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: amoxicillin / adhesive tape / tegaderm attending: chief complaint: hypotension major surgical or invasive procedure: : with sphincterotomy, stent placement history of present illness: mr. had undergone a right hepatic lobectomy on and had been recovering well: he was discharged with a jp drain in place as it was producing greater than 50-70cc per day of fairly bilious output. he presented for on to evaluate for possible biliary leak and received both sphincterotomy and stent placement in the main duct; contrast extravasation was noted at the level of the intrahepatics without clear localization of the leak. pre-procedure the patient was noted per report to have a blood pressure in the 80's systolic, though he was mentating well. peri-procedurally, he became hypotensive to the 60's systolic without evidence of hemodynamic instability. he was resuscitated with upwards of 5l of crystalloid and was placed on neosynephrine and transferred to the sicu for further monitoring. past medical history: pmh: metastatic colon cancer s/p chemotherapy, hld, htn, cad s/p mi (rca stent , pci ), copd, psoriasis psh: right colectomy (), r. hepatic lobectomy () social history: 35 years smoking, current smoker; occasional alcohol. denied illicit drug use. no history of iv drug use, marijuana use, blood transfusions, tattoos or piercing. married; and has two children. retired airport limosine driver. family history: mother: died at age 73 of metastatic breast cancer. father: died at age 70 of liver cancer. his maternal grandmother died of unknown causes. his maternal grandfather died of lung cancer. his paternal grandparents died of unknown causes. physical exam: vital signs: temp: 98.0 pulse:65 bp:95/51 rr:17 o2 sat:97% room air gen:wd/wn neuro/psych: oriented x3, affect normal, nad, cooperative with exam. neck: no masses, trachea midline, thyroid normal size, non- tender, no masses or nodules, no right carotid bruit, no left carotid bruit, supple. nodes: no clavicular/cervical adenopathy, no inguinal adenopathy . skin: no atypical lesions. heart: regular rate and rhythm. lungs: clear, normal respiratory effort. gastrointestinal: soft, not distended, not tender to palpation, no masses, guarding or rebound, no hepatosplenomegaly, no hernia, no aaa, bowel sounds present. rectal: normal tone, no gross blood, guaiac negative. extremities: no popliteal aneurysm, no femoral bruit/thrill, no rle edema, no lle edema, no varicosities, no skin changes pertinent results: diagnostics: : ecg: sinus bradycardia. prior inferior myocardial infarction. q-t interval prolongation. non-specific inferior st-t wave changes. compared to the previous tracing of the rate has slowed, the q-t interval is prolonged. clinical correlation is suggested. : cxr: small right pleural effusion unchanged since , right infrahilar consolidation increased, most likely atelectasis. lungs are otherwise clear. no appreciable left pleural effusion. heart size normal. no free subdiaphragmatic gas. right upper quadrant drain and biliary catheter in place, not fully evaluated by this examination. : tte: the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. lv systolic function appears depressed (ejection fraction 40 percent) secondary to severe hypokinesis with focal akinesis of the inferior septum, inferior free wall, and posterior wall. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. : tte: the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity is moderately dilated. there is severe global left ventricular dysfunction with severe hypokinesis of the basal inferolateral wall and akinesis in the remainder of the lv (lvef = 10%). a left ventricular mass/thrombus is not seen but cannot be fully excluded. the right ventricular cavity is dilated with hyperkinesis of the basal free wall but mid-to-distal wall severe hypokinesis to akinesis (with slight contraction of rv apex). the aortic valve is not well seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is a trivial to very small pericardial effusion. there are no echocardiographic signs of tamponade. : ct abdomen-pelvis: new large right and moderate left pleural effusions. diffuse reticular opacities in the left lung and right middle lobe, which likely represent infection and less likely asymmetric edema. pulmonary nodules, many of which are obscured by pleural effusions. recommend continued