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: patient recorded as having no known allergies to drugs attending: chief complaint: sleeping all day, fatigue, decreased po intake major surgical or invasive procedure: therapeutic paracentesis history of present illness: 46 yo m w/cryptogenic cirrhosis ( nash or alpha-1-antitrypsin deficiency), gerd, osa, awaiting liver transplant (meld of 24), well known to our service, here with vomiting x 1 day, decreased po intake x several months, extreme fatigue/sleepiness x 3 days. history was acquired from the patient's wife, since the patient was cooperative but too somnolent to answer questions. the patient vomited 3-4 times yesterday, small amounts, watery, no blood. he has vomited blood once in his life several months ago, and not since. he has had no sick contacts. he has had decreased po intake for the past year since being diagnosed with cirrhosis, with a 50 lb weight loss over the past year, thought to be due from decreased po intake. patient has no appetite, but no abdominal pain upon eating and no vomiting with eating. he has had no blood in his stool. this decreased po intake has been progressively becoming more severe over the past several months. he has had extreme fatigue/sleepiness for the past 3 days. he has been taking lactulose 30 ml and his wife confirms that he did actually take these doses, but she feels that although he has been having bms, that they have been small. he has not been able to take more lactulose than due to sleepiness. his last paracentesis was 3.5 l, performed 5 days ago in outpatient clinic. 3-4 weeks ago, he had a thoracentesis of his r lung, 2 l removed. past medical history: 1)cryptogenic cirrhosis ( nash vs. alpha-1-antitrypsin deficiency), meld score 21. patient was found to be negative for hemachromatosis genes. he is negative for hepatitis a, b and c. he is hiv negative, negative. is positive with a low titer of 140. recent alpha-fetoprotein was 2.7. alpha-1 antitrypsin genotype which was negative. 2)osa on cpap 3)gerd 4)s/p inguinal hernia repair about 40 years ago social history: the patient lives with his wife and two children. he works in a sprayed asphalt business for approximately 18 years. he does not smoke tobacco or drink etoh. family history: the patient's sister has been treated for non- lymphoma. the patient's brother has hypertension. the patient's father had hypertension and alcoholism. the patient's mother had kidney disease. physical exam: vs: 98.4, 84/50, 61, 16, 94 ra general: diffusely jaundiced, easily arousable but very sleepy, cooperative heent: moist mm, perrl, icteric sclera lungs: cta b, no rales, no wheezing heart: rrr, no m/r/g, pmi nondisplaced abdomen: soft, mildly distended, +bs, no tenderness to palpation throughout, clean para site with no erythema extr: 1+ pitting edema bilaterally, mild asterixis skin: skin tags in axillae bilaterally, cherry angiomata on abdomen, no rash neuro: normal gait, motor pertinent results: 12:45pm wbc-4.1 rbc-2.77* hgb-11.0* hct-32.0* mcv-116* mch-39.6* mchc-34.3 rdw-15.4 12:45pm alt(sgpt)-87* ast(sgot)-105* ld(ldh)-207 alk phos-94 amylase-35 tot bili-10.7* 03:20am blood wbc-7.5 rbc-3.15* hgb-10.5* hct-30.2* mcv-96 mch-33.2* mchc-34.6 rdw-20.2* plt ct-265 05:35am blood wbc-5.4 rbc-2.93* hgb-9.1* hct-27.7* mcv-94 mch-30.9 mchc-32.8 rdw-19.9* plt ct-217 03:20am blood pt-12.4 ptt-24.1 inr(pt)-1.0 03:20am blood glucose-120* urean-17 creat-0.6 na-136 k-4.1 cl-97 hco3-37* angap-6* 05:35am blood glucose-101 urean-13 creat-0.5 na-140 k-4.2 cl-99 hco3-33* angap-12 03:20am blood alt-24 ast-15 alkphos-65 totbili-0.6 05:35am blood alt-24 ast-16 alkphos-62 totbili-0.6 03:20am blood calcium-8.3* phos-4.7* mg-1.2* 05:06am blood vitb12-783 folate-9.6 05:10am blood triglyc-50 hdl-17 chol/hd-3.7 ldlcalc-36 05:06am blood tsh-3.4 03:20am blood fk506-15.5 (not true trough, as blood drawn early) 05:35am blood fk506-11.6 05:15am blood fk506-10.2 brief hospital course: he was initally admitted to the medical service and the following problems were managed. #gi bleed,n/v: few episodes of melanotic stool associated with drop in hct. prbcs given; however,melanotic stools continued and hematocrit not maintained. transfered icu. a total of 8 units ffp, 6 units ffp, 1 unit cryo given. egd showed diffuse portal gastrophy but no evidence of active bleeding. hct stabalized in upper 30's. lasix, spironolactone, nadolol held for bp 85/50. iv hydration given. blood cx, urine cx, and