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: abdominal pain major surgical or invasive procedure: ercp history of present illness: is an 87-year-old man with a previous history of a spindle cell myoepithelial tumor involving the right parotid gland. in addition, he has myelodysplastic disorder, which is transforming to leukemia. he was recently admitted to from for altered mental status and febrile neutropenia. no clear cause for his altered mental was found and he had a negative lp and mri. it eventually spontaneously improved. he was initially treated with vanc/ctx/amp/acyclovir but was changed to cefepime/vanc on when the lp was negative. d/c'd on 7 day course of levofloxacin for febrile neutropenia with no clear source. . he now returns with severe epigastric pain since this morning with associated profuse vomitting and diarrhea. he could no characterize the vomit. denies any aggravating or alleviating symptoms. states he may have had a somewhat similar pain "a while ago". denies ha, visual changes, cp, sob, palpitations, f/c, dysuria, focal weakness, numbness or tingling. . review of systems is otherwise negative. . in the emergency department, initial vs were: 97.3, 66, 136/66, 16, 100% ra. an initial ct scan showed signs concerning for pancreatitis. he remained afebrile but given his persistent neutropenia and a lactate of 4.6, he was given cefepime, vanco, and clindamycin. he remained hd but received a total of 3l ns. he was also treated for a k+ of 5.4 with calcium gluconate, 10 units of insulin, and 1 amp d50. the patient also had some brief ( sec) of asymptomatic bradycardia to the 30s to 40s. bp remained stable and no intervention given. he is admitted to the for further care and monitoring past medical history: past oncologic history (as per previous notes): mr. was first evaluated by dr. and dr. on , . he first noticed a soft-tissue mass in front of his right ear in . the painless mass grew in size so a ct head was done on , which was notable for a 2 cm enhancing mass in the superficial lobe of the right parotid gland. he underwent a superficial parotidectomy on . pathology was consistent with a 3.2 cm spindle cell myoepithelial carcinoma focally extending into the surrounding fibroadipose tissue. it was less than 1 mm from the inked margin. it was in the background of a residual pleomorphic adenoma. he then started radiation, but unfortunately the mass continued to increase in size during radiation. it was re-biopsied on , and found to be consistent with mild pleomorphic spindle cells. he restarted radiation therapy on . the decision at that time was to start concurrent erbitux for radiosensitization. this was started on . he continued erbitux through , and completed radiation on . on , he went back to the or and underwent right anterolateral thigh flap to the right facial and temporal region and multiple facial nerve grafts after undergoing total parotidectomy, with sacrifice of the facial nerve and subtotal right auriculectomy and a right modified radical neck dissection. pathology was notable for a tumor which measured 2.4 cm in greatest dimension in the cartilage of the external ear canal. lvi was not seen. pathology seemed consistent with but not completely compatible with his previous myoepithelial carcinoma, although the thought was this difference was secondary to radiation. no malignancy was identified in 10 lymph nodes. he was seen in follow up with dr. on . at that time, he remained persistently pancytopenic and a concern for myelodysplastic syndrome was raised. mr. and his family wanted to defer a bone marrow biopsy at that time. he had a blood transfusion on , at . on , he underwent a revision flap with right myocutaneous facial flap, right lower lid repair. surgery was uncomplicated. on , , he underwent further revision with a split-thickness skin graft external auditory canal. after creation of the external auditory canal with adjacent tissue of the thigh flap, he developed redness and drainage at the site of thigh flap on . this was felt to be adequately treated with topical antibiotics. he started decitabine therapy on and has received 2 cycles. . past medical history: 1. postoperative dvt. lle dvt following original parotid mass resection in . thrombus extended from the inferior portions of the superficial femoral vein to the entire popliteal vein and superior portions of the left saphenous vein with nonocclusive thrombus in the mid superficial femoral vein. initially, patient was treated with lovenox as a bridge to coumadin. lupus anticoagulant and cardiolipin antibodies were sent at that time per the discharge summary. it was later reported la was positive. coumadin discontinued due to ongoing thrombocytopenia. 