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: ms. is a 60-year-old female with primary biliary cirrhosis who presented for an orthotopic liver transplant. she was initially evaluated in the transplant center in for end-stage liver disease. she was then seen in clinic in . she had the usual preoperative workup. at that time she was not complaining of any abdominal pain. no nausea, vomiting, chest pain or shortness of breath. she seemed a little fatigued but otherwise she was doing well. the patient presented on , for orthotopic liver transplant which took place on . past medical history: 1. end-stage liver disease secondary to primary biliary cirrhosis. 2. history of mental status changes and encephalopathy. 3. hypothyroidism. 4. depression. 5. osteoarthritis. 6. thrombocytopenia. 7. esophageal varices. 8. history of transient ischemic attacks. allergies: penicillin causes hives. medications on admission: 1. ursodiol. 2. nexium. physical examination on admission: temperature 97.2, blood pressure 130/80, heart rate 63, respiratory rate 18, oxygen saturation 98% on room air. she was an elderly lady in no acute distress. oriented to time and place. head, eyes, ears, nose and throat: extraocular movements intact. pupils equal, round and reactive to light and accommodation. moist mucus membranes. the neck was supple. there was no jugular venous distention present. there was no scleral icterus. lungs were clear to auscultation bilaterally. cardiovascularly regular rate and rhythm. normal s1, s2. abdomen was soft and non-tender, non-distended. bowel sounds were present. extremities: there was no clubbing, cyanosis or edema. good pulses throughout. skin: no jaundice. neuro: cranial nerves were intact. moving all extremities. laboratory on admission: white count 4.5, hematocrit 37.3, hemoglobin 14.6. platelet count 132,000. pt 14.7, ptt 32.9, inr 1.4. sodium 142, potassium 4.1, chloride 112, bicarbonate 23, bun 16, creatinine 0.6, glucose 85. radiology: chest x-ray was negative. electrocardiogram: normal sinus rhythm. hospital course: ms. is a 60-year-old female with primary biliary cirrhosis and portal hypertension with one bout of preoperative encephalopathy and no history of bleeds who underwent an orthotopic liver transplant on . intraoperatively the course was remarkable for an increase in the pulmonary artery pressures, systolic 60-70's, mean in the 50's, particularly post. new line placed. the patient was refractory to nitroglycerin, calcium channel blockers. otherwise hemodynamically stable. the patient did have some lateral st depressions, however, transesophageal echocardiogram intraoperatively indicated no wall motion abnormalities and she was brought to the surgical intensive care unit intubated. the patient was kept at pulmonary artery pressures around 35 which was equivalent to patient's baseline. the patient was running 50's over 20 on nitric oxide. at that point she was placed on an immunosuppressive regimen of mycophenolate mofetil and methylprednisolone as well as the usual prophylactic agents. to control blood pressure she was placed on metoprolol 5 mg q. 6h. as well as nitroglycerin and hydralazine p.r.n. pulmonary hypertension. there was a question of whether it was volume related. mean pulse pressure decreased by 10 on nitric oxide if it was agreed with diureses. the patient was making good urine output and she was ruling out for myocardial infarction. the patient was placed on imipenem. the patient had a duplex ultrasound of the transplanted liver on , which indicated normal evaluation of the hepatic artery, portal vein and extrahepatic vein. there were two hemangiomas demonstrated with the liver. on the liver function tests at that point her alt was 383 down from 400. her ast was 441 down from 652. her alk phos was 116 and her t. bilirubin was 2.0 and her d. bilirubin was 1.2. the patient had an echocardiogram on which showed moderate symmetric left ventricular hypertrophy, a normal left ventricular cavity size and an ejection fraction of 55%. there was mild 1+ aortic regurgitation, 1+ mitral regurgitation and moderate 2+ tricuspid regurgitation and there was moderate pulmonary artery systolic hypertension. on postoperative day three she was making 3.6 liters of urine. she was being weaned off of nitric oxide. the patient was receiving lasix b.i.d. on postoperative day two fluid balance was positive ten liters so far. diuresis was planned before weaning from vent. cardiology had been consulted for increase in pulmonary artery pressures as well as to rule out any evidence of acute ischemic event. the patient was seen by the pulmonary hypertensive service. on postoperative day four, the patient was extubated. the pulmonary artery pressure was less than 40, and the pa catheter was removed. the patient was a little confused but oriented to time, place. at that point she was placed on enalapril for blood pressure control in addition to hydralazine and clonidine. by postoperative day seven, the patient was tolerating clears as well as being at goal tpn since . on the 15th clinic was consulted for blood sugar management secondary to steroids. the patient was stable and transferred to the floor. by postoperative day nine, on examination the patient's abdomen was soft, minimally distended with some peri-incisional tenderness. the wound was clean, dry and intact. there was a slight increase in total bilirubin