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: codeine attending: chief complaint: abdominal pain, fever, chills major surgical or invasive procedure: ercp right internal jugular venous central line history of present illness: mr. is a 76 year-old male with recent diagnosis of pancreatic mass presumed to be cancer s/p biliary obstruction with stent placement and sphincterotomy presented to the who presented to the emergency department on with epigastric pain, fever, chills and s/p fall. he denied nausea, vomiting, diarrhea, chest pain. on the morning of presentation, he had lost his balance while using the toilet and hit the back on the toilet. he did not hit his head. he denied dizziness but reported some shaking chills and nausea. he went to an appointment with dr. , his oncologist, and was found to have a 101.3 fever in clinic and was sent to the emergency department. mr was diagnosed in , when he started to notice jaundice and have pruritus. he went to his pcp and /s was performed the next day showing biliary obstruction. ercp was performed twice ( and ) and on and obstruction was relieved with a metal stent and pruritus resolved. he has had a few biopsies but the samples have been inadequate. thus, he currently does not have a tissue diagnosis. he had been seen by the surgeon, dr. and deemed not operatable because his pancreatic head mass causing near complete encasement and narrowing of the superior mesenteric vein and abutting both the portal venous confluence, as well as the duodenum. . past medical history: coronary atery disease s/p cabg porcine avr bilateral carotid endarterectomies cataracts pancreatitis in gerd htn "irregular heartbeat" social history: lives at home with his wife. six children that live locally. retired employee for ge. prior smoker (100 pack year history) but quit 5 years prior. previously drank beers/night but has not drunk over the past month. family history: mother had jaundice and possibly cancer in her 70s physical exam: physical exam documented on admission: vital signs: 99.3 76 136/48 17 100% on 2l nc weight: 144 lbs, height: 66 inches, bmi: 23.2 kg/m2, general: pleasant elderly male with mild jaundice in nad head: non-traumatic, no lesion heent: perrla, eomi, mmm, no thrush. conjuctiva pale and with mild jaundice neck: supple, from ln: no cervical, submandibular, supraclavicular lad lungs: clear bilaterally, no wheezes or rubs cardiac: rrr, nl s1/s2, no m/r/g. abd: soft, nt, nd, no hepatosplenomegaly, nl bs, no ascites cns: cn nl, a&o x3, no asterixis ext: no edema, no rash, no erythema skin: mild jaundice down to mid abdomen pertinent results: 11:32pm glucose-153* urea n-7 creat-0.6 sodium-141 potassium-4.3 chloride-108 total co2-23 anion gap-14 10:09pm comments-green top 10:09pm lactate-1.3 10:09pm hgb-11.9* calchct-36 o2 sat-92 09:10pm comments-green top 09:10pm lactate-1.3 09:10pm o2 sat-93 08:13pm comments-green top 08:13pm lactate-1.2 07:51pm pt-14.1* ptt-24.7 inr(pt)-1.2* 07:35pm urine color-yellow appear-clear sp -1.003 07:35pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 05:55pm glucose-104 urea n-8 creat-0.8 sodium-132* potassium-4.2 chloride-94* total co2-27 anion gap-15 05:55pm estgfr-using this 05:55pm alt(sgpt)-50* ast(sgot)-84* ld(ldh)-279* alk phos-367* amylase-68 tot bili-2.3* 05:55pm lipase-192* 05:55pm albumin-2.9* calcium-8.8 phosphate-3.0 magnesium-1.8 05:55pm cortisol-41.8* 05:55pm crp-14.0* 05:55pm wbc-21.2* rbc-4.37* hgb-13.7* hct-37.8* mcv-87 mch-31.4 mchc-36.3* rdw-16.7* 05:55pm neuts-82.6* lymphs-12.6* monos-4.5 eos-0.1 basos-0.2 05:55pm plt count-306 05:52pm comments-green top 05:52pm lactate-2.3* sinus rhythm with ventricular premature depolarizations. compared to previous tracing ventricular ectopic activity is now evident. otherwise, no major change. sinus bradycardia. compared to previous tracing cardiac rhythm is now sinus mechanism. intervals axes rate pr qrs qt/qtc p qrs t 68 /462.85 91 -46 -34 tracing #2 read by: , brief hospital course: mr. is a 76 year-old man with new pancreatic mass seen int he emergency department for fever, epigastric pain, nausea and chills. . 1) sepsis/ cholangitis: in the emergency department, he was hypotensive to the 70s systolic despite 4l ivf and his wbcs were found to be 21. lactate was initially 2.3. sepsis code was called, and he was given levophed. a central line was placed for administration of fluids after which time his blood pressure improved to 127/4. he was started empirically on flagyl and levoquin for cholangitis and he was subsequently transferred to the medical intensive care unit. after his transfer, he was afebrile and his blood pressure remained stable with a systolic blood pressure on the low 100s. he was started on ampicillin to cover for enterococcus. an ercp was performed which revealed a previously placed biliary metal stent whic was blocked with debris and sludge. cannulation of the metal stent in biliary duct was performed and the sludge and debris were extracted successfully using a 8.5 mm balloon. a 10 cm by 10 fr plastic biliary stent was placed successfully into the metal stent. bile flow was seen. the gastroenterology clinic will call mr. to schedule a follow-up ercp for stent removal. he was transferred to the floor on and he continued to remain afebrile and normotensive. he was switched to oral antibiotics and discharged with a two week course. . 