followup once acute disease resolves. status post right hepatic lobectomy with surgical drain and a cbd stent in place. status post colectomy. extensive vascular disease with a small infrarenal aortic ectasia/aneurysm. anasarca. within the right lower quadrant, located anterior to the right psoas muscle abutting the ivc anterolaterally, is a reniform collection of fluid measuring approximately 4.7 x 9.8 x 3.1 cm (transverse x cc x ap), which could represent a seroma, biloma, or fluid collection. there is no pelvic side wall or inguinal lymphadenopathy by size criteria. : ct abdomen-pelvis: fluid collections seen anterior to the right psoas is ascitic in nature. marked volume overload marked by bilateral pleural effusions, slightly increased on the left since prior, moderate ascites and anasarca. brief hospital course: in brief, mr. was admitted to the sicu post for hypotension. he was entirely asymptomatic from his hypotension (except uop was pressure dependent and his cr did trend up) yet required levophed to maintain his sbp in the 90s (and maintain adequate urine output). he was started on midodrine po and slowly weaned from the levophed. an echocardiogram demonstrated an ef of 40% but no apparent acute changes. he was eventually weaned from the levophed entirely, hemodynamically stable (on midodrine) and transferred to the floor on hd2. unfortunately, later that evening, he became hypoxic to an sao2 of the 80% with tachypnea to the 30s and tachycardia to the 140s. cxr demonstrated new pulmonary edema versus consolidation and he was transferred back to the icu for further monitoring and resuscitation where he was intubated shortly after transfer for persistent tachypnea and excessive work of breathing. he became hypotensive and required triple pressor therapy to ensure adequate hemodynamics. an echocardiogram demonstrated a new ef of 10% and there were mild but unimpressive troponin rise (cardiology felt was all demand ischemia and the depressed cardiac function was directly related to an inflammatory state....sepsis). a ct scan did not show any acute intraabdominal process (fluid related to ongoing bile drainage present) but did show impressive bilateral ground glass reticular appearance to the lung. he was started on broad spectrum antibiotics to treat the presumed source (pneumonia) and a few days later sputum culture/bal demonstrated and he was started on fungal coverage with micafungin. he improved rapidly thereafter. there were some changes to his pressor regimen (levophed, vasopressin, dobutamine initially, then transitioned to levo-vaso-milrinone) before he was ultimately able to be successfully weaned. the vent was in the process of being weaned when it he self dc'd it on hd 9 and, to everyone's surprise, did well from a respiratory standpoint, remaining extubated. he was transferred to the floor on hd 14, hemodynamically stable and remained as such for the remainder of his hospital stay (a repeat echocardiogram on hd 18 demonstrated a return to baseline cardiac function with an ef of 45%), which was characterized by optimizing his nutritional status and aggressive physical therapy to build back his strength from his extended stay in the icu. pertinent details of his hospital course, by systems: neurologic: no acute issues on discharge. he was aaox3 and appropriate. immediately post-extubation in the icu, he did demonstrate some temporary confusion and agitation. he was treated to good effect with zyprexa and when he was transferred out of the icu, he was continued on this medication (zyprexa 2.5 mg daily). cardiovascular: as described above -- initially hypotensive but with an overall normal/baseline echocardiogram (ef 40%). upon readmission to the icu in sepsis, his ef on repeat echo was 10%. he had a swan-ganz catheter placed to assist assessment of his cardiac status. he was on multiple pressors which were eventually weaned when he was adequately treated for his sepsis. his cardiac function returned to baseline, with a repeat echo on demonstrating a normal ef of 40-45%. he remained hemodynamically stable throughout the remainder of his hospital stay. he was continued on metoprolol 12.5 mg , lisinopril 5 mg daily and aspirin 81 mg. the lisinopril was discontinued prior to discharge as sbp was generally 90-100 respiratory: intubated, as above. treated for severe pneumonia, as above (and see id section). he remained stable