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: hypotension major surgical or invasive procedure: endoscopy with tube placement and failed tips tips repeat tips with ultrasound guided biopsy history of present illness: 66 y/o white male resident of house with a h/o hep b and t2dm who presented to the ed approximately 2 hours after being discharged from (recent admission to for ugib) with dizziness and nausea. patient states that soon after he arrived home he began to have some nausea and felt dizzy. he went to the bathroom and had a bowel movement which made him feel somewhat better. afterwards, he still had nausea and dizziness that was not improving. he then presented to the ed with the above complaints. he denied any loc, cp, sob, diaphoresis, vomiting, or hematemesis. . when he arrived to the ed his vitals were as follows: initial bp was 90/50 at which point 1l bolus ivf ns was given. bp after first bolus was 126/88. bp then was 150/75 and then 135/70 after a total of 3l ns given in ed. . in the ed, patient stated that he felt better but some nausea remained. bp responded to fluids and initial hct was 27.5 but re-calculated to be 31 and then 30 from a hct of 32.6 from am labs when he was discharged earlier today. t 97.2 hr 105 bp 122/69 rr 20 o2sat 96% ros: + for nausea and dizziness negative for cp, sob, vomiting, hematemesis, diaphoresis all other review of systems negative and consistent with patient's condition upon discharge earlier today. past medical history: 1) hep b 2) type 2 dm 3) etoh/drug abuse 4) schizophrenia 5) dementia 6) hypercholesterolemia 7) cad, unclear status social history: history of etoh abuse physical exam: vitals upon presentation: see hpi general: lying on side in bed. nad. a/o x3. heent: nc/at. perrla. eomi. neck supple. cv: normal s1 and s2 with no m/r/g. pulm: ctab, no wheezes or crackles. abd: soft, nt, nd with normoactive bs. ext: no cyanosis or edema. 2+ dp b/l. exam otherwise unchanged since patient discharged earlier today. pertinent results: 08:06pm hgb-9.9* calchct-30 04:58pm k+-4.1 04:58pm hgb-10.2* calchct-31 04:50pm glucose-151* urea n-20 creat-1.1 sodium-137 potassium-6.1* chloride-107 total co2-23 anion gap-13 04:50pm alt(sgpt)-28 ast(sgot)-54* ck(cpk)-107 alk phos-61 amylase-13 tot bili-0.4 04:50pm ctropnt-<0.01 04:50pm ck-mb-2 04:50pm albumin-2.8* calcium-7.8* phosphate-4.2# magnesium-1.8 04:50pm wbc-10.4 rbc-2.98* hgb-9.7* hct-27.5* mcv-93 mch-32.7* mchc-35.4* rdw-14.6 04:50pm neuts-84.3* bands-0 lymphs-9.8* monos-3.9 eos-1.9 basos-0.1 04:50pm hypochrom-normal anisocyt-occasional poikilocy-occasional macrocyt-normal microcyt-occasional polychrom-occasional ovalocyt-occasional 04:50pm plt smr-low plt count-127* 04:50pm pt-14.9* ptt-28.9 inr(pt)-1.3* brief hospital course: micu course: the patient is a 66 yo m recently admitted with an ugib and was discharged home only to return 12 hours later to the ed with dizziness. in the ed, the patient was hypotensive and eceived 3l ns. his pressures increased from 90/50 to 135/70. his hct was stable from the time of discharge (32 -->31). he was admitted to the floor where he then became tacycardic and again hypotensive. he was thought to be re-bleeding and was transferred to the icu for an egd. upon arrival in the icu, he was again stable with bp's in the 120's and hr 70's. 4 hours later (prior to the egd), the patient acutely dropped his pressures to the 60's and was tachycardic to the 150's. a hct showed a drop from 31 --> 24. he was transfused 5 units of prbc and had approximately 4l of ns. he was intubated and an egd was performed which showed his known gastric varice with evidence of recent bleeding. tube was inflated and arrangements were made for an urgent tips procedure. he was taken to ir and a tips was attempted but unsuccessful. the tube was deflated after 12 hours. the patients hct again stabalized. a tips was then reattempted x 3 and was successful on third try on hd# 6, pt spiked a temp to 101. sputum from et tube grew out 4+gnr and 4+gpc. given his recent hospitalization, he was broadly covered with vancomycin and zosyn. also, pt was noted to be minimally responsive off sedation thought to be slowed clearance of versed by his liver. head ct was negative. his mental status was initially poor in the unit. on hd # pt. was transferred out to the floor. he susequently developed respiratory distress and was readmitted to the micu for aspiration pneumonia. he was treated with levoquin and flagyl in the unit and became afebrile. he continued to have ascites and paracentesis was performed in the unit. pt's respiratory status improved after paracentesis. 