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: sulfa (sulfonamides) attending: chief complaint: ascites major surgical or invasive procedure: paracentesis x 2 unsuccessful tips x 2 hepatic artery arterogram central line placement history of present illness: 63 m with cryptogeneic cirrhoiss with complications of hepatic encephalopathy, varicies, cad, dm 2, who presents with 3-4 weeks of increasing abd girth. he has had 2 prior taps, one with 8 l removed another 3 weeks ago with 6 l removed. three days prior he fell on his back with no loc, some lbp. he denies jaundice, confusion, tremor or change in bowel habits. mild nausea this morning but no vomiting. no f/c/sob/cp. in past, he has had sob when ascites was even greater. no le edema or cough. frustrated by poor medical options given his liver disease and concominant heart disease. came from home for further evaluation and possible tips procedure. of note, his liver disease was found after he had bloody emesis in . ros: no neuro finding, no change in appetite, no wt loss, no gu sxs past medical history: 1. cryptogenic cirrhosis (from dr. note ) liver bx: portal and periportal pmn inflammation grade 2, periportal and portal fibrosis stage 3 liver bx: grad 2 portal and periportal pmn,, mildly predominant macrovasc. statosis and inc in portal and focal periportal fibrosis (stage 2-3) egd: recurrent espoh. varicies, 4 bands placed, portal gastropathy mri: mod cirrhosis with splenomegaly and splenic varicies, perihep/splenic fluid, nonoccl thrombus in med of left portal and ant branches of right protal vein, 4mm arterial ehancement in right liver lobe ct abd: espohageal, gastrohepatic, . varicies, cirrhosis, splenomegaly, min ascites, cholelithiasis, simple right kidney cortical cyst 2. dm 2 with neuropathy 3. sinusitis 4. depression 5. cad: at had positive stress test, cath showed 3 vd, no intervention psh: 1. right knee surgery in 9/00 2. acl repair 3. right cataract surgery in social history: college educated with degree in chemistry. worked as a plant manager for many years, short term jobs since then for 10 yrs, now on full time disability, 3 children, sons 37, 24; daughter 32; married for 37 years to current wife family history: nc physical exam: temp 97 4 bp 100/60 pulse 79 resp 18 o2 sat 100% ra gen - alert, no acute distress, tired heent - perrl, extraocular motions intact, anicteric, mucous membranes moist neck - jvp 7 cm, no cervical lymphadenopathy chest - clear to auscultation bilaterally cv - normal s1/s2, rrr, no murmurs, rubs, or gallops abd - + bs, distanded abd, + fluid wave, nt, uable to feel liver or spleen on exam, marked "x" for tap back - no costovertebral angle tendernes, non tender spine, no ecchymosis extr - no clubbing, cyanosis, trace ankle edema. 2+ dp pulses bilaterally neuro - alert and oriented x 3, cranial nerves intact, upper and lower extremity strength 5/5 bilaterally, sensation grossly intact, no asterixis skin - no rash pertinent results: abd u/s: impression: 1. large amount of abdominal ascites. an appropriate spot was marked on the skin for a paracentesis to be performed by the hepatology service. 2. findings consistent with liver cirrhosis. markedly diminutive main portal vein with demonstration of slow hepatopetal flow. patent hepatic arteries and veins, as discussed above 3. cholelithiasis. * cytology for peritoneal fluid: negative for malignant cells. * echo: the left atrium is mildly dilated. left ventricular wall thickness, cavity size, and systolic function are normal (lvef 60-70%). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic root is moderately dilated. the ascending aorta is moderately dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. * mri abd: 1) cirrhotic liver without focal mass. 2) partial thrombus within the smv and extrahepatic main portal vein with some extension its very proximal portion in the hilum. patent intrahepatic portal venous radicles. features of portal hypertension as described above. gallstones without evidence of cholecystitis or choledocholithiasis. * abd u/s: 1. cirrhosis. 2. large amount of ascites. 3. normal flow in the main and right hepatic arteries. 4. patent but diminutive portal vein with slow hepatopedal flow. the findings are stable from the prior ultrasound and are consistent with recent mri findings of nonocclusive portal vein thrombus. * peritoneal fluid anlaysis: 09:13am ascites totpro-1.7 glucose-137 creat-0.9 ld(ldh)-76 amylase-16 totbili-0.3 albumin-<1.0 triglyc-75 10:30am ascites triglyc-74 09:13am ascites wbc-112* rbc-1370* polys-1* lymphs-79* monos-18* mesothe-2* 11:44am ascites wbc-133* rbc-* polys-5* lymphs-67* monos-22* eos-1* mesothe-2* macroph-2* other-1* * urine cx and peritoneal fluid cx pending at time of summary * labs: 11:10am pt-14.9* inr(pt)-1.4 11:10am plt count-116* 11:10am anisocyt-1+ microcyt-1+ 11:10am neuts-70.9* lymphs-17.0* monos-8.5 eos-3.0 basos-0.5 11:10am wbc-4.1 rbc-4.15* hgb-12.3* hct-35.0* mcv-84 mch-29.6 mchc-35.0 rdw-16.3* 11:10am afp-2.9 11:10am albumin-3.2* calcium-8.3* 11:10am alt(sgpt)-15 ast(sgot)-29 alk phos-130* tot bili-0.7 11:10am urea n-21* creat-1.1 sodium-133 potassium-4.7 chloride-102 total co2-24 anion gap-12 11:10am glucose-200* 06:25am blood wbc-3.8* rbc-3.76* hgb-10.9* hct-31.6* mcv-84 mch-28.9 mchc-34.3 rdw-16.7* plt ct-104* 06:25am blood plt ct-104* 06:25am blood glucose-72 urean-19 creat-1.0 na-136 k-3.7 cl-107 hco3-23 angap-10 06:25am blood alt-17 ast-29 alkphos-143* totbili-0.8 06:25am blood calcium-8.3* phos-3.1 mg-1.9 05:55am blood triglyc-143 11:10am blood afp-2.9 brief hospital course: a and p/ 63 m with crytpogeneic liver disease with multiple complications in the past, who has recurrent ascites, and unfortunately due to his 3 vd cad and several thromboses, he is not a transplant candidate. 