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: nadolol attending: chief complaint: elevated total bilirubin (refrred by outpatient clinic). major surgical or invasive procedure: ercp (). intubation history of present illness: recently admitted () with jaundice and liver failure. up to that point, he had noticed a one month history of jaundice and scleral icterus. discriminant function at admission to osh was 26. he was started no prednisone and discharged on 20mg daily. given grade i varices on egd nadolol and a ppi were started. at the time of discharge, his total bili was 24. upon recheck after discharge it was noted to be 31 with his other lfts also up from discharge. noted to have ascited and to be afebrile in liver clinic. given the worsening lfts and ascites he was admitted for further evaluation. since discharge, the patient has been feeling well. denies any fevers/chills, abdominal pain, emesis, diarrhea, constipation, melena or brbpr. hasn't noticed any change in his abdominal size. since his weight has decreased from 210 to 189 pounds. past medical history: 1. alcoholic liver disease 2. alcoholism 3. diverticulosis 4. left knee arthroscopic surgery social history: patient lives with his wife and 3 children (13,17,22), has another son who is incarcerated. he was a policeman for 10yrs and has subsequently been working in at massport for the past 19 yrs. he drives into daily. current stressors in his life include financial difficulty and concern about his incarcerated son. smoking: 50 pack years etoh: 1 bottle of wine/day. moderate drinker as long as wife can remember (for 17 years). then 5 years ago, drinking increased. patients endorses drinking for past 40yrs. as per pt, he has began working with a substance abuse counselor, and plans to use the support of his family and a ?psychiatrist at to aid his cessatio of alcohol use. ivdu: never family history: adopted at 1 yr of age. per wife, his biological mother may have had alcoholism physical exam: gen - jaundiced, lying in bed in no distress heent - icteric sclera, no palor cv - rrr, no murmurs, nl s1,s2 pulm - crackles at left base; otherwise clear abd - soft but obese; non-tender; liver is difficult to palpate but appears 1-2cm below costal margin ext - warm with 1-2+ edema bilaterally, no nail changes skin - jaundice, no palmar erythema, no obvious spider angiomas or telangiectasias pertinent results: 08:10pm alt(sgpt)-242* ast(sgot)-270* ld(ldh)-292* alk phos-181* tot bili-25.7* albumin-2.0* 08:10pm pt-19.2* ptt-35.1* inr(pt)-1.8* 08:10pm hbsag-negative hbs ab-negative hbc ab-negative 08:10pm ethanol-neg acetmnphn-10.6 08:10pm wbc-22.3*# rbc-3.98* hgb-14.8 hct-44.0 mcv-111* mch-37.1* mchc-33.6 rdw-15.9* plt count-204 08:10pm glucose-108* urea n-19 creat-0.9 sodium-135 potassium-3.7 chloride-101 total co2-25 anion gap-13 duplex dop abd/pel limited: 1. no significant change since , with evidence of heterogeneous echogenic liver, which may be secondary to fatty liver, but cirrhosis cannot be excluded by ultrasound. no focal intrahepatic lesions. 2. unchanged appearance of flow reversal within the portal venous system, without definite evidence of thrombus. chest (pa & lat): lungs are fully expanded and previous interstitial pulmonary abnormality in the lung bases has cleared. there is no pleural effusion or evidence of central adenopathy. azygous distention his unchanged. . ercp biliary&pancreas by gi unit 12:56 pm ten fluoroscopic images are available for review obtained without a radiologist present. cholangiogram demonstrates a normal-appearing common bile duct, cystic duct, opacified gallbladder, and intrahepatic biliary radicles. no strictures or filling defects to suggest stone is identified. impression: unremarkable cholangiogram. . us abd limit, single organ 3:46 pm four-quadrant ultrasound reveals a small amount of ascitic fluid. the volume is not suitable for therapeutic paracentesis. . ct abdomen w/contrast 5:43 pm 1. tiny bilateral pleural effusions. 2. ascites. 3. sigmoid diverticulosis without evidence of diverticulitis. 4. diffuse anasarca, which is symmetric. 