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: glipizide attending: chief complaint: hypotension major surgical or invasive procedure: central line placement intubation transjugular liver biopsy history of present illness: 44 yo male with hcv (vl 37,000), hiv (cd4 of 284, vl<50), previously on liver transplant list, dm2, esld, secondary polycythemia, and hepatopulmonary syndrome who presented initially with fevers/chills to 103.5. patient states that in the last two weeks, he had myalgias, rhinorrhea, and fatigue, as well as low grade fevers. over the course of the last day, he developed acute worsening of his symptoms, with associated abdominal bloating, abdominal pain, profuse diarrhea and emesis, as well as high fevers to 103-104. patient states that he had a less severe episode last year, which resolved with outpatient antibiotics. patient denies neck stiffness, headache, photophobia, chest pain except in the context of anxiety, trouble breathing, sputum production, hemoptysis, hematuria, dysuria, or blood in stool. . at osh, patient was noted to have 26% bandemia. in the ed, patient complained of ruq tenderness, and had bedside ultrasound which showed gallstones. patient with sbps 79/42 with hr of 103, o2 sats in 88 on ra, 93% 4l. patient had lsc placed and code sepsis was initiation. patient was given levo, flagyl and ceftazidime and placed on a levophed gtt. patient also had arterial line placed, and lp performed. past medical history: 1. chronic hepatitis c genotype 1, biopsy proven cirrhosis () s/p interferon and ribavarin therapy for 48 weeks (). initially with svr then with relapse after months. hcv vl 502,000 . - followed by dr. , recently off the transplant list (since ) due to concurrent marihuana use, unresolved medical problems. 2. hiv (dx ) last cd4 = 284 () viral load = < 50 () no history of oi. - followed by dr. 3. dm (dx ) thought due to pegifn. did not tolerate oral hypoglycemics, on insulin. - dr. 4. hypothryoidism 5. grade i varices and portal gastropathy 6. cholestatic jaundice thought to be due to glipizide 7. hepatitis b with undetectable vl. 8. hyperthyroidism, briefly on ptu-thought to be due to pegifn 9. hypoxemia/home o2 - followed by dr. - hepatopulmonary syndrome, parenchymal lung disease related to his smoking, or an intracardiac shunt. on 2l nc at home 10. mild pulmonary htn on echo 11. recent pfts - subtle obstructive defect and a mild reduction in his diffusing capacity 12. bubble echo - showed delayed bubble entry into /w pulmonary shunt. 13. marihuana use - due to anxiety and poor appetite per patient 14. secondary polycythemia - followed by dr. , elevated epo, elevated iron, ferritin - ? due to hepatoma vs renal cell ca. 15. l cheek swelling - ? due to parotid gland obstruction/infection. social history: moved to the u.s. from at age 12. lives in with his brother. spends time in with his partner. a sixty pack year smoking hx but quit. heavy alcohol use x 20 years but now sober. currently uses marijuana only. no hx ivdu. family history: he a brother with hepatitis c, died of liver cancer. physical exam: vs: 101.3 bp 112/65 hr 92 rr 22 o2sat 95% on face tent gen: ill appearing heent: scleral icterus. no parotid gland swelling. neck: supple hrt: rrr. no mrg lungs: ctab no rrw. abd: distended. nontender. normoactive bowel sounds. no guarding. guaiac negative per ed. ext: wwp. no edema. neuro: no asterixis. alert and oriented x 3. cn2-12 intact. strength. dtrs intact. pertinent results: aerobic bottle (final ): reported by phone to vare 4i 1:25p. vibrio species. strain 1. probable vibrio vulnificus. cefotaxime = <=8 mcg/ml, tetracycline = <=4 mcg/ml , levofloxacin = <=2 mcg/ml, ceftazidime = <=2 mcg/ml, ceftriaxone = <=4 mcg/ml. sensitivity testing performed by microscan. vibrio species. strain 2. probable vibrio vulnificus. cefotaxime = <=8 mcg/ml, tetracycline = <=4 mcg/ml , levofloxacin = <=2mcg/ml, ceftazidime = <=2mcg/ml , ceftriaxone = <=4 mcg/ml. sensitivity testing performed by microscan. anaerobic bottle (final ): vibrio species. of two colonial morphologies. sensitivities performed from aerobic bottle. probable vibrio vulnificus. . ekg: nsr. cxr 5/15a: low lung volumes with mild bibasilar atelectasis. no pneumonia or chf. . abdominal ultrasound : comparison: . findings: nodular hepatic contour and coarsened echotexture is again consistent with cirrhosis. perihepatic ascites is noted with extension of fluid into the gallbladder bed. previously noted lesion within the left lobe of the liver is not evaluated on this limited bedside evaluation. no stones are identified within the gallbladder with mild-to-moderate gallbladder wall thickening, likely secondary to underlying cirrhosis. no intra- or extra- hepatic ductal dilatation is seen. the aorta is of normal caliber. the right kidney measures 10.5 cm. the left kidney measures 12.0 cm. no focal renal lesion nor hydronephrosis seen. previously identified left renal cyst is not identified today. splenomegaly with varices at the splenic hilum again seen. the main portal vein, its branches, and the hepatic vein and its branches, and the hepatic artery and its branches are patent with appropriate directionality of flow. mild slowing of flow within the hepatic veins is suggestin, but unchanged. impression: 1. cirrhosis with ascites. focal hepatic lesion not evaluated today. 