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: splenectomy picc placement history of present illness: 42 yo male inmate who presents with luq/llq abdominal pain on transfer from hospital with scan showing ungraded splenic laceration. he is s/p unspecified abdominal trauma to left side during "running game" in the prison yard two days ago (). hct at 29. past medical history: type ii dm (diet controlled) cirrhosis, hepatitis c family history: noncontributory physical exam: exam on admission: tc 100.7 hr 84 bp 143/64 rr 22 sats 100% ra gen: wdwn m in nad heent: perrla cv: rrr, no murmurs, rubs or gallops resp: ctab gi/abd: soft, slightly distended ext: no cyanosis, clubbing or edema exam on discharge: gen: wd, thin m w/ no movement heent: icteric sclera, pupils fixed at 6mm, nonreactive, blood dripping from nose, excoriated lips with dried blood present cv: no rhythm, no radial pulses, no brachial pulse, no carotid pulse resp: no respirations, no breath sounds, no respiratory effort skin: grossly jaundiced pertinent results: 07:50pm glucose-96 urea n-8 creat-0.8 sodium-136 potassium-4.1 chloride-104 total co2-23 anion gap-13 07:50pm ast(sgot)-129* 07:50pm wbc-5.9 rbc-3.00* hgb-9.3* hct-29.2* mcv-97 mch-30.8 mchc-31.7 rdw-13.4 07:50pm plt smr-very low plt count-81* cta abd: there is mild dependent atelectasis, (left greater than right). a left pleural effusion is minute. a hiatal hernia is small. there is a complex splenic laceration, which traverses the spleen at multiple sites. there are also multiple sites of devascularized parenchyma, which comprise less than 25% of the total splenic volume. in the arterial phase of enhancement, there is an 8-mm contrast collection in the parenchyma, which is contiguous with a splenic artery branch in the hilum (3a, 39). there is a second 3- mm focus in the anterior superior spleen (3a, 25), which is surrounded by more ill defined high attenuation in the arterial phase. these focal collections are suggestive of pseudoaneurysms, as they do not increase in size and in fact become less conspicuous on delayed phases. the hyperattenuation surrounding the smaller focus is suggestive of active contrast extravasation. the spleen is enlarged at 16.2 cm. there is a heterogeneously hyperattenuating capsular hematoma, which measures 33 mm in thickness. there is moderate hemoperitoneum, particularly in the pelvis. the liver, pancreas, adrenal glands, and kidneys are within normal limits. there are multiple mildly enlarged periportal, portacaval, celiac and retroperitoneal nodes, which measure up to 13 mm in short axis and may be reactive. gallstones are present. there is no bowel dilatation or free intraperitoneal air. the osseous structures are intact. impression: 1. complex splenic laceration (grade iii/iv) with two pseudoaneurysms, the smaller of which appears to be associated with active extravasation. there is a moderate splenic capsular hematoma and associated hemoperitoneum. liver biopsy: 1. advanced fibrosis with bridging, sinusoidal fibrosis and multifocal early nodule formation, suspicious for evolving cirrhosis (stage 3-4, confirmed by trichrome stain). 2. mild-to-moderate portal septal, mild periportal and lobular predominantly mononuclear cell inflammation (grade 2). 3. mild cholestasis. 4. no significant steatosis or intracellular hyalin seen. 5. iron stain shows mild focal iron deposition in hepatocytes and kupffer cells. note: the findings are consistent with chronic viral hepatitis, clinically hcv. the sinusoidal fibrosis is suggestive of a component of prior toxic/metabolic injury. ct head: normal head ct without evidence of brain edema abd us: the liver shows no focal or textural abnormalities. the gallbladder contains sludge and shows wall edema. no intra or extrahepatic biliary dilatation is appreciated. the common duct measures 4 mm. the portal vein is patent with hepatopetal flow. small amount of ascites is present. the pancreas is poorly visualized. the patient is status post splenectomy. ct abd/pelvis: status post splenectomy with small amount of fluid remaining in the abdomen, but no evidence of abscess or recurrence of hematoma. new bibasilar pulmonary parenchymal opacities could reflect pulmonary edema/ards, aspiration or pneumonia. correlation is recommended. diffuse mild dilation of small bowel, most likely representing ileus. decreased size of a small rim-enhancing collection in the right lower quadrant, which could reflect appendiceal pathology including improving tip appendicitis. however, there is a question of coloenteric fistula and therefore repeat ct with contrast is recommended when symptoms have resolved. abd us: no significant interval change in the appearance of gallbladder. although these findings may be related to hypoalbuminemia and prolonged npo status, acute cholecystitis cannot be excluded. right pleural effusion. brief hospital course: he was admitted to the trauma service on . he was taken to the trauma icu for close monitoring. his hematocrit was followed closely; he continued to have left shoulder pain and tachycardia; concerning for hemorrhage. he was taken to the operating room for splenectomy on . there were no intraoperative complications. postoperatively his tachycardia persisted; he also had a low urinary output. he was given intravenous fluid bolus with increased urine output. he required supplemental oxygen because of low oxygen saturations; incentive spirometer use was strongly encouraged. on post operative day 1 () he was transfused 1 unit prbc and transferred to the floor. on he was again transfused for a low hematocrit. on post op day 3, he developed increasing somnolence and he was started on lactulose, his narcotics were discontinued and hepatology was consulted. an ammonia level was 71 and he continued to have low urine output. he was started on rifaximin and albumin. on his mental status worsened, he had vomiting and his abdominal wound dehisced with an ascitic leak. he was transferred back to the trauma icu for further care. he was started on tube feeds for nutrition. a vac dressing was placed in the abdominal wound. he was intubated for worsening mental status and airway protection on . 1 of 2 blood cultures drawn on returned as positive for vancomycin sensitive enterococcus and he was started on vancomycin and zosyn on , which was continued for 10 days. he had a normal head ct and a ruq ultrasound which showed a sludge filled gallbladder and no stones. he continued to have an ascitic leak, and his bloodwork results were followed closely for increasing bilirubin, creatinine peak of 2.4, moderately increased lfts and pancreatic enzymes, elevated inr (peak of 1.9) and increased ammonia levels. he was extubated on and his mental status improved. his bilirubin remained elevated, his ammonia level decreased and his creatinine returned to baseline. he was awake and alert and was able to be transferred to the floor on and was started on a regular diet on . he continued to have an ascitic leak and his vac was changed every 3 days on the floor. his inr and bilirubin continued to increase. in discussions with mds regarding his overall poor prognosis, he clarified that he still preferred aggressive treatment unless he was dying of irreversible liver failure. psychiatry evaluated him and determined that he was currently competent to make this decision despite any underlying encephalopathic process. he was evaluated and treated by physical therapy. a repeat ct abdomen on showed slight increase in the free fluid in the pelvis, decreased left subphrenic collection and improvement in the bibasilar aspiration and pneumonia of the lung fields. a chest xray on showed marked improvement in widespread pulmonary opacities with no definite new abnormalities to suggest acute pneumonia. mr. was made dnr/dni per dr. on . on the evening of the patient had blood pressures that dropped into the 80s/50s while resting in a chair. he was found to have electrolytes that were very irregular on the evening of . mr. started to have agonal breathing later that evening, and started bleeding persistently from his nose and mouth. on the morning of the patient appeared in distress with agonal, noisy wet sounding breaths. the patient was made cmo by dr. on . mr. died secondary to respiratory failure on at 1:09pm. neuro: the patient was started on a narcotic pain regimen upon admission to the trauma service. he was weaned off of the narcotics on . his mental status was noted to be worsened on . between the dates of and , his mental status has waxed and waned persistently. on his mental status deteriorated profoundly to the point where the patient was nonverbal and only moved his head in response to other people's voices. on the patient became unresponsive to others in the room. he was put on a morphine drip which was titrated for comfort. heent: the patient had intermittent