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: bactrim attending: chief complaint: fatigue and malaise major surgical or invasive procedure: therapeutic paracentesis history of present illness: patient is a 57 year old male with history of hepatitis c cirrhosis (acquired via blood transfusion) c/b grade i-ii esophageal varices, episodes of sbp and hepatic encephalopathy who presents with fatigue and malaise. patient had scheduled therapeutic paracentesis earlier today, but felt to weak to travel. wife called hepatology division, with suggestion to proceed to ed for evaluation. patient endorses increasing fatigue over past few days. associated diffuse abdominal pain. denies fevers/chills. he also denies n/v/melena/brbpr. his appetite has been okay. he also notes increased weight gain over past few days. he initially was evaluated osh, and transferred to ed for further management. . in the ed, initial vs were: t 102.4 p 83 bp 102/57 r 18 o2 sat 100% 2 liters n/c. ruq u/s showed patent portal vein. diagnostic para showed wbc > 4000. blood cultures were obtained, and patient was given a dose of vancomycin and pip-tazo. he was admitted to the icu given concern for his initial work of breathing. . upon arrival to the icu, patient was complaining of luq and lower abdominal discomfort. he also noted some neck tenderness on the right, and was asking for another pillow. he was otherwise asymptomatic. . review of sytems: (+) per hpi (-) denies fever, chills, night sweats. denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. past medical history: (per omr) 1. cirrhosis: - secondary to hepatitis c (from blood txn) - listed for liver transplant - afp 2.3 () - 3 cords of grade ii and 1 cord of grade 1 non-bleeding varices () - ascites requiring paracenteses q2-4 weeks previously but well controlled now - h/o hepatic encephalopathy - h/o sbp on cipro prophylaxis 2. hepatitis c: - genotype 1, viral load 412,000 iu/ml () - failed interferon tx (thrombocytopenia) 3. history of cva, w/ mild residual r sided weakness 4. heterozygous for h63d for hemochromatosis 5. hypertension 6. osteoporosis 7. h/o ptx with pleural effusion thought to be transudative by pulm in clinic 8. progressive le weakness thought to be parkinsonism or manganism chronic liver disease by neuro in 9. s/p r ankle fx in social history: (per omr) married and lives with his wife. formerly worked as a custodian. history of smoking but quit 10 years ago. smoked 1ppd x years. denies alcohol or drug use. family history: (per omr) significant for alzheimer disease in mother and an unspecified cancer in father and brother. physical exam: on admission: vitals: t: afebrile bp: 90s/60s p: 70s r: 16 o2: 100% 2 liters n/c general: alert, oriented, no acute distress heent: sclera mildly icteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi, slightly decreased at right base cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, distended, tender in luq and lower quadrants without rebound or guarding, bowel sounds present, no rebound tenderness or guarding gu: foley in place ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro- cns ii-xii intact, rue and rle 4/5 strength at baseline, no asterixis, sensation intact . pertinent results: 12:00pm blood neuts-74* bands-9* lymphs-5* monos-9 eos-0 baso-0 atyps-2* metas-1* myelos-0 08:55am blood wbc-2.4* rbc-2.34* hgb-8.1* hct-23.5* mcv-101* mch-34.7* mchc-34.4 rdw-17.9* plt ct-30* 05:45am blood wbc-2.1* rbc-2.29* hgb-7.9* hct-23.5* mcv-102* mch-34.4* mchc-33.6 rdw-17.5* plt ct-40* 08:50pm blood wbc-3.7* rbc-2.76* hgb-9.6* hct-28.6* mcv-104* mch-34.8* mchc-33.5 rdw-19.0* plt ct-21* 06:43am blood wbc-3.4* rbc-2.88* hgb-9.9* hct-29.1* mcv-101* mch-34.4* mchc-34.0 rdw-19.1* plt ct-29* 09:02am blood neuts-85.7* lymphs-5.7* monos-5.2 eos-2.8 baso-0.6 08:00am blood neuts-78.7* lymphs-6.9* monos-10.6 eos-3.3 baso-0.5 04:40am blood neuts-70.4* lymphs-13.5* monos-10.7 eos-4.8* baso-0.6 08:55am blood plt ct-30* 08:55am blood pt-22.9* ptt-49.9* inr(pt)-2.2* 05:45am blood plt smr-low plt ct-40* 05:45am blood pt-22.8* ptt-41.7* inr(pt)-2.2* 05:55am blood plt ct-36* 06:43am blood fibrino-154 12:21am blood fibrino-153 08:55am blood