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: amoxicillin / adhesive bandage / dicloxacillin / linezolid attending: chief complaint: altered mental status major surgical or invasive procedure: none history of present illness: this is 41 yo m w/ hx cirrhosis secondary to etoh + hcv, osa, pah and hypothyroidism, w/ recurrent episodes of severe enceophalopathy and ascites well-known to the micu who was transferred from the liver service for encephalopathy. . mr. has been at rehab since discharge from on . per his mother he has been having more frequent encephalopathic episodes this month. over the past few days she reports that has been in good health without fevers, night sweats, n/v, or abdominal pain. over the last few days he has been having ~6bms/day. notably, she reports the rehab would not increase the lactulose frequency from q4hr which often requires when he is becoming encephalopathic. . notably, patient's most recent admission was also for changes in mental status. he was found to have a klebsiella bacteremia and uti treated with 3 weeks of ceftriaxone (, to complete on ). neurologic work-up demonstrated that he has a comunicating hydrocephalus, etiology of which remains unclear. . in the ed vitals: 78 98/63 18 99% ra. he received 30ml of po lactulose as well as vanc/cipro/flagyl for question of infection.he received 2l ns. cxr with mild atelectasis. duplex u/s showed flow in l portal vein, pt combative and this could not be completed. . in the icu, patient able to follow directions though continued to have agitated outbursts. denied any pain or discomfort. past medical history: - end stage liver disease alcohol and hepatitis c. currently on the list. course complicated by recurrent ascites, sbp, pulmonary hypertension. currently on the list (s/p aborted liver given elevated pulmonary pressures in or ) - sepsis w/ enterococcus avium and group b step, recent discharge on - spontaneous bacterial peritonitis early on cipro prophylaxis - grade ii esophageal varices - recurrent hepatic encephalopathy on vegetarian diet - pulmonary hypertension - hypothyroidism - anxiety disorder - history of alcohol and ivdu - osteoporosis of hip and spine per pt - anemia with history of guaiac positive stool social history: he lives with his mother. remote history of smoking ppd. quit drinking 11 years ago. prior history of ivdu as a teenager. family history: mother with diabetes and hypertension. father with rheumatic heart disease. physical exam: in micu: gen: awake, alert, agitated intermittently heent: dry mm, + scleral icterus pulm: lungs clear bilaterally, no wheezes or rhonchi cv: s1 & s2 regular without murmur abd: +bs, soft, non-tender, mildly-distended ext: no lower extremity edema neuro: alert, unable to comply with neuro exam pertinent results: 11:07pm glucose-100 urea n-39* creat-1.2 sodium-154* potassium-3.7 chloride-122* total co2-25 anion gap-11 11:07pm alt(sgpt)-20 ast(sgot)-47* ld(ldh)-208 alk phos-120* tot bili-7.8* 11:07pm albumin-3.3* calcium-9.8 phosphate-2.8 magnesium-1.7 11:07pm wbc-3.7* rbc-2.17* hgb-6.7* hct-22.7* mcv-104* mch-31.0 mchc-29.7* rdw-21.5* 11:07pm neuts-76.5* lymphs-13.9* monos-6.7 eos-2.7 basos-0.2 11:07pm plt count-32* 11:07pm pt-28.4* ptt-53.0* inr(pt)-2.8* 05:09pm lactate-1.3 05:05pm urine blood-sm nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 05:05pm urine rbc-0-2 wbc-0-2 bacteria-few yeast-none epi-0-2 imaging/studies: cxr: left and right mid lung subsegmental atelectasis. no focal consolidation or pulmonary edema. . abd u/s: 1. cirrhosis, ascites, splenomegaly. 2. limited doppler exam without evaluation of the main portal vein. if there is high clinical concern for vascular thrombosis, a ct is suggested. 3. cholelithiasis. . abd us 1. flow within the main portal vein, now demonstrates a hepatofugal (reversed) directionality (as demonstrated on a prior study from ) although patent. flow within the left portal vein could not be obtained no doppler evaluation either secondary to occlusion or very slow flow in this uncooperative patient. 2. shrunken cirrhotic liver consistent with known cirrhosis. cholelithiasis with gallbladder wall edema/thickening unchanged over multiple comparisons likely secondary to third spacing from decompensated liver disease rather than acute cholecystitis. 3. large amount of intra-abdominal ascites. . head ct : no interval change in moderate ventriculomegaly. no evidence of intracranial hemorrhage. . mri head : 1. prominent lateral ventricles with evidence for transependymal csf flow suggestive of communicating hydrocephalus; also prominence of the sulci suggestive of atrophy. 2. no acute intracranial process. unchanged diffuse hydrocephalus since (new since ) with mild transependymal csf flow. . csf fluid: neg cryptococcal, fungal wbc 0-2, polys 0, lymphs 0-56 brief hospital course: 41 year old man with cirrhosis secondary to etoh and hcv, complicated by recurrent ascites, history of sbp and esophageal varices, who has been hospital w/ recurrent episodes of encephalopathy presents with an episode of encephalopathy. . # recurrent encephalopathy: presentation secondary to inadequate bowel regimen while at rehab facility. work up negative for infection (stool, blood, urine), gi bleed, and u/s failed to show significant ascites. a ct of abdomen was done to evaluate questionable poor flow through the portal vein seen on us. the ct was sig for patent portal vein. patient was treated with rifaximin and q2hr lactulose and produced ~4l of stools per day. mental status improved to baseline on discharge. cipro was continued for sbp prophylaxis. he was also continued on his vegetarian diet. a decision was made to discharge patient home w/ services as mother felt that she could provide better care at home. physical therapy was consulted who agreed that the patient