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: codeine / amitriptyline / adhesive tape / flexeril / carbonic anhydrase inhibitors / phenergan / darvocet-n 100 / propoxyphene / robitussin-dm / sulfa (sulfonamides) / vicodin attending: chief complaint: altered ms major surgical or invasive procedure: thoracentesis diagnostic and therapeutic thoracentesis history of present illness: this is a 64 yo w/ hep c cirrhosis on transplant list who was at an osh since where she was treated for hepatic encephalopathy and failure to thrive. she initially presented w/altered ms x 1wk. of note, pt had been recently discharged from where she was treated for hydrothorax and exacerbation of chronic abdominal pain. . briefly, at the osh, pt was initially taken off of topamax which had been started and though to be worsening ms, elavil was also discontinued. lfts and cbc were near pt's baseline. a gi consult was obtained, they did not feel at that time that pt was encephalopathic . thoracentesis was performed for right sided pleural effusion. per report, pt's ms improved . she was started on prednisone for a copd flare and continues on a taper. micro data was negative and there was no incident of gib. there is no documentation of diagnostic paracentesis/blood cx. . upon transfer, vitals were t 95.9 hr 99 rr 18 bp 128/81 sat 99%2lnc . ros: currently feels like ms is better but still feels confused. she denies any pain, feels that chest is "congested" and w/cough though it has improved. also notes diffuse swelling which she does not think is much better. past medical history: # hep c cirrhosis, genotype 1, on transplant list # chronic abdominal pain. # coronary artery disease - had pci w/stenting x 1 in at hospital in , ri anatomy unknown. no mi per pt report. # h/o ccy # h/o appendectomy # h/o hysterectomy # h/o cin in # h/o hydrothorax presumed due to liver disease # lower extremity edema presumed due to liver disease (echo normal) # h/o 18-mm hepatic lesion in , possibly present on a ct from 12/. findings may represent a dysplastic nodule, however, hepatoma could not be excluded # last colonoscopy w/divertiulosis ans small esophgeal varices physical exam: vitals t96.1 bp 110/72 hr 92 rr 18 97%2l wt: 212.7 (dry weight is reportedly 174) gen: well appearing, resting comfortably heent: +sclera icteric, elevated jvp, no lymphadenopathy cvs: rr s1, s2, no m/g/r pulm: decreased breath sounds 2/3 up on right w/bronchial bs, increased tactile fremitus on right, clear on left w/rhonchi at left base abd: distended, mild tenderness to palpation in periumbilical region but soft, w/o rigidity/rebound/guarding; scar noted from prior cholecystectomy. ext: 2+ pitting edema bl neuro: + astrixis pertinent results: ekg: w/o acute ischemic changes, unchanged from comparison . labs: osh on discharge: sodium 127 potassium 4.9, chloride 89, bicarbonate 33, bun 54, creatinine 1.3, glucose 122, ast 125, alt 62, alk phos 123, t bili 5.3, d.bili 2.1 cbc: wbc 10.7, hct 30.6, platelets 82 inr 2.11 micro: : u/a (-) sputum gram stain: mixed flora, c.diff(-), pleural fluid afb(-)/cyto (-) imaging: osh :ct head: negative for ich brief hospital course: 64 yo f with hepatitis c cirrhosis who was admitted to osh on for hepatic encephalopathy and failure to thrive and transferred here on to the hepatorenal service for further mgmt. pt was noted to have r hydrothorax which was tapped for 1.5 liters. she was also found to have an enterococcal uti for which she was treated with ampicillin/vancomycin. she was starting to develop a hepatorenal picture on her first several days on the floor, was aggressively diuresed with an increase in creatinine and oliguria, then became anuric. she was then given a fluid challenge with albumin and subsequently developed pulmonary edema on the l side, requiring nrb. she was transferred to the micu on and was intubated and started on cvvh. her r pleural effusion was tapped in the micu; dr. did not wish to have a pigtail catheter. she had a total of 72 hrs of cvvh. during cvvh, she was hypotensive, initially felt to be hypovolemic (intravascularly depleted) and possibly septic and her abx was broadened from ampicillin to cover enterococci uti to vanc/cefepime though all other culture data was negative. pt did not have enough ascites to tap. she was then noted to have failed her stim (she was previously on prednisone for copd flare at osh) and was started on stress dose steroids. this was tapered to 10 mg po prednisone on . on she is now normotensive with sbp in 120s back on her home bisoprolol, which has been titrated up. uop has also returned and she was restarted on lasix/aldactone. she was stable enough to transfer back to the hepatorenal floor service by where she was stable but with guarded status given her hepatorenal syndrome. her issues are summarized by issue below: . # hepatorenal syndrome: pt came in w/cr of 1.2. and was rapidly climbing. urine studies were c/w hrs type/prerenal over atn. pt was anuric after uf on ; uop has returned. off cvvh since friday , hd line dc'd . however, the patient's cr remained at 1.9 which had been trending upwards. uop slowing down on the floor, so on she was started mitodrine 5mg tid, octreotide 100mg sc tid. renal was involved regarding management of her fluid status as we would prefer to remove fluid by hd to protect kidneys than give fluid by albumin as pt had fluid overload, resp distress last time. the family is aware that her status is guarded and after many discussions, the decision was made to discharge her to home with hospice. . # hypotension/sepsis: initially thought to be likely multifactorial with the main component being recent thoracentesis and then hd