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: penicillins attending: chief complaint: lethargy, sob major surgical or invasive procedure: central line placement history of present illness: 61yo male with recent dx of liver failure/? alcoholic hepatitis who became lethargic and sob in setting of trazadone, oxycodone and ativan administraion. his attending found him to be lethargic and sob this am, was given narcan and flumazinil with some increase in alertness. vs were stable with bp 120/70, hr 112, rr 10, ox sat 94%ra. liver attending req icu tx for monitoring. . he was in usoh living in until 3.5 weeks prior to this admission when he developed acute diarrhea and severe abdominal pain and cramping. he saw his pcp who gave him a pill for the diarrhea (?lomotil) and his symptoms got better. over the next week he slowly became jaundiced and developed puritis and dark urine. for the week after that he developed severe fatigue and a sleep disturbance. 10 days prior to admission, he was unable to get out of bed and his wife found him in the afternoon esentially comatose, responding minimally. . he was admitted to hospital and a work up was begun. per report, mri showed no ductal dilation. his bili was 23. his hep serologies were all negative. his ms improved on lactulose therapy. his cr at a baseline of 1.5 and on day of icu transfer is 3. iron was 150 and tibc 160. hemochromatosis genotype pending from osh. he was tx to for further workup. he had an abdominal us that showed ascites and patent pv, appropriate direction of flow, cirrhosis, no liver lesion. he was started on pentoxyphylline. . ros: patient has gained about 30# in the past monht, puritis, jaundice. past medical history: asthma, htn, arthritis, s/p appy social history: patient lives in with wife. is an architect and in real estate, has 4 kids. no hx of tobacco use. drinks 4 drinks (vodka) per day for past 20 years. has never had problems with . family history: diverticulitis, mother with "intestinal cancer", daughter with autoimmune hepatitis physical exam: pe: 97.5 153/51, 112, 17-24, 98% 2l gen: confused, oriented to self only heent: mmm, sclera icteric, perrl, neck supple cv: rrr s1s2 +systolic murmur pulm: clear bilat abd: hypoactive bs, distended, mildly tender to palpation, anasarca ext: pitting edema to mid thigh neuro: +asterixis pertinent results: 07:56pm glucose-102 urea n-47* creat-2.4* sodium-131* potassium-4.3 chloride-100 total co2-19* anion gap-16 07:56pm alt(sgpt)-75* ast(sgot)-107* ld(ldh)-283* alk phos-209* tot bili-21.9* 07:56pm albumin-2.7* calcium-8.5 phosphate-3.8 magnesium-2.8* iron-142 07:56pm caltibc-146 ferritin-greater th trf-112* 07:56pm ammonia-36 07:56pm wbc-7.8 rbc-2.93* hgb-10.9* hct-31.6* mcv-108* mch-37.2* mchc-34.4 rdw-15.2 07:56pm plt count-117* 07:56pm pt-17.7* ptt-41.6* inr(pt)-1.7* 11:44am blood wbc-25.2* rbc-2.63* hgb-8.9* hct-25.2* mcv-96 mch-33.8* mchc-35.3* rdw-24.3* plt ct-103* 03:30am blood neuts-55 bands-6* lymphs-5* monos-5 eos-5* baso-3* atyps-0 metas-5* myelos-16* nrbc-1* 11:44am blood plt ct-103* 11:44am blood glucose-102 urean-72* creat-6.0* na-131* k-5.9* cl99 hco3-17* angap-21* 11:44am blood alt-55* ast-130* ld(ldh)-391* alkphos-142* totbili-21.2* 04:00am blood lipase-48 11:44am blood albumin-2.1* calcium-10.1 phos-7.7* mg-3.1* 10:20am blood hbsag-negative hbsab-positive hbcab-negative hav ab-positive 10:20am blood cea-5.6* psa-0.4 04:02pm blood hiv ab-negative 10:20am blood hcv ab-negative 03:28am blood type-art temp-38.4 rates-/35 tidal v-400 peep-5 fio2-40 po2-71* pco2-30* ph-7.41 caltco2-20* base xs--3 intubat-intubated 12:26pm blood lactate-3.2* . liver us : the examination is limited due to body habitus. specifically, there is limited evaluation of the liver parenchyma and gallbladder; however, there is no evidence suggestive of cholecystitis such as no evidence of wall thickening, gallstones, or intra- or extra-hepatic biliary ductal dilatation. the common duct measures 2.6 mm, within normal limits. duplex doppler interrogation of the main portal vein demonstrates normal direction of flow. a small amount of ascites is seen in the right lower quadrant. . mri