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: heparin agents attending: chief complaint: dizziness x 1 day major surgical or invasive procedure: none history of present illness: 73 yo f with h/o pbc, decompensated cirrhosis c/b encephalopathy, ascites, and esoph varices who presents with c/o lightheadedness, dizziness x 1 day. feels weak with decreased energy level. of note, recently discharged on after hypotensive/hypothermic episode w/ suspected sepsis, treated empirically with a course of ceftriaxone, flagyl and stress-dose steroids. no infectious source was identified. discharged to home to complete prednisone taper. . in ed today, found to be hypotensive (sbp's in 80's) and hypothermic (31 c rectal temp). ekg w/ bradycardia to 40's. plt 18. inr 1.5. given rewarming blankets. b/l ej piv placed. given 3l ivf's followed by peripheral dopa in ed. recieved empiric steroids w/ dex for ?adrenal insuff. vanco, levo, flagyl initiated. given plt, coags, then right femoral line placed. . denies n/v/abd pain. + loose stools x 7 days. no brbpr . admit to micu for hypotension, sepsis w/u past medical history: 1. pbc cirrhosis x 13 yrs, known varices, followed by dr. 2. liver cirrhosis 3. hypothyroidism 4. osteopenia 5. status post cholecystectomy 6. history of ankle fractures 7. hypertension social history: tobacco stopped 15 yrs ago, 30 pack-yrs, no alcohol or drug use, married with three children. lives at home with husband family history: no family history of strokes, seizures. mother and father died in 90s. physical exam: t 33.9, bp 101/47, hr 45, rr 18, 98% ra gen- sleepy but arousable, garbled speech, non-toxic appearing heent-eomi. pupils 4->2 b/l. mm dry neck- diff to assess jvp 2/2 body habitus, b/l ej's in place cv- brady. regular. no murmurs pulm- anteriorly clear to auscultation w/o ronchi,rales,wheezes abd- distended w/ dull flanks. non-tender to palpation. ext- 3+ periph edema b/l. ext warm (bear hugger in place) neuro- follows commands, grip strength equal b/l, moving all extremities, oriented to person, hospital; no asterixis. skin- superficial ulcerations on r elbow, hand. rect- yellow-brown stool, trace guaiac positive pertinent results: 09:20pm glucose-90 urea n-46* creat-1.0 sodium-143 potassium-4.3 chloride-109* total co2-25 anion gap-13 09:20pm alt(sgpt)-70* ast(sgot)-90* ck(cpk)-112 alk phos-154* amylase-107* tot bili-3.6* 09:20pm ctropnt-<0.01 09:20pm ck-mb-12* mb indx-10.7* 09:20pm albumin-3.4 calcium-9.1 phosphate-3.3 magnesium-2.1 09:20pm wbc-5.6 rbc-3.51* hgb-10.7* hct-32.5* mcv-93 mch-30.5 mchc-33.0 rdw-21.0* 09:20pm neuts-82.7* bands-0 lymphs-7.7* monos-3.8 eos-5.3* basos-0.5 09:20pm plt count-99*# 09:20pm pt-15.6* ptt-35.8* inr(pt)-1.4* 07:16pm lactate-1.7 07:02pm urine color-yellow appear-clear sp -1.010 07:02pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-tr 07:02pm urine rbc-0 wbc-0 bacteria-none yeast-mod epi-0 05:36pm glucose-98 urea n-49* creat-1.1 sodium-142 potassium-4.6 chloride-108 total co2-26 anion gap-13 05:36pm ast(sgot)-96* ck(cpk)-114 alk phos-155* tot bili-3.4* 05:36pm ck-mb-13* mb indx-11.4* ctropnt-0.02* 05:36pm albumin-2.9* 05:36pm tsh-1.9 05:36pm free t4-1.4 05:36pm cortisol-9.2 05:36pm wbc-4.5 rbc-3.61* hgb-11.2* hct-33.4* mcv-93 mch-31.0 mchc-33.4 rdw-20.9* 05:36pm neuts-75.3* lymphs-13.4* monos-5.6 eos-5.5* basos-0.3 05:36pm hypochrom-1+ anisocyt-2+ macrocyt-2+ microcyt-1+ 05:36pm plt smr-rare plt count-18*# lplt-2+ 05:36pm pt-16.4* ptt-38.5* inr(pt)-1.5* cxr- rul opacity ekg- sinus brady 49 bpm, lad, qt 489, no st/t changes, no block . recent studies: ct abd - 1. diffuse anasarca with soft tissue edema as well as ascites and nonspecific mesenteric stranding. ascites is increased compared to the previous study. 2. limited evaluation of the bowel with no definite wall thickening. there is no pneumatosis or free air. patency within mesenteric vessels cannot be assessed without iv contrast. 