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: penicillins / adhesive tape attending: chief complaint: melena major surgical or invasive procedure: : gi bleeding study : sigmoidoscopy : gi bleeding study : colonoscopy and egd : angiogram, no intervention : exploratory laparotomy, intraoperative endoscopy. : post pyloric feeding tube placement history of present illness: 55 year-old male with hepatitis c cirrhosis s/p liver with recurrent hepatitis c complicated by ascites/ encephalopathy/ varices (3 cords grade i varices)/ portal hypertensive gastropathy/chronic portal and splenic venous thrombosis, recently discharged from yesterday with upper gi bleed, who presents with recurrent melena. he reports he arrived home yesterday and ate a seafood salad with several dk brown stools last night and some abd cramping. pt this am had black loose stool with abdominal cramping. the patient was hospitalized at from for melanotic stools. he was admitted to the micu for hemodynamic monitoring. gi performed endoscopy on which showed non-bleeding esophageal and gastric varices, portal hypertensive gastropathy, and a bleeding polyp noted in proximal body of stomach injected with epinephrine with hemostasis, as well as a colonoscopy on and old blood. he received 3 u prbcs, his hct remained stable at 27, and he was called out to - on , where his stools were noted to clear prior to discharged home. in the ed, 97.9 77 95/47 18 100% on ra. pt noted to be alert and mentating well. ng lavage not performed. laboratory data significant for hematocrit 26 (baseline 31) and cre of 1.4 (baseline 0.8). patient was noted to become hypotensive to 68 sbp and was treated with 2 l ns given wide open-> response of sbps to 90s, and 1 u prbcs with second unit written for. gi saw the patient, recommended tagged rbc scan and plan for repeat egd. on transfer to micu, vs were afebrile 63 12 86/40 100% on the floor vitals were 109/54 hr70 rr18 99%ra, pt reports feeling well. reports nonproductive cough, longstanding. possible palpitations last night. denies dizziness, weakness, chest pain, shortness of breath. reports occasional cramping in lower abdomen. denies nausea, vomiting, dysuria, hematuria, weakness, numbness, muscle aches, bruising. past medical history: -hepatitis c -esld s/p liver tx , s/p revision ; complicated with rejection and steroid use since to present; also complicated with hepatitis c recurrence and restarted peg interferon . hep c possibly contracted from tatoo . -chronic pancreatitis -primary hypogonadism -itp -svt last episode approximately , medically managed at this time (atenolol) -thoracic compression fractures: -cognitive disorders: h/o post hypoxic encephalopathy . -depression /anxiety -neutropenia and infections including c. diff x3, streptococcal septicemia, anal fistula -history of fistula in anus s/p fistulectomy -chronic pain especially rectal pain -diabetes : steroid induced, managed at clinic, recent hba1c 5.1 % (had received blood transfusions with splenectomy), insulin requirements decreased -s/p appy -s/p tonsillectomy -bilateral inguinal hernia -s/p hernia repair which has failed -s/p umbilical hernia repair and right inguinal hernia repair -s/p ccy -left sided hydronephrosis due to obstruction from splenomegaly, s/p left ureteral stent placement . -secondary hyperparathyroidism due to ckd managed by dr. at . -splenectomy, distal pancreatectomy, c/w fistula, s/p stent and then removal -history of peripancreatic abscess social history: lives with mother in and they both help with ther health issues. he has a sister that is also very involved in his care. patient sates he smoked in highschool socially (only in parties), but quit since then. he denies any current or past alcohol intake. he also denies at thit time any illegal substance use, however, he also is denying any past illegal substance use. family history: mother has dm2 and htn. uncle with cancer in his 80s (unknown site). denies any family history of mi, sudden cardiac death, stroke and lung diseases has dm2 physical exam: general: alert, oriented, comfortable heent: sclera anicteric, dry mucous membranes neck: jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, ii/vi