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: morphine attending: chief complaint: hospitalist admit note patient name: dob: pcp: transferring facility: transferring physician:. contact : transferring floor: n3 3122 contact : . cc: major surgical or invasive procedure: ercp history of present illness: 85 yo f with htn, skin melanoma in and skin squamous cell cancer in who developed new onset jaundice and nausea. at osh, t bili 16 and direct bili 13. ast/alt: 124/103; ap 303. inr 5.4. ct showed a 7x6x5 cm cystic lesion with calcification at the head of pancreas. cbd and pd were dilated. she had mild respiratory distress and cxr showed lll infiltrate for which she was started on ampicillin. she was given vitk and 4 unit of ffp due to coagulopathy, inr improved to 1.3. she underwent ercp with dr. yesterday under general anesthesia. cannulation of cbd was not successful. only pd was cannulated. patient with increasing bili today, needing transfer for repeat ercp. per report, vitals prior to transfer. tx 101. tc:99.8 bp:140-170/70 hr:70-80 rr: 15 o2 sat: 89-93 4l/min o2-per transferring physician patient with no respiratory symptoms after ercp despite o2 requirement. . pt reports that that she developed 1 week of nausea, vomiting, fever up to 102.7, abdominal distention and 1 day of dark urine prior to admission to osh. reports that symptoms were intermittent, but worsened on sat prior to admit. pt reports she was diagnosed with a uti on fri and started on cipro. she reports intermittent chills, weight loss of ~15-20lbs over months. in addition, pt reports intermittent diarrhea-non bloody- over last few months. pt denies new foods, travel, sick contacts, abdominal pain, constipation, melena, brbpr, cp, sob, palpitations, uri/cough, rash, paresthesias, weakness, dysuria, headache, but does report chronic intermittent dizziness. pt reports decreased appetite and po intake x1 week. past medical history: appendectomy, hysterectomy, tonsillectomy, removal of skin cancer and melanoma -formerly had htn -formerly hl -hypothyroidism social history: pt lives at home alone, but multiple family members nearby to help. ambulates with a cane occasionally. former smoker, quit 25yrs ago, former alcoholic quit 27 years ago. denies drug use family history: mother died at 86-arthritis, "cancer" dad-alcoholic physical exam: gen: lying in bed, jaundiced, nad vitals: t 97.2, bp 152/68, hr 75, rr 24, sat 93% on 4l heent: nc/at, eomi, +icterus, dry mm neck: supple, +thyromegaly, +jvd to earlobe chest: +b/l crackles heart: rrr, m/r/g abd: +bs, soft, mildly tender, softly distended, no guarding or rebound, back: non-tender, no cva tenderness ext: no c/c/e 2+pulses skin: multiple areas of scaring, hypo and hyperpigementation. l.shin with sutures from recent resection-c/d/i neuro: aaox3, cn2-12 intact, motor x4, sensation intact to lt, no tremor psych: calm, cooperative pertinent results: labs: t bili 16 and direct bili 13. ast/alt: 124/103; ap 303. inr 5.4. . imaging: ct showed a 7x6x5 cm cystic lesion with calcification at the head of pancreas. ercp-cbd and pd were dilated. cxr-lll infiltrate . ercp -cystic neoplasia of pancreas. unable to access bile duct. . ekg nsr q iii, twi iii, avf . ct abd/pelvis--severe ventilation of the intereim bilary ducts as well as the main pancreatitic duct. multiloculated cystic lesion in the head of the pancreas associated with small punctate calcifications that can be related to a pancreatic neoplasia like serous cystadenoma of the pancreas. suboptimal evaluation due to the lack of iv contrast. ercp or mrcp is recommended for further eval. mild free fluid in pelvis. diverticulosis without diverticulitis. b/l cortical renal cysts. . ruq u/s -marked intrahepatic and extrahepatic biliary ductal dilatation of ? etiology. . cxr -streaky lll infiltrate otherwise no significant acute finding. . wbc 13, hct 29, plt 167. inr 1.3, ap 343, tbili 23.3, direct 13.1, bun 26, ca 9 creat 0.81, gluc 95, lip 33, ast 166, alt 110, tsh 0.654 brief hospital course: 85 yo f with htn, skin melanoma in and skin squamous cell cancer in who developed new onset jaundice, nausea with vomiting and was found to have a cystic pancreatic mass at osh. . # cmo: patient was made comfort measure after discussion with family. palliative care saw patient and it was decided that she would go home with hospice care. she was comfortable at the time of discharge. she was sent home on oxycodone, zofran, promethazine, compazine, & ativan for symptom management. patient medications were reviewed and non-palliative medications were removed from regimen. we called the pcp couple of times during this stay and were only able to reach his answering machine. we left messages with the new changes in care goals and with numbers for him to contact us. family (very involved) has also said that they will be in touch with her pcp as well. she will continue to have her foley and oxygen with n as needed at home, which hospice can provide. . #bile duct obstruction with obstructive jaundice/cystic pancreatic head