glucose-122* urean-33* creat-1.8* na-138 k-3.9 cl-101 hco3-28 angap-13 05:45am blood glucose-120* urean-27* creat-1.9* na-138 k-4.0 cl-101 hco3-28 angap-13 05:55am blood glucose-130* urean-23* creat-2.0* na-138 k-3.7 cl-101 hco3-28 angap-13 03:45pm blood creat-2.0* 05:06am blood glucose-105* urean-16 creat-1.6* na-132* k-3.7 cl-101 hco3-21* angap-14 12:43pm blood glucose-95 urean-15 creat-1.5* na-133 k-3.6 cl-101 hco3-26 angap-10 05:00am blood glucose-103* urean-15 creat-1.5* na-135 k-3.2* cl-102 hco3-25 angap-11 07:20pm blood urean-12 creat-1.7* 08:58am blood glucose-105* urean-13 creat-1.5* na-135 k-3.6 cl-100 hco3-27 angap-12 11:56pm blood glucose-125* urean-11 creat-1.2 na-132* k-3.6 cl-103 hco3-23 angap-10 04:51am blood glucose-105* urean-11 creat-0.9 na-137 k-3.7 cl-106 hco3-23 angap-12 06:14am blood glucose-103* urean-12 creat-0.8 na-138 k-3.2* cl-107 hco3-25 angap-9 08:55am blood alt-5 ast-21 ld(ldh)-126 alkphos-47 totbili-1.7* 05:45am blood alt-5 ast-20 ld(ldh)-134 alkphos-49 totbili-1.9* 05:55am blood alt-5 ast-18 ld(ldh)-123 alkphos-43 totbili-2.6* 09:02am blood alt-10 ast-18 ld(ldh)-125 alkphos-44 totbili-4.0* dirbili-0.9* indbili-3.1 06:43am blood alt-14 ast-19 alkphos-47 totbili-10.0* 12:00pm blood alt-27 ast-58* ck(cpk)-50 alkphos-115 totbili-5.0* 09:02am blood ggt-10 12:00pm blood lipase-40 08:55am blood albumin-4.7 calcium-9.1 phos-1.8* mg-1.9 05:45am blood albumin-4.7 calcium-9.4 phos-1.8* mg-2.0 05:55am blood albumin-4.6 calcium-9.1 phos-2.4* mg-2.0 02:25pm blood pep-polyclonal igg-2563* iga-485* igm-212 05:37am blood vanco-13.8 06:16am blood vanco-24.0* 05:00am blood vanco-14.8 09:43pm urine color-amber appear-clear sp -1.020 09:43pm urine blood-lg nitrite-neg protein-25 glucose-neg ketone-15 bilirub-neg urobiln-neg ph-5.0 leuks-sm 05:50pm urine blood-mod nitrite-neg protein-neg glucose-neg ketone-tr bilirub-neg urobiln-neg ph-5.0 leuks-neg 12:20pm urine blood-neg nitrite-neg protein-30 glucose-neg ketone-tr bilirub-sm urobiln-1 ph-5.0 leuks-neg 09:46am ascites wbc-60* rbc-380* polys-5* lymphs-63* monos-26* mesothe-2* macroph-4* 06:02pm ascites wbc-150* rbc-390* polys-5* lymphs-35* monos-22* eos-1* mesothe-1* macroph-36* 04:02pm ascites wbc-625* rbc-2250* polys-53* lymphs-6* monos-22* macroph-19* 07:52pm ascites wbc-1850* rbc-5150* polys-86* lymphs-4* monos-4* macroph-6* . ct abd/pelvis impression: 1. little interval change to small bowel containing right inguinal hernia with dilated loops of mid and distal small bowel, upstream to this location and decompressed distal ileum distal to this location. air and stool is noted within the large bowel, suggesting that this is likely a partial obstruction but can correlate with serial abdominal radiographs for contrast progression into the large bowel. 2. slight interval redistribution of bilateral pleural effusions, now moderate-sized on the left and small on right. one-year stability to right middle lobe pulmonary nodule which is sub 4 mm in size suggesting benignity. 3. unchanged atherosclerotic disease, infrarenal aortic aneurysm and cholelithiasis. 4. known sequelae of underlying cirrhosis including splenomegaly and intra-abdominal collateral vessels consistent with underlying portal hypertension. 5. large right hydrocele. micro blood cx : sensitivities: mic expressed in mcg/ml _________________________________________________________ staphylococcus, coagulase negative | clindamycin----------- r erythromycin---------- =>8 r gentamicin------------ <=0.5 s levofloxacin---------- =>8 r oxacillin------------- 1 r rifampin-------------- =>32 r tetracycline---------- <=1 s vancomycin------------ 1 s blood cx : blood culture, routine (final ): escherichia coli. final sensitivities. sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | ampicillin------------ <=2 s ampicillin/sulbactam-- <=2 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin--------- =>4 r gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s peritoneal fluid : sensitivities: mic expressed in mcg/ml _________________________________________________________ escherichia coli | ampicillin------------ <=2 s ampicillin/sulbactam-- <=2 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s ciprofloxacin--------- =>4 r gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s brief hospital course: 57yo man with hcv cirrhosis c/b esophageal varices (grade 1), ascites, sbp, pse, on transplant list, found to have sbp, and bacteremia. he completed the necessary course of abx, and now with suspected hepatorenal syndrome. also, new fevers with an unknown course. being covered with ceftriaxone. . #. sbp - diagnostic paracentesis (+) with 1850 wbcs upon admission, initially received vancomycin + zosyn, changed to ceftriaxone on admission to micu. finished his course of ctx and subsequent paracenteses were negative for sbp. he was started on cefpodoxime for ppx which was discontinued when he was reinitiated on ceftriaxone for new fevers (because of instrumentation w/ paracentesis on the day of his second large volume tap). he received an additional 6 days of ceftriaxone, and fevers resolved. he was afebrile for >36 hours after ceftriaxone was discontinued, and had no abdominal pain. he was started on cefpodoxime for sbp prophylaxis because the organism in peritoneal fluid was quinolone resistant and he has a bactrim allergy. . # coagulase negative staph: he was also found to be bacteremic with pan sensitive coag negative staph. he was treated with vancomycin for a 14 day course. surveillance cultures were negative. . #. hrs - his creatinine had worsened early in his course and returned to baseline with albumin treatment and eradication of his infection. his creatinine then bumped again to 1.2, and he had a large volume paracentesis. his creatinine bumped to 1.5 and 1.7. he was placed on octreotide, midodrine, and albumin. his creatinine remained 1.7-1.8. octreotide and albumin both stopped and creatinine remained stable. he had minimal improvement to 1.6 on discharge. diuretics were held on discharge. he was discharged on midodrine with plan for repeat labs on if able to be checked by vna versus if this is not possible b/c of labor day holiday. . # small bowel obstruction: he has a reducible inguinal hernia that has caused a partial sbo during admission. he is not a surgical candidate. pt was asymptomatic. it seems to occur when he has accumulated a large volume of ascites. during paracenteses he needs it to be reduced to avoid strangulation and incarcerated hernia. his po lactulose was being held for the partial sbo so we were giving pr. once he was having bowel movements and tolerating po intake, lactulose po was restarted and was continued on discharge. of note, all of his paracenteses were perforemd by ir, and he did have 4 l tapped prior to discharge on . . # hyponatremia: he was hyponatremic at times during admission. it was likely hypervolemic hyponatremia, and it resolved during admission with paracentesis and holding diuretics. . #. hepatitis c cirrhosis. currently back on the liver transplant list. he was being worked up for , however, he became to ill, and remained in . he did endorse a great deal of frustration, and did threaten to remove ngt placed for tube feeds b/c he felt, "what's the point if i won't get a liver?" these feelings seemed to resolve/improve on discharge, but patient's citalopram was increased from 10mg to 20mg. . # varices: nadolol was held given renal dysfunction and relative hypotension with sbps in 90s and hr in 70's. if tolerated, may consider restarting as an outpatient. . # osteopenia: contact dr. about starting once yearly bisphosphonate infusions, but now that patient's renal function is borderline, he would like to hold off. these medications require crcl of 35 or greater, which mr. is barely above. furthermore, his alendronate was held on discharge b/c of new renal failure and also because of known esophageal varices. he will f/u with dr. as an outpatient. medications on admission: spironolactone 200 mg qam, 100 mg qpm androgel 50mg/5grams daily caltrate plus 600-400mg tid ciprofloxacin 250 mg daily citalopram 10 mg daily colace 100 mg compazine 10 mg prn nausea folic acid 1 mg daily furosemide 80 mg daily lactulose 30-60 mg q6h prn nadolol 20 mg daily omeprazole 20 mg daily rifaximin 600 mg senna mvi discharge medications: 1. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 2. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po every six (6) hours. 