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: hyperbilirubinemia, ascites, diffuse body pain major surgical or invasive procedure: liver biopsy history of present illness: osh course: 74 yo m with etoh cirrhosis, no active etoh x8 years, remote h/o lung ca s/p lobectomy presented to osh on . pt admitted from initially for coffee ground emesis, subsequently had hematemesis and hypotention. pt fluid responsive to ivf and 2uprbc, egd showed grade i esophageal varices, & erosive gastritis, unclear if banding or sclerosis done. pt was treated with octreotide and ppi iv. pt remained hd stable, no further prbc transfursion required. pt was noted to have elevated bili=32-36 unclear etiology, underwent ercp - normal and mrcp done at osh-also unremarkable. further w/u included negative hemochromatosis gene, normal cerulospasm, negative hbc, hcv, hev serologies, autoimmune hepatitis also negative. liver bx deferred due to high risk of bleed, transferred to for possible liver bx and further evaluation. of note had a large volume paracentesis done on prior to this admit, unclear volume, unclear whether received albumin with paracentesis, negative fluid for sbp; saag>1.1. ua notable for +uti, started on cipro past medical history: -gerd -etoh cirrhosis c/b esophageal varices -lung ca s/p r lobectomy -?ugib -urinary retention (?bph) -cataract surgery -b/l inguinal hernia repair -thalassemia minor social history: -hindi speaking only, recently bed bound in nh per d/c summary, significant decline in adls x2months. immigrated from 15 years ago -quit tob 15 years ago; sober etoh x8 years- drinks/night, denies any other drug use. family history: -m:htn -f:died age 25 unclear infectious dz unclear of liver disease in family physical exam: vs: t 95.4 bp 140/64 hr 62 rr 16 97%ra gen: ill appearing, cachectic in nad skin: jaundiced throughout heent: icteric sclera, op clear, no cervical lad resp: ctabl ant'ly, inspiratory crackles at bases b/l cv: distant heart sounds, nml s1, s2, no m/r/g abd: soft, distended, +fluid wave, mild tenderness to palpation over lower quadrants, no rebound, no guarding ext: 2+ pitting edema at ankles with dependent sacral edema neuro: difficult to assess due to language barrier, alert, follows commands appropriately, minimal asterixis, no tremor, gait not assess. pertinent results: admission labs: . 10:37pm urine hours-random creat-83 tot prot-73 prot/crea-0.9* 10:37pm urine color-amber appear-hazy sp -1.016 10:37pm urine blood-lg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-lg urobilngn-12* ph-6.5 leuk-sm 10:37pm urine rbc-21-50* wbc-0-2 bacteria-few yeast-none epi-0 08:00pm glucose-109* urea n-18 creat-1.0 sodium-142 potassium-3.6 chloride-115* total co2-19* anion gap-12 08:00pm estgfr-using this 08:00pm estgfr-using this 08:00pm alt(sgpt)-111* ast(sgot)-140* ld(ldh)-214 alk phos-112 tot bili-27.0* dir bili-19.2* indir bil-7.8 08:00pm tot prot-4.3* albumin-2.8* globulin-1.5* calcium-8.4 phosphate-1.9* magnesium-2.0 iron-65 08:00pm caltibc-126* ferritin-greater th trf-97* 08:00pm wbc-6.7 rbc-4.02* hgb-9.6* hct-31.3* mcv-78* mch-23.8* mchc-30.6* rdw-23.3* 08:00pm neuts-72.4* bands-0 lymphs-22.3 monos-3.7 eos-1.2 basos-0.4 08:00pm plt smr-low plt count-91* 08:00pm pt-16.9* ptt-43.9* inr(pt)-1.5* 08:00pm ret aut-3.5* . osh notable labs: cr 3.2--> 2.5 hepatitis a serologies / -hav igm-negative -hav ab-positive hepatitis b serologies -hbv sag-negative -hbv sab-negative -hbv cab-negative . osh-echo -ef 60%, normal wall motion, no pericardial effusion . cxr -elevated r hemidiaphragm, no significant blunting of costophrenic angles b/l, no consilidation noted, deviated trachea to r . ekg -nsr hr 62, diffuse low voltage, normal axis and intervals, no st-t changes, unchanged from osh ekg . pertinent labs: 06:30am blood wbc-12.9* rbc-3.59* hgb-8.8* hct-27.1* mcv-76* mch-24.4* mchc-32.3 rdw-22.7* plt ct-153 06:45am blood wbc-13.5* rbc-4.79 hgb-11.9* hct-37.7* mcv-79* mch-24.8* mchc-31.5 