lesion-etiology of patients symptoms, abdominal distention, nausea, jaundice is likely related to obstruction from pancreatic head mass. ddx includes malignancy vs. cyst. pt does have h.o skin cancer, but unlikely to metastasize to pancreas. pt may also have stricture or stones. she had an ercp with 8cm by 10mm wallflex fully covered biliary stent which was successfully placed with large amounts of mucin which drained. patient presented with nausea and continued to have nausea intermittently throughout stay. have increased regimen as above to control nausea, able to tolerate po meds, gingerale, and some soft foods. . #hypoxia-?lll infiltrate--pt thought to have pna at osh. cxr found streaky lll infiltrate. pt does have a leukocytosis, but denies cough. on exam, pt with elevated jvp/crackles more c/w volume overload. pt does have suspicion of malignancy, and will consider if continued hypoxia. will continue to cover for suspected pna including atypicals with levofloxacin to end on . able to tolerate po so will go home with po regimen. . #transient bacteremia s/p ercp: will treat with flagyl in addition to levoflox as above for total of 2 wk course, to end on . have been tolerating po as well. . #h.o skin cancer/squamous cell/melanoma--stable, will f/u outpt if necessary but cmo at this point . #afib: patient found to have atrial fibrillation to procedure, which has resolved and has not recurred. no need for any anticoagulation especially given goals of care. . #hypothyroidism: will continue home levothyroxine as it might help patient feel better, more energetic. . #code-dnr/dni, cmo, d/w patient in presence of hcp. medications on admission: levothyroxine 75mcg daily, hctz-not on prior to admit, mvi, prochlorperazine cipro 250mg inpatient: she is on ampicillin 1.5gm q6hours and prn albuterol. allergy: morphine discharge medications: 1. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 2. ativan 1 mg tablet sig: one (1) tablet po every 4-6 hours as needed for nausea. disp:*180 tablet(s)* refills:*2* 3. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q4h (every 4 hours) as needed for sob/wheezing. 4. metronidazole 500 mg tablet sig: one (1) tablet po q8h (every 8 hours) for 11 days: end date . disp:*32 tablet(s)* refills:*0* 5. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 11 days: last day = . disp:*11 tablet(s)* refills:*0* 6. prochlorperazine 25 mg suppository sig: one (1) suppository rectal q12h (every 12 hours) as needed for nausea. disp:*60 suppository(s)* refills:*2* 7. promethazine 25 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for nausea. disp:*240 tablet(s)* refills:*0* 8. ondansetron 8 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po q 8h (every 8 hours) as needed for nausea. disp:*90 tablet, rapid dissolve(s)* refills:*0* 9. oxycodone 20 mg/ml concentrate sig: 5-10 mg po q2h:prn as needed for pain and shortness of breath. disp:*100 ml* refills:*0* discharge disposition: home with service facility: vna of central & discharge diagnosis: pancreatic head mass bile duct obstruction/hyperbilirubinemia hypoxia pneumonia . htn, benign discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted for further work up of a blockage noted in your bile ducts and a mass that was seen in your pancreas. you underwent a procedure called an ercp that showed significant blockage of your biliary system. there was a stent placed which relieved the blockage. you were also continued on antibiotics for a pneumonia and prophylaxis after ercp which you will continue until . . you had significant nausea during your hospitalization. you will be sent on on many different medications for your nausea. . medication changes: start oxycodone liquid 20mg/ml 5-10mg po q4-6h for pain and shortness of breath sl start ativan 1mg q4-6h as needed for anxiety and shortness of breath continue flagyl q8h until continue levofloxacin 250mg every day until continue prochlorperazine 25mg twice a day as needed for nausea continue promethazine 50mg tablet every 6 hours as needed for nausea continue zofran 8mg every day as needed for nausea . please take all of your medications as prescribed and follow up with the appointments below. followup instructions: please follow up with your pcp . at after discharge. md procedure: endoscopic sphincterotomy and papillotomy endoscopic insertion of stent (tube) into bile duct diagnoses: pneumonia, organism unspecified anemia, unspecified other postoperative infection unspecified acquired hypothyroidism atrial fibrillation nausea with vomiting other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure personal history of other malignant neoplasm of skin bacteremia hypoxemia encounter for palliative care do not resuscitate status cholangitis obstruction of bile duct personal history of malignant melanoma of skin other specified bacterial infections in conditions classified elsewhere and of unspecified site, other specified bacteria unspecified disease of pancreas benign essential hypertension 

Answer: The patient is high likely exposed to