5. no evidence of soft tissue or intramuscular gas. . knee (ap, lat & oblique) left port 10:35 am there are no previous studies available for a direct comparison. please note that the study is limited due to difficulty in positioning patient due to pain. the left hip joint is suboptimally evaluated due to the patient's large body habitus and technique. however allowing for this, no focal fractures are identified. the rest of the femur is intact. no gas is seen within the subcutaneous soft tissues. there are mild degenerative changes seen of the medial knee joint with small marginal osteophytes. a small knee joint effusion is present on lateral view. the left tibia and fibula are intact without acute fractures. no gas is seen within the subcutaneous soft tissues of the left leg. limited study without signs for acute bony injury or soft tissue gas. . unilat lower ext veins left 4:28 am no evidence of dvt. brief hospital course: 59 yr old male with hx of alcoholic cirrhosis admitted for worsening liver failure. floor course: 1. liver disease- has history of significant alcohol use; this is presumed to be the cause of his liver disease. at osh prior to his recent admission, he had hepatitis serologies which showed: neg, hbc iga neg, hbsag neg, hcv neg. an afp was 1.9. over the initial days of his hospitalization, the lfts remained stable if markedly elevated. ultrasound of the liver was performed which and showed a heterogeneous echogenic liver flow reversal within the portal venous system. a trans-jugular biopsy was performed and was consistent with obstruction and showed extensive sinusoidal fibrosis, increased portal fibrosis, with bridging fibrosis (stage 3). given the possibility of obstruction, an ercp was perfomed - it did not show any evidence of this. prednisone was continued despite the poor response. ursodiol and cholestyramine were also used. lactulose and rifaximin were initially added, although the lactulose was stopped given persistent diarrhea. 2. acute renal failure- developed acute renal failure on (scr increased to 1.9), with the possibility of hepatorenal syndrome. urine sodium was <10. was challenged with ivf; resulting improvement in creatinine made a pre-renal state much more likely. 3. diarrhea-soon after initiation of lactulose, developed diarrhea with up to 10 or more bowel movements per day. the diarrhea continued even with titration of the lactulose down and off. c.diff was sent and negative, but empiric treatment was begun with flagyl. 4. grade i varices- continued propranolol, although he missed many doses given his low blood pressures. 5. alcohol use- report sobriety since . monitored for withdrawal signs/symptoms. micu course: on floor patient began to complain of left thigh pain and overnight developed erythema of the lle. no evidence of dvt. started on vancomycin in the am. was noted to be hypotensive on routine vital signs check with a bp 76/p. he was given 1.3 liters of ns bolus and started on albumin 5% 25 gm iv once. bp to 85/50. pt was oriented to self. abg ph 7.34/pco2 24/p02 91. lactate 5.2. a foley was placed with 125 cc urine. pt was transferred to the micu, where exam positive for 2+ le edema with feet cool bilaterally. pulses dopplerable. lle exquisitely tender to palpation out of proportion to exam. erythema and swelling. dark discoloration of posterior thigh and calf. great concern for necrotizing fascitis, though patient previously with diarrhea. pt was started on pressors, broad antibiotic coverage with vanco/ceftriaxone/ clindamycin/ flagyl changed to vanc/clinda/zosyn after discussion with infectious disease. stress dose steroids given. surgery consulted, concern for sepsis in the setting of nec fasc, but pt unstable dependent on four pressors, acidotic. pt intubated for respiratory distress/ severe acidosis. episodes of bradycardia down to the 30's with hypotension. brief attempt at epi drip without improvement. continued discussion with family and code status confirmed dnr. 1:31 am pt expired with family and medical team at bedside. medications on admission: 1. prednisone 20 mg daily 2. nadolol 20 mg daily 3. pantoprazole 40 mg daily 4. lactulose 10 g/15 ml 30 ml 5. hexavitamin discharge medications: none discharge disposition: expired discharge diagnosis: primary: 1. liver failure, alcohol induced. pt expired discharge condition: expired discharge instructions: expired followup instructions: pt expired procedure: venous catheterization, not elsewhere classified insertion of endotracheal tube closed (percutaneous) [needle] biopsy of liver endoscopic retrograde cholangiopancreatography [ercp] diagnoses: acidosis thrombocytopenia, unspecified alcoholic cirrhosis of liver acute kidney failure, unspecified other pulmonary insufficiency, not elsewhere classified unspecified septicemia unspecified protein-calorie malnutrition severe sepsis candidiasis of mouth hepatic encephalopathy other and unspecified alcohol dependence, continuous acute alcoholic hepatitis 

Answer: The patient is high likely exposed to