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 / ambien / shellfish derived attending: chief complaint: altered mental status major surgical or invasive procedure: diagnostic paracentesis intubation, mechanical ventilation history of present illness: mr. is a 55 y.o m with hcv cirrhosis, hcc s/p rfa, s/p , now with recurrent hep c, htn, adrenal insufficiency, type ii dm who presented to osh on with ams. he was found to be hypoglycemic along with combative and altered. he was intubated, sedated and transfered to the for further evaluation. at the time of transfer, he was admitted to micu at which time he remained intubated but became more interactive. the micu team was alerted that cultures from the osh grew gpcs in pairs and chains which ended up being strep mitis. the patient was initially treated with vancomycin and then coverage was narrowed to cefazolin. he was extubated without difficulty and has been stable from a respiratory standpoint for 24 hours. his mental status was attributed to hepatic encephalopathy in the setting of sepsis and he has been treated with lactulose and rifaximin. . upon arrival to the floor vitals were 97.0 155/88 66 20 100ra glucose 188. the patient was able to respond to simple questions. he did not follow instructions. he was aox2 (date ). past medical history: - hepatitis c cirrhosis and hepatocellular carcinoma s/p radiofrequency ablation x 3, s/p liver transplantation , recurrent hep c after transpant, now with decompensated liver failure with ascites and encephalopathy, listed. last egd in showed 1 cords of grade i varices. - recurrent hep c after transpant- last viral load 69 on . - htn - hx of type ii dm - adrenal insufficiency: . after cortisal stimulation test. - s/p appendectomy - s/p tonsillectomy - s/p cervical laminectomy - s/p right forearm orif - s/p bone graft from right hip to elbow - s/p knee surgery social history: former fireman and barowner; positive tobacco history; 2 packs per day x 30 years, quit prior to liver . he is not using iv drugs. family history: his father has renal failure. his mother has hypothyroidism. physical exam: vitals: bp 167/78 hr 67 rr 16 sao2 100%ra general: somnolent male, nad heent: ng tube in place, mild scleral icterus, no oral lesions, dry mm neck: jvp not elevated lungs: clear to auscultation bilaterally on anterior exam, no wheezes or crackles cv: regular rhythm, normal rate, s1, s2, ii/vi systolic murmur llsb abdomen: soft, mild destension, nontender, +bs, scar from prior surgery inplace. gu/rectal: foley and flexiseal in place ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema, no splinter hemorrhages or lesions pertinent results: micro: osh culture: s. mitis peritoneal fluid: negative cultures: negative urine culture: pending . images: abdominal ultrasound: there is moderate amount of ascites in the perihepatic and perisplenic region. the macronodular liver is echogenic in echotexture but without focal lesions, compatible with cirrhosis. the right, mid and left portal veins are widely patent with normal hepatopetal flow. a 3-cm focal dilation of the main portal vein is similar in appearance compared to prior ct study. slight turbulent flow is noted around the focal dilation. the hepatic veins and arteries are patent and normal in doppler waveforms. the spleen measures 14.8 cm. the right kidney measures 11.3 cm. the left kidney measures 12.0 cm. there is no hydronephrosis, hydroureter or stone. impression: patent hepatic vasculature. cirrhotic liver with moderate ascites. normal kidneys. splenomegaly. cxr: findings: the ng tube has its tip projected over the stomach. there is blunting of the costophrenic angles bilaterally. the heart remains enlarged. there is no significant change in the bibasilar atelectasis. impression: 1. bibasal atelectasis and bibasal effusions along with cardiomegaly, overall appearances are suggestive of chf. 2. the nasogastric tube terminates in the proximal stomach, recommended advancing up to 5 cm brief hospital course: mr. is a 55-year old male with hcc s/p rfa, hcv cirrhosis, s/p olt , with hcv recurrence and cirrhosis complicated by encephalopathy, ascites, varices who was admitted with altered mental status and streptococcal bacteremia. 1. bacteremia- original cultures from showed strep mitis, but subsequent speciation showed strep sanguinus and salivarius species, all of which are consistent with oral flora, as patient has poor dentition. we obtained a panorex dental x-ray to better evaluate infectious foci in his oropharynx. he was treated with a 7-day course of cefazolin which was changed to iv ceftriaxone for ease of dosing upon discharge, for a total treatment duration of 14 days. infectious disease service was consulted regarding the treatment of this microorganism. a tte was obtained to rule out endocarditis, and there were no obvious vegetations. a tee was not pursued due to low clinical probability of endocarditis given lack of adequate duke's criteria. he was discharged with antibiotic course to be administered through picc line. 2. hepatic encephalopathy- mr. was quite encephalopathic on admission, and his mental status improved slowly each day on lactulose and rifaxamin. at the time of discharge, he was mentating at his baseline. 