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: aspirin attending: chief complaint: admit for elective portal venogram/thrombectomy and attempted tips procedure. major surgical or invasive procedure: transcutaneous intrahepatic porto-systemic shunt placement 1) portal venogram 2) attempted tips procedure history of present illness: 57 y/o m with hx etoh cirrhosis, portal hypertension and gastroesophageal varices who presents for evaluation of portal vein thrombectomy or tips placement. the patient has had a 14-15 yr history of liver disease in the setting of heavy drinking (8-9 beers daily) since teenage. he has been completely abstinent of etoh since his diagnosis (14-15 years). he has had a 5 yr hx of ascites, and reports recent acceleration of ascites accumulation, with sob being a prominent symptom of the accumulated ascites. his sob resolves upon a therapeutic paracentesis; most recent paracentesis performed at removed 4l fluid. on ct his known main portal vein thrombus x 10 years was found to have extended into l portal and splenic veins. he also has gastroesophageal varices with hx of bleeding which presented as dehydration and lightheadedness with no melena/hematochezia/hematemesis; last major bleed in with icu admission but no recent bleeding episodes, last banded by dr. () summer . ros: denies any jaundice, confusion or mental status changes, myoclonus, melena, hematochezia, hematemesis, dysuria, hematuria. reports one episode of emesis and lightheadedness this morning due to "anxiety" before leaving for the hospital. past medical history: 1. cirrhosis, etoh related. 2. portal hypertension gastropathy with gastroesophageal varices. 3. question acute renal failure with previous admission. 4. borderline diabetes mellitus 2, diet control only. 5. hypertension, on medication. 6. silent mi discovered on chemical stress test at 7. rheumatoid arthritis, previously on remicade stopped 1 month ago 8. c. diff enterocolitis. 9. chronic anemia. 10. anxiety. 11. bipolar disorder. 12. asthma. past surgical history: 1. orif, left femur 9/. 2. total hip replacement bilaterally. 3. total knee replacement bilaterally, , . social history: patient states that he quit smoking approximately seven weeks ago, previously 3ppd hx for 45 years. he denies any alcohol for the past 14 years. he also denies any recreational drug use. physical exam: exam on initial admission post-portal venogram, : vs: t 98.9, bp 106/74, hr 79, rr 16, o2 sat 100% ra. gen: pleasant, talkative middle-aged male lying in bed in nad without tachypnea. neuro: a+o x 3, appropriate, no asterixis or confusion. skin: spider angiomata on face, erythematous scaly lesions on scalp, no jaundice, no palmar erythema. heent: perrl (4->3mm bilat), eomi, sclerae anicteric. mmm, op clear, tongue midline. neck: supple, no jvd. cv: rrr, no m/r/g. pulm: fine end-inspiratory crackles lll, otherwise clear. abd: distended with caput medusae, somewhat tense, +bs, +splenomegaly, 3x ir entry sites on r flank clean and dry. ext: no edema, poor perfusion in feet but +dopplers bilaterally in pacu. exam on icu admission: gen: intubated, sedated skin: spider angiomata on face, erythematous scaly lesions on scalp, no jaundice, no palmar erythema. heent: sclerae anicteric. mmm, op clear, et tube inplace neck: supple, no jvd. cv: rrr, no m/r/g. pulm: upper airway sounds abd: distended with caput medusae, soft +bs, +splenomegaly, 3x ir entry sites on r flank clean and dry. ext: no edema, palp pulses pertinent results: labs: : 139 | 101 | 28 ---------------< 153 3.9 | 34 | 1.3 8.7 4.5 >-----< 83 25.9 pt 14.1, ptt 21.9, inr 2.1 albumin 3.2, ca 8.6 phos 3.6 mg 2.1 lab results post tips, : 139 | 106 | 27 ---------------< 167 4.1 | 27 | 1.1 10.8 9.1 >-----< 115 30.3 pt 13.6, ptt 22.4, inr 1.2 retic count 1.6%, fibrinogen 487 portal venogram prelim report: portal venogram demonstrated the portal vein was completely occluded with a collateral vein connecting the splenic vein to the right and the left portal veins. this collateral vein is in good size and with no pressure gradient drop from the splenic vein to the collateral and further to the left and right portal veins. no clots were visualized inside the collateral vein a highpressure was measured inside the collateral vein, which was 36mmhg. a tips procedure should be evaluated for the patient. tips procedure preliminary provisional report: 1. unsuccessful tips procedure. the patient's systolic blood pressure dropped into the mid 70s and due to two capsular perforations and this being an elective case, the procedure was terminated. 