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: no known allergies / adverse drug reactions attending: chief complaint: confusion/lethargy major surgical or invasive procedure: : esophagogastroduodenoscopy : visceral angiography, intracranial angiography with embolization : exploratory laparotomy, decompressive laparotomy : abdominal washout : abdominal washout history of present illness: this is a 61 yom with hep c cirrhosis genotype i with grade ii varices and hepatic encephalopathy on lactulose/rifaximin with calculated meld score of 22 as of . he is currently on the liver tx list with workup complete. he was recently admitted on for volume overload now presenting with confusion and lethargy. most of the history is obtained from his daughter who reports an acute decompensation yesterday with increaed confusion. he has been taking lactulose 6x/day in addition to miralax but has not had any bm for 2 days. he denies any increase in ascites, fevers, cp, sob, abd pain, or increased swelling of his extremities. his daughter does note an increase in his jaundice. he denies any blood in his stool or melena. . on the floor, pt is interactive but slow to respond and appears to be searching for words. he appears frustrated by his confusion. past medical history: 1. hcv cirrhosis: genotype i -grade ii varices no h/o variceal bleeding -hepatic encephalopathy on lactulose/rifaximin (admitted and ) 2. iddm 3. hemorrhoids past surgical history: r hip replacement x 2, remote appendectomy. social history: married, has 3 daughters. works as an engineer at teradyne (on short-term disability). he denies any alcohol use or tobacco use. remote history of ivda. family history: mom with dm. physical exam: admission exam vitals: 97.3 130/80 55 18 100% ra general: pleasant aa male in nad. he is oriented to person, place and year, but not month. heent: op dry, eom intact. scleral icterus present neck: supple heart: rrr no m/r/g lungs: ctab abdomen: soft, nt, nd, no palpable liver extremities: trace edema bilaterally in the le neurological: a/o x2.5. asterixis present discharge exam expired pertinent results: admission labs: 04:40pm blood wbc-4.9 rbc-2.69* hgb-8.9* hct-27.4* mcv-102* mch-33.2* mchc-32.6 rdw-18.4* plt ct-42* 04:40pm blood neuts-56.7 lymphs-31.4 monos-11.2* eos-0.2 baso-0.4 04:40pm blood pt-30.3* ptt-62.3* inr(pt)-3.0* 04:40pm blood glucose-177* urean-15 creat-1.1 na-117* k-5.0 cl-87* hco3-25 angap-10 04:40pm blood alt-182* ast-492* ld(ldh)-630* alkphos-218* totbili-8.2* 04:40pm blood albumin-1.9* calcium-9.2 phos-2.9 mg-1.7 iron-130 ct abdomen/pelvis : 1. no intra-abdominal hemorrhage. 2. sequelae of portal hypertension including varices and moderate perihepatic simple ascites. 3. severe degenerative changes of the left hip. visceral arteriography : 1. normal celiac artery angiogram with selective catheterization of the gastroduodenal artery and left gastric artery. 2. normal superior mesenteric artery angiogram. 3. no active arterial extravasation from the visceral aortic branches. tte : the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size. regional left ventricular wall motion is normal. left ventricular systolic function is hyperdynamic (ef>75%). there is a mild resting left ventricular outflow tract obstruction. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the prior study (images reviewed) of , the lv cavity is slightly smaller, there is some turbulence in the lvot with a mild functional outflow tract gradient. tte : the left atrium and right atrium are normal in cavity size. left ventricular systolic function is hyperdynamic (ef>75%). no masses or vegetations are seen on the aortic valve. no aortic regurgitation is seen. there is no mitral valve prolapse. no mass or vegetation is seen on the mitral valve. physiologic mitral regurgitation is seen (within normal limits). tricuspid regurgitation is present but cannot be quantified. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. no interval change in comparison to . brief hospital course: 61-year-old african-american pleasant male with genotype 1 hepatitis c-induced cirrhosis who is on the liver transplant list presenting with confusion/lethargy to encephalopathy and/or hyponatremia. . pertaining to his hospital course to : . # hep c cirrhosis with he: pt is on the liver transplant list with meld of 28 on admission. family had noted an increase in confusion over past few days prior to admission in setting of not having bms despite taking his lactulose and miralax. patient was given frequent lactulose with miralax and started stooling adequately. mental status and asterixis was waxing and throughout his hospital stay. he was also continued on rifaximin and nadolol. his infectious workup was negative. his lasix was initially held given hyponatremia. . # hyponatremia: pt with na+ of 117 on admisssion. he has chronically low sodium, however his baseline was 125. his renal ultrasound was normal. renal was consulted and after he did not respond to fluid restriction, he was started on one dose of tolvaptan, however did not respond and this was discontinued. after starting the tolvaptan his urinary output decreased and there was concern for hrs. he was about to be challenged with a volume challenge when he was no longer holding his pressures and required transfer to the unit. . # dm - pt was given 5u of glargine