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: history of present illness: this is a 54 year old male with a long history of alcohol abuse transferred from to for suspected gastrointestinal bleeding. the patient was originally admitted to the outside hospital on , with complaints of several weeks of increased lethargy, weakness, jaundice, increased abdominal girth and pain, dark urine and increased edema. the patient was initially with a sodium of 127, potassium of 2.1, creatinine of 2.3 and a total bilirubin of 18.5. albumin was noted at 2.8 and inr of 1.55. the patient had an abdominal ultrasound on showing fatty infiltration of the liver and mild splenomegaly. portal vein flows could not be assessed and a moderate amount of abdominal ascites was present. the patient had a paracentesis with removal of 5.5 liters of fluid. white blood cell count was shown to be 76 and cultures were positive for coagulase negative staphylococcus. the patient was started on zosyn for empiric subacute bacterial peritonitis. cytology was negative for malignant cells. the patient had a hepatic panel showing negative for hepatitis a, b or c. the patient was given lactulose for changes in mental status. initial hematocrit was 37.0, however, patient had persistently heme positive stools. mental status improved throughout the initial hospital course and creatinine decreased to 1.0. the patient was started on lasix and aldactone and gradually increased his creatinine to 3.1 on the day of transfer. a ct scan of his abdomen and pelvis on showed a small scarred liver, diffuse abdominal ascites and unremarkable spleen. the patient had black tarry stools and ultimately went for esophagogastroduodenoscopy which revealed multiple pre-pyloric gastric nonbleeding ulcers; no varices. the patient was continued on tube feeds and started on triple therapy for helicobacter pylori. the patient with a persistently increased creatinine of 3.0 to 3.6 which was felt secondary to hypovolemia and not hepatorenal syndrome. renal was consulted. the patient was changed to ..........coverage and was transferred to the floor on . past medical history: 1. alcoholism. 2. post-traumatic stress disorder post viet nam war. 3. liver failure with encephalopathy. 4. gastrointestinal bleeding. medications on transfer: 1. albumin 25%. 2. octreotide. 3. primaxin. 4. multivitamin. 5. thiamine. 6. folate. 7. protonix. medications at home: 1. motrin. 2. gas-x. social history: significant for alcohol, one pint of vodka per day times 25 years. last drink was on . denies tobacco and denies any drug use. the patient currently prior to admission was living with friends, however, he is currently divorced. he has to sons. family history: mother died at age 89 of old age. father died of diabetes mellitus. the patient has two brothers who are alcoholic. laboratory: relevant laboratory values: peritoneal fluid showed white blood cell count of 645, red blood cells of 75, 39% polys, total pmns of 260. albumin was 1.0, glucose 162, total protein 1.9. saag was greater than 1.1, which is consistent with portal hypertension. bilirubin on admission was 22.6 which had decreased to 11.2 at the time of discharge, and trending down. creatinine 3.6, decreased to 1.3 and 1.4, stable. no further episode of gastrointestinal bleeding noted. hematocrit was stable at 36.0. due to poor synthetic liver function, the patient's pt and ptt were 15.9 and 40.3 with an inr of 1.7. blood cultures remained negative. hospital course: the patient was called out from the medical intensive care unit for admission for gastrointestinal bleeding. esophagogastroduodenoscopy as above showed nonbleeding ulcers. the patient was put on therapy for helicobacter pylori; no further evidence of gastrointestinal bleed noted. on the floor, the patient was treated for multiple problems: 1. cirrhosis: the patient with a large volume ascites resulting in right hydrothorax, increased shortness of breath and nausea and vomiting with associated constipation. paracentesis was performed, removing three liters of fluid. this fluid was positive for sbp with pmns greater than 260. the patient was treated with a ten day course of intravenous ceftriaxone. albumin was repleted. the patient received 37.5 mg of albumin, not high dose albumin. as the patient's creatinine became stable, the patient was started on diuretics (aldactone and lasix), and renal function on discharge was stable to 1.3 to 1.4. total bilirubin was monitored daily and was found to be decreasing from initially 23.0 down to 11.0. during hospitalization, the patient's mental status had significantly improved. daily weights were monitored and the patient gained weight daily until diuretic therapy was initiated. the patient was also continued on ursodiol, pentoxifylline, multivitamins in light of poor hepatic function. 