early systolic murmur lusb abdomen: normoactive bowel sounds, prior incision scars noted, soft, non-tender gu: no foley rectal: per ed, guaiac positive brown stool ext: thin; warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: no asterixis pertinent results: admission labs: 04:15am wbc-5.8 rbc-2.48* hgb-8.5* hct-26.1* mcv-106* plt ct-136* 04:15am glucose-77 urean-22 cr-1.0 na-135 k-4.8 cl-110* hco3-20* 04:15am alt-43* ast-92* alkphos-236* totbili-1.4 04:15am tacrofk-8.5 micro: cmv vl: undetectable studies: rbc scan: delayed imaging shows activity in the midline at the level of the aortic bifurcation which is likely in small bowel. there was no active bleeding during the time of imaging. kub: no evidence of a capsule is seen within the abdomen. . : cta 1. multiple variceal vessels are identified in the abdomen. no active extravasation of contrast is seen to indicate a site of active hemorrhage. 2. unchanged thrombosis of the portal vein, splenic vein, and superior mesenteric vein. 3. fluid in the left abdominal flank is stable in size and morphology. . : gi bleeding study: no evidence of active gi bleeding at the time of the study. discharge labs: wbc-8.9 rbc-2.76* hgb-8.9* hct-28.0* mcv-102* mch-32.4* mchc-32.0 rdw-24.5* plt ct-213 pt-16.3* ptt-39.3* inr(pt)-1.4* glucose-106* urean-50* creat-1.1 na-138 k-5.2* cl-106 hco3-26 angap-11 alt-14 ast-25 alkphos-270* totbili-1.1 calcium-9.9 phos-3.2 mg-2.1 tacrofk-8.8 brief hospital course: 55m with hepatitis c cirrhosis s/p liver with recurrent hepatitis c complicated by ascites, gastric and esophageal varices, and encephalopathy admitted with recurrent melena. 1. lgib: reported to have melena, although at different time noted to have brown stool with bloody mucous. immediate concern was for ugib, particularly variceal bleeding or portal gastropathy in this patient with decompensated liver disease. pt with small intestine ulcers on recent capsule study. egd on with non bleeding varices at the lower third of the esophagus and gastroesophageal junction, portal hypertensive gastropathy, polyp in proximal body of stomach, and 8 mm non bleeding polyp adjacent to hepatico-jejunostomy. the patient had an rbc scan, which showed no definite bleeding seen on 90 minute dynamic imaging, but activity in the rectum on left lateral is compatible with rectal bleeding. pt had a sigmoidoscopy the next morning on that noted blood coating the colon, but no e/o active bleeding. ir declined angiography at this time, as it would be very low yield as no bleeding was noted on the rbc scan. over the pt's icu course, he was transfused 5 units prbcs. the patient's hct remained stable at 34 prior to call out to the floor. on the floor the patient remained hemodynamically stable however he continued to experience melanotic stools with a downward trend in his hematocrit. he became transfusion dependent, requiring about 2units/day. he subsequently had a ct-a to looked for vascular abnormalities such as scarred varices however this was unremarkable. a tagged red blood cell study was repeated which showed no source of bleeding. the patient continued to have melena, requiring units of prbcs to maintain adequate hematocrit. the decision was made between the patient and the team to proceed with an exploratory laparotomy and a possible endoscopy in the or. the patient was taken to the or on with dr . at the time of surgery a small enterotomy was made longitudinally and just in the roux limb just beyond the jejunojejunostomy. a colonoscope was advanced in from this location distally toward the terminal ileum and then withdrawn. no evidence of ulcerations or intramucosal or intraluminal pathology was identified. a second enterotomy was made distally in the mid to distal ileum, again transversely and then the colonoscope was placed in this location and advance distally into the terminal ileum and then eventually into the cecum. this was withdrawn and again no identified lesions were noted. a bleeding source was not identified during the surgery. on pod 2 the patient had hr in the 130's and was found to be in afib, he was given beta blocker and monitored. hematocrit was trended, in the