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: nsaids attending: chief complaint: hcv/etoh cirrhosis here for liver transplant major surgical or invasive procedure: : orthotopic liver transplant portal vein to portal vein,common bile duct to common bile duct (no t tube), supraceliac conduit to celiac axis of the donor. :ercp with 10 fr biliary stent : 8 fr drain to r subhepatic fluid collection : angiogram history of present illness: ms. is a 50 year old female with history of decompensated alcoholic and hcv cirrhosis, hrs, hyponatremia, sbp, ascites, grade 1 varices, recently admitted to the medical liver service for acute renal failure who presents today for a liver transplant. she was sent to rehabilitation 3 days ago following a hospitalization at for and hyponatremia. the was thought to be due to hrs and the hyponatremia was hypervolemic hyponatremia due to fluid excess, likely related to her cirrhosis as well. she was started on octreotide and midodrine while in the hospital. she has not required dialysis to date. they were planning serial paracenteses every 1-2 weeks and she has been taking cipro empirically for sbp prophylaxis. when we learned that a liver became available her rehab was contact and she was admitted directly to the floor, anticipating a liver transplant. . currently she is complaining of a persistent abdominal pain (states same as last hospitalization). the pain is around her umbilicus, sharp, and worse with movement. other than this she states she is ready for surgery but is clearly frightened of the procedure. she has no other complaints at this time. . ros: full review of systems was performed and negative except as per hpi. past medical history: decompsenated cirrhosis chronic hcv etoh abuse knee surgery depression, with a suicide attempt one and a half years ago social history: the patient is single, has never been married, has four children and ten grandchildren, oldest child is 27. she currently lives with her mother, who is her healthcare proxy (faith ). -tobacco history: quit ; used to smoke less than one pack a day for 43 years. -etoh: she does not drink alcohol currently over the past 25 years, but for 20+ years, she was drinking a bottle plus of vodka daily. -illicit drugs: she also used heroin, cocaine, and marijuana last approximately four years ago. she is not currently in a program. family history: no family history of liver disease or hepatitis physical exam: gen: hiding under covers, appears older than stated age, frightened vs: t: 98.4 p: 91 bp: 147/76 rr: 20 o2sat: 100ra heent: ncat, eomi, mmm, palate midline, pallor present neck: supple, no lad noted card: rrr, systolic murmur heard best on this exam in noisy environment over lusb pulm: lungs are very wheezy bilaterally, l>r, good air entry, some accessory muscle use abd: soft, distended with fluid wave and shifting dullness present, diffusely tender, voluntary guarding in all guadrants, no rebound, no guarding, pain not distractable ext: wwp, + b/l le edema to thighs neuro: a&ox3, no focal neurologic deficits pertinent results: on admission: wbc-6.1 rbc-1.93* hgb-7.5* hct-22.6* mcv-117* mch-39.2* mchc-33.3 rdw-19.1* plt ct-59* pt-20.3* ptt-35.4 inr(pt)-1.9* glucose-121* urean-120* creat-4.4* na-138 k-3.8 cl-107 hco3-18* angap-17 alt-35 ast-83* alkphos-46 totbili-4.2* lipase-43 albumin-3.8 calcium-8.9 phos-4.9* mg-1.8 hbsag-negative hbsab-negative hiv ab-negative at discharge: wbc-7.0 rbc-2.49* hgb-7.8* hct-24.2* mcv-97 mch-31.5 mchc-32.4 rdw-18.6* plt ct-225 pt-11.5 ptt-27.8 inr(pt)-1.1 glucose-133* urean-36* creat-1.4* na-141 k-3.4 cl-106 hco3-22 angap-16 alt-20 ast-19 alkphos-490* totbili-2.1* calcium-8.3* phos-3.4 mg-1.5* prograf pending at time of discharge. brief hospital course: 50 y/o female with hcv and etoh cirrhosis who underwent orthotopic deceased donor liver transplant (piggyback) portal vein to portal vein, common bile duct to common bile duct (no t tube), supraceliac conduit to celiac axis of the donor. the surgeon was dr . the donor was a cdc high-risk because of the possibility of the donor trading sex for drugs. the patient was informed of these high-risk behaviors and accepted the liver. hbsag, hbsab, hiv of recipient were negative at the time of transplant. the hbcab of the donor was positive, and the patient has received hbig per protocol with subsequent hbsab titers > 500, and negative hbsag. due to the level of her renal dysfunction, she required cvvhd during the transplant. she required one further day of cvvh. she was extubated on pod 1. she remained in the icu and while off renal replacement therapy, her bun and creatinine continued to rise, however her urine output was approximately 1.5 liters daily. on pod 3 her bun was 117, and prograf level was 15. the patient was noted to start having tonic-clonic seizures, neuro was consulted, she was started on keppra and received an additional hemodialysis treatment. following that treatment, the bun was in the 70s or less, and creatinine, which peaked at 4.1 has slowly but steadily declined to less than 2. once these interventions were complete, the patient did not appear to have further seizure activity, however the neurology recommendations are to continue the keppra for 6 months. the patient was transferred out of the icu on pod 7. appetite was poor, and feeding tubes have been placed. she has intermittently pulled the tubes out, despite bridling. the patients mental status does not appear to be at baseline, she is noted to be very quiet and uninvolved in