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: morphine attending: chief complaint: recurrent ascites major surgical or invasive procedure: transjugular intrahepatic portosysyemic shunt placement therapeutic paracentesis transesophageal echocardiogram history of present illness: briefly, 38 yo m with a h/o hep c cirrhosis, episode of sbp, s/p liver transplant in , recent admission at for arf in the setting of new diuretic regimen, now transfered from an osh for evaluation of worsening lfts, which developed during a hospitalization for mi. as above the pt was recently admitted to for arf that developed after starting a regimen of lasix. with d/c of lasix, the pt's renal failure had largely resolved at the time of discharge from on . the day following discharge the pt had an episode of severe b/l neck pain that radiated down into his chest, associated with dyspnea. ems was called and pt's pain continued until he was electively intubated for catheterization, given ekg with st elevations in v1-v3. cath revealed a proximally occluded lad that underwent successful pci with a vision stent placed with a good result. pt was extubated on . his lft's were elevated with ast of 345 and alt of 127. the pt was transferred to and was initially admitted to the ccu to ensure cardiac stability. he is now being transfered to the hepatorenal service for further evaluation of his elevated lfts. presently he is denying cp/sob/hps/abdominal pain. he denies n/v. had loose bms last night. past medical history: 1 chronic hepatitis c -> cirrhosis - h/o ascites, encephalopathy, sbp - orthotopic deceased donor liver transplant on - one nodule of hcc found at time of transplant - c/b recurrent hep c after transplant - tx with interferon and ribavirin -> no response - vl 12,600,000 on - ifn, ribavarin d/c on - also c/b biliary anastamotic stricture s/p dilation and stenting - stent removed - liver bx shows recurrent, progressive hep c but no hcc - recurrent ascites 2 h/o hemochromatosis 3 dm2 4 h/o dvt and bilateral pe 5 h/o splenic infarct 6 ho stemi () social history: currently living with his mom. h/o etoh - quit in ' h/o ivdu - quit in ' family history: non-contrib physical exam: temp 98 bp 100/50 pulse 76 resp 20 o2 sat 100% ra gen - alert, no acute distress - extraocular motions intact, anicteric, mucous membranes dry neck - no jvd, no cervical lymphadenopathy chest - diminished breath sounds r base cv - normal s1/s2, rrr, no murmurs appreciated abd - soft, mildly distended, ruq tenderness to deep palpation, normoactive bowel sounds extr - no clubbing, cyanosis, or edema. 2+ dp pulses bilaterally neuro - non-focal skin - no rash pertinent results: 08:19pm glucose-167* urea n-42* creat-1.7* sodium-140 potassium-4.8 chloride-112* total co2-22 anion gap-11 08:19pm alt(sgpt)-115* ast(sgot)-304* ld(ldh)-322* ck(cpk)-29* alk phos-342* amylase-15 tot bili-2.2* 08:19pm lipase-9 08:19pm albumin-2.1* calcium-7.5* phosphate-3.5 magnesium-1.9 08:19pm wbc-4.1# rbc-3.00* hgb-10.1* hct-31.2* mcv-104* mch-33.7* mchc-32.4 rdw-15.6* 08:19pm neuts-64 bands-0 lymphs-20 monos-15* eos-1 basos-0 atyps-0 metas-0 myelos-0 08:19pm plt count-84* 08:19pm pt-14.0* ptt-37.3* inr(pt)-1.2* 04:30am blood wbc-3.9* rbc-3.46* hgb-11.2* hct-33.8* mcv-98 mch-32.4* mchc-33.2 rdw-16.8* plt ct-79* 04:30am blood plt ct-79* 04:30am blood pt-14.4* ptt-40.1* inr(pt)-1.3* 04:30am blood glucose-182* urean-38* creat-1.1 na-139 k-4.7 cl-111* hco3-22 angap-11 04:30am blood alt-138* ast-361* alkphos-351* totbili-2.8* 04:30am blood calcium-7.2* phos-3.5 mg-2.0 09:11pm urine color-amber appear-clear sp -1.018 09:11pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-sm urobiln-0.2 ph-5.0 leuks-neg 12:00pm ascites wbc-248* rbc-3889* polys-1* lymphs-78* monos-18* macroph-3* 12:00pm ascites totpro-1.8 ld(ldh)-141 albumin-1.1 11:01 am peritoneal fluid gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. fluid culture (final ): no growth. anaerobic culture (preliminary): no growth. blood culture pending blood culture aerobic bottle-pending; anaerobic bottle-pending inpatient blood culture aerobic bottle-pending; anaerobic bottle-pending inpatient immunology (cmv) cmv viral load-final negative ___________________ doppler u/s impression: 1) patent hepatic vasculature with unremarkable doppler waveforms. 