3. midodrine 10 mg tablet sig: one (1) tablet po three times a day. disp:*90 tablet(s)* refills:*0* 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 5. caltrate 600+d plus minerals 600 mg (1,500 mg)-400 unit tablet, chewable sig: one (1) tablet, chewable po three times a day. 6. multivitamin tablet sig: one (1) tablet po once a day. 7. rifaximin 200 mg tablet sig: three (3) tablet po twice a day. 8. prochlorperazine maleate 10 mg tablet sig: one (1) tablet po twice a day as needed for nausea. 9. colace 100 mg capsule sig: one (1) capsule po twice a day. 10. senna 8.6 mg capsule sig: one (1) capsule po twice a day as needed for constipation. 11. sucralfate 1 gram tablet sig: one (1) tablet po four times a day. 12. outpatient lab work please have complete metabolic panel processed stat, checked on the morning of tuesday, and reported to /dr. phone: ( fax:( 13. citalopram 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 14. cefpodoxime 100 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: primary diagnoses: spontaneous bacterial peritonitis hepatorenal syndrome small bowel obstruction coagulase-negative staphylococcus bacteremia . secondary diagnosis: hepatitis c cirrhosis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were initially admitted for increasing lethargy, increasing abdominal distension, and a high fever. you were seen at and then transferred to us at . when we removed fluid from your abdomen, it was found to be infected and you were started on antibiotics. you were also found to have an obstruction in your small bowel due to a hernia that seemed to resolve over time. further blood testing showed that you had a blood infection and another set of antibiotics was prescribed to treat this. your kidney function was decreased during the admission, likely due in part to your liver disease, and you were given albumin treatments to help this. upon discharge, your kidney function did not improve to your previous baseline level, but was stable. the following changes have been made to your medications: 1. stop spironolactone (because of your kidney function) 2. stop furosemide (because of your kidney function) 3. stop ciprofloxacin (because you are going to switch to a different antibiotic) 4. stop nadolol (because of your kidney function and your blood pressure is low) 5. stop alendronate (because of your kidney function, and your esophageal varices) 6. increase citalopram 10mg daily to 20mg daily 7. start cefpodoxime 100mg daily to prevent infection in your abdomen. followup instructions: provider: , md phone: date/time: wednesday at 2:20 pm. (transplant hepatology clinic) provider: , md phone: date/time: 8:00 your visiting nurse will try to do your labwork on monday. if it cannot be done on monday, please have your labwork done first thing tuesday morning and sent to and dr. at the transplant center. you are being provided with a prescription for this. procedure: venous catheterization, not elsewhere classified percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage removal of other device from thorax diagnoses: anemia, unspecified unspecified pleural effusion cirrhosis of liver without mention of alcohol acute kidney failure, unspecified hepatorenal syndrome unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia bacteremia osteoporosis, unspecified other late effects of cerebrovascular disease other sequelae of chronic liver disease calculus of gallbladder without mention of cholecystitis, without mention of obstruction other ascites esophageal varices in diseases classified elsewhere, without mention of bleeding staphylococcus infection in conditions classified elsewhere and of unspecified site, other staphylococcus splenomegaly spontaneous bacterial peritonitis inguinal hernia, without mention of obstruction or gangrene, unilateral or unspecified (not specified as recurrent) other musculoskeletal symptoms referable to limbs unspecified viral hepatitis c with hepatic coma inguinal hernia, with obstruction, without mention of gangrene, unilateral or unspecified (not specified as recurrent) body mass index 32.0-32.9, adult 

Answer: The patient is high likely exposed to