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: mr. is an 86-year-old gentleman with a history of laryngeal cancer, status post laryngectomy, right radical neck dissection, with postoperative radiation therapy two years ago, with a second course of radiation therapy for question of a recurrence. the patient has since developed an orocutaneous fistula which has been resistant to local wound care and an advancement flap. the patient now presents with a large orocutaneous fistula anteriorly to the left neck measuring approximately 7 cm x 8 cm with saliva and purulent discharge. the patient was noted to have a large volume of bleeding from the wound earlier in the day, at which time the patient was transferred to the for further evaluation. past medical history: 1. laryngeal cancer. 2. coronary artery disease. past surgical history: 1. laryngectomy. 2. radical neck dissection. 3. g-tube placement. 4. aortic valve replacement. medications on admission: coumadin 2.5 mg p.o. monday through friday and 5 mg p.o. on saturday and sunday, roxicet elixir for pain physical examination on presentation: at the time of admission, the patient was awake and alert, in no apparent distress. he was afebrile with stable vital signs. on head and neck, his cranial nerve examinations were all intact. there was a 7-cm x 8-cm orocutaneous fistula anteriorly over the left neck with saliva and purulent discharge extruding from the wound. the laryngeal stoma was intact. the airway was secured. his lungs were clear to auscultation bilaterally. his heart had a regular rate and rhythm. his abdomen was soft, nontender, and nondistended. a g-tube secured in place. hospital course: because of the nature of this wound, and near exposure of the left carotid artery, neurosurgery was consulted for angiography to rule out any carotid bleeding given this patient's history of a large amount of blood extruding from the wound. the angiography was performed, and there was no sign of any pseudoaneurysm, dissection, or extravasation. an incidental finding was noted on ct. the patient had bilateral subdural hematomas. at the time of admission, the patient's inr was 2.9, and he was being anticoagulated for his prosthetic aortic valve. at this point, the patient began receiving blood products to reverse his inr in anticipation of the patient needing surgical correction for his neck as well as potential subdural hematomas. while this was being done, the patient developed congestive heart failure but rapidly responded to lasix and did not require any ventilatory support. on hospital day five, the patient had been adequately reversed and was taken to the operating room by the otolaryngology team where he underwent biopsies of the margins to insure there was no remaining cancer prior to placement of a flap for closure of this wound. biopsy results of the wound were negative for any remaining signs of malignancy. at this point, it was decided by the neurosurgery team that, despite the patient's subdural hematomas, the patient was suffering no neurologic compromise. there were no radiologic findings to suggest midline shift, and it was decided at this point that the patient would be of significant risk and of decreased benefit with the hematomas. over the next several days the patient was seen by the physical therapy team and the nutrition team as the patient was prepared for operative repair of his orocutaneous fistula. on , the patient was taken to the operating room where he underwent left pectoralis myocutaneous skin flap for closure of the orocutaneous fistula. the patient tolerated the procedure well, and there were no perioperative complications. the patient was taken to the surgical intensive care unit overnight for observation and monitoring of flap. the patient had no problems in the immediate perioperative period and was therefore transferred to the floor on postoperative day one. at this point, the patient's tube feeds were restarted, and the patient was begun on his home medications as well as restarted on heparin and coumadin while waiting for the patient to become adequately anticoagulated in the setting of his prosthetic aortic valve. the patient was also treated with penicillin and ancef postoperatively. the patient's pectoralis donor site was initially managed with a bulb suction drain. over the next couple of days, the patient continued to do well. his rotational flap continued to thrive, with the only concern being that the level where his tracheostomy appeared to be causing some necrosis at the level of the right lateral inferior aspect of the flap. otolaryngology was consulted, and it was decided the patient did not need a tracheostomy as the patient had a very mature stoma. after the tracheostomy was removed, the patient continued to do well; and, again, the flap continued to thrive. on postoperative day six, the patient developed a large left chest wall hematoma and had to be taken to the operating room for evacuation. the bulb suction drain which had been draining the chest wound had been discharged two days previously. the drainage output from the drain prior to it being removed had been less than 15 cc per day for the two previous days prior to it being removed. again, the patient tolerated evacuation well with no perioperative complications. the patient did receive 2 units of packed red blood cells, as the patient's hematocrit during this bleeding episode had dropped to 26. the patient responded appropriately increasing his hematocrit to 30. over the next two days, the patient continued to rapidly improve. he was seen by the physical therapy department and began ambulating with assistance. from a nutritional standpoint he continued to do well on his tube feeds. on postoperative day nine, the patient had a barium swallow performed which revealed no signs of any leakage or persistent orocutaneous fistula. at this point, the patient was begun on soft solids, and swallow consultation was obtained. also at this time, the patient's antibiotics were changed from penicillin and ancef to clindamycin, and the patient was deemed medically stable and ready for discharge to a rehabilitation facility. condition at discharge: the patient was stable at the time of discharge. his orocutaneous skin flap was doing well. discharge status: the patient was to be discharged to an acute rehabilitation facility. medications on discharge: 1. clindamycin 300 mg per g-tube q.i.d. 2. acetaminophen 325 mg to 650 mg per g-tube q.4-6h. p.r.n. 3. ascorbic acid 500 mg per g-tube b.i.d. 4. tocopheryl 400 iu per g-tube q.d. 5. zinc sulfate 220 mg per g-tube q.d. 6. metoprolol 25 mg per g-tube b.i.d. 7. albuterol 1 to 2 puffs per stoma q.4h. p.r.n. for wheezing. 8. artificial tears 1 to 2 drop ou p.r.n. 9. coumadin 2.5 mg p.o. q.d. monday through friday and 5 mg p.o. q.d. on saturday and sunday. 10. dulcolax per g-tube b.i.d. 11. roxicet elixir 5 ml to 10 ml per g-tube q.4-6h. p.r.n. 12. g-tube feedings with promod fiber full strength at 80 cc per hour with a plan to wean the tube feeds as the patient's oral intake is gradually increased. discharge followup: the patient was to see dr. in clinic in one week for followup. , m.d. dictated by: medquist36 d: 18:03 t: 09:12 job#: procedure: arteriography of cerebral arteries attachment of pedicle or flap graft to other sites excisional debridement of wound, infection, or burn other incision with drainage of skin and subcutaneous tissue other incision with drainage of skin and subcutaneous tissue closed [endoscopic] biopsy of larynx other craniotomy closed [endoscopic] biopsy of esophagus diagnoses: congestive heart failure, unspecified atrial fibrillation aortocoronary bypass status hematoma complicating a procedure heart valve replaced by other means other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation subdural hemorrhage gastrostomy status persistent postoperative fistula 

Answer: The patient is high likely exposed to