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: sulfa (sulfonamide antibiotics) attending: chief complaint: persistent encephalopathy major surgical or invasive procedure: intubation and mechanical ventilation endoscopy (osh) history of present illness: mr. is a 60y/o gentleman with etoh and hcv cirrhosis complicated by ascites, varices with bleeding in the past, hcc s/p tace who presented to hospital on after being found unresponsive requring intubation and is transferred to the micu due to continued encephalopathy. . his wife reports that on the evening of he was doing fine (oriented x3). early on at 2am he felt nauseated and had dry heaves. passed foul-smelling loose stools. was lethargic and confused, not answering questions appropriately so his wife gave him an extra dose of lactulose. later that morning at 10am she found him unresponsive with slow breathing. she called 911 and he was taken to hospital. . there, he was hemodynamically stable, was intubated for airway protection. head ct and ct abdomen/pelvis were unrevealing. he was noted to have maroon stools. his hospital course has been significant for gi bleed (hct 32 but was noted to pass some blood clots per rectum so received a total of 3u prbc, 2u ffp, vitamin k, and is on an iv ppi and octreotide gtt), fever to 102 of unclear source being covered empirically with ctx/flagyl then switched to zosyn/flagyl on when he developed a leukocytosis, and shaking episodes yesterday and today (head tilting to right with head jerking movements - received ativan yesterday). he was being sedated with a versed drip @8/hr for ~36hrs, but then he was switched to propofol. despite qid lactulose, his mental status is no more clear so he is transferred here for further workup/management. . on arrival to the micu, he is intubated and sedated. not responding to voice but withdrawing from pain. past medical history: past medical history: - etoh and hep c cirrhosis, hepatocellular ca, ascites, esld - s/p tace transarterial chemoembolization of hcc - 3 bands of grade 1 varices, last bleed () - failed treatment for hcv (ifn, ifn/ribavirin 10 yesrs ago) - gi bleed from duodenal ulcer - dilated cardiomyopathy with an ejection fraction of 55% - hypertension - hypogonadism - ibs . past surgical history: - herniorrhaphy x 3 - right wrist fracture s/p fixation - left toe surgery - knee arthroscopy x 4 social history: -home: lives with wife . they have an adopted daughter. 4 children from a prior marriage. -tobacco: none -etoh: prior history of heavy use, quit 6 yrs ago but relapsed and now has been sober again for 6 months -illicits: none family history: no history of cancer or hepatitis. physical exam: admission vitals: t: 100.1 bp: 125/62 p: 117 o2sat 100% on ps 10/5, rate 20, fio2 60% gen: well-nourished gentleman appearing his stated age, intubated, sedated heent: anicteric sclerae, mmm, normal oropharynx cvs: rrr, no mrg. resp: ctab, no rhonchi or crackles abd: obese but nondistended, no rebound or guarding ext: warm, 2+ dp and pt pulses bilaterally; no edema or cyanosis; right femoral cvl site with no erythema or hematoma neuro: withdraws to pain, vor intact, bracioradialis 2+ bilaterally, patellar reflexes 1+ bilaterally discharge: expired pertinent results: egd (osh) small esophageal varices without bleeding, no blood in the stomach, nodules in the gastric body, few gastric antral erosions . ct abdomen/pelvis w/o contrast (osh) 1. abnormality of the right hemicolon with mural thickening may be secondary to portal hypertension although the possibility of colitis is difficult to exclude 2. hepatic cirrhosis and new extensive abnormality in the right lobe of the liver suspicious for hcc 3. abdominal ascites 4. periportal lymphadenopathy 5. gallstones 6. right renal cyst unchanged and isodense nodule of right kidney also unchanged 7. colonic diverticulosis without acute diverticulitis 8. small right inguinal hernia containing fat 9. bibasilar atelectasis and/or infiltrates . ct head w/o contrast (osh) no evidence of acute intracranial abnormality. mucous retention cysts in maxillary sinuses. . liver u/s limited examination showing unchanged thrombosis of the anterior right portal vein. minimal/slow flow in the main portal vein noted, although this could be related to the limited examination. patent hepatic artery. no significant ascitic fluid noted. . cta abd/pelvis 1. hyperdense material within the cecum and small bowel resection anastomosis. these regions are potential candidates for a bleed source. no active extravasation is seen. 2. new, likely bland thrombus within the main portal (nearly occlusive) and right portal veins (occlusive)and origin of left portla vein (nearly occlusive) since the mr examination. 