rdw-23.3* plt ct-143* 03:37am blood wbc-21.3*# rbc-4.28* hgb-11.1* hct-33.9* mcv-79* mch-25.9* mchc-32.7 rdw-22.9* plt ct-129* 06:10am blood wbc-13.3* rbc-3.93* hgb-10.5* hct-32.4* mcv-82 mch-26.8* mchc-32.5 rdw-22.1* plt ct-74* 08:54pm blood wbc-26.9*# rbc-4.27* hgb-11.7* hct-34.4* mcv-81* mch-27.4 mchc-34.0 rdw-23.5* plt ct-129*# 05:55am blood pt-16.7* inr(pt)-1.5* 03:37am blood pt-20.1* ptt-40.2* inr(pt)-1.9* 05:20am blood pt-21.2* ptt-50.7* inr(pt)-2.0* 08:54pm blood plt ct-129*# 04:30pm blood glucose-89 urean-17 creat-1.1 na-138 k-3.5 cl-109* hco3-20* angap-13 06:25am blood glucose-124* urean-18 creat-0.6 na-140 k-3.9 cl-109* hco3-22 angap-13 06:45am blood glucose-130* urean-40* creat-0.5 na-139 k-4.2 cl-96 hco3-28 angap-19 03:37am blood glucose-73 urean-58* creat-0.5 na-147* k-4.5 cl-109* hco3-22 angap-21* 03:13am blood glucose-82 urean-59* creat-1.0 na-150* k-3.2* cl-114* hco3-22 angap-17 08:54pm blood glucose-94 urean-43* creat-0.6 na-142 k-5.3* cl-108 hco3-20* angap-19 06:20am blood alt-90* ast-161* ld(ldh)-249 alkphos-145* totbili-22.4* 05:30am blood alt-107* ast-183* ld(ldh)-273* alkphos-207* totbili-24.3* 06:20am blood alt-95* ast-165* ld(ldh)-389* alkphos-191* totbili-33.9* 06:10am blood alt-170* ast-212* ld(ldh)-617* alkphos-233* totbili-41.3* 03:13am blood alt-152* ast-184* alkphos-167* totbili-52.3* 08:54pm blood alt-77* ast-136* ld(ldh)-796* alkphos-179* totbili-49.8* 08:00pm blood totprot-4.3* albumin-2.8* globuln-1.5* calcium-8.4 phos-1.9* mg-2.0 iron-65 05:40am blood albumin-3.2* calcium-9.3 phos-4.2 mg-3.1* 03:37am blood albumin-2.9* calcium-9.7 phos-5.3*# mg-3.6* 03:48am blood albumin-4.0 calcium-10.2 phos-2.8 mg-2.9* 08:54pm blood albumin-3.7 calcium-10.3* phos-1.6* mg-3.0* 11:05am blood hbsag-negative hbsab-negative hbcab-negative hav ab-positive 02:02pm blood cortsol-16.0 03:11pm blood cortsol-25.2* 10:39pm blood pth-55 05:20am blood tsh-4.9* 03:13am blood osmolal-328* 05:30am blood afp-2.8 03:26pm blood vanco-26.8* 06:10am blood vanco-13.8 11:05am blood hcv ab-negative 11:37am blood type-art po2-81* pco2-30* ph-7.37 caltco2-18* base xs--6 07:13pm blood type-art po2-109* pco2-36 ph-7.40 caltco2-23 base xs--1 07:13pm blood lactate-4.5* 09:34pm blood lactate-4.1* 11:05am blood hepatitis e antibody (igm)-test 11:05am blood hepatitis e antibody (igg)-test. . pertinent microbiology: dipstick urinalysis blood nitrite protein glucose ketone bilirub urobiln ph leuks 10:27am mod neg neg neg neg lg 8* 7.0 neg source: catheter 03:38am neg neg neg neg neg lg 4* 7.5 neg source: catheter 03:55pm neg neg neg neg neg lg 4* 8.0 neg . 2:27 pm peritoneal fluid peritoneal fluid. . **final report ** gram stain (final ): no polymorphonuclear leukocytes seen. no microorganisms seen. this is a concentrated smear made by cytospin method, please refer to hematology for a quantitative white blood cell count.. fluid culture (final ): no growth. anaerobic culture (final ): no growth. clostridium difficile toxin a & b test (final ): feces negative for c.difficile toxin a & b by eia . blood culture, routine (final ): no growth . abdominal ultrasound: impression: 1. marked ascites. spot marked in the right lower quadrant for paracentesis. 2. cirrhosis. 3. slow flow within patent main portal vein. 4. patent umbilical vein indicative of portal venous hypertension. 5. enlarged spleen measuring 15 cm. . () peritoneal fluid: negative for malignant cells. . () cxr: history: lobectomy with increased white count, to evaluate for pneumonia. findings: in comparison with study of , there is little change. specifically, no evidence of acute pneumonia. the dobbhoff tube remains coiled in the upper stomach. () lenis impression: no evidence of dvt in either lower extremity . cxr: lungs remain low in volume but clear. no pneumonia. no pleural effusion or pneumothorax. heart size is normal. stomach distended. feeding tube ends near the pylorus . pertinent cytology: liver core biopsy: 1) marked cholestasis, intracellular hyalin and focal mixed cell inflammation. 