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: no known allergies / adverse drug reactions attending: chief complaint: jaundice major surgical or invasive procedure: ercp history of present illness: mr. is a 66 year old man with a history of alcoholic cirrhosis. he presented to his pcp with painless jaundice and malaise. 4 days prior to arrival, patient noted insidious onset of fatigue. he also noted some loose dark stool. the next day he noted he was jaundiced with nausea/chills and lip cracking. he denied any abdominal pain, fevers. he did note low urine output, dizziness on standing. he gradually felt better, but an orthpedic surgeon friend urged him to see his pcp. saw his pcp today, who referred him to the ed there labs demonstrated cr 5.3, total bili 11.9, direct bili 10.2, alk phos 141, alt 124, ast 30. wbc 11.79 hct 37.0 plt 114. ruq u/s showed portal vein thrombosis, cbd dilatation 9mm. he was given cipro/flagyl for ? cholangitis, iv protonix. transferred to for consideration of ercp. on arrival to the ed t 97.2 hr 57 bp 95/56 rr 15 spo2 95%/ra. on exam, he was jaundiced, but otherwise well. ercp consulted, recommended mrcp. admitted to for observation, possible ercp. vs on transfer bp 86/43, hr 57, rr 15, spo2 100/ra. on arrival to the ed, he is comfortable and has no complaints. review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: 1. alcoholic cirrhosis. he has been sober for eight years. 2. history of hepatic encephalopathy, well-maintained on lactulose. 3. history of ulcers per egd in . 4. history of left bundle branch block. 5. history of hyperlipidemia. social history: per omr, retired from the in , where he worked in management construction for 26 years. also says he worked as a nfl football coach for the eagles. has a long term partner, , and 6 children. formerly a heavy weekend drinker. does not smoke or use other illicits family history: father died of mi, mother died of "old age" physical exam: on admission (to ): general: obese middle aged man, appears stated age, no acute distress heent: perrl, + scleral icteris, mmm, oropharynx clear neck: supple, jvp not elevated lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema on discharge: vitals: 99.3, 116/56, 68, 20, 97% ra general: obese, not markedly jaundiced today, alert, oriented, no acute distress heent: sclera icteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally except for right basilar rales, no wheezes, ronchi cv: regular rate, normal s1 + s2, no murmurs, rubs, gallops abdomen: obese, soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: labs: on admission: 07:55pm blood wbc-8.0 rbc-3.34* hgb-11.5* hct-32.1* mcv-96 mch-34.4* mchc-35.8* rdw-13.2 plt ct-108* 07:55pm blood neuts-82* bands-0 lymphs-7* monos-9 eos-2 baso-0 atyps-0 metas-0 myelos-0 07:55pm blood pt-13.6* ptt-28.6 inr(pt)-1.3* 07:55pm blood glucose-120* urean-89* creat-4.5*# na-129* k-3.2* cl-97 hco3-20* angap-15 07:55pm blood alt-91* ast-16 totbili-9.7* 07:55pm blood lipase-122* 07:55pm blood calcium-8.3* mg-2.1 08:39pm blood lactate-1.7 urine culture negative blood culture negative imaging: cxr: low lung volumes with crowding of the pulmonary vasculature and no focal airspace consolidation to suggest pneumonia. no pleural effusions or pneumothoraces. overall cardiac and mediastinal contours are likely stable given differences in technique and positioning between studies. ercp: esophagus: limited exam of the esophagus was normal stomach: limited exam of the stomach was normal duodenum: limited exam of the duodenum was normal major papilla: normal major papilla cannulation: cannulation of the biliary duct was successful and deep with a sphincterotome after a guidewire was placed. contrast medium was injected resulting in complete opacification. biliary tree fluoroscopic interpretation: a single 8 mm round stone that was causing partial obstruction was seen at the distal common bile duct. a sphincterotomy was performed in the 12 o'clock position using a sphincterotome over an existing guidewire. balloon sweep was performed, but the stone was unable to be successfully extracted given hard consistency and size. a 7cm by 10fr plastic biliary stent was placed successfully. excellent drainage of bile was seen post-deployment. mri abdomen 1. subacute thrombus in the portal venous system, occluding the right main, anterior, and posterior portal veins with partial flow still demonstrated within the main and left portal veins. non-occlusive thrombus is also present in the left and main portal veins. 2. cirrhosis with sequela of portal hypertension, including extensive retroperitoneal varices, recanalized paraumbilical vein, and splenomegaly. 