2) pancreatic mass- no tissue diagnosis has been obtained at this point. previous fna biopsies have been unrevealing and current metal stent preclues a biopsy with subsequent ercp. mr. is followed by dr. . he has been seen by surgeon dr. who deemed the mass unresectable on the basis of ct findings of a pancreatic head mass causing near complete encasement and narrowing of the superior mesenteric vein and abutting both the portal venous confluence, as well as the duodenum. mr. has an appointment with radiation oncology to determine if cyberknife is possible to be used in conjunction with chemotherapy with a curative intent. he will subsequently follow-up in oncology clinic with dr. and dr. to determine chemotherapy options. . 3) atrial fibrillation- mr. has intermittent atrial fibrillation during this hospitalization. his metoprolol was initially witheld due to hypotension but was restarted upon transfer to the floor. he did have episodes tachycardia to 120s prior to starting metoprolol. he was continued on his home digoxin and a level was found to be 0.4mg. he was discharged on his previous home regimen on metoprolol and digoxin. also, given his paroxysmal atrial fibrillation during this admission and his presumed hypercoagulability due to pancreatic cancer, mr. was started on lovenox to be continued after discharge. lovenox was chosen in favor of coumadin given that it may be more easily discontinued prior to diagnostic procedures. he was advised to follow-up with dr. for further management of anticoagulation. . 4) hyperglycemia - fingersticks have ranged during his admission between 122-211. be due to pancreatic mass. he was advised to follow-up with his primary care provider . to further evaluate hyperglycemia. . 5) s/p fall- this fall was thought to be due to weakness in the setting of his sepsis. medications on admission: lisinopril 10mg po qday toprol 25 mg po qday, digoxin 0.25 mg po qday meclizine 25mg po qid. discharge medications: 1. meclizine 12.5 mg tablet sig: two (2) tablet po qid (4 times a day). 2. digoxin 250 mcg tablet sig: one (1) tablet po daily (daily). 3. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 4. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 2 weeks: continue taking until . :*28 tablet(s)* refills:*0* 5. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 2 weeks: continue taking until . :*90 tablet(s)* refills:*2* 6. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 7. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. :*30 tablet, delayed release (e.c.)(s)* refills:*2* 8. ampicillin 250 mg capsule sig: two (2) capsule po q6h (every 6 hours) for 2 weeks: continue taking until . :*112 capsule(s)* refills:*0* 9. enoxaparin 80 mg/0.8 ml syringe sig: 0.7 ml subcutaneous (2 times a day): please continue this medication until otherwise directed by your doctor. :*60 syringes* refills:*2* discharge disposition: home with service facility: discharge diagnosis: sepsis cholangitis pancreatic mass elevated blood sugar paroxysmal atrial fibrillation discharge condition: stable discharge instructions: you were admitted for fever, abdominal pain, near loss of consciousness, and nausea and were found to have very low blood pressure. you were thought to have sepsis (systemic infection) from an infection in your bile ducts. you were admitted to the intensive care unit and started on medications to control your blood pressure. you were given antibiotics. you had an ercp which showed blockage in the stent in your bile duct. this blockage was drained and a smaller plastic stent was placed. gastroenterology will call to you to schedule a follow-up appointment for possible removal of this stent. you should continue taking antibiotics to complete a 2 week course on . also, you were noted to have elevated blood sugar (up to 180-200) during your admission. you should follow-up with dr. about this because this could be a sign that you are developing diabetes. the following medications were started: ciprofloxacin 500mg by mouth twice a day, metronidazole 500mg by mouth 3 times a day, ampicillin 250mg by mouth every 6 hours. these are anitbiotics that should be taken until . you were also started on the blood thinner lovenox 70mg injection twice a day. you should take this medication until otherwise directed by your doctors. you should call your doctor or go the emergency room if you have fever, chills, nausea, vomiting, abdominal pain, diarrhea, dizziness, lightheadedness, loss of consciousness or any other symptoms that concern you. followup instructions: you should attend your appointment on with radiation oncology at 10:00 am. ( you should attend your appointment with dr. and dr. on at 2:00pm phone: you should follow-up with dr. as soon as possible. please call to make an appointment. procedure: venous catheterization, not elsewhere classified endoscopic retrograde cholangiopancreatography [ercp] replacement of stent (tube) in biliary or pancreatic duct diagnoses: mitral valve disorders urinary tract infection, site not specified unspecified essential hypertension atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status personal history of tobacco use heart valve replaced by other means malignant neoplasm of head of pancreas streptococcal septicemia cholangitis obstruction of bile duct other abnormal glucose unspecified disease of pancreas nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] 

Answer: The patient is high likely exposed to