ensuing days he received a total of 4 units prbcs. he was also evaluated by nutrition services. after following oral intakenit was determined to place a post pyloric feeding tube and start tube feeds. the wound was having ascitic fluid drainage, several clips were removed and a vac was placed. the patient had copius amounts of fluid from the vac, and the output was repleted with intermittent albumin and iv fluids. on pod 19 the patient was transferred to the sicu for increased confusion. a head ct was obtained which showed no evidence of acute intracranial abnormalities. the patient remained in the sicu for 8 days. he was additionally followed by neurology who atributed his confusion to encephelopathy of metabolic of infectious etiology. an lp was performed and infectious etiologies including cryptococcus were ruled out. he had been started on acyclovir pending results of lp, he received 6 days of this. in addition he received 6 days of fluconazole for yeast in the urine. an eeg showed an abnormal routine eeg in the waking state due to a mildly slow and disorganized background with frequent theta rhythms. there were no focal, lateralized, or epileptiform abnormalities noted. he also had an unremarkable bal. he was covered with vanco and meropenum, but never was febrile and all cultures were returned as negative and the antibiotics were discontinued. the patient eventually cleared and was able to be transferred back to 10. he continued to have large volume ascited from the wound vac and continued with albumin and fluid replacements, the albumin replacement will continue upon discharge and extra fluids are being instilled with tube feeds. two days prior to discharge, he spiked a fever and had increased abdominal pain. his ua was concerning for a potential uti, and he was covered with ciprofloxacin. his urine cultures eventually returned contaminated, and the ciprofloxacin was dicontinued. additionally, his picc line was removed and sent for culture, which showed no significant growth. 2. acute on chronic renal failure: creatinine 1.4 on admission, likely due to decreased perfusion in the setting of bleed. improved to 1.0 but then elevated post op as high as 1.7. medications were adjusted accordingly. with adequate hydration and use of albumin the patient once again returned to baseline creatinine of 1.1 by day of discharge. . medications on admission: alendronate - 70 mg tablet - 1 tablet(s) by mouth weekly take 30 minutes before other meds or food. take w/ 8 oz water & remain upright for 30 min. after dose. atenolol - 25 mg tablet - 1 tablet(s) by mouth once a day clindamycin hcl - 300 mg capsule - 2 capsule(s) by mouth x 1 1 hour before dental work or cleanings. ergocalciferol (vitamin d2) - 50,000 unit capsule - 1 capsule(s) by mouth weekly lamivudine - 100 mg tablet - 1 tablet(s) by mouth once a day latanoprost - 0.005 % drops - 1 drops(s) in each eye hs (at bedtime) both eyes lipase-protease-amylase - 20,000 unit-,500 unit-,000 unit capsule, delayed release(e.c.) - 2 capsule(s) by mouth three times a day with meals omeprazole - 20 mg capsule, delayed release(e.c.) - 2 capsule(s) by mouth twice a day sertraline - 50 mg tablet - 1 tablet(s) by mouth once a day sulfamethoxazole-trimethoprim - 800 mg-160 mg tablet - 1 tablet(s) by mouth three times a day tacrolimus - 0.5 mg capsule - 1 capsule(s) by mouth twice a day testosterone - 50 mg/5 gram (1 %) gel in packet - apply one packet per day daily (patient should get 5 gram per day) - no substitution trazodone - 100 mg tablet - 1 tablet(s) by mouth hs (at bedtime) as needed for insomnia ursodiol - 300 mg capsule - 1 capsule(s) by mouth twice a day acetaminophen - 325 mg tablet - 2 tablet(s) by mouth three times daily calcium citrate-vitamin d3 - 315 mg-200 unit tablet - 1 tablet(s) by mouth twice a day simethicone - 80 mg tablet, chewable - 40 mg by mouth three times a day zinc oxide - 16 % paste - apply topically three times daily as needed discharge medications: 1. latanoprost 0.005 % drops : one (1) drop ophthalmic hs (at bedtime). 2. ursodiol 300 mg capsule : one (1) capsule po bid (2 times a day). 