3. metabolic acidosis- chronic metabolic acidosis with partially compensated respiratory alkalosis as per gas and daily labs. could be partially due to volume depletion from greatly increased stool output from lactulose, as patient was hypokalemica and bicarb depleted. renal was consulted and recommended fluid challenge. he was also given albumin and bicarbonate with some improvement in lab values, but this derangement appears chronic. medications on admission: 1. hydrocortisone 10 mg po qam 2. hydrocortisone 5 mg po qpm 3. metoprolol tartrate 50 mg po bid 4. pantoprazole ec 40 mg po bid 5. paroxetine hcl 20 mg po daily 6. rifaximin 600 mg po tid 7. sucralfate oral 8. ferrous sulfate 325 mg po daily 9. magnesium oxide oral 10. doxazosin 1 mg po hs 11. trimethoprim-sulfamethoxazole 80-400 mg po mwf (-wednesday-friday). 12. ciprofloxacin 250 mg tablet po qsunday. 13. lactulose 60 gram po every 4-6 hours (titrate to 3bm) 14. lidocaine 5 %(700 mg/patch) adhesive patch daily prn 15. tacrolimus 0.5 mg po q12h 16. insulin nph & regular human 100 unit/ml (70-30) suspension subcutaneous discharge medications: 1. paroxetine hcl 20 mg tablet sig: two (2) tablet po daily (daily). 2. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 3. doxazosin 1 mg tablet sig: two (2) tablet po hs (at bedtime). 4. ceftriaxone 2 gram recon soln sig: two (2) grams intravenous once a day for 8 days: to end . disp:*16 grams* refills:*0* 5. trimethoprim-sulfamethoxazole 160-800 mg tablet sig: one (1) tablet po mwf (-wednesday-friday). 6. hydrocortisone 5 mg tablet sig: one (1) tablet po qpm (once a day (in the evening)). 7. ciprofloxacin 500 mg tablet sig: 1.5 tablets po qsun (every ). 8. tacrolimus 0.5 mg capsule sig: capsule po q12h (every 12 hours). 9. lidocaine-prilocaine 2.5-2.5 % cream sig: one (1) appl topical prn (as needed) as needed for pain. 10. lactulose 10 gram/15 ml syrup sig: forty five (45) ml po qid (4 times a day). 11. propranolol 10 mg tablet sig: two (2) tablet po bid (2 times a day). 12. alum-mag hydroxide-simeth 200-200-20 mg/5 ml suspension sig: 15-30 mls po qid (4 times a day) as needed for indigestion. 13. rifaximin 200 mg tablet sig: two (2) tablet po tid (3 times a day). 14. hydrocortisone 5 mg tablet sig: two (2) tablet po qam (once a day (in the morning)). 15. bisacodyl 10 mg suppository sig: one (1) suppository rectal (2 times a day) as needed for constipation. 16. insulin nph & regular human 100 unit/ml (70-30) suspension sig: sixty (60) units subcutaneous twice a day: 60 units nph in am and 48 units in afternoon . discharge disposition: home with service facility: vna discharge diagnosis: primary: strep sanguis and strep salivarium bacteremia, hepatic encephalopathy secondary: hcc s/p rfa, hcv s/p olt ', c/b recurrence hcv w/ ascites, varices and pse discharge condition: activity status:ambulatory - requires assistance or aid (walker or cane) level of consciousness:alert and interactive mental status:clear and coherent discharge instructions: it was a pleasure being involved in your care, mr. . you were admitted to the hospital because of a bacterial infection in your , for which you were treated with antibiotics. the likely source of this bacteria is from your mouth, so it is important to follow-up with good dental care. you also were confused which is due to your hepatic encephalopathy. you cleared up with lactulose by the time you were sent home. your medications have changed as follows: 1. we added ceftriaxone 2g iv q24h (antibiotic) for a total 14 day course to end on the rest of your medications are the same, please continue to take them as you have been. please keep your follow-up appointments below. call your doctor or 911 you experience crushing chest pain, difficulty breathing, intractable nausea or vomiting, in your urine vomit or stool or any other concerning medical problem. followup instructions: 1. please see your liver doctor, , md phone: date/time: 8:00 2. please make an appointment to see your primary care doctor, dr. . phone for a post-hospital stay follow-up visit procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified percutaneous abdominal drainage diagnoses: acidosis cirrhosis of liver without mention of alcohol chronic hepatitis c with hepatic coma acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified hypopotassemia chronic kidney disease, unspecified acute respiratory failure alkalosis bacteremia diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled other ascites awaiting organ transplant status complications of transplanted liver glucocorticoid deficiency hyperosmolality and/or hypernatremia esophageal varices in diseases classified elsewhere, without mention of bleeding streptococcus infection in conditions classified elsewhere and of unspecified site, other streptococcus personal history of malignant neoplasm of liver surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation 

Answer: The patient is high likely exposed to