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: vicodin / penicillins attending: chief complaint: abdominal pain major surgical or invasive procedure: right internal jugular central line placement diagnostic paracentesis right arterial line history of present illness: 57 y/o man w/ etoh cirrhosis presenting with abdominal pain. pain began @ midnight last night and he came to the emergency department. . paracentesis performed in ed showed hemorrhagic ascites with rbc and sbp with 6500 wbc, 83% polys. he was treated with vanco/levo/clinda in the emergency department. ekg showed rapid atrial fibrillation vs. flutter but bp was low so he was bolused with 3l normal saline total. no rate controlling medications were given. . he reports that he took his morning medications including nadolol, digoxin, . once in the icu an arterial and central rij line were placed. he was volume resusitated with 1.5l bringing total to 4.5l. he also recevied 150grams of albumin. liver was consulted and will be by to see the patient. a dig level returned <.2 so he was dig loaded with .25 mg iv q6h x 24 hours. past medical history: 1. hypertension - not an issue since liver failure 2. atrial fibrillation on coumadin 3. seasonal allergies 4. shingles 5. dental abscess 6. peptic ulcer disease 7. cll: in remission social history: significant for no tobacco usage, significant alcohol usage. he used to drink heavily in the past, with no history of any withdrawals or delirium tremens. he drinks about 14 glasses of wine a week family history: diabetes, cancer and stroke. physical exam: vitals: 97.6 130-150, irregular 83/50-100/50 17 98%2lnc general: awake, alert, nad. heent: + jvd, no lad, moist oral mucose. pulmonary: lungs cta bilaterally cardiac: irregular rate and rhytm, holosystolic murmur abdomen: obese, soft, nt/nd, normoactive bowel sounds, liver ~ 2 cm below costal border; no asterixis. minimal tenderness to palpation back: no pain on palpation extremities: 2+ edema le neuro: slightly flat affect skin: mild scleral icterus, mild jaundice pertinent results: 05:00am pt-15.9* ptt-35.0 inr(pt)-1.4* 05:00am plt smr-normal plt count-200 05:00am hypochrom-1+ anisocyt-3+ poikilocy-1+ macrocyt-3+ microcyt-normal polychrom-1+ ovalocyt-1+ burr-1+ elliptocy-1+ 05:00am neuts-26* bands-1 lymphs-58* monos-3 eos-2 basos-0 atyps-10* metas-0 myelos-0 nuc rbcs-1* 05:00am wbc-23.8* rbc-2.95* hgb-10.2* hct-29.2* mcv-99* mch-34.6* mchc-34.9 rdw-25.2* 05:00am tot prot-4.2* albumin-3.3* globulin-0.9* calcium-8.9 phosphate-3.8 magnesium-2.2 05:00am ck-mb-notdone 05:00am ctropnt-<0.01 05:00am lipase-43 05:00am alt(sgpt)-22 ast(sgot)-64* ld(ldh)-484* ck(cpk)-40 alk phos-100 tot bili-8.8* dir bili-2.1* indir bil-6.7 05:00am estgfr-using this 05:00am glucose-112* urea n-23* creat-1.0 sodium-136 potassium-5.4* chloride-106 total co2-20* anion gap-15 05:09am lactate-2.7* 05:09am comments-green top 05:13am ammonia-110* 05:30am ascites wbc-6500* rbc-* polys-83* lymphs-11* monos-5* eos-1* 05:30am ascites tot prot-1.8 glucose-56 ld(ldh)-142 albumin-1.5 07:59am pt-17.7* ptt-43.6* inr(pt)-1.6* 07:59am plt smr-low plt count-151 07:59am hypochrom-normal anisocyt-2+ poikilocy-normal macrocyt-1+ microcyt-normal polychrom-2+ schistocy-occasional 07:59am neuts-37* bands-14* lymphs-48* monos-1* eos-0 basos-0 atyps-0 metas-0 myelos-0 07:59am wbc-13.5* rbc-2.55* hgb-8.5* hct-25.6* mcv-100* mch-33.5* mchc-33.3 rdw-25.4* 07:59am digoxin-<0.2* 07:59am albumin-2.8* calcium-7.5* phosphate-3.4 magnesium-1.9 07:59am lipase-34 07:59am alt(sgpt)-19 ast(sgot)-32 ld(ldh)-190 alk phos-83 amylase-59 tot bili-7.2* 07:59am glucose-124* urea n-21* creat-0.8 sodium-138 potassium-4.2 chloride-110* total co2-21* anion gap-11 08:38am lactate-1.6 08:38am type-art 02:21pm hct-19.5* 02:21pm cortisol-27.3* 02:39pm type-art po2-126* pco2-32* ph-7.40 total co2-21 base xs--3 03:05pm cortisol-42.8* 03:26pm cortisol-45.4* 08:05pm hct-21.6* . microbiology (positive cxs): peritoneal fluid - e. coli sputum - klebsiella pneumoniae sputum - klebsiella pneumoniae sputum - klebsiella pneumoniae sputum - yeast bal - yeast sputum - yeast, klebsiella pneumoniae . cxr : compared to radiograph of seven hours prior. there is a new right ij catheter with its tip at the atriocaval junction. there is no pneumothorax. again seen are extensive calcified pleural plaques the sequela of prior asbestos exposure, emphysema, and a prominent basilar interstitial pattern which could relate to emphysema, asbestos related chronic lung disease, a component of volume overload, or a combination thereof. persisting small left pleural effusion. right cp angle excluded on this study. . ct abd/pelvis : 1. hepatic cirrhosis with stigmata of portal hypotension including numerous varices, a recanalized umbilical vein and worsening splenomegaly at 18 cm. 2. large amount of ascites overall similar in distribution and volume to ct. thickening of the peritoneum is stable. no evidence of hemoperitoneum. 3. small pericardial effusion incompletely evaluated on this abdominal ct. . echo : the left atrium is moderately dilated. the right atrium is markedly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the ascending aorta is mildly dilated. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is mild prolapse of the anterior mitral leaflet. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. the end-diastolic pulmonic regurgitation velocity is increased suggesting pulmonary artery diastolic hypertension. there is a small circumferential pericardial effusion. there are no echocardiographic signs of tamponade. impression: mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. mitral valve prolapse with mild regurgitation. moderate pulmonary hypertension. compared with the prior study (images reviewed) of , pulmonary pressures are slightly lower (but still moderately elevated). the other findings are similar. . abd/pelvis ct: impression: 1. no focal abscess identified. 2. areas of consolidation in the dependent aspect of both lungs, likely representing a combination of atelectasis and infection. 3. cirrhosis, with portal hypertension, varices, splenomegaly, and moderate ascites. 4. enlarged right hilar, mediastinal lymph nodes, with pleural effusions, possibly reactive. given some more nodular componenets also seen within the lungs, followup chest ct is recommended after resolution of current acute symptoms. brief hospital course: mr. was initially admitted to the hospital with recurrent sbp, after having recently completed a hospital coure for sbp having been dicharged on ciprofloxacin. on re-admission, paracentesis demonstrated e coli that was resistant to ciprofloxacin, and he was therefore switched to aztreonam and completed a 14 day course. however, his hospital course was further complicated by transfer to micu due to hypercarbic hypoxic respiratory failure requiring intubation and hypotension with diagnosis of sepsis. numerous cultures were sent from his blood, urine, stool, and sputum during his prolonged micu course/infectious-sepsis work up, and positive culture data included sputum with growth of klebsiella pneumoniae and yeast. patient was on numerous different antibiotics empirically during his hospital and micu stay and eventually remained on meropenem and gentamicin for coverage of klebsiella, and vancomycin, caspofungin, and flagyl for empiric anti-microbial coverage. he also suffered from persisent hypotension causing his transfer to the micu and throughout his micu course for which he was on and off pressor support, including neosynephrine and vasopressin. mr. also had ongoing hematological difficulties during his hospital course in part felt to be due to his underlying diagnosis of cll along with his liver disease and his sepsis. these issues included persistent anemia requiring numerous blood transfusions to maintain his hematocrit, neutropenia for which he was treated with a 3 day course of ivig and maintained on g-csf, and thrombocytopenia requiring numerous platelet transfusions. his coagulopathy from his liver disease was also managed with numerous infusions of ffp to treat his elevated inrs. the patient also suffered from acute renal failure due presumably to sepsis which waxed and waned during his hospital course. he also developed severe anasarca with 32 liters positive during his micu course, although he remained intravascularly dry with pressor requirement and renal failure. his anasarca was minimally responsive to lasix boluses, followed by starting on lasix drip, which was not tolerated by his blood pressure. he also had a history of atrial fibrillation, for which he was maintained on digoxin with poor heart rate control. different measures were tried to control his heart rate, including nodal agents such as an esmolol gtt, but were not tolerated by his blood pressure. given his prolonged micu course, surgery was consulted for possible trach and peg placement, but felt that mr. peri-operative mortality risk was > 60%, and therefore was not a candidate for these procedures. given his overall poor prognostic picture based on the above, his continued fever spikes and pressor requirement despite prolonged broad spectrum antibiotics coverage, along with his prolonged intubation without option of tracheostomy, discussions were had with the patient's sister and best friend, who were the health care proxy, including goals of care. per discussion with the health care proxy's, they stated that the patient's goals would be quality, not quantity of life, and his goals of care were changed to comfort measures. the patient was extubated and pressor support discontinued and expired shortly after. medications on admission: coumadin 6 mg every other day; 5 mg other days lasix 80 (increaased 10 days ago from 40 ) lisinopril 2.5 daily digoxin 0.25 daily ppi nadolol 20 daily pravastatin 10 daily aldactone 50 mg daily discharge medications: na discharge disposition: expired discharge diagnosis: alcoholic cirrhosis spontaneous bacterial peritonitis sepsis klebsiella pneumonia respiratory failure pancytopenia chronic lymphocytic leukemia atrial fibrillation discharge condition: expired discharge instructions: na - patient expired followup instructions: na - patient expired 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 insertion of endotracheal tube enteral infusion of concentrated nutritional substances percutaneous abdominal drainage arterial catheterization diagnoses: anemia, unspecified unspecified essential hypertension alcoholic cirrhosis of liver acute kidney failure, unspecified severe sepsis atrial fibrillation atrial flutter acute respiratory failure septic shock paralytic ileus other septicemia due to gram-negative organisms other ascites hepatic encephalopathy hemorrhage of gastrointestinal tract, unspecified hyperosmolality and/or hypernatremia pneumonia due to klebsiella pneumoniae spontaneous bacterial peritonitis chronic lymphoid leukemia, in remission 

Answer: The patient is high likely exposed to