2) mild steatosis. 3) trichrome: marked periportal and sinusoidal fibrosis with bridging, consistent with cirrhosis (stage 3-4). 4) iron stain: moderate iron deposition in hepatocytes. note: the features are consistent with toxic/metabolic liver disease. dr. and dr. were notified on . addendum: test performed by , medical laboratories, department of lab medicine and pathology ?????? , nw, , for specimen s08-, block a. test requested hi/lo reference range performance site iron, liver ts iron, liver ts 1881 /g dry wt sdl hepatic iron index 0.5 umol/g/yr <1.0 sdl results of hepatic iron index <1.0 are normal, indicating no iron accumulation. results between 1.0-1.9 suggest mild, nonspecific iron accumulation as may be seen in alcoholic liver disease or heterozygous hemochromatosis. results >1.9 indicate homozygous hemochromatosis or transfusion-related iron overload. chronic blood loss or frequent phlebotomy will decrease the hepatic iron index. brief hospital course: 74 yo m with etoh cirrhosis (no etoh x10y), and h/o lung ca s/p lobectomy, with a 3 month history of anorexia and transferred from osh after ugi bleed with decompensated liver disease. . the patient had a long stay at that consisted of the patient of being kept on the 10, - service, as well as a transfer to the unit. the patient was transferred back to the floor before expiring the early the morning of . . decompensated esld: the pt presented to from an osh with a meld score 24. dopplar us was completed and indicated marked ascites, cirrhosis, slow flow within patent main portal vein, patent umbilical vein indicative of portal venous hypertension, as well as splenomegaly. there was no evidence of sbp by exam or on paracentesis. lactulose was continued. therapeutic paracentesis was completed on and 4.5 l was removed and 25 grams of albumin was given. on a liver biopsy was completed with ultrasound guidance, showing marked cholestasis, and c/w toxic/metabolic liver dz. he also had 1.9l removed at that time, and post-bx pt hct dropped to 25.8 and became hypotensive 70s/40s. pt was given 12.5gm albumin and pressures stablized. ct abd r/o'd occult bleed. pt did not have any further bleeding on admission, and hct and vitals remained stable throughout the remaining hospital course. . the pt's tbili steadily increased over his hospital course from a baseline that was markedly elevated. prednisone was started empirically since pt was classified as terminal (and did not have a current infection) possibly to help with alcoholic hepatitis. pt's mental status improved once tf were started and pt began having regular bowel movements. but pt's mental status worsened on when he began having sleep changes, and then on was not a&ox3. it was thought that this was due to hepatic encephalopathy. although his energy increased, was conversing more, and eating more oral in addition to tf, his tbili continued to rise, and on with a tuberculosis of 40 his prednisone was discontinued. the patients tuberculosis peaked at 50 during his hospital course. in regards to the patients mental status his previous ct was negative on admission, and was not repeated. pt's lactulose was increased to 45ml tid. however over the first week in the patients mental status appeared to worsen on the floor, presumed encephalopathy, continued on lactulose and the pt was given haldol and zyprexa. the patient pulled out his dobhoof tube on 3 occassions requiring ir placenent mulitple times. the pt was empirically started on ceftriaxone to treat sbp although the pt was not compliant for a successful diagnostic paracentesis. once dobhoff was replaced, was able to give lactulose po. . on the 23rd day of admission the pt was transferred to the micu with new hypoxia, hypotension. his hypotension was fluid responsive and he was given several doses of albumin with good results. while in the micu, the pt had a