600cc ascites fluid was negative for sbp, and patient was prophylaxed on rifaxamin. he progressively regained mental status and respiratory status and after remaining afebrile he came back to the floor on hd# 19 with no antibiotic coverage. once on the floor pt's course continued as follows. # respiratory distress: ddx included pe (pt has not been on sq hep coagulopathy from liver dz), aspiration (tube feeds), increasing abdominal distention leading to atelectasis and poor inspiration, fluid overload, hepatopulm syndrome. to nc with sats>95. cta was not done as suspicion was low for pe due to adequeate oxygenation. pts breathing was much more comfortable after paracentesis. pt. initially suspicious for pulm edema. he was diuresed with lasix and spirinolactone. his respiratory status and cxr improved with diuresis. pt. o2 requirement progressed from non-rebreather to nc and by hd#26 he was saturating 95% on ra. # gib: patient with known cirrhosis and gastric varices. recent melanotic episodes, egd done with fundic varices but no active bleed. pt. continued to have + guaics on floor after gib. by hd#21 guaics were negative and nursing d/c guaic checks. no further episodes of gi bleeding were noted. - ppi -successful tips in the unit, nadolol not necessary per hepatology because of tips. . # cirrhosis: -pt was followed along by hepatology during hospitalization. his ascites was treated with lasix and spirinolactone for diuresis which was successful. pt. initially had some symptoms of encephalopathy on the floor. he was given lactulose titrated to 4 bm's per day. his mental status progressively improved and he was conversant with no asterixis, a&o x 3 on hd#26. rifaxamin for sbp prophylaxis. - liver lesions on ultrasound concerning for malignancy; afp elevated; will need liver biopsy of lesions once stable if mri proves that a mass is there - pt. coags were stable on d/c -pt requires mri of liver to determine if there is a mass suspicious for . u/s was suspicious for liver mass, that requires further work-up. pt. declined mri x 2 hepatology fine for mri to be arranged as outpatient. pt. likely to require biopsy if mri shows liver lesion suspicious for . . # pt. hematocrit was stable on the floor. because of history of anemia, anemia work-up was undertaken which showed no evidence of hemolysis or iron deficiency. hct on hd #26 was 28.6 # dm: riss -sugars stable throughout floor stay . # schizophrenia: psych following. started back on haldol 5mg per psych recs; cont zydis -added 10 mg celexa per psych. celexa can advance to 20 mg if necessary. standing haldol and cogentin and perphenazine were added per psych recs. . # fen: speech and swallow eval showed pt. unable to take any liquids and he was getting tf via donhoff when pt. arrived on the floor. tf were d/c when pt. pulled out his dobhoff tube and we were unable to replace it on hd#22. pt. received tpn for 2 days and then on hd#26 s&s reeval showed pt. able to take pureed solids and thickened liquids. pt. returned to regular diet with aforementioned caveats and all po meds. pt is to take po meds with thickened liquids. -hypernatremia: pt had a few episodes of hypernatremia in the micu as well as on the floor. on hd#19 he was requiring free water boluses to trend down his sodium. on hd#26 pt. sodium had been stable for 3 days. pt. also required aggressive potassium repletion throughout his hospital stay. on hd#26 patient passed speech and swallow eval so will begin taking po spirinolactone and hopefully spare potassium a little more. # id: paracentesis fluid negative for sbp on gram stain and cx. blood cx and catheter tip cx negative. afebrile and no abx at present save rifaxamin for sbp prophylaxis. - pt had one episode of left sided erythema/thrombophlebitis from left picc on hd#23 . iv team was consulted and deemed that the line was not infected and that erythema was from mechanical thrombophlebitis. pt never spiked a temp, and erythema resolved over the next day. . #cv: had sinus tach with pac's in the unit. one episode on hd# 21 of 10 beats of vtach. pt was asymptomatic with stable vital signs. ekg showed possible pac's. no further episodes. . wound care: pt. with left le pressure ulcer. evaluated by wound care nursing and was d/c with instructions for duoderm dressing changes. . # access: picc (placed )-pt. pulled out ; was replaced by ir , lij placed -pulled out by patient . piv placed . # ppx: ppi, pneumoboots throughout hospital stay . #dispo: pt was dischargec to in stable condition. he was scheduled for follow up in the liver clinic and with dr. as listed on d/c instructions. medications on admission: 1. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 2. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 3. glyburide 2.5 mg tablet sig: one (1) tablet po daily (daily). 4. olanzapine 5 mg tablet sig: one (1) tablet po daily (daily). 5. olanzapine oral 6. gemfibrozil 600 mg tablet sig: one (1) tablet po bid (2 times a day). 7. pentoxifylline 400 mg tablet sustained release sig: one (1) tablet sustained release po bid (2 times a day). 