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: the patient is a 49-year-old gentleman with a history of alcoholic cirrhosis, hepatitis c, gastritis, duodenitis, and upper gastrointestinal bleed times three. he was previously admitted to the from to with a gastrointestinal bleed after transfer from an outside hospital. the patient was treated with octreotide and subsequently was discharged to home. the patient then presented via ambulance on with vomiting and melena. the patient was admitted to the intensive care unit and while awaiting transfer sent out against medical advice and presented to the emergency department. the patient received 6 units of packed red blood cells at the outside hospital. the patient was admitted to the intensive care unit and underwent transjugular intrahepatic portosystemic shunt on without complications initially. however, the next day the patient became febrile with a temperature maximum of 103. the patient's liver function tests continued to rise, and a computerized axial tomography a right hepatic lobe infarction. the patient was subsequently discharged home after doing well on . over the next two days, the patient developed lethargy and fatigue and stated that he did take all his medications. he also noted that he had melanotic stools and subsequently presented to the emergency department. in the emergency department, his vital signs revealed temperature was 97.2, blood pressure was 119/60, heart rate was 100, and his oxygen saturation was 98% on room air. his hematocrit dropped to 23.4. the patient was subsequently admitted to the medical intensive care unit for esophagogastroduodenoscopy and observation. past medical history: 1. alcoholic cirrhosis; hepatitis c induced. 2. the patient has a history of portal hypertension. 3. numerous admissions with upper gastrointestinal bleeds. 4. as mentioned previously, the patient was admitted on and underwent transjugular intrahepatic portosystemic shunt on which was complicated by localized hepatic infarction and was subsequently admitted on . 5. the patient has a history of hepatitis c virus. the patient failed pegylated interferon. at the outside hospital the patient was also treated with ribavirin. 6. the patient has a history of gastritis and duodenitis by esophagogastroduodenoscopy in . 7. type 2 diabetes mellitus. 8. lumbar disk herniation. 9. echocardiogram with a normal ejection fraction of 60% and 1+ mitral regurgitation. medications on admission: 1. multivitamin. 2. lactulose 30 ml by mouth three times per day. 3. protonix 40 mg by mouth once per day. 4. oxycodone 5 mg by mouth four times per day as needed. 5. tylenol 325 mg by mouth as needed. allergies: the patient has no known drug allergies. family history: family history was noncontributory. social history: the patient has a history of heavy alcohol use. he quit nine months prior to presentation. he has a history of cocaine and marijuana use. the patient has a 20-year history of tobacco use. the patient is unemployed and lives with his mother. has a history of arrests and . physical examination on presentation: physical examination on admission revealed vital signs with a temperature of 97.2, blood pressure was 119/60, heart rate was 100, respiratory rate was 18, and oxygen saturation was 985 on room air. in general, the patient was lying in bed in no apparent distress. head, eyes, ears, nose, and throat examination revealed pupils were equal, round, and reactive to light and accommodation. extraocular muscles were intact. sclerae were icteric. the mucous membranes were dry. neck examination revealed no jugular venous distention. no carotid bruits. cardiovascular examination revealed a regular rate and rhythm. normal first heart sounds and second heart sounds. no murmurs, rubs, or gallops. the lungs were clear to auscultation bilaterally. the abdomen was distended. soft and nontender with good bowel sounds. extremities revealed 1+ lower extremity edema bilaterally. dorsalis pedis pulses were 1+ bilaterally. neurologically, the patient was alert and oriented times three. the patient had somewhat slurred speech. the patient was tired-appearing. the patient had positive asterixis. deep tendon reflexes were 2+ bilaterally. the toes were downgoing. pertinent laboratory values on presentation: the patient's laboratory values on admission revealed white blood cell count was 5.6, hematocrit was 23.4, and platelets were 105. sodium was 133, potassium was 4.5, chloride was 114, bicarbonate was 25, blood urea nitrogen was 13, creatinine was 0.6, and blood glucose was 194. alt was 146, ast was 113, alkaline phosphatase was 199, lactate dehydrogenase was 281, and total protein was 3.1. inr was 1.6. hospital course by issue/system: as mentioned above, the patient was readmitted on with melena, a drop in hematocrit, and lethargy. 