2. chf. he most recently had an ef of 35%. 3. hypertension. 4. history of coronary artery disease-- no history of mi or cabg, . has severe inferior hypokinesis, and less severe hypokinesis in the anterior/anterolateral/anteroseptal walls on echo (). 5. bph. 6. facial cellulitis . past surgical history: - extensive surgery and reconstruction related to his parotid gland tumor (as above). he is also status post appendectomy and turp. social history: he has a history of tobacco use. he smoked 3 packs a day for 15 to 20 years approximately 45 years ago. he rarely drinks wine. he lives with his wife. family history: he has no family history of cancers that he is aware of. no family history of blood disorders that he is aware of. physical exam: 94.2, 141/48, 66, 97% ra . . physical exam general: pleasant, well appearing male in nad heent: s/p facial reconstruction on right with facial nerve palsy. well healed reconstructive surgery. perrl, op clear (exam limited) without ulcers or thrush, mmm, poor dentition cardiac: regular rhythm with occ. pvc, normal rate. normal s1, s2. no murmurs, rubs or . jvp 7-8cm lungs: ctab, good air movement biaterally. abdomen: soft, diffusely tender in epigastrium, no rebound, voluntary guarding extremities: no edema or calf pain, 2+ dorsalis pedis/ posterior tibial pulses. skin: no rashes/lesions, ecchymoses. neuro: a&ox3. appropriate. cn 7 palsy. preserved sensation throughout. 5/5 strength throughout. + reflexes, equal bl. normal coordination. gait assessment deferred psych: listens and responds to questions appropriately, pleasant . pertinent results: ctabd 1. findings compatible with acute pancreatitis. 2. cholelithiasis. recommend clinical correlation for gallstone pancreatitis. consider us to further assess for choledocholithiasis. 3. diverticulosis without evidence of diverticulitis. 4. abdominal aortic aneurysm measuring up to 3.9 cm in diameter. 5. foley catheter in place with balloon at the level of the prostatic urethra. recommendation for repositioning was made with dr. at approximately 7:25 p.m. on . ct head1. no evidence of acute hemorrhage. 2. bilateral mastoid air cell opacification with an air-fluid level is in the left mastoid air cells, chronic ruq u/s impression: equivocal findings for cholecystitis with gallstones, gallbladder wall thickening and pericholecystic fluid but no biliary ductal dilatation or son sign. while gb wall thickening and free fluid may be reactive secondary to underlying pancreatitis, acute cholecystitis cannot be entirely excluded. consider hida or mrcp to further assess. ercp successful removal of sludge from the common bile duct with interval placement of common bile duct stent. otherwise, unremarkable biliary system. please refer to ercp note in omr from , for further findings, full details, and further recommendations cxr: findings: worsening volume status of the patient with increasing perihilar haziness and interstitial edema. persistent left basilar opacity with adjacent small-to-moderate left pleural effusion. brief hospital course: 87 year old male mds s/p gallstone pancreatitis and febrile neutropenia, hospital course complicated by tachy-brady syndrome, altered mental status in the setting of peri-operative opiods, hypernatremia, and pancreatitis. patient recovered mental status with correction of hypernatremia and treatment of pancreatitis long enough to express his wishes for hospice. made dnr/dni/cmo and expired in the hospital while awaiting transfer to hospice. #delerium: multiple etiologies including peri-operative opiods, hypernatremia worsened by poor po intake and diarrhea, hypoxia in the setting of pulmonary edema, and gallstone pancreatitis. noticed to be delerious the night after ercp, so pain meds were held. patient was frequently re-oriented. pancreatitis and hypernatremia were treated (see below), and all bowel regimen was held. patient recovered from delerium long enough to express wishes for hospice. once dnr/dni/cmo, all unessential medications were removed, comfort medications including morphine, and gentle fluids with d5 were continued for comfort since patient remained npo, and picc line was placed