on his empiric antibiotics. overall, he was hemodynamically stable, lactate cleared, and he was transferred to the floor. he was later readmitted to the medical intensive care unit with respiratory distress. he was intubated for respiratory distress. he had low negative inspiratory pressures. he was extubated but required high oxygen amounts, including non-rebreather. his cxr was consistent with aspiration or hemorrhage, along with several metastatic desposits. metastatic carcinoma, unknown primary the patient was found to have a malignant lesion, large in size and diffusely metastatic to liver, peritoneum, and lung, on prior admission last month. on admission, he had interval progression and increase in number of his liver lesions. he underwent ct guided biopsy of one liver lesion. final pathology was pending at time of discharge, but consistent with a very poorly differentiated carcinoma. given the patient's extensive tumor burden, and in conjunction with palliative care consultation and help from the patient's primary care physician, decision was ultimately reached by his health care proxy and family to make the patient comfort measures/comfort care only. he was transferred to the floor of the hospital where he expired. metabolic acidosis the patient had an increase in lactate, likely reflective of anaerobic metabolism from his extensive tumor burden. acute renal failure pre-renal etiology by low fena, possibly contrast induced nephropathy. continued to have elevated creatinine toward end of course. splenic vein thrombosis no active management given recent large gi bleed. medications on admission: ranitidine 150mg po bid discharge medications: none discharge disposition: expired discharge diagnosis: primary: metastatic carcinoma, unknown primary acute renal failure sepsis/ gram positive rod bacteremia pneumonia, aspiration, bacterial splenic vein thrombosis. secondary: gastroesophageal reflux disorder discharge condition: expired procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube closed (percutaneous) [needle] biopsy of liver diagnoses: acidosis esophageal reflux malignant neoplasm of liver, secondary acute kidney failure, unspecified unspecified septicemia severe sepsis acute respiratory failure pneumonitis due to inhalation of food or vomitus septic shock chronic obstructive asthma, unspecified secondary malignant neoplasm of lung other malignant neoplasm without specification of site other diseases of spleen secondary malignant neoplasm of retroperitoneum and peritoneum 

Answer: The patient is high likely exposed to