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: 47-year-old male with history of hiv and hepatitis c with cirrhosis presents to micu with multiple electrolyte abnormalities. the patient was in his usual state of health until three days prior to admission when he developed a watery diarrhea. he denied any mucus or blood. he reported about five bowel movements per day, denied any fevers, chills, nausea, vomiting or sick contacts. denied any recent travel, uncooked foods and no international visitors. the patient has a history of ascites and encephalopathy without any history of varices as of 11/00. his last paracentesis was during an admission in . the patient recently had started two medications in the past five days including ultram and ms contin. he also recently increased his aldactone dose from 100 mg to 150 mg . the patient reports no po times 24 hours secondary to anorexia. he also noted an increase in abdominal girth and diffuse abdominal discomfort. he presented to the emergency room secondary to abdominal pain and increased girth. review of systems: significant for bilateral leg pain which he reports is chronic but worse over the last 10 days. he also complains of dysuria and a question of urinary retention. he denies any cough, shortness of breath, chest pain, palpitations, visual disturbances, headache, bright red blood per rectum or melena. in the emergency room the patient was found to have a potassium of 7.3 for which he was given calcium gluconate, kayexalate, one amp of d50 and 10 units of iv insulin. also one amp of bicarb. the patient was given levo and flagyl in addition and also two units of ffp prior to a diagnostic paracentesis. past medical history: 1) hepatitis c with history of cirrhosis and ascites. the patient also is status post a trial of low dose pegylated interferon without improvement, no history of varices as of 11/00. 2) hiv, viral load from was 67,600 and cd4 was 29. 3) anemia. 4) thrombocytopenia. 5) leukopenia. 6) umbilical hernia repair. 7) non insulin dependent diabetes. 8) depression. 9) aphthous ulcers. medications: famvir 250 mg po bid, epogen 40,000 units subcu q week, nystatin cream, bactrim ds q d, levaquin 250 mg po q d, aldactone 150 mg po bid, bumex 1-2 mg po q d, protonix 40 mg po q d, zithromax 1200 mg po q week, lactulose, celexa 10 mg po q d, fluconazole 100 mg po q d, prn thrush, flomax 0.4 mg po q d, chloral hydrate, ultram 50 mg po bid and msir 10 mg and quinine 325 mg po q h.s. social history: the patient is married, with five children. he has distant history of iv drug abuse, no recent alcohol times 6 years and a 20 pack year smoking history. physical examination: general: resting in bed in no acute distress. t 96.0, pulse 64, blood pressure 110/41, respiratory rate 22 and 99% on room air. heent: normocephalic, atraumatic, pupils are equal, round, and reactive to light and accommodation, extraocular movements intact, dry mucus membranes, dried blood on lips. neck supple without lymphadenopathy. lung, decreased breath sounds at the bilateral bases with mild crackles, no wheezes,no spinal or paraspinal tenderness to percussion or palpation. cardiovascular, regular rate and rhythm, normal s1 and s2, holosystolic murmur throughout the precordium with radiation to the bilateral carotids, jvp 8 cm. abdomen, diffuse mild tenderness, soft, normal abdominal bowel sounds. extremities, no clubbing, cyanosis or edema, 2+ dp and pt pulses. cns: alert and oriented times three, strength 5/5 throughout, sensation intact. rectal, guaiac negative with good rectal tone. laboratory data: chemistry was significant for sodium of 116, potassium 7.3, 96 chloride, 17 co2, 49 bun and 2.5 creatinine, glucose 95. cbc, white count 3.2 with 67% neutrophils, 23% lymphs and 20 monos. hematocrit 23.4, platelet count 72,000, inr 2.1, calcium 7.7, magnesium 2.1, alt 31, ast 82, alkaline phosphatase 278,000, total bilirubin 1.5, albumin 2.0, lipase 87. urinalysis, specific gravity 1.025, negative for signs of infection or hematuria. inr 2.6, ptt 52.6. abdominal ultrasound showed no evidence for thrombosis, evidence of ascites consistent with cirrhotic liver. abdominal ct showed ascites and a cirrhotic liver with a 7 mm stone in the gallbladder. there was also diffuse colonic wall thickening. the spleen, pancreas, adrenals and kidneys were all normal and there was evidence of mesenteric retroperitoneal pelvic and inguinal lymphadenopathy. ekg from the emergency room showed normal sinus rhythm at rates in the low 60's. of significance were prolonged qrs interval to .214 milliseconds and flattened t's in 3 and v2. peritoneal fluid from diagnostic taps showed 170 whites, 658 reds, 9 neutrophils, 36 lymphs, 33 monos, glucose 133, ldh 40, total protein 1.0 and negative gram stain. impression: 47-year-old hiv positive and hep c cirrhotic admitted with diarrhea, acute renal failure, decompensated cirrhosis with significant electrolyte abnormalities with potassium 7.3 and sodium 116. hospital course: the patient was admitted to the intensive care unit. 1. fluids, electrolytes & nutrition: patient with significant hyperkalemia in setting of acute renal failure. he had received kayexalate, calcium gluconate, insulin, d50 and bicarb in the emergency room. upon arrival to the floor his potassium was still elevated at 6.9, therefore he was given another 60 cc of kayexalate and more calcium gluconate. even after 120 cc total of kayexalate, patient's potassium still remained elevated to 6.5 the following morning at which time he was given an additional total of 45 cc of kayexalate to finally