8. perphenazine 2 mg tablet sig: two (2) tablet po bid (2 times a day). 9. clonazepam 0.5 mg tablet sig: one (1) tablet po qid (4 times a day). 10. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 11. mirtazapine 15 mg tablet sig: 0.5 tablet po hs (at bedtime). 12. disulfiram 250 mg tablet sig: 0.5 tablet po daily (daily). 13. benzonatate 100 mg capsule sig: one (1) capsule po tid (3 times a day). 14. benztropine 0.5 mg tablet sig: one (1) tablet po daily (daily). 15. naltrexone 50 mg tablet sig: one (1) tablet po qd (). 16. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day: please take for 1 month and then re-access after repeat egd in 1 month. disp:*60 tablet, delayed release (e.c.)(s)* refills:*0* 17. amoxicillin 500 mg capsule sig: two (2) capsule po twice a day for 2 weeks. disp:*56 capsule(s)* refills:*0* 18. clarithromycin 500 mg tablet sig: one (1) tablet po twice a day for 2 weeks. disp:*28 tablet(s)* refills:*0* 19. triamterene-hydrochlorothiazid 37.5-25 mg capsule sig: one (1) capsule po once a day. 20. trazodone 50 mg tablet sig: one (1) tablet po at bedtime as needed for insomnia. discharge medications: 1. insulin regular human 100 unit/ml cartridge sig: units injection per sliding scale as needed for hyperglycemia. 2. insulin nph human recomb 100 unit/ml suspension sig: ten (10) units subcutaneous at breakfast and dinner. 3. aluminum-magnesium hydroxide 225-200 mg/5 ml suspension sig: 15-30 mls po qid (4 times a day) as needed. 4. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po daily (daily). 5. rifaximin 200 mg tablet sig: two (2) tablet po tid (3 times a day). 6. ipratropium bromide 0.02 % solution sig: one (1) neb ih inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 7. albuterol sulfate 0.083 % solution sig: one (1) neb ih inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 8. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day). 9. spironolactone 25 mg tablet sig: two (2) tablet po daily (daily). 10. citalopram 20 mg tablet sig: 0.5 tablet po daily (daily). 11. sodium chloride 0.65 % aerosol, spray sig: sprays nasal tid (3 times a day) as needed for nasal congestion. 12. perphenazine 8 mg tablet sig: one (1) tablet po bid (2 times a day). 13. benztropine 0.5 mg tablet sig: one (1) tablet po daily (daily). 14. heparin lock flush (porcine) 100 unit/ml syringe sig: one (1) ml intravenous daily (daily) as needed: 10ml ns followed by 1ml of 100 units/ml heparin (100 units heparin) each lumen qd and prn. inspect site every shift. 15. lactulose 10 g/15 ml syrup sig: thirty (30) ml po tid (3 times a day). 16. haloperidol 2 mg tablet sig: one (1) tablet po q6-8h (every 6 to 8 hours) as needed. 17. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 18. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). discharge disposition: extended care facility: & rehab center - discharge diagnosis: gastric variceal bleeding aspiration pneumonia discharge condition: good discharge instructions: you have been admitted to the hospital following a gastrointestinal bleed from cirrhosis and a hospital course complicated by aspiration pneumonia. you should call your doctor or return to the emergency room should you experience any of the following: fever > 101 nausea and vomiting bloody stools severe abdominal pain chest pain shortness of breath dizziness loss of vision followup instructions: follow up in clinic with dr. in monday at 11:30 am. please call ( if you need to reschedule this appointment. please follow up in liver clinic with dr. on at 11:00am. please call ( if you need to reschedule this appointment md procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other endoscopy of small intestine other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous abdominal drainage transfusion of packed cells transfusion of other serum injection of anesthetic into spinal canal for analgesia intra-abdominal venous shunt insertion of sengstaken tube diagnoses: pneumonia due to other gram-negative bacteria acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled alcoholic cirrhosis of liver unspecified septicemia portal hypertension sepsis other persistent mental disorders due to conditions classified elsewhere acute respiratory failure pneumonitis due to inhalation of food or vomitus other sequelae of chronic liver disease malignant neoplasm of liver, primary hematemesis varices of other sites hyperosmolality and/or hypernatremia other and unspecified alcohol dependence, unspecified viral hepatitis b with hepatic coma, acute or unspecified, without mention of hepatitis delta secondary malignant neoplasm of bone and bone marrow other specified hypotension paranoid type schizophrenia, unspecified procedure not carried out for other reasons 

Answer: The patient is high likely exposed to