1. gastrointestinal issues: the patient had an esophagogastroduodenoscopy that showed a nonbleeding ulcer. the patient had a doppler ultrasound showing reversible flow in the left portal vein, and decreased transjugular intrahepatic portosystemic shunt velocities, and worsening ascites; consistent with decreased transjugular intrahepatic portosystemic shunt patency. the patient subsequently underwent a transjugular intrahepatic portosystemic shunt revision on during which the patient was found to have a spontaneous splenorenal shunt stealing blood flow from the transjugular intrahepatic portosystemic shunt. the shunt was coiled and the transjugular intrahepatic portosystemic shunt was angioplastied. subsequently, the patient was doing well. however, an ultrasound from showed slowed flow through the transjugular intrahepatic portosystemic shunt. therefore, the patient was started on heparin 600 units per hour. an ultrasound was repeated the following morning. the repeat ultrasound showed patent forward flow and increased transjugular intrahepatic portosystemic shunt velocity; consistent with a patent transjugular intrahepatic portosystemic shunt. heparin was discontinued. the patient was subsequently transferred to the general nursing floor for further observation where the patient did extremely well. the patient did not show any signs of return of encephalopathy or fluid overload. the patient's regimen consisted of aldactone 100 mg by mouth once per day, lasix 40 mg by mouth once per day, as well as fluid restriction, lactulose, and multivitamins. from a cirrhosis point of view, the patient had a successful transjugular intrahepatic portosystemic shunt revision; status post angioplasty of transjugular intrahepatic portosystemic shunt and coiling of spontaneous splenorenal shunt. liver function tests were followed daily. the patient was followed by the liver service. 2. hematologic issues: anemia and thrombocytopenia were stable. the patient did not show any evidence of active bleed. the thrombocytopenia was likely secondary to splenic sequestration and was stable. 3. infectious disease issues: the patient was placed on ciprofloxacin 500 mg by mouth every day for spontaneous bacterial peritonitis prophylaxis. 4. renal issues: hyponatremia was stable; most likely secondary to end-stage liver disease/ascites/total body sodium overload. a stable level for the patient. normal renal function with good urine output. 5. pulmonary issues: the patient was stable with normal oxygen saturations. 6. diabetes issues: the patient was managed with a regular insulin sliding-scale. 7. prophylaxis issues: for prophylaxis the patient was put on a proton pump inhibitor, pneumo boots, as well as ciprofloxacin for spontaneous bacterial peritonitis prophylaxis. discharge disposition: on the patient had a repeat renal ultrasound which showed good flow through the transjugular intrahepatic portosystemic shunt. the patient was discussed with the liver service and was discharged to home with close followup in the liver clinic two weeks status post discharge. condition at discharge: condition on discharge was good. discharge status: discharge status was to home. discharge diagnoses: 1. gastrointestinal bleed. 2. thrombocytopenia. 3. alcoholic liver cirrhosis. 4. portal hypertension. 5. encephalopathy. 6. anemia. 7. decreased patency of original transjugular intrahepatic portosystemic shunt; status post revision with good flow. medications on discharge: 1. pantoprazole 40 mg by mouth once per day. 2. multivitamin. 3. thiamine. 4. folic acid 1 mg by mouth once per day. 5. lactulose 30 ml by mouth three times per day (titrate to three bowel movements once per day). 6. spironolactone 100 mg by mouth once per day. discharge instructions/followup: the patient was to follow up in the liver clinic in one to two weeks after discharge. the patient was to call and make this appointment. , md dictated by: medquist36 procedure: other endoscopy of small intestine angioplasty of other non-coronary vessel(s) other endovascular procedures on other vessels diagnoses: thrombocytopenia, unspecified chronic hepatitis c without mention of hepatic coma acute posthemorrhagic anemia alcoholic cirrhosis of liver hepatic encephalopathy hemorrhage of gastrointestinal tract, unspecified other and unspecified alcohol dependence, unspecified mechanical complication of other vascular device, implant, and graft 

Answer: The patient is high likely exposed to