3. trace perihepatic ascites and small bilateral pleural effusions. on discharge: 05:20am blood wbc-7.4 rbc-2.80* hgb-9.4* hct-27.9* mcv-100* mch-33.6* mchc-33.8 rdw-14.0 plt ct-147* 05:20am blood pt-17.3* ptt-32.6 inr(pt)-1.6* 05:20am blood glucose-90 urean-19 creat-1.1 na-140 k-3.7 cl-109* hco3-24 angap-11 05:20am blood alt-27 ast-26 ld(ldh)-161 alkphos-86 totbili-3.2* 05:20am blood albumin-3.2* calcium-7.7* phos-3.0 mg-1.7 brief hospital course: mr. is a 66 year old man with alcoholic cirrhosis who presented with new onset jaundice, a biliary stone, and a portal vein thrombus. . # early cholangitis: mr. had an obstructing stone on ercp. it could not be removed, but was stented. he was started on cipro and flagyl for concern of cholangitis. he did not have any documented fevers. however, was hypotensive on admission. therefore, he was placed in the icu. once he stabilized, he was transferred to the floor. his lft's trended down throughout the admission. he will return in one month for a repeat ercp. he will complete a seven day course of ciprofloxacin and flagyl. # acute renal failure: creatinine elevated to 4.5 on admission from a baseline of around 1.1 (per omr labs 11/). most likely pre-renal given low urinary sodium. his creatinine trended down with aggressive iv fluids and albumin. his diuretics were initially held. they were to be restarted following discharge. he had repeat labs to be scheduled following discharge. # portal vein thombosis: a portal vein thrombus was seen on a ruq ultrasound performed at an outside hospital. this was confirmed with an mri. he was started on enoxaparin and warfarin three days following ercp. he was scheduled for an inr check two days following discharge. his pcp was and agreed to monitor his inr. mr. hepatology team followed him in the hospital. . # alcoholic cirrhosis: he was continued on home nadolol and lactulose. . # hsv: he developed several perioral lesions consistent with hsv. he was started on acyclovir. medications on admission: (confirmed with patient): - furosemide 20 mg once a day - enulose as needed for constipation - lisinopril 10 mg daily - nadolol 20 mg daily, - protonix 40 mg once a day - rifaximin 200 mg two tablets three times a day - calcium and vitamin d discharge medications: 1. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed for constipation. 2. nadolol 20 mg tablet sig: one (1) tablet po daily (daily). 3. rifaximin 200 mg tablet sig: two (2) tablet po tid (3 times a day). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. acyclovir 400 mg tablet sig: one (1) tablet po q8h (every 8 hours) for 2 days. disp:*7 tablet(s)* refills:*0* 6. enoxaparin 120 mg/0.8 ml syringe sig: one hundred-eighteen (118) mg subcutaneous (2 times a day) for 7 days: please follow instructions from your pcp about dose adjustments. disp:*14 syringes* refills:*0* 7. warfarin 2.5 mg tablet sig: two (2) tablet po once daily at 4 pm. disp:*60 tablet(s)* refills:*0* 8. outpatient lab work please draw inr, chem-7 on . please fax results to dr. . fax . phone number . 9. furosemide 20 mg tablet sig: one (1) tablet po once a day. 10. cipro 500 mg tablet sig: one (1) tablet po twice a day for 2 days. disp:*4 tablet(s)* refills:*0* 11. metronidazole 500 mg tablet sig: one (1) tablet po twice a day for 2 days. disp:*4 tablet(s)* refills:*0* 12. lisinopril 10 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: vna discharge diagnosis: primary diagnoses: - choledocholithiasis - possible cholangitis - portal vein thrombosis - acute kidney injury () secondary diagnosis: - alcohol induced cirrhosis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: it was a pleasure taking care of you at . you were admitted from for a procedure to place a stent in your bile duct. you had a stone in one of your ducts which was causing you to experience fatigue, jaundice and nausea/chills. following your procedure, you improved signifcantly. an ultrasound performed at showed the presence of a clot in your portal vein (a vein that supplies the liver). after consulting with your gastroenterologist, dr. - we sent you for an mri scan which confirmed the presence of a clot. you will need to take a blood thinning medication to treat this. this medication is called warfarin or coumadin. since this takes time to become effective, we have started you on another medication at the same time called lovenox or enoxaparin. you will need regular blood tests to assess the efficiency of your warfarin and determine how long to be on lovenox. please note: 1) we have made several follow-up appointments for you as noted below. 2) we have your primary care physician (pcp) who will follow-up with you on your warfarin and lovenox medication. 3) we have added a new medication to your current regimen, called acyclovir for the rash around your mouth. you will take this for two more days. 4) we added two antibiotics, ciprofloxacin and metronidazole, for two more days. it is very important to follow the instructions for being on warfarin. please see the information that we gave you for more information. followup instructions: name: , p. location: medical associates address: , , phone: *please contact your primary care physician to book follow up appointment for your hospitalization. it is recommended you follow up within 2 weeks. department: transplant when: wednesday at 10:20 am with: transplant clinic building: lm campus: west best parking: garage you will have a repeat procedure (ercp) in one month. the ercp office will call you to schedule a repeat procedure. if you have any questions, the phone number is . procedure: endoscopic sphincterotomy and papillotomy endoscopic insertion of stent (tube) into bile duct diagnoses: unspecified essential hypertension alcoholic cirrhosis of liver acute kidney failure, unspecified other and unspecified alcohol dependence, in remission other and unspecified hyperlipidemia other left bundle branch block hepatic encephalopathy dehydration cholangitis herpes simplex without mention of complication calculus of bile duct without mention of cholecystitis, with obstruction portal vein thrombosis 

Answer: The patient is high likely exposed to