3. sulfamethoxazole-trimethoprim 800-160 mg tablet : one (1) tablet po tid (3 times a day): long term suppression for pancreatic abscess. 4. lamivudine 100 mg tablet : one (1) tablet po daily (daily). 5. lipase-protease-amylase 16,000-48,000 -48,000 unit capsule, delayed release(e.c.) : two (2) cap po tid w/meals (3 times a day with meals). 6. calcium carbonate 500 mg tablet, chewable : one (1) tablet, chewable po qid (4 times a day) as needed for heartburn. 7. ursodiol 300 mg capsule : one (1) capsule po bid (2 times a day). 8. albumin, human 25 % 25 % parenteral solution : 12.5 grams intravenous every other day (every other day). 9. tacrolimus 0.5 mg capsule : one (1) capsule po q12h (every 12 hours). 10. sertraline 50 mg tablet : 1.5 tablets po daily (daily). 11. epoetin alfa 4,000 unit/ml solution : one (1) ml injection qmowefr (monday -wednesday-friday). 12. rifaximin 550 mg tablet : one (1) tablet po bid (2 times a day). 13. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler : four (4) puff inhalation q4h (every 4 hours) as needed for wheezes. 14. nystatin 100,000 unit/ml suspension : five (5) ml po qid (4 times a day) as needed for thrush. 15. thiamine hcl 100 mg tablet : one (1) tablet po daily (daily). 16. therapeutic multivitamin liquid : one (1) tablet po daily (daily). 17. folic acid 1 mg tablet : one (1) tablet po daily (daily). 18. atenolol 25 mg tablet : one (1) tablet po daily (daily). 19. trazodone 50 mg tablet : 0.5 tablet po hs (at bedtime) as needed for insomnia. 20. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 21. lactulose 10 gram/15 ml syrup : thirty (30) ml po tid (3 times a day): titrate to bms per day. 22. fludrocortisone 0.1 mg tablet : one (1) tablet po daily (daily). 23. multivitamin tablet : one (1) tablet po daily (daily). 24. hydromorphone 2 mg tablet : one (1) tablet po every four (4) hours as needed for pain. 25. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day): hold if stools loose. discharge disposition: extended care facility: hospital - discharge diagnosis: gi bleed. high output ascites malnutrition uti acute on chronic renal failure: resolved . secondary: s/p liver (). discharge condition: alert and oriented to person, place and time. ambulatory with supervision. fall risk discharge instructions: please call the office if you experience any of the warning signs listed below you will be going to labs should be drawn twice weekly on monday and thursday you will require iv albumin every other day tube feeds via post pyloric feeding tube wound vac, primarily for ascites drainage picc line in place, care per facility protocol followup instructions: , md phone: date/time: , md phone: date/time: 10:20 , md phone: date/time: 1:40 , rn,ms,: date/time: 10:00 procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more spinal tap incision of lung parenteral infusion of concentrated nutritional substances other endoscopy of small intestine insertion of endotracheal tube exploratory laparotomy closed [endoscopic] biopsy of bronchus colonoscopy arteriography of other intra-abdominal arteries flexible sigmoidoscopy insertion of (naso-)intestinal tube other immobilization, pressure, and attention to wound transabdominal endoscopy of large intestine diagnoses: congestive heart failure, unspecified acute kidney failure, unspecified unspecified septicemia severe sepsis unspecified viral hepatitis c without hepatic coma hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, unspecified dysthymic disorder acute respiratory failure osteoporosis, unspecified blood in stool septic shock accidents occurring in other specified places secondary hyperparathyroidism (of renal origin) encephalopathy, unspecified varices of other sites complications of transplanted liver esophageal varices in diseases classified elsewhere, without mention of bleeding surgical operation with transplant of whole organ causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation other specified disorders of stomach and duodenum chronic pancreatitis first degree atrioventricular block esophageal varices without mention of bleeding other severe protein-calorie malnutrition ulceration of intestine benign neoplasm of stomach 

Answer: The patient is high likely exposed to