3. post-tace changes and small hypodense nodules, representing tumor thrombi, in segment 5. no definite arterially enhancing hepatic lesions identified. 4. varicose veins at the anterior abdominal hernia repair site and small bowel anastomosis. 5. cholelithiasis. 6. small amount of abdominal and pelvic ascites. brief hospital course: mr. is a 60y/o gentleman with etoh and hcv cirrhosis complicated by ascites, varices, hcc s/p tace who is transferred from an osh with continued encephalopathy, gi bleed, and fevers. . #. encephalopathy: likely multifactorial. acute onset of depressed level of consciousness at home could represent hepatic encophalopathy. has been taking lactulose qid but no report of if he has been stooling. precipitants could include upper gi bleed, medication effect (was on a versed drip at osh for ~36h), or infection (see "fevers" below). doppler and ct abdomen visualized portal vein thrombus which likely is contributing to current presentation of encephalopathy. switched to bolus sedation and continued lactulose and rifaximin without improvement of mental status. given his poor prognosis and absence of mental status, patient was terminally extubated on and transitioned to cmo. . #. bloody loose stools: lower gi bleed vs brisk upper gi bleed. has history of bleeding ulcers as well as esophageal varices. at the osh, he underwent egd showing portal gastropathy and small gastric nodules which were not bleeding; had "diminutive varices." patient had persistent hct drops during this hospitalization along with persistently bloody bowel movements. patient was transfused a total of 5units and cta was obtained showing sources of bleeding in the cecum and at a prior small bowel anastomosis, likely ectopic varices. initial plan was for colonoscopy but goals of care were discussed with family and as it was felt that this was a nonintervenable source of bleeding, supportive transfusions were discontinued and no further interventions were undertaken. ppi and octreotide drips were continued and patient was transitioned to cmo. . #. fevers: initially concerning for infection. had leukocytosis and had bandemia at osh. sources could include pna (especially concerning while intubated), uti, sbp. tap here was not suggestive of infection and cxr and urine were unremarkable. he was covered with zosyn and flagyl which were discontinued on hd #2 as there was no clear source of infection. . #. : prerenal with low urine na and fena. creatinine improved somewhat with fluids. . #. hcv and etoh cirrhosis: no response to lactulose and rifaximin so these were discontinued. his lasix and spironolactone were held. . # code status: given patient's persistent absence of mental status improvement, his poor prognosis given his underlying hcc and ongoing gi bleed, patient was made cmo on hd #2. medications on admission: - spironolactone 200 mg daily - furosemide 80 mg tablet daily - ursodiol 500 mg - lactulose 10 gram/15 ml 15-30 mls po qid - rifaximin 550 mg - gabapentin 300 mg tid - temazepam 30 mg qhs - citalopram 10 mg daily - sodium fluoride 1.1 % gel - pantoprazole 40 mg - b complex vitamins daily - magnesium oxide 400 mg daily - calcium 600 + d(3) 600 mg(1,500mg) -400 unit - testosterone 1 %(50 mg/5 gram) gel daily discharge medications: expired discharge disposition: expired discharge diagnosis: expired discharge condition: expired discharge instructions: expired followup instructions: expired md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours percutaneous abdominal drainage central venous catheter placement with guidance diagnoses: other primary cardiomyopathies unspecified essential hypertension acute posthemorrhagic anemia chronic hepatitis c with hepatic coma alcoholic cirrhosis of liver acute kidney failure, unspecified acute respiratory failure other sequelae of chronic liver disease other encephalopathy malignant neoplasm of liver, primary do not resuscitate status hemorrhage of gastrointestinal tract, unspecified hyperosmolality and/or hypernatremia leukocytosis, unspecified portal vein thrombosis alcohol abuse, in remission 

Answer: The patient is high likely exposed to