abdomen : examination of the liver and renal parenchyma demonstrates no overt or dominant mass, allowing for the limitations of this examination. the right lobe of the liver is disproportionately smaller than the left, consistent with cirrhosis. varices are seen. there is splenomegaly, also consistent with portal hypertension. within the limits of the examination, no nodules are seen within the liver, and no adenopathy is seen. the portal vein shows appropriate hepatopetal flow, and the hepatic veins appear patent as well. the pancreas, kidneys, and adrenal glands appear grossly unremarkable. . tte : the left atrium is mildly dilated. left ventricular wall thickness, cavity size, and systolic function are normal (lvef 70%). 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 appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. . cxr : a tracheostomy tube is present. a right ij line is present, tip over distal svc. an ng tube is present, tip extending beneath diaphragm, off film. the patient is rotated, markedly limiting assessment of the cardiomediastinal silhouette. there is probable mild cardiomegaly, with an unfolded aorta. there is upper zone redistribution and diffuse vascular blurring, with some more confluent alveolar opacities at the bases. right and left costophrenic angles are excluded from the film, but no gross effusion is identified. old healed right-sided rib fractures noted. brief hospital course: a/p: 61 yo male with hx of mod etoh abuse presents to on with diarrheal illness, hepatitis, altered mental status. found to also have elevated creatinine, ? hepatorenal. transferred to the icu on after found to be lethargic and short of breath. in icu, pt started having coffee ground emesis. he was electively intubated and egd showed portal gastropathy and grade i varices. . # resp failure/ards: pt was intubated on for egd in setting of upper gi bleed. pt was extubated 2 days later but placed on bipap soon thereafter for reps distress. later that day, he was reintubated for resp distress not improved with bipap. he was emergently bronched following intubation for suspected aspiration and 250cc of bilious fluid was suctioned out. it was thought that this aspiration the led to ards picture. he was continued on abx and then due to prolonged intubation along with impending liver transplant, patient was trach'ed on . pt initially did well and tolerated trials of trach mask. however, after a traumatic ngt placement leading to a likely aspiration pneumonitis/pneumonia, pt was sedated and placed back on ac. he remained on ac until he expired on . . # hepatitis/liver failure: probable etoh hepatitis but hemochromatosis also on differential. pt was started on albumin and rifaxamin for hepatorenal syndrome. he was also started on lactulose. abd u/s showed ascites, however there was not enough fluid to tap. he was evaluated by liver who believed he was a liver tx candidate given his meld of 40. the appropriate liver tx labs were sent and patient awaited a tx. transplant team followed for the entire course of the hospitalization but continued to feel that he was not a transplant candidate given his persistant hypotension and fever with no clear source, despite broad antibiotic/antifungal coverage. a concensus was finally reached with the transplant team and the medical team that he would not be a candidate for transplant. this was conveyed to the family after which they decided to withdraw support and made mr. . . # gi bleed: thought to be esophagitis, has grade i varices but no overt signs of bleeding. initially hct dropped 5 points but stablized with 5u of prbcs. he was started on an octreotide drip and iv ppi, with the octreotide gtt eventually weaned off given his stable hct. then again, on , pt had a large amount of hematemesis and another variceal bleed was found. it was banded and octreotide was again started. his hct again stabilized. . # elevated ptt: pt found to have elevated ptt. a mixing study was ordered but was not done elevated thrombin time. this is likely due to his liver disease. other etiologies of the elevated ptt, pt and thrombin time include