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: ceftriaxone attending: chief complaint: abdominal pain major surgical or invasive procedure: egd sigmoidoscopy paracentesis history of present illness: mr. is a 55 year old man recently admitted to with acute alcoholic hepatitis and found to be cirrhotic. his course was complicated by hepatic encephalopathy and hepatorenal syndrome. he was discharged to rehab two weeks ago. pt reports that he was improving and was about to be discharged home from rehab, but over past week has been noticing that his abdomen has becoming more and more distended. he has also been gaining weight but does not know exactly how much. pt reports that his appetite has been decreasing over past week. two days ago he began to experience abdominal pain, which slowly progressed until last night when it reached an . pain was described as a stabbing sensation in the midline of abdomen, nonradiating. pt denies any fever or chills, nausea, vomitting or change in bowel habits. no dysuria or change in urination frequency. . in , pt was given a paracentesis which did not show infection and u/s of abdomen, which revealed decreased flow in portal system. . on floor pt's vitals were stable, reports that abdominal pain has been improved. . review of sytems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. past medical history: retinoschisis - bullous low back pain lower extremity joint pain alcohol-induced liver cirrhosis. history of tonsillectomy as a child. esophageal varices diagnosed on endoscopy. hepatic encephalopathy. ascites without sbp. social history: worked in an insurance company as a finance researcher (stat cruncher) for 22 years up until 5 years ago when he was fired. became depressed and began drinking. drank off and on often trying to quit, but coming back to it after 2-4 months. denies smoking, no other drugs. he is married with 2 kids, one graduated from college recently and the other is in high school. family history: + father alcoholic, no family h/o liver disease; family history remarkable for diabetes physical exam: on initial presentation: vs - temp 97.3 f, bp 152/88, hr 108, r 14, 100 o2-sat % ra general - well-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 bilat, no r/rh/wh, good air movement, resp unlabored, no accessory muscle use heart - pmi non-displaced, rrr, systolic murmur best heard over rusb no rg, nl s1-s2 abdomen - distended, hepatospenomegaly, slightly tender to palpation midline, no rebound/guarding extremities - wwp, no c/c/ 3+ edema to the thighs, 2+ peripheral pulses (radials, dps) skin - no rashes or lesions jaundiced lymph - no cervical, axillary, or inguinal lad neuro - awake, a&ox3, cns ii-xii grossly intact, muscle strength throughout, sensation grossly intact throughout, dtrs 2+ and symmetric, cerebellar exam intact, steady gait prior to discharge: patient expired pertinent results: admission labs: 11:35am wbc-28.8* rbc-2.85* hgb-10.2* hct-31.0* mcv-109* mch-35.7* mchc-32.9 rdw-17.5* 11:35am neuts-91* bands-0 lymphs-2* monos-4 eos-2 basos-0 atyps-0 metas-0 myelos-1* 11:35am plt smr-normal plt count-242 11:35am pt-16.8* ptt-27.0 inr(pt)-1.5* 11:35am ammonia-67* 11:35am albumin-3.4* 11:35am lipase-50 11:35am alt(sgpt)-83* ast(sgot)-95* alk phos-465* tot bili-7.6* studies: ruq ultrasound: 1. no flow detected within the main, left, and right portal vein which can be due to thrombosis or extremely slow flow. contrast-enhanced ct or mr is recommended for further evaluation. this was discussed by phone with dr. at 4:15 pm, . 2. chronic liver disease with splenomegaly and moderate volume ascites. 3. gallbladder wall thickening likely due to underlying chronic liver disease. no evidence of acute cholecystitis. mri abdomen: 1. the central portal veins are patent with appropriate direction of flow. 2. moderate ascites. 3. nodular liver consistent with cirrhosis. no concerning focal liver lesions. 4. retroperitoneal varices, predominantly infrarenal. ecg: sinus tachycardia. the tracing is marred by baseline artifact. there is prominent voltage in leads i and avl for left ventricular hypertrophy, more prominent as compared to the previous tracing of . the rate has increased. there is diffuse st-t wave flattening. no diagnostic interim change. ct abd/pelvis: 1. diffuse dilation and air-fluid levels of the entire small bowel with no transition point, most consistent with ileus. small bowel measures up to 4.8cm in diameter, likely stable in size when compared to the kub of , given differences in technique. 2. moderate amount of ascites, unchanged in amount since abdominal mri. cirrhotic liver with varices, unchanged. 3. stable l1 vertebral body compression fracture. tte: suboptimal image quality. mild symmetric left ventricular hypertrophy with preserved regional and excellent global biventricular systolic function. mitral regurgitation with normal valve morphology. ugi study/barium swallow: the study was extremely limited due to the patient's immobility. with this limitation in mind, barium was introduced into the esophagus and freed slowly into the stomach. once within the stomach, barium is seen pooling and does not transit any further despite a one-hour wait time. again, this is likely consistent with the patient's known diagnosis of ileus. evidence for distal obstruction was not obtained due to patient's discomfort and the likelihood that the transit of the barium into the small bowel would take many hours. ascites cytology: negative for malignant cells. ruq ultrasound: 1. large volume ascites. 2. no intra- or extra-hepatic biliary dilatation. 