could be discharged home. . # hypernatremia: secondary to reduced access to free water in the setting of encephalopathy and high stool output. resolved with free water replacement. . # esld. secondary etoh and hcv. patient initially presented with improved ascites and edema. an ultrasound of the abdomen showed poor flow through the portal vein, and ct of the abdomen was done for further assessment. the ct demonstrated patent portal vein. patient was continued on his lactulose and rifaximin as above. he was also continued on cipro for sbp ppx, his home diuretics and ppi. octreotide and midodrine were discontinued while in the icu. the patient's creatine remained stable off treatments. patient was ultimately disharged to home (see above). . # h/o hrs: octreotide and midodrine discontinued while in the icu and were held throughout his hospital course. creatinine stable off octreotide and midodrine. . # anemia: initial hct of 23 lower than baseline of 25-28. patient hcts were followed throughout hospitalization and were stable. . # thrombocytopenia: stable and secondary to liver disease. . # hypothyroidism: stable, patient was continued on home levothyroxine. . # pulmonary htn: there were no active issues during his hospitalization and the patient was continued iloprost. . # osteoporosis: patient was continued on his home regimen of vit d and calcium medications on admission: clotrimazole 10 mg troche sig: one (1) troche mucous membrane 5x/day (5 times a day). ursodiol 300 mg capsule sig: two (2) capsule po daily miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day) as needed for candidiasis. levothyroxine 88 mcg tablet sig: one (1) tablet po daily rifaximin 200 mg tablet sig: two (2) tablet po tid (3 times a day). zinc sulfate 220 mg capsule sig: one (1) capsule po daily cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). omeprazole 20 mg capsule, delayed release(e.c.) sig:po daily lactulose 10 gram/15 ml syrup sig: 30-60 mls po qid octreotide acetate 100 mcg/ml solution sig:q8h iloprost 10 mcg/ml solution for nebulization sig:inhalation 6x/day furosemide 40 mg tablet sig: one (1) tablet po daily spironolactone 25 mg tablet sig: one (1) tablet po daily midodrine 10 mg tablet sig: tid simethicone 80 mg tablet, chewable sig: 0.5-1 tablet, discharge medications: 1. clotrimazole 10 mg troche sig: one (1) troche mucous membrane qid (4 times a day): no script given. disp:*0 troche(s)* refills:*0* 2. ursodiol 300 mg capsule sig: two (2) capsule po qam (once a day (in the morning)): no script given. disp:*0 capsule(s)* refills:*0* 3. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day): no script given. disp:*0 bottle* refills:*0* 4. levothyroxine 88 mcg tablet sig: one (1) tablet po daily (daily): no script given. disp:*0 tablet(s)* refills:*0* 5. rifaximin 200 mg tablet sig: two (2) tablet po tid (3 times a day): no script given. disp:*0 tablet(s)* refills:*0* 6. zinc sulfate 220 mg capsule sig: one (1) capsule po daily (daily): no script given. disp:*0 capsule(s)* refills:*0* 7. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed for bloating: no script given. disp:*0 tablet, chewable(s)* refills:*0* 8. iloprost 10 mcg/ml solution for nebulization sig: one (1) ml inhalation q4hr (): no script given. disp:*0 ml(s)* refills:*0* 9. lactulose 10 gram/15 ml syrup sig: 30-60 mls po q2h (every 2 hours) as needed for encephalopathy: for bowel movements per day. disp:*0 ml(s)* refills:*0* 10. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours): no script given. disp:*0 tablet(s)* refills:*0* 11. zinc sulfate 220 mg tablet sig: one (1) tablet po once a day: no script given. disp:*0 tablet(s)* refills:*0* 12. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day: no script given. disp:*0 capsule, delayed release(e.c.)(s)* refills:*0* 13. calcium carbonate-vitamin d3 500 mg(1,250mg) -400 unit tablet sig: one (1) tablet po once a day. 14. tubefeeding tubefeeding: nutren 2.0 full strength rate: 35 ml/hr; do not advance rate goal rate: 35 ml/hr flush w/ 250 ml water q2h 15. outpatient physical therapy to continue with home physical therapy discharge disposition: home with service facility: vna of southeastern mass discharge diagnosis: primary: hepatic encephalopathy secondary: history of sbp, grade ii esophageal varices, pulmonary hypertension, hypothyroidism, osteoporosis, anemia discharge condition: stable discharge instructions: you were seen in the hospital for your confusion. this was because of your liver disease and we treated you with lactulose. we did an ultrasound of your abdomen that did not show worsening ascites but showed poor flow through the portal vein. ct of your abdomen however showed a patent portal vein. while you were in the hospital, we replaced your feeding tube. your mental status improved to baseline on discharge. we have made the changes to your home medications: 1. you do not need to take lasix, midodrine and octreotide 2. please continue the rest of your home medications. please return to the emergency room if you should experience further confusion, severe abdominal pain, fevers > 101, or any concerning symptoms. followup instructions: please follow up with gastroenterology: provider: , md phone: date/time: 9:00 procedure: insertion of other (naso-)gastric tube diagnoses: thrombocytopenia, unspecified obstructive sleep apnea (adult)(pediatric) anemia, unspecified alcoholic cirrhosis of liver other and unspecified alcohol dependence, in remission unspecified acquired hypothyroidism other chronic pulmonary heart diseases pulmonary collapse anxiety state, unspecified osteoporosis, unspecified other ascites awaiting organ transplant status hyperosmolality and/or hypernatremia communicating hydrocephalus unspecified viral hepatitis c with hepatic coma 

Answer: The patient is high likely exposed to