stool cx negative. vomiting improved by . #50 lb weight loss over the past year with decreased po intake due to lack of appetite and intermittent vomiting. dobhoff placed under fluoroscopy by ir and tube feeds were started. #fatigue/sleepiness: likely from decreased lactulose intake and decreased bms, in addition to evolving cirrhotic disease. there was concern on admission for sbp, although the patient had confusion 5 days before admission and had undergone a therapeutic paracentesis of 3.5l showing no sbp. mental status improved with lactulose. a diagnostic tap showed no sbp. lactulose qid was titrate with slow improvement of his mental status. rifaximin was continued. a complete infectious work up was completed which only revealed a small lingular pneumonia for which levoquin was given. # hyponatremia: na slowly began to improve but subsequently dropped to 119 on and 117 on . fluid restriction was tightened to 1 liter. sodium continued to be low and was not responsive to the fluid restriction. stim test performed interpreted as low. stress dose steroids started and transitioned to oral therapy without improvement of his hyponatremia. free cortisol was low normal. an endocrine consult was obtained and they did not believe that his clinical situation could be completely explained by the adrenal insufficiency. #hyperkalemia: patient was noted to have refractory hyperkalemia. initial concern was for adrenal insufficiency. however, acth was low. endocrine deemed this to not be compatable with primary adrenal insufficiency. they believed that his aldosterone axis should be intact. #high mcv: the patient was noted to have a high mcv while admitted. his b12, folate, and tfts were normal. it was thought that the degree of elevation of his mcv was higher than typically seen in liver disease. heme/onc was consulted and they performed a bone marrow biopsy which showed ... normocellular erythroid-dominant bone marrow with maturing trilineage hematopoiesis # right hepatic hydrothorax: on his last admission 3-4 weeks ago, he was found to have a r hepatic hydrothorax with associated rml collapse. thoracentesis showed serosanguinous fluid. two ct scans of his chest during his stay showed improvement of the rml collapse. he was followed by the pulmonary clinic , noting improvement. on he underwent cadaveric liver transplant with roux-en-y hepaticojejunostomy reconstruction from a 21 y.o. brain dead donor. surgeon was dr. . the transplant surgical service managed his care postop. please see operative report for further details. ebl was 600cc. he received standard induction immunosuppression. two jps and a roux tube were present. immediately postop, he was transferred to the sicu intubated for management. hcts trended down and he required 4 units of prbc and 5 platelets on . he was taken back to the or for exploration for concern for hemorrhage. surgeon was dr. . per the or report, "there was an area in the retroperitoneum which was oozing which was cauterized. there was also some noted on the diaphragm which was oozing which was cauterized." postop, he returned to the sicu. he had high outputs from the medial and lateral jps (up to 3.5liters/day)for which he received iv fluid replacements and albumin. the drains were eventually removed. lfts trended down to normal ranges. on , he was transferred out of the sicu. mental status was altered with lethargy. a head ct was done and this was normal. neuro was consulted and felt that altered mental status was secondary to encephalopathy with altered sleep-wake cycle. thyroid function was normal, as well as b12, folate. eeg findings were suggestive of excessive drowsiness but could not rule out an early mild encephalopathy. there were no areas of prominent focal slowing. there were no epileptiform features. an mri was done showing no acute infarct or abnormal enhancement identified. increased pre-gadolinium signal in the basal ganglia was consistent with a history of hepatic disease. mental status slowly improved. on , a liver duplex was performed to evaluate hepatic vasculature. there was moderate volume ascites with more loculated ascites below the left lobe of the liver. doppler examination of the liver was normal with patent portal and hepatic veins, as well as hepatic arteries. as previously state, the jps were eventually removed. the incision remained dry and without redness. staples were to remain in place until follow up in the outpatient transplant center. diet was