personal care and learning medications. tsh was sent, result was 7.4 and levothyroxine was started. ast and alt have trended down to normal, however the alk phos which initially w starting to normalize, had started to trend back up into the 400s, and the total bilirubin which peaked at 16.1 while in the icu, has trended down, but not normalized. on pod 14, due to these findings, an ercp was performed showing mild diffuse dilation at the biliary tree with the cbd measuring 10 mm. the duct-to-duct anastomosis site appeared patent. a balloon sweep was performed through the anastomotic site with minimal resistance. an occlusion cholangiogram revealed extravasation of contrast most likely from the right hepatic system consistent with a high grade bile leak. the rest of the bile duct appeared unremarkable. a 10 fr biliary stent was placed. of note, there was a 3mm stomach body ulcer noted. famotidine was switched to protonix. mental status continued as flat and disengaged. tsh was checked and found to be elevated at 7.3 with t4 of 7.1. levothyroxine was started. an ultrasound/duplex of liver was done to assess for collection. findings were notable for high velocity in hepatic artery concerning for hepatic artery stenosis, large sub-hepatic fluid collection, large amount of abdominal and pelvic ascites adn small right pleural effusion. she then underwent us guided drainage of subhepatic/paracentesis fluid drainage (2 liters of biliuous fluid)with placement of an 8 fr drain. cell count had wbc of 2750 with 82 polys. this fluid bilirubin level was 17. culture was negative. zosyn was started for infected bile collection. she was given 25grams of albumin. another 2 liters of bilious fluid drained out with patient becoming tachycardic. albumin 5%/500ml was administered with resolution of tachycardia. on hepatic angiogram was performed via right groin approach with limited contrast used due to creatinine elevation of 1.7. she was prehydrated with iv bicarb fluid overnight prior to study. findings were notable for moderate stenosis just beyond anastomosis. ir was unable to stent. on , repeat angiogram was done with successful stent placement. aspirin and plavix were started for the stent. total bilirubin continued to decrease, however, alk phos continued to remain in the mid 400 range. on , hct had decreased to 20.9 from 25.6. two units of prbc were transfused with hct increase to 27. an abdominal ct was done to evaluate for bleeding. ct demonstrated the following: large subcapsular liver collection that is likely not being drained by the pigtail catheter in place at the inferior aspect of the liver. air within this collection likely is due to communication with the biliary tree. however, superinfection cannot be excluded. 2. generalized anasarca with intra-abdominal ascites and multiple collections identified, the largest of which is in the pelvis, as described above. 3. no evidence for intra-abdominal or pelvic bleed to explain the patient's recent drop in hematocrit. on , ct guided placement of an 8 french drain was placed into the the right perihepatic collection. per report, 100 ml of blood-tinged fluid removed. no further fluid could be aspirated despite the drain being in satisfactory position, which raises the possibility of a loculated collection. 100 ml of straw-colored fluid was aspirated through the existing right-sided 8french pigtail catheter, which was left in place. gram stain of fluid was no organisms or pmns, culture was negative. drain continued to have thin, yellow colored drainage averaging 50 -150 ml daily. on , zosyn was discontinued and cipro started for peritonitis prophylaxis. repeat culture was sent on drain fluid showing 1+ pmn with culture negative to date. mental status was much improved. she was more interactive, animated and able to participate in care. she was ambulating with walker with supervision. pt continued to recommend rehab. hepatitis b immune globulin was administered im on per protocol (postop day 21)as liver donor was hb core positive. she will receive this on postop day 29 at her next appointment at clinic. hbsab titer was greater than 500 and hbsag remained negative. she will continue to receive this per protocol arranged by transplant. on , a bed was available at rehab in . she was transferred there on . medications on admission: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 2. clotrimazole 10 mg troche sig: one (1) troche mucous membrane qid (4 times a day). 3. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day). 4. rifaximin 550 mg tablet sig: one (1) tablet po bid (2 times a day). 5. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 6. multivitamin tablet sig: one (1) tablet po daily (daily). 7. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 8. octreotide acetate 500 mcg/ml solution sig: one (1) injection q8h (every 8 hours). 9. sevelamer carbonate 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). 10. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily(daily). 11. midodrine 5 mg tablet sig: three (3) tablet po tid (3 times a day). 12. ciprofloxacin 250 mg tablet sig: two (2) tablet po q24h (every 24 hours). 13. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 14. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for sob/wheezing. 15. lorazepam 0.5 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for anxiety. 16. albumin, human 25 % 25 % parenteral solution sig: one (1)intravenous daily (daily). discharge medications: 1. fluconazole 200 mg tablet sig: one (1) tablet po q24h (every 24 hours). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 4. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for wheezing. 5. valganciclovir 450 mg tablet sig: one (1) tablet po once a day. 6. lamivudine 100 mg tablet sig: one (1) tablet po daily (daily). 7. mycophenolate mofetil 500 mg tablet sig: two (2) tablet po bid (2 times a day). 8. sulfamethoxazole-trimethoprim 400-80 mg tablet sig: one (1) tablet po daily (daily). 9. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours) as needed for wheezing. 10. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 11. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 12. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily): started . tsh in 6 weeks. 13. cyanocobalamin (vitamin b-12) 100 mcg tablet sig: 0.5 tablet po daily (daily). 14. hydromorphone 2 mg tablet sig: 1-2 tablets po every four (4) hours as needed for pain. 15. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain: no more than 2000mg per day. 16. prednisone 5 mg tablet sig: 3.5 tablets po daily (daily): decrease per taper . 17. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 18. tacrolimus 1 mg capsule sig: three (3) capsule po q12h (every 12 hours). 19. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours): peritonitis prophylaxis while drains in place. do not discontinue. 20. dextrose 50% 12.5 gm iv prn hypoglycemia protocol 21. glucagon (human recombinant) 1 mg recon soln sig: one (1) recon soln injection q15min () as needed for hypoglycemia protocol. 22. insulin regular human 100 unit/ml solution sig: follow sliding scale units injection four times a day. 23. outpatient lab work friday then every monday and thursday for cbc, chem 10, ast, alt, alk phos, t.bili and trough tacrolimus level with stat results. fax results to transplant see printed recs and labels 24. hepatitis b immune globulin postop day 28-to be given at clinic on 25. levetiracetam 500 mg tablet sig: two (2) tablet po twice a day. 26. metoprolol tartrate 100 mg tablet sig: one (1) tablet po three times a day: hold for sbp < 120 or hr < 60. discharge disposition: extended care facility: - discharge diagnosis: hcv/etoh cirrhosis now s/p liver transplant with conduit bile leak s/p biliary stent placement infected abdominal bile collections hepatic artery stenosis seizures acute on chronic kidney failure hypothyroid malnutrition 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: you will be transferred to rehab in please call the clinic at if the patient has fever of 101 or greater, chills, nausea, vomiting,jaundice, diarrhea, constipation, increased abdominal pain, inability to tolerate food, fluids or medications, incisional redness, drainage or bleeding, or abdominal drain outputs increase or stop. please empty and record all drain outputs every shift and as needed. send copy of drain output log to the transplant clinic. labs friday then every monday and thursday for cbc, chem 10, ast, alt, alk phos, t bili, trough prograf level with results faxed to transplant clinic at please do not add, or take away, or adjust medication dosages without first consulting with the transplant team. patient may shower, do not allow drains to hang freely. no tub baths or swimming no lifting greater than 10 pounds followup instructions: please call transplant coordinator for f/u appointment week of provider: . & tarulla (neurology)phone: date/time: 2:30, md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours hemodialysis angioplasty of other non-coronary vessel(s) percutaneous abdominal drainage endoscopic sphincterotomy and papillotomy endoscopic insertion of stent (tube) into bile duct other transplant of liver arteriography of other intra-abdominal arteries insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) other percutaneous procedures on biliary tract other operations on lacrimal gland transplant from cadaver cranial or peripheral nerve graft insertion of one vascular stent procedure on single vessel procedure on vessel bifurcation diagnoses: end stage renal disease need for prophylactic vaccination and inoculation against viral hepatitis alcoholic cirrhosis of liver acute kidney failure, unspecified hepatorenal syndrome unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia other and unspecified alcohol dependence, in remission portal hypertension unspecified viral hepatitis c without hepatic coma personal history of tobacco use hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease pressure ulcer, buttock other specified disorders of biliary tract other ascites gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] chronic obstructive asthma, unspecified esophageal varices in diseases classified elsewhere, without mention of bleeding surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation precipitous drop in hematocrit localization-related (focal) (partial) epilepsy and epileptic syndromes with simple partial seizures, without mention of intractable epilepsy other alteration of consciousness pressure ulcer, stage ii nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [ldh] spontaneous bacterial peritonitis major depressive affective disorder, single episode, severe, without mention of psychotic behavior other fluid overload atherosclerosis of other specified arteries chronic congestive splenomegaly other, mixed, or unspecified drug abuse, in remission other specified disorders of metabolism choleperitonitis other digestive system complications 

Answer: The patient is high likely exposed to