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: patient recorded as having no known allergies to drugs attending: chief complaint: hypernatremia and hypokalemia (asymptomatic) major surgical or invasive procedure: paracentesis thoracentesis central line history of present illness: pleasant 60 year old woman with hemochromatosis --> liver cirrhosis complicated by gastric varices and ascites, type 2 diabetes (diet controlled) and gout who presents to the ed with hypokalemia and hyponatremia. the patient had been seen in liver clinic yesterday for intiation of evaluation and had had routine labs drawn. her potassium was 2.7 and sodium 120. patient has been asymptomatic. . in ed, vitals initially were t99.2, hr90, bp108/36, rr17, o2 sat 97% on ra. she received potassium chloride 60mg po and 40mg iv and had ekg and liver ultrasound performed. ekg was within normal limits. . on floor, patient was sleeping comfortably in bed. she states she does not feel any different from before, mentating well. . ros: denies fever, chills, headache, rhinorrhea, congestion, sore throat, cough, shortness of breath, chest pain, abdominal pain, nausea, vomiting, diarrhea, constipation, brbpr, melena, hematochezia, dysuria, hematuria. . past medical history: * cirrhosis - heterozygous hfe mutation, ascites, gastric varices * type 2 diabetes, diet controlled * right rotator cuff surgery in * gout . social history: married with two children. she is on disability and previously worked as a cashier. denies tobacco and illicit drug use. drinks alcoholic drinks per week. . family history: father had throat cancer, mother had lung cancer. physical exam: on admission: vs - temp 98.5f, bp 106/58, hr 95, r 24, o2-sat 96% ra general - chronically ill-appearing woman in nad, comfortable, appropriate heent - nc/at, perrla, eomi, sclerae icteric, mmm, op clear neck - soft, supple, no jvd/lad lungs - cta bilat, no r/rh/wh, good air movement, resp unlabored heart - pmi non-displaced, rrr, no mrg, nl s1-s2 abdomen - nabs, soft/nt, +fluid wave with ascites extremities - wwp, no cyanosis/ecchymosis, 3+ pitting edema of bilateral lower extremities up to above the knees, +dp/pt pulses limited palpation by edema, no asterixis skin - no rashes or lesions neuro - awake, a&ox3, cns ii-xii grossly intact, strength and sensation grossly intact on discharge: vs - 98.2, 97.3, 100/50 (96-111/42-50), 60 (59-75), 20, 98% on 3l i/o: 270/? bmx3; 1800/400+ bm x5 general - nad, sitting in chair with legs elevated heent - sclerae icteric neck - soft, supple, no jvd lungs - cta on left side w/ decreased bs in base with slight crackles; decreased breath sounds on right lung way up field with some crackles at the base; no wheezes or rhonchi; breathing through pursed lips heart - rrr, no mrg, nl s1-s2 abdomen - nabs, soft/nt, +fluid wave with ascites extremities - wwp, no cyanosis/ecchymosis, 3+ pedal edema, 2+ pitting edema of bilateral lower extremities up to knees neuro - awake, a&ox3, strength and sensation grossly intact pertinent results: labs on admission: 12:45pm potassium-3.7 chloride-88* 11:35am urine hours-random urea n-439 creat-100 sodium-13 potassium-29 chloride-13 07:25am glucose-125* urea n-10 creat-1.0 sodium-122* potassium-3.2* chloride-91* total co2-19* anion gap-15 07:25am alt(sgpt)-12 ast(sgot)-26 ld(ldh)-140 alk phos-105 tot bili-10.3* 07:25am calcium-7.9* phosphate-2.6* magnesium-1.2* 07:25am wbc-5.2 rbc-2.66* hgb-9.7* hct-28.1* mcv-106* mch-36.4* mchc-34.5 rdw-16.8* 07:25am plt count-162 07:25am pt-19.5* ptt-42.5* inr(pt)-1.8* 04:20am sodium-121* potassium-3.1* chloride-90* 08:40pm glucose-122* urea n-13 creat-1.0 sodium-120* potassium-2.7* chloride-84* total co2-20* anion gap-19 08:40pm alt(sgpt)-12 ast(sgot)-37 alk phos-116* tot bili-11.3* 08:40pm lipase-220* 08:40pm albumin-3.2* 08:40pm wbc-6.9 rbc-2.78* hgb-10.1* hct-29.6* mcv-107* mch-36.3* mchc-34.1 rdw-16.4* 08:40pm neuts-73.7* lymphs-15.8* monos-7.1 eos-2.9 basos-0.4 08:40pm plt count-203 08:40pm pt-18.4* ptt-38.7* inr(pt)-1.7* 10:30am glucose-154* 10:30am urea n-11 creat-1.0 sodium-120* potassium-2.6* chloride-84* total co2-19* anion gap-20 10:30am estgfr-using this 10:30am alt(sgpt)-15 