advanced, but intake was insufficient partially due to his altered mental status. kcals were low. -intestinal tube was placed and tube feedings were initiated. replete with fiber was the final formula utilized. his po intake did improve some. he did experience loose, frequent stools. stools were negative for c.diff x2. pt evaluated and recommended rehab for deconditioning and self-care deficit. he was ambulatory with supervision. he did experience a fall while transferring from bed to chair sustaining l facial abrasion that was healing at time of discharge. on , an u/s was done for l arm swelling. this was negative for dvt. immunosuppresion was adjusted with steroids tapered per protocol. prednisone dose was 20mg qd. cellcept remained at 1 gram and prograf dose was adjusted based on trough levels that were in the 10-12 range. goal trough levels were . he was started on ciprofloxacin 500mg qd for sbp prophylaxis. he was remain on this indefinately. the plan is for him to transfer to rehab. twice weekly labs should be drawn on mondays and thursdays with results fax'd immediately to attention , rn coordinator. medications on admission: 1. lactulose 10 gram/15 ml syrup sig: forty five (45) ml po tid (3 times a day). 2. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). 3. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 4. metoclopramide 10 mg tablet sig: 0.5 tablet po tid (3 times a day). 5. rifaximin 200 mg tablet sig: two (2) tablet po tid (3 times a day). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. prochlorperazine maleate 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for nausea. 8. spironolactone 25 mg tablet sig: two (2) tablet po daily (daily). 9. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). discharge medications: 1. fluconazole 200 mg tablet sig: two (2) tablet po q24h (every 24 hours). 2. prednisone 20 mg tablet sig: one (1) tablet po daily (daily). 3. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection (2 times a day). 4. miconazole nitrate 2 % powder sig: one (1) appl topical qid (4 times a day) as needed. 5. trimethoprim-sulfamethoxazole 80-400 mg tablet sig: one (1) tablet po daily (daily). 6. valganciclovir 450 mg tablet sig: two (2) tablet po daily (daily). 7. mycophenolate mofetil 500 mg tablet sig: two (2) tablet po bid (2 times a day). 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 9. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours). 10. insulin regular human 100 unit/ml solution sig: follow sliding scale injection four times a day. 11. outpatient lab work labs every monday and thursday for cbc, chem 10, ast, alt, alk phos, t.bili, albumin, and trough prograf level. fax results to attention , rn coordinator 12. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed. 13. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 14. tacrolimus 1 mg capsule sig: one (1) capsule po q12h (every 12 hours). 15. tacrolimus 0.5 mg capsule sig: one (1) capsule po twice a day. discharge disposition: extended care facility: & rehab center - discharge diagnosis: esld malnutrition discharge condition: good discharge instructions: please call the transplant office if you develop fever, chills, nausea, vomiting, inability to take any of your medications, abdominal pain/distension, jaundice, incision redness/drainage or any concerns. followup instructions: provider: , md phone: date/time: 1:10 provider: , transplant social work date/time: 11:30 provider: , md phone: date/time: 11:20 procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine enteral infusion of concentrated nutritional substances percutaneous abdominal drainage biopsy of bone marrow other transplant of liver reopening of recent laparotomy site transfusion of packed cells transfusion of other serum transfusion of platelets transfusion of coagulation factors other operations on lacrimal gland transplant from cadaver diagnoses: hyperpotassemia cirrhosis of liver without mention of alcohol unspecified protein-calorie malnutrition hyposmolality and/or hyponatremia paroxysmal ventricular tachycardia hemorrhage complicating a procedure hypotension, unspecified unspecified sleep apnea other ascites hemorrhage of gastrointestinal tract, unspecified dehydration esophageal varices in diseases classified elsewhere, without mention of bleeding other specified disorders of stomach and duodenum other specified diseases of blood and blood-forming organs 

Answer: The patient is high likely exposed to