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: service:medicine history of present illness: the patient was transferred from the micu to the medicine team. he is a 24 year-old previously healthy male who was well until after returning from the caribbean at the end of when he developed right upper quadrant pain, nausea, vomiting and anorexia. he have increased liver function tests, right pleural effusion, pericardial effusion and ascites. the right pleural effusion was found to be transudative. he became short of breath and hypotensive during that hospital stay. ct angiogram showed a pulmonary embolus and he was started on heparin and transferred to . he was in the micu for hypoxic respiratory failure, pulmonary embolus, pleural and increased liver function tests. his ast was as high as 855, alt as high as 827, alkaline phosphatase 57, t bili 1.2 and albumin 2.7. his echocardiogram on showed a normal left ventricular ejection fraction and a large pericardial effusion with right ventricle diastolic collapse consistent with tamponade physiology. right upper quadrant ultrasound revealed a patent hepatic and portal veins and he underwent a pericardiocentesis and drain on . his micu was significant for temperature spikes to 102.8 and he was treated with intravenous vancomycin for three days. past medical history: negative. allergies: no known drug allergies. family history: positive for diabetes, father passed away of lung cancer, however, no liver or clotting diseases were noted. social history: the patient is from . he recently traveled to the caribbean as he is a sailor. he does have an alcohol habit, however, no tobacco or intravenous drug use. medications at home: prilosec. medications on transfer to the medicine team: heparin at 1400 units an hour, zantac 150 mg b.i.d., colace 100 mg b.i.d., serax 15 mg q.h.s. and tylenol. physical examination on transfer to the medicine team: temperature 100.6, respiratory rate 20, heart rate 88, blood pressure 132/80 and 95% on room air. in general, he is an alert, well appearing male sitting in the chair in no apparent distress. heent oropharynx clear. mucous membranes are moist. pupils are equal, round and reactive to light. extraocular muscles are intact. neck, no jvp, no lymphadenopathy. neck supple. chest with decreased breath sounds at the bases bilaterally. positive for egophony and dullness to percussion. heart regular rate and rhythm. loud s1 and s2 and no murmurs, rubs or gallops. abdomen soft, nontender, nondistended. normoactive bowel sounds. extremities trace to 1+ lower extremity edema more so on the left then the right. doppler dorsalis pedis pulses +2 bilaterally. laboratories on transfer: white count 6.1, hematocrit 32.1, sodium 141, potassium 3.5, chloride 106, bicarb 21, bun 5, creatinine 0.7, glucose 93, ptt 62.9, albumin 2.4, calcium 7.9, phosphate 3.9, magnesium 1.6, esr 18. alt 232, ast 44, ldh 365, alkaline phosphatase 56, t bili 0.4. hospital course: 1. respiratory: the patient had large bilateral pleural effusions and was being treated for a pulmonary embolus. throughout the course of his stay his effusions were subsequently drained by interventional radiology and ultrasound guided thoracentesis. he continued incentive spirometry and is o2 sats improved. he was found eventually found to be positive for factor v liden deficiency and he was continued on heparin and is was discussed with the patient that he will need life long anticoagulation therapy. 2. pericarditis: it was considered likely post viral as his autoimmune infectious workup were negative throughout the course of his stay. repeat echocardiogram showed no significant reaccumulation of fluids and no cardiothoracic surgery was deemed necessary. 3. infectious disease: he had temperature spikes to 102.8 in the micu. he was given vancomycin for a three day course and low grade temperatures after this antibiotics course was considered secondary to atelectasis. his infectious disease workup was negative. 4. hematology: he was anemic at times throughout his stay, however, this resolved prior to discharge. 5. gastrointestinal: his high liver function tests were considered likely secondary to his hepatic shock and congestion and they eventually returned to and he also was given colace for constipation. 6. fluids, electrolytes and nutrition: the patient autodiuresed and he was advanced to a regular diet and tolerated po well. 7. prophylaxis: he was maintained on zantac and intravenous heparin. 8. disposition: the patient told us that he was going to be staying in the area with friends for at least a month after discharge. he was to follow up with pulmonary, hematology and cardiovascular clinics and he received lovenox teaching prior to discharge. discharge diagnoses: 1. status post pericarditis, pulmonary embolus and hypercoagulable state secondary to factor v liden deficiency. medications on discharge: coumadin, lovenox and non-steroidal anti-inflammatory drugs. discharge instructions: return for a fever greater then 101, increased pain, chest pain, dizziness, palpitations or shortness of breath. follow up with cardiology, pulmonary and coumadin clinics next week. , m.d. dictated by: medquist36 d: 14:58 t: 14:44 job#: procedure: insertion of intercostal catheter for drainage pericardiocentesis thoracentesis diagnoses: unspecified pleural effusion acute respiratory failure other pulmonary embolism and infarction hepatitis, unspecified acute idiopathic pericarditis 

Answer: The patient is high likely exposed to