amyloidosis and multiple myeloma. his inr slowly trended down and was corrected with ffp as needed prior to procedures. . # bacteremia - e.coli bacteremia from blood cx, sensitive to ceftriaxone for which he received a 14 day course (completed ). . # fever: on , five days after completion of ceftriaxone, pt spiked a fever to 101. sputum grew out 1+ gpc so vancomycin was started. he was also started on levaquin per id recs. following his traumatic ngt placement concerning for an aspiration event, he was rebroadened to cefepime/flagyl and vanc. patient continued to spike fevers and no clear source of infection was found. id was following and recommended adding caspofungin to his regimen to cover fungals. . # aflutter: stable with rate in the 130s. cardiology was consulted for pre-transplant evaluation and they recommended starting low dose beta blocker which pt did not tolerate with hypotension. due to his liver and renal failure, he was not a candidate for chemical cardioversion, and on , pt was electrically cardioverted with 200j. he converted to nsr with improvement in his baseline bps. . # arf: on admission, pt's creatinine elevated to 2.7. it continued to rise over the next 5-6 days thought to be hepatorenal syndrome. renal was consulted and recommended high doses of diuretics. when this failed, he was started on cvvhd. over the next several days, pt was slowly diuresed with cvvhd and maintained on cvvhd until his bp stabilized. once he was off pressors, a trial of intermittent hd was attempted but pt became hypotensive to the 60s so cvvhd was reinitiated. he remained on cvvhd, however patient continued to become progressively more hypotensive over the course of the hospitalization and he was started on pressors once again to maintain maps >60. he was unable to be weaned off of pressors. . # thrombocytopenia - likely secondary to liver failure. patient was transfused platelets as necessary for procedures. . #fen: patient was started on tpn for nutrition as he had a prolonged stay in the icu. . on the patient expired after being made by his family. given his refractory hypotension, requiring pressors and his persistant fever despite very broad coverage he was deemed not be a transplant candidate. after lengthy discussion with the family it was decided to make the patient as his prognosis without a transplant was grim. medications on admission: meds on transfer: levofloxacin albuterol 0.083% neb soln 1 neb ih q6h:prn midodrine hcl 10 mg po tid albumin 25% (12.5 g) 25 gm iv daily clonidine tts 1 patch 1 ptch td qsat octreotide acetate 100 mcg sc q8h pentoxifylline 400 mg po tid sarna lotion 1 appl tp qid hydroxyzine hcl 25 mg po q4-6h:prn ursodiol 300 mg po tid lansoprazole 15 mg po daily lactulose 30 ml po bid discharge disposition: expired discharge diagnosis: acute liver failure discharge condition: expired discharge instructions: n/a followup instructions: n/a procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances other endoscopy of small intestine other endoscopy of small intestine insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis other electric countershock of heart other electric countershock of heart venous catheterization for renal dialysis temporary tracheostomy closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus endoscopic excision or destruction of lesion or tissue of esophagus bronchoscopy through artificial stoma transfusion of packed cells transfusion of other serum infusion of vasopressor agent diagnoses: thrombocytopenia, unspecified acute kidney failure with lesion of tubular necrosis unspecified essential hypertension acute posthemorrhagic anemia acute and subacute necrosis of liver alcoholic cirrhosis of liver hepatorenal syndrome acquired coagulation factor deficiency severe sepsis portal hypertension atrial flutter pneumonitis due to inhalation of food or vomitus septic shock esophageal varices in diseases classified elsewhere, with bleeding hepatic encephalopathy other specified disorders of stomach and duodenum septicemia due to escherichia coli [e. coli] other tracheostomy complications 

Answer: The patient is high likely exposed to