2. 3 liters of bloody ascites fluid removed. abd/pelvis ct: 1. ascites, slightly increased in comparison to , with contrast layering dependently related to attempted tips placement. 2. no active extravasation seen on post-contrast imaging. 3. unchanged cirrhosis and portal hypertension. 4. extrahepatic and probable intrahepatic locules of gas associated with the posterior segment of the right lobe of the liver. 5. splenic, superior mesenteric and portal venous thrombosis is better evaluated on the previous ct. brief hospital course: 57 y/o m with hx etoh cirrhosis, portal hypertension and gastroesophageal varices s/p portal venogram with unsuccessful thrombectomy , s/p attempted tips complicated by bleeding and hypotension . . patient was initially admitted after elective portal venogram and evaluation for thrombectomy of portal vein thrombus on . this was unsuccessful, however, 1.7l ascites was removed. patient was then admitted for observation awaiting elective tips eval and procedure on . . on , his hematocrit was found to drop from a preop baseline of 30 to a low of 22; he remained asymptomatic without lightheadedness, tachycardia or significant hypotension. he then received 2u prbcs pm, which increased his hct to 29-30 the next day. . on , he was taken by interventional radiology for a elective tips eval/placement. for detailed report by ir see pertinent results. roughly 3 l of bloody ascites was removed prior to the procedure. briefly, during the procedure contrast was observed to extravasate along the track/tract made during the prior procedure on ; up to 5 passes were made in an attempt to place tips device, but this was complicated by repeated bouts of hypotension to sbp of 90s and finally 70s. at this point the procedure was aborted; the patient was started on a low continuous dose of neosynephrine and transferred to the micu for observation and management. surgery was consulted. ct did not show evidence of a active bleed around the liver or in the abdomen. . per the ir team notes online, contrast injection revealed extrahepatic pooling lateral to liver likely from transhepatic access. in addition, the ir team speculates that there is likely a second capsular perforation inferiorly from one of today's passes. ra pressure were noted to be 16 mmhg without an ivc gradient. micu course: : the patient developed sbps to the 70s during failed tips procedure. he was given 2 units of prbcs prior during the procedure and in the pacu, intubated, and placed on neosynephrine. after intubation and on proprofol drip, sbps were in 100s on low dose neo. in the icu, propofol/neo were weaned. antihypertensives and diuretics were held and hematocrit was monitored closely. his hct stabilized at 30, and remained stable throughout hd2. as propofol was weaned, the patient awoke and self-extubated overnight. his respiratory status was stable throughout the day post-extubation. his pressures improved overnight in the icu and were stable with sbps 110-120s upon discharge to the floor. per ir recommendations, the patient was given prophylactic ceftriaxone. on , patient was called out to the floor from the micu. as above, bp improved overnight and hct was stable. on the floor, his bp was stable (100s - 120s) although lower than his usual baseline (130s) hence his bp meds were held. he was instructed not to restart his diltiazem and metoprolol until he speaks to his pcp. hct continued to be stable at 29-30 with no sign or symptom of cardiovascular instability or gi bleed; he was discharged with instructions for followup in the next 2 weeks with dr. and his pcp. medications on admission: 1. advair 1 puff daily 2. spironolactone 50mg daily 3. colace 100mg daily 4. diltiazem 180mg daily 5. folate 6. lasix 40mg daily 7. metoprolol xl 25mg daily 8. prednisone 5mg 9. pantoprazole 40mg 10. trazodone 100mg qhs 11. vicodin 5/500 q6h prn 12. lithium 300mg daily 13. vitamin d2 50,000u qfriday 14. lexapro 20mg daily 15. "iv iron" likely ferrelecit * remicade for ra stopped 1 month ago for liver intervention. discharge medications: 1. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). tablet(s) 2. prednisone 5 mg tablet sig: one (1) tablet po bid (2 times a day). 3. escitalopram 10 mg tablet sig: two (2) tablet po daily (daily). 4. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: disk with devices inhalation (2 times a day). 5. cefpodoxime 200 mg tablet sig: one (1) tablet po twice a day for 6 days: please continue to take this medication until it is finished. disp:*12 tablet(s)* refills:*0* 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. 7. ergocalciferol (vitamin d2) 50,000 unit capsule sig: one (1) capsule po qfriday (). 8. docusate sodium 50 mg/5 ml liquid sig: two (2) po once a day. 9. spironolactone 50 mg tablet sig: one (1) tablet po once a day. 10. lasix 40 mg tablet sig: 1-2 tablets po once a day. 11. trazodone 100 mg tablet sig: one (1) tablet po at bedtime. 12. vicodin 5-500 mg tablet sig: 1-2 tablets po q6h:prn as needed for pain. 13. lithium carbonate 300 mg capsule sig: one (1) capsule po once a day. discharge disposition: home discharge diagnosis: 1) liver cirrhosis secondary to alcohol. 2) portal gastropathy 3) portal hypertension discharge condition: afebrile, ambulating, blood pressures stable, no lightheadedness, dizziness, tachycardia, no abdominal pain at rest. discharge instructions: you were admitted for an evaluation for a procedure called tips, which was aimed at reducing the likelihood of bleeding from the distended veins in your stomach and esophagus, as well as reducing the fluid in your abdomen. however, the procedure could not be successfully performed due to intraoperative complications where there was a small amount of bleeding around your liver with a drop in your blood pressure. you were given 4 units of blood during your stay due to low blood counts. important: due to your current low blood pressure, we have stopped the following medications. please do not take these medications: 1) diltiazem (cardizem) 2) metoprolol (toprol) you should see your pcp or other doctor in days after discharge for an evaluation before restarting both these medications. please continue to take all your other medications as prescribed previously. we have also added a new medication called cefpodoxime which is an antibiotic that you have to take twice a day for 6 days. please finish the entire course of this medication. if you experience any dizziness, lightheadedness, fainting spells, increase in your abdominal pain, nausea/vomiting or find blood in your stool, urine or vomit, notice black tarry stools or feel unwell, please seek medical help as soon as possible. please call the liver center for an appointment with dr. (see below) followup instructions: it is very important that you follow up with these providers: 1) dr. , your liver doctor here at within 2 weeks. call ( to schedule an appointment. 2) please follow up with your pcp, . during the next week about your blood pressure medications. 3) please follow up with your liver doctors as soon as possible. procedure: venous catheterization, not elsewhere classified percutaneous abdominal drainage percutaneous abdominal drainage transfusion of packed cells phlebography of the portal venous system using contrast material phlebography of the portal venous system using contrast material diagnoses: other iatrogenic hypotension anemia, unspecified alcoholic cirrhosis of liver other and unspecified alcohol dependence, in remission portal hypertension asthma, unspecified type, unspecified accidental puncture or laceration during a procedure, not elsewhere classified anxiety state, unspecified other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation old myocardial infarction rheumatoid arthritis personal history of venous thrombosis and embolism other ascites varices of other sites other and unspecified complications of medical care, not elsewhere classified bipolar disorder, unspecified knee joint replacement other abnormal glucose hip joint replacement accidental cut, puncture, perforation or hemorrhage during surgical operation 

Answer: The patient is high likely exposed to