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: lower extremity cellulitis. major surgical or invasive procedure: --paracentesis x5 (, 2, 9, 17, and 23) --intubation --incision and drainage of left foot () --upper endoscopy and sigmoidoscopy () --bronchoscopy with broncheoalveolar lavage history of present illness: mr. is a 52-year-old man with history of cirrhosis and alcoholic hepatitis who was admitted to on due to lle cellulitis. he was started on iv antibiotics at that time (eventually broadened to vanc/zosyn) and had his left foot i&d'd by podiatry. wound cultures from left foot were positive for pansensitive klebsiella. hospital course was also complicated by sbp, for which he was given 5 days of treatment. repeat diagnostic paracentesis were negative. on , patient began complaining of worsening abodminal pain and his mental status began to deteriorate; he also spiked a fever to 101. he subsequently had a bright red bowel movement. in the context of this clinical change, mr. was transferred to the micu for further care. in the icu, patient had an egd, which showed severe gastritis and enteropathy. he had one non-bleeding grade i varix; a flex sig showed bleeding hemorrhoids. ct scan on showed pneumotosis intestinalis thus, patient was unable to receive lactulose. mr. was eventually intubated due to worsening mental status and inability to protect airway. ng tube was placed for bowel decompression and tpn was started. id suggested broad spectrum antibiotics including: dapto, flagyl, zosyn, and cefepime. klebsiella grew in wound and in sputum, but all cultures are otherwise ngt. antibiotics were tailored to just cefepime. on , patient self-extubated. he was transferred back to 10 on . upon examination in the micu, patient is oriented only to self. he cannot accurately explain where he is, but does think it is the "17th" instead of the "16th" of . past medical history: 1) etoh abuse 2) cirrhosis (diagnosed in ) egd screening for varicies on showed portal hypertensive gastropathy without esophageal or gastric varicies 3) gerd 4) vre screen positive 5) psoriasis 6) onychomycosis social history: living with mother and sister since hospitalization in . tobacco: quit . prior 6 cigs/day x 25 years. etoh: 1 pint - qt per day of whisky x 20 years. last drink per patient was immediately prior to hospitalization. denies alcohol use since hospitalization. drugs: denies history of cocaine or ivdu hiv: negative 2 years ago family history: father: pancreatic cancer - deceased. sister: breast cancer brother: bladder cancer physical exam: vs: t 100.2, hr 112, bp 150/68, rr 17, o2 99% ra gen: inattentive, nad heent: sclera icteric, perrl, neck: supple, jvp ~10 cm with respiratory variation pulm: anterior exam with decreased breath sounds and crackles at bilateral bases card: tachy, nl s1, nl s2, iii/vi murmur across precordium abd: bs+, distended, mildy tender epigastrum, tympanitic gu: foley in place ext: 2+ pitting edema of ble above level of knees, l foot bandaged with strikethrough serosanguinous fluid on bandage, expanding erythema from l foot up l calf, bilateral dp and pt dopplerable, r foot with erythema (non-blanching) and a scaling rash on dorsum of foot neuro: oriented to location and clinic situation, though unable to correctly report date, asterixis present pertinent results: 11:34am urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-neg mthdone-neg 03:05am urine color-amber appear-clear sp -1.020 03:05am urine blood-tr nitrite-neg protein-30 glucose-neg ketone-tr bilirubin-lg urobilngn-0.2 ph-6.0 leuk-neg 03:05am urine rbc-0-2 wbc-1 bacteria-few yeast-none epi-1 01:35am alt(sgpt)-124* ast(sgot)-128* alk phos-280* tot bili-14.8* 01:35am asa-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 01:35am wbc-9.3 rbc-3.01* hgb-10.3* hct-30.9* mcv-103* mch-34.1* mchc-33.2 rdw-17.1* 01:35am neuts-87.0* bands-0 lymphs-7.8* monos-2.6 eos-2.3 basos-0.2 01:35am pt-19.5* ptt-32.4 inr(pt)-1.8* 01:35am plt count-54* ct chest : 1. scattered ground-glass opacities predominantly in the left upper lobe, lingula and right lower lobe. the appearance is nonspecific and may represent infection, chronic eosinophilic pneumonia, and cryptogenic organizing pneumonia. followup is recommended post-treatment. 2. scattered up to 6-mm pulmonary nodules. followup chest ct is recommended in six months as guidelines. 3. incompletely evaluated cirrhosis of the liver, upper abdominal ascites and splenomegaly. portable abdomen : multiple loops of dilated small bowel, with no large bowel seen, more compatible with obstruction. a nasogastric tube terminates appropriately within the collapsed stomach. leni : no evidence of dvt in bilateral lower extremities. ct 1. upper lobe predominant centrilobular ground-glass opacities likely reflecting an infectious or inflammatory etiology. 