2) coarsened, heterogeneous appearance of the transplant liver, largely new from , significance uncertain. 3) large amount of ascites; a site was marked in the right lower quadrant for paracentesis. 4) splenomegaly. tte conclusions: the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is preserved except for probable mild mid anteroseptal hypokinesis. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is a small pericardial effusion. compared with the prior study (images reviewed) of , there is now a mobile echodense structure on the ventricular side of the mitral valve that may represent vegetation. left ventricular systolic function is now minimally depressed. tee : conclusions: 1. left ventricular wall thicknesses and cavity size are normal. overall left ventricular systolic function is mildly depressed. 2. mild (1+) mitral regurgitation is seen. 3. no vegetations duplex u/s, : conclusion: fully patent tips with main portal velocity of 39 cm per second and intra tips velocities ranging from 85-143 cm per second. brief hospital course: a/p: 38 yo m s/p liver transplant in , h/o recurrent hepatitis c transferred from osh for eval of elevated lfts s/p mi. . #elevated lfts: chronically elevated since . initially s/p tx pt's ast/alt were normal. however, in were ranging 40s to low 100s. acute bump occured in late . ast/alt have remained on the high 100s to 300s since that time. as this has been a chronic change post transplant, this may be to known recurrence of hep c and/or hemachromatosis. of note, the pt's interferon therapy was discontinued a few weeks ago, but the pt had not appeared to respond to the therapy. more concerning these changes may be associated with rejection. ruq showed patent vasculature, no e/o cirrhosis. pt. was continued on lactulose, and his lfts remained stable throughout his stay. given his recurrent ascites, he was given a paracentesis taking off 3l, which recurred over the next few days, so tips was placed by ir. post, tips, bili rose slightly, but stabilized by discharge with edema and ascites stable. post-tips u/s showed tips patency. . #stemi: pt symptomatically stable, vss on tele throughout his stay without chest pain or shortness of breath. a tte was performed which showed minimally depressed lv function and an echodense structure on the mitral valve worrisome for endocarditis. subsequent tee ruled this out. he was coninued on bb/asa/ticlopidine with no statin, given concurrent liver dz. . #hyperkalemia: pt. was hyperkalemic, peaking at 5.9 in the context of arf. he was placed on a low potassium diet and kayexylate tid with resultant decrease in his potassium. he will require close follow up as outpt. to ensure that he does not develop hyperkalemia. . #arf: early in year, cr 0.7, but had been trending up. baseline prior to previous admissions 1.0-1.1. initially presented a few weeks back with arf in setting of increased diuretics. cr. had been trending down to 1.3 at previous discharge. upon current discharge, cr returned to baseline 1.1, after peaking at 2.0. arf thought to be prerenal vs. hepatorenal vs. contrast during cath/ fk506 toxicity. his urine lytes were consistent with prerenal arf, and gentle fluids and transfusion of 2u helped to return his cr to baseline upon discharge. his fk506 dose was decreased, maintaining level of at trough, given his concurrent renal failure and his diuretics were held throughout his stay. his cr returned to his baseline by discharge. diuretics were not restarted upon discharge . #anemia: hct drop since last d/c to present admit (31 at admission). likely to bleeding at cath site. had hct drop to 28 prior to therapeutic paracentesis, 24 immediately afterwards and received 2u prbcs with correction back to 33. suspect that the hct of have been measurement issue. stools were guaiac negative, and hct was stable for the last few days of his stay. . #ascites/pleural effusions: diminished breath sounds with known r pleural effusions, cxr stable. pt. with increasing ascites as has not been receiving diuretics renal status. received 3.5l therapeutic tap on , with