3. acute right posterior rib fracture that does not appear to be present on the study of . no evidence of pneumothorax in the imaged portions of the lungs . ruq u/s 1. patent portal vein with hepatopetal flow. 2. small amount of ascites. . egd : no active bleeding in esophagus, stomach, duodenum mosaiac pattern in stomach c/w portal gastropathy . colonoscopy : grade 1 internal hemmoroids few diverticula. no ischemic colitis brief hospital course: hospital course: 73 y/o f w/ pbc, decompensated cirrhosis c/b encephalopathy, ascites, and esoph varices who presents with c/o lightheadedness, dizziness x 1 day, found to be hypotensive, hypothermic requiring the icu. she was called out to the floor but remained medically tenuous and elected to be made cmo. . # hypotension/hypothermia: on admission the likely causes were felt to be adrenal insufficiency and sepsis. -stim test, the patient was started on fludro and hydrocort empirically presuming her to be adrenally insufficient. she was also covered broadly with vanc,levo, flagyl as concerned for sepsis and question of pna on cxr. her abdominal ultrasound was negative for significant ascites for diagnostic paracentesis. blood cultures from admission returned positive for streptococcus and flagyl was discontinued. with antibiotics and steroids, pt was weaned off dopamine and blood pressure remained stable for pt to go to the floor. once on the floor she was weaned off iv steroids and then completed a taper of po steroids. she also completed a course of levofloxacin and vanc. . # primary biliary cirrhosis- initially the patient's medications were held in the setting of sepsis. however, once on the floor, her ursodiol, lactulose, rifaximin, and diuretics were resumed. her diuretics were titrated up as her renal function could tolerate it. her ursodiol was discontinued as it was felt to be of little benefit. her rifaximin and lactulose were discontinued when the patient elected to be cmo. her diuretics were continued anticipating that they would provide some relief, given her fluid burden. . # arf- this was likely hypotension, some component of acute renal failure on hepatorenal syndrome. she was placed on midodrine and octreotide and with improved hypotension, her urine out-pt increased. however, her creatinine elevated and remained persistently elevated on increased diuretics for her anasarca. . # thrombocytopenia- the patient had progressively lowering platelets throughout the admission. further work-up was done and her labwork was also revealed to possibly be c/w dic. however, on discussion with heme/onc, it was felt that her low platelets, low fibrinogen, and elevated coags were in fact related to her end stage liver disease. . # hypothyroidsm: the patient was continued on her levothyroxine throughout the admission. . # fen: once her mental status was improved on the floor she was maintained on a regular diet. her electrolytes were followed daily. . # ppx - she was placed on a ppi and sc heparin during the admission. . # communication/dispo - several discussions were held with ms. family regarding her medical course and prognosis. she and her family agreed that she be made dnr/dni on . a later discussion was held with the patient, her family, the medical team, palliative care team, and social work. the patient and her family expressed understanding that the pt was not a liver transplant candidate and that recovery of her independence prior to admission would be unlikely. at that time, given her prognosis, the patient decided to be made cmo with anticipation for discharge to a with hospice. medications on admission: levothyroxine 75 mcg po daily furosemide 40 mg po daily spironolactone 100mg po daily (recently increased from 50 mg ) rifaximin 400mg po tid lactulose(30) ml po q6h prn (once/day per pt) pantoprazole 40 mg po q24h ursodiol 500mg po qam ursodiol 750 mg qpm nadolol 10 mg po daily citracal ld 2 pills prednisone taper- completed on: discharge disposition: extended care facility: family hospice house - discharge diagnosis: primary: primary biliary cirrhosis, encephalopathy secondary: hypothyroidism, osteopenia discharge condition: ms. needs related to comfort are continuing to be addressed. discharge instructions: you will be discharged to a specialized nursing facility. if you have any needs related to your comfort there, you should feel free to address them with the staff of the facility. followup instructions: you will be followed closely by your health care providers at your specialized nursing facility. you will also be followed closely by the hospice providers. procedure: venous catheterization, not elsewhere classified arterial catheterization infusion of vasopressor agent diagnoses: thrombocytopenia, unspecified unspecified essential hypertension acute kidney failure, unspecified hepatorenal syndrome unspecified acquired hypothyroidism defibrination syndrome hepatic encephalopathy streptococcal septicemia systemic inflammatory response syndrome due to noninfectious process with acute organ dysfunction disorder of bone and cartilage, unspecified biliary cirrhosis 

Answer: The patient is high likely exposed to