session with removal of 2l of uf. there was mild response from sbp of low 80s to high 80s after 500 cc bolus of ivfs and 1 unit of prbcs. however, map began to drift below 60 in am of and pt was started on levophed. bp also began to fall after intubation, may be due to meds v. positive pressure ventilation (however, higher peep seems to be improving aeration of r lung). pt is less likely to be septic given hr, lack of fever, lack of leukocytosis though pt began to deteriorate after switching from vanc to amp. the patient's antibiotic coverage was broadened in the icu to cefepime/vanc as pt began to deteriorate after switching from vanc to amp for enterococcal uti-treat for a two week course ending on . adrenal insufficiency now considered to be primary cause. by the time she was transferred from the icu, she was off all pressors, and antibiotic coverage for sepsis. her bp ran high so she was restarted on bisoprolol 10mg daily which was discontinued on as her bp was starting to trend downwards. the patient was also restarted on midodrine and octreotide to maintain her bp. . # s/p hypoxic respiratory failure in the icu: this is likely due to pulm edema after fluid resuscitation in the setting of r hydrothorax and anuria, also mental status. per liver, no pigtail catheter as patient was still being considered for liver transplant. she was successfully extubated on , satting well on room air. on the floor after transfer from the icu, the patient's respiratory status has been stable. . # adrenal insufficiency- the patient had an abnormal stim test while septic, so given stress dose steroids and quickly tapered off steroids by . her blood pressure remained stable off the steroids. . #hypernatremia-likely secondary to intravascular volume depletion. the patient's tube feeds were adjusted to correct for hypernatremia. . #hyperglycemia: likely exacerbated by stress dose steroids and tpn. the patient's lantus was uptitrated given the patient's hyperglycemia. . # uti: the patient was initially found to have enterococcal uti which was adequately treated with ampicillin and vancomycin. she continued to grow out yeast in her cultures so was started on on a course of fluconazole. . # hepatic encephalopathy: no signs of infection or abnormalities in portal flow. pt has only trace ascites, difficult to tap. she was continued on lactulose and rifaximin titrating up to keep bm>4/day . # hep c cirrhosis and end stage liver disease: patient with meld of 37 on and complications including hrs, recurrent hepatic hydrothorax. patient was treated for hepatorenal syndrome as above. . # recurrent r hydrothorax: patient had been reaccumulating fluid during her hospital stay given her liver function. she had multiple thoracenteses on the floor and on the unit. . # copd: patient was transferred from osh on steroid taper for presumed copd flare. she was continued on albuterol and ipratroprium nebs prn and her home advair (fluticasone/salmeterol) 100/50 1 puff , combivent (ipratroprium/albuterol) 18 mcg-103 mcg (90 mcg)/actuation aerosol 2 puffs twice a day. no evidence of copd flare during this stay. . dispo: patient was discharged to home with hospice. . medications on admission: meds: per last dc summary in fluticasone-salmeterol aspirin 81 mg daily combivent two puffs inhalation twice a day. lasix 40 mg 2 once a day. lactulose 30 ml po tid nexium 40 mg po once a day. spironolactone 100 mg po daily bisoprolol 5 mg po bid lidocaine 5 % off for 12 hrs. oxycontin 10 mg q12 hr oxycodone 5 mg po q8h as needed. topiramate 25 mg po qhs singulair 10 mg po once a day. calcium 500 mg po three times a day. vitamin d 400 unit qdaily . medications on transfer: advair 100/50 1 puff daily albuterol nebs q3h albuterol/ipratropium inh q4h asa 81mg daily bisoprolol 2.5mg twice daily calcium carbonate 600 mg twice daily prednisone 2.5 mg(taper) lasix 40mg twice daily guaifenasin/dextrometh q4h prn insulin ss lactulose 20mg three times a day milk of mag 30mg qhs prn omprazole 20mg once daily oxycodone 5-10mg q4h prn vitamin k po 5mg daily rifaximin 200mg tid spironolactone 25 once daily vitamin d 1000unit once daily discharge medications: 1. ativan 1 mg tablet sig: one (1) tablet po every four (4) hours as needed. disp:*30 tablet(s)* refills:*2* 2. morphine concentrate 20 mg/ml solution sig: 2.5-10 mg po q1h as needed. disp:*30 cc* refills:*0* . discharge disposition: home with service facility: home &hospice of discharge diagnosis: final diagnosis hepatorenal syndrome recurrent hepatic hydrothorax hepatitis c cirrhosis . discharge condition: stable . discharge instructions: you were admitted from an outside hospital and found to have a syndrome called hepatorenal syndrome which means that your liver function is bad enough that your kidneys start to fail. you also have known fluid accumulation in your right lung which required multiple fluid removal procedures. you are now being discharged home with hospice care to keep you comfortable. . followup instructions: . procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis thoracentesis diagnoses: coronary atherosclerosis of native coronary artery unspecified pleural effusion urinary tract infection, site not specified cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma acute kidney failure, unspecified hepatorenal syndrome hyposmolality and/or hyponatremia severe sepsis obstructive chronic bronchitis with (acute) exacerbation percutaneous transluminal coronary angioplasty status chronic kidney disease, unspecified acute respiratory failure paralytic ileus hepatic encephalopathy hyperosmolality and/or hypernatremia streptococcal septicemia 

Answer: The patient is high likely exposed to