nightly (takes levamir at home). he was also maintained on insulin sliding scale while in the hospital. . on - the patient became oliguric, and developed hypotension despite fluid bolus and hypothermia and was felt that he could have sepsis of unknown origin and he was transferred to the sicu. pertaining to his hospital course to : . on , the patient was transferred to the sicu on the transplant surgery service for hypothermia (t 93) and hypotension (sbp 80). blood and urine cultures were repeated, which showed no growth. blood was also negative for fungemia. he was transfused 2u prbc for hct 24.7, after which hct 22.1. rectal exam revealed positive occult blood without gross blood. nasogastric lavage revealed coffee grounds fluid which did not clear significantly after 1l lavage. he was further transfused and started on octreotide and pantoprazole gtts. he was intubated and egd found no obvious source of bleeding. bronchoscopy found no obvious bleed. he developed epistaxis, for which ent was consulted, and his nasopharynx was packed. . on , he was taken to ir. arteriography of the celiac and superior mesenteric arteries revealed no obvious ugi bleed. bilateral inferior maxillary arteries were embolized for his continued epistaxis. at the end of the procedure, his abdomen was distended and he was increasingly difficult to ventilate. he was brought emergently to the operating room for decompressive laparotomy, which revealed no intraperitoneal bleed or hematoma. he was left with an open abdomen and returned to the sicu. he developed worsening hypotension, requiring norepinephrine gtt, and his abdomen was re-explored, revealing some blood, but insufficient to explain his transfusion requirements. bloodwork (low haptoglobin, high ldh) suggested hemolysis with no clear aetiology. . on , hypothermia resolved and cvvh was started for worsening renal function. he continued to have a mild ooze from his nose and mouth and was transfused for hct <30. . on , he underwent abdominal washout at the bedside, which was unrevealing. there was again no obvious source of bleeding. the bowel appeared less edematous and the ioban dressing was replaced. post-operatively, he required additional vasopressors, and vasopressin gtt was added. for sedation, propofol gtt was changed to fentanyl and midazolam gtts. cortisol stimulation test was equivocal. . on , he remained hypotensive and continued to bleed from jp, ngt, left ear, and mouth. refractory hypotension to pressors, some response to volume. bedside echo showed hyperdynamic empty lv and hypodynamic strained rv with pap in the 60's. started nitric oxide with improved bp, pao2. switched to meropenem and micafungin for broad empiric coverage. brief episode of afib with rvr. spontaneous conversion to sr. delisted from liver transplant list on account of his critical illness. overnight, his hypotension worsened, requiring up to three vasopressors, though these were weaned to one by morning. . on , in the morning, he received 2 units prbcs for a hematocrit of 26.1, with response in hematocrit to 30.6, but subsequent continued decline to 29.1. he received 1 unit of frozen plasma with no subsequent change in inr. in the early afternoon, per the patient's family's request, the patient was rendered comfort measures only, and he died at 14:20. medications on admission: calcium plus d3 clotrimazole 10mg troche 5x daily vitmain d2 u q week lasix 20mg po bid levemir 5u nightly humalog up to 20u daily as needed lactulose 30ml po 6x daily nadolol 20mg po daily omeprazole 20mg po daily polyethylene glycol 3350 17g powder daily when no bm rifaximin 550mg po bid spironalactone 50mg po daily discharge medications: none discharge disposition: expired discharge diagnosis: expired. discharge condition: expired. discharge instructions: he who has gone, so we but cherish his memory. followup instructions: none. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other endoscopy of small intestine insertion of endotracheal tube hemodialysis other bronchoscopy exploratory laparotomy arteriography of cerebral arteries injection or infusion of other therapeutic or prophylactic substance arterial catheterization arteriography of other intra-abdominal arteries reopening of recent laparotomy site reopening of recent laparotomy site control of epistaxis by anterior nasal packing central venous catheter placement with guidance central venous catheter placement with guidance diagnoses: hyperpotassemia thrombocytopenia, unspecified acute kidney failure with lesion of tubular necrosis cirrhosis of liver without mention of alcohol diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic hepatitis c with hepatic coma hepatorenal syndrome unspecified septicemia hyposmolality and/or hyponatremia severe sepsis other chronic pulmonary heart diseases hemorrhage complicating a procedure acute respiratory failure long-term (current) use of insulin septic shock other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation awaiting organ transplant status do not resuscitate status esophageal varices in diseases classified elsewhere, without mention of bleeding other and unspecified coagulation defects epistaxis volume depletion, unspecified hip joint replacement mixed acid-base balance disorder nontraumatic compartment syndrome of abdomen 

Answer: The patient is high likely exposed to