tips done by ir on . post-tips doppler u/s showed patent tips prior to discharge. . #dm2: sugars continued to be high during admission, initially with sugars into the 300s. given recent mi, pt.'s sugars were more aggressively controlled. at discharge he was taking 16u nph (up from 10u on admit) with an increased iss. medications on admission: asa 325mg qd lopressor 12.5mg ticlopidine colace 100mg qd protonix 40mg qd tacrolimus 1mg remeron 15 mg qhs bactrim ds one tab qd sliding scale insulin discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. docusate sodium 100 mg capsule sig: one (1) capsule po daily (daily). disp:*30 capsule(s)* refills:*2* 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 4. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: take 1 tab sl for chest pain. repeat after 5 minutes x 2. disp:*30 tablet, sublingual(s)* refills:*0* 6. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 7. ticlopidine 250 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 8. metoprolol succinate 25 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). disp:*30 tablet sustained release 24hr(s)* refills:*2* 9. hydromorphone 2 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for back pain. disp:*30 tablet(s)* refills:*0* 10. rifaximin 200 mg tablet sig: two (2) tablet po tid (3 times a day). disp:*180 tablet(s)* refills:*2* 11. tacrolimus 0.5 mg capsule sig: one (1) capsule po qam (once a day (in the morning)). disp:*30 capsule(s)* refills:*2* 12. insulin nph human recomb 100 unit/ml suspension sig: sixteen (16) units subcutaneous twice a day: give 16u in am and 16u in pm. disp:*3 bottles* refills:*2* 13. insulin regular human 100 unit/ml solution sig: per sliding scale units injection four times a day: give number of units per sliding scale. disp:*2 qs* refills:*2* 14. ciprofloxacin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 2 weeks. disp:*27 tablet(s)* refills:*0* 15. lactulose (for encephalopathy) 10 g/15 ml solution sig: thirty (30) mg po three times a day: titrate lactulose to bowel movements per day. disp:*3 qs* refills:*2* discharge disposition: home discharge diagnosis: recurrent ascites s/p liver transplant diabetes mellitus ________________ s/p stemi recurrent hepatitis c discharge condition: good, amblating, afebrile tolerating pos, satting well on ra. discharge instructions: please seek medical attention should you develop any of the following symptoms: increased confusion, lethargy, chest or abdominal pain, shortness of breath, bleeding from your rectum, henatemesis, decreased urine output, or increased abdominal distension. please adhere to a strict low potassium diet (<1g/day) for now until further notified by your pcp. take all medications as prescribed, including your tacrolimus at 0.5mg qday. take your lactulose regularly and titrate it to >3 bowel movements per day. take your ciprofloxacin, the antibiotic for your urinary infection twice a day for two more weeks. it is important to complete this antibiotic course. follow up with dr. at the appt. outlined below next week. have your labs drawn on monday prior to that appointment. followup instructions: please follow up with dr. on wed. at 11:30am to follow up your prograf levels, bilirubin, potassium and creatinine. in conjunction with your cardiologist dr. , he may decide to start you on a statin medication for your cholesterol as you have recently had an mi. please also attend the following appointments: cardiology: dr. 3:00 pm. , , ma . provider: , md phone: date/time: 11:40 procedure: diagnostic ultrasound of heart percutaneous abdominal drainage other endovascular procedures on other vessels injection of anesthetic into spinal canal for analgesia intra-abdominal venous shunt diagnoses: hyperpotassemia coronary atherosclerosis of native coronary artery chronic hepatitis c without mention of hepatic coma acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified acute myocardial infarction of other anterior wall, initial episode of care percutaneous transluminal coronary angioplasty status complications of transplanted liver surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation 

Answer: The patient is high likely exposed to