ast(sgot)-41* alk phos-125* tot bili-12.0* micro: peritoneal fluid: gram stain negative; culture no growth urine cx: klebsiella pneumoniae. >100,000 organisms/ml.. blood cx: no growth blood culture: negative x 2 urine culture: negative c diff: negative for toxin a and b urine culture: no growth. fungal culture (final ): yeast, presumptively not c. albicans. c. diff: negative for toxin a and b urine culture (final ): yeast. >100,000 organisms/ml. sputum site: endotracheal; gram stain (final ): >25 pmns and <10 epithelial cells/100x field. no microorganisms seen. respiratory culture (final ): commensal respiratory flora absent. yeast. sparse growth. 3:52 pm bronchoalveolar lavage- gram stain (final ): 2+ (1-5 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. respiratory culture (final ): commensal respiratory flora absent. yeast. 10,000-100,000 organisms/ml.. fungal culture (final ): yeast. urine culture: negative stool- negative for c. diff urine cx- no growth. studies: duplex doppler abd/pelvis: 1. findings compatible with cirrhosis. 2. no intra- or extra-hepatic biliary ductal dilatation. 3. although evaluation is limited by patient's inability to breath-hold, flow could not definitely be detected in the main portal vein and there is possible reversal of flow in the left portal vein. dedicated liver doppler is recommended during normal business hours to further evaluate for portal vein thrombosis. cta abd/pelvis: 1. findings consistent with cirrhosis with ascites, nodular heterogenous liver and multiple varices. 2. no discrete arterially enhancing liver lesions seen. 3. possible stenosis at the celiac artery origin. 4. right pleural effusion with associated atelectasis. 5. estimated liver volume 1616cm3, estimated splenic volume 514.5cm3. cxr: mild-to-moderate right pleural effusion. acute interstitial pulmonary edema. echo: the left atrium is mildly dilated. the right atrial pressure is indeterminate. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels 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. mild to moderate (+) mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. impression: normal biventricular systolic function. mild to moderate mitral regurgitation. cxr: right internal jugular line tip is at the level of lower svc. cardiomediastinal silhouette is stable. there is no change in pulmonary edema and bilateral right more than left at least moderate pleural effusion. the left subclavian line tip is at the superior svc. 9/2 persantine stress mibi: patient received 0.142mg/kg/min of iv persantine infused over 3.15 minutes. she complained of nausea, chest tightness and shortness of breath at 3 minutes into the infusion: therefore the persantine was d/c'd at 3 minutes. symptoms resolved with administration of iv aminophylline at 1.5 minutes post persantine infusion. there were no significant st segment changes noted with the infusion; however, this was in the setting of development of lbbb during the infusion which returned back to baseline by the end of recovery period. the rhythm was sinus with rare apbs and one atrial couplet. there was an appropriate hemodynamic response to persantine. at 1.5 minutes post infusion, 125mg of iv aminophylline was given to reverse the persantine side effects. impression: probable persantine-induced symptoms as outlined. no significant st segment changes noted but, in the setting of the development of lbbb/ivcd during the persantine infusion, is probably uninterpetable for ischemia. nuclear report: no myocardial perfusion defects. no wall motion abnormalities. lvef of 70%. brief hospital course: summary ms. had a long course. initially admitted with hypona and hypok, she went on to develop severe fluid overload requiring intubation and crrt as well as a uti and presumptive pna treated with broad spectrum antibiotics. her fluid overload was complicated by svt that prompted initiation of selective beta blockade and a cardiac evaluation (negative nuclear stress). she went on to tolerate aggressive diuresis and was discharged by problem # hyponatremia to cirrhotic hemodynamics, fluid overload hypotension, shock with septic physiology on admission, na+ was 120 and she was asymptomatic. initially treated with fluid restriction with little success, then with tolvaptan 15mg then 30mg with increases of meq per day, plateauing at 126. on she was hypotensive to the 90's with orthostasis. she was transferred to the surgery team and sicu on for dyspnea and hemodynamic management. her respiratory status declined to the point of requiring intubation (see respiratory failure). she required the support of 2 pressors. despite no clear source of her septic response, with supportive care and antibiotic treatment, the patient's hemodynamics and respirtory systems stabilized. on , ceftriaxone, vanco, and flagyl due to her hypotension and worsening leukocytosis. on fluc was started. there was not a clear source of the patient's hypotension and leukocytosis. on , antibiotics were stopped. the patient was then transferred back to the floor in stable condition. # respiratory failure fluid overload hepatic hydrothorax oliguric renal failure on admission she was short of breath, but saturating well 95-98% on room air. she became breathless with 5-7 word sentences. a paracentesis removed one liter of fluid on , without much resolution of symptoms, an ultrasounds on found insufficient ascites to tap. thoracetesis on , removed 900cc of pleural transudative fluid. cxr on for sob found pulmonary edema with sats 90-92%. after albumin/lasix/albuterol sats improved to 94-96% on 3l nc and creatinine rose to 1.4. her saturations were at 90-92% sitting, and on standing her sats dropped to 85%. she was transferred to the icu where she required intubation and crrt. on , the patient failed bipap and was intubated. bronch on showed minimal secretions. as more fluid was removed and her hypotension improved, the patient was weaned to ps from cmv. on , the patient was extubated. on , the patient tolerated being 2.6l negative on cvvhd along with bp support on pressors. the patient tolerated having 2l removed daily. by , the cvvhd was running even. on , cvvhd was stopped the patient's urine output slowly increased. upon return to the floor, she tolerated aggressive diuresis with midodrine for bp support. # atrial fibrillation patent forament ovale normal ef, normal nuclear stress on sicu admission, the patient had a stable blood pressure. on , the patient went into atrial fibrillation with a rapid response. cardiology was consulted and recommended continued diuresis and to add metoprolol 12.5 po bid for rate control. on an echo cardiogram (tte and tee) was performed which showed normal systolic function and a pfo. cardiac enzymes were negative x 3. the patient went into intermittent a. fib. on , the patient was started on low dose dopamine with no cardiovascular or renal response. on , neo-synephrine was started and the lopressor was d/c'ed. vasporessin was also started for hypotension. due to presumed sepsis, the neo-synephrine was transitioned to levophed. pressors were weaned over the next few days. the patient received intermittent iv and po lopressor for bouts of a. fib. on the floor, she was maintained on 12.5 mg metop tartrate tid. a nuclear stress was negative, save for persantine induced symptoms. cardiology recommends continuing beta blockade through her # hypokalemia she was repleted with kcl and her potassium corrected and was stable for the remainder of the admission. # cirrhosis, likely from nash (t2dm, hx of obesity, htn, dyslipidemia) the patient was continued on tube feeds (isosource 1.5). she was continued on lactulose and ursodiol, gastric varices, and ascites. # t2dm the patient is on an regular insulin ss for her dmii. in the icu, on , an insulin gtt was started to improved glucose control. the insulin gtt was weaned and the patient was started on nph and sliding scale which she tolerated well. # uti the patient was on ciprofloxacin for a klebsiella uti. the patient was then started on daily ciprofloxacin for sbp prophylaxis. medications on admission: * calcium carbonate 500 mg po/ng daily * ursodiol 250 mg po tid * multivitamins w/minerals 1 tab po daily * vitamin d 400 unit po/ng daily (unclear dose) * probenescid 500 mg tablet twice daily * furosemide 40mg daily (started one month ago) * spironolactone 50mg daily (started one month ago) discharge medications: 1. probenecid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 2. senna 8.8 mg/5 ml syrup sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. ursodiol 250 mg tablet sig: one (1) tablet po tid (3 times a day). 4. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 5. multivitamin,tx-minerals tablet sig: one (1) tablet po daily (daily). 6. ciprofloxacin 250 mg tablet sig: two (2) tablet po q24h (every 24 hours). 7. ipratropium bromide 17 mcg/actuation hfa aerosol inhaler sig: four (4) puff inhalation q4h (every 4 hours). 8. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed) as needed for dry eyes. 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: nebs inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 10. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day). 11. spironolactone 100 mg tablet sig: one (1) tablet po daily (daily). 12. furosemide 80 mg iv daily start: in am 13. sodium chloride 0.9% flush 3 ml iv q8h:prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. 14. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed for gas pain. 15. lactulose 10 gram/15 ml syrup sig: fifteen (15) ml po tid (3 times a day). 16. midodrine 5 mg tablet sig: two (2) tablet po tid (3 times a day). 17. ondansetron 4 mg iv q8h:prn nausea 18. outpatient lab work please check na, k and bun/cr every two days. please adjust the dose of lasix if cr rises > 1.2 19. outpatient lab work once every week: please fax an inr, creat, na, albumin, and tbili to wedge at 20. heparin dvt prophylaxis please provide heparin dvt prophylaxis and check platelets once per week. 21. cxr please take a chest xray on wednesday, , or earlier if ms. is breathing on room air to 1l 22. abg please assess chest xray on . if the hydrothorax (right pleural effusion) is moderate, then take an arterial blood gas while ms. is sitting upright while she is on room air. please fax results to . 23. daily weights please take daily weights. use the weights and creatinine to track response to diuresis discharge disposition: extended care facility: - discharge diagnosis: hyponatremia fluid overload, hepatic hydrothorax cirrhosis diabetes mellitus type 2 gout discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: ms. , you were admitted with difficulties in your sodium, potassium and body fluid. in a little over a month, you required lung intubation, dialysis and feeding tube placement. by the time that you left for rehab, you were tolerating large doses of diuretics to lower your fluid levels. in summary we made the following changes to your medications: - start midodrine - start metoprolol - start lactulose - start ciprofloxacin - change your dose of lasix from 40 mg daily to iv lasix per orders - change your dose of spironolactone from 50 mg daily to 100 mg daily - start taking ipratroprium nebulizer treatments as needed for shortness of breath it was a pleasure taking care of you at the . we wish you a speedy recovery. followup instructions: please follow-up with your doctor at the following appointments: provider: clinic; ; phone: date/time: 11:20 provider: , md phone: date/time: 9:45 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis thoracentesis thoracentesis percutaneous abdominal drainage arterial catheterization closed [endoscopic] biopsy of bronchus diagnoses: pneumonia, organism unspecified urinary tract infection, site not specified unspecified essential hypertension friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site cirrhosis of liver without mention of alcohol diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hepatorenal syndrome unspecified septicemia hyposmolality and/or hyponatremia severe sepsis portal hypertension gout, unspecified atrial fibrillation hypopotassemia other and unspecified hyperlipidemia acute respiratory failure other specified cardiac dysrhythmias ostium secundum type atrial septal defect septic shock other ascites awaiting organ transplant status other chronic nonalcoholic liver disease other specified forms of effusion, except tuberculous 

Answer: The patient is high likely exposed to