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: versed / lactose attending: chief complaint: painless jaundice major surgical or invasive procedure: ercp with bile duct stent and sphincterotomy on history of present illness: m h/o aaa repair in , h/o cva , h/o iliac stenting who developed painless jaundice 4d prior to admission. he is admitted for observation following ercp with biliary stenting and sphincterotomy today. there was a stricture in his cbd with evidence of gallstones and possible extrinsic compression found on the ercp. his lfts are significant for a dirict bilibunemia to above 5 with elevated alt and ast above 500s. he was hospitalized one year ago with cholecystitis at , but was found to not be a surgical candidate and he was treated with medical management and low fat diet. he has intermittent episodes of ruq pain but has not been for that recently. he is not a drinker and he does not know if has been diagnosed with hepatitis before if he has had blood transfusions. ros: denies sob, doe, orthopnea, cp, but he is minimally active given l leg weakness. denies previous coronary stenting, prior mi, or recent tte past medical history: aaa s/p repair in iliac stenting and embolization treatment (aneurysm?) l leg weakness following aaa repair cva without residual symtpoms, presented with l arm weakenss bladder cancer h/o diverticulitis h/o falls social history: lives alone, daughter lives in house next door wife is in for dementia retired vet former smoker no etoh family history: father with diabetes physical exam: physical exam on admission: 120/84, hr 60, afebrile extremely pleasant elderly male with poor hearing, aox3, no distress heent: scleral icterus present neck supple cv: rrr nmrg, jvp not distended pulm: ctab no wheezes abd: soft, trace rlq tenderness, but no rebound, not distended extremities: l foot with joint deformity skin: jaundice, multiple sebhorric keratosis on back, no skin breakdown or ulceration in le neuro: cn grossly intact, speech fluent, l leg strength diminished psych: calm pertinent results: 01:15pm blood wbc-4.7 rbc-3.64* hgb-10.1* hct-31.2* mcv-86 mch-27.8 mchc-32.4 rdw-14.2 plt ct-192 01:15pm blood pt-14.9* ptt-26.2 inr(pt)-1.3* 01:15pm blood urean-31* creat-1.6* na-142 k-4.6 cl-105 hco3-27 angap-15 01:15pm blood alt-389* ast-454* alkphos-1059* amylase-37 totbili-6.7* dirbili-5.0* indbili-1.7 01:15pm blood lipase-19 ercp report: procedures: a sphincterotomy was performed in the 12 o'clock position using a sphincterotome over an existing guidewire. cytology samples were obtained for histology using a brush. a 13cm by 10fr cotton biliary stent was placed successfully. impression: successful cannulation of bile duct (cannulation) successful sphincterotomy was performed irregular 2 cm common hepatic stricture cytology samples were obtained for histology using a brush. a 13cm by 10fr cotton biliary stent was placed successfully. otherwise normal ercp to third part of the duodenum ekg sinus brady, first degree av block, l axis deviation, poor r wave progression, brief hospital course: primary reason for hospitalization: m yo m with history of aaa repair in , cva , iliac stenting who developed painless jaundice 4d prior to admission, and after ercp with sphincterotomy developed a gi bleed with 10 point hct drop, thus was transferred to the icu. active diagnoses: #gi bleed: upon admission to the icu the patient had a 10 point hct drop after 2 maroon bms on the floor. also with 1 episode of black emesis. thus, upper gi bleed is most likely, and given recent ercp with sphincterotomy, source of bleeding is most likely secondary to instrumentation. on arrival to icu, another bloody bm. vital signs are stable, no hypotension/tachycardia and patient asymptomatic. he was given a total of 4 units prbcs, and q6h hematocrits were checked. asprin and plavix were held in the setting of spincerotomy and bleed. he received a picc line for venous access. hct stabilized over the course of the day and patient did not require any further transfusions. patient received another ercp in which no active bleeding was seen. #jaundice: on ercp, there was an irregular 2 cm common hepatic stricture. also, a single irregular stricture that was 2 cm long was seen at the common hepatic duct. there was no post-obstructive dilation. two large stones were seen just outside common hepatic duct. on ct scan, moderately dilated bile ducts, hypodensities in r hepatic , ill defined soft tissue mass which may be neoplastic implant. the gallbladder itself is decompressed and the wall is indistinct. this raised concern for infiltrating gallbladder carcinoma into the adjacent hepatic parenchyma. patient afebrile and , no concern for cholangitis. also be sclerosing cholangitis, but less likely. mirizzi syndrome on differential. hepatitis is not likely as no known history, but possible. hepatitis serologies were obtained and returned negative. patient was empirically covered on unasyn. patient was taken for ercp and was found to have purulent drainage and 2cm hepatic stricture, raising the possibility of mirizzi's syndrome. previously placed stent had migrated and was remove and two other stents placed. surgery was consulted and took the patient to the or for open cholecystectomy on . at the time of surgical exploration, he had a gallbladder that was filled with 3 large stones and severalsmaller stones. there were marked adhesions around the gallbladder. frozen sections of the gallbladder obtained intra-op were