to 1.9 from 0.8. she had a liver ultrasound which showed adequate flow and no obstruction. by postoperative day ten, the patient had an increase in liver function tests which prompted a liver biopsy which indicated portal neutrophilic infiltrate with acute cholangitis and mild duct proliferation. there was no acute cellular rejection seen and there was minimal lobular cholestasis and focal minimal lobular neutrophilic infiltrate. since liver function tests were rising, cholangitis was suspected so she was started on intravenous levofloxacin q. day. ercp showed a biliary anastomotic stricture, therefore sphincterotomy with stent placement was performed. the patient's transaminases were increasing and her hematocrit had decreased to 20. on , the patient underwent an ultrasound of the abdomen which showed a large peritransplant hematoma with likely intraparenchymal component so the patient underwent a re-exploration of the abdomen with a liver biopsy and revision of the common bile duct and anastomosis. the patient postoperatively was readmitted to the surgical intensive care unit on the 23rd intubated. the patient had another duplex ultrasound of the abdomen the following day which showed no definite subcapsular hematoma and a normal doppler evaluation of the liver. the patient was extubated stable on nitroglycerin. the patient was transferred to the floor on postoperative day 16 and number three. her blood pressure, however, continued to be elevated with systolic blood pressures in the 170's. she was continued on lopressor 50 mg b.i.d., lasix 20 iv and given hydralazine. by postoperative day 17 and five, the patient was tolerating regular diet and her abdominal pain was well controlled with percocet. she was being evaluated by physical therapy and occupational therapy. on postoperative day 19 and six, the patient became a little confused and removed her central line from her neck. her oxygen saturation had decreased to 85%. she was immediately placed on higher oxygen levels. the patient returned to oxygen saturations greater than 95%. cardiology was consulted and a swan catheter placed to check pulmonary artery pressures once again. neurology was consulted for mental status changes. they felt that her mental status examination was essentially normal. they felt the mental status changes were most likely due to exacerbation of sedatives or neuroleptics on top of metabolic derangement. the patient underwent a ct of the head without contrast which showed no acute intracranial hemorrhage or major vascular territorial infarction. on postoperative day 22 and nine, the patient was transferred to the medical intensive care unit secondary to bed required still a little hypertensive and her captopril dose was increased. she was tolerating a regular diet, maintaining good urine output and eventually transferred back to the floor in stable condition. the patient was restarted on synthroid 75 mcg q. day given her past medical history of hypothyroidism. nutrition had been consulted and following the regular hospital admissions, liver function tests were improved. pain was well tolerated. she was having regular bowel movements, ambulating regularly, tolerating solid foods and it was decided at that point to consider rehabilitation screening. her discharge liver function tests were alt 127, ast 52, alk phos 463 and t. bilirubin of 1.8. the patient was clinically improving and, as such, felt to be ready for discharge to a rehabilitation center on . discharge status: stable. discharge diagnoses: 1. end-stage liver disease secondary to primary biliary cirrhosis. . 2. status post orthotopic liver transplant. 3. pulmonary hypertension. 4. hypothyroidism. 5. depression. 6. osteoarthritis. 7. thrombocytopenia. 8. esophageal varices. 9. history of transient ischemic attacks. follow-up plan: the patient is to follow up with dr. at the transplant center, telephone number , on , at 10:20 a.m., as well as with dr. at the transplant center at on , at 10:20 a.m. and again on , at 10:20 a.m. additionally, patient will be instructed to schedule an appointment in seven to ten days with dr. at . discharge medications: 1. captopril 100 mg p.o. t.i.d. 2. hydralazine hydrochloride 50 mg p.o. q. 6h. 3. levothyroxine sodium 75 mcg p.o. q. day. 4. mycophenolate mofetil 500 mg p.o. b.i.d. 5. metoprolol 50 mg p.o. b.i.d. 6. protonix 40 mg p.o. q. day. 7. fluconazole 400 mg p.o. q. 24h. 8. bactrim es one tab p.o. q. day. 9. clonidine hydrochloride 0.3 mg p.o. t.i.d. 10. prednisone 20 mg p.o. q. day. 11. valacyclovir hydrochloride 450 mg p.o. q. day. 12. neoral 75 mg p.o. b.i.d. 13. percocet 5/325 mg one to two tablets p.o. q. 6h. p.r.n. pain. , m.d. dictated by: medquist36 d: 21:24 t: 21:56 job#: procedure: venous catheterization, not elsewhere classified diagnostic ultrasound of heart closed (percutaneous) [needle] biopsy of liver endoscopic sphincterotomy and papillotomy endoscopic insertion of stent (tube) into bile duct other transplant of liver pulmonary artery wedge monitoring reopening of recent laparotomy site open biopsy of liver hepatotomy administration of inhaled nitric oxide diagnoses: hematoma complicating a procedure hemorrhage complicating a procedure primary pulmonary hypertension other sequelae of chronic liver disease cholangitis tricuspid valve disorders, specified as nonrheumatic biliary cirrhosis 

Answer: The patient is high likely exposed to