get his potassium down to 4.8. the patient's ekg changes resolved completely and he showed no other signs of ectopy or arrhythmia. it was hypothesized that patient's potassium remained elevated and was so difficult to control likely secondary to patient's high aldactone dosage, that he had been taking prior to admission along with his acute renal failure. patient also with chronic hyponatremia with a baseline around 124. he presented with a sodium of 116. he was originally treated with normal saline concurrent with iv bumex in order to increase patient's total sodium load. after one liter patient's sodium slowly corrected during hospital stay. it was decided to discontinue iv fluid resuscitation and ultimately due to patient's hematocrit, increase his intravascular volume with packed red blood cell infusion. by time of discharge patient's sodium had corrected to 127. 2. renal: patient presented with an increased creatinine to 2.5 from baseline of 1.1 to 1.4. initially it was believed to be secondary to prerenal physiology vs hepatorenal syndrome. given that patient's urinalysis was negative for protein, red blood cells or white blood cells, it made nephritis or nephrotic syndrome unlikely. with volume resuscitation the patient's creatinine improved to 1.7 at time of discharge. this will be followed up as an outpatient to make sure that patient's creatinine continues to correct. 3. gi: patient with known cirrhosis secondary to hep c with history of ascites and encephalopathy. patient had discussed tips during prior admission but did not have a desire for the procedure. patient now with decompensated cirrhosis with an increased inr, increase in ascites, although there was not significant fluid on abdominal ct for therapeutic paracentesis. patient also with new complaint of diarrhea on chronic lactulose therapy. gi service was consulted and patient was taken for sigmoidoscopy with plan for biopsy. the sigmoidoscopy extended 40 cm up to the flexure of the descending colon and a biopsy was decided against secondary to patient's normal looking mucosa. gi service felt that patient's diffuse colonic thickening most likely was secondary to his hypoalbuminemia. therefore, stool cultures had been sent and on return negative, including for cryptosporidia, isosporidium, microsporidia. c. diff were pending. the patient was maintained on levaquin for sbp prophylaxis and we held patient's lactulose during diarrhea. 24 hours prior to discharge patient without any bowel movements and therefore he was restarted on lactulose to prevent hepatic encephalopathy prior to discharge. 4. id: patient with hiv, last cd4 29 and viral load of 67,000. off of heart therapy, only on famvir. no history of opportunistic infection. the patient was maintained on his bactrim for pcp prophylaxis, zithromax for prophylaxis, fluconazole for oral thrush and famvir for his herpes labialis. he was also maintained on levaquin for sbp prophylaxis. there were no other active issues during hospital stay. 5. heme: patient was chronic pancytopenic, thrombocytopenic, possibly secondary to chronic splenic sequestration vs hiv marrow suppression. the patient's anemia secondary to chronic iron deficiency. he was maintained on weekly epogen injections. additionally, patient with a question of multiple myeloma per prior presentation and an abnormal spep. the plan was for patient to have follow-up with hematologist/oncologist as an outpatient for which patient did not keep his appointment. on admission patient's hematocrit was 23.4. he received two units of packed red blood cells with only a bump from 21.1 to 23.2. therefore, patient was infused with two more units of packed red blood cells. hemolysis labs were checked though not completely accurate secondary to patient recent transfusion. his ldh, haptoglobin were normal and he was maintained at his baseline total bilirubin of 1.6. after the fourth unit of packed red blood cells, the patient's hematocrit appropriately bumped to 28.6. patient should follow-up as an outpatient with oncology for further work-up of multiple myeloma as previously planned. patient's code status is dnr/dni. disposition: after three days in the icu, the patient's symptoms resolved and he was able to be discharged right to home with vna follow-up. discharge diagnosis: 1. decompensated cirrhosis. 2. hyperkalemia. 3. hyponatremia. 4. acute renal failure. 5. diarrhea. discharge condition: stable. discharge medications: bumex 1-2 mg po q d, depending on weight, aldactone 100 mg po bid, famvir 250 mg po bid, epogen 40,000 units subcu q week, bactrim ds one tablet po q d, levaquin 250 mg po q d, protonix 40 mg po q d, zithromax 250 mg po q week, lactulose 30 cc po qid prn to goal 2-3 per day, celexa 10 mg po q d, fluconazole 100 mg po q d prn thrush, flomax .4 mg po q d, ultram 50 mg po bid, msir 10 mg po q 6 hours prn pain. diet: low sodium, low potassium diet. plan: patient should continue daily weights and should titrate his lactulose to bowel movements of stool per day. patient will follow-up with dr. at on and a chem 7 should be rechecked at that time. the patient will continue to follow-up with gi service as previously scheduled. patient did not require physical therapy and will be followed at home by vna service. , m.d. dictated by: medquist36 procedure: rigid proctosigmoidoscopy diagnoses: hyperpotassemia cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma acute kidney failure, unspecified hyposmolality and/or hyponatremia portal hypertension human immunodeficiency virus [hiv] disease 

Answer: The patient is high likely exposed to