leukocytosis with transient hypothermia. due to concern of infection, he was pan cultured and flagyl was started in addition to his ceftriaxone. his ceftriaxone dose was also increased to full in order to cover for sbp. mental status waxed and waned throughout his micu course. the acute nature of his hypoxia had suggested aspiration from newly restarted tube feeds, or pna. the pt was started on vanc/ceftriaxone. his cxr was with diminished lung markings on left likely due to rll lobectomy and appears similar to prior films, but otherwise no infiltrate. lenis were negative but pt was unable to cooperate so a v/q scan was never completed. over the course of his micu stay, his o2 requirements lessened and he transferred back to the floor. a family meeting was held prior to transfer out of the micu and he was made dnr/dni and no pressors should he become hypotensive again. the patient was subsequently transferred back to the floor. the patient's mental status was evaluated through an interpreter on mulitiple ocassions where he was found to be alert to the country, the year, and to his wife. the patients clinical status did not improve once transferred back to the floor. . on the night of the patient developed hemoptysis, low blood pressures and changes in mental status. the patient was treated supportively and passed away in the early the following morning with his wife at his side. . anorexia: for the pt's anorexia other causes were investigated, like how pt had lung cancer with node involvement and never had adjunctive chemo/rad, but the ct chest proved negative for recurring lung ca causing the 3mo hx of anorexia. his h/o lung cancer is also what keeps him from being on the transplant list, and why only palliative care is the option for him. afp was also not significantly elevated, and in the end his anorexia was attributed to his primary liver disease. the patients dobhoff was pulled out on 3 occassions and needed replacement via interventional radiology for placement. the pt's energy improved significantly when tf were originally started. the patient was given ritalin to help with energy, which was later d'c when the pt appeared to become aggitated. discussed his goals of care extensively. he and his wife understand his time left is very limited. pt's goal was to be healthy enough to fly back to to see his sons one last time before dying, which clarified why he was not originally dnr/dni. h/o lung ca s/p r lobectomy: pt had node invovlement but never received adjuvant chemotx/radiation and it was investigated whether this was causing the pt's anorexia and or mental status change. a ct chest was ordered but did not show any evidence of axillary or mediastianal lymph node changes worrisome for malignancy. uti: have been cause of pt's incontience, pt was given 14 day course of cipro. medications on admission: -protonix 40mg po bid -cipro 250mg po bid -lactulose 20mg q2hr -dulcolax 10mg pr as needed -acetominophen 650mg q6hr prn -received 3 doses -vitamin k 2mg po x1 on ; 2.5mg po x1 on discharge medications: pt expired discharge disposition: expired discharge diagnosis: expired discharge condition: expired discharge instructions: expired followup instructions: expired procedure: other endoscopy of small intestine enteral infusion of concentrated nutritional substances closed (percutaneous) [needle] biopsy of liver percutaneous abdominal drainage percutaneous abdominal drainage diagnoses: esophageal reflux alcoholic cirrhosis of liver acute kidney failure, unspecified portal hypertension personal history of malignant neoplasm of bronchus and lung chronic kidney disease, unspecified acute respiratory failure cachexia other ascites esophageal varices in diseases classified elsewhere, with bleeding hepatic encephalopathy hypovolemia hyperosmolality and/or hypernatremia other thalassemia acute alcoholic hepatitis spontaneous bacterial peritonitis 

Answer: The patient is high likely exposed to