from this perspective post-extubation. no acute issues thereafter. he completed his course of antibiotics (see id). gi: he was npo initially, briefly on tpn before a post-pyloric dobhoff was placed on when tube feeds were started and slowly ramped up to his goal feeding rate. his diet was advanced as well after extubation but he was unable to maintain adequate caloric intake (lack of appetite) prompting continuation of tube feeds and evantually transitioning them to cycled feeds with weaning rate to accomodate for increased caloric intake during the day. on discharge his rate was 45 cc /hour cycled over 12 hours at night gu: initially had a normal cr (0.7 on admission), this slowly trended upwards to a peak of 3.2 on before declining slowly back to his baseline on . his urine output was adequate and there were no active issues on discharge. id: initially started on vanc and zosyn for broad spectrum empiric coverage. he grew enterobacter cloacae (meropenem sensitive) and yeast on a bal. he was started on and then completed a two-week course of meropenem and micafungin. he grew coag negative staph on a blood culture (presumed to be from his central line); the cvl was dc'd and he completed a 5 day course of vancomycin per the recommendations of the id team. he was afebrile with a normal white blood cell count throughout the tail end of his hospitalization and was discharged without acute id issues. medications on admission: clonazepam 1 , diphenoxylate atropine 5/0.5''' prn diarrhea, lisinopril 10', lovastatin 80', metoprolol tartrate 50'', prochlorperazine 10 q8h, trazodone 50 , 81' discharge medications: 1. aspirin 81 mg po daily 2. lovastatin *nf* 80 mg oral daily reason for ordering: wish to maintain preadmission medication while hospitalized, as there is no acceptable substitute drug product available on formulary. 3. olanzapine (disintegrating tablet) 2.5 mg po daily rx *olanzapine 2.5 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*1 4. diphenoxylate-atropine 1 tab po q8h:prn diarrhea 5. tube feed order tubefeeding: isosource 1.5 cal full strength; goal rate: 45 ml/hr cycle start: cycle end: 0800 flush w/ 30 ml water q6h and when disconnecting tube not in use during day icd-9: 263.0 6. metoprolol tartrate 12.5 mg po bid hold for sbp < 100 or hr < 60 rx *metoprolol tartrate 25 mg 0.5 (one half) tablet(s) by mouth twice a day disp #*15 tablet refills:*3 discharge disposition: home with service facility: district nursing association discharge diagnosis: bile leak bacteremia sepsis pneumonia decompensated chf discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: please call dr. office if you have any of the following: temperature of 101 or greater, chills, nausea, vomiting, jaundice, abdominal pain, malfunction of feeding tube, increased jp drain output, or output stops, jp insertion site appears red or has drainage, diarrhea or constipation -continue cycled tube feeds as ordered. flush drain with 50cc of water every 6 hours and after any feeding disconnect. -keep a food diary -empty and record all jp drain output. bring record of drainage to next appointment with dr. jp drain dressing daily (dry dressing) weigh yourself every morning, md if weight goes up more than 3 lbs. infusion resource will supply tube feeds vna has been arranged followup instructions: provider: , md, phd: date/time: 09:00 provider: phone: date/time: 09:40 provider: 2 (st-4) gi rooms date/time: 10:00 md, procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances endoscopic sphincterotomy and papillotomy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus endoscopic insertion of stent (tube) into bile duct diagnoses: pneumonia, organism unspecified other primary cardiomyopathies thrombocytopenia, unspecified tobacco use disorder acute kidney failure with lesion of tubular necrosis congestive heart failure, unspecified unspecified septicemia severe sepsis percutaneous transluminal coronary angioplasty status other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure other shock without mention of trauma old myocardial infarction candidiasis of lung personal history of malignant neoplasm of large intestine personal history of malignant neoplasm of liver other psoriasis venous (peripheral) insufficiency, unspecified bloodstream infection due to central venous catheter other digestive system complications 

Answer: The patient is high likely exposed to