at the wishes of the family to minimize pain/blood draws. the day of death, patient was noted to be having more secretions, and sounding more rhonchorous on exam. fluids were stopped, scopolamine patch was placed. patient noted to become oliguric/anuric with discontinuation of iv fluids, and passed away peacefully on . #. gallstone pancreatitis: pt. was initially admitted with elevated lfts, bilirubin and amylase/lipase consistent with gallstone pancreatitis. he went to ercp and sludge was extracted from the bile ducts and a plastic stent was placed without sphincterotomy. he initially required frequent fluid boluses to maintain his blood pressure but then began to autodiurese. enzymes were trending downwards on transfer to bmt floor. patient never recovered mental status enough to tolerate a regular diet and was made npo to prevent aspiration per speech and swallow consult. was initially treated with cefepime/flagyl and vancomycin, all of which were d/c-ed once patient was made cmo. # hypernatremia: noted to be hypernatremic in the setting of poor po intake and diarrhea secondary to lactulose (given in icu presumably to treat encephalopathy). corrected with d5w and d5 1/2 ns to low 140s, and patient recovered mental status enough to agree to hospice. once made dnr/dni/cmo, gentle d5 1/2 ns at 50 ccs/hr was administered for comfort as patient was npo, and d/c-ed once patient began having more secretions. #atrial fibrillation, with rvr: improving after autodiuresis. treated with po metoprolol and iv metoprolol when patient unable to take pos. stopped upon cmo status. #tachy-brady syndrome: patient noted to be tachycardic and bradycardic intermittently, without hemodynamic instability. per hcp, patient was not to be coded (shocked, have chest compressions, or iv medications) if hemodynamically unstable in the event of any persistent tachycardic or bradycardic events. cardiology was consulted, who recommended iv metoprolol 5 mg q6h around the clock. pacer not recommend (unofficially) by ep due to patients poor cancer prognosis. metoprolol stopped and telemetry discontinued once patient was made cmo. #.arf: undulating baseline, was prerenal on admission but then improved with ivfs. once made cmo and all iv fluids were stopped, patient rapidly became oliguric and passed away. #. mds/aml: patient has mds transforming to leukemia, with poor prognosis (< 1 year). neutrapenia improving spontaneously. received one transfusion of packed red blood cells while in the icu. counts appeared improved after recent 2 cycles of dacogen therapy. no further chemotherapy plans were made once patient was made cmo. #. chf: ef of 35%. held ramipril and careful hemodynamic monitoring. stopped all chf meds once patient made cmo. access:picc line placed to minimize blood sticks per family request. code status: dnr/dni/cmo emergency contact: hcp is , disposition: expired medications on admission: 1. ramipril 2.5mg po daily 2. allopurinol 15 mg po daily 3. multivitamin po daily 4. acetaminophen 650mg q6 prn 5. neomycin-polymyxin-hc 3.5-10,000-1 mg-unit/ml-% drops, four (4) drop otic tid 6. levofloxacin 500 mg po q24h until discharge medications: none, expired discharge disposition: expired discharge diagnosis: you were admitted with abdominal pain due to gallstone pancreatitis. you underwent an ercp and gallstones were improved. you were also noted to have high sodium levels that were treated with iv fluids. your mental status never improved despite correction of all medical causes of confusion. it was decided to make you comfort measures only and to seek hospice. in the process of doing so, patient passed away peacefully in the hospital. discharge condition: expired discharge instructions: none followup instructions: none procedure: venous catheterization, not elsewhere classified endoscopic insertion of stent (tube) into bile duct diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) chronic systolic heart failure personal history of venous thrombosis and embolism abdominal aneurysm without mention of rupture sinoatrial node dysfunction hyperosmolality and/or hypernatremia delirium due to conditions classified elsewhere acute pancreatitis acute myeloid leukemia, without mention of having achieved remission personal history of malignant neoplasm of other and unspecified oral cavity and pharynx calculus of bile duct with acute cholecystitis, with obstruction 

Answer: The patient is high likely exposed to