sent to patholohy and demonstrated no evidence of malignancy. during the procedure after removing the stones in the upper portion of the gallbladder, a small glimpse of stent in the common duct at the base of the inside of what had been the gallbladder was noted, and was thought to most likely be the base of the cystic duct communicating with the common duct. there was no bile emanating from this site,and was a very small pinpoint opening. a jp drain was placed. the patient recovered well post-operatively and was tolerating a clear liquid diet by pod#1 and was later advanced to a regular diet on pod#2 without issue. however on pod#1 it was noted that output from the jp drain had become bilious and the volumes persisted in the range of 500-700 daily over the following days. due to concern that this might be secondary to obstruction or further migration of his biliary stents, the patient was sent for a repeat ercp on pod#4 () which demonstrated a biliary leak as well as two small superficial non-bleeding ulcerations in the wall of the bile ducts secondary to migration of the previous biliary stents. the stents were replaced and re-positioned in the r. and l. main hepatic ducts. the patient did well post-procedure, with improvement in his serum bilirubin levels. #pvd: patient with history of aaa repair: asa and plavix were held prior to sphincterotomy and continued to be held in the setting of gi bleed following first ercp. aspirin and plavix were re-started following the open cholecystectomy and third ercp. #ckd: patient with stage 3 chronic kidney disease, with previous cr measured at 1.6 in prior to admission. medications were renally dosed. upon discharge, cr was stabilized to 1.4-1.5 as the patient was working well with physical therapy, tolerating po, pain was well managed, and continued to recover well post-op, he was determined to be stable for discharge to nursing home on pod#5 with jp drain until follow-up appointment with dr. . picc line was removed prior to discharge, without complication. medications on admission: simvastatin 40mg qhs atenolol 25mg qd aspirin 81mg qd (held 4d ago) plavix 75mg qd (held 4d ago) fluticasone nasal spray remeron 7.5mg qhs tylenol prn discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. fluticasone 50 mcg/actuation spray, suspension sig: two (2) spray nasal daily (daily): 2 sprays in each nostril once daily as needed. 4. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). 5. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 7. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain: maximum 6 tablets daily. 8. multivitamin tablet sig: one (1) tablet po daily (daily). 9. mirtazapine 7.5 mg tablet sig: one (1) tablet po hs (at bedtime). 10. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 11. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 12. cipro 500 mg tablet sig: one (1) tablet po twice a day for 5 days. disp:*10 tablet(s)* refills:*0* discharge disposition: extended care facility: nursing home - discharge diagnosis: mirizzi's syndrome (status-post ercp complicated by bleeding from the sphincterotomy site and now status-post open cholecystectomy) cad/atherosclerosis aaa s/p repair history of cva () discharge condition: mental status: clear and coherent. level of consciousness: and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: wound (right abdominal incision along the costal border): incision is closed with subcutaneous sutures. please leave the overlying steri-strips in place as they will fall off on their own with regular wear. patient may shower as per usual routine. avoid baths/soaking. avoid application of topical creams/lotions to the incision. can cover with dry gauze dressing as needed. drain (jp drain in the right mid-abdomen): this drain will remain in place and will be re-evaluated upon follow-up. please empty the drain every four hours or sooner as needed if full. it is very important that the amount of all drain output be recorded on the sheets provided. strip the drain hourly and after each emptying. pain: low dose oxycodone and tylenol (2 grams daily maximum) activity: ambulate as tolerated. avoid heavy lifting (>10lbs) followup instructions: md, . follow up appointment will be arranged and you will receive a call regarding follow-up from rn, hepatobiliary coordinator md, procedure: endoscopic sphincterotomy and papillotomy cholecystectomy endoscopic insertion of stent (tube) into bile duct endoscopic retrograde cholangiopancreatography [ercp] other closed [endoscopic] biopsy of biliary duct or sphincter of oddi replacement of stent (tube) in biliary or pancreatic duct replacement of stent (tube) in biliary or pancreatic duct central venous catheter placement with guidance diagnoses: coronary atherosclerosis of native coronary artery acute posthemorrhagic anemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified peripheral vascular disease, unspecified chronic kidney disease, stage iii (moderate) hemorrhage complicating a procedure loss of weight blood in stool personal history of malignant neoplasm of bladder other specified disorders of biliary tract mechanical complication due to other implant and internal device, not elsewhere classified personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation calculus of gallbladder and bile duct without cholecystitis, with obstruction other specified disorders of gallbladder other musculoskeletal symptoms referable to limbs 

Answer: The patient is high likely exposed to