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: abdominal pain major surgical or invasive procedure: egd tube tips placement history of present illness: patient is a 53yo male with hepatitis c cirrhosis, ascites, encephalopathy admitted on with abdominal pain sbp, treated with ceftriaxone. . patient was admitted on with a variety of abdominal symptoms. he developed melena on and was transferred to the micu for egd, which demonstrated grade ii esophageal varices that were banded x 2. patient started on octreotide gtt, pantoprazole and sucralfate. his hct remained stable on so he was called out to the floor. . on , he developed sudden onset of large rectal bleed, found to have lost about 900cc of venous blood. hct dropped from 30.5 to 21.5, and was transferred back to the micu for further management of this gi bleed. in the icu, he intubated for emergent egd, which showed frank blood in the esophagus. he underwent urgent tips, with transhepatic gradient decreasing from 28 mmhg to 10 mmhg. following procedure, the patient has not had a recurrence of ugib. he was extubated following improvement in his mental status. however, mental status continued to wax and wane, and he was treated for hepatic encephalopathy with lactulose. . prior to transfer, pt is tolerating lactulose well. trauma line has been removed this morning after hct has been stable at 28-30 for greater than two days. he states he felt weak with abdominal discomfort during his ugib. he denies abdominal pain/lightheadedness/weakness currently. also denies chest pain/sob. no n/v/d/f/c. last bm one hour ago, loose, light brown, non-bloody, no melena. . past medical history: -hepatitis c -asthma -depression -hydronephrosis -chronic low back pain - spinal stenosis social history: he is currently smoking ppd. he reports last using heroin 3 weeks ago. he reports no current etoh use (last drink 4 months ago). he is married and lives at home with his wife. family history: maternal grandfather with cad/pvd; mother with dm physical exam: vs - afebrile, 114/61 , hr 76 , 20 r , o2-sat 98% ra general - jaundiced-appearing man in nad, comfortable, appropriate heent - nc/at, perrla, eomi, sclerae icteric, mmm, op clear neck - supple, no thyromegaly, no jvd, no carotid bruits lungs - cta anteriorly heart - pmi non-displaced, rrr, no mrg, nl s1-s2 abdomen - nabs, soft/nt, distended, no masses or hsm, no rebound/guarding extremities - wwp, 2+ pitting edema to knees, 2+ peripheral pulses (radials, dps) skin - no rashes or lesions lymph - no cervical, axillary, or inguinal lad neuro - awake, a&ox3, cns ii-xii grossly intact pertinent results: 03:10am pt-19.8* ptt-36.4* inr(pt)-1.8* 03:10am plt count-84* 03:10am neuts-76.3* lymphs-14.8* monos-5.1 eos-3.5 basos-0.3 03:10am wbc-7.7 rbc-3.48* hgb-11.5* hct-33.2* mcv-96 mch-33.2* mchc-34.7 rdw-16.6* 03:10am asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 03:10am albumin-2.4* 03:10am lipase-38 03:10am alt(sgpt)-39 ast(sgot)-71* alk phos-94 tot bili-4.1* 03:10am estgfr-using this 03:10am glucose-158* urea n-35* creat-1.4* sodium-139 potassium-4.0 chloride-107 total co2-24 anion gap-12 03:15am lactate-1.7 05:10am urine rbc-0-2 wbc- bacteria-few yeast-none epi-0 05:10am urine blood-tr nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-4* ph-5.0 leuk-neg 05:10am urine color-amber appear-clear sp -1.023 05:10am urine gr hold-hold 05:10am urine uhold-hold 05:10am urine hours-random 05:10am urine hours-random 06:00am ascites wbc-825* rbc-1675* polys-56* lymphs-31* monos-0 mesotheli-2* macrophag-11* 06:00am ascites tot prot-0.9 glucose-160 ld(ldh)-62 albumin-<1.0 labs at discharge: wbc rbc hgb hct mcv mch mchc rdw plt ct 10.3 3.21* 10.6* 29.6* 92 32.9* 35.6* 20.3* 82* inr 3.1 glucose urean creat na k cl hco3 angap 143 14 0.5 137 3.8 108 22 11 alt ast alkphos totbili dirbili indbili 38 86* 70 22.2* 13.2 9.0 albumin calcium phos mg 2.4* 7.2* 1.8* 1.9 afp 4.2 hiv negative ascites analysis wbc rbc polys lymphs monos eos atyps mesothe 08:11 440* 630* 11* 62* 5* 1* 1* 4* 06:00 825* 1675* 56* 31* 0 2* 11* mr abdomen: impression: 1. evidence of hepatic cirrhosis and portal hypertension, with moderate ascites, paraesophageal varices, and marked splenomegaly. 