2. cholelithiasis. 3. moderate ascites with cirrhosis. brief hospital course: this is a 52-year-old gentleman with a history of alcoholic cirrhosis who was initially admitted to for lower extremity cellulitis. patient subsequently developed sepsis, and was transferred to the micu on for brbpr, fever, tachycardia, and sbo. he was transferred back to the floor in stable condition, though still encephalopathic and with fevers. # cellulitis: this was patient's presenting complaint and reason for coming to the hospital. he was initially started on vancomycin and unasyn, later switched to vancomycin and zosyn, however, he failed to respond to treatment. a ct scan was performed of left foot, which showed evidence of subacute fracture. orthopedics was consulted and did not recommend immediate surgical treatment, but recommended follow-up in 6 weeks with touch-down weight bearing status. podiatry was consulted as well, who recommended i&d in or. patient went for i&d on , and cultures came back as pan-sensitive klebsiella; vanc and zosyn were continued. however, on , patient became increasingly restless, started spiking fevers, and his mental status deteriorated. he was started on multiple broad spectrum antibiotics and transferred to the micu. podiatry followed patient in micu and continued to direct dressing changes. upon discharge a wound vac was placed by the podiatry service. this should be changed every three days until patient follows up in podiatry clinic, which should be scheduled for one week after discharge. # fever: mr. had low-grade fevers throughout his hospital course. initially it was thought that fevers were from cellulitis. on , patient was transferred to micu for fevers and change in mental status, and at that time, his antibiotics were broadened to include vre and fungal coverage. mr. was intubated for airway protection, and a bal was done, which grew out mdr klebsiella (sensitive to cefepime). antibiotics were eventually switched to cefepime and flagyl. a ct scan showed multiple infiltrates, suggestive of pneumonia. the flagyl and cefepime were stopped after a seven-day course, and patient defervesced. # altered mental status: patient had worsening mental status, starting around , which was likely secondary to infection and worsening hepatic encephalopathy. he could not be given lactulose for a period of time in context of an sbo; however, when lactulose was restarted, he began to clear. by the time of his transfer out of the micu to the general floor, patient was alert and oriented, but continued to be tangential and at times, non-sensical. we continued to treat his infection with antibiotics and eventually his mental status returned to baseline - aaox3, interactive. # gi bleed: patient had a large bloody bowel movement on . an egd and flex sig showed no obvious source of bleeding, but were consistent with gastritis, grade 1 nonbleeding varice, and hemorrhoids. mr. was transferred to the micu, fluid resuscitated, and remained hemodynamically stable. he was continued on lanzoprazole and eventually discharged on his home ppi - omeprazole. # respiratory failure: mr. was intubated in the micu for airway protection. he was not receiving lactulose in context of sbo and gi bleed and as such, became profoundly encephalopathic. he eventually "self-extubated" but was able to breathe well on his own and remained off the ventilator. # cirrhosis: patient with etoh-related cirrhosis with alcohol use up until the spring of . mr. was maintained on rifaxamin, folic acid, thiamine, and lactulose. patient received multiple paracentesis for diagnostic and therapeutic purposes. he will benefit from alcohol rehab once stable. mr. can be considered for a liver transplant once he is sober for 3-6 months. he should continue spironolactone for prevention of edema. # spontaneous bacterial peritonitis: mr. had a paracentesis early on in his admission that was consistent with sbp. he was already on antibiotics for his cellulitis (see above) that provided good covereage for sbp. after the antibiotic course as above, he was started on prophlactic treatment with ciprofloxacin. # sbo/ pneumotosis intestinalis: mr. went to the micu on for fever, change in mental status, abdominal distention, and brbpr. imaging on transfer was suggestive of sbo; patient subsequently developed pneumotosis intestinalis. he was made strictly npo. infectious and metabolic causes of sbo were investigated. sbo and pneumotosis intestinalis eventually resolved, and patient began a normal diet. # lung nodules: mr. had an incidental finding of lung nodules on numerous ct scans. he will need to follow-up with repeat imaging in 6 months. # hypertension: patient was started on amlodipine. # fen/gi: continue tube feeds and encourage oral foods # prophylaxis: ppi, lactulose, pneumatic boots # code status: full code medications on admission: 1) omeprazole 40 mg daily 2) prednisone 20 mg daily w/ taper (starting , taper by 5mg q5 days) 3) multivitamins 4) rifaximin 400 mg tid 5) folate/thiamine/multivitamin 6) simethicone prn 7) lactulose tapered to bowel movements daily discharge medications: 1. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 2. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 3. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 4. multivitamin capsule sig: one (1) capsule po once a day. 5. rifaximin 200 mg tablet sig: two (2) tablet po tid (3 times a day). 6. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed for gas/cramps. 7. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day). 8. spironolactone 25 mg tablet sig: two (2) tablet po daily (daily). 9. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 10. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours). discharge disposition: extended care facility: hospital - discharge diagnosis: primary diagnoses --bilateral lower extremity cellulitis --subacute fracture of the left distal fibula --hospital-associated pneumonia secondary diagnoses --etoh abuse --cirrhosis --gastroesophageal reflux disease discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. **touch-down weight bearing in left lower extremity until follow-up in clinic** discharge instructions: you were admitted to the hospital for treatment of skin infections on the legs. the hospital course was complicated by infections in the lungs and in the intestine. you were treated with antibiotics and your symptoms improved. in addition, you were noted on x-ray to have a subacute fracture in a small bone in the left ankle. for the fracture, orthopedics has recommended touch down weight-bearing until your follow-up appointment with dr. (see below). for the foot infection, in addition to antibiotics above, you underwent incision and drainage of the left foot and should continue to use the wound vac dressing until you follow-up in podiatry clinic with dr. . during this admission, we made the following changes to your medications: --we added ciprofloxacin for prevention of infection --we added spironolactone for prevention of fluid accumulation --we added amlodipine for treatment of high blood pressure there were no other changes to your medicines. followup instructions: --dr. is available for urgent care issues related to primary care. his office number is . he was contact during this admission and would like to schedule you for a full office visit in the next 1-3 months. please call his office to confirm. --dr. will call you regarding follow-up appointment in weeks in the liver clinic. --please schedule an appointment with dr. in podiatry clinic in one week. the number to schedule is . --please schedule an appointment with dr. in orthopedics clinic in two weeks. the number to schedule is . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage closed [endoscopic] biopsy of bronchus colonoscopy other incision with drainage of skin and subcutaneous tissue other incision with drainage of skin and subcutaneous tissue diagnoses: acidosis thrombocytopenia, unspecified esophageal reflux alcoholic cirrhosis of liver acute kidney failure, unspecified severe sepsis portal hypertension perforation of intestine obstructive chronic bronchitis with (acute) exacerbation personal history of tobacco use hypopotassemia ulcer of other part of foot other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure acute respiratory failure cellulitis and abscess of leg, except foot disorders of phosphorus metabolism unspecified gastritis and gastroduodenitis, with hemorrhage paralytic ileus other constipation other septicemia due to gram-negative organisms other diseases of lung, not elsewhere classified other ascites esophageal varices in diseases classified elsewhere, with bleeding other specified disorders of stomach and duodenum internal hemorrhoids with other complication ventilator associated pneumonia acute vascular insufficiency of intestine other psoriasis delirium due to conditions classified elsewhere pneumonia due to klebsiella pneumoniae cellulitis and abscess of foot, except toes acute alcoholic hepatitis spontaneous bacterial peritonitis fracture of medial malleolus, closed unspecified viral hepatitis c with hepatic coma fracture, cause unspecified 

Answer: The patient is high likely exposed to