2. lumbar compression fracture: the patient was seen to have a compression fracture of l2 and l4 with a burst type compression fracture at l4 causing 25% spinal stenosis. neurosurgery was consulted and the fracture was deemed to be stable. the patient did not demonstrate any neurological signs. neurological function remained intact. the patient with good rectal tone. no reports of bladder or bowel incontinence. lumbar compression fracture was thought to be due to a fall that the patient sustained prior to admission. a thoracolumbar spine brace was constructed for the patient. he was instructed to wear this brace at all times unless lying in bed. per neurosurgery, the patient was able to undergo physical therapy while wearing the brace. at the time of discharge, the patient did not demonstrate any neurologic symptoms. strength was four plus out of five bilaterally. deep tendon reflex were intact. no paresthesias were noted. 3. renal: creatinine improved to approximately 1.3 to 1.4; creatinine remained stable at this level for approximately one week. therefore, the patient was started on aldactone and lasix. the patient was likely to be intervascularly depleted, however, diuretics were necessary to address current status with volume overload. diuretics were titrated as renal function tolerated. the patient requires standing dose diuretics to prevent reaccumulation of ascitic fluid. 4. nutrition: the patient has a poor nutritional status with a large ascites, causing him to have occasional nausea, vomiting and constipation. however, the patient was symptomatically controlled with zofran and lactulose. the patient was seen in the hospital by a nutritionist for diet supplementation. although the patient was on a 1.5 liter fluid restriction, his overall p.o. intake was poor. during hospitalization the patient has been encouraged to drink supplemental shakes. his diet includes low sodium, normal protein diet. 5. hyponatremia: the patient's urine sodium decreased to 126, however, this improved on a 1.5 liter fluid restriction thought to be due to the patient's poor nutritional status. intravenous fluids, on an option of extravasation of the third disc space was likely. at the time of discharge, the hyponatremia was corrected and the patient was on a standing dose of diuretics. 6. physical therapy: the patient is severely deconditioned secondary to long hospital course and long history of alcoholic cirrhosis. the patient with a compression fracture, however, deemed safe for physical therapy per neurosurgery only if wearing his spine brace. the patient will require a long course of rehabilitation and physical therapy upon discharge from the hospital. 7. alcohol abuse / counseling: the patient is willing to accept treatment from counseling. he is aware of his fragile medical condition and understands the terminal complications of further alcohol abuse. the family is involved and supportive and per hepatology service, they advised that they would list the patient as a transplant candidate if able to abstain from alcohol fro the next six months. the patient will require this counseling upon discharge from the hospital. condition on discharge: fair. prognosis: to receive medical care and follow-up. discharge medications: 1. bactrim single strength one tablet p.o. q. day for sbp prophylaxis. 2. ursodiol 300 mg p.o. twice a day. 3. pantoprazole 40 mg p.o. q. 12. 4. pentoxifylline 400 mg p.o. three times a day. 5. lactulose 30 mg q. two hours; titrate to four to five bowel movements per day. 6. miconazole powder 2% topical four times a day p.r.n. 7. folic acid 1 mg p.o. q. day. 8. thiamine 100 mg p.o. q. day. 9. multivitamin one capsule p.o. q. day. 10. the patient's current diuretic regimen includes furosemide 20 mg p.o. twice a day. 11. spironolactone 50 mg q. day. discharge instructions: 1. follow-up will be arranged through the hepatology service. 2. the patient is to receive physical therapy upon discharge. 3. the patient is to receive alcohol counseling upon discharge. , m.d. dictated by: medquist36 procedure: other endoscopy of small intestine enteral infusion of concentrated nutritional substances percutaneous abdominal drainage diagnoses: acute gastric ulcer with hemorrhage, without mention of obstruction acute and subacute necrosis of liver hyposmolality and/or hyponatremia other and unspecified alcohol dependence, continuous acute alcoholic hepatitis 

Answer: The patient is high likely exposed to