2. no focally arterial enhancing lesion is identified within the liver parenchyma. no other hepatic parenchymal lesion is seen to correlate with finding on prior ultrasound study renal u/s impression: 1. moderate right hydronephrosis with no identified cause. no hydronephrosis on the left. 2. moderate amount of ascites. abdominal ultrasound: comparison: comparison is made to prior ultrasound performed . findings: a moderate amount of ascites is identified. a site suitable for percutaneous aspiration of ascites was marked on the right lower anterolateral abdominal wall with patient supine and probe held perpendicular to the skin surface. the tips is patent, with wall-to-wall flow on color imaging. the tips has a flexed appearance. the peak velocity at the proximal end of the tips is 93 cm/sec, and at mid tips 120 cm/sec. there is elevated velocity at the distal portion of the tips with peak measurement 151 cm/sec. appropriate reversed flow is identified within the left branch of the portal vein. there is probable slow reverse flow in the anterior right portal branch, but doppler tracing is suboptimal, probably as the vessel is diminutive in size as demonstrated on mr study . the gallbladder is mildly distended with echogenic debris in its dependent portion. no intrahepatic biliary duct dilatation is seen. the common bile duct is normal in caliber. no other focal parenchymal abnormality is identified in the liver. the pancreatic head and body appear unremarkable, but the pancreatic tail is not fully visualized. the spleen is markedly enlarged measuring 19.0 cm bipolar diameter. small bilateral basal pleural effusions are seen. impression: 1. site suitable for aspiration of ascites marked on right lower anterior abdominal wall as indicated above. 2. patent tips, with flexed appearance and elevated flow velocity at its distal portion. short interval followup is advised. brief hospital course: patient is a 53 yo male with hepatitis c cirrhosis, ascites, encephalopathy admitted on with abdominal pain secondary to spontaneous bacterial peritonitis, treated with ceftriaxone, with hospital course complicated by esophageal variceal bleed x 2. micu course- patient transferred to the micu for egd on . egd showed grade ii varices with cherry red spots, likely bleeding from esophageal varices. performed band ligation x 2. also has portal gastropathy. patient placed on octreotide gtt and sucralfate. remained hemodynamically stable while in the micu. called out to floor on micu course ii- patient transferred back to the micu with massive gi bleed on . massive transfusion protocol was initiated and he received 11u prbcs as well as multiple units of ffp and platelets. he underwent urgent egd which showed a bleeding gastric varices. once stablized, he underwent tips procedure with resulting drop in portal pressure from 28 to 10. he remained intubated until . tolerated extubation well. he had altered mental status which was thought to be secondary to a combination of hepatic encephalopathy and sedation. it improved with time and lactulose. he had no new episodes of gi bleed and did not require any additional blood products while here. hct was actually increased on day of transfer to - service (). # variceal hemorrhage- status post tips, tolerated procedure well, with decrease in portocaval gradient from 28 mmhg to 10 mmhg (still elevated). no recurrence of melena/brbpr since tips, hematocrit stable at 28-31. received 11 units prbcs, 10 units of ffp, 2 bags of platelets during course. continued pantoprazole , sucrulfate. . #) spontaneous bacterial peritonitis: cell count consistent with sbp on diagnostic paracentesis on , first episode. received 3 doses of albumin. completed sbp treatment. started ciprofloxacin 500 mg daily for secondary prevention of sbp. . #) hcv with cirrhosis: right upper lobe hypoechoic lesion noted on imaging , for which mri was recommended. upon admission, had genotyping, afp level, hiv test, hepatitis b and a markers, and iron studies. transaminases are elevated similar to admission in --total bilirubin also elevated above prior (3.7, was 2.2-2.9 in ). thrombocytopenia and inr also at baseline, suspected to be due to poor synthetic function. evidence of prior hepatitis b exposure. afp 4.2. hiv negative. restarted diuretics prior to discharge, continued nadolol, decreased lactulose. . #) thrombocytopenia: stable from last admission, presumably from chronic liver disease. . #) lower back pain: appears chronic in nature, no