1. liver disease: pt arrived and was tapped on hd 2 with 8 l fluid removed with albumin replacement. studies were sent which were negative for cytology, micro, and cell ct did not suggest sbp. an mri abd showed multiple portal vein clots with some flow. the study was reviewed with ir and it was determined a tips could be attempted. after several days, a tips was attemepted under geta with anaesthesia consult given pts 3 vd cad; the pt was consented tolerated the procedure well however the tips was not sucessfully completed. a venogram was obtained which showed no bleeding. pt had no residual hematoma or complications from femoral vessels being accessed. liver team and ir reviewed the films again and it decdied that a second attempt at tips would be tried a day later with a different approach. dr. , ir attending tried to perform the procedure under geta, however was unsuccessful. the hepatic artery was punctured, a stent placed, and angiogram did not show any bleeding. he was trasnferred to the micu for o/n observation throughout which he was stable. he was then trasnferred to the floor day prior to d/c. day of d/c a large volume paracentesis was performed (8 l), studies sent, and 50 gm albumin infused post procedure. a pressure dressing applied to site for possible leakage as a large incision was needed to access the fluid. lfts and bilibrubin remain stable throughout his stay. he was maintained on flagyl, lactulose. he will have liver clinic follow up in weeks for repeat tap. he was also evaluated by surgery for possible portocaval shunt, however this option was no elected at this time as it would not be the safest for him. he was d/c'd home on lasix and spironolactone. 2. cad: stable at present. 3 vd prvents pt from having a liver transplant. zetia continued, held for tips and then restarted per ir. 3. dm 2: controlled on nph and ss insulin, fs qid, diabetic diet. nph doses were reduced when pt was npo. 4. depression: effexor and provigil continued. sw consulted for support and coping. pt was often sad and frustrated by his course of care, patient advocate alos involved. 5. back pain: to fall priro to admission. no neuro defects. tramadol prn. 6. full code 7. dispo: pt was sent home with liver clinic follow up. he was advised against any long distance travel. d/cd with vna at home with instructions. 8. tips complication: 2nd tips attempt complicated by artery puntcutre which was deemed stable. ir dr secretary to call pt about f/u us and appt with dr in clinic. medications on admission: effexor 75 mg qd/37.5 mg prn, flagyl 250 mg , ambien 10 mg , , zetia 10 mg qd, provigel 100 mg qd, prevacid 30 mg , lactulose 60 cc qd, nph 46 u qam/44 u qhs, ss humalog; aldactone and lasix d/c () discharge medications: 1. venlafaxine hcl 75 mg capsule, sust. release 24hr sig: one (1) capsule, sust. release 24hr po daily (daily). 2. metronidazole 250 mg tablet sig: one (1) tablet po bid (2 times a day). 3. zolpidem tartrate 5 mg tablet sig: two (2) tablet po hs (at bedtime). 4. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 5. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 6. lansoprazole 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 7. lactulose 10 g/15 ml syrup sig: sixty (60) ml po daily (daily). 8. modafinil 100 mg tablet sig: one (1) tablet po qd (). 9. gabapentin 100 mg capsule sig: one (1) capsule po bid (2 times a day). 10. propranolol hcl 20 mg tablet sig: one (1) tablet po bid (2 times a day). 11. tramadol hcl 50 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 12. modafinil 100 mg tablet sig: one (1) tablet po qd (). 13. spironolactone 50 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 14. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: discharge diagnosis: 1. ascites 2. coronary artery disease 3. diabetes 4. depression 5. back pain discharge condition: good discharge instructions: if you have chest pain, shortness of breath, fevers/chills, increasing wt/ascities, please call your pcp or come to the ed. 1. take all meds 2. daily wts 3. low na diet 4. attend f/u appointments 5. per ir fellow dr , can restart followup instructions: please call your pcp for /u in 1 week liver clinic: please call to book a f/u appt in early . radiology: you will be contact by staff to set up a f/u us and visit. procedure: venous catheterization, not elsewhere classified percutaneous abdominal drainage arteriography of other intra-abdominal arteries insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) transfusion of packed cells diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery cirrhosis of liver without mention of alcohol portal hypertension diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes accidental puncture or laceration during a procedure, not elsewhere classified esophageal varices in diseases classified elsewhere, without mention of bleeding portal vein thrombosis 

Answer: The patient is high likely exposed to