3. echogenic liver consistent with fatty infiltration. more serious forms of liver cirrhosis/fibrosis cannot be ruled out on the basis of this study. egd impression: an ng tube and dubboff were indentified going in from the esophagus all the way into the small bowel. large amount of liquid was seen in the 2nd portion that was aspirated with the suction channel. otherwise normal egd to third part of the duodenum sigmoidoscopy mildly dilated colon up to the splenic flexure otherwise normal sigmoidoscopy to splenic flexure brief hospital course: mr. is a 55 year old man with a history of alcoholic cirrhosis diagnosed in complicated by hepatic encephalopathy and hepatorenal syndrome who presented with abdominal pain from an ileus and had a prolonged hospitalization complicated by respiratory distress requiring micu transfer. while in the micu the patients condition continued to decompensate despite supportive care. multiple family meetings took place between micu team and patient's wife. the patient was made dnr/dni and moved to the general medical floor. on the general medical floor, the patient continued to decline with a calculated meld consistently >40 and a rising bilirubin. durring family meeting between floor team and patient's wife, he was made comfort measures only and he was enrolled into an in hospital hospice program. he expired on . #. ileus: mri and ct demonstrated dilated bowel without obstruction. he was treated with reglan, erythromycin, and methylnaltrexone with unclear benefit. he had an ngt to suction and endoscopic decompression was attempted as well. after approximately 2 weeks his ileus resolved and he began passing stools. he was on tpn until resolution of his ileus and then was started on tube feeds. following making the patient comfort measures only on the medical floor, the patient removed his feeding tube and it was determined that the tube should not be replaced. #. leukocytosis: although he never had any definitive source or culture data he was empirically treated with a full course of vanc/meropenem/flagyl completed . multiple diagnostic paracenteses were negative for sbp. cdif toxin was negative on multiple occassions. serial chest x-rays were negative for pneumonia. the patient's white count started to trend upwards again a few days after stopping antibiotics and the patient spiked a fever and therefore he was started again on broad coverage with vanc/meropenem/flagyl . his bps began to fall and his lactate level increased to 6. his lactate level improved after receiving 2 units of prbcs. it is unclear if the benefit was because of increased oxygen delivery or increased intravascular volume. nevertheless he continued to have low blood pressures in the 80s systolic despite colloids and crystalloids. the only culture data that became positive was a urine culture showing 10,000-100,000 colonies of vre. the u/a from the same time was negative for le or nitrite. it was unclear if this was colonization vs true infection as the patient had no symptoms of uti. following the decision to make the patient comfort measures only, his antibiotics were discontinued. #. hypernatremia: likely related to lack of access to free water. this resolved after free water flushes were increased. #. decreased urine output: he had hepatorenal syndrome during his previous hospitalization with creatinine peak of 5.7. during this hospitalization he may have had hrs as well as a component of intravascular volume depletion. he was treated with midodrine and octreotide again throughout this hospitalization. urine lytes showed urine na < 10. creatinine continued to trend upwards despite albumin challenge. #. altered mental status: likely due to hepatic encephalopathy. he was continued on lactulose and rifaximin after his ileus had resolved. see above transition to comfort measures only. #. respiratory distress: he required micu transfer although he did not require intubation. he had substantial improvement after a 9 liter paracentesis on and was then was able to tolerate room air. see above transition to comfort measures only. #. etoh cirhosis: he initially presented with etoh hepatitis. he completed a prednisone taper. see above transition to comfort measures only. #. sinus tachycardia: likely related to intravascular volume depletion in the setting of total body volume overload. he had only minimal response to albumin. see above transition to comfort measures only. # anemia: stable, no evidence of bleed. see above transition to comfort measures only. # goals of care: he and his wife shifted focus to a more comfort-focused approach. pressors were not initiated. medications that are uncomfortable (e.g sc octreotide) were discontinued. however other interventions that make the patient more comfortable were continued. see above transition to comfort measures only. transitional issues:patient expired medications on admission: folic acid - (prescribed by other provider) - 1 mg tablet - 1 tablet(s) by mouth once a day lactulose - (prescribed by other provider) - 10 gram/15 ml solution - 30 ml(s) by mouth twice a day midodrine - (prescribed by other provider) - 5 mg tablet - 1 tablet(s) by mouth two times a day omeprazole - (prescribed by other provider) - 20 mg capsule, delayed release(e.c.) - 1 capsule(s) by mouth twice a day prednisone - (prescribed by other provider) - 30 mg tablet - 1 tablet(s) by mouth once a day rifaximin - (prescribed by other provider) - 550 mg tablet - 1 tablet(s) by mouth twice a day acetaminophen - (prescribed by other provider) - 325 mg tablet - 1 tablet(s) by mouth every six (6) hours as needed for pain cyanocobalamin (vitamin b-12) - (prescribed by other provider) - 100 mcg tablet - 0.5 (one half) tablet(s) by mouth once a day multivitamin - (prescribed by other provider) - tablet - 1 tablet(s) by mouth once a day sennosides - (prescribed by other provider) - 8.6 mg tablet - 1 tablet(s) by mouth once a day thiamine hcl - (prescribed by other provider) - 100 mg tablet - 1 tablet(s) by mouth once a day discharge medications: patient expired discharge disposition: expired discharge diagnosis: alcoholic cirrhosis discharge condition: patient expired discharge instructions: patient expired followup instructions: patient expired procedure: parenteral infusion of concentrated nutritional substances other endoscopy of small intestine enteral infusion of concentrated nutritional substances percutaneous abdominal drainage percutaneous abdominal drainage percutaneous abdominal drainage rigid proctosigmoidoscopy central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified other primary cardiomyopathies thrombocytopenia, unspecified anemia, unspecified acute and subacute necrosis of liver alcoholic cirrhosis of liver acute kidney failure, unspecified hepatorenal syndrome unspecified septicemia severe sepsis candidiasis of other urogenital sites hypopotassemia constipation, unspecified pneumonitis due to inhalation of food or vomitus septic shock paralytic ileus other ascites hypoxemia encounter for palliative care do not resuscitate status hepatic encephalopathy hyperosmolality and/or hypernatremia other and unspecified coagulation defects other and unspecified alcohol dependence, continuous acute alcoholic hepatitis mixed acid-base balance disorder 

Answer: The patient is high likely exposed to