reported new neurologic concerns. if continues to have fever, imaging is consideration (as brought up by primary team, can't necessarily exclude pathology such as epidural abscess given iv drug use and fevers, though have other likely potential explanation with sbp) . #) communication: patient and wife (. . #) code: full . #. fen - sodium restricted diet/renal diet medications on admission: 1. senna 8.6 mg po bid prn 2. docusate sodium 100 mg po bid prn 3. furosemide 20 mg po bid 4. lactulose 30 mls po tid 5. gabapentin 300 mg po q8h 6. hydrocortisone 2.5 % cream apply rectally as needed for rash. discharge medications: 1. sucralfate 1 gram tablet sig: one (1) tablet po three times a day: take 1 hour after ciprofloxacin as can block drug effect. disp:*120 tablet(s)* refills:*2* 2. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 5. ciprofloxacin 500 mg tablet sig: one (1) tablet po once a day: take in the morning. disp:*30 tablet(s)* refills:*2* 6. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po bid (2 times a day). 7. rifaximin 200 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 8. spironolactone 50 mg tablet sig: three (3) tablet po once a day. disp:*90 tablet(s)* refills:*2* 9. gabapentin 300 mg capsule sig: one (1) capsule po three times a day. 10. outpatient lab work please draw chem-10 and fax results to , the . discharge disposition: home discharge diagnosis: primary: spontaneous bacterial peritonitis upper gastrointestinal bleeding esophageal varices abdominal ascites secondary: hepatitis c cirrhosis ivda with heroin discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital with abdominal pain secondary to an infection in the fluid in your abdomen. you also had a serious gastrointestinal bleed that required placement of a shunt in your liver called a tips. the bleeding stopped and your condition stabilized. there is still a risk of bleeding. we started you on a medication to help reduce the chance of another bleed. on the day of discharge we removed a little over 3 liters of fluid from your abdomen. this will likely reaccumulate over time. please eat a low salt diet and take your medicine to slow the rate of reaccumulation. changes to your medications include: decrease furosemide to 20mg daily start sucralfate three times a day start pantoprazole 40mg twice a day start nadolol 20mg daily start ciprofloxacin 500mg daily (take 1 hour prior to sucralfate) start rifaximin 200mg three times a day start spironolactone 150mg (3 tabs) daily ** you will need to have your blood drawn on . you have been given a lab order to have this completed. you can go to the liver center located at , to have that drawn. please follow up with your new doctors as below. followup instructions: provider: , md phone: date/time: 2:35 provider: , md phone: date/time: 2:40. we are attempting to set up an earlier appointment in the next two weeks. the office will contact you. if you do not hear from the liver center in the next 1-2 days, please call the number above. md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified insertion of endotracheal tube percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage endoscopic control of gastric or duodenal bleeding endoscopic control of gastric or duodenal bleeding endoscopic excision or destruction of lesion or tissue of esophagus endoscopic excision or destruction of lesion or tissue of esophagus injection of anesthetic into spinal canal for analgesia intra-abdominal venous shunt diagnoses: thrombocytopenia, unspecified tobacco use disorder cirrhosis of liver without mention of alcohol acute posthemorrhagic anemia chronic hepatitis c with hepatic coma alcoholic cirrhosis of liver acute kidney failure, unspecified unspecified protein-calorie malnutrition portal hypertension asthma, unspecified type, unspecified depressive disorder, not elsewhere classified diaphragmatic hernia without mention of obstruction or gangrene acute respiratory failure esophageal varices in diseases classified elsewhere, with bleeding varices of other sites other specified disorders of stomach and duodenum hydronephrosis spinal stenosis, unspecified region opioid abuse, unspecified personal history of alcoholism spontaneous bacterial peritonitis spinal stenosis, lumbar region, without neurogenic claudication 

Answer: The patient is high likely exposed to