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: diarrhea, fatigue major surgical or invasive procedure: paracentesis central venous line tracheal intubation history of present illness: mr is a 72 year old man with known alcoholic cirrhosis, who refused transplant evaluation last year, and who comes today with a five day history of diarrhea and weakness. he and his daughter say he was in his usual state of health until earlier this week, the daughter thinks around tuesday. he began to have diarrhea which he said was not bloody or black. earlier this week (thursday?) he was in the bathtub and was feeling so weak that he could not get out and stayed there for hours. he says that he also fell down some stairs; he hit his buttocks and back but denies any head trauma. he has more recently been having shaking chills, including this morning when his chills were at their worst yet. further review of systems is detailed below. when he presented to the ed, his initial vitals were: t 100.4; bp 112/57; hr 72; rr 18; o2 99% on 3l nc. in the emergency department he had an x-ray which showed no pulmonary edema or consolidation, and a clean ua. his blood pressures dipped down into the 80s and low 90s, at which point the sepsis protocol was initiated. from 11:40 am to 14:40 her received 4 l of ns as well as a fifth liter running at 200 cc/hr which was mostly complete by the time he arrived in the micu. additionally at 15:30 levophed drip was started. he was started on antibiotics with zosyn 4.5 mg iv and vancomycin 1 gram iv, each as one-time doses given at 1320 (zosyn) and 1550 (vanco). additionally, early in his stay, he also received zofran 4 mg iv x1 and tylenol 1g po. by report gi recommended 150 grams of albumin but the ed was not able to give this. a central venous line was placed with an appropriate central line checklist placed in the chart. ros: constitutional: fatigue, weight loss, gained weight overall but daughter and pt feel he has lost weight in other areas besides his distended abdomen ear, nose, throat: dry mouth, no(t) epistaxis cardiovascular: no(t) chest pain, no(t) palpitations, no(t) orthopnea respiratory: no(t) cough, no(t) dyspnea gastrointestinal: no(t) abdominal pain, no(t) nausea, no(t) emesis, diarrhea genitourinary: foley integumentary (skin): jaundice heme / lymph: anemia neurologic: no(t) headache pain: no pain / appears comfortable past medical history: cirrhosis; turned down evaluation for transplant in ; grade ii esophageal varices seen in egd along with portal hypertensive gastropathy but no gastric varices past etoh abuse type ii dm, last hgba1c 6.7 hypertension social history: no tobacco, no illicits, patient denies alcohol but per daughters think patient still drinks family history: non-contributory physical exam: t: 36 ??????c hr: 72 bp: 118/61 rr: 19 spo2: 95% 3lnc general appearance: gaunt face, thin other than quite distended abdomen eyes / conjunctiva: perrl, no(t) conjunctiva pale, jaundice head, ears, nose, throat: normocephalic, mucus membranes dry; back of op dark color of red without any apparent blood or fluid cardiovascular: (s1: normal), (s2: normal), distant heart sounds peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: diminished), (left dp pulse: diminished), cool feet in context of levophed respiratory / chest: (expansion: symmetric), (breath sounds: clear : , no(t) crackles : , no(t) bronchial: , no(t) wheezes : , no(t) rhonchorous: ) abdominal: soft, non-tender, bowel sounds present, distended, markedly distended; angiomas; caput at umbilicus; bulging flanks; extremities: right: 1+, left: 1+ musculoskeletal: muscle wasting, facial wasting skin: warm, jaundice, mostly warm except feet/le which were cool; scattered ecchymoses on back neurologic: attentive, follows simple commands, responds to: verbal stimuli, oriented (to): hospital, , , , "", movement: not assessed, tone: not assessed, very slight asterixis pertinent results: on admission: 12:15pm blood wbc-15.3*# rbc-3.39* hgb-12.4* hct-33.5* mcv-99* mch-36.5* mchc-36.9* rdw-15.6* plt ct-110* 12:15pm blood neuts-84* bands-6* lymphs-1* monos-9 eos-0 baso-0 atyps-0 metas-0 myelos-0 12:15pm blood pt-24.1* ptt-34.5 inr(pt)-2.3* 12:15pm urean-43* creat-1.7* na-129* k-4.2 cl-99 hco3-21* angap-13 10:05pm calcium-7.0* phos-4.0 mg-2.3 creatinine trend 10:05pm urean-43* creat-1.8* na-133 k-4.7 cl-104 hco3-22 09:13am urean-54* creat-2.5* na-133 k-4.9 cl-101 hco3-17* 03:58am urean-68* creat-3.3* na-130* k-4.4 cl-100 hco3-16* 03:18am urean-88* creat-4.8* na-127* k-4.4 cl-97 hco3-16* lfts 12:15pm alt-74* ast-136* alkphos-108 totbili-7.2* dirbili-4.4* indbili-2.8 09:13am alt-67* ast-126* ld(ldh)-283* alkphos-87 totbili-9.9* 03:58am alt-54* ast-90* alkphos-68 totbili-9.8* 03:34pm alt-52* ast-80* alkphos-68 totbili-11.2* 03:18am alt-49* ast-76* alkphos-70 totbili-12.9* iron studies 12:15pm blood iron-55 caltibc-135* hapto-25* ferritn-903* trf-104* 03:58am blood afp-<1.0 09:13am blood ethanol-neg lactate trend 11:59am blood lactate-3.1* 03:55pm blood lactate-2.0 05:25pm blood glucose-71 lactate-2.1* 06:14pm blood lactate-1.9 07:33pm blood lactate-2.0 10:31pm blood lactate-2.0 cultures: 12:15 pm blood culture 4/4 bottles blood culture, routine (preliminary): klebsiella pneumoniae. final sensitivities. gram negative rod #2. gram negative rod #3. 3rd morphology. sensitivities: mic expressed in mcg/ml _________________________________________________________ klebsiella pneumoniae | ampicillin/sulbactam-- 4 s cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 2 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- <=1 s ascites cultures 12/13 and with no growth to date albumin <1 and cytology negative for malignant cells wbc rbc polys lymphs monos mesothe macrophages totprot glucose ldh 95* 235* 20* 5* 72* 3* 1.7 131 54 148* 85* 34* 24* 26* 16* 1.6 84 urine culture: no growth 3:29 pm stool consistency: formed source: stool. **final report ** fecal culture (final ): no salmonella or shigella found. campylobacter culture (final ): no campylobacter found. ova + parasites (final ): no ova and parasites seen. this test does not reliably detect cryptosporidium, cyclospora or microsporidium. while most cases of giardia are detected by routine o+p, the giardia antigen test may enhance detection when organisms are rare. fecal culture - r/o vibrio (final ): no vibrio found. clostridium difficile toxin a & b test (final ): feces negative for c.difficile toxin a & b by eia. (reference range-negative). radiology cxr: no evidence of pneumonia or volume overload. atelectasis at the left lung base. : abd x-ray there is gas seen in several featureless loops of likely small bowel within the mid abdomen. no dilated loops of colon is identified. findings are non-specific. there is no free intra-abdominal gas. degenerative changes are seen at the lumbar spine and of the hips bilaterally. liver/gallbladder us 1. gallbladder wall edema without pericholecystic fluid or son sign. cholelithiasis with gallbladder wall sludge. overall, findings equivocal for acute cholecystitis and if persistent clinical concern for acute cholecystitis, a hida scan is recommended. 2. right hepatic lobe heterogeneously echogenic vascular mass as described above, raising concern for hepatocellular carcinoma in the setting of cirrhosis, was noted on the ct abdomen from , however, direct comparison in size cannot be made due to technique-related differences. mr characterization is recommended. 3. cirrhosis, splenomegaly, ascites indicating portal hypertension. ecg : sinus rhythm. findings are within normal limits. compared to the previous tracing of there is no significant diagnostic change. brief hospital course: 72 year old man with known alcoholic cirrhosis, esophageal varices, type ii diabetes and hypertension, who presented with diarrhea, fevers and chills, and severe weakness; consistent with sepsis. patient was empirically started on vancomycin, zosyn, ciprofloxacin and flagyl. patient grew gram negative rods in blood eventually speciated as pan-sensitive klebsiella. unclear source of bacteremia as urine culture was negative and patient did not have cxr consistent with pneumonia. patient did have mildly wall thickening of gall bladder, although there was no ductal dilation, but patient was also in worsening liver and renal failure and a very poor surgical candidate. patient also had low hct and guaiac positive stool suggesting he may have had a gi bleed with translocation of organisms precipitating his presentation. repeat cultures on antibiotics were negative. the patient's acute renal failure was initially attributed to prerenal etiology or peritonitis. peritoneal fluid and paracentesis were negative for infection. volume resuscitation with fluid and albumin did not improve creatinine or urine output. patient was felt to have type 1 hepatorenal syndrome and was treated with octreotide and midodrine. in the setting of attempted the volume resuscitation, despite a paracentesis that removed 3 liters of fluid, the patient's respiratory status declined. the patient was intubated for hypoxemic respiratory failure. given worsening end-stage cirrhosis with rising bilirubin and ultrasound negative for obstruction, renal failure attributed to hepatorenal syndrome and patient's prior refusal for any transplant evaluation, cvvhd or hd to attempt to improve renal/volume status was futile. over the course of the admission, the patient became more confused attributed to his hepatic encephalopathy. discussion with family regarding the patient's poor prognosis resulted in the family changing his goals of care to comfort measures. the liver service worked closely with the micu service in coordinating this patient's care. the patient died with family at his bedside. the family, including all of his daughters, declined an autopsy. medications on admission: aldactone 1.5 tablets by mouth once daily furosemide 80 mg oral glipizide 5 mg oral nadolol 40 mg po one touch ultra oxazepam 15 mg oral hs prn discharge medications: n/a discharge disposition: expired discharge diagnosis: endstage liver disease due to alcoholic cirrhosis acute renal failure, likely hepatorenal syndrome cardiac arrest discharge condition: death discharge instructions: n/a followup instructions: n/a procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube percutaneous abdominal drainage diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled alcoholic cirrhosis of liver acute kidney failure, unspecified hepatorenal syndrome severe sepsis portal hypertension acute respiratory failure other septicemia due to gram-negative organisms other ascites diarrhea hepatic encephalopathy esophageal varices in diseases classified elsewhere, without mention of bleeding 

Answer: The patient is high likely exposed to