nose bleeds during his hospitalization. an ent consult was placed on for persistent nose bleeds. absorbable packing was placed intranasally which controlled the bleeding for some time. on ent was reconsulted because the patient started bleeding from the nose again and the bleeding vessel was identified and cauterized. nonabsorbable packing was placed intranasally and antibiotics were started at that time. his packing was removed 5 days later and he did not have another nose bleed at that time. cv: the patient had no problems with his cardiovascular status during his hospitalization. resp: the patient had low oxygen saturations postoperatively. he was extubated on . he was weaned off of supplemental oxygen when he was transferred to the floor on . he developed agonal breathing on due to his worsening encephalopathy and persistent, uncontrolled bleeding. gi: the patient was started on lansoprazole on for gi prophylaxis. he was also started on lactulose for his chronic hepatic failure. on admission his liver function panel had some slightly elevated values. his alt was 89 , ast 175, t bili 3.1 d bili 1.8 alb 2.4. his liver function panel on had an ast 342, alt 140, t bili 28 d bili 15.4. a hepatology consult was called on and it was suggested that he be started on rifamixin. on hepatology agreed with continuing his rifamixin and albumin replacement for wound vac losses. gu: the patient had no problems with this system during his hospitalization. fen: the patient was started on a regular diet on . he was tolerating a regular diet until when he started having less of an appetite. mr. electrolytes were monitored every third day showing a persistent hyponatremia starting on . his bun had a bimodal distribution of elevation first peaking at 45 on and then peaking again at 97 on . his potassium peaked at 5.5 on but then returned to only to peak again on to 7.0. his creatinine initially peaked at 2.4 on and then returned to levels until he peaked on to 6.9. heme: mr. admitting coagulation profile was pt 14.7 inr 1.3 ptt 31.3. his admitting hematocrit was 29.2 and platelets were 81. postoperatively, the patient received 2units of packed red blood cells for a hematocrit of 23.9. on , he received a unit of ffp and a unit of packed red blood cells. his last hematocrit on was 27.1. id: the patient had positive blood cultures on for vancomycin sensitive enterococcus. he also had a positive sputum culture on which grew haemophilus influenza. he was started on vancomycin and zosyn on for the positive cultures. the antibiotics were stopped on . mr. was started on augmentin on for prophylaxis against gram positive microbes while he had nasal packing in place. it was discontinued on . the patient had a history of viral hepatitis. discharge disposition: expired discharge diagnosis: s/p assault grade iii/iv splenic laceartion s/p splenectomy hepatic encephalopathy respiratory failure multi organ system failure chronic hepatitis c discharge condition: deceased followup instructions: n/a procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances closed (percutaneous) [needle] biopsy of liver total splenectomy transfusion of packed cells transfusion of other serum computerized axial tomography of head control of epistaxis by anterior nasal packing other immobilization, pressure, and attention to wound control of epistaxis by cauterization (and packing) diagnostic ultrasound of abdomen and retroperitoneum diagnoses: cirrhosis of liver without mention of alcohol diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia portal hypertension cardiac complications, not elsewhere classified acute respiratory failure pneumonitis due to inhalation of food or vomitus pressure ulcer, lower back other sequelae of chronic liver disease streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, group d [enterococcus] unarmed fight or brawl accidents occurring in residential institution other and unspecified coagulation defects tachycardia, unspecified epistaxis oliguria and anuria disruption of external operation (surgical) wound injury to other intra-abdominal organs without mention of open wound into cavity, peritoneum hemophilus influenzae [h. influenzae] infection in conditions classified elsewhere and of unspecified site unspecified viral hepatitis c with hepatic coma injury to spleen with open wound into cavity, laceration extending into parenchyma 

Answer: The patient is high likely exposed to