2. splenomegaly with splenic varices. 3. patent hepatic vessels. . cxr 5/15b: no acute change from above. 141 113 10 / 104 agap=13 ------------ 2.9 18 0.8 \ ca: 7.4 mg: 1.6 p: 1.8 alt: 40 ap: 131 tbili: 4.2 alb: 3.0 ast: 57 : 125 cortsol: 28.1 crp: 11.8 pt: 16.1 ptt: 36.0 inr: 1.5 111 7.9 \ 14.9 / 61 ------ 43.9 n:73.6 band:18.9 l:0 m:0 e:0 bas:0 metas: 1.9 myelos: 0.9 nrbc: 1 other: 4.7 . echo : the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. . cxr : in comparison to the prior day study, the position of both the endotracheal and nasogastric tubes been optimized and both tubes are now in satisfactory position. otherwise, no new support tubes or lines have been introduced. there been a redistribution of the diffuse interstitial and alveolar edema-like pattern. there is marked improvement in the right perihilar region and decrease in the edema of the right lower lobe. there however been increased density of the large opacity of the left lower lung and worsening edema in the left upper lung as well. no definite effusions are noted, there is no pneumothorax. impression: as above, there been a redistribution of the edema in this ards pattern. endotracheal and nasogastric tube positions have been optimized. specimen submitted: liver. procedure date tissue received report date diagnosed by dr. /cma?????? previous biopsies: antrum biopsy (1 jar). liver bx rt ear lobe. liver biopsy/da. ************this report contains an addendum*********** diagnosis: liver, needle core biopsy: 1. established cirrhosis. 2. marked canalicular cholestasis, with no ductular features. 3. minimal lobular inflammation, and mild septal predominantly mononuclear inflammation. 4. trichrome stain focal minimal sinusoidal fibrosis. 5. iron stain shows mild to moderate increase in kupffer cells and hepatocytes seen on special stains. addendum: no micro-organisms seen on pas, gms, or afb special stains. addendum added by: dr. /cma?????? date: clinical: hepatitis b/hepatitis c. cirrhosis, hiv with hyperbilirubinemia. gross: received in one formalin container labeled with the patient's name, " ", and the medical record number, are multiple cores measuring up to 0.3 cm, entirely submitted in cassette a. please note, please do an iron, trichrome and four additional cuts up front in case any additional stains are needed. brief hospital course: mr. is a 44 y.o. m with hcv, esld, not currently on transplant list, hiv (cd4 284, vl<50 who presented with fevers/chills, bandemia, hypotension consistent with sepsis from vibrio vulnificus infection. . # micu course - vibrio vulnificus isolated from blood cultures, source thought to be gastroenteritis likely acquired from eating raw oysters two days before becoming ill. broad spectrum antibiotics initiated, narrowed to with ceftazidime and doxycycline. received fluid resuscitation through central line and started on levophed and vasopressin. paracentesis and lp negative for other sources of infection. blood, stool, and urine cultures were sent, and an initial cxr and abdominal ultrasound was performed as well. also started on insulin gtt for tight glycemic control. followed by both the hepatology and infectious disease services. after cultures cleared and patient stabilized, extubated and off pressors, he was transferred to liver service for further management. . # hypoxemic respiratory failure. history of hepatopulmonary syndrome with home oxygen dependence. also intubated during hemodynamic instability and developed ards in setting of sepsis, which subsequently resolved. esophageal balloon was used to measure intrathoracic pressures, and ventilatory setting adjusted accordingly he was kept supine given his hepatopulmonary syndrome. echo did not show evidence of left sided failure, he had a normal bnp and his ekg showed normal sinus rhythm. he was aggressively diuresed with a lasix drip. he was slowly able to be weaned off venitilator and extubated on . after extubation continued to need oxygen supplementation. . # cirrhosis - hyperbilirubinemia presumed secondary to cephalosporin and doxycycline, and poor hepatic functional reserve. transjugular liver biopsy revealed cholestasis but no other new changes. bilirubin was trending down prior to discharge and will need to be followed as an outpatient. diagnostic paracentesis in micu was not revealing. 3 liter therapeutic paracentesis performed on liver service, also without infection. . # hiv - cd4 248 and vl <50 in . antiretrovirals held due to acute illness and hyperbilirubinemia. will be restarted by id as an outpatient once hyperbilirubinemia resolved. . #. l cheek parotiditis - transient and resolved. no further workup besides imaging. . #. diabetes mellitus - lantus titrated up to 50 units prior to discharge based on requirements. . # leukocytosis - presumed secondary to c. difficile infection given antibiotic courses. resolved with empiric metronidazole, which patient was discharged on, to complete a 14 day course. . #. prophylaxis - pneumoboots for dvt. ppi. . # diet: nutrition consulted. initially recommended supplemental feeding, but patient's po intake imroved after therapeutic paracentesis. . #. communication. given multiple family members involved in care, have designed nephew as point of contact. cell phone number is . medications on admission: atripla qd efavirenz, emtricitabine, tenofivir) humalog sliding scale lantus 20 u qhs oxycodone 5mg :prn lactulose 30 mg tid - not filled prescription sonata prn discharge medications: 1. artificial tear with lanolin 0.1-0.1 % ointment sig: one (1) appl ophthalmic prn (as needed). 2. bisacodyl 10 mg suppository sig: one (1) suppository rectal hs (at bedtime) as needed for constipation. disp:*30 suppository(s)* refills:*0* 3. lactulose 10 g/15 ml syrup sig: thirty (30) ml po bid (2 times a day). disp:*1800 ml(s)* refills:*2* 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 5. ciprofloxacin 750 mg tablet sig: one (1) tablet po qsunday. disp:*5 tablet(s)* refills:*2* 6. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 7 days. disp:*21 tablet(s)* refills:*0* 7. insulin regular human 100 unit/ml solution sig: per sliding scale injection qachs. disp:*2 vials* refills:*2* 8. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. cyanocobalamin 100 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 11. spironolactone 25 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 12. insulin glargine 100 unit/ml solution sig: forty five (45) units subcutaneous at bedtime. disp:*2 vials* refills:*2* discharge disposition: home with service facility: , discharge diagnosis: c. difficile colitis v. vulnificus sepsis acute respiratory distress syndrome secondary diagnoses: cirrhosis hepatitis c hiv esophageal varices hypothyroidism hepatitis b diabetes hepatopulmonary syndrome pulmonary hypertension discharge condition: vital signs table, tolerating oral diet, ambulatory. discharge instructions: you were admitted for bloodstream infection. you were admitted to the icu and received antibiotics intravenously. you were also found to have an infection of your colon. please continue to take the prescribed antibiotics for the full course. followup instructions: you have the following appointments scheduled: with dr. in the liver clinic on thursday, at 10:40 am. please call with any questions or to change your appointment. with dr. in the clinic on at 10:00 am in order to discuss restarting your hiv medications. please call with any questions or to change your appointment. 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 insertion of endotracheal tube enteral infusion of concentrated nutritional substances closed (percutaneous) [needle] biopsy of liver percutaneous abdominal drainage percutaneous abdominal drainage non-invasive mechanical ventilation closed [endoscopic] biopsy of bronchus diagnoses: cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute and subacute necrosis of liver acquired coagulation factor deficiency severe sepsis unspecified acquired hypothyroidism other chronic pulmonary heart diseases acute respiratory failure long-term (current) use of insulin intestinal infection due to clostridium difficile other specified disorders of biliary tract septicemia due to anaerobes esophageal varices in diseases classified elsewhere, without mention of bleeding chronic viral hepatitis b without mention of hepatic coma without mention of hepatitis delta asymptomatic human immunodeficiency virus [hiv] infection status polycythemia, secondary acute edema of lung, unspecified other suppurative peritonitis cannabis abuse